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7,506 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: ossification of the posterior longitudinal ligament ( opll ) , a result of heterotopic ossification , can induce spinal canal stenosis and lead to the development of severe myelopathy .
there have been numerous studies of surgical techniques or clinical outcomes for opll of the cervical spine.1 in contrast , there are only a few reports regarding opll of the lumbar spine , and its clinical characteristics have not yet been well established because the number of patients who require surgical treatment is quite low.2 to our knowledge , there has been only six reports of surgically treated lumbar opll published in english.7 according to the data in the database for the spinal injuries center in fukuoka , japan , during the past 27 years , although 6,192 patients underwent operations for degenerative lumbar spine diseases , only ten underwent surgery for lumbar opll.2 thus , the frequency of lumbar opll requiring surgical treatment was remarkably low , indicating a lack of awareness of the disease even among orthopedic surgeons .
we have recently witnessed that radiculopathy due to lumbar opll was found to be the cause of chronic right lower abdominal pain in a japanese man.8 after encountering this unusual case , we thought that lumbar opll should be considered to be a factor for not only orthopedic symptoms but also abdominal symptoms . because abdominal symptoms are common in the primary care setting,9 we tried to clarify the incidence of lumbar opll in an outpatient clinic in japan where primary care physicians are working .
we analyzed consecutive outpatients making their first visit to the department of general medicine , asahikawa medical university hospital , between april 2009 and march 2012 .
as we have recently demonstrated,913 the hospital consists of 602 beds in which approximately 250 doctors are working to address almost all medical problems . among them , four or five primary care physicians are working in the department of general medicine . during the period , we analyzed the patients ( n = 393... | purposelittle is known about the prevalence and epidemiological characteristics of lumbar ossification of the posterior longitudinal ligament ( opll ) .
we analyzed the rate of lumbar opll in an outpatient unit where primary care physicians are working in japan , to better understand the epidemiological characteristics of the disease.methodswe analyzed consecutive , first - time visiting outpatients who received abdominal and pelvic computed tomography ( ct ) scan at the department of general medicine , asahikawa medical university hospital , japan , between april 2009 and march 2012 .
each parameter such as age , sex , and clinical presentation was investigated.resultsout of 393 patients who underwent abdominal and pelvic ct scan , 33 ( 8.4% ) were diagnosed as lumbar opll .
when compared with patients without lumbar opll ( n = 360 ) , there was no significant difference in gender , body mass index ( bmi ) , presence of hypertension , diabetes mellitus or hyperlipidemia , and smoking habit , while the age in patients with lumbar opll was significantly higher.conclusionthese results suggest for the first time that lumbar opll is frequently observed in elderly people in the primary care setting , in japan . |
7,507 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: primary cutaneous apocrine gland carcinoma , a subtype of sweat gland carcinoma , is an extremely rare malignant neoplasm [ 1 , 2 , 3 ] .
most of these neoplasms involve the axilla , but lesions can also occur elsewhere on the skin . most often , they are indolent and slowly developing , but some are rapidly progressive and extremely aggressive [ 1 , 4 , 5 , 6 ] .
the treatment of choice is wide local excision with clear margins , with or without lymph node dissection [ 1 , 3 , 5 , 7 ] .
a 67-year - old man presented to our hospital with an ulcerated nodule in the right axilla measuring 1 0.8 cm .
the nodule had been present for more than 3 years , but only grew in size over the past 6 months . bilateral breast examination , skin examination and complete lymph node survey
were unremarkable . ultrasound examination and a mammogram revealed no significant lesions in either breast , consistent with the physical examination .
microscopic examination revealed a well - to - moderately differentiated adenocarcinoma which contained ductal and glandular structures with obvious apocrine features .
in addition , the cytoplasm of the tumour cells contained pas - positive diastase - resistant granules without iron - staining granules .
the tumour tissue invaded the papillary and reticular dermis and ulcerated the epidermis without extension to the subcutaneous tissue ( fig . 1 , fig .
the immunohistochemical study showed that the tumour cells were positive for ker7 , ema and e - cadherin and negative for cea , sloop and psa .
no oestrogen or progesterone receptors were detected , making the diagnosis of male breast cancer metastaticto the axilla unlikely ( fig .
cutaneous apocrine gland carcinoma , a subtype of sweat gland carcinoma , is a very rare malignant neoplasm arising in areas of high apocrine sweat gland density . to date , only few cases ( about 50 cases ] have been reported in the literature .
these lesions occur primarily in the axilla , but can also occur elsewhere on the skin [ 1 , 2 , 3 9 ] .
apocrine... | cutaneous apocrine gland carcinoma , a subtype of sweat gland carcinoma , is a very rare malignancy , and only few cases have been reported in the literature .
many of these carcinomas are indolent and slowly developing , but some are rapidly progressive .
the treatment of choice is wide local excision with clear margins , with or without lymph node dissection .
we report a case of a 67-year - old man who came to our hospital with an ulcerated nodule in the right axilla measuring 1 0.8 cm .
histological evaluation showed features of an apocrine gland carcinoma arising in an area of high apocrine gland density . |
7,508 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: research on materials used for hard / soft tissue regeneration has focused on those that are degradable and capable of stimulating new tissue formation . in this context ,
they can be prepared in different forms : blocks , rods , powder , fibres , or microtubes according to the intended application [ 14 ] .
for instance , bulk glasses have been proven to enhance new bone formation and to reduce the number of staphylococcus aureus and methicillin resistant staphylococcus aureus ( mrsa ) that are normally associated with bone infection in an in vitro model designed for that purpose .
glass fibres were also shown to allow for the formation of prototypic muscle fibre and to reduce the number of staphylococcus epidermidis that are mostly associated with biomaterials - related infection .
they demonstrated better sealing ability than the commercially available gutta percha filling material when incorporated as powder into polycaprolactone matrix and used as root canal filling material .
furthermore , they can be potentially used for other applications such as augmentation of alveolar ridge , treatment of peri - implantitis or infection associated with dry socket that occasionally occurs after tooth extraction , and cell - delivery vehicle to inaccessible areas ( e.g. , advanced periodontitis ) .
currently , for the treatment of osseous defects , atrophic alveolar ridge as an example , autograft represents the gold standard modality for such application , but the material supply is often a problem . guided bone regeneration technique is another approach ; nevertheless , providing enough space for bone regeneration is always a problem .
bioactive glasses as perioglas and biogran that can be easily molded and packed into the bony defect are also used ; however , the compromise between the particle sizes and degradation to produce particles favourable for osteogenesis without inducing inflammation is always a dilemma .
phosphate glasses with large particle sizes and even a combination of different particles... | this study challenged to produce phosphate - based glasses ( pbg ) for the treatment of osseous defects .
the glasses contained , among other components , 40 mol% cao and 15 mol% tio2 . the mechanical performance and in vitro biocompatibility using both human osteosarcoma and primary osteoblasts were carried out .
incorporation of tio2 into pbg had no significant effect on strength and modulus .
these glasses encouraged attachment and maintained high viability of osteosarcoma cells similar to the positive control surface . cells grown directly ( on glasses ) or indirectly ( in the presence of glass extracts ) showed similar proliferation pattern to the positive control cells with no significant effect of tio2 detected .
increasing tio2 content , however , has a profound effect on cytoskeleton organization and spreading and maturation of primary osteoblasts .
it is believed that tio2 might have acted as a chemical cue - modulating cells response , and hence the substrates supported maturation / mineralization of the primary osteoblasts . |
7,509 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: latinos constitute the largest and most rapidly growing ethnic group in the us . currently and over the past twenty years
, non - latino adolescent alcohol use has declined , yet alcohol use among latino youth has remained high . the latino population continues to grow and is at a high risk because of the trends in demographics .
latino youths have a higher high school dropout rate , a higher proportion of families living in poverty , and the highest fertility rate compared to other minority groups .
in addition , there are numerous alcohol - related problems reported by young drinkers , such as interpersonal problems , impaired school and work performance , risky sexual behaviors , and drunk driving [ 46 ] . for many reasons , such as limited access to the population and
an increased diversity of the latino population , research on latino adolescent alcohol use is sparse and many studies group all latino subgroups together , making it difficult to understand differences and similarities between groups [ 7 , 8 ] .
study findings on a variety of health outcomes , including substance use , have shown differences by latino subgroup [ 9 , 10 ] .
this study focuses on mexican american youth because of the lack of specific knowledge on parenting in this subgroup of latinos .
in addition , various studies have shown that mexican americans , compared to other latino subgroups such as puerto rican 's , have unique family composition , cultural attitudes , and substance use [ 11 , 12 ] .
it has been demonstrated that family mechanisms , in particular parenting styles , may be of important influence on substance use tendencies among young individuals .
baumrind 's theoretical framework of parenting delineated four dimensions to parenting styles : permissive , authoritarian , authoritative , and uninvolved .
one of the critical ideas from baumrind 's four quadrants of parenting styles is that parenting revolves around issues of warmth and control .
the categorization of these two characteristics , warmth and control... | the purpose of this study is to further the understanding of how parenting and the relationship between the parent and the youth influence adolescent alcohol use in mexican american families , with particular attention to acculturation .
results indicated that parental warmth is a strong factor in predicting adolescent alcohol use among mexican adolescents .
the parent - youth relationship played an important role in lowering alcohol use for mexican american youth .
acculturation has an impact on the level of warmth , control , and the parent - youth relationship for mexican american families .
findings indicate that there are unique family mechanisms for mexican american families that should be considered when developing prevention and treatment options . |
7,510 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
ethics statement - this study was in accordance with the ethical
standards of the national ethical clearance committee of brazil as well as with the
ethical committee for human research of the oswaldo cruz foundation ( cep - fiocruz ) and
the evandro chagas clinical research institute ( cep - ipec / fiocruz ) and with the helsinki
declaration of 1975 , as revised in 1983 .
patients and controls - the study included healthy subjects ( hs ) ( n =
18 ) and two cohorts of cl patients : patients with active disease ( pad ) ( n = 14 ) , showing
ulcerated skin lesions , and pcc ( n = 11 ) , evaluated eighty day after the beginning of
treatment , at which time clinical cure was defined as full epithelialisation of
ulcerated lesions , regression of crust , desquamation and infiltration .
all adults
included were between 18 - 60 years of age with a mean age of 35.1 13.2 years .
all hs enrolled in this study were from nonendemic areas in rj , showing neither a
previous history of leishmaniasis nor any other comorbidity .
2000 ) and were
recruited at the leishmaniasis surveillance laboratory , ipec / fiocruz .
the diagnosis of leishmaniasis was based on clinical and epidemiological evidence ;
positive montenegro skin test ( mst ) and parasitological exams .
all patients were
submitted to meglumine antimoniate treatment independent of their enrolment in our
study , according to the guidelines of the brazilian ministry of health ( svs / ms 2010 ) .
we investigated clinical and
epidemiologic information , such as age , sex , number and diameter of lesion at active
phase and evolution period .
patients who presented with comorbidity , reactivation of cl ,
reinfection or nonresponse to antimonial therapy were excluded from the study .
analysis of the v repertoire and cell phenotyping - venous blood was
collected from cl patients and hs in heparinised tubes and peripheral blood mononuclear
cells ( pbmc ) were obtained by ficoll - hypaque density gradient centrifugation ( sigma
... | in human cutaneous leishmaniasis ( cl ) , the immune response is mainly mediated by
t - cells .
the role of cd8 + t - lymphocytes , which are related to healing or
deleterious functions , in affecting clinical outcome is controversial .
the aim of
this study was to evaluate t - cell receptor diversity in late - differentiated effector
( lde ) and memory cd8 + t - cell subsets in order to create a profile of
specific clones engaged in deleterious or protective cl immune responses .
healthy
subjects , patients with active disease ( pad ) and clinically cured patients were
enrolled in the study .
total cd8 + t - lymphocytes showed a disturbance in
the expression of the v2 , v9 , v13.2 , v18 and v23 families .
the analyses of
cd8+t - lymphocyte subsets showed high frequencies of lde
cd8+t - lymphocytes expressing v12 and v22 in pad , as well as
effector - memory cd8 + t - cells expressing v22 .
we also observed low
frequencies of effector and central - memory cd8 + t - cells expressing v2 in
pad , which correlated with a greater lesion size .
particular v expansions point to
cd8 + t - cell clones that are selected during cl immune responses ,
suggesting that cd8 + t - lymphocytes expressing v12 or v22 are involved in
a lde response and that v2 contractions in memory cd8+t - cells are
associated with larger lesions . |
7,511 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it has been suggested previously that the malignant potential of prostate cancer correlates strongly with the size of the primary cancer . reflecting this ,
numerous studies have also shown that prostate cancer volume correlates with other prognostic indicators and with progression after radical prostatectomy .
these observations suggest that obtaining an accurate estimation of tumor volume preoperatively might aid the treatment decision .
however , it remains difficult to estimate tumor volume preoperatively on the basis of clinical parameters such as preoperative biopsy data .
indeed , there is often significant discord between the extent of cancer detected on biopsy and the tumor volume in the final surgical specimen .
moreover , although prostate - specific antigen ( psa ) is the most widely used tumor marker in clinical practice for the diagnosis , staging , and monitoring of prostate cancer , psa associates only weakly with prostate cancer volume in men treated by radical prostatectomy .
the aim of this study was to determine whether it is possible to estimate tumor volume on the basis of preoperative clinical variables and whether such predicted tumor volumes could predict pathologic stage in patients who undergo radical prostatectomy .
for this purpose , we developed a regression model composed of several preoperative variables to predict total tumor volume .
approval of the study was obtained from the institutional review board of our institution . between 2000 and 2004 , 260 radical retropubic prostatectomies for the treatment of prostate cancer were performed at a single institution .
the clinical and pathologic data of these patients were obtained from our surgical database and were reviewed retrospectively .
patients with positive lymph nodes and who had received neoadjuvant or immediate adjuvant androgen ablation or radiotherapy were excluded from the study .
individuals who visited our department for a variety of reasons , such as prostate cancer screening or because of voiding symptoms , were... | purposethe purpose of this study was to evaluate whether predicted tumor volume could predict pathologic stage in patients undergoing radical prostatectomy.materials and methodsthe clinical and pathologic data of 236 patients who underwent a 12-core needle biopsy followed by radical prostatectomy were obtained from our database and reviewed retrospectively.resultsobserved tumor volume correlated best with serum prostate - specific antigen ( psa ) level ( r=0.677 , p<0.001 ) and the number of positive biopsy cores ( r=0.489 , p<0.001 ) .
stepwise multiple linear regression analysis was used to develop a model for predicting tumor volume before radical prostatectomy . all explanatory variables except psa and
the number of positive biopsy cores were eliminated , yielding the equation ( [ predicted tumor volume]=0.381x[psa]+0.921x[no . of positive biopsy cores]-0.992 ) .
tumor volume predicted by this equation correlated strongly with observed tumor volume ( r=0.722 , p<0.001 ) .
this was also true when a different cohort of 159 patients was analyzed ( r=0.638 , p<0.001 ) .
the areas under the receiver operating characteristic curves of predicted tumor volume were 68.5% for extracapsular extension , 75.7% for seminal vesicle invasion , and 70.4% for positive surgical margin .
kaplan - meier curves revealed that predicted tumor volume correlated significantly with biochemical recurrence - free survival ( p<0.001 ; log - rank test).conclusionsour findings suggest that tumor volume predicted on the basis of psa levels and number of positive biopsy cores may predict pathologic stage with reasonable accuracy . |
7,512 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the whi was designed to address the major causes of morbidity and mortality in postmenopausal women ( 18 ) , including both multicenter clinical trials and an observational study .
details of the scientific rationale , eligibility requirements , and baseline characteristics of the participants in the whi have previously been published ( 1923 ) .
briefly , a total of 161,808 women ages 5079 years were recruited at 40 clinical centers throughout the u.s . between 1 september 1993 and 31 december 1998 .
the whi clinical trial includes four overlapping components : two hormone therapy trials ( 27,347 women ) , a dietary modification trial ( 48,835 women ) , and a calcium / vitamin d supplementation trial ( 36,282 women ) .
participants in the observational study included 93,676 women who were screened for the clinical trials but proved to be ineligible or unwilling to participate or were recruited through a direct invitation for the observational study .
the study was overseen by institutional review boards at all 40 clinical centers and at the coordinating center , as well as by a study - wide data- and safety - monitoring board .
the following participants were excluded from the original cohort of 161,808 for this analysis : 14,849 women who had a history of cancer ( except nonmelanoma skin cancer ) at baseline , 783 women who enrolled in whi but provided no follow - up information , 217 women who were diagnosed with diabetes before age 20 years and/or who were ever hospitalized for diabetic coma ( these were deemed likely to have type 1 diabetes diagnosis and not comparable ) , and 194 women who had missing values of the main exposures ( including diagnosis of diabetes , age at diagnosis , and diabetes treatment ) .
prevalence of diabetes at enrollment was defined by a positive answer to the following question : did a doctor ever say that you had sugar diabetes or high blood sugar when you were not pregnant ? . treated diabetes at enrollment
was defined as the participant reporting ever having been treated... | objectiveepidemiological evidence of diabetes as a lung cancer risk factor is limited and conflicting .
therefore , we assessed associations among diabetes , diabetes therapy , and lung cancer risk in postmenopausal women participating in the women s health initiative ( whi ) study.research design and methodspostmenopausal women ( n = 145,765 ) , ages 5079 years , including 8,154 women with diabetes at study entry were followed for a mean of 11 years with 2,257 lung cancers diagnosed .
information on diabetes therapy was collected via two methods ( self - reported information on treatment history collected on a questionnaire at baseline and a face - to - face review of current medication containers that participants brought to the baseline visit ) .
lung cancers were confirmed by central medical record and pathology report review .
cox proportional hazards regression models adjusted for lung cancer risk factors were used to estimate hazard ratios ( hrs ) ( 95% ci ) for diagnosis of diabetes and treatment of disease as risk factors for lung cancer.resultscompared with women without diabetes , women with self - reported treated diabetes had a significantly higher risk of lung cancer ( hr 1.27 [ 95% ci 1.021.59 ] ) , with risks increasing for women with diabetes requiring insulin treatment ( 1.71 [ 1.152.53 ] ) .
however , we did not observe a significant association between lung cancer risk and diabetes not treated with medication or with duration of diabetes.conclusionspostmenopausal women with treated diabetes , especially those using insulin , have a significantly higher risk of lung cancer .
the influence of diabetes severity and specific classes of therapy for diabetes on lung cancer risk require future study . |
7,513 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: after w. c. von roentgen discovered x - rays in 1896 , a german dentist , o. walkhoff , used radiographs for dental diagnosis . at the beginning of the last century , attempts were made to image the whole jaw with intraoral radiography .
panoramic technique developed to image the teeth and jaws became an essential element in oral radiology .
orthopantomography ( opt ) became a very popular and widely accepted technique of dental radiography .
it is a curved plane tomographic radiographic technique used to depict on a single image the body of the mandible and maxilla , the lower part of the maxillary sinuses , and the temporomandibular joints .
opts have a wide variety of uses , including the screening of patients during dental treatment for evidence of cysts , impacted teeth , foreign bodies , and neoplasms .
opts are also used to evaluate pathological situations related to the temporomandibular joints and maxillary sinuses and to evaluate mandibular fractures .
in addition , opts offer information about the locations of important anatomic structures in the orofacial region which are needed for dental implant planning .
the evolution of more precise three - dimensional techniques such as conventional computed tomography ( ct ) , cone beam computed tomography ( cbct ) , and magnetic resonance imaging has improved oral diagnosis and implant treatment planning by virtue of their higher precision . in comparison with ct and other expensive precision radiographs
, opt is a simple , low - cost imaging modality with patients being exposed to relatively low dose of radiation .
the effective doses may vary significantly among cbct machines ; however , when compared to medical ct , cbct is considered to be a low - dose technique for use in dental implant procedure .
the effective dose from cbct examinations could range from 13 to 479 sv with different commercially available cbct machines , while the effective dose from one opt is approximately 1014 sv . on the other hand , the exposure from a maxillomandibular medical... | objectives : orthopantomographs are commonly used for diagnosis in clinical dentistry . although the manufacturers claim a constant magnification effect , the reliability of measuring dimensions on the panoramic radiographs is not clear .
the aim of this study was to evaluate the accuracy of measuring vertical dimensions in the posterior mandibular area on digital orthopantomographs.materials and methods : a retrospective survey of 20 orthopantomographs with unrestored implants ( only with cover screw ) in the mandibular posterior region ( molars and premolars ) was conducted .
all radiographs were taken using the same machine by skilled technicians .
two examiners were asked to measure the vertical dimension of the implants seen on the radiographs viewed using two differently sized display screens .
inter - examiner and intra - examiner reliability tests were performed .
differences between the measured length and the actual length using each screen type were compared.results:high coefficients of reliability were observed on intra- and inter - examiner correlation .
the overall reliability of measuring the vertical dimensions of implants between both examiners for the large screen and the small screen were 97.4% ( cronbach 's alpha 0.993 ) and 94.0% ( cronbach 's alpha 0.984 ) , respectively .
there were no significant differences between the errors seen with either the large screen or the small screen , when each of them was compared to the original length ( p = 0.146).conclusion : this study shows that vertical dimensions in the posterior mandibular region ( molar and premolars ) can be reliably measured on an orthopantomograph using a calibrated machine and special software . |
7,514 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: heterotopic pancreas ( hp ) is pancreatic tissue that develops in areas other than the normal site of the pancreas , having no anatomical or vascular continuity with the normal pancreas [ 1 , 2 ] .
hp of the small intestine , if enlarged , may be diagnosed due to symptoms such as ileus , bowel intussusception , melena and pancreatitis , but it often remains asymptomatic and is incidentally detected on surgery for other diseases or autopsy [ 3 , 4 ] .
we encountered 2 patients with jejunal hp incidentally detected by computed tomography ( ct ) performed for close evaluation of other diseases .
these cases are presented with a review of the literature , particularly focusing on ct findings .
case 1 was a 57-year - old woman who had been under antihypertensive medication for a few years .
when she consulted a local physician due to epigastric and back pain , a tumoral lesion 30 mm in diameter was detected on the dorsal portion of the pancreas head on abdominal ultrasonography , and the patient was referred to our hospital .
the mass was suspected to be schwannoma , castleman disease , malignant lymphoma or reactive lymphoid hyperplasia by imaging studies including ct and magnetic resonance imaging .
the contrast of the mass was nearly homogeneously enhanced in the arterial phase , and enhancement was sustained in the equilibrium phase , suggesting a submucosal tumor ( fig .
double contrast intestinal imaging showed a defect of about 14 mm in diameter in the jejunum , and a gently elevated submucosal mass with a smooth mucosal surface was confirmed by subsequent capsule endoscopy ( fig .
diseases including gastrointestinal stromal tumor and leiomyoma were suspected preoperatively , and laparotomy was performed to simultaneously remove the masses in the head of the pancreas and small intestine .
the mass in the head of the pancreas was intraoperatively suspected to be disadherable , with enlarged # 8p and # 13a lymph nodes , and was eventually diagnosed by histopathological examination as reactive lymphoid... | heterotopic pancreas ( hp ) is typically an asymptomatic malformation that can present anywhere along the gastrointestinal tract .
it is often detected incidentally on surgery for other diseases or autopsy .
we encountered 2 patients with jejunal hp incidentally detected by computed tomography ( ct ) performed for close evaluation of other diseases . in a 57-year - old woman diagnosed with reactive lymphoid hyperplasia on the dorsal portion of the pancreas head , ct detected a 15 mm oval - shaped submucosal lesion at the jejunum . in an 87-year - old woman
diagnosed with type 2 adenocarcinoma occupying the sigmoid colon , ct detected a round - shaped submucosal tumor 15 mm in diameter in the jejunum .
both cases were histologically diagnosed as type 1 hp according to the classification by heinrich .
contrast - enhanced ct revealed that the ct analyses of hp and pancreatic parenchyma were nearly identical in the arterial phase , but in the equilibrium phase , contrast enhancement persisted longer in hp than in the pancreatic parenchyma .
there has been no report of asymptomatic jejunal hp preoperatively diagnosed by ct .
these cases are presented with a review of the literature , particularly focusing on ct findings . |
7,515 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gemcitabine is a chemotherapy agent frequently elected to treat solid tumors , including breast , colonic , ovarian , pancreatic , and non - small cell lung cancers [ 112 ] .
metastatic gallbladder cancer is a complex and uncommon event [ 1417 ] . in this report
, we describe a case of gallbladder metastatic colonic adenocarcinoma associated with fatal gemcitabine - induced pulmonary toxicity and discuss the histologic appearance of this dysfunction .
a 72-year - old male patient experienced an incidental diagnostic of tubular adenocarcinoma inside the gallbladder after elective laparoscopic cholecystectomy for chronic cholecystitis .
four days after cholecystectomy , he was submitted to laparotomy aiming radical resection ; however , peritoneal carcinomatosis was observed .
the patient was submitted to a tumor screening and a pet scan pointed out a hot - spot in the left colon .
this lesion was removed by colonoscopy and a histological examination confirmed a margin - free resection of a tubular adenocarcinoma .
the patient was finally scheduled to receive three sections of gemcitabine ( 1,600 mg / m ) once a week .
three weeks after the completion of chemotherapy , he developed an important respiratory distress requiring ventilator support .
a helicoidal ct scan showed bilateral and diffuse lung infiltrates ( fig . 1 ) .
a surgical lung biopsy was done and an accelerated usual interstitial pneumonia ( uip ) ( fig .
2 ) , consistent with drug - induced toxicity , was observed . the patient presented with progressive impairment of respiratory function , coagulopathy , hypotension , and acute renal failure despite the use of methylprednisolone pulse therapy , large spectrum antimicrobial therapy , and full respiratory , hemodynamic and dialytic support .
he died 1 month later . to assess the probability that the event was caused by gemcitabine we computed a naranjo et al .
average point score , which is based on the direction of causality between the drug and the manifestation of adverse effects... | gemcitabine is a chemotherapy agent that may cause unpredictable side effects . in this report
, we describe a fatal gemcitabine - induced pulmonary toxicity in a patient with gallbladder metastatic adenocarcinoma .
a 72-year - old patient was submitted to an elective laparoscopic cholecystectomy , and a tubular adenocarcinoma in the gallbladder was incidentally diagnosed .
ct scan and ultrasound before the surgery did not show any tumor .
after the surgery a pet scan was positive for a hot - spot in the left colon .
the colonic lesion was conveniently removed and the histology evaluation confirmed the diagnosis of adenocarcinoma tubular .
the patient was then submitted to three sections of 1,600 mg / m2 of gemcitabine with intervals of 1 week .
three weeks later he developed severe respiratory distress .
a helicoidal ct scan showed diffuse and severe interstitial pneumonitis , and lung biopsy confirmed accelerated usual interstitial pneumonia consistent with drug - induced toxicity .
the patient presented unfavorable evolution with progressive worsening of respiratory function , hypotension , and renal failure .
he died 1 month later in spite of methylprednisolone pulse therapy , large spectrum antimicrobial therapy , and full support of respiratory , hemodynamic and renal systems .
gemcitabine - induced pulmonary toxicity is usually a dramatic condition .
physicians should suspect pulmonary toxicity in patients with respiratory distress after gemcitabine chemotherapy , mainly in elderly patients . |
7,516 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: socioeconomic inequalities in mortality are the most widely documented evidence of social disparities in health globally.1 the recognition that health is not only the result of current circumstances , but rather of multiple processes operating across the entire life course , has led scholars to investigate the association between early - life socioeconomic conditions and adult mortality.210 a systematic review11 shows that socioeconomic characteristics in childhood are important predictors of all - cause mortality in later life , although the association becomes attenuated in models adjusted by adult socioeconomic position .
this has led to the conclusion that measuring socioeconomic characteristics at only one point in time is not enough to capture the full extent of socioeconomic inequalities in health.4 however , there are still gaps that need to be explored to better understand the role of childhood socioeconomic conditions on mortality
. studies in this field are usually conducted on participants recruited after reaching adulthood,12 with childhood information obtained either from census data ( ie , not measured at birth for all participants),3
5 or else from interviews conducted later in childhood2 or during adulthood,13 the latter of which has been shown to underestimate the true association.14 furthermore , most studies are performed in relatively young cohorts,24
6
15 which does not allow tracking of the effects beyond premature mortality ( ie , after 70 years of age)16 or investigation of potential variation in the strength of the effect across different age intervals .
it is necessary to fill this gap in order to determine how long the impact of childhood socioeconomic conditions lasts throughout the life course .
apart from methodological limitations , most epidemiological studies in this area focus only on childhood socioeconomic conditions , for example , parental occupation or other proxies for material living standards .
such is the case for mother 's marital status , which can lead to... | backgroundample evidence has shown that early - life social conditions are associated with mortality later in life .
however , little attention has been given to the strength of these effects across specific age intervals from birth to old age .
in this paper , we study the effect of the family 's socioeconomic position and mother 's marital status at birth on all - cause mortality at different age intervals in a swedish cohort of 11 868 individuals followed across their lifespan.methodsusing the uppsala birth cohort multigenerational study , we fitted cox regression models to estimate age - varying hrs of all - cause mortality according to mother 's marital status and family 's socioeconomic position.resultsmother's marital status and family 's socioeconomic position at birth were associated with higher mortality rates throughout life ( hr 1.18 ( 95% ci 1.12 to 1.26 ) for unmarried mothers ; 1.19 ( 95% ci 1.12 to 1.25 ) for low socioeconomic position ) .
while the effect of family 's socioeconomic position showed little variation across different age groups , the effect of marital status was stronger for infant mortality ( hr 1.47 ( 95% ci 1.23 to 1.76 ) ; p=0.04 for heterogeneity ) . the results remained robust when early life and adult mediator variables were included.conclusionsfamily's socioeconomic position and mother 's marital status involve different dimensions of social stratification with independent effects on mortality throughout life .
our findings support the importance of improving early - life conditions in order to enhance healthy ageing . |
7,517 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cervical radiculopathy is caused by the compression of the cervical nerves or nerve
roots1 . a herniated intervertebral disc ,
the common
symptoms of cervical radiculopathy involve pain , muscle weakness spreading into the neck and
upper extremities , loss of sensation2 , and
proprioception deficits3 .
although the
symptoms experienced by patients with cervical radiculopathy vary , the symptoms generally
appear at certain regions and with specific characteristics depending on the level of nerve
compression .
the treatment options for cervical radiculopathy can be divided into surgical and
conventional treatments , both of which aim to reduce pain and symptoms , increase nerve
function , and prevent recurrence of cervical radiculopathy .
no study with a high level of
evidence has proved that surgical intervention alone for cervical radiculopathy is
effective4 .
surgical interventions are
often combined with conventional nonsurgical treatments , such as medications , use of a
cervical collar , cervical traction , and manual therapy .
these conventional treatments ,
however , have not been proven effective by studies with a high level of evidence either5 , 6 . among the methods used for pain and symptom relief in cervical radiculopathy ,
however , no systematic
review has been made summarizing the effects of the exercise training on cervical
radiculopathy , either as an alternative to surgery or as a post - operative treatment option .
the present study searched the literature to determine the treatment effects of exercise
interventions for patients with cervical radiculopathy after receiving nonsurgical or
surgical treatments .
studies from january 1997 to may 2014 found on four online databases ( i.e. , medline ,
cinahl , scopus and pubmed ) were searched using the following key words : ( a ) cervical
radiculopathy or cervical spondylotic radiculopathy ; ( b ) exercise training or physiotherapy .
the selection criterion was that the exercise programs used to treat... | [ purpose ] cervical radiculopathy is a clinical condition associated with pain , numbness
and/or muscle weaknesses of the upper extremities due to a compression or irritation of
the cervical nerve roots .
it is usually managed conservatively but surgical intervention
is sometimes required for those who fail to respond adequately .
this study performed a
literature review to determine the effects of exercise on non - operative and post - operative
cervical radiculopathy patients .
[ methods ] the pubmed , medline , cinahl and scopus
databases were searched to identify relevant articles published from january 1997 to may
2014 , which explicitly stated that an exercise program was employed as an intervention for
cervical radiculopathy . the therapeutic effectiveness and outcomes
were then classified
based on the international classification of functioning , disability and health ( icf )
model .
[ results ] eleven studies were identified and included in the final analysis . in
these studies ,
the main forms of exercise training were specific strengthening and general
stretching exercises .
levels of evidence were graded as either i or ii for all studies
according to the oxford centre for evidence - based medicine . the pedro scale score of these
studies ranged from 5 to 8 . [ conclusion ] a review of eleven high - level evidence and
high - quality studies revealed that , based on the icf model , exercise training is
beneficial for improving the body function as well as activity participation of cervical
radiculopathy patients . |
7,518 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: to date , safety data of immune checkpoint inhibitors in patients with an underlying autoimmune disease are scarce .
this report provides information of the use of immune checkpoints inhibitors in real - world clinical practice , such in patients with autoimmune disorders .
although our patient presented with a grade 4 immuno - related colitis , a complete response was observed after two infusions of ipilimumab .
autoimmune diseases may not be an absolute contraindication for immune checkpoints inhibitors in those patients that can potentially benefit from them .
each patient should be individually assessed depending on the therapeutic options available and the status of the underlying autoimmune condition .
ipilimumab , a fully human antibody against ctla-4 ( cytotoxic t - lymphocyte antigen 4 ) , is an immune - checkpoint receptor inhibitor approved for the treatment of metastatic melanoma . as a result of its mechanism of action and subsequent activation of the immune system
, ipilimumab is associated with immune - related adverse events ( iraes ) , being dermatitis and colitis the most frequently reported.1 clinical trials with ipilimumab and other immune - checkpoint inhibitors have excluded patients with underlying autoimmune diseases because of the concern of the activation of the immune system and the possibility of induction or exacerbation of the disease , and even the development of ipilimumab - related adverse side effects .
( a ) was taken on 2 september , 2014 and ( b ) was taken 12 weeks after first dose of ipilimumab , on 5 november , 2014 .
we can observe regression in number and size of multiples skin metastases on the left limb and less swelling .
we report the case of a patient with a braf - mutant metastatic melanoma and a medical history of rheumatoid arthritis ( ra ) .
ipilimumab induced a complete response , with no exacerbation of her ra but the patient developed a life - threatening diarrhoea - colitis .
a 51-year - old woman presented in august 2010 with pain and swelling of small... | immune checkpoint inhibitors , such as ipilimumab ( an anti - ctla4 antibody ) , have become a commonly used therapy in cancer .
to date , safety data of patients with underlying autoimmune disease is limited .
we present a case of a patient with rheumatoid arthritis who was diagnosed of a braf - mutant metastatic melanoma .
the patient was treated with ipilimumab and presented with high - grade colitis requiring immunosuppressors . despite of the immune - related adverse event , no exacerbation of the rheumatoid arthritis was observed and the patient achieved a complete response .
this case report contributes to the scarce literature on the use of immune checkpoint inhibitors in patients with an underlying autoimmune condition . |
7,519 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: this was a multi - institute , single - group clinical trial conducted at seoul st .
approval was granted by the respective institutional review boards of each institute , and a clinical trial permit was obtained from the ministry of food and drug safety .
this study was carried out in accordance with the tenets of the declaration of helsinki . at the screening visits ,
the investigators informed the subjects of the complete details of the clinical trial , after which the subjects signed a written consent form .
we then obtained demographic information , history of ocular diseases , and current disease information from each subject and determined visual acuity , refractive error , corneal topography , slit - lamp microscopy , corneal endothelial cell count , central corneal thickness ( cct ) , intraocular pressure , schirmer 's test result , and tear break - up time .
the inclusion criteria for subjects were as follows : ( 1 ) age between 7 and 49 years , ( 2 ) myopic refractive error of -0.75 to -6.0 diopters ( d ) and astigmatic refractive error of 1.25 to 4.0 d , ( 3 ) radius of corneal curvature within the range of 46.00 to 39.75 d ( 7.34 to 8.5 mm ) , ( 4 ) horizontal corneal diameter larger than 11.0 mm , ( 5 ) occupation and environment allowing wear of lenses for more than 7 hours during sleep , ( 6 ) ability to follow instructions during the clinical trial , and ( 7 ) willingness to participate in the clinical trial and provide signed written consent .
the exclusion criteria were : ( 1 ) schirmer test result less than 10 mm or tear break - up time shorter than 10 seconds , ( 2 ) abnormal findings during slit - lamp microscopy ; inflammation , erosions , ulcers , or angiogenesis in the cornea after wearing the lens for a 30-minute trial period , ( 3 ) allergies , ( 4 ) eye diseases that would have made participation in the trial difficult as judged by the investigator , ( 5 ) contraindication for wearing contact lenses , ( 6 ) wearing of rgp lenses within the 2 weeks prior to the screening visit , ( 7... | purposethe purpose of this multi - institute , single - group clinical trial was to evaluate the effectiveness and safety of toric orthokeratology lenses for the treatment of patients with combined myopia and astigmatism.methodsa total of 44 patients were included in this clinical trial .
the patients ranged in age from 7 to 49 years , with myopia of -0.75 to -6.0 diopters ( d ) and astigmatism of 1.25 to 4.0 d. after excluding 21 subjects , 23 subjects ( 39 eyes ) were analyzed after toric orthokeratology lens use .
the subjects underwent ophthalmologic examination after 1 day and 1 , 2 , 3 , and 4 weeks of wearing overnight toric orthokeratology lenses.resultsa total of 19 subjects ( 31 eyes ) completed the trial after five subjects ( eight eyes ) dropped out . in the patients who completed the study by wearing lenses for 4 weeks , the myopic refractive error decreased significantly by 2.60 2.21 d ( p < 0.001 ) , from -3.65 1.62 to -1.05 1.64 d. the astigmatic refractive error were also significantly decreased by 0.63 0.98 d ( p = 0.001 ) , from 2.07 0.83 to 1.44 0.99 d. the mean uncorrected and corrected visual acuities before wearing the lenses were 2.14 0.80 logarithm of the logmar ( logmar ) and 0.05 0.13 logmar , respectively , which changed to 0.12 0.30 logarithm of the logmar ( p < 0.001 ) and 0.01 0.04 logmar ( p = 0.156 ) after 4 weeks .
no serious adverse reactions were reported during the clinical trial.conclusionsour results suggest that toric orthokeratology is an effective and safe treatment for correcting visual acuity in patients with combined myopia and astigmatism . |
7,520 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: pseudotumor cerebri ( ptc ) is a condition that classically presents with optic disc elevation and edema resulting from increased intracranial pressure in absence of hydrocephalus , space occupying lesion , or any other intracranial disease .
studies show that obese women in their childbearing years are most frequently affected with an incidence rate more than a hundred times that of the general population ( 90/100,000 women vs 0.91.7/100,000 people ) ( campos and olitsky 1995 ) .
the symptom complex of a patient with ptc is variable but commonly includes nausea , emesis , amaurosis fugax , diplopia , tinnitus , retrobulbar pain , and postural headaches ( campos and olitsky 1995 ) .
although there are few cases of pediatric ptc in literature , current reports suggest that pediatric ptc symptoms are typically less severe as compared to adults and no sexual predilection or correlation with obesity has been shown to exist .
symptoms appear to parallel adult - like symptoms the older the child is at time of presentation ( raghaven et al 1997 ) .
emotional irritability and somnolence are two key symptoms that appear to more commonly afflict infants and younger children who suffer from pediatric ptc ( raghaven et al 1997 ) . in both the adult or pediatric presentations , preservation of vision and visual field are principle concerns that must be addressed immediately .
it has been shown that 85% of the patients presenting with signs and symptoms of ptc possess a visual field abnormality ( cincirpini et al 1999 ) . in pediatric ptc cases , the degree of visual field loss is between 13%38% with 46% of these cases demonstrating an enlarged blind spot ( cincirpini et al 1999 ) .
although the cause of pediatric ptc is often a mystery , the contributions of several secondary factors have surfaced including various endocrine disorders and iatrogenic causes ( wilson and baker 2005 ) ( table 1 ) .
the following report illustrates the toxic contribution of oral levothyroxine therapy ( synthroid , abbott laboratories , abbott... | papilledema is considered a neuro - ophthalmic emergency because of its capacity to induce irreversible end - organ damage and the often grave nature of its precipitating factor .
even more concern is warranted when papilledema presents in a pediatric setting .
after excluded the contributions of intracranial masses , congenital malformations , ischemic insults and acute infections , the investigation must focus on determining the contributions of other uncharacteristic causes of pediatric pseudotumor cerebri .
pediatric pseudotumor cerebri is a rare clinical entity which shares few commonalities to the adult condition in regards to its predicating factors or symptoms . without adequate medical history questioning ,
funduscopic evaluation and ancillary testing , the possibility of an erroneous diagnosis is plausible .
this case report aims to disclose the toxic role levothyroxine sodium tablets ( synthroid , abbott laboratories , abbott park , il , usa ) played in inducing pseudotumor cerebri in a pediatric patient being treated for congenital hypothyroidism . |
7,521 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: healthcare - seeking behaviors declined markedly during the ebola epidemic ( 2 ) , which likely contributed to probable underreporting of measles cases , a fact further substantiated by the lack of fatalities reported to dps .
although there are wide variances in estimates of measles case - fatality rates , a large study has suggested an average case - fatality rate of 3.7% for africa ( 13 ) , which would correspond with 26 deaths from the 702 suspected cases reported in lola during january june 2015 .
the lack of reported fatalities may also be related to the effect of the ebola epidemic on burial practices ; any families notifying authorities about deaths would be required to conduct safe and dignified burials , a protocol that had been met with resistance by many local groups ( 2 ) .
when the full shipment of vaccines arrived in lola in mid - april , logistical planning was challenged by shortages of personnel , fuel for automobiles , and appropriate vehicles for traversing difficult terrain during the onset of the rainy season . the campaign is estimated to have reached 92% of the target population , but persons in some urban areas and villages were reluctant to receive vaccinations .
the launch of the campaign coincided with reduced measles transmission ( figure ) , but further modeling research would be required to assess its effect on the course of the outbreak . in the aftermath of the ebola epidemic ,
. the front lines of disease surveillance and outbreak detection often occur in rural settings that are understaffed and underresourced . as guinea transitions to a post - ebola phase
this reduction would be unfortunate , because the technical and cultural expertise of the doctors from guinea in lola and other similar settings transcends ebola and could be harnessed to support a wide range of public health activities . strengthened investments in local public health systems will be essential to ensure the population of guinea can recover from the ebola epidemic and be better protected from future... | during public health crises such as the recent outbreaks of ebola virus disease in west africa , breakdowns in public health systems can lead to epidemics of vaccine - preventable diseases .
we report here on an outbreak of measles in the prefecture of lola , guinea , which started in january 2015 . |
7,522 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it also causes damage to deoxyribonucleic acid ( dna ) and dna - protein cross - links and induces cellular death .
there is a direct relationship between the effects of ionizing radiation and the type of tissue receiving the radiation and the absorbed radiation dose .
dental radiology represents the most frequently applied radiological diagnostic tool , the enormous diagnostic benefits of which make its use indispensable .
however , while individual doses and risks are low , the collective dose is not inconsiderable .
patients most commonly receive ionizing radiation to the head , and several studies have shown dental radiography to be associated with an increased risk of meningioma , brain cancer and parotid gland tumors as well as breast cancer [ 59 ] .
four different types of x - ray examination techniques are commonly used in dentistry for diagnostic purposes : posterior bitewings , periapical films , lateral cephalometric radiographs and panoramic radiographs ( opg ) .
in addition , cone - beam computerized tomography ( cbct ) has recently been accepted as an emerging x - ray technology in dentomaxillofacial imaging .
all these imaging techniques have been implicated in nuclear alterations of stomatognathic system cells that are closely related to genotoxicity .
the fact that imaging may subject regions not specifically under consideration to x - ray radiation warrants an assessment of what types of protective devices can be produced from nano - materials to shield areas of the jaw and the rest of the body outside the area of interest from the harmful effects of x - rays .
many techniques are available for evaluating the structural characteristics of materials that have metallic particles .
small angle x - ray scattering is one such technique used for the structural characterization of solid and fluid materials in the nanometer ( nm ) range .
measurements are commonly performed in transmission geometry by using a narrow , well - collimated and intense x - ray beam .
x - ray absorption is related to... | objectives : this study aimed to compare a number of new nano - composites capable of protecting the jaw from ionizing radiation.materials and methods : four different types of nano - powders [ ti , zr ( iv ) oxide , ag and co ] were mixed in a polymer matrix to create nano - composites with doping values of 8% in weight .
small - angle x - ray scattering ( saxs ) analysis was performed using a hecussaxs system with 50 kv- 50 ma .
co nano - composites ( co - pnm ) yielded the most promising values of the four nanocomposites tested in terms of x - ray absorption .
thus , 42 cm co - pnm samples of different thicknesses ( 0.20 , 0.50 , 0.57 and 0.60 cm ) were prepared , and saxs analysis was performed in order to assess the effects of material thickness on xray absorption .
an experimental multi part shield was constructed from co - pnm around tooth # 36 to test the effect of nanomaterial on the image quality under x - ray beam.results:logarithmic distributions of the transmitted intensity values ( i ) showed that 0.20 cm co - pnm had the highest transmission value ( 16.05 ) followed by 0.50 cm co - pnm ( 15.44 ) , 0.57 cm co - pnm ( 15.07 ) and 0.60 cm co - pnm ( 15.06 ) .
the 0.2 cm co - pnm had an effective radius of the nano - aggregation value ( 77.44 ) lower than that of the other thicknesses ( 0.50 , 0.57 and 0.60 cm ) of co - pnm , which had similar values ranging from 66.22 to 66.34 .
the 0.50 cm co - pnm had the lowest dmax value of the different thicknesses of co - pnm tested.conclusion:co nanocomposite can be used as a protection shield for the harmful effects of dental x - ray . |
7,523 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: antituberculosis drug - induced hepatitis is one of the most prevalent drug - induced liver injuries ( 1 ) .
rifampin ( rif ) , isoniazid ( inh ) , pyrazinamide ( pza ) and ethambutol ( emb ) are first line chemotherapeutic agents in treatment of tuberculosis ( tb ) ( 2 - 5 ) . among these drugs ,
hepatotoxicity of inh can be presented as a mild transient elevation in aminotransferases in 10 to 20% of tuberculosis patients to rare cases of overt hepatitis ( 7 ) metabolism pathways and toxic metabolites of anti - tb agents play a central role in hepatotoxicity of these agents ( 8) .
acetyltransferase-2 ( nat2)-mediated acetylation , resulting in acetyl - inh , which is hydrolyzed to acetylhydrazine and isonicotinic acid ( 9 ) .
another important factor in inh - induced hepatotoxicity is genetic variations ( 6 , 9 ) .
there are large variations in the inh acetylation capacity suggesting a pharmacogenetic polymorphism of nat2 ( 10 , 11 ) .
this variability in the acetylation capacity results from a wide range of n- acetylation activity and has been characterized by bimodal or trimodal distribution ( 12,13 ) .
the frequency of slow and rapid acetylators differs among ethnic populations ( 14 - 17 ) .
although primary studies had suggested that the fast acetylators are more susceptible to developing inh induced hepatotoxicity ( 17 , 18 ) , recent studies showed that the slow acetylators are more vulnerable to inh induced hepatotoxicity ( 19 , 20 ) .
still the association between acetylation phenotype and drug - induced hepatotoxicity is controversial ( 6 , 10 ) . the goal of this study was to evaluate relationship of acetylator phenotype and the incidence of antituberculosis drugs - induced hepatotoxicity in iranian pulmonary tb patients .
this study was a prospective , cross - sectional one . a total of 50 unrelated patients ( age > 18 ) with newly diagnosed pulmonary tb from the infectious diseases ward from imam referral hospital affiliated to tehran university of medical sciences ( tehran , iran ) were... | the aim of this study was to determine the association of n - acetyltransferase-2 polymorphisms and anti - tuberculosis drug - induced hepatotoxicity in iranian pulmonary tuberculosis patients .
acetylating phenotypes was studied in 50 iranian pulmonary tuberculosis patients using metabolic ratio of plasma acetyl - isoniazid to isoniazid .
the association between hepatotoxicity and the n - acetyltransferase-2 phenotype was evaluated by using the chi - square ( x2 ) test.the metabolic ratio had a bimodal distribution with an antimode value of 1.0 .
based on the metabolic ratio of the mentioned patients , 20 ( 40% ) were slow acetylators and 30 ( 60% ) were fast ones .
hepatotoxicity was manifested in 9 of 20 slow acetylators ( 45% ) and only in 5 of 30 rapid acetylators ( 16.7% ) .
there was a significant difference in the frequency of hepatotoxicity between the slow and fast acetylators ( x2 = 4.778 , and p = 0.03 ) .
sex and age were not found to be risk factors for hepatotoxicity .
our findings show that slow acetylation profile is significantly associated with a higher risk of developing hepatotoxicity due to the anti - tb drugs in iranian pulmonary tuberculosis patients . |
7,524 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: enzyme replacement therapy ( ert ) is currently the major form of treatment for a number of lysosomal storage diseases , although its efficacy varies among the individual disorders . most of these inherited disorders arise from the lack of activity of a single lysosomal enzyme , which leads to the accumulation of the material normally degraded by the enzyme .
the build - up of the storage material in the lysosome eventually results in cell and organ dysfunction .
the goal of ert is to introduce sufficient amounts of normal enzyme into the lysosomes of the deficient cells to clear the storage material and restore lysosome function .
this form of therapy was first used in patients with type 1 gaucher disease , who lack acid -glucocerebrosidase ( gba ) activity and accumulate glucosylceramide primarily in macrophage type cells .
the replacement enzyme , containing n - linked glycans with terminal mannose residues , is infused intravenously and taken up by macrophages via cell surface mannose receptors . the endocytosed enzyme is then transported via endosomes to lysosomes , where it functions with good clinical results in this disorder . because most cell types lack mannose receptors , the replacement enzymes used to treat lysosomal storage disorders that involve cell types other than macrophages use binding to the cation - independent mannose 6-phosphate receptor ( ci - mpr ) at the cell surface for subsequent delivery to lysosomes . in this regard ,
studies of a mouse model of gaucher disease have produced evidence for the involvement of multiple cell lineages other than macrophages in the pathophysiology of this disorder , particularly osteoblasts , dendritic cells , and t cells .
therefore , a therapy that included these cell types may be of clinical benefit in this disorder .
the enzymes used for ert are purified from the secretions of mammalian cells , mostly chinese hamster ovary cells , engineered to produce high levels of the enzyme of interest .
the feasibility of this approach is dependent upon the... | several lysosomal enzymes currently used for enzyme replacement therapy in patients with lysosomal storage diseases contain very low levels of mannose 6-phosphate , limiting their uptake via mannose 6-phosphate receptors on the surface of the deficient cells .
these enzymes are produced at high levels by mammalian cells and depend on endogenous glcnac-1-phosphotransferase / precursor to phosphorylate the mannose residues on their glycan chains .
we show that co - expression of an engineered truncated glcnac-1-phosphotransferase / precursor and the lysosomal enzyme of interest in the producing cells resulted in markedly increased phosphorylation and cellular uptake of the secreted lysosomal enzyme .
this method also results in the production of highly phosphorylated acid -glucocerebrosidase , a lysosomal enzyme that normally has just trace amounts of this modification . |
7,525 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: composite resins are routinely used as restorative materials in anterior and posterior teeth due to the resins ' excellent aesthetics,1 their strong mechanical and physical properties,2 and their high resistance to dissolution.3 however , despite improvements in resin composite formulations over the years , polymerization shrinkage of the resin matrix is still considered problematic due to unsuccessful direct composite resin restorations.4 the high viscosity and stickiness of the highly filled composite makes insertion and adaptation of the material to the preparation walls difficult.5 poor adhesion between the dentin and restorative material causes gap formation .
ultimately , marginal gap formation leads to microleakage , which may be responsible for increased postoperative sensitivity , pulpal inflammation , staining , and recurrent caries.6,7 to receive an excellently sealed , long - term restoration , material adaptation to the cavity walls is important.8 the preheating of resin systems has many benefits .
the increased flow can improve the adaptation of the prepared tooth walls , which in turn may reduce microleakage.9 uctasli et al10 stated that preheating the treatment did not change the mechanical properties of the composite resin materials so the tested composite resin materials could be preheated because of the clinical advantages like more adaptation to the cavity walls .
heating the resin composite prior to placement and polymerizing also increases monomer conversion.11 with increased paste temperature , free radicals and increasing polymer chains become more fluid as a consequence of decreased paste viscosity and they react to a greater extent , resulting in a more complete polymerization reaction and greater crosslinking .
the increase in polymerization may lead to improved mechanical properties and increased wear resistance.12 preheating devices are commercially used at a temperature range of 5468c , which is questioned regarding pulp compatibility in deep cavities .
nevertheless , only a 0.8c... | objectives : this study aimed to evaluate the extent of microleakage of a single type of composite resin ( clearfil majesty posterior , kuraray , osaka , japan ) following different preheating procedures in class v cavities prepared with a diamond bur or er : yag ( erbium : yttrium aluminum garnet ) laser.methods:the study randomly divided 72 permanent molar teeth divided into eight groups ( n = 9 ) : g1 : diamond bur unheated composite resin ( room temperature-24 c ) ; g2 : diamond bur
composite preheated to 37 c ; g3 : diamond bur
composite preheated to 54 c ; g4 : diamond bur
composite preheated to 68 c ; g5 : er : yag laser unheated composite resin ( room temperature-24 c ) ; g6 : er : yag laser composite preheated to 37 c ; g7 : er : yag laser composite preheated to 54 c ; and g8 : er : yag laser composite preheated to 68 c .
the specimens were subjected to a thermal cycling regimen of 5000 cycles between 5 and 55 c ; then they were immersed in a solution of 0.5% basic fuchsin dye for 24 hours .
the dyed specimens were sectioned in the buccolingual direction and dye penetration was scored in a blinded manner using a five - point qualitative scale .
microleakage scores were analyzed with the kruskall - wallis , mann - whitney u , and wilcoxon tests.results:there were no statistically significant differences between the microleakages of composite applied to cavities prepared by either the er : yag laser or diamond bur ( p>.05 ) .
statistical analysis revealed significant differences between the enamel and dentin in all restorations ( p<.001 ) .
however , there were no significant differences among the preheated groups ( p>.05).conclusions : for all groups , microleakage values were higher at gingival margins than at occlusal margins . the use of the er : yag laser at different preheating procedures did not influence the marginal sealing in class v composite resin restorations . |
7,526 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the normal total body iron content of 34 g is the result of a tight balance between iron absorbed from the gastrointestinal tract and iron lost in stool , sweat and via shed skin cells .
if the iron supply or gastrointestinal tract absorption of dietary iron exceeds the amount needed , there is no mechanism to eliminate the excessive iron .
this state of presence of iron in excess of what is needed is called iron overload .
iron overload diseases are frequently associated with hereditary defects or secondary disturbances of iron metabolism that result from excessive blood transfusions , iron supplementation or iron injections .
hereditary hemochromatosis , which is characterized by a genetic predisposition to absorb excess iron from the diet , is the most frequent form of genetic iron overload .
iron overload , irrespective of the underlying etiology , has varying manifestations , depending on the organs affected by the excessive iron deposit .
it may present as fatigue , skin color changes , abdominal pain , joint pain , irregular menstruation , infertility , impotence , irregular heart rhythm , heart failure , new - onset diabetes or difficulty controlling established diabetes and elevation in liver enzymes .
hemochromatosis , the most common genetic iron overload disorder , may also lead to the development of life - threatening complications like cirrhosis and hepatocellular carcinoma .
manifestations of iron overload in hemochromatosis are related to mutations of the hfe gene , but not all patients with an inherited hemochromatosis - like phenotype carry pathogenic mutations in the hfe gene .
several other genetic mutations involving the hemojuvelin , the hepcidin , the transferrin receptor 2 and the ferroportin gene have been discovered and known to cause manifestations similar to classic hereditary hemochromatosis . the hemojuvelin and hepcidin genes are implicated in causing juvenile hemochromatosis , transferrin receptor 2 gene mutation causes type 3 hemochromatosis , and ferroportin gene mutation... | disturbances in iron metabolism can be genetic or acquired and accordingly manifest as primary or secondary iron overload state
. organ damage may result from iron overload and manifest clinically as cirrhosis , diabetes mellitus , arthritis , endocrine abnormalities and cardiomyopathy .
hemochromatosis inherited as an autosomal recessive disorder is the most common genetic iron overload disorder .
expert societies recommend screening of asymptomatic and symptomatic individuals with hemochromatosis by obtaining transferrin saturation ( calculated as serum iron / total iron binding capacity 100 ) .
further testing for the hemochromatosis gene is recommended if transferrin saturation is > 45% with or without hyperferritinemia .
however , management of individuals with low or normal transferrin saturation is not clear . in patients with features of iron overload and high serum ferritin levels , low or normal transferrin saturation should alert the physician to other primary as well as secondary causes of iron overload besides hemochromatosis .
we present here a possible approach to patients with hyperferritinemia but normal transferrin saturation . |
7,527 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: urinary incontinence ( ui ) is well - known to profoundly affect the qol ( quality of life ) of
women
. many cases of ui are stress urinary incontinence ( sui ) , and the success of pelvic
floor muscle ( pfm ) exercise in the management of sui has been confirmed by multiple
randomized controlled studies .
pfm exercise has been reported to be from 50% to 69%
effective at reducing urine loss episodes in women1,2,3,4 .
many ui cases are the
result of pfm weakness , suggesting that risk of ui can be evaluated by pfm .
recently ,
several studies reported that the pfm , as the inner unit along with the transverse abdominal
muscle ( ta ) , multifidus muscle , and diaphragm , acts to maintain the stability of the trunk ,
and the pfm has begun to be used in approaches for not only ui but also lumbar pain5,6,7 . in our previous study , we found a
significant relationship between the thickness of the ta and the iemg of the levator ani
muscle8 .
this result suggests that
changes in the thickness of the ta may be used to indicate changes in the electrical
activity of the pfm .
the purpose of this study was to devise a new urinary incontinence exercise using
co - contraction of both the transverse abdominal muscle and pelvic floor muscle and examine
the intervention effect in middle - aged women with stress urinary incontinence .
the subjects were fifteen women who had experienced one or more sui events in the past 1
month .
the subjects were divided into two groups randomly : the ta and pfm co - contraction
exercise group ( n=9 ) and the control group ( n=6 ) ( table
1table 1 .
subject characteristicsage ( y)height ( cm)weight ( kg)exercise group ( n= 9)52.1 9.5156.1 6.251.9 5.3control group ( n= 6)52.0 7.6161.0 7.455.7
all
experimental procedures in this study were reviewed and approved by the ethical review
committee of jilin dianli hospital .
the thickness of the ta was measured in all subjects under four conditions
at random in the supine position .
2 ) the
second... | [ purpose ] the purpose of this study was to devise a new urinary incontinence exercise
using co - contraction of both the transverse abdominal muscle ( ta ) and pelvic floor muscle
( pfm ) and examine the intervention effect in middle - aged women with stress urinary
incontinence ( sui ) .
[ subjects ] the subjects were fifteen women with sui who were divided
into two groups : the ta and pfm co - contraction exercise group ( n=9 ) and the control group
( n=6 ) . [ methods ] participants in the exercise group performed ta and pfm co - contraction
exercise . the thickness of the ta was measured before and after 8 weeks of exercise using
ultrasound .
the thickness of the ta was measured under 4 conditions : ( 1 ) at rest , ( 2 )
maximal contraction of the ta , ( 3 ) maximal contraction of the pfm , and ( 4 ) maximal
co - contraction of both the ta and pfm .
[ results ] there were no significant differences
among the results of the control group . in the exercise group ,
the cure rate of sui was
88.9% after the intervention .
there were significant differences in the thickness of the
ta during maximal co - contraction of both the ta and pfm after the intervention .
[ conclusion ] the ta and pfm co - contraction exercise intervention increases the thickness
of the ta and may be recommended to improve sui in middle - aged women . |
7,528 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a total of 118 undergoing craniotomy or stereotactic biopsy in seoul national university bundang hospital from may 2003 to september 2011 , and 32 patients received craniotomy or stereotactic biopsy in seoul national university hospital from may 2011 to september 2011 .
the mean age of 150 glioblastoma patients was 58.8 years with range of 19 to 85 years .
the patient group consisted of equal numbers of men and women , 75 patients each .
patients with history of an evolution from diffuse or anaplastic astrocytoma were diagnosed as having clinically secondary glioblastoma , and de novo cases were regarded as clinically primary glioblastomas .
they consisted of 146 cases of clinically primary glioblastomas and 4 cases of clinically secondary glioblastomas .
the mean age of clinically primary and secondary glioblastomas was 59.2 years and 44.0 years , respectively .
immunohistochemical staining for p53 and egfr was performed in 150 cases using formalin - fixed paraffin - embedded tumor blocks . idh-1
immunohistochemical stains were performed in 144 cases of glioblastoma for which paraffin blocks were available .
briefly , 4-m - thick tissue sections were deparaffinized in xylene and hydrated by immersing in a series of graded ethanol .
antigen retrieval was performed in a microwave by placing the sections in epitope retrieval solution ( 0.01 m citrate buffer , ph 6.0 ) for 20 minutes ; endogenous peroxidase was inhibited by immersing the sections in 0.3% hydrogen peroxide for 10 minutes.15 sections were then incubated with combinations of egfr ( 1:150 , dako , camarillo , ca , usa ) , p53 ( 1:1,000 , dako , glostrup , denmark ) , and/or idh-1 ( 1:100 , dianova , hamburg , germany ) antibodies .
immunohistochemical stains for egfr were graded as follows : 0 ( no cell stained ) , 1 + ( < 5% tumor cells stained ) , 2 + ( 5 - 50% cells stained ) , and 3 + ( > 50% cells stained ) . for statistical analysis , a score of 0 and 1 was considered negative and a score of 2 or 3 was considered positive .
nuclear staining of... | backgroundglioblastomas may develop de novo ( primary glioblastomas , p - gbls ) or through progression from lower - grade astrocytomas ( secondary glioblastomas , s - gbls ) .
the aim of this study was to compare the immunohistochemical classification of glioblastomas with clinically determined p - gbls and s - gbls to identify the best combination of antibodies for immunohistochemical classification.methodswe evaluated the immunohistochemical expression of epidermal growth factor receptor ( egfr ) , p53 , and isocitrate dehydrogenase 1 ( idh-1 ) in 150 glioblastoma cases.resultsaccording to clinical history , the glioblastomas analyzed in this study consisted of 146 p - gbls and 4 s - gbls .
immunohistochemical expression of egfr , p53 , and idh-1 was observed in 62.6% , 49.3% , and 11.1% , respectively .
immunohistochemical profiles of egfr(+)/p53(- ) , idh-1(-)/egfr(+)/p53(- ) , and egfr(-)/p53(+ ) were noted in 41.3% , 40.2% , and 28.7% , respectively .
expression of idh-1 and egfr(-)/p53(+ ) was positively correlated with young age .
the typical immunohistochemical features of s - gbls comprised idh-1(+)/egfr(-)/p53(+ ) , and were noted in 3.6% of clinically p - gbls . the combination of idh-1(- ) or egfr(+ ) was the best set of immunohistochemical stains for identifying p - gbls , whereas the combination of idh-1(+ ) and egfr(- ) was best for identifying s-gbls.conclusionswe recommend a combination of idh-1 and egfr for immunohistochemical classification of glioblastomas .
we expect our results to be useful for determining treatment strategies for glioblastoma patients . |
7,529 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cyclic peptides have a
number of properties that make them useful
for biomedical applications . the constraints of cyclization give them
a smaller accessible conformational space than acyclic peptides , which
leads to a smaller loss of entropy when they bind to a receptor .
they are also very stable because they are not
broken down by exopeptidases , which digest peptides by removing residues
from the end of the peptide chain .
cyclic
peptides of all sizes are biologically active , starting from cyclic
dipeptides , which are known as diketopiperazines .
interesting cyclic tetrapeptides include the antitumor
agent trapoxin , the antimalarial apicidin , and the phytotoxic tentoxin .
there are also many examples of biologically active cyclic
peptides containing five , six , or more peptide groups .
understanding the
energy landscapes of cyclic peptides will account
for their conformational dynamics and provide some insight into their
biological activity .
small cyclic peptides have very different conformational
behavior to acyclic peptides , most significantly with respect to cis / trans
isomerization of the peptide groups .
cyclic dipeptides have both peptide
bonds in the cis conformation because this is the only configuration
that allows for closure of the ring .
all of the known experimental
structures for cyclic tripeptides have all - cis conformations , but
ab initio calculations on cyclic triglycine show that the all - cis
and trans cis cis isomers are close in energy . many cyclic tetrapeptides exhibit interesting
conformational dynamics with slow interconversion of several structures
and competition between the cis and trans isomers of the peptide groups . as the size of the ring increases , the cis / trans
ratio in cyclic peptides
the conformations of cyclic peptides have
been explored with a
variety of computational techniques .
the most stable conformers of
several cyclic tetrapeptides have been located either by systematic or monte carlo searches... | cyclic tetrapeptides are an important class of biologically
active
molecules that exhibit interesting conformational dynamics , with slow
interconversion of several different structures .
we present calculations
on their energy landscapes using discrete path sampling . in acyclic
peptides and large cyclic peptides , isomers containing
cis - peptide
groups are much less stable than the all - trans isomers and separated
from them by large barriers .
strain in small cyclic peptides causes
the cis and trans isomers to be closer in energy and separated by
much lower barriers .
if d - amino acids or proline residues
are introduced , isomers containing cis - peptides become more stable
than the all - trans structures .
we also show that changing the polarity
of the solvent has a significant effect on the energy landscapes of
cyclic tetrapeptides , causing changes in the orientations of the peptide
groups and in the degree of intramolecular hydrogen bonding . |
7,530 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hospitalized patients , especially those in intensive care units ( icus ) , require specialized care .
their critical health conditions make them more dependent on a multidisciplinary team able to provide ethical , humane , and clinical help , especially in their daily activities .
most of these patients are not able to perform the simplest activities , including their own oral hygiene .
oral hygiene is necessary for patients in icus because it helps to maintain the health of their stomatognathic systems . without proper assistance ,
finally , changes in salivary flow caused by medications that worsen and unbalance the oral environment may increase biofilm formation .
previous reports have suggested that professionals working in brazilian hospitals give little credibility to dental activities such as oral hygiene , and do not usually recognize the close association between oral hygiene and prevention of systemic diseases .
health care professionals must be made aware that oral hygiene may improve the health conditions of hospitalized patients .
dentistry practice in hospitals aims to prevent and eliminate potential infection sources , including inflammation and painful symptoms caused by oral problems that may directly affect systemic conditions of critically ill patients and jeopardize their recovery .
they assess the accumulation of biofilm , tongue coating , dental caries , halitosis , oral lesions , partial or full prosthetics , periodontal disease , and residual fungal diseases within the oral cavity .
. however , the balance of oral microflora of patients hospitalized in icus for more than 48 h tends to change .
these changes lead to a prevalence of gram - negative bacteria such as staphylococcus aureus , streptococcus pneumoniae , acinetobacter baumanii , haemophilus influenzae , and pseudomonas aeruginosa .
studies have correlated biofilm on the tongue with increased levels of gram - negative bacteria .
biofilm on tooth surfaces , coated tongues , and periodontal disease tend to aggravate patient... | objective : to assess the level of knowledge and difficulties concerning hospitalized patients regarding preventive oral health measures among professionals working in intensive care units ( icus).study population and methods : a cross - sectional survey was conducted among 71 health professionals working in the icu .
a self - administered questionnaire was used to determine the methods used , frequency , and attitude toward oral care provided to patients in brazilian icus .
the variables were analyzed using descriptive statistics ( percentages ) .
a one - sample t - test between proportions was used to assess significant differences between percentages .
t - statistics were considered statistically significant for p < 0.05 .
bonferroni correction was applied to account for multiple testing.results:most participants were nursing professionals ( 80.3% ) working 12-h shifts in the icu ( 70.4% ) ; about 87.3% and 66.2% reported having knowledge about coated tongue and nosocomial pneumonia , respectively ( p < 0.05 ) .
most reported using spatulas , gauze , and toothbrushes ( 49.3% ) or only toothbrushes ( 28.2% ) with 0.12% chlorhexidine ( 49.3% ) to sanitize the oral cavity of icu patients ( p < 0.01 ) .
most professionals felt that adequate time was available to provide oral care to icu patients and that oral care was a priority for mechanically ventilated patients ( 80.3% and 83.1% , respectively , p < 0.05 ) .
however , most professionals ( 56.4% ) reported feeling that the oral cavity was difficult to clean ( p < 0.05).conclusion : the survey results suggest that additional education is necessary to increase awareness among icu professionals of the association between dental plaque and systemic conditions of patients , to standardize oral care protocols , and to promote the oral health of patients in icus . |
7,531 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: colorectal carcinoma ( crc ) is a common cause of morbidity and mortality worldwide . as a major life - threatening malignancy
, crc ranks second to lung carcinoma in men , third to breast cancer and lung cancer in women , and overall second to other cancer types in men and women .
approximately 142,820 new cases were diagnosed and 50,830 individuals died because of crc in 2013 .
clinical and pathological stages at the time of diagnosis largely determine the prognosis of diagnosed patients .
the curative rates of crc in t1n0m0 , t2n0m0 , and t3n0m0 stages are greater than 90% , 85% , and 70% , respectively .
therefore , crc screening is an efficient strategy to reduce death caused by this disease .
current screening modalities have resulted in a modest decrease in mortality and failed to achieve high public participation . among these modalities ,
highly sensitive colonoscopy is the standard technique used to detect and remove early lesions , but colonoscopy is invasive and costly . for population - wide screening , simple and noninvasive procedures , such as guaiac or immunochemical stool occult blood testing ( fobt ) , are preferred .
however , the performances of these tests are low . as such , molecular tests should be conducted to improve their efficiency .
for example , stool aberrant dna methylation has been developed as a biomarker for crc initiation and progression . in this article , this technique was discussed to develop real time polymerase chain reaction ( qpcr ) dna methylation biomarker test for stool to diagnose crc .
stool qpcr dna methylation biomarkers were also examined to predict outcomes and responses to crc chemotherapy .
approximately 98% of crc are adenocarcinomas that almost originate from adenomas as generally curable by resection .
the peak incidence age of crc is 60 to 70 years , and less than 20% of cases occur before the age of 50 years .
genetic and epidemiologic studies have linked crc to several factors , including inherited predisposition , somatic mutation , dietary... | colorectal carcinoma ( crc ) is a common cause of morbidity and mortality worldwide .
two pathogenic pathways are involved in the development of adenoma to crc .
the first pathway involvesapc/-catenin characterized by chromosomal instability resulting in the accumulation of mutations .
the second pathway is characterized by lesions indna mismatch repair genes .
aberrant dna methylation in selected gene promoters has emerged as a new epigenetic pathway in crc development .
crc screening is the most efficient strategy to reduce death .
specific dna methylation events occur in multistep carcinogenesis .
epigenetic gene silencing is a causative factor of crc development .
dna methylations have been extensively examined in stool from crc and precursor lesions .
many methylated genes have been described in crc and adenoma , although no definite dna methylation biomarkers panel has been established .
multiple dna methylation biomarkers , including secreted frizzled - related protein 2 , secreted frizzled - related protein 1 , tissue factor pathway inhibitor 2 , vimentin , and methylguanine dna methyltransferase , have been further investigated , and observations have revealed that dna methylation biomarkers exhibit with high sensitivity and specificity .
these markers may also be used to diagnose crc and adenoma in early stages .
real time polymerase chain reaction ( qpcr ) is sensitive , scalable , specific , reliable , time saving , and cost effective .
stool exfoliated markers provide advantages , including sensitivity and specificity .
a stool qpcr methylation test may also be an enhanced tool for crc and adenoma screening . |
7,532 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it has been described in patients with increased venous pressure and stasis caused by venous insufficiency , congenital / acquired arteriovenous anomalies , arteriovenous shunts and lower limb paralysis or amputation stumps .
different names , like congenital dysplastic angiopathy , pseudo - kaposi sarcoma , and acral capillary angiomatosis , have been used .
first type namely the mali type of acroangiodermatitis is related to chronic venous insuffiency and second the stewart - bluefarb type is associated with arteriovenous malformations .
this lesion is usually encountered mostly on extensor surfaces of lower extremities , and clinically characterized by angiomatous red - violaceous , brown papules , plaques or nodules .
it is seen more frequently in males and according to underlying causes may be presented in childhood or early adulthood .
a 26-year - old male was admitted to our hospital with unilateral , multifocal irregularly contoured , purplish red colored , papular , plaque - shaped and nodular lesions on his right ankle .
microscopically epidermis showed minimal achantosis with a melanin pigment increase in the basal cell layer .
the lesion was located in dermis demonstrating a lobular architecture and was composed of small proliferating capillaries that are separating from each other with a slightly edematous matrix or forming nodular structures in which the luminal formations can hardly be identified .
stroma contained minimal spindle cell proliferation around vessels , diffuse hemosiderin granules and extravasated erythrocytes .
( h and e , 400 ) for differential diagnosis , immunohistochemical stains cd 34 , cd 31 and factor 8 were used .
positive immunostainings for cd 34 , cd 31 , and factor 8 were observed in endothelial cells figure 5 .
acroangiodermatitis is vasoproliferative disorder which is mostly related to vascular stasis and venous insufficiency , but rare cases without venous dysfunction are reported as in our case . whereas some authors classify acroangiodermatitis as a vascular... | acroangiodermatitis is a rare self - limited angioproliferative lesion which can be associated with congenital vascular malformations or acquired venous insufficiency . despite of its benign character , differential diagnosis of this lesion
is very important because it closely resembles kaposi sarcoma . here
we present a 26-year - old male patient with unilateral , purplish - red colored papules on his right ankle which diagnosed as acroangiodermatitis and discuss histopathological features , differential diagnosis and treatment of this unusual condition . |
7,533 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: there are three common
types of protein glycosylation that modify
large numbers of protein substrates in mammalian cells .
proteins localized
to the secretory pathway and the cell surface or secreted into the
extracellular space can be modified by oligosaccharide structures ,
such as n - linked glycosylation ( linked through asparagine )
or mucin o - linked glycosylation ( linked through serine
and threonine ) .
additionally , cytoplasmic , nuclear , and mitochondrial
proteins can be substrates for the addition of the single monosaccharide n - acetyl - glucosamine , termed o - glcnac modification
( o - glcnacylation , linked through serine and threonine ) .
it is added to protein substrates by one of three isoforms
of o - glcnac transferase ( ogt ) and removed by two
isoforms of o - glcnacase ( oga ) .
the expression of these enzymes is also required for embryonic
development in mice and drosophila.(68)o - glcnac modification displays significant crosstalk
with other posttranslational modifications ( ptms ) , most significantly
phosphorylation and ubiquitination , setting up o - glcnacylation
as a key regulator of cellular pathways . a wide variety of proteins
have been shown to be o - glcnac modified , including regulators of transcription and translation ,
cytoskeletal proteins , signaling proteins , and metabolic enzymes .
the specific consequences of most of these modifications are unknown ;
however , limited biochemical analyses demonstrate that o - glcnac modification can change protein localization , stability ,
molecular interactions , and activity .
critically , o - glcnacylation is also misregulated in alzheimer s disease
and cancer .
for example , in neurodegenerative disorders such as alzheimer s
disease , o - glcnacylation levels are diminished directly
leading to protein aggregation and cell death , and we have demonstrated that it likely plays a similar
role in parkinson s disease
. finally ,
higher levels of o - glcnac modification are a common
... | metabolic chemical reporters ( mcrs )
of glycosylation are analogues
of monosaccharides that contain bioorthogonal functionalities and
enable the direct visualization and identification of glycoproteins
from living cells . each mcr was initially thought to report on specific
types of glycosylation .
we and others have demonstrated that several
mcrs are metabolically transformed and enter multiple glycosylation
pathways .
therefore , the development of selective mcrs remains a key
unmet goal .
we demonstrate here that 6-azido-6-deoxy - n - acetyl - glucosamine ( 6azglcnac ) is a specific mcr for o - glcnacylated proteins . biochemical analysis and comparative proteomics
with 6azglcnac , n - azidoacetyl - glucosamine ( glcnaz ) ,
and n - azidoacetyl - galactosamine ( galnaz ) revealed
that 6azglcnac exclusively labels intracellular proteins , while glcnaz
and galnaz are incorporated into a combination of intracellular and
extracellular / lumenal glycoproteins .
notably , 6azglcnac can not be
biosynthetically transformed into the corresponding udp sugar - donor
by the canonical salvage - pathway that requires phosphorylation at
the 6-hydroxyl . in vitro experiments
showed that 6azglcnac can bypass
this roadblock through direct phosphorylation of its 1-hydroxyl by
the enzyme phosphoacetylglucosamine mutase ( agm1 ) .
taken together ,
6azglcnac enables the specific analysis of o - glcnacylated
proteins , and these results suggest that specific mcrs for other types
of glycosylation can be developed .
additionally , our data demonstrate
that cells are equipped with a somewhat unappreciated metabolic flexibility
with important implications for the biosynthesis of natural and unnatural
carbohydrates . |
7,534 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: regular physical activity ( pa ) has many physical and mental health benefits for older adults including lowering the risk of early death , improving bone health , increasing cardiorespiratory and muscular fitness , decreasing levels of body fat , and reducing anxiety and depression . to achieve these benefits ,
the 2008 physical activity guidelines for americans ( pag ) recommend that adults should complete 150 min a week of moderate intensity aerobic pa or 75 min a week of vigorous intensity aerobic pa ( or a combination of both ) , as well as two days a week of muscle strengthening activities .
pa participation progressively declines as people age , and currently only 17.1% and 15.9% of adults 5564 years and 65 years and older , respectively , meet these guidelines ; therefore , interventions to increase pa participation among older adults are warranted .
meta - analytic evidence demonstrated that interventions are effective for increasing pa participation [ 4 , 5 ] , and specific characteristics of the intervention produced larger effects on behavior .
for instance , in a review of 141 studies , dishman and buckworth found significantly larger effect sizes for interventions that used behavior modification strategies such as reinforcement , stimulus control , or behavioral contracts ( r = 0.92 weighted ; r = 0.56 not weighted ) and for those that were delivered using a mediated approach via indirect implementation through mailings or telecommunications ( r = 0.91 weighted ; r = 0.41 not weighted ) .
behavior modification techniques are based on the premise that the antecedents and consequences ( including expected consequences ) of the activity influence behavior .
stimulus control involves manipulating environmental conditions , such as using prompts or reminders to decrease the problem behavior ( physical inactivity ) and increase the targeted behavior ( pa participation ) and this strategy has frequently been incorporated into health behavior interventions . in a systematic review of 19 weight loss... | the purpose of this study was to determine if electronic messaging would increase min of aerobic physical activity ( pa ) among older adults .
participants were active older adults ( n = 28 ; m age = 60 years , sd = 5.99 , and range = 5174 years ) .
using an incomplete within - subjects crossover design , participants were randomly assigned to begin the 4-week study receiving the treatment condition ( a morning and evening text message ) or the control condition ( an evening text message ) .
participants self - reported min of completed aerobic pa by cell phone text .
the 1-way within - subjects anova showed significant group differences ( p < 0.05 ) .
specifically , when participants were in the treatment condition , they reported significantly greater average weekly min of aerobic pa ( m = 96.88 min , sd = 62.9 ) compared to when they completed the control condition ( m = 71.68 min , sd = 40.98 ) .
electronic messaging delivered via cell phones was effective at increasing min of aerobic pa among older adults . |
7,535 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in a number of clinical situations , concomitant use of two or more drugs is imperative . in particular in chronic disease treatment course , patients must take more than one drug for an extended period of time .
in this course , many drug interactions have received a great deal of attention to avoid any side effects to the patients .
the greater the number of drugs prescribed to a patient , the greater the risk of drug interactions . in an epidemiological study , conducted at a community hospital to investigate the clinical relevance of drug - drug interactions ( ddis ) ,
it was reported that incidence of interactions raises up to 7% in those patients taking 610 drugs and 40% in those taking 1620 drugs a day . beside the off target effects
, ddis can lead to termination of drug development in early stages , refusal of approval , very strong prescribing restrictions , and withdrawal of drugs from market . furthermore , frequent and severe side effects due to ddis in elderly patients because of the impaired physiological functions are reportedly increasing , necessitating the requirement of more information regarding the ddis , while giving any combination therapy .
many of the major pharmacokinetic ( pk ) interactions between drugs are due to cytochrome 450 ( cyp450 ) enzymes , whose genetic expressions are being affected ( induction or inhibition ) by previously or simultaneously administered drugs . in addition , such interactions may exist at the level of absorption , distribution , clearance , and transporters .
such interactions are investigated in terms of the pk parameter changes of the concerned drug .
these substantial changes in pk parameters may be used to indicate clinical importance of ddis , when substrate and interacting drugs are likely to be given simultaneously either for short periods or chronically for an extended periods of time during the combinational therapy . the present study aimed to evaluate the influences of coadministration of antiepileptic drugs ( aeds ) on an antimalarial... | objective . the study aimed to evaluate the influences of coadministration of antiepileptic drugs ( aeds ) on an antimalarial candidate 99/411 pharmacokinetic ( pk ) profile
. method . for this
, single oral dose pk drug interaction studies were conducted between 99/411 and fda approved aeds , namely , phenytoin ( pht ) , carbamazepine ( cbz ) , and gabapentin ( gb ) in both male and female sd rats , to assess the coadministered and intersexual influences on 99/411 pk profile . results .
studies revealed that there were no significant alterations in the pk profile of 99/411 upon pht and cbz coadministration in both male and female rats , while systemic exposure of 99/411 was significantly increased by about 80% in female rats upon gb coadministration . in terms of auc
, there was an increase from 2471 586 to 4560 1396 ngh / ml .
overall , it was concluded that simultaneous administration of aeds with 99/411 excludes the requirements for dose adjustment , additional therapeutic monitoring , contraindication to concomitant use , and/or other measures to mitigate risk , except for gb coadministration in females .
these findings are further helpful to predict such interactions in humans , when potentially applied through proper allometric scaling to extrapolate the data . |
7,536 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the neurovascular unit is comprised of the endothelial cells which make up the vessels as well as several other associated cell - types including astrocytes and perivascular cells such as pericytes and smooth muscle cells .
pericytes wrap around vessels and are in direct contact with endothelial cells via gap junctions ( figure 1b ; reviewed in bergers and song , 2005 ) .
these cells provide structural support for vessels and also participate in vasomotion ( vaso - constriction and dilation ) thereby affecting cerebral blood flow .
pinocytosis and phagocytosis have been observed in pericytes , suggesting that these cells also play macrophagic roles .
blood vessels in the brain are also surrounded by the endfeet of astrocytes ( figure 1 ) .
astrocyte endfeet located on vessels interact directly with endothelial cells and are capable of up - take and/or release of a number of molecules ( e.g. amino acids , growth factors ; reviewed in abbott , 2002 ; abbot et al . , 2006 ) .
astrocytes are then able to release lactate into the extracellular milieu , providing neurons with the lactate necessary for energy production via glucose metabolism ( reviewed in tsacopoulos and magistretti , 1996 ) .
there are a number of reasons why we have included instruction and demonstration of the cerebral vasculature and the neurovascular unit in undergraduate neuroscience lecture and lab - based courses .
the first and most obvious is that the brain ( neurons , glia , etc . )
natural extensions of this fact include the neural and functional consequences of ischemia ( e.g. stroke ) or decreased oxygen content ( e.g. due to high altitude ) .
second , neuronal activity ( action potential generation ) comes at a high metabolic cost , requiring glucose metabolism .
this fact relates to the hemodynamic correlates of neural activity which is measured by blood - oxygen - level dependent function magnetic resonance imaging ( bold - fmri ; thompson et al .
finally , changes in vascularity ( e.g. vessel loss , angiogenesis ) have been... | one challenge of neuroscience educators is to make accessible to students as many aspects of brain structure and function as possible .
the anatomy and function of the cerebrovasculature is among many topics of neuroscience that are underrepresented in undergraduate neuroscience education . recognizing this deficit , we evaluated methods to produce archival tissue specimens of the cerebrovasculature and the neurovascular unit for instruction and demonstration in the teaching lab .
an additional goal of this project was to identify the costs of each method as well as to determine which method(s ) could be adapted into lab exercises , where students participate in the tissue preparation , staining , etc . in the present report , we detail several methods for demonstrating the cerebrovasculature and suggest that including this material can be a valuable addition to more traditional anatomy / physiology demonstrations and exercises . |
7,537 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is defined by the national institutes of health ( nih ) by having at least three of the following conditions : central obesity , elevated triglycerides , low high - density lipoprotein cholesterol , hypertension or elevated fasting plasma glucose . although it is widely accepted that lifestyle factors such as obesity , high caloric diet , and smoking contribute to the development of metabolic syndrome by virtue of their role in diabetes and cardiovascular disease
, substantial research supports the role of early life exposures in the etiology of metabolic syndrome and related disorders including obesity and type 2 diabetes ( t2d ) .
historical epidemiologic observations have led to further study of the association between the intrauterine environment and subsequent disease .
most notably , the dutch famine of 19441945 led to the epidemiologic observation that children born to mothers who were in the early stages of pregnancy during the famine were at significantly increased risk of cardiometabolic disorders in adulthood.1 hales and barker observed the relationship between low birth weight and increased risk for t2d in a british cohort , leading to the proposal of the thrifty phenotype hypothesis , which posited that malnutrition during pregnancy results in structural and functional changes in the developing fetus.2 since the proposal of the thrifty phenotype hypothesis in 1992 , numerous studies have replicated the finding that low birth weight and other pregnancy complications confer increased risk for adult chronic disease in the offspring , including hypertension , t2d , and cardiovascular disease.36 this concept has evolved into the developmental origins of adult disease
hypothesis , to encompass the interplay between an individual s genetic background and the intrauterine environment that results in permanent metabolic changes that impact the risk for later life chronic disease.7 changes occurring during critical periods of development , such as embryonic and fetal development , that promote... | metabolic syndrome is a growing cause of morbidity and mortality worldwide .
metabolic syndrome is characterized by the presence of a variety of metabolic disturbances including obesity , hyperlipidemia , hypertension , and elevated fasting blood sugar .
although the risk for metabolic syndrome has largely been attributed to adult lifestyle factors such as poor nutrition , lack of exercise , and smoking , there is now strong evidence suggesting that predisposition to the development of metabolic syndrome begins in utero .
first posited by hales and barker in 1992 , the thrifty phenotype hypothesis proposes that susceptibility to adult chronic diseases can occur in response to exposures in the prenatal and perinatal periods .
this hypothesis has been continually supported by epidemiologic studies and studies involving animal models . in this review , we describe the structural , metabolic and epigenetic changes that occur in response to adverse intrauterine environments including prenatal and postnatal diet , maternal obesity , and pregnancy complications . given the increasing prevalence of metabolic syndrome in both the developed and developing worlds , a greater understanding and appreciation for the role of the intrauterine environment in adult chronic disease etiology is imperative . |
7,538 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: brazil boasts the greatest plant diversity on the world ( approximately 55,000 species of higher plants ) .
brazilian plants represent a large source of potentially therapeutic compounds , a variety of which have been used in attempts to treat several infectious and/or inflammatory conditions .
esenbeckia species , such as esenbeckia leiocarpa ( rutaceae ) , are wide spread in several brazilian regions .
the presence of various chemical constituents , primarily alkaloids , has already been demonstrated in this genus [ 2 , 3 ] .
in addition , coumarins , chalcones , as well as triterpenes and lignans have been shown to be , at least in part , responsible for different biological properties already attributed to this herb , including antimalarial , antiparasitic , antimicrobial , and anticholinesterasic effects .
there are few studies investigating the anti - inflammatory effect of esenbeckia leiocarpa . however , previous reports have singled out alkaloids as playing a pivotal role in inflammatory conditions . for instance , jiao et al . showed that some alkaloids promote a potent inhibitory activity on the production of nitric oxide ( no ) , tumor necrosis factor ( tnf- ) , or interleukin 6 ( il-6 ) , in mouse macrophage raw264.7 cells stimulated by lipopolysaccharide ( lps ) .
others have demonstrated that the alkaloid 6-ethoxybuphanidrine was effective in inducing apoptosis in hl-60 and mda - mb-231 tumor cell lines .
moreover , chalcones were effective in inducing early apoptosis in hl60 cells [ 10 , 11 ] .
recently , esenbeckia leiocarpa was found to possess interesting anti - inflammatory activity in vivo since it protected against carrageenan - induced inflammation .
these cells are the first to arrive at inflammatory sites , where they secrete different cytokines / chemokines that attract either other pmns or other leukocytes [ 1315 ] . because the resolution of inflammation is known to occur by the elimination of apoptotic pmns by professional phagocytes , it is important to identify new agents... | despite the fact that esenbeckia leiocarpa , a brazilian plant , possesses potential anti - inflammatory properties , its effect in neutrophils , key players in inflammation , has never been investigated . in this study ,
a crude hydroalcoholic extract ( che ) was used to evaluate the potential toxic or agonistic effect of e. leiocarpa in human neutrophils . at a noncytotoxic concentration of 500 g / ml ,
che increased actin polymerization and cell signaling events , especially p38 mapk .
its modulatory activity on neutrophil cell apoptosis was investigated by cytology and by flow cytometry and , although che increased the apoptotic rate ( by cytology ) and increased annexin - v binding , it did not , unexpectedly , increase cd16 shedding .
che increased the degradation of the cytoskeletal proteins gelsolin and paxillin but , surprisingly , not of vimentin .
the proapoptotic activity of che was reversed by a pan - caspase inhibitor but not by a p38 inhibitor .
we conclude that che is a novel human neutrophil agonist that induces apoptosis by a caspase - dependent and p38-independent mechanism in an atypical fashion based on its lack of effect on cd16 shedding and vimentin degradation . since the resolution of inflammation occurs by elimination of apoptotic neutrophils , the ability of che to induce neutrophil apoptosis correlates well with its anti - inflammatory properties , as previously reported . |
7,539 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acne vulgaris is a common inflammatory disease of the pilosebaceous unit , which affects up to 87% adolescence and 54% of adults with varying degrees of severity .
left untreated or inadequately treated , acne vulgaris can lead to psychological and physical scarring .
treatment improves the qol of patients with acne and can prevent scarring . according to severity of acne , there are various topical and systemic treatment modalities . in systemic therapy ,
the multiple modes of action of isotretinoin ( 13-cis - retinoic acid ) makes this compound the major pharmacological breakthrough in acne therapeutics . over the time , oral isotretinoin has proven to be a
wonder drug that is highly effective in the treatment of all forms and grades of acne vulgaris , even in lower dosages .
oral isotretinoin in the standard regimen of 0.51.0 mg / kg / day for 1632 weeks causes many dose - dependent mucocutaneous and systemic adverse effects .
various studies have reinforced the view that lower doses of isotretinoin are also effective in terms of response , adverse effects , and cost ; therefore , other regimens should be used instead of the daily standard regimen .
there are few randomized comparative studies of low - dose regimens of oral isotretinoin in the indian literature .
thus , the present study was undertaken to compare the efficacy and tolerability of two different fixed low - dose oral isotretinoin regimens in moderate to severe acne vulgaris with a lager sample size and a longer follow - up period . to assess and compare the efficacy and tolerability of two fixed low - dose ( 20 mg daily and alternate day ) oral isotretinoin regimens in moderate to severe acne vulgaris .
to assess and compare the efficacy and tolerability of two fixed low - dose ( 20 mg daily and alternate day ) oral isotretinoin regimens in moderate to severe acne vulgaris .
this prospective randomized comparative study included 240 patients with moderate to severe acne vulgaris attending the outpatient clinic in the dermatology department... | background : oral isotretinoin is highly effective in all forms and grades of acne , even in lower dosages ( < 0.5 mg / kg / day ) .
there is a paucity of comparative data on the various low - dose regimens of oral isotretinoin in the indian literature.objectives:to assess and compare the efficacy and tolerability of two low - dose oral isotretinoin treatment regimens ( 20 mg daily and 20 mg alternate days ) in moderate to severe acne vulgaris.materials and methods : a total of 240 patients with moderate to severe acne vulgaris were selected and randomized into two groups and treated with a fixed dose of 20 mg of isotretinoin ( group a - daily and group b - alternate days ) for 24 weeks and followed up for 12 weeks post therapy.results:a total of 234 patients completed the study . at the end of therapy ,
decrease in the total acne loads up to 98.99% ( group a ) and 97.69% ( group b ) was achieved from the baseline ( p < 0.01 ) , excellent response was observed in 98.3% ( group a ) and 93.96% ( group b ) patients ( p = 0.166 ) . in the severe acne ,
group a performed significantly better than group b until the end of 36 weeks . while in the moderate acne , significant difference in the response between both groups was observed only up to 12 weeks .
no serious side effect was observed.conclusion:both isotretinoin regimens were well tolerated and found to be an effective treatment for moderate to severe acne vulgaris .
however , in moderate acne 20 mg alternate day regimen may be preferred .
a 20 mg daily regimen is a better choice for severe acne in terms of response.limitation:small sample size and short follow - up period . |
7,540 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: choledochal cysts are congenitally malformed thin walled , dilated , intrahepatic or extrahepatic bile ducts .
these cysts offer a major challenge for diagnosis and treatment during pregnancy because of the altered physiology associated with it .
there has to be fine balance between the benefits as well as the risks associated with the treatment .
it is secondary to raised intracystic pressure because of distal stricture or stones [ 4 , 5 ] .
spontaneous rupture of the choledochal cyst during immediate post partum has rarely been reported [ 7 , 8 ] . here
we describe a young female who presented to us with choledochal cyst with cholangitis during pregnancy .
but unfortunately she presented in the immediate post partum with peritonitis secondary to spontaneous rupture of the cyst .
the rarity of this presentation in post partum poses a diagnostic dilemma in the minds of treating clinician .
this complication should be kept in mind while treating a known patient of choledochal cyst who presents to the emergency with peritonitis .
a 27-year - old primigravida presented to surgical emergency with obstructive jaundice and grade ii cholangitis at 6 months of pregnancy .
she was evaluated and was found to have a choledochal cyst on ultrasound and this was subsequently confirmed as type iv ( fig .
1 ) on magnetic resonance cholangiopancreatography ( mrcp ) . for these complaints , she underwent ercp and a biliary stent was placed so as to tide over the situation .
an endobiliary stent could be placed and she was being managed conservatively but had pain abdomen , fever and vomiting 1 week after stenting .
tachycardia ( pr : 120/min ) was present and there was generalized guarding and rigidity on abdominal examination .
a contrast - enhanced ct scan was done that revealed the rupture of the suprapancreatic part of the choledochal cyst with free fluid in the abdominal cavity ( fig .
2 ) . after optimization , this patient underwent cyst excision with roux - en - y hepaticojejunostomy .
histopathology of this excised... | with the advent of newer radiological investigations , choledochal cysts are being diagnosed more often in present era .
these cysts are commonly diagnosed in early childhood and infancy , although some go undetected to be diagnosed in adulthood .
these malformations are associated with multiple complications like cholangitis , jaundice , pancreatitis , rupture or even malignancy . here
we describe a post partum female , who was diagnosed to have choledochal cyst during sixth month of pregnancy .
she presented with obstructive jaundice in cholangitis and was subjected to endoscopic retrograde cholangiopancreatography ( ercp ) with stenting .
this female delivered normally at term .
she again had jaundice with cholangitis during early post partum period .
endoscopic stenting could be performed .
she had features of peritonitis after 1 week of stenting .
investigations were performed and a diagnosis of spontaneous rupture of choledochal cyst was made .
she underwent laparotomy and lavage with complete excision of the choledochal cyst and roux - en - y hepaticojejunostomy . |
7,541 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the introduction of osseointegration and the use of endosseous implants provide alternative treatment options to clinicians for all indications of edentulism.1 implant - supported , fixed restorations are usually classified as screw- or cement - retained.2,3 the advantage of screw - retained restorations is the combination of a rigid connection between the restoration - abutment complex and its retrievability .
however , these restorations are usually more expensive than cement - retained restorations because of the use of extra components and laboratory costs.4 cement - retained restorations were introduced to compensate for problems of screw loosening and the lack of esthetics of screw - retained restorations.4 the lack of fastening screws in cement - retained restorations reduces the possibility of preload stress and screw loosening.5 the major advantages of cement - retained restorations are the passive fit of frameworks , enhanced esthetics resulting from lack of screw access holes , and reduced complexity of laboratory procedures and chair - side time.6,7,8 the disadvantages of cement - retained restorations include the requirement for extra time for cementation , removal of residual excess cement , limited design possibilities for superstructure , and the reduced possibility for modifying treatment in case of periimplantitis.9 the existence of residual excess cement in peri - implant sulcus is a common complication of cement - retained implant prostheses.10,11 if there is excess cement located in the soft tissue deeper than 3 mm , it might be difficult to observe and remove .
insufficient removal of excess cement may result in swelling , soreness , exudation or bleeding on probing , and can initiate a local inflammatory process , which is evidence of peri - implant disease and can ultimately lead to implant failure.12,13,14 moreover , removal of excess cement may cause scratching and gouging on the implant surfaces when plastic and metal scalers are used.15 several authors have reported on techniques... | the major drawback of cement - retained restorations is the extrusion of the excess cement into the peri - implant sulcus , with subsequent complications .
insufficient removal of the excess cement may initiate a local inflammatory process , which may lead to implant failure .
this article presents a method of controlling cement flow on implant abutments , minimizing the excess cement around implant - retained restorations . |
7,542 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the cerebral abscess is a common central nervous system infection that can result from trauma , hematogenous spread , or spread from an adjacent infection such as otitis media or sinusitis . despite exhaustive searches ,
15 to 30% of abscesses are termed cryptogenic when no source of infection is identified20 ) . a distant infection focus that can cause brain abscesses
is a cardiac right to left shunt , which is related to patent foramen ovale15 ) , cyanotic cardiac disease15 ) or pulmonary arteriovenous malformation or fistula ( avf ) .
pulmonary avf is a rare congenital vascular malformation involving direct communication between the pulmonary artery and vein without an intervening capillary bed .
approximately 8095% of pulmonary avfs are associated with hereditary hemorrhagic telangiectasia ( hht ) , known as osler - weber - rendu syndrome5,8,9 ) .
the clinical triads of pulmonary avf is cyanosis , exertional dyspnea , and digital clubbing ; however , 56% of one large series were asymptomatic8 ) .
the most prominent central nervous system ( cns ) complications associated with pulmonary avfs are neurologic events , including transient ischemic attacks31 ) , recurrent stroke1,6,18,27 ) , brain abscesses , and seizures26 ) .
. we will focus on the cryptogenic brain abscess as developed by patients with idiopathic pulmonary avf , which may be detected only if we consider it may cause the brain abscess .
a 65-year - old woman was admitted with a 1-month history of headache and cognitive impairment that had become aggravated 10 days prior .
she showed impairment in orientation and judgment , but there were no lateralization signs of motor paralysis or cranial nerve deficits .
there was no history of diabetes mellitus , hypertension , lung disease or heart disease .
her blood pressure was 110/70 mmhg , pulse rate was 74/min , body temperature was 36.5c , and her respiration rate was 20 breaths / min .
erythrocyte sedimentation rate was 54 mm / h and c - reactive protein ( crp ) was 0.22 mg / l .
arterial blood... | brain abscess commonly occurs secondary to an adjacent infection ( mostly in the middle ear or paranasal sinuses ) or due to hematogenous spread from a distant infection or trauma .
pulmonary arteriovenous fistulas ( avfs ) are abnormal direct communications between the pulmonary artery and vein .
we present two cases of brain abscess associated with asymptomatic pulmonary avf .
a 65-year - old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior .
an magnetic resonance ( mr ) imaging revealed a brain abscess with severe edema in the right frontal lobe .
we performed a craniotomy and abscess removal .
bacteriological culture proved negative .
her chest computed tomography ( ct ) showed multiple avfs .
therapeutic embolization of multiple pulmonary avfs was performed and antibiotics were administered for 8 weeks . a 45-year - old woman presented with a 7-day history of progressive left hemiparesis .
she had no remarkable past medical history or family history . on admission ,
blood examination showed a white blood cell count of 6290 cells / ul and a high sensitive c - reactive protein of 2.62 mg / l .
ct and mr imaging with mr spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess .
a chest ct revealed a pulmonary avf in the right upper lung .
the pulmonary avf was obliterated with embolization .
there needs to consider pulmonary avf as an etiology of cerebral abscess when routine investigations fail to detect a source . |
7,543 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in the field of dentistry , gingival hypertrophy ( gh ) is a common presenting complaint , especially among patients belonging to pediatric age group .
gingivitis is a commonly occurring phenomenon since the oral cavity is a potential site for active infection as it is constantly exposed to pathogenic microorganisms .
the prevalence of gh among school going children is nearly 14% , inflammatory origin being the most common cause followed by chronic drug intake .
hence , there is a tendency among us to consider gh as a mere inflammatory response to local infection rather than considering systemic illnesses ; this can eventually lead to delay in diagnosis and initiating appropriate treatment .
gh due to acute myeloid leukemia ( aml ) in a child is extremely rare . here
, we report a case of aml ( subtype m5 of fab classification ) in a 3-year - old male child wherein the disease primarily presented as gh .
a 3-year - old male child presented to us with fever and body pain for 2 weeks , gum swelling for 1-month duration , initially presented to a pediatrician and a dentist , for which symptomatic treatment was given . the child was again reviewed with the pediatrician after 1 week with persisting symptoms .
no history of halitosis or dental caries . on general examination , he had pallor ; there was no icterus , cyanosis , clubbing , pedal edema , or generalized lymphadenopathy .
oral examination revealed the enlargement of maxillary and mandibular gingiva covering two - third of the crown structure in buccal , lingual , and palatal aspects .
gingiva was reddish with the loss of stippling , soft , spongy , bleeding on touch but was nontender and not warm [ figure 1 ] . on abdominal examination , the liver was palpable 2.5 cm below the right costal margin , and the spleen was palpable 2 cm beyond the left costal margin .
g / l , total white blood cell count was 5.6 10/l with 90% blast cells and 10% lymphocytes , and platelet count was 0.9 10/l .
his renal and liver function tests were within the normal range ;... | acute leukemia is the most common malignant disorder of childhood .
acute leukemia is characterized by marrow failure due to the replacement of marrow elements by leukemic blasts .
gingival hypertrophy ( gh ) due to acute myeloid leukemia ( aml ) in a child is extremely rare . here
, we report a case of aml ( subtype m5 of fab classification ) in a 3-year - old male child wherein the disease primarily presented as gh . |
7,544 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: interferon - alfa ( ifn- ) monotherapy has been found with normalization of alanine aminotransferase ( alt ) levels in a few patients diagnosed as non - a , non - b hepatitis even before hepatitis c virus ( hcv ) was identified as the chief etiologic agent in this diagnosis . in 1989 ,
the first cases of successful treatment of documented chronic hepatitis c ( chc ) with ifn- monotherapy were reported , but relapse after the cessation of treatment was common [ 2 , 3 ] .
the introduction of combination therapy with ifn- and ribavirin has markedly improved treatment response . nevertheless , less than one - half of patients with chc were able to experience a favorable response to the combination therapy [ 46 ] . since 2000 , the attachment of inert polyethylene glycol to conventional ifn- , pegylated ifn- ( pegifn- ) , reduced degradation and clearance , prolonging the half - life of ifn and permitting less frequent , weekly dosing while maintaining higher sustained ifn levels ( compared with 3 times weekly for conventional ifn ) .
now , pegifn--ribavirin combination treatment has been recommended for all patients infected with hcv . for patients infected with hcv genotype 1 ( hcv-1 ) ,
the recommended treatment duration is 48 weeks , whereas for patients infected with hcv-2 or hcv-3 , the recommended treatment duration is 24 weeks .
there are two distinct but complementary mechanisms for the antiviral effects of ifn- : ( a ) induction of a non - virus - specific antiviral state in infected cells , resulting in direct inhibition of viral replication , and ( b ) immunomodulatory effects that enhance the host 's specific antiviral immune responses and may accelerate the death of infected cells .
food and drug administration ( fda ) has approved 3 ifn preparations for treatment of hcv : ( a ) 3 million units ( mus ) ifn--2a 3 times weekly ; ( b ) 3 mus of ifn--2b 3 times weekly ; and ( c ) 9 gs of ifn alfacon-1 twice weekly , or 15 g 3 times weekly in nonresponders . pegifn is a product of pegylation to... | since 1986 , interferon - alfa ( ifn- ) monotherapy has been administered for patients with chronic hepatitis c ( chc ) . however , sustained response rate is only about 8% to 9% .
subsequent introduction of ribavirin in combination with ifn- was a major breakthrough in the treatment of chc .
sustained virological responses ( svrs ) rate is about 30% in hepatitis c virus genotype 1 ( hcv-1 ) patients , and is about 65% in hcv-2 or -3 patients .
after 2000 , pegylated interferon ( pegifn ) much improved the rates of svr .
presently , pegifn--ribavirin combination therapy has been current standard of care for patients infected with hcv . in patients with hcv-1 ,
treatment for 48 weeks is optimal , but 24 weeks of treatment is sufficient in hcv-2 or -3 infected patients .
clinical factors have been identified as predictors for the efficacy of the ifn - based therapy .
the baseline factor most strongly predictive of an svr is the presence of hcv-2 or -3 infections .
rapid virological response ( rvr ) is the single best predictor of an svr to pegifn - ribavirin therapy .
if patients ca n't achieve a rvr but achieve a complete early virological response ( cevr ) , treatment with current standard of care can provide more than 90% svr rate .
hcv-1 patients who do not achieve an evr should discontinue the therapy .
recent advances of protease inhibitor may contribute the development of a novel triple combination therapy . |
7,545 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: twelve adult beagle dogs , 110 years old and weighing 9.515.8 kg , were used in this study .
dogs were divided into a conscious group ( n=6 ) and a sedated group ( n=6 ) .
all dogs were
healthy based on physical examination and normal cbc and serum biochemistry including
alanine aminotransferase , aspartate aminotransferase , alkaline phosphatase ,
gamma - glutamyltranspeptidase , ammonia , and fasting and post - prandial total bile acid levels .
prior to the ceus study , b - mode us was performed on all the dogs , and no focal or diffuse
hepatic abnormalities were noted .
all b - mode us and ceus examinations were performed by the
same sonographer ( km ) with 10 years of experience in performing liver ultrasound .
an ultrasound scanner ( aplio xg , toshiba medical systems , otawara , japan ) with a 511 mhz
broadband linear probe ( plt-704 at , toshiba medical systems ) suitable for pulse subtracting
imaging was used for ceus .
imaging was performed with a low mechanical index of 0.21 and a
frame rate of 23 frames per sec .
the contrast imaging gain was set at 80 db , and the focus
was set at a depth of 4 cm .
scanning in the
sedated group was performed under anesthesia with propofol at an induction dosage of 6 mg / kg
and a maintenance rate of 0.40.6 mg / kg / min .
the
dogs were positioned in left lateral recumbency , and the right hv was identified using an
intercostal approach ( fig .
1.color doppler and ceus images of the right hv obtained using a right intercostal
approach .
( a ) right hv displayed in blue with color doppler flowed into the caudal
vena cava ( cvc ) .
( b ) at 8 sec , the hv , outlined by a dashed line , was not enhanced , although
surrounding liver parenchyma was slightly enhanced .
region of interest ( roi ) was
manually placed in the hv ( circle ) to measure the tissue intensity .
( c ) hv reached its
pi , which was similar in intensity to the liver parenchyma ( shown here 23 sec after
bolus injection of contrast agent ) .
( d ) at the end of... | contrast - enhanced ultrasonography ( ceus ) of the hepatic vein can assess intrahepatic
hemodynamic changes and has been studied as a noninvasive method to assess the severity of
portal hypertension and hepatic fibrosis in humans .
however , few reports have described
its usefulness in veterinary medicine . the purpose of this study was to characterize ceus
findings of the hepatic vein in normal dogs and assess the repeatability of this method
both in a conscious group ( n=6 ) and a sedated group ( n=6 ) .
sonazoid ( 0.01
ml / kg ) was used as a contrast agent , and scanning of the hepatic vein
was performed for 2 min .
time - intensity curves were generated from regions of interest in
the hepatic vein .
four perfusion parameters were measured for quantitative analysis :
hepatic vein arrival time ( hvat ) , time to peak ( ttp ) , time to peak phase ( ttpp ) and
wash - out ratio ( wr ) .
ceus examinations were performed three times in each dog . the median
( range )
values of hvat , ttp , ttpp and wr in the conscious group were 13.5 sec ( 922 sec ) ,
12.5 sec ( 624 sec ) , 8 sec ( 613 sec ) and 78.0% ( 60.791.7% ) , respectively .
median ( range )
values of hvat , ttp , ttpp and wr in the sedated group were 12 sec ( 817 sec ) , 12.5 sec
( 917 sec ) , 9 sec ( 713 sec ) and 84.1% ( 63.094.4% ) , respectively .
the coefficients of
variation of these parameters in the conscious and sedated groups were 7.629.7% and
11.814.8% , respectively . |
7,546 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in the century of spectacular medical therapies , there is still a lack of substance that may protect the brain cells against neurodegeneration . since the discovery of neurosteroids , scientists have made a great effort to evaluate their function , including possible neuroprotective properties . according to most commonly used definition neurosteroids
cover both steroid hormones , which are synthesized de novo in neurons and glial cells , and their metabolites acting within the central nervous system ( cns ) ( compagnone and mellon , 2000 ) ( figure 1 ) .
hormones may regulate brain function in an autocrine and paracrine manner via membrane or nuclear receptors ( baulieu , 1998 ; baulieu et al .
, 2001 ; plassart - schiess and baulieu , 2001 ; singh , 2006 ) . regular neurosteroids act as positive or negative modulators of neurotransmitter receptors : gamma - amino butyric acid a ( gabaa ) receptor , n - methyl - d - aspartate ( nmda ) receptor , -amino-3-hydroxy-5-methylisoxazole propionate ( ampa ) receptor , sigma-1 ( 1 ) , nicotinic , muscarinic , kainic , serotoninergic and glycine receptors , regulate gene expression , or signaling cascades ( wojtal et al . , 2006 ; borowicz et al . ,
we review the main neurosteroids , including pregnenolone ( preg ) and pregnenolone sulfate ( pregs ) , progesterone ( prog ) , allopregnanolone ( allo ) , dehydroepiandrosterone ( dhea ) , dhea sulfate ( dheas ) , deoxycorticosterone ( doc ) , and tetrahydrodeoxycorticosterone ( thdoc ) .
, preg is a hormone precursor , prog , doc , and dhea represent hormones , while allo ( a prog metabolite ) and thdoc ( a doc derivative ) belong to neurosteroids , which are entirely devoid of hormonal action .
synthetic neurosteroids have even longer half - time , and may be administered orally , in contrast to natural steroids ( wojtal et al . , 2006 ; borowicz et al . ,
neuroprotection involves mechanisms protecting against neuronal injury or degeneration in the central and peripheral nervous system .
all these processes may be a... | neurosteroids were initially defined as steroid hormones locally synthesized within the nervous tissue .
subsequently , they were described as steroid hormone derivatives that devoid hormonal action but still affect neuronal excitability through modulation of ionotropic receptors .
neurosteroids are further subdivided into natural ( produced in the brain ) and synthetic .
some authors distinguish between hormonal and regular neurosteroids in the group of natural ones .
the latter group , including hormone metabolites like allopregnanolone or tetrahydrodeoxycorticosterone , is devoid of hormonal activity .
both hormones and their derivatives share , however , most of the physiological functions .
it is usually very difficult to distinguish the effects of hormones and their metabolites .
all these substances may influence seizure phenomena and exhibit neuroprotective effects .
neuroprotection offered by steroid hormones may be realized in both genomic and non - genomic mechanisms and involve regulation of the pro- and anti - apoptotic factors expression , intracellular signaling pathways , neurotransmission , oxidative , and inflammatory processes .
since regular neurosteroids show no affinity for steroid receptors , they may act only in a non - genomic mode .
multiple studies have been conducted so far to show efficacy of neurosteroids in the treatment of the central and peripheral nervous system injury , ischemia , neurodegenerative diseases , or seizures . in this review
we focused primarily on neurosteroid mechanisms of action and their role in the process of neurodegeneration .
most of the data refers to results obtained in experimental studies .
however , it should be realized that knowledge about neuroactive steroids remains still incomplete and requires confirmation in clinical conditions . |
7,547 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: streptococcus pneumoniae otherwise call pneumococcus has remained an extremely important human bacterial pathogen since its initial recognition in the late 1800s and remained an important public health concern throughout the world .
globally it is the most common cause of community - acquired pneumonia ( cap ) , sporadic bacterial meningitis and bacteraemia .
while pneumococcal disease is a significant cause of morbidity and mortality worldwide , some groups bear a disproportionate share of the burden , such as the very young , the elderly , the economically disadvantaged , africans , and those with hiv / aids . from the beginning of the antibiotic era to the mid-1970s , pneumococcus remained uniformly susceptible to all classes of antibiotics that had been active against the organism , with the possible exception of tetracycline .
however , in 1977 and 1978 an outbreaks of penicillin - resistance pneumococci ( prp ) were reported in durban and johannesburg , south africa .
although they were originally called prp , these organisms appeared to have acquired genetic material that encoded resistance to both penicillin and other commonly used antibiotics .
the major mechanism of resistance involves the introduction of mutations in genes encoding penicillin - binding proteins and selective pressure is thought to play an important role .
high - level penicillin resistance , macrolide resistance and multidrug - resistance often complicate the management of pneumococcal infection and make choosing empiric antimicrobial therapy for suspected cases of meningitis and pneumonia increasingly difficult .
an alarming increase in infections due to penicillin non - susceptible pneumococci ( pnsp ) has been documented in nearly all countries in the world .
reported 30.4% of pneumococci as non - susceptible to penicillin in four african cities ( abidjan , casablanca , dakar , tunisia ) . in kano ,
north - west nigeria , 93% , 92% , 84% , 53% and 21% of pneumococci were non - susceptible to penicillin , co - trimoxazole ,... | background : an alarming increase in infections due to penicillin non - susceptible pneumococci ( pnsp ) has been documented in nearly all countries .
increasingly , pnsp are also resistant to other antibiotics , and a growing number of clinical failures following the use of these agents have been reported.aims:to determine the resistance pattern of pneumococcal isolates from patients with invasive pneumococcal infection in north west nigeria.materials and methods : in a cross - sectional study clinical specimens were obtained from patients with community acquired pneumonia ( cap ) , meningitis and bacteraemia over a 2 year period .
pneumococcus strains were identified .
isolates were tested against a panel of antibiotics using e - test strips , and interpreted according to the clsi criteria .
0.06 g / ml was used as break point for penicillin .
analysis was carried out using descriptive statistics ; relationships determined using chi - squared or fisher 's exact tests , with p < 0.05 regarded as significant.results:total number of isolates was 132 .
twenty - two ( 16.7% ) of the isolates were fully sensitive to penicillin while 73 ( 55.3% ) and 37 ( 28.0% ) were intermediately and fully resistant , respectively .
one hundred and twenty - seven ( 96.2% ) of the isolates were fully resistant to trimethoprim sulphamethoxazole .
eleven ( 8.5% ) were fully resistant to amoxicillin and 104 ( 78.8% ) and 17 ( 12.9% ) were intermediately resistant and fully susceptible .
one hundred and six ( 80.3% ) of the isolates were fully susceptible to chloramphenicol .
resistance to penicillin was shown to infer resistance to other antibiotics.conclusions:pneumococcal resistance is common in north west nigeria .
ceftriaxone retains excellent activity against most of the invasive isolate , while trimethoprim - sulphamethoxazole is almost uniformly resistant . |
7,548 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: during malignant transformation , cells undergo stages of gene expression reprogramming and mutagenesis that alter their metabolic phenotype(s ) [ 15 ] . initial stimuli ( not all known ) dysregulate information signaling and activate oncogenes and/or cancer stem cells , resulting in a partial glycolytic warburg
phenotype [ 15 ] in which pyruvate is diverted , at least to a certain extent , from oxidative phosphorylation ( oxphos ) .
high proliferation and impaired angiogenesis subsequently cause hypoxia in certain regions within a growing tumor , and then hypoxia - mediated metabolic reprogramming ( such as that promoted by hypoxia - induced factor , hif [ 68 ] ) further intensifies the glycolytic phenotype and may nearly completely divert pyruvate from pyruvate dehydrogenase ( pdh ) , that is , from oxphos .
the sustained high rate of cell proliferation , however , results in aglycemia , initiating the revival of oxphos in conjunction with the promotion of glutaminolysis [ 1 , 2 , 9 , 10 ] .
the overall glutaminolysis provides cytosolic pyruvate / lactate and also yields nadph via citrate export from mitochondria and subsequent atp - citrate lyase and malic enzyme reactions .
this compensates for the reduced net energy production by the glycolytic pathway and pentose phosphate pathway ( ppp ) .
pyruvate imported into mitochondria is the precursor of not only acetyl - coa but also citrate , which is required for fatty acid synthesis and hence for phospholipid synthesis , so it is essential for cell growth [ 15 ] .
the final established phenotype is exemplified by human glioblastoma cells , which , despite their low respiration , maintain a constant pyruvate flux through pdh and hence partial oxphos .
for the purpose of this paper , we shall use the term glutaminolysis in a more general way than just the transformation of glutamine to 2-oxoglutarate ( 2og ) .
if 2og resulting from glutamine acts in the forward krebs cycle ( despite possible ongoing citrate extrusion and truncation of the cycle so that... | isocitrate dehydrogenase 2 ( idh2 ) is located in the mitochondrial matrix .
idh2 acts in the forward krebs cycle as an nadp+-consuming enzyme , providing nadph for maintenance of the reduced glutathione and peroxiredoxin systems and for self - maintenance by reactivation of cystine - inactivated idh2 by glutaredoxin 2 . in highly respiring cells
, the resulting nad+ accumulation then induces sirtuin-3-mediated activating idh2 deacetylation , thus increasing its protective function .
reductive carboxylation of 2-oxoglutarate by idh2 ( in the reverse krebs cycle direction ) , which consumes nadph , may follow glutaminolysis of glutamine to 2-oxoglutarate in cancer cells . when the reverse aconitase reaction and citrate efflux are added , this overall anoxic glutaminolysis mode may help highly malignant tumors survive aglycemia during hypoxia
. intermittent glycolysis would hypothetically be required to provide atp .
when oxidative phosphorylation is dormant , this mode causes substantial oxidative stress .
arg172 mutants of human idh2frequently found with similar mutants of cytosolic idh1 in grade 2 and 3 gliomas , secondary glioblastomas , and acute myeloid leukemia
catalyze reductive carboxylation of 2-oxoglutarate and reduction to d-2-hydroxyglutarate , which strengthens the neoplastic phenotype by competitive inhibition of histone demethylation and 5-methylcytosine hydroxylation , leading to genome - wide histone and dna methylation alternations .
d-2-hydroxyglutarate also interferes with proline hydroxylation and thus may stabilize hypoxia - induced factor . |
7,549 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
panel of samples - in this study , we included 34 samples from long - term
residents of an endemic amazon rural community , colniza , state of mato grosso ( mt ) ;
subclinical malaria infections were characterised in this area during a detailed
descriptive epidemiology study carried out between 2003 - 2009 ( maciel 2011 ) . in that study ,
the parasitological and
epidemiological data from seven consecutive years identified a small community , herein
referred to as colniza , where 55.91% of all malaria cases were subclinical .
consequently , malaria infection could not be excluded a priori in the
individuals exposed to malaria in colniza .
colniza is located inside the amazon forest
in the northwest of mt , roughly 1,200 km from the capital cuiab ; colniza can be
accessed by two paved roads , which connect mt to the states of amazonas ( br-174 ) and
rondnia ( mt-206 ) .
the economic activities of this municipality are based mainly on wood
extraction and livestock .
malaria is transmitted year - round with an annual
parasitological index ( api ) of 98.5 cases per 1,000 inhabitants ( maciel 2011 ) .
samples were collected in this area in 2008 during a
survey of asymptomatic patients in the area .
the following eligibility criteria were
included : ( i ) a minimum age of 15 years , ( ii ) the absence of pregnancy , ( iii ) a lifetime
exposure to malaria in the colniza area , ( iv ) no self - reported symptoms suggestive of
malaria , such as fever , myalgia , chills or headache and ( v ) negative blood parasites by
direct examination of giemsa - stained thick blood smears . although all samples were
negative by om , 14 out of 34 ( 41% ) samples were positive according to a malaria - specific
nested - pcr ( snounou et al .
consequently , all of the colniza samples were
initially considered individuals who might have submicroscopic parasitaemia and may
therefore be potential malaria carriers . as a positive control ,
we included 52 field
samples from patients who sought... | the polymerase chain reaction ( pcr)-based methods for the diagnosis of malaria
infection are expected to accurately identify submicroscopic parasite carriers .
although a significant number of pcr protocols have been described , few studies have
addressed the performance of pcr amplification in cases of field samples with
submicroscopic malaria infection . here , the reproducibility of two well - established
pcr protocols ( nested - pcr and real - time pcr for the plasmodium 18
small subunit rrna gene ) were evaluated in a panel of 34 blood field samples from
individuals that are potential reservoirs of malaria infection , but were negative for
malaria by optical microscopy .
regardless of the pcr protocol , a large variation
between the pcr replicates was observed , leading to alternating positive and negative
results in 38% ( 13 out of 34 ) of the samples .
these findings were quite different
from those obtained from the microscopy - positive patients or the unexposed
individuals ; the diagnosis of these individuals could be confirmed based on the high
reproducibility and specificity of the pcr - based protocols .
the limitation of pcr
amplification was restricted to the field samples with very low levels of
parasitaemia because titrations of the dna templates were able to detect < 3
parasites/l in the blood . in conclusion ,
conventional pcr protocols require careful
interpretation in cases of submicroscopic malaria infection , as inconsistent and
false - negative results can occur . |
7,550 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: tgf- is a multi - functional cytokine and its signaling pathway contributes to a wide range of immunological and biological effects on various cell types and several diseases .
tgf- has regulatory functions in cell proliferation , differentiation , migration , and survival that affect multiple biological processes such as cell development , carcinogenesis , fibrosis , and wound healing , as well as immune responses ( 1 ) .
there is some controversy in the literature as to the precise functions of tgf- ; for example , in atherosclerosis , it is not clear whether tgf- is pro - atherogenic or anti - atherogenic .
the inhibition of tgf-1 activity induces pro - atherogenic changes in the vessel wall of atherosclerotic animal models ( 2 ) .
furthermore , the neutralization of tgf-1 leads to an inflammatory response of the vessel wall and provokes plaque instability ( 3 ) .
after the engagement of tgf- type i & ii receptors , the smad - dependent pathways are activated .
the biological effects that result depend on the types of smad complex involved in this signaling response ( 4 ) .
this process is modulated by other accessory receptors such as tgf- type iii receptor ( 5 ) .
although the expression of endoglin is increased in atherosclerotic lesions , the functional roles of endoglin in atherosclerosis have not been fully clarified .
this review aims to suggest a hypothetical role for endoglin in atherosclerosis on the basis of previous reports .
endoglin ( cd105 ) is a homodimer composed of two identical 95 kda disulfide - linked subunits , and it is known as a hypoxia - inducible transmembrane glycoprotein ( 6 ) .
it consists of three domains : a large extracellular domain , a transmembrane domain , and a short intracellular domain .
the extracellular domain contains an arg - gly - asp ( rgd ) tri - peptide , four n - linked glycosylation sites , and one o - linked glycosylation site ( 7 ) .
the intracellular domain includes several serine and threonine residues , some of which are phosphorylation sites ( 8) .... | endoglin ( also known as cd105 or tgf- type iii receptor ) is a co - receptor involved in tgf- signaling . in atherosclerosis , tgf- signaling is crucial in regulating disease progression owing to its anti - inflammatory effects as well as its inhibitory effects on smooth muscle cell proliferation and migration .
endoglin is a regulator of tgf- signaling , but its role in atherosclerosis has yet to be defined .
this review focuses on the roles of the various forms of endoglin in atherosclerosis .
the expression of the two isoforms of endoglin ( long - form and short - form ) is increased in atherosclerotic lesions , and the expression of the soluble forms of endoglin is upregulated in sera of patients with hypercholesterolemia and atherosclerosis .
interestingly , long - form endoglin shows an atheroprotective effect via the induction of enos expression , while short - form and soluble endoglin enhance atherogenesis by inhibiting enos expression and tgf- signaling .
this review summarizes evidence suggesting that the different forms of endoglin have distinct roles in atherosclerosis . |
7,551 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acute disseminated encephalomyelitis ( adem ) is an immune - mediated , demyelinating disease of the central nervous system . in 50 to 75% of all cases , the clinical onset of disease
is preceded by viral or bacterial infections , mostly nonspecific upper respiratory tract infections . in children who are diagnosed with adem
, a history of febrile event can be established in 50 to 75% of all cases1,2 ) .
vaccine - associated adem is frequently observed after measles , mumps or rubella vaccination1 ) . to date , there are no reported large population studies or estimated incidence rates reporting an association between influenza vaccination and adem3 ) .
we report an uncommon case involving a previously healthy 34-month - old boy in whom adem developed following vaccination against novel influenza a ( h1n1 ) .
a previously healthy 34-month - old boy visited emergency room on december 2009 with a clonic seizure affecting his left hand .
he was administered a vaccination against novel influenza a ( h1n1 ) five days ago and had no history of fever following this .
he had received prior vaccination against 2008 influenza , japanese b encephalitis , diphtheria - pertussis - tetanus ( dpt ) , poliomyelitis , measles and hepatitis b , without complications . on assessment ,
cranial nerve and sensory examination , deep tendon reflex and pathologic reflex did not show any abnormalities or pathologic findings .
real - time reverse transcription - polymerase chain reaction ( rt - pcr ) for h1n1 influenza was negative .
spinal tap revealed clear and colorless cerebrospinal fluid ( csf ) containing 58 white cells/l ( 100% lymphocytes ) .
csf protein level was 32.1 mg / dl and glucose level was 57 mg / dl ( serum glucose concentration 93 mg / dl ) .
complete blood count , erythrocyte sedimentation rate , c - reactive protein , blood culture , liver and renal function test and sleep electroencephalogram were normal . magnetic resonance imaging ( mri ) revealed multiple patchy hyperintense lesions in the frontal and parietal... | acute disseminated encephalomyelitis ( adem ) is an inflammatory demyelinating disease of the central nervous system that typically follows an infection or vaccination and has a favorable long - term prognosis .
we describe the first reported case of adem after vaccination against novel influenza a ( h1n1 ) . a previously healthy 34-month - old boy who developed adem presented with a seizure and left - sided weakness 5 days after vaccination against novel influenza a ( h1n1 ) .
cerebrospinal fluid examination revealed elevated cell counts .
t2-weighted images and fluid - attenuated inversion recovery images revealed multiple patchy hyperintense lesions in the frontal and parietal subcortical white matter and the left thalamus .
after the administration of intravenous corticosteroid , the patient 's clinical symptoms improved and he recovered completely without neurologic sequelae . |
7,552 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 56-year - old caucasian male with polycythemia vera controlled with interferon alpha treatment for 2 years presented to our institution with decreased vision , greater on the right than left , scintillating scotomata , and floaters .
intraocular pressures were 14 mmhg in the right eye ( od ) and 12 mmhg in the left eye ( os ) .
fundus examination on the right showed nerve fiber layer swelling at 12 and 6 oclock , a very distended and tortuous superior branch retinal vein , one flame - shaped peripapillary hemorrhage , and one preretinal hemorrhage alongside areas of ischemia at the inferior pole ( figure 1 ) .
the left eye showed one peripapillary hemorrhage with a white center ( roth spot ) with slight retinal nerve fiber layer swelling at the optic disc margin superiorly and inferiorly , but much less venous distention ( figure 2 ) .
fluorescein angiography confirmed impending retinal vein occlusion with delayed transit time ( 20 seconds for the right superior hemi vein ) , more in od than os , but no choroidal infarction .
interferon was stopped immediately , and the patient started pentoxifylline 400 mg every day to treat polycythemia vera , and prednisone 40 mg every day to counter any interferon - induced inflammation . within 3 weeks ,
his vision became clear , the afferent papillary defect resolved , and fundus examination revealed complete resolution of the aforementioned vascular abnormalities .
he was slowly tapered down to prednisone 7.5 mg every other day and maintained on pentoxifylline 400 mg three times a day .
here we describe the course and likely pathophysiology of interferon alpha and polycythemia vera - associated impending aion , retinal vessel ischemia , and hemorrhage .
our patient s bilateral optic disc edema did not have the supporting signs or symptoms of elevated intracranial pressure or malignant hypertension .
in fact , our patient s optic disc edema was concentrated at the superior and inferior poles , corresponding to the locations of venous compromise .
thus , considering... | we describe the course and likely pathophysiology of impending anterior ischemic optic neuropathy ( aion ) and retinal vein occlusion in a 56-year - old man with polycythemia vera managed with interferon alpha for 2 years . our patient presented with decreased vision , scintillating scotomata , and floaters .
fundus examination findings and results of a fluorescein angiogram led to the diagnosis of impending aion and retinal vein occlusion . considering that both polycythemia vera and interferon have possible influences on vascular occlusion and optic disc edema , we stopped interferon treatment and immediately attempted to treat the polycythemia vera empirically with pentoxifylline and any interferon - associated inflammation with prednisone .
our patient experienced complete resolution of fundus abnormalities and return of normal vision within 3 weeks , which may be attributed to our successful treatment of both etiologies .
thus , further study is warranted to elucidate the treatment of both polycythemia vera and interferon - induced impending aion . |
7,553 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: worldwide meningitis was estimated to cause 1 , 73 , 000 deaths in 2002 , most of them were children from the developing world ( 1 ) . in the high - mortality countries of the eastern mediterranean region bacterial meningitis
accounted for 23,000 ( 2.5% ) of the 0.96 million deaths caused by infectious diseases in the region and contributed 13.3% of death due to meningitis worldwide ( 1 ) .
the annual incidence of bacterial meningitis in usa before the introduction of hib conjugate vaccines was between 30 - 70/100 000 ( 2 ) .
bacterial meningitis affects 35.000 europeans each year and has a mortality rate of about 20% ( 3 ) . in 2011 in poland , it was recorded 2915 cases of meningitis and/or encephalitis .
this included 1438 cases of viral etiology , 888 of bacterial etiology ( 4 ) .
a study conducted in europe and mediterranean region during 2007 found that neisseria meningitidis , streptococcus pneumoniae and haemophilus influenzae type b were most commonly associated with bacterial meningitis accounting for almost 90% of reported cases of acute bacterial meningitis in infants over 60 days of age and young children(5 ) .
in contrast , another study was carried out in eastern of mediterranean region during 2005 - 2010 found that the most commonly isolated pathogens were s. pneumoniae ( 27% of confirmed cases ) , n. meningitidis ( 22% ) , and h. influenzae ( 10% ) ( 6 ) . in the middle east region
different studies have been carried out in order to estimate the rate of infection and to find out the etiological agents .
accordingly n. meningitides , h. influenzae and s. pneumoniae were the predominant pathogens with different proportions ( 710 ) . during the last two decades witnessed major advances in the understanding of the etiology and pathophysiology of bacterial meningitis ; however , the major breakthrough was in the prevention of meningitis with the introduction of the hib conjugate vaccine in the early 1980s .
this resulted in a significant decrease in the incidence of bacterial meningitis in areas... | abstractbackgroundbacterial meningitis is still the leading cause of high morbidity and mortality among the children .
the present study was conducted to determine the epidemiology , clinical characteristics of bacterial meningitis and to evaluate the risk factors associated with developing the infection.methodsthis cross sectional study was conducted in three hospitals of gaza strip -palestine during the period 2009 .
all the children with clinical diagnosis of meningitis /meningoencephalitis admitted to these hospitals were included in the study .
they were subjected to clinical examination as well as csf bacteriological and serological investigations.resultsduring the period ( 2009 ) , 1853 patients were admitted to the hospitals with suspect of meningitis by pediatricians , 73 ( 3.9% ) proved by culture to be acute bacterial meningitis , of these patients 62% were males and 38% were females .
the common isolated pathogens were neisseria meningitides ( 47.9% ) , streptococcus pneumonia ( 15.1% ) , haemophilus influenza ( 13.7% ) , e. coli ( 11.0% ) , enterobacter spp .
( 6.8% ) , citrobacter spp .
( 2.7% ) , providencia spp .
( 1.4% ) , and pseudomonas aeruginosa ( 1.4% ) .
the common recorded symptoms were fever ( 78% ) , neck stiffness ( 47% ) , vomiting ( 37% ) , poor feeding ( 19% ) , and irritability ( 16% ) . statistical analysis showed that there was statistical significance associated developing of infection with malnutrition ( low hemoglobin level ) , high house crowdness and irritability ( p - value < 0.05 ) .
the anova statistical analysis showed that s. pneumonia has an impact on developing low hemoglobin level and leukocytosis.conclusionn .
meningitides is still dominant and needs vaccination .
the risk factors should be taken into consideration in any future plan . |
7,554 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: crohn 's disease ( cd ) and ulcerative colitis ( uc ) are two types of inflammatory bowel disease ( ibd ) of unknown aetiology that result in significant morbidity and health expenditure .
recent data suggests that the prevalence of ibd in general practice in the uk has exponentially increased to around 400 per 100,000 .
the incidence rate of juvenile onset ibd has risen by nearly 30% in scotland over the last twenty years with a concerning decline in age at presentation .
purest form of disease without many extraneous influences of adult behaviour e.g. smoking or disease comorbidity . studying the aetiological factors of this form of the disease
is perhaps more likely to further our understanding of the initiating events of these debilitating conditions .
the current paradigm of ibd pathogenesis suggests an exaggerated immune response against the luminal microbiota in genetically susceptible individuals .
the risk - associated genes are critical in the innate immune system that recognises and distinguishes pathogens from commensal microorganisms , are involved in the clearance of pathogens or pertain to the regulation of adaptive immunity .
crucially , a significant proportion of individuals with ibd do not have any evidence of heritable genetic susceptibility indicating that environmental triggers play an important role in the pathogenesis of ibd .
the gastrointestinal microbiota has come to the fore in efforts to explain this pathogenesis gap .
the normal gastrointestinal tract harbours a complex community of commensal microbes that are critical to normal physiological functioning .
in fact , the microbial gene set within the gut lumen is 150 times larger than the entire human gene complement .
traditional culture methods have been unsuccessful in characterising the entire microbiota with many microbes going undetected .
newer molecular methods and next generation sequence analysis in particular have vastly enhanced the yield of bacteria and fungi that can be identified within the gut [ 810 ] .
in... | inflammatory bowel disease ( ibd ) is characterised by an inappropriate chronic immune response against resident gut microbes .
this may be on account of distinct changes in the gut microbiota termed as dysbiosis .
the role of fungi in this altered luminal environment has been scarcely reported .
we studied the fungal microbiome in de - novo paediatric ibd patients utilising next generation sequencing and compared with adult disease and normal controls .
we report a distinct difference in fungal species with ascomycota predominating in control subjects compared to basidiomycota dominance in children with ibd , which could be as a result of altered tolerance in these patients . |
7,555 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the piriformis muscle ( pm ) is located posterior to the hip joint and passes out of the pelvis through the greater sciatic foramen , dividing it into two topographic areas of utmost clinical importance : suprapiriform and infra - piriform foramina . due to the fact that a large number of invasive medical procedures are performed in the gluteal region ,
knowledge of the typical and variant anatomical relationships between the pm and sciatic nerve ( sn ) may be crucial to ensure the best outcome .
the pm may be also associated with etiopathogenesis of pain syndrome whose symptoms resemble sciatica and which is called piriformis syndrome .
the traditional approach describes piriformis syndrome as a neuromuscular disorder classified as compression neuropathy , caused by compression on the sn at the level of the pm [ 25 ] . however , there are some patients with abdominal pain of uncertain etiology ( e.g. , some anatomical variants of vasculature of the abdomen ) that may lead to unnecessary investigation and intervention .
piriformis syndrome poses a considerable diagnostic problem , and data on its etiopathogenesis , especially with regard to its anatomical conditions , are still scarce . upon detailed literature review
, the authors of the present work have found no anatomy research in which morphometric differences between a group with a typical pm morphology and a typical sn course in the infra - piriform foramen and a group with anatomical variations of both these structures would be statistically analyzed .
the article aims at : 1 ) studying the incidence of anatomical variations in the sn course in relation to the piriformis ; 2 ) taking precise anthropometric measurements of selected pm and sn parameters ; and 3 ) comparing the measurement results of the group with a typical sn course and the group with variations of the sn , as well as comparing the results found in male and female limbs .
thirty randomized , formalin - fixed human lower limbs of adults of both sexes were studied .
the specimens were 14... | backgroundthe aim of this study was to determine relationships between piriformis muscle ( pm ) and sciatic nerve ( sn ) with reference to sex and anatomical variations.material/methodsdeep dissection of the gluteal region was performed on 30 randomized , formalin - fixed human lower limbs of adults of both sexes of the polish population .
anthropometric measurements were taken and then statistically analyzed.resultsthe conducted research revealed that , apart from the typical structure of the piriformis muscle , the most common variation was division of the piriformis muscle into two heads , with the common peroneal nerve running between them ( 20% ) .
the group with anatomical variations of the sciatic nerve course displayed greater diversity of morphometric measurement results .
there was a statistically significant correlation between the lower limb length and the distance from the sciatic nerve to the greater trochanter in the male specimens .
on the other hand , in the female specimens , a statistically significant correlation was observed between the lower limb length and the distance from the sciatic nerve to the ischial tuberosity . the shortest distance from the sciatic nerve to the greater trochanter measured at the level of the inferior edge of
the piriformis was 21 mm , while the shortest distance to the ischial tuberosity was 63 mm .
such correlations should be taken into account during invasive medical procedures performed in the gluteal region.conclusionsit is possible to distinguish several anatomical variations of the sciatic nerve course within the deep gluteal region .
the statistically significant correlations between some anthropometric measurements were only present within particular groups of male and female limbs . |
7,556 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 60-year - old male was referred to the asan medical center for a nodule in the left lower lobe ( lll ) .
the nodule was incidentally detected during the preoperative evaluation of gallstone , for which he underwent laparoscopic cholecystectomy at an outside hospital three months prior to his presentation to us .
on his visit , he did not have any respiratory complaints such as productive cough or dyspnea .
further , the patient had been a non - smoker for 10 years although he used to smoke half a pack a day for 30 years before quitting .
we found that the patient 's physical examination was unremarkable except decreased breath sounds over the left lower lung field .
chest x - ray and computed tomography scan revealed a mass having the following dimensions : 20105 mm .
the mass obstructed the secondary bronchus entering into the lll , which resulted in a total collapse of lll ( fig .
1 ) . a flexible bronchoscopy showed an endobronchial mass filling the basal segments of the lll ( fig .
the patient underwent a left lower lobectomy via left posterolateral thoracotomy through the 5th intercostal space .
we divided the lll bronchus at the level of the left upper lobe spur and performed a left lower lobectomy .
the medial side of the left main bronchus was repaired using an interrupted anastomosis of 3 - 0 vicryl .
the resection margin of the bronchial stump was clear from the tumor on the frozen section .
immunohistochemical staining demonstrated the positivity for s-100 protein , and the ki-67 labeling index was low ( 1% ) , supporting the current diagnosis .
granular cell tumor ( gct ) , a rare benign neoplasm that most commonly occurs in the tongue , skin , subcutaneous tissue , and breast , was first described by abrikossoff in 1926 .
pulmonary gct , known to comprise 6% to 10% of all gtcs , was first reported by kramer in 1938 , and since then , less than 80 cases of gct arising in the lung have been reported in the english - language literature . in korea , seo et al .
it was traditionally termed '... | we report a rare case of granular cell tumor arising in the left lower lobe ( lll ) bronchus with secondary obstructive change in a 60-year - old male . the patient was found to have a nodule in the lll on a computed tomography scan , three months prior to his presentation to the asan medical center .
bronchoscopic biopsies revealed a granular cell tumor . after undergoing lll lobectomy with bronchoplasty
, the patient has not experienced any tumor recurrence . |
7,557 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: w klinice , w ktrej pracuj autorzy , rdoperacyjne badanie ultrasonograficzne jest wykonywane w codziennej praktyce .
badania rdoperacyjne przeprowadzane byy przez chirurga , ktry dokonywa oceny przed zabiegiem , co pozwolio na weryfikacj rozpozna .
przytoczony materia dotyczy 145 procedur ious wykonywanych podczas laparotomii z powodu zmian chorobowych trzustki , w tym 57 zastosowanych w przypadku procesu zapalnego .
ious jest wiarygodnym badaniem w ocenie ostrych zmian zapalnych w trzustce , gwnie w trakcie operacji przewlekego , objawowego zapalenia tego narzdu .
badanie rnicuje zmiany torbielowate , guzy o torbielowatym charakterze , okrela prawidowy sposb drenau lub weryfikuje wskazania do wycicia zmiany chorobowej .
ocenia miejsce i zakres operacji drenaowych w przypadku nadcinienia w drogach trzustkowych spowodowanego zwapnieniami miszu lub kamic przewodow w przebiegu przewlekego zapalenia trzustki .
w raku trzustki weryfikuje stan miejscowego zaawansowania zmian guzowatych , pozwala na ocen zajcia naczy okootrzustkowych , wzw chonnych oraz wykazuje obecno przerzutw miejscowych
the ii department of general and gastrointestinal surgery and surgical oncology of the alimentary tract has been performing ultrasound examinations since 1996 . during this period ,
approximately 500 such procedures have been carried out , mainly necessitated by the various diseases of the liver and the pancreas . since 2007 ,
pro focus system , and the 5 - 12 mhz linear array probe with oblong i
previously , the examination was performer using a 12 mhz linear probe and a hitachi eub 410 12 ultrasound . in the last 10 years , over 280 procedures of intraoperative ultrasonography were performed , including 145 cases of laparotomy due to various pancreatic diseases . in this group of patients ,
percutaneous ultrasound , including doppler , was used prior to surgery , with multislice ct , 33 mri or pet performer in the case of 113 patients . in patients with underlying disease of the pancreas , in most cases
the reason for uous... | both acute and chronic inflammation of the pancreas often lead to complications that nowadays can be resolved using endoscopic and surgical procedures . in many cases , intraoperative ultrasound examination ( ious )
enables correct assessment of the extent of the lesion , and allows for safe surgery , while also shortening its length.aim of the researchat the authors clinic , intraoperative ultrasound is performed in daily practice . in this paper
, we try to share our experiences in the application of this particular imaging technique.research sample and methodologyintraoperative examination conducted by a surgeon who has assessed the patient prior to surgery , which enabled the surgeon to verify the initial diagnosis .
the material presented in this paper includes 145 ious procedures performed during laparotomy due to lesions of the pancreas , 57 of which were carried out in cases of inflammatory process.results and conclusionsious is a reliable examination tool in the evaluation of acute inflammatory lesions in the pancreas , especially during the surgery of chronic , symptomatic inflammation of the organ .
the procedure allows for a correct determination of the necessary scope of the planned surgery .
the examination allows for the differentiation between cystic lesions and tumors of cystic nature , dictates the correct strategy for draining , as well as validates the indications for the lesion 's surgical removal .
ious also allows the estimation of place and scope of drainage procedures in cases of overpressure in the pancreatic ducts caused by calcification of the parenchyma or choledocholitiasis in chronic pancreatitis . in pancreatic cancer
, ious provides a verification of the local extent of tumor - like lesions , allowing for the assessment of pancreatic and lymph nodes metastasis , and indicating the presence of distant and local metastases , including the liver .
ious significantly improves the effectiveness of intraoperative bac aspiration or drainage of fluid reservoirs . |
7,558 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: this process requires insulin , a peptide hormone that lowers glycemia by triggering the uptake of glucose into cells . as the exclusive source of insulin , pancreatic cells play an essential role in glucose homeostasis .
they are responsible for the production , storage and release of insulin in a manner that is strictly coupled to demand .
what is clear is that glucosestimulated insulin secretion ( gsis ) is a complex and tightly regulated process , the disruption of which has severe consequences .
evidence of this can be seen in diabetes , a widespread metabolic disease resulting from the failure of cells to meet the physiological requirements for insulin . in type 1 diabetes , this is caused by the autoimmunemediated destruction of cells . in type 2
diabetes , cells fail to adequately compensate for the insulin resistance often ensuing in conditions such as obesity . early cell dysfunction , characterized by impaired gsis , is considered fundamental in this process .
the deficits in gsis observed in type 2 diabetes have been attributed to numerous factors .
cholesterol is an essential constituent of mammalian cell membranes , which influences their fluidity , permeability and curvature .
it is also a major component of membrane rafts dynamic nanoscale assemblies of sterols , sphingolipids and proteins that can be stabilized to coalesce into platforms that facilitate various cellular processes .
these domains are now widely considered to participate in the regulation of gsis , a conclusion based primarily on two observations .
first , numerous proteins involved in either gsis or the biogenesis of secretory granules ( sgs ) , the intracellular storage organelles from which insulin is secreted , have been shown to partition with detergentresistant membranes ( drms ) in the light fractions of sucrose density gradients after solubilization at 4c with triton x100 or other nonionic detergents .
second , perturbation of membrane cholesterol often induced a repartitioning of these proteins that corresponded... | abstractthe failure of pancreatic cells to supply insulin in quantities sufficient to maintain euglycemia is a hallmark of type 2 diabetes .
perturbation of cell cholesterol homeostasis , culminating in elevated intracellular cholesterol levels , impairs insulin secretion and has therefore been proposed as a mechanism contributing to cell dysfunction .
the manner in which this occurs , however , is unclear .
cholesterol is an essential lipid , as well as a major component of membrane rafts , and numerous proteins critical for the regulation of insulin secretion have been reported to associate with these domains .
although this suggests that alterations in membrane rafts could partially account for the reduction in insulin secretion observed when cell cholesterol accumulates , this has not yet been demonstrated . in this review
, we provide a brief overview of recent work implicating membrane rafts in some of the basic molecular mechanisms of insulin secretion , and discuss the insight it provides into the cell dysfunction characteristic of type 2 diabetes .
( j diabetes invest , doi : 10.1111/j.20401124.2012.00200.x , 2012 ) |
7,559 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chronic otitis media is characterized by a defect to the tympanic membrane , conductive hearing loss ( or mixed hearing loss where the concurrent sensorineural component is involved ) , and permanent or periodical discharge from the ear .
depending on the character of lesions to the middle ear mucous , different types of this abnormality are distinguished : simple chronic otitis media , chronic cholesteatoma otitis media , chronic granulomatous otitis media , and chronic otitis media associated with specific diseases . particularly notable is the occurrence of cholesteatoma and granulation tissue , which are characterized by a tendency to damage the bone tissue , implying the risk of otogenic intracranial and intratemporal complications ( figure 1 ) [ 13 ] .
the treatment of choice is surgery aimed at the elimination of abnormalities from the middle ear , the generation of dry and duly aired postoperative cavity , and hearing improvement .
an important component of the methodology of surgical treatment consists in the preservation of the upper posterior wall of the external auditory meatus in order to protect the region of the middle ear from contacting the external environment . in the case of canal wall - down tympanoplasty
, a search for methods enabling the reconstruction of the upper posterior wall of the external auditory meatus has been underway .
the aim of non - invasive treatment in the course of chronic otitis media is to ensure supplementary treatment in the form of individually selected pharmacotherapy in order to obtain the so - called dry ear during the preoperative period or to eliminate the discharge from the ear occurring periodically in the aftermath of canal wall - down tympanoplasty . hearing improvement after otosurgery
is measured by the degree of closure of the air - bone gap ( the shift in air conduction threshold level compared to bone conduction threshold level ) in pure tone audiometry ( pta ) .
attention is also paid to the shift in bone conduction threshold level after middle ear... | backgroundmiddle ear surgery aims to eliminate pathology from the middle ear , improve drainage and ventilation of the postoperative cavity , and reconstruct the tympanic membrane and ossicles.the aim of this work is to define the factors that affect abg ( air - bone gap ) and bone conduction in the patients operated on due to chronic otitis media.material/methodsa prospective analysis of patients operated on due to diseases of the middle ear during 20092012 was carried out .
the cases of patients operated on for the first time due to chronic otitis media were analyzed.the analysis encompassed patients who had undergone middle ear surgery .
the patients were divided into several groups taking into account the abnormalities of the middle ear mucous and damage of the ossicular chain observed during otosurgery.resultsa significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a porp was used in the reconstruction .
granulation tissue was an unfavorable factor of hearing improvement following tympanoplasty.a significant improvement of bone conduction was observed in the patients with dry perforation without other lesions in the middle ear.the elimination of granulation lesions was a positive factor for the future improvement of the function of the inner ear.conclusionsthe presence of granuloma - related lesions in the middle ear spaces is likely to impede hearing improvement.damage to the ossicular chain rules out the possibility of bone conduction improvement after surgery.the prognosis on tube - related simple chronic otitis media after myringoplasty , with the preserved continuity of the ossicular chain , consists of closing the abg and leads to significant improvement of bone conduction . |
7,560 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hypertension is associated with increased peripheral resistance , resulting predominantly from functional , structural , and mechanical alterations at the level of small - resistance arteries .
functional alterations , which include an impaired endothelial function , are mainly assessed as an impaired acetylcholine - induced , endothelium - dependent relaxation .
vascular structural changes include vascular remodeling , secondary to an increased cell growth , cell migration , and low - grade vascular inflammation [ 1 , 2 ] . in particular , an increased media - to - lumen ratio ( m / l ) may result from a reduced outer diameter that narrows the lumen without net growth ( eutrophic remodeling ) or from a thicker media encroaching on the lumen ( hypertrophic remodeling ) [ 1 , 2 ] .
another hallmark of hypertension - induced structural abnormalities is represented by changes in the mechanical properties of arteries , with particular regard for increased stiffness .
vascular fibrosis is critically important in the determinism of vascular structural modifications , and it involves changes in extracellular matrix ( ecm ) components , including collagen type i and iii , elastin , and fibronectin . an increase in collagen and fibronectin and a decrease in elastin contents have been shown in the media of small arteries from hypertensive animals [ 35 ] .
it is widely accepted that angiotensin ( ang ) ii , traditionally involved in modulating blood pressure and electrolyte homeostasis , is also greatly implicated in the pathogenesis of endothelial dysfunction and vascular remodeling [ 68 ] .
this concept is strengthened by the evidence that chronic at1 receptor blockade is able to correct the altered structure and endothelial dysfunction of subcutaneous resistance small vessels from patients with essential hypertension whereas the -receptor blockade has no effect , despite similar blood pressure lowering effect .
major mechanisms whereby ang ii exerts vascular damage include generation of reactive oxygen species (... | reactive oxygen species are oxygen derivates and play an active role in vascular biology .
these compounds are generated within the vascular wall , at the level of endothelial and vascular smooth muscle cells , as well as by adventitial fibroblasts . in healthy conditions ,
ros are produced in a controlled manner at low concentrations and function as signaling molecules regulating vascular contraction - relaxation and cell growth .
physiologically , the rate of ros generation is counterbalanced by the rate of elimination . in hypertension ,
an enhanced ros generation occurs , which is not counterbalanced by the endogenous antioxidant mechanisms , leading to a state of oxidative stress . in the present paper , major angiotensin ii - induced vascular ros generation within the vasculature , and relative sources ,
will be discussed .
recent development of signalling pathways whereby angiotensin ii - driven vascular ros induce and accelerate functional and structural vascular injury will be also considered . |
7,561 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the income , prestige , and authority of doctors in most western countries reflects their omnipotence amongst health care professionals and their power within our society .
however , concurrent with the increasing number of women entering medicine , there has been a recent decrease in that power .
for example , a significant proportion of female family physicians reports being sexually harassed by male patients .
sexual harassment is an abusive behaviour perpetrated by those with power on the more vulnerable .
the victimization of female doctors could only occur if the offending male patients saw their physicians as vulnerable women rather than powerful professionals , that is , if gender rather than professional role was the primary determinant of power in the relationship .
if female physicians are " women first " in the eyes of some male patients , do their overwhelmingly female nurse colleagues also view them through a gender lens ?
how will the increasing percentage of women in medicine change professional relationships between doctors and nurses ?
this study examines whether the traditional authority of doctors over nurses is eroded when that authority arises solely from profession and not from gender .
historically both the gendered role of nursing and the sex of nurses was almost exclusively female .
the profession primarily attracted working class or immigrant women whose background fostered unquestioning obedience to authority .
the " doctor nurse " game described by stein ( 1967 ) indicated that despite the passage of time , roles had not changed substantially . by showing initiative and making important recommendations , while appearing to defer passively to the doctor 's authority
stein revisited the nurse - doctor game in 1990 and argued that nurses had unilaterally decided to stop playing .
the change was , in part , attributed to an increasing number of female physicians and male nurses , both of whom were unable to play .
nurses ' recent overt refusal to be dominated by physicians is... | backgroundthe nurse - doctor relationship is historically one of female nurse deference to male physician authority .
we investigated the effects of physicians ' sex on female nurses ' behaviour.methodsnurses at an urban , university based hospital completed one of two forms of a vignette - based survey in january , 2000 .
each survey included four clinical scenarios . in form 1 of the questionnaire
the physicians described were female , male , female , and male . in form 2 , vignettes were identical but the physician sex was changed to male , female , male , and female .
differences in responses to questions based on the sex of the physician in each vignette were studiedresults199 self - selected nurses completed the survey .
the responses of 177 female respondents and 11 respondents who did not specifiy their sex , and were assumed to be female based on the overall sex ratio of respondents , were analysed .
persistent sex - role stereotypes influenced the relationship between female nurses and physicians .
nurses were more willing to serve and defer to male physicians .
they approached female physicians on a more egalitarian basis , were more comfortable communicating with them , yet more hostile toward them.conclusionwhen nurses and doctors are female , traditional power imbalances in their relationship diminish , suggesting that these imbalances are based as much on gender as on professional hierarchy .
the effects of this change on the authority of the medical profession , the role of nurses , and on patient care merit further exploration . |
7,562 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the data sources for this study include the u.s . census bureau ( 6 ) and the search study ( 2,3,711 ) .
population by ages ( 0 , 1 , 2, ,19 years ) , race / ethnicity ( nhw , non - hispanic black [ nhb ] , hispanic , asian and pacific islander [ api ] , american indian / alaska native [ aian ] ) , and sex , as well as projection estimates of births , deaths , and net migration by the same dimensions for the years 20022050 . for each of these components of population change fertility , mortality and net migration
we used the series using the middle assumption for each of these components , also designated as the middle series .
search data include diabetes prevalence in 2001 and incidence from 2002 to 2007 collected from geographically defined populations in ohio , colorado , south carolina , and washington , as well as indian health service beneficiaries from four american indian populations , and enrollees in managed health care plans in california and hawaii .
search is a multicenter study that began in 2001 and is conducting population - based ascertainment of youth aged < 20 years with clinically diagnosed , nongestational diabetes .
we used poisson regression to estimate t1 dm and t2 dm prevalence as a function of age ( 0,1, ,19 years ) , race / ethnicity ( nhw , nhb , hispanic , api , aian ) , and sex .
the bayesian information criterion was used to select the best fitting models ( 12 ) .
the bayesian information criterion selects a model from a collection of possible nonnested models by maximizing the likelihood but with a penalty for higher dimensional models .
posterior predictive checking was used to assess model consistency with the data ( 13 ) .
bayesian p values do not work like the more common frequentist p values ; values between 0.1 and 0.9 indicate good model fit ( 14 ) .
the final models included a cubic spline for age ( knots at 0 , 9 , and 19 years ) , race / ethnicity , and sex .
posterior predictive checking yielded bayesian p values equal to 0.39 and 0.22 , indicating good model... | objectiveto forecast the number of u.s .
individuals aged < 20 years with type 1 diabetes mellitus ( t1 dm ) or type 2 diabetes mellitus ( t2 dm ) through 2050 , accounting for changing demography and diabetes incidence.research design and methodswe used markov modeling framework to generate yearly forecasts of the number of individuals in each of three states ( diabetes , no diabetes , and death ) .
we used 2001 prevalence and 2002 incidence of t1 dm and t2 dm from the search for diabetes in youth study and u.s .
census bureau population demographic projections .
two scenarios were considered for t1 dm and t2 dm incidence : 1 ) constant incidence over time ; 2 ) for t1 dm yearly percentage increases of 3.5 , 2.2 , 1.8 , and 2.1% by age - groups 04 years , 59 years , 1014 years , and 1519 years , respectively , and for t2 dm a yearly 2.3% increase across all ages.resultsunder scenario 1 , the projected number of youth with t1 dm rises from 166,018 to 203,382 and with t2 dm from 20,203 to 30,111 , respectively , in 2010 and 2050 . under scenario 2 , the number of youth with t1 dm nearly triples from 179,388 in 2010 to 587,488 in 2050 ( prevalence 2.13/1,000 and 5.20/1,000 [ + 144% increase ] ) , with the greatest increase in youth of minority racial / ethnic groups .
the number of youth with t2 dm almost quadruples from 22,820 in 2010 to 84,131 in 2050 ; prevalence increases from 0.27/1,000 to 0.75/1,000 ( + 178% increase).conclusionsa linear increase in diabetes incidence could result in a substantial increase in the number of youth with t1 dm and t2 dm over the next 40 years , especially those of minority race / ethnicity . |
7,563 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: myelodysplastic syndromes ( mds ) describe a heterogeneous group of malignant hematopoietic stem cell disorders which characterized by dysplastic and ineffective blood cell production and a variable risk of transformation to acute leukemia . because of a variable reduction in production of normal blood cells , a variety of systemic consequences including anemia , bleeding , and an increased risk of infection may occur .
there are some case reports and series indicating the association of mds with inflammatory arthritis or vasculitis syndromes . in some cases ,
patients with inflammatory arthritis and cytopenia are often diagnosed with sle , ra ( felty 's syndrome ) or sarcoidosis , but clinician should remember that it may be a combination of inflammatory arthritis and mds .
from jan 2013 to may 2014 , eighty consecutive patients with mds were referred by a hematologist to the rheumatology clinic in sari , northern iran .
the diagnosis of mds and its subtypes was confirmed by study of peripheral blood smear ( pbs ) and bone marrow aspiration .
all patients with unexplained cytopenia including monocytopenia , bicytopenia or pancytopenia in initial evaluation underwent bone marrow aspiration ; biopsy and iron staining for ringed sideroblasts .
patients with unexplained morphologic features of dysplasia in blood and marrow were included in the study .
the subtypes of mds are refractory cytopenia with unilinage dysplasia refractory anemia with ring sideroblasts(rars ) , refractory cytopenia with multilinage dysplasia ( rcmd ) , refractory anemia with excess blast ( raeb ) , mds with isolated del(5q ) and mds unclassified .
patients ' information including age , gender , and history of systemic disorders , disease duration and subtype of mds were recorded .
a rheumatologist evaluated the patients by history ( for joint symptoms , skin rashes , and family and drug history ) and physical examination for inflammatory rheumatic diseases including rheumatoid arthritis ( ra ) , systemic lupus erythematosus ( sle ) and... | abstractbackgroundthe aim of this study was to determine the prevalence and characteristics of rheumatologic manifestations associated with mds.methods:eighty patients with mds were evaluated by history and physical examination for inflammatory rheumatologic disorders from jan 2013 to may 2014 .
patients who had any signs or symptoms of rheumatologic disorders underwent evaluation by laboratory tests .
patients with and without inflammatory rheumatic disorders were compared for their characteristics.results:of 80 participants with mds , 9 ( 11.3% ) patients were diagnosed as having rheumatic disorders .
mds patients with or without rheumatologic disorder were similar in demographic and hematologic parameters , except age which was lower in patients with rheumatologic disorders .
( p=0.016 ) . in younger patients , refractory cytopenia and refractory cytopenia with multilinage dysplasia were more prevalent.conclusion:the findings of this study indicate that rheumatologic manifestations may be present in mds patients .
younger patients are more prone to the occurrence of mds and rheumatic disorders . |
7,564 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 4-year - old neutered male labrador retriever presented to the washington state university veterinary teaching hospital neurology service following an acute worsening of thoracolumbar pain .
the dog had previously been diagnosed with diskospondylitis via radiography by a referring veterinarian and had not responded to a course of enrofloxacin , carprofen , and tramadol .
thoracic , abdominal , pelvic , and stifle radiographs performed by the referring veterinarian showed no obvious lesions other than diskospondylitis .
the dog also developed a mild right - sided head tilt 4 months prior to the presentation .
neurologic examination revealed severe pain on spinal palpation in the thoracolumbar area along with severe epaxial muscle atrophy .
the dog had a short , stiff - strided gait in the pelvic limbs and a root signature sign in the left pelvic limb .
neuroanatomic localization was in two separate areas : thoracolumbar spine due to pain and right peripheral vestibular .
a complete blood count , chemistry panel , urinalysis , urine culture , and blood culture were performed .
biochemical abnormalities noted were a mildly increased total protein level ( reference range ) at 7.8 g / dl ( 5.67.6 g / dl ) and an increased globulin level at 4.8 g / dl ( 2.73.8 g / dl ) .
the blood fungal culture isolated an organism that was initially identified as a penicillium species , but was furthered characterized as geosmithia argillacea using dna sequencing .
no susceptibility testing was performed at this time due to cost concerns of the client .
spinal digital radiography was performed using a digital radiography system ( canon cxdi-50 g digital radiography system ; canon usa , irvine , ca ) . left lateral and ventrodorsal views of the thoracolumbar spinal region were obtained .
destruction of the adjacent end plates along the central portions of the intervertebral disks at t6t7 , t9t11 , t1213 , l1l2 , l3l4 , and l6l7 forming concave radiolucent defects were present with variable collapse of the intervertebral... | key clinical messagea 4-year - old male castrated labrador retriever presented for severe spinal pain .
radiographs and magnetic resonance imaging showed evidence of diskospondylitis and meningoencephalomyelitis .
blood culture revealed a geosmithia argillacea fungal infection after dna sequencing , initially misdiagnosed as penicillium species .
geosmithia argillacea should be considered as a differential for disseminated fungal diskospondylitis . |
7,565 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: salivary gland tumors occurring in the sublingual gland are rare as compared to other locations , such as the parotid and submandibular glands . among malignant salivary gland tumors , the most frequent type is adenoid cystic carcinoma , followed by adenocarcinoma and carcinoma ex pleomorphic adenoma .
the malignant component is frequently a poorly differentiated carcinoma , high - grade adenocarcinoma or salivary duct carcinoma .
however , most other types of salivary gland carcinomas have been described in carcinoma ex pleomorphic adenoma , and some cases show diverse differentiation with several distinct types within the tumor mass . according to the world health organization histological classification published in 2005 ,
malignat changes in the pleomorphic adenoma include three different types : carcinoma ex pleomorphic adenoma , carcinosarcoma and metastasizing pleomorphic adenoma .
the macroscopic features that suggest malignant transformation in pleomorphic adenoma include poorly defined and/or infiltrative tumor margins , the presence of foci of hemorrhage , and necrosis .
also the coexistent benign and malignant elements are considered as well . herein , we report a case of carcinoma ex pleomorphic adenoma that occurred in the sublingual gland , and presented histological findings of microinvasion beyond the original capsule and abundant myoepithelial cells .
a 70-year - old japanese man was referred to our clinic for further evaluation of a mass located in the left floor of the mouth .
there were no subjective symptoms , including pain and tenderness , and the patient had not noticed it until his dentist pointed it out .
extraoral examination results were unremarkable and no abnormal mass in the face or lymphadenopathy in the bilateral neck was seen .
an intraoral examination revealed a painless , non - tender , elastic hard , smooth mass measuring 1.5 cm1.5 cm .
the mass was covered by intact oral mucosa and it was not fixed to the surrounding structures , including the mandible ( figure 1 ) .
a... | we report a case of carcinoma ex pleomorphic adenoma of a sublingual gland in a 70-year - old man . under a clinical diagnosis of benign salivary gland tumor , excision of the mass with the sublingual salivary gland in an en bloc fashion via an intraoral approach was performed .
histopathologically , there was a rupture of the fibrous capsule and diffuse cell - rich sheets composed of myoepithelial cells with round nuclei were also seen .
immunohistochemically , the cells that composed of cell rich sheets were positive to smooth muscle actin .
final diagnosis of myoepithelial carcinoma ex pleomorphic adenoma was made . |
7,566 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mean age was 51 years of age and mean bmi was 34.0 kg / m ( 3 ) .
sixty - eight percent were women , and forty - five percent were members of minority groups ( 3 ) .
the goals for participants randomized to lifestyle were to achieve and maintain a weight reduction of at least 7% of initial body weight through diet and physical activity of moderate intensity , such as brisk walking , for at least 150-min per week .
a 16-session core curriculum ( given approximately weekly in individual participant sessions ) and subsequent individual sessions ( usually monthly ) and group sessions with case managers were designed to reinforce the behavioral changes .
the medication interventions ( metformin and placebo ) were initiated at a dose of 850 mg taken orally once a day . at 1 month , the dose was increased to 850-mg twice daily .
standard lifestyle recommendations were provided to all groups through written information and an annual 20- to 30-min individual session that emphasized the importance of a healthy lifestyle .
mean follow - up at the end of the dpp was 3.2 years . for the purposes of this analysis
, we assumed that all subjects were enrolled in the dpp for exactly 3 years . at the end of the dpp in july 2001 , masked treatment was discontinued and each participant had a 1-h debriefing and closure visit during which he or she was informed of the main dpp results .
in light of the proven benefits of lifestyle , all participants were offered a group - implemented 16-session lifestyle intervention between january and july 2002 .
forty percent of lifestyle , fifty - eight percent of metformin , and fifty - seven percent of placebo participants attended at least one session ( 11 ) .
the original lifestyle group was offered additional lifestyle support and was not encouraged to take metformin .
the original metformin group was encouraged to continue metformin and to participate in the group lifestyle intervention .
those randomized to placebo stopped placebo and were encouraged to participate in the group... | objectivethe diabetes prevention program ( dpp ) and its outcomes study ( dppos ) demonstrated that either intensive lifestyle intervention or metformin could prevent type 2 diabetes in high - risk adults for at least 10 years after randomization .
we report the 10-year within - trial cost - effectiveness of the interventions.research design and methodsdata on resource utilization , cost , and quality of life were collected prospectively .
economic analyses were performed from health system and societal perspectives.resultsover 10 years , the cumulative , undiscounted per capita direct medical costs of the interventions , as implemented during the dpp , were greater for lifestyle ( $ 4,601 ) than metformin ( $ 2,300 ) or placebo ( $ 769 ) .
the cumulative direct medical costs of care outside the dpp / dppos were least for lifestyle ( $ 24,563 lifestyle vs. $ 25,616 metformin vs. $ 27,468 placebo ) .
the cumulative , combined total direct medical costs were greatest for lifestyle and least for metformin ( $ 29,164 lifestyle vs. $ 27,915 metformin vs. $ 28,236 placebo ) .
the cumulative quality - adjusted life - years ( qalys ) accrued over 10 years were greater for lifestyle ( 6.81 ) than metformin ( 6.69 ) or placebo ( 6.67 ) . when costs and outcomes were discounted at 3% , lifestyle cost $ 10,037 per qaly , and metformin had slightly lower costs and nearly the same qalys as placebo.conclusionsover 10 years , from a payer perspective , lifestyle was cost - effective and metformin was marginally cost - saving compared with placebo .
investment in lifestyle and metformin interventions for diabetes prevention in high - risk adults provides good value for the money spent . |
7,567 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the authors have designed a dual - sided electrosurgery handpiece where a cylindrical electrode used for cutting and a spherical electrode used for coagulation are combined at the opposite ends of the same handpiece allowing alternative use of the two electrodes with a simple handpiece flip .
the device could be a simple and safe alternative to the traditional electrosurgery pencil allowing the simultaneous use of two electrodes without the hassle of frequent electrode replacement .
direct heating of tissues as a therapeutic tool has been used for thousands of years ; however , it was not until 1900 and only by chance that joseph rivere accidentally proved darsonval s theorem that electric energy could be transformed into heat energy which can be used to coagulate tissues.13 more than 2 decades later , the american plant physiologist william t bovie introduced his electrosurgical unit ( esu ) to dr harvey cushing , a neurosurgeon from boston , massachusetts , who used the instrument in 1926 to remove a highly vascular brain myeloma , and the era of electrosurgery was officially born.1,3 the two fundamental tissue effects of electrosurgery , ie , cutting and coagulation , involve joule heating of the conductive tissue by high - frequency electric current that leads either to vaporization and ionization of the water content in tissues ( cutting ) , which is achieved with a sinusoidal wave that results in extreme spikes of temperature rise , or thermal denaturation without tissue vaporization ( coagulation ) , which is achieved with a series of discontinuous wave packets where periods of quiescence interrupt the sinusoidal wave cycles and allow the tissues to relatively cool down a little creating a coagulum ( figure 1).3,4 electrode geometry is a major factor influencing the final impact that an esu has on tissues .
electrodes come in a variety of shapes and designs , each built for a specific purpose , but changing the electrodes during surgery every time the situation demands may be time - consuming ;... | objectiveto introduce and evaluate the safety of a novel dual - sided electrosurgery handpiece design for simultaneous tissue cutting and coagulation.methodswe designed a prototype double - sided handpiece allowing automatic switching between two electrodes with a simple handpiece flip .
the concept of the system as a surgical instrument was assessed by an animal experiment.resultsthe skin of 15 wistar albino white rats could be successfully incised and coagulated using both ends of the handpiece , thereby confirming the prospects and clinical applications of the system.conclusionthe dual - sided electrosurgery handpiece is a simple and safe alternative to the traditional electrosurgery pencil , allowing the simultaneous use of two electrodes without the hassle of frequent electrode replacement . |
7,568 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chronic complications are the major outcome of type 2 dm ( t2 dm ) progress , which reduces the quality of life of patients , incurs heavy burdens to the healthcare system , and increases diabetic mortality . after adjusting for age , the death rate of people with t2 dm is about twice as high as their non - diabetic peers .
about 50 - 80% of all individuals with diabetes die of cardiovascular and cerebrovascular diseases .
the fall of glomerular filtration rate ( gfr ) in case of diabetic nephropathy is usually rapid and appears to be linear with time .
hyperlipidemia has received attention as one of the factors incriminated in this process by participation in the progression of glomerular injury .
more rapid decline of renal function has been observed in diabetic nephropathy patients with hyperlipidemia than in those without it .
prospective studies suggested that an adverse lipid profile might cause nephropathy in both type 1 and type 2 diabetic patients through possible mechanisms , including mesengial cell proliferation , recruitment of macrophages , altered cytokine responses , and increased matrix deposition . low density lipoprotein ( ldl ) consists of a heterogeneous spectrum of particles with highly variable atherogenic potential .
small dense ldl ( sdldl ) particles are believed to be particularly atherogenic due to increased susceptibility to oxidation , high endothelia permeability , decreased ldl receptor affinity , and an increased interaction with matrix components . on the other hand
, ldl size seems to be an important predictor of cardiovascular events and progression of coronary artery disease , and a predominance of sdldl has been accepted as an emerging cardiovascular risk factor by the national cholesterol education program adult . a number of studies have demonstrated a high prevalence of sdldl particles in t2 dm patients with nephropathy as compared with that in t2 dm without nephropathy or in non - diabetic controls .
the high prevalence of small - sized ldl may in part explain the... | background : the risk for diabetic nephropathy in type 2 diabetes is about 30 - 40% , and it is considered the leading cause of end - stage renal disease .
small dense low - density lipoprotein ( sdldl ) particles are believed to be atherogenic , and its predominance has been accepted as an emerging cardiovascular risk factor .
this study aimed to assess small dense ldl as a potential risk factor and a possible predictor for diabetic nephropathy in type 2 diabetic patients.patients and methods : according to microalbuminuria test , 40 diabetic patients were categorized into two groups : diabetic patients without nephropathy ( microalbuminuria negative group ) and diabetic patients with nephropathy ( microalbuminuria positive group ) , each group consists of 20 patients and all were non - obese and normotensive .
the patients were re - classified into three sub - groups depending on the glomerular filtration rate ( gfr).results : the mean of small dense ldl level in the microalbuminuria positive group was higher than that in the microalbuminuria negative group , but without statistical significance .
it was significantly higher in patients with either mild or moderate decrease in estimated gfr than in patients with normal estimated gfr .
there was statistically significant correlation between small dense ldl and albuminuria and significant inverse correlation between small dense ldl and estimated gfr in all patients in the study . based on microalbuminuria ,
the sensitivity and specificity of small dense ldl in the diagnosis of diabetic nephropathy was 40% and 80% , respectively , with cutoff values of small dense ldl > 55.14 mg / dl . on the other hand , based on gfr ,
the sensitivity and specificity were 88.24% and 73.91% respectively , with cutoff values of small dense ldl > 41.89 mg / dl.conclusion : small dense ldl is correlated with the incidence and severity of diabetic nephropathy in type 2 diabetic patients .
it should be considered as a potential risk factor and as a diagnostic... |
7,569 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: heart failure ( hf ) is a common medical problem , in which the heart fails to meet the peripheral tissue demands at a normal filling pressure .
the global prevalence of hf is estimated to be 2.33.9% per annum.[24 ] around 25 million people around the world are suffering from hf , and each year 2 million new cases of hf are diagnosed .
it has a high mortality and morbidity rates and an enormous impact on health care system and public health.[510 ] the incidence and prevalence of hf continue to increase likely due to therapeutic improvement in the treatment of acute myocardial infarction and hypertension and also due to increase in the aging population .
evidence from the literature showed that gender discrepancies in hf management may exist.[1116 ] elderly women make up a greater proportion of hf patients in those over 75 years of age .
earlier studies such as framingham reported better survival among female patients with hf compared to males . other recent trials with accurate assessment of left ventricular function showed contradicting results where female patients with hf had a higher mortality rate . although gender bias in ischemic heart disease ( ihd ) management is well studied,[1829 ] the evidence of gender bias in hf management is scarce .
the aseer region ( population of 1,200,000 ) is located in the southwest of saudi arabia covering an area of more than 80,000 km .
the region extends from the high mountains of sarawat ( with an altitude of 3200 m above sea level ) to the red sea .
health service delivery in the aseer region is provided by a network of 244 primary health care centers , 16 referral hospitals and one tertiary hospital , aseer central hospital ( ach ) .
ach , with 500 beds , is run by the ministry of health and the college of medicine of king khalid university ( kku ) , abha .
this study was designed to investigate whether gender difference exists in the management of hf patients admitted to ach , aseer region / saudi arabia .
a retrospective cohort of all consecutive patients... | background : heart failure ( hf ) is a common medical problem with a high impact on public health .
evidence of gender difference in management of hf is scarce .
we conducted a retrospective study to evaluate the presence of gender difference in management of hf patients admitted to the tertiary care hospital in the aseer region / saudi arabia.patients and methods : a chart review was conducted at aseer central hospital ( ach ) on consecutive patients admitted with the primary diagnosis of hf between jun 2007 and may 2009 .
data were collected on clinical and management profiles and analyzed for the presence of gender difference in hf management.results:a total of 206 male patients and 94 female patients with hf were reviewed .
ischemic and dilated cardiomyopathy etiologies were significantly higher in male patients ( 42.7 vs. 28.7% , p < 0.021 ) and ( 13.1% vs. 3.2% , p < 0.008 ) , respectively .
renal failure and atrial fibrillation were significantly higher in female patients with hf ( 20.2 vs. , 5.3% p < 0.001 ) and ( 20.2 vs. 10.2% , p < 0.018 ) , respectively .
smoking was significantly higher in male patients ( 11.7 vs. 0% , p < 0.001 ) .
echocardiography was performed equally for both genders and ejection fraction was significantly higher in female patients ( 38.2 16.9% vs. 30.4 16.6% , p < 0.001 ) .
beta - blockers were prescribed significantly less to female patients ( 36.2 vs. 57.8% , p < 0.001 ) , while ace inhibitors and digoxin were prescribed significantly less to male patients ( 64.1 vs.75.5% , p < 0.049 ) and ( 24.8 vs. 36.2% , p < 0.042 ) , respectively.conclusion:gender differences were detected in clinical presentation and management of hf .
female patients with hf had less ischemic etiology and smoking , but more atrial fibrillation and renal dysfunction .
female patients were under - treated by beta - blockers while male patients were under - treated by ace inhibitors and digoxin .
both genders were investigated equally , and female patients had a better ejection... |
7,570 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: natural orifice translumenal endoscopic surgery ( notes ) is on the forefront of surgical technique and is pushing the perceptions and boundaries of abdominal surgery , as laparoscopy did when first introduced .
however , in spite of enthusiasm on behalf of researchers for the technical aspects of notes , what will truly lead to its wider implementation will be improved patient outcomes and acceptance . while better patient outcomes ( less postoperative pain , fewer if any scars , and decreased length of hospital stay ) are touted to be the main goal of this technique
however , patient acceptance of the procedure and its risks can be assessed through surveys in advance of outcomes data .
though multiple studies have addressed attitudes towards this developing technique , the ability to interpret these variable study results is challenging .
secondly , the larger scale studies have come mainly from europe , thus making direct inferences to a north american population potentially incorrect .
finally , these surveys have emphasized gender and age as variables in assessing interest in notes but have not assessed whether previous surgery affects patients perceptions of scars and postsurgical pain .
it is known that obese patients are at higher risk for developing postoperative hernias and wound infections [ 14 ] and thus may be a group that could derive significant benefit from notes . in this paper , we surveyed a large number of patients at a canadian centre to assess opinions regarding scarless surgical procedures and whether increased risks would affect their choices . a large sample also allowed for subgroup analyses based on gender , age , and body mass index .
the survey instrument was developed by a team of general surgeons , gastroenterologists , and a statistician .
approval for the study was obtained from the queen 's university health sciences & affiliated teaching hospitals research ethics board .
a pilot study was performed with 10 people and feedback incorporated into the survey tool .
the final... | natural orifice translumenal endoscopic surgery ( notes ) is on the forefront of surgical technique , but existing research has produced mixed results regarding factors associated with interest in the procedure .
our objective was to ascertain patient opinions at a canadian centre regarding scarless surgery .
a survey comprising demographic data ( gender , age , body mass index [ bmi ] ) , interest in notes , impact of increased risk , as well as importance of further research and shorter recovery time was administered to volunteer patients at outpatient general surgery clinics .
nonparametric tests were utilized to examine difference in response by age , sex , bmi , and preexisting scars .
of the 335 participants ( 57% female , mean age of 54.5 15.9 years , mean bmi of 28.7 6.9 ) , the majority ( 83% ) showed some interest , but this dropped to 38% when additional risk was factored in .
generally , women , those under 50 years of age and those of healthy weight , were more interested than male , older , and/or heavier patients .
most felt that research into notes and reduced length of inpatient stay were important ( 80% and 95% , respectively ) .
further investigation into objective notes outcomes are needed to provide patients adequate data to make an informed choice regarding surgical route . |
7,571 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the supraspinatus is one of the rotator cuff muscles ; it is positioned at the supraspinous
fossa and under the trapezius and it abducts the shoulder joints to rotate externally1 , 2 .
the rotator cuff muscles are highly important for dynamic stability of the shoulders , but it
is the supraspinatus that plays an important role in dynamic stability during shoulder
abduction . the supraspinatus is also the most frequently injured area when the rotator cuff
muscles are injured3 .
thus , strengthening
the supraspinatus is essential to prevent damage to the rotator cuff .
generally , the full can and empty can positions are recommended as exercises that
strengthen the supraspinatus4 , 5 .
boettcher et al.6 indicated that there was no distinctive difference in muscle
activity between the full can and empty can positions .
however , few studies have been
conducted to determine changes in the cross - sectional areas of the supraspinatus according
to abduction angles , suggesting no definite answers concerning which posture and abduct
angles are the best for strengthening the supraspinatus . jobe and
moyne7 suggested an abduction
angle of approximately 90 for the supraspinatus strengthening exercise , while escamilla et
al.8 suggested that muscle activity of
the supraspinatus was highest at an abduction angle of 60. however , in clinical practice ,
no recommendation for the abduction angle has been made for the supraspinatus strengthening
exercise , so various angles have been applied by physiotherapists .
it would be much easier
for physiotherapists to determine the criteria for strengthening exercises if they knew
which abduction angle of the shoulders incurs the largest cross - sectional area of the
supraspinatus .
therefore , the objective of this study was to determine by ultrasonography
the changes in the supraspinatus cross - sectional areas according to shoulder abduction
angles .
forty subjects at d college participated in the present study ( 20 males and 20 females )... | [ purpose ] the purpose of this study was to determine the changes in the supraspinatus
cross - sectional areas according to shoulder abduction angles , using ultrasonography .
[ subjects and methods ] the subjects consisted of 40 individuals ( 20 males and 20 females ) .
the cross - sectional areas of the supraspinatus of all subjects were measured with
ultrasonography at abduction angle of 0 , 30 , 60 , 90 , and 120. we set four abduction
angle levels ( i , ii , iii , and iv ) , 0 to 30 , 30 to 60 , 60 to 90 , and 90 to 120 ,
respectively , when determining the largest change in cross - sectional area . [ results ]
the
results revealed that cross - sectional areas of the supraspinatus increased at all levels ,
but the abduction angle level with the largest increase in cross - sectional area of the
supraspinatus was level iii .
[ conclusion ] the above results indicate that performing
exercises at an abduction angle between 60 and 90 will be the most effective for
supraspinatus strengthening in clinical practice . |
7,572 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: caspases coordinate , in a proteolytic cascade and with the help of other proteases , the rapid and efficient elimination of a cell by apoptosis .
they are classified into monomeric initiator caspases ( caspase-8 and -9 ) with long prodomains ( death effector domain [ ded ] , and caspase recruitment domain [ card ] ) , which are activated by recruitment to and dimerization on protein platforms , and already dimerized effector caspases ( caspase-3 , -6 and -7 ) , which require for their activation the cleavage ( e.g. , by initiator caspases ) of an intersubunit linker that binds to the dimer interface . in the extrinsic signaling pathway ,
the recruitment platform is the death - inducing signaling complex ( disc ) consisting of the activated death receptor , the adapter fadd ( fas - associated protein with death domain ) and initiator caspase-8 and -10 . in the intrinsic mitochondrial pathway ,
the platform is the apoptosome , a complex of the adapter apaf-1 ( apoptotic protease activating factor 1 ) , mitochondrially - released cytochrome c and initiator caspase-9 . in both cases ,
the main role of caspase-8 and -9 is to cleave and activate effector caspase-3 and -7 .
caspase-6 is an effector caspase with a limited substrate specificity whose exact role in apoptosis remains ill - defined .
caspase-2 is recruited to another platform , the piddosome ( pidd is the p53-induced protein with death domain ) , which is involved in translating a danger signal , such as dna damage , into either a repair or death response depending on the cellular or environmental context .
similarly , caspases-1 , -4 and -5 in humans and caspase-11 in mice are part of inflammasome platforms that assemble in response to external , pathogenic stimuli and guide the production and secretion of pro - inflammatory cytokines such as interleukin ( il)-1 and il-18 . under certain circumstances , such as salmonella - infected macrophages ,
the antimicrobial , inflammatory response may result in a caspase-1-mediated form of programmed cell death... | undoubtedly , caspases are the major driving force for apoptosis execution and mechanisms of their activation and inhibition have been largely unveiled .
recent progress has been made with regard to the exact intracellular ordering of caspases , monitoring their activities in vivo and unveiling their substrate degradomes . moreover , non - caspase proteases seem to assist caspases in the completion of the death execution program . here
we will consider some very recent data dealing with these aspects .
we will also provide novel insights into the mechanisms that dictate apoptotic variability within a cell population . |
7,573 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the world health organization estimated that worldwide , 10 million people were diagnosed with cancer in 2000 , and that the cancer incidence rate would increase by 50% to 15 million by 2020 .
furthermore , as treatment outcomes improve and cancer patients have an increased survival21 ) , the incidence and prevalence of spinal metastases , which are known to occur in 30 - 50% of cancer patients22,27,41 ) , are also set to rise .
the majority of these patients will undergo palliative radiation therapy , and the role of radiation therapy for the treatment of metastatic tumors of the spine is well established7,23,37 ) . conventional radiation therapy ( rt )
is defined as radiation delivered using 1 to 2 beams without high precision or highly conformal treatment .
therefore , the effectiveness of conventional radiation therapy has been limited by the poor radiation tolerance of the spinal cord , which is highly susceptible to radiation . in recent years
, advances in imaging technology and computed treatment planning have allowed the safe delivery of high - dose radiation to spinal metastases , even when in close proximity to the spinal cord .
these treatments are administered in 1 to 5 fractions of high - dose radiation ( to ensure safety ) , which limit the dose delivered to the spinal cord12 ) .
the emerging technique of stereotactic radiosurgery ( srs ) for spine metastases represents a logical extension of the current state - of - the - art of radiation therapy .
stereotactic radiosurgery has emerged as a new treatment option for the multidisciplinary management of metastases located within or adjacent to vertebral bodies and the spinal cord .
the goals of stereotactic radiosurgery parallel those of brain radiosurgery , that is , to improve local control over conventional fractionated radiation therapy and to be effective for the treatment of previously irradiated lesions with an acceptable safety profile .
herein , we present a systematic review regarding the value of spinal stereotactic radiosurgery in the... | objectivethe incidence and prevalence of spinal metastases are increasing , and although the role of radiation therapy in the treatment of metastatic tumors of the spine has been well established , the same can not be said about the role of stereotactic radiosurgery . herein , the authors present a systematic review regarding the value of spinal stereotactic radiosurgery in the management of spinal metastasis.methodsa systematic literature search for stereotactic radiosurgery of spinal metastases was undertaken .
grades of recommendation , assessment , development , and education ( grade ) working group criteria was used to evaluate the qualities of study datasets.resultsthirty-one studies met the study inclusion criteria .
twenty - three studies were of low quality , and 8 were of very low quality according to the grade criteria .
stereotactic radiosurgery was reported to be highly effective in reducing pain , regardless of prior treatment .
the overall local control rate was approximately 90% .
additional asymptomatic lesions may be treated by stereotactic radiosurgery to avoid further irradiation of neural elements and further bone - marrow suppression .
stereotactic radiosurgery may be preferred in previously irradiated patients when considering the radiation tolerance of the spinal cord .
furthermore , residual tumors after surgery can be safely treated by stereotactic radiosurgery , which decreases the likelihood of repeat surgery and accompanying surgical morbidities .
encompassing one vertebral body above and below the involved vertebrae is unnecessary .
complications associated with stereotactic radiosurgery are generally self - limited and mild.conclusionin the management of spinal metastasis , stereotactic radiosurgery appears to provide high rates of tumor control , regardless of histologic diagnosis , and can be used in previously irradiated patients .
however , the quality of literature available on the subject is not sufficient . |
7,574 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: despite existing initiatives to integrate health services in the americas health care fragmentation remains a significant challenge .
excessive fragmentation leads to difficulties in access to services , delivery of services of poor technical quality , inefficient use of resources , increases in production costs , and low user satisfaction . to address this problem ,
the pan american health organization ( paho ) has launched the integrated health services delivery networks ( ihsdn ) initiative to support the development of more accessible , equitable and efficient health care models in the region .
ihsdn are defined as a network of organizations that provides , or makes arrangements to provide , equitable , comprehensive , and integrated health services to a defined population and is willing to be held accountable for its clinical and economic outcomes and the health status of the population served .
ihsdn require 14 essential attributes for their adequate operation grouped according to four principal domains : model of care , governance and strategy , organization and management , and financial allocation and incentives .
an extensive literature review , expert meetings and country consultations ( national , subregional and regional ) in the americas resulted in a set of consensus - based essential attributes and policy options for implementing ihsdn .
the research and evidence on health services integration remains limited ; however , several studies suggest that ihsdn could improve health systems performance .
principal lessons learned include : i ) integration processes are difficult , complex and long term ; ii ) integration requires extensive systemic changes and a commitment by health workers , health service managers and policymakers ; and iii ) multiple modalities and degrees of integration can coexist within a single system .
the public policy objective is to propose a design that meets each system s specific organizational needs . | introductiondespite existing initiatives to integrate health services in the americas health care fragmentation remains a significant challenge .
excessive fragmentation leads to difficulties in access to services , delivery of services of poor technical quality , inefficient use of resources , increases in production costs , and low user satisfaction . to address this problem ,
the pan american health organization ( paho ) has launched the integrated health services delivery networks ( ihsdn ) initiative to support the development of more accessible , equitable and efficient health care models in the region [ 1].theory / conceptual frameworkihsdn are defined as a network of organizations that provides , or makes arrangements to provide , equitable , comprehensive , and integrated health services to a defined population and is willing to be held accountable for its clinical and economic outcomes and the health status of the population served .
ihsdn require 14 essential attributes for their adequate operation grouped according to four principal domains : model of care , governance and strategy , organization and management , and financial allocation and incentives [ 1].methodsan extensive literature review , expert meetings and country consultations ( national , subregional and regional ) in the americas resulted in a set of consensus - based essential attributes and policy options for implementing ihsdn.results and conclusionsthe research and evidence on health services integration remains limited ; however , several studies suggest that ihsdn could improve health systems performance .
principal lessons learned include : i ) integration processes are difficult , complex and long term ; ii ) integration requires extensive systemic changes and a commitment by health workers , health service managers and policymakers ; and iii ) multiple modalities and degrees of integration can coexist within a single system .
the public policy objective is to propose a design that meets each system s specific... |
7,575 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: crohn s disease is a chronic granulomatous inflammatory disease that may involve any part of the alimentary tract , although the ileum is the most frequent location .
the presenting symptoms are variable and include abdominal pain , growth failure , and , less commonly , diarrhea . in the early stages , crohn s disease causes small erosions on the inner surface of the bowel ( aphthous ulcers ) . with time , the erosions become deeper and larger , causing scarring and stiffness of the bowel .
histologically , the active mucosal lesion shows a mixed infiltrate of lymphocytes , plasma cells , and neutrophils .
non - necrotizing granulomas are found in about 50% of resection specimens and may be located in any portion of the bowel wall .
crohn s disease was shown to be a predisposing factor for ileoileal intussusception ( 1 ) .
intussusception occurs when a proximal segment of bowel telescopes into an adjacent distal segment . unlike in children
we describe an unusual case of acute intestinal obstruction due to ileoileal intussusception as an initial manifestation of crohn s disease .
we speculate that intussusception was secondary to inflammatory edema and spasm , which led to impaired contraction of the bowel and allowed unbalanced peristaltic forces to rotate the intestinal wall inwards and initiate the invagination .
hence , crohn s disease should be taken into consideration in young patients with intestinal intussusception if no other cause is found .
a 20-year - old patient presented to emergency with complaints of central abdominal pain , vomitting , and bloody stool for the previous 2 days .
the abdomen was distended and examination revealed mild central abdominal tenderness with diminished bowel sounds .
routine investigations showed a raised white cell count of 21,200/mm , and a mild metabolic acidosis ( ph of 7.34 , serum level of bicarbonate of 18.12
an abdominal x - ray showed grossly distended loops of small intestine with absent colonic shadows , suggestive of mid - bowel obstruction ( figure 1 )... | intussusception is usually considered a childhood condition , but it may also be present in adults , where it is more often associated with an underlying pathology . there is no agreement upon the correct treatment of adult intussusception , although surgical intervention is considered necessary .
resection without prior reduction has been the traditional treatment of choice due to the significant risk for malignancy found in most series .
we describe an unusual case of intestinal necrosis secondary to ileoileal intussusception caused by crohn s disease .
a long intestinal resection was necessary and the patient was discharged without major complications .
based on the details of this case , the authors emphasize the potential importance of considering individualized treatment of adult intussusception . the practical benefit for reduction of viable bowel in crohns patients is the preservation of bowel length . |
7,576 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: preterm birth , as one of the pregnancy problems , is the leading cause of neonatal mortality and the second cause of child deaths under the age of 5 .
it is defined as birth before 37 weeks of gestation , which affects 518% of the pregnancies . for the families and health - care systems , short- and long - term morbidity and financial implications of preterm birth
primary symptoms of preterm labor ( ptl ) are often mild , and the associated symptoms occur too late , so , it is difficult to diagnose early .
some methods are used to predict preterm delivery ( ptd ) by clinical symptoms and epidemiological risk factors such as obstetric history , but these are neither sensitive nor specific .
the presence of a method , enabling to a rapid and accurate diagnosis of actual ptl in pregnancy , could be useful to lower treatment costs and unnecessary interventions .
nitric oxide ( no ) , as one of the pivotal metabolic factors , has been implicated in a variety of biological and reproductive processes including oocyte maturation , fertilization , and embryonic progression .
no has a short half - life time and promptly oxidized by nitrite oxide which is changed to nitrite oxide metabolites ( nox ) , contained to no3 ( nitrates ) and no2 ( nitrites ) .
assessment of no metabolite can be measured easily from plasma , urine , and vaginal secretions .
even though the effects of tocolytics on neonatal outcomes improvement have been not shown , they are the important interventions in obstetrics to delay ptd .
the aim of tocolytic therapy is to delay ptd long enough for antenatal corticosteroids to be administered or transporting the mother to a tertiary care center , thereby reducing neonatal morbidity and mortality .
the use of tocolytic agents in contemporary obstetric practice should be customized based on the available evidences of efficacy and fetomaternal safety , gestational age , maternal conditions , and drugs potential complications .
magnesium sulfate is one of the tocolytic agents which is commonly used for... | background : preterm labor ( ptl ) is the main challenge in prenatal health care , leads to high rate of mortality and increases cost of health services . to evaluate the preterm delivery ( ptd)-related risk factors
, we decided to measure nitrite oxide metabolites and cervical length ( cl ) as the diagnostic and predictive tools for ptd in women and response to tocolytic therapy.materials and methods : in this case control study , sixty women of 1835 years with first pregnancy during the 2434 gestational weeks with ptl in case group admitted to the delivery section of beheshti hospital , isfahan , iran were included .
sixty women in control group have the same specifications .
no and cl level were assessed , and the collected data were analyzed by spss software , version 20 and medcalc software , version 15.1.results:the two groups were similar regarding maternal and gestational age ( p > 0.05 ) .
lower level of no was observed in ptl women with a mean of 35.30 8.27
mol / l compared to the normal gestation group with a mean of 39.05 10.17 mol / l ( p = 0.035 ) . in addition , the diagnostic accuracy of both ptl - predicting factors was determined ( no 31 , sensitivity 99.7% , specificity 82.5% and cl 22 , sensitivity 80% , specificity 99.9%).conclusion : as the previous investigations stated , it can be claimed that no might be the reliable marker for predicting the ptl , and administration of no synthesis could be a candidate for the future therapeutic target . |
7,577 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: interventional radiology is a clinically - oriented specialty that employs image guidance in order to perform minimally invasive diagnostic and therapeutic procedures.1 technological developments of imaging equipment coupled with the advanced engineering of pinhole therapeutic applicators and minuscule endovascular instruments have fuelled worldwide adoption of transcatheter and percutaneous techniques in the treatment of various vascular and solid organ pathologies with increased efficacy and reduced rates of morbidity and mortality.2 elderly patients may be poor anesthetic candidates and are usually denied surgical treatments because of underlying comorbidities .
in addition , elderly patients are in a higher risk of developing peri- and post - operative complications and usually require a longer and more cost - consuming recovery and rehabilitation period . moreover , there is decreased pain sensitivity and perception with aging , which may further complicate therapy and management of the geriatric population .
elderly cancer patients , in particular , may suffer from increased drug toxicity and peri - operative morbidity and mortality because of age - related physiological decline and reduced functional reserve capacity.36 front - line minimally invasive therapeutic procedures that are alternatives or may serve as adjuncts to traditional surgical treatments are becoming all the more important in the curative or palliative management of elderly frail patients with multiple comorbid conditions .
the present report provides a concise review of several interventional radiological - guided procedures with a special focus on the treatment of the primary debilitating pathologies of the elderly population .
in particular , the authors elaborate on thermoablation of solid organ malignancies , palliative stent placement for gastrointestinal tract cancer , endovascular management of aortic and peripheral arterial vascular disease , and cement stabilization of osteoporotic vertebral fractures ( figure 1 ) .
however ,... | interventional radiological percutaneous procedures are becoming all the more important in the curative or palliative management of elderly frail patients with multiple underlying comorbidities .
they may serve either as alternative primary minimally invasive therapies or adjuncts to traditional surgical treatments .
the present report provides a concise review of the most important interventional radiological procedures with a special focus on the treatment of the primary debilitating pathologies of the elderly population .
the authors elaborate on the scientific evidence and latest developments of thermoablation of solid organ malignancies , palliative stent placement for gastrointestinal tract cancer , airway stenting for tracheobronchial strictures , endovascular management of aortic and peripheral arterial vascular disease , and cement stabilization of osteoporotic vertebral fractures .
the added benefits of high technical and clinical success coupled with lower procedural mortality and morbidity are highlighted . |
7,578 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: this cross - sectional study was carried out in a university hospital in shiraz , iran .
this hospital was selected because of the availability and the subsequent enthusiasm of its nursing managers .
this hospital admits patients from southern iran , and nurses who work in this hospital play a vital role in providing health care for people living in this area .
a census sampling was used . the sample comprised of all nurses ( n=330 ) and head nurses ( n=19 ) working in this hospital , and all inpatient wards including medical , surgical , pediatrics , emergency ,
criteria for selecting the samples included1 graduation in the bsc nursing program2 and working full - time in university hospital as a nurse . in the beginning of the study ,
an explanatory session was held for the head nurses and nurses to introduce the whole plan , its objectives and its method .
then , prepared envelops each containing two similar competence questionnaires , one for the nurses and the other for the head nurses , along with an informed consent form and a manual of the instructions of filling the questionnaire were distributed among the head nurses .
they had the responsibility of handing the envelops to the nurses of their respective wards . in the manual ,
the nurses were asked if they agreed to participate in the study , they filled the questionnaire independently and handed the head nurse the second questionnaire to be filled in .
the two questionnaires were completely identical in their content and structure . after completing the questionnaires ,
data collection process lasted for one month . to maintain the privacy of the participants , all closed envelops were delivered to the main investigator .
the instrument used in this research was nurse competence scale ( ncs ) which assesses 73 skills in 7 different categories .
these categories were as follows : helping role ( 7 skills ) , teaching coaching ( 16 skills ) , diagnostic functions ( 7 skills ) , managing situations ( 8 skills ) , therapeutic interventions ( 10 skills )... | background : nurses play a crucial role in patient - care .
therefore , assessing nurses clinical competence is essential to achieve qualified and safe care .
the aim of this study was to determine and compare the competence assessments made by head nurses and practicing nurses in a university hospital in iran in 2009.methods:a cross - sectional survey was conducted to make comparisons of both self - assessment of nurse competence as well as assessment made by their respective head nurses working in a university hospital setting in iran .
the instrument employed for data collection was nurse competence scale ( ncs ) , whose reliability and validity have been previously confirmed .
the clinical competence of the nurses in 73 skills under 7 categories was determined based on a visual analogue scale ( vas ) ( 0 to 100 ) .
they were also asked to indicate the extent to which their competence was actually used in clinical practice on a four - point scale of likert .
the data was analyzed through descriptive and inferential statistics.results:comparison of self - assessment ( 87.03 10.03 ) and the assessment done by head nurses ( 80.15 15.54 ) showed a significant difference but no precise differences were found between the assessment methods for the frequency of using these competencies.conclusions:the results of this study indicated no consensus between the nurses owns assessment and their head nurse assessment .
therefore , it is necessary to use a combination of nurses competence assessment methods in order to reach a more valid and precise conclusion . |
7,579 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a great number of patients with major injuries [ 13 ] suffer from accidental hypothermia ranging from 12 to 66% [ 4 , 5 ] . in the current literature ,
an increase of mortality has been demonstrated below a core temperature of 34c in patients with multiple injuries , this temperature threshold seems to be critical in trauma patients and therefore a modified definition is reasonable .
thereby , the extent of hypothermia correlates with the overall injury severity and is increased by pelvic or abdominal surgery ; furthermore , hypothermic polytrauma patients suffer from an increased incidence of posttraumatic complications [ 2 , 4 , 810 ] as well as a an increased mortality [ 2 , 8 , 11 ] . depending on its origin ,
endogenous hypothermia results from a metabolic dysfunction with a decreased heat production ( e.g. , hypothyreodism , hypoglycaemia , hypoadrenalism ) or a disturbed thermoregulation ( e.g. , intracranial tumor , degenerative neurologic disorders ) .
accidental hypothermia is characterized by an unintentional decrease of the core temperature due to exposure to a cold environment without a thermoregulative dysfunction .
the infusion of cold fluids as , for example , 2 l of crystalloids ( 18 ) decreases core temperatures about 0.6c .
in addition , a reduced oxygen supply with an anaerobic state decreases the amount of adenosine trisphosphate ( atp ) and subsequent heat production .
furthermore , the application of anaesthetics and skeletal muscle relaxants prevents shivering and vasoconstriction and therefore advances heat loss .
while the first two entities do not play a major role after trauma , accidental hypothermia is common in trauma patients as well as patients undergoing major surgery [ 4 , 5 ] .
in contrast to accidental hypothermia that needs to be addressed in the treatment of severely injured patients due to its detrimental effects , induced hypothermia is commonly used , that is , in elective cardiac surgery .
in addition there exists a strong recommendation for the induction of... | numerous multiple trauma and surgical patients suffer from accidental hypothermia .
while induced hypothermia is commonly used in elective cardiac surgery due to its protective effects , accidental hypothermia is associated with increased posttraumatic complications and even mortality in severely injured patients .
this paper focuses on protective molecular mechanisms of hypothermia on apoptosis and the posttraumatic immune response .
although information regarding severe trauma is limited , there is evidence that induced hypothermia may have beneficial effects on the posttraumatic immune response as well as apoptosis in animal studies and certain clinical situations .
however , more profound knowledge of mechanisms is necessary before randomized clinical trials in trauma patients can be initiated . |
7,580 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: after birth , the neonate must transition to the gastrointestinal system as the primary source of nutrition .
in premature newborns , the gastrointestinal system and other organ systems in the body are underdeveloped .
this is a challenge because the neonatologist must assess the function of the intestine for management of enteral feeding .
much of the knowledge about the physiology of the intestines in neonates is derived and subsequently inferred from experimental animal models .
clinical methods to assess intestinal function include abdominal distension , aspiration of gastric residuals ( gr ) , bowel auscultation , and abdominal x - ray .
however , recently two noninvasive technologies have demonstrated potential to assess intestinal function in the neonatal intensive care unit ( nicu ) : transabdominal ultrasonography ( us ) and near - infrared spectroscopy ( nirs ) .
different modalities of transabdominal us have been utilized by some investigators for assessment of necrotizing enterocolitis ( nec ) [ 813 ] .
for example , studies have found that us is more sensitive than x - rays in detecting intramural gas , portal venous gas , free peritoneal gas and free peritoneal fluid [ 1317 ] .
color doppler us of the abdominal wall is more accurate than clinical examination and x - ray in detecting bowel necrosis . in principle , transabdominal us allows the visualization of peristaltic movements .
the bowel walls are visible as multiple white echoic lines in a darker hypoechoic background of peritoneum .
peristaltic contractions appear as wormlike movements of the bowel wall . in a recent publication , richburg and kim
duodenojejunal manometry , another measure of small intestinal motility , has previously been found to be a sensitive predictor of feeding intolerance in preterm infants . however , this method is more invasive than transabdominal ultrasonography , and requires more specialized equipment and operator training .
near - infrared spectroscopy ( nirs ) is a noninvasive technology available to... | backgroundnear - infrared spectroscopy ( nirs ) has the potential to continuously and noninvasively monitor intestinal function
. this technology may be valuable because among neonates , intestinal maturity is highly variable and difficult to assess based solely on clinical signs .
the aim of this study was to determine if there is an association between nirs - based sto2 measurements and peristaltic activity assessed by transabdominal ultrasonography ( us).material / methodsnineteen neonates of gestational age > 32 weeks were categorized according to no / low versus normal / hyperactive motility levels , based on blinded us scan results .
sto2 was recorded every 2 s for 24 h , following the ultrasound recording .
differences between the resulting estimates of average sto2 ( bias of fits ) and goodness - of - fit ( residuals ) were evaluated.resultsnewborns with normal / hyperactive motility had higher mean sto2 than newborns with no / low motility ( 72.34.4 vs. 65.57.9 , p<0.05 , f=5.65 ) .
residual errors were not significantly different between the 2 groups ( p=0.213 , f=0.213 ) .
a multivariate linear regression model using the means , residuals , and pairwise products of both , demonstrated more significant separation ( 0.470.26 vs. 0.240.33 , p<0.01 , f=27.4 ) . a non - linear variant of the multivariate linear regression model demonstrated greatest separation ( 0.680.24 vs. 0.490.53 , p<0.01
, f=41.9).conclusionsthis is the first study to demonstrate an association between nirs - based sto2 measurements and peristaltic activity visualized by ultrasound imaging .
nirs may offer a continuous , noninvasive method to assess motility .
this may have significant implications in premature infants at risk for feeding intolerance or necrotizing enterocolitis . |
7,581 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: spigelian hernia ( sh ) is a ventral hernia that occurs through slit - like defects in the anterior abdominal wall adjacent to the semilunar line .
adriaan van der spiegel is credited as the first to describe the semilunar line in 1645 . however , in 1764 klinkosch1 described a spontaneous lateral ventral hernia specifically located in the semilunar line . in 1935
, scopinaro2 was the first to report a lateral ventral hernia in a pediatric patient .
only 37 cases have been reported in the pediatric age group in a review of the literature from 1935 to 2000.3 in children , shs range is from newborn to 17 years of age ( average , 4.52 years ) , they are more frequent in males than females ( ratio , 3.7:1 ) , and they are more commonly left - sided and may occur bilaterally in 15% of cases.4
5
6 in adults , they most occur on the right side , between fourth to seventh decade of life , they are more frequent in women ( ratio , 4:3 ) and are rarely bilateral.4
7
8 although adult hernias are considered to be acquired because of trauma or increased intra - abdominal pressure , the pediatric cases are suspected to be congenital.4 it is difficult to establish the correct clinical diagnosis because there are no characteristic symptoms9 and sh may be interparietal with no signs on inspection or palpation.8
10 generally , patients present a localized pain that in time becomes diffuse and aggravating . in doubtful cases , ultrasonography ( us ) , computed tomography ( ct ) , and magnetic resonance imaging ( mri ) can help to establish the correct diagnosis .
we report a case of sh in a 14-year - old girl presented with recurrent abdominal pain . in a review of literature from 2000 to 2013
, we collected only 24 cases of sh in children younger than the age of 14 years , for a total of 25 cases including our case .
we had considered the following parameters : age , sex , side , associated risk factors , associated anomalies , and content of hernia sac .
a tall , thin 14-year - old girl without other comorbid... | spigelian hernia ( sh ) is a surgical rarity in children , which occurs through slit - like defects in the anterior abdominal wall adjacent to the semilunar line , the convexity lateral line which joins the nine ribs to the pubic tubercle and signs the limit between the muscular and aponeurotic portion of transversus abdominis muscle . as there are no specific symptoms and signs , the diagnosis is difficult , especially in children .
we report a case of sh that comes to our observation : a 14-year - old girl presented recurrent abdominal pain associated to intermittent palpable mass in the paraumbilical region .
starting from our case report , we review the literature of pediatric sh from 2000 to 2013 and we describe the anatomy , etiology , clinical presentation , instrumental diagnosis , and surgical technique of pediatric sh . |
7,582 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: studies on asthmatic patients and animal models of allergy have demonstrated that th2 cells produce cytokines il-4 , il-5 , and il-13 and thus contribute to development of asthma characterized by airway inflammation , mucus hypersecretion , and airway hyperresponsiveness .
however , the mechanisms through which nave t cells differentiate to th2 cells in response to allergens remain unclear .
dcs are a group of cells which possess the ability in dictating nave cd4 + t cells differentiation to either th1 or th2 cells depending on ambient microenvironment [ 1 , 2 ] .
it is still an enigma how antigen - specific th2 cells get skewed polarization and how they maintain a dominant status in allergy .
recent studies have showed that dcs express t cell immunoglobulin mucin domain ( tim)4 that ligates tim1 on th2 cells to promote th2 cells development .
tim is a new family of cell surface proteins that are potentially involved in the regulation of effector t cell responses .
accumulated data suggest that several tim molecules play critical roles in the regulation of th1 and th2 immune responses . among them
, dc - derived tim4 has been found to be able to drive cd4 + t cells into th2 cells [ 4 , 5 ] .
it has also been observed that the expression of tim4 on dcs could be up - regulated dramatically upon activation [ 6 , 7 ] .
however , little is known about the actions of allergens in tim4 upregulation on dcs .
cockroaches have been identified to induce allergy in different regions of the world [ 811 ] .
the most common cockroach species , which are frequently found in homes , are b. germanica and periplaneta americana ( p. americana ) [ 12 , 13 ] .
over the past decade , seven allergens of b. germanica ( bla g 1 , bla g 2 , bla g 4 , bla g 5 , bla g 6 , bla g 7 , and bla g 8) have been cloned [ 1417 ] . among them , bla g 7 is a tropomyosin and has a highly cross - reactive pan - allergen to serum ige . since the structure of bla g 7 is very similar to per a 7 ( a tropomyosin from p. americana ) , which has been... | as one of the most common sources of indoor aeroallergens worldwide , cockroach is important in causing rhinitis and asthma while the mechanisms underlying remain obscure . since t helper ( th ) type 2 polarization plays an important role in the pathogenesis of allergic diseases , we investigated the effect of bla g 7 , a pan - allergen from blattella germanica ( b. germanica ) , on th polarization which is controlled by monocyte - derived dendritic cells ( dcs ) . challenged by recombinant bla g 7 ( rbla g 7 ) , immature dcs obtained from human exhibited upregulated levels of tim4 , cd80 , and cd86 and increased il-13 secretion
. cocultured with cd4 + t cells , challenged dcs increased the ratio of il-4 + versus ifn-+ of cd4 + t cells , suggesting a balance shift from th1 to th2 .
moreover , antibodies against tim4 , cd80 , and cd86 reversed the enhancement of il-4+/ifn-+ ratio and alleviated the il-13 release induced by rbla g 7 , indicating that the th2 polarization provoked by rbla g 7 challenged dcs is via tim4- , cd80- , and cd86-dependent mechanisms . in conclusion , the present findings implied a crucial role of bla g 7 in the development of cockroach allergy and highlighted an involvement of dcs - induced th2 polarization in cockroach allergy . |
7,583 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: this study compared travel histories of c. gattii infected case - patients with travel patterns of the general public to validate and refine these risk areas on vi .
we also examined spatial progression of these areas over time to assess whether c. gattii spread from a single focal point since its emergence in 1999 . c. gattii infected case - patients were defined as bc residents with culture - confirmed c. gattii infection or hiv - negative residents of bc with cryptococcus sp .
analysis included all cases diagnosed from january 1999 through december 2006 in which the patient had documented travel history on vi .
case - patients were interviewed by using a standard questionnaire and asked about travel to any city outside their city of residence in the 12 months before symptom onset or diagnosis ( 8) .
tourism bc ( www.hellobc.com/en-ca/default.htm ) provided aggregated monthly visitor volume to 14 visitor centers in major tourist destinations ( figure ) on vi during 20002006 .
only visitors classified as bc residents were included in these analyses ; additional personal attributes of visitors were not collected ( c. jenkins , pers .
proportion of visits to each visitor center city was defined as number of visits to a visitor center city divided by total number of visits to all visitor center cities . for case - patients ,
the proportion was similarly defined . in both instances , visits to multiple cities by the same person were counted multiple times . differences between proportion of case - patient visits and tourism bc visits were evaluated by fisher exact test and statxact software ( cytel inc . , cambridge , ma , usa ) .
analysis was conducted for all years combined and in 2 four - year increments ( 19992002 and 20032006 ) to assess potential spread of c. gattii on vi over time . because tourism bc visitor data were unavailable for 1999 , case data for 19992002 were compared with aggregated tourism bc visitor data from 2000 through 2002 .
analysis was also conducted for a subset of case - patients... | we compared travel histories of case - patients with cryptococcus gattii infection during 19992006 to travel destinations of the general public on vancouver island , british columbia , canada .
findings validated and refined estimates of risk on the basis of place of residence and showed no spatial progression of risk areas on this island over time . |
7,584 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cutaneous manifestations of crohn s disease ( cd ) typically present as lesions that are contiguous with the gastrointestinal tract , such as peri - oral and peri - anal lesions [ 1 , 2 ] .
vulval involvement , mostly due to distant spread of granulomata ( metastatic cd ) , is rare , especially in children [ 2 , 3 ] . here ,
a 10-year - old girl presented to the dermatology department at york hospital with a 12-month history of asymptomatic erythema and swelling of the vulva .
the patient was a healthy - looking girl with normal height and weight for her age .
peau dorange appearance , with a large skin tag in the anterior peri - anal area ( fig . 1 ) .
examination of the oral mucosa , rectum , and the rest of the skin was unremarkable .
the patient was treated with tacrolimus ointment 0.03% which resulted in good control of the disease . a year after the initial presentation
1vulval swelling noted in patient 1 vulval swelling noted in patient 1 a 13-year - old girl presented with a 9-month history of asymptomatic vulval swelling .
the patient was diagnosed with cd at the age of 5 years and had been well - controlled on methotrexate .
examination of the peri - anal skin showed fissures and skin tags ( fig . 2 ) .
examination of the rest of the skin , oral mucosa , and other systems was unremarkable .
biopsy of the affected vulval area showed typical features of non - caseating granulomata with negative stains and culture for organisms .
the patient was treated with intralesional triamcinolone and oral metronidazole , which resulted in a clear improvement in terms of swelling after 3 months.fig .
2unilateral vulval swelling with erythema noted in patient 2 unilateral vulval swelling with erythema noted in patient 2
a 10-year - old girl presented to the dermatology department at york hospital with a 12-month history of asymptomatic erythema and swelling of the vulva .
the patient was a healthy - looking girl with normal height and weight for her age .
peau dorange appearance , with a large skin tag in... | vulval involvement in crohn s disease ( cd ) is rare , particularly in children .
the clinical features include erythema , edema , ulceration , and labial skin tags .
the authors present two cases of children with vulval cd . in both cases ,
marked labial edema was the presenting feature .
in one patient the immunomodulator tacrolimus ointment 0.03% was used with success . in the second patient control
was achieved with intralesional triamcinolone in combination with systemic metronidazole . |
7,585 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: despite advances in diagnostic techniques , fever of unknown origin ( fuo ) remains a formidable challenge , with the cause of fever not being identified in 7%38% of patients.1 oren - gedoku - to ( ogt ) has been used traditionally to remove heat and poison from the body.2 on the basis of this theory in oriental medicine , it has been used in clinical practice to treat inflammation , hypertension , gastrointestinal disorders , and liver and cerebrovascular disease.2 in japan , ogt is manufactured as a powdered , freeze - dried water extract by tsumura co , ltd ( tokyo , japan ) .
a 33-year - old woman was admitted to our general medicine department with fuo which had persisted for longer than 2 months and was resistant to treatment with nonsteroidal anti - inflammatory drugs and prednisolone 20 mg / day .
she reported sweating and headache , but did not complain of body weight change , pain , nausea , abnormal vaginal bleeding , or diarrhea . to treat dysmenorrhea and premenstrual syndrome ,
she had been prescribed oral contraceptives ( levonorgestrel , ethinylestradiol ) for 7 years , and the dose had remained unchanged during that period .
she had no history of pregnancy , and a gynecologic examination revealed no infectious or malignant findings .
she had been receiving regular follow - up care for mild depression for 3 years at our department of psychiatry and had been prescribed the antidepressants , aripiprazole and duloxetine hydrochloride , until 2 months before admission .
she had asthma , which was well controlled with the inhaled steroid budesonide ( 200 g , once daily ) .
she was a housewife and only had sexual contact with her husband who had no sexually transmitted diseases .
her mental status was alert , and blood pressure was 92/60 mmhg in a sitting position .
although the rise in body temperature was accompanied by an increase in pulse rate , her pulse was normal , ranging from 58 to 82 beats per minute .
her pulse rate was regular in rhythm , and its size , and tension were within the... | oren - gedoku - to is a traditional medicine used for treating inflammatory conditions and is given by prescription in japan , people s republic of china , and korea .
its anti - inflammatory effect is related to the arachidonate cascade and inhibition of cyclo - oxygenase , but research on other anti - inflammatory pathways is ongoing .
we report a case of fever of unknown origin in a 33-year - old woman .
the possibility of infection due to human immunodeficiency virus , autoimmune , neoplastic , or other disease was examined and excluded .
oren - gedoku - to was successfully used to treat her symptoms and may thus be a suitable treatment for patients with undiagnosed fever of unknown origin |
7,586 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nutritional therapy in critically ill - patients improves wound healing , reduces rates of certain complications and mortality seems to reduce .
enteral nutrition is recommended as the first option for most patients in light of the evidence of significant benefits while parenteral nutrition does not seem to add benefit to most critically ill - patients . however , gastric intolerance is common , associated with the opioid or vasopressor use and shock , it reduces the energy delivery and can increase the incidence of nosocomial pneumonia .
the slow gastric emptying may contribute to an increase in gastric residual volume predisposing to bacterial colonization and the occurrence of aspiration pneumonia in critically ill - patients .
the nutrition by a postpyloric tube can overcome the difficulty of gastric emptying , and as the jejunum has a higher absorptive capacity and is less susceptible to decreased motility , it could be advantageous
. however , studies and meta - analyzes comparing nasojejunal and nasogastric nutrition show inconsistent results regarding the delivery of nutrition or of pneumonia even when patients at risk for reduced gastric motility are included . a meta - analysis published in 2013 evaluated 15 randomized trials until 2011 and concluded that the incidence of pneumonia is increased .
davies et al . , in the largest randomized trial comparing the use of nasogastric and nasojejunal tube , did not observe any significant differences in outcome .
our hypothesis is that the use of a jejunal tube does not reduce the incidence of nosocomial pneumonia .
the primary objective of this study is to evaluate the incidence of pneumonia throughout the stay in intensive care unit ( icu ) comparing gastric with jejunal nutrition .
secondarily , we evaluated the mortality rate in the icu until the 28 day and other complications potentially related to enteral feeding .
all patients admitted to a university icu for a period of 12 months were eligible for the study .
data collection was... | background and aims : studies comparing jejunal and gastric nutrition show inconsistent results regarding pneumonia .
the aim of this study was to evaluate the incidence of pneumonia comparing gastric with jejunal nutrition .
secondarily , we evaluated 28th day intensive care unit ( icu ) mortality rate and other complications related to enteral feeding.subjects:age > 18 years ; need for enteral nutrition without contraindication for placement of an enteral tube , duration of icu stay > than 48 h.methods:patients were randomly assigned to receive enteral feed via a gastric or jejunal tube .
jejunal tubes were inserted at bedside and placement was confirmed radiographically.results:a total of 115 patients were enrolled , with 61 patients into the gastric tube group and 54 patients into the jejunal group tube .
baseline characteristics were similar .
there was no difference in pneumonia or icu mortality rates , icu length of stay and ventilator days .
complications rates were similar.conclusions:we conclude that the enteral nutrition through a jejunal tube does not reduce the rate of pneumonia in comparison to a gastric tube .
in addition , we did not observe differences in rates of gastrointestinal complications or icu mortality .
the routine placement of a jejunal tube in critically ill - patients can not be recommended . |
7,587 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: micrornas ( mirnas ) are small non - coding rnas of approximately 19 to 25 nucleotides that post - transcriptionally regulate gene expression .
they bind to the 3'-untranslated region ( utr ) of their target messenger rnas ( mrnas ) through complementary recognition , which then leads to mrna degradation or repression of protein expression ( 1,2 ) . to date , over 2000 mature mirna products have been identified in the human genome and the number registered on the mirna database is still growing .
more important than the expanding numbers is the complex regulatory network mediated by mirnas , which controls a spectrum of biological events ranging from cell differentiation , proliferation and homeostasis , cell - cell interactions to intracellular signalling responses ( 3,4,5,6 ) .
furthermore , mirnas play important roles in the development and function of innate and adaptive immune cells ( 7,8 ) .
many immunoregulatory genes , including transcription factors , cofactors and chromatin modifiers , are mirna targets and some even harbour binding sites for eight or more different mirnas ( 9 ) .
likewise , each mirna could potentially recognise many , or even up to hundreds of , target genes ( 4 ) .
therefore , dysfunction of mirnas or dysregulation of their expression in the immune cells would lead to immunodeficiency or autoimmunity .
systemic lupus erythematosus ( sle ) is a potentially lethal chronic autoimmune disease , which affects multiple organ systems ranging from the skin , kidney , central nervous system , to the haematological , musculoskeletal , cardiovascular and the gastrointestinal systems ( 10,11,12 ) .
overall , the array of clinical manifestations in sle is intricate , suggesting that the pathogenesis of sle may involve the interplay of multiple factors .
immunologically , sle is the consequence of loss of self - tolerance and amplification of self - antigen - mediated hyperactivation of t and b lymphocytes . since the discovery of mirnas , a growing attention has been drawn to their... | micrornas ( mirnas ) are endogenous small rna molecules best known for their function in post - transcriptional gene regulation .
immunologically , mirna regulates the differentiation and function of immune cells and its malfunction contributes to the development of various autoimmune diseases including systemic lupus erythematosus ( sle ) . over the last decade , accumulating researches provide evidence for the connection between dysregulated mirna network and autoimmunity .
interruption of mirna biogenesis machinery contributes to the abnormal t and b cell development and particularly a reduced suppressive function of regulatory t cells , leading to systemic autoimmune diseases .
additionally , multiple factors under autoimmune conditions interfere with mirna generation via key mirna processing enzymes , thus further skewing the mirna expression profile .
indeed , several independent mirna profiling studies reported significant differences between sle patients and healthy controls . despite the lack of a consistent expression pattern on individual dysregulated mirnas in sle among these studies , the aberrant expression of distinct groups of mirnas causes overlapping functional outcomes including perturbed type i interferon signalling cascade , dna hypomethylation and hyperactivation of t and b cells
.
the impact of specific mirna - mediated regulation on function of major immune cells in lupus is also discussed .
although research on the clinical application of mirnas is still immature , through an integrated approach with advances in next generation sequencing , novel tools in bioinformatics database analysis and new in vitro and in vivo models for functional evaluation , the diagnostic and therapeutic potentials of mirnas may bring to fruition in the future . |
7,588 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: down syndrome is popularly known as trisomy 21 , because it is a genetic disorder caused by a presence of all or part of a third copy of chromosome 21 , patterson .
globally , as of 2010 , down syndrome occurs in about 1 per 1000 live births and results in about 17,000 deaths .
most of the hospitals in bangladesh do not have any facilities to confirm the diagnosis of down syndrome using genetic sequencing .
thus , we often rely on clinical diagnosis of down syndrome . children with down syndrome are more likely to have multiple health problems than the general population .
some of these problems are associated with failure to thrive leading to life threatening serious illness .
it is therefore important to be aware of conditions involved and of their presenting symptoms and management .
although diarrhea may be a common comorbidity in down syndrome children under 5 years , little is known about such population . like other hospitals of bangladesh and in other developing countries , the case - load of clinically diagnosed down syndrome children having diarrhea is not uncommon at the dhaka hospital of the international centre for diarrhoeal disease research , bangladesh ( icddr , b ) , the only international organization that works on diarrhea disease research . however , there is no published data on the factors associated with clinically diagnosed down syndrome children having diarrhea .
identification of factors associated with clinically diagnosed down syndrome and diarrhea in such population may help to reduce morbidity and deaths in resource poor settings .
thus , the aim of our study was to describe our experience with down syndrome patients admitted with diarrhea by identifying the factors associated with clinically diagnosed down syndrome in diarrheal children .
in this chart review , data were analyzed anonymously ; thus , no parental or ethical consent was required .
this was a retrospective chart review that was conducted at the dhaka hospital of icddr , b using electronic database of the hospital... | there is lack of information in the medical literature on clinically diagnosed down syndrome children presenting with diarrhea .
our aim was to describe our experience with down syndrome patients admitted with diarrhea by evaluating the factors associated with down syndrome presenting with diarrheal illness . in this retrospective chart analysis
, we enrolled all the diarrheal children aged 059 months admitted to the dhaka hospital of the international centre for diarrheal disease research , bangladesh ( icddr , b ) , from march 2011 to february 2013 .
down syndrome children with diarrhea constituted cases and randomly selected threefold diarrheal children without down syndrome constituted controls .
among 8422 enrolled children 32 and 96 were the cases and the controls , respectively .
median age ( months ) of the cases and the controls was comparable ( 7.6 ( 4.0 , 15.0 ) versus 9.0 ( 5.0 , 16.8 ) ; p = 0.496 ) .
the cases more often presented with severe acute malnutrition , developmental delay , congenital heart disease , hypothyroidism , sepsis , hypocalcemia , developed hospital acquired infection ( hai ) during hospitalization , and required prolonged stay at hospital compared to the controls ( for all p < 0.05 ) . thus , diarrheal children with clinically diagnosed down syndrome should be investigated for these simple clinical parameters for their prompt management that may prevent hai and prolonged hospital stay . |
7,589 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a team from oxford outcomes , inc . , in collaboration with the american academy of orthopedic surgeons ( aaos ) , developed a survey of orthopedic practices to determine if the orthopedic practice had onsite mri capacity , and if so the type of mri capacity ( extremity or full body ) , the date of acquisition for the mri equipment , and general information about the practice .
the survey platform was developed using sawtooth software ( orem , ut ; www.sawtoothsoftware.com ) , web - based survey tool .
a web - hosted platform was selected because of the user - friendly , interactive format , and the ability to monitor participation and data collection in real - time . on july 19 , 2012
, the survey was sent to practice administrators and physician aaos members by means of multiple forms of communication containing an e - mail link to the survey .
two rounds of reminder communications at approximately 3-week intervals after the initial communication were used in an effort to increase participation .
while the survey was in the field , the oxford outcomes team provided assistance to practices with questions about the survey .
4th , 2012 , a total of 770 orthopedic practice survey responses had been received , and the survey data collection was considered complete .
after closing the survey data collection process , all survey response data was downloaded into a master excel spreadsheet , and variable names were assigned to each component of the survey .
preliminary data verification consisted of the following : ( i ) deleting duplicate entries ; ( ii ) converting verbatim responses ( e.g. , respondent states
we do not own an mri ) to appropriate code values for survey variable ( e.g. , mri = 1 for onsite mri , or = 0 for no onsite mri ) , ( iii ) converting mri acquisition dates as entered in the survey to a uniform date format ( dd / mm / yyyy ) ; and ( iv ) combining web - based survey data with the e - mailed spreadsheets containing practice provider i d numbers .
duplicate responses from twenty - nine... | background : despite ongoing policy debate , little is known about the growth in orthopedic surgery practices with onsite magnetic resonance imaging ( mri ) capacity , or practice characteristics associated with the acquisition of in - office mri equipment.methods : in july 2012 , american academy of orthopaedic surgeons ( aaos ) member practices received a web - based survey requesting general information about their practice , such as number practice providers authorized to order mris , the type of onsite mri capacity present ( if any ) , and the date of acquisition for the mri equipment .
survey responses were augmented with county - level measures of practice area characteristics as of the year of first onsite mri acquisition ( or 2012 for practices without an onsite mri).results : the survey obtained usable responses from 740 orthopedic practices , which were geographically representative of aaos member practices . forty percent ( 298 ) reported onsite mri capacity .
onsite mri acquisition occurred at a steady pace over 20002012 , with no dramatic increase occurring in any particular year over that period .
multivariate logistic regression indicated that practice size ( number of providers ) was the most important factor affecting the likelihood of onsite mri acquisition .
there was no association between onsite mri acquisition and any of the county - level practice area characteristics included in the analysis.conclusions : orthopedic practices acquiring onsite mri equipment on average are much larger than practices without onsite mri capacity .
larger practices may be more likely to attain the economies of scale necessary to absorb the fixed costs associated with onsite mri acquisition . |
7,590 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the presence of an indwelling urinary catheter ( iuc ) is the principal risk factor for catheter - associated urinary tract infection ( cauti ) development . despite the risk of prolonged catheter placement
, few hospitals actively track catheterized patients , and providers are often not aware of the presence of catheters in their patients [ 13 ] .
nurses are at the frontline of catheter care . as the providers most involved with iucs in hospitalized patients , nurses are responsible for iuc placement , day - to - day catheter management , and the removal of iucs .
responsible for specimen collection , nurses play a vital role in the diagnosis of cautis . among catheterized patients ,
they are often the first to notice a clinical change or technical problem . despite their central role in iuc care and management , only a handful of published reports
the majority of these publications have followed a quality improvement ( qi ) approach , at times bundled with hospital - wide policy changes [ 47 ] . in a recent paper by drekonja et al .
however , reeducation of surgical nurses in urinary catheter management has shown to have a modest decrease in catheter days .
gaps in knowledge may potentially impair the effectiveness nurses may play in the prevention of catheter - related complications . with a goal of increasing awareness about the presence of iucs among medical inpatients , our team developed an educational curriculum .
after eliciting staff engagement by cultivating champions and involving the staff in all stages of the process , we instituted a practical , catheter - care curriculum which introduced qi concepts and incorporated principles of basic microbiology and hand hygiene to mirror established infection - control practices .
the curriculum targeted aspects of catheter care within the scope of practice of nursing providers and was built on published guidelines [ 810 ] .
the purpose of the qi project was to improve compliance with documentation of indwelling urinary catheter insertion .
as a... | catheter - associated urinary tract infections ( cautis ) are preventable complications of hospitalization .
an interdisciplinary team developed a curriculum to increase awareness of the presence of indwelling urinary catheters ( iucs ) in hospitalized patients , addressed practical , primarily nurse - controlled inpatient risk - reduction interventions , and promoted the use of the iuc labels ( tags ) .
five thirty - minute educational sessions were cycled over three daily nursing shifts on two inpatient medical floors over a 1-year period ; participants were surveyed ( n = 152 ) to elicit feedback and provide real - time insight on the learning objectives .
nurse self - reported iuc tagging was early and sustained ; after the iuc tag was introduced , there was a significant increase in tagging reported by the end of the block of educational sessions ( from 46.2% to 84.6% , p = 0.001 ) .
early engagement combined with a targeted educational initiative led to increased knowledge , changes in behavior , and renewed cauti awareness in hospitalized patients with iucs .
the processes employed in this small - scale project can be applied to broader , hospitalwide initiatives and to large - scale initiatives for healthcare interventions . as first - line providers with responsibility for the placement and daily maintenance of iucs ,
nurses are ideally positioned to implement efforts addressing cautis in the hospital setting . |
7,591 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: most teratomas are immature in nature , and solid lesions having few focii of cystic degeneration , only 2 - 4% of lesions are predominantly cystic ( the more mature and well differentiated ) in nature whatever the case might be , these lesions usually present with signs and symptoms attributable to mass effect . on rare occasions , however , teratomas may erode into adjacent structures , such as the pleural space , pericardium and lung and/or trachea - bronchial tree .
the presenting symptom in the latter scenario is one of expectoration of mature hair follicles known as trichoptysis .
the incidence of this complication is exceedingly rare and is seen more commonly with cystic than with solid lesions .
trichoptysis as a symptom has been described in only nine cases as yet but remains pathognomonic for a mediastinal teratoma having broncho - pulmonary communication .
though computed tomography ( ct ) scan features of such a lesion have been described previously , none of these reports demonstrates a lesion to bronchus fistula on imaging . in the present report
, we not only demonstrate a fistulous communication between the tumor and the bronchial tree , but also suggest certain technical modifications and postprocessing maneuvers , which may enable an unequivocal depiction of such fistulas , to the benefit of our surgical colleagues .
a 35-year - old male with intractable cough for the preceding year associated with recurrent hemoptysis was referred for ct scan of the thorax .
the patient had been on antitubercular therapy in another hospital for 6 months with no response .
on careful interrogation , the patient complained of expectoration of fine white hairy material in his sputum , that was presumed by us to be organized mucus .
the patient however insisted that it was hair and not anything else .
a contrast - enhanced ct scan of the thorax was done as per standard protocol , which revealed a rounded , well - defined , but heterogeneous mass adjacent to the lower lobe of the left lung .
the... | trichoptysis is a rare symptom , but pathognomonic of a teratoma having a bronchial communication .
thoracic teratomas are usually located within the anterior mediastinum , but rarely present with trichoptysis , as transpleural erosion of a mediastinal teratoma into lung and hence bronchial tree is exceedingly rare .
we report the characteristic radiological and clinical features in one such case with ruptured mature mediastinal teratoma having a bronchial communication leading to trichoptysis .
only nine cases of trichoptysis have been reported in the literature as yet , but a fistulous communication with the bronchial tree on computed tomography , as seen in the present report , has not been demonstrated in any of these preceding reports .
histopathological sample obtained during the surgery further confirmed the presence of a mediastinal teratoma with transpleural broncho - pulmonary communication . |
7,592 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: anterior post - traumatic dislocation of the shoulder is the most common type of dislocation and is caused by excessive external rotation and hyperextension of the arm in the overhead direction .
as the humeral head is levered out of the glenoid , the anterior post - traumatic dislocation of the shoulder can be associated with fracture of the glenoid ( i.e. bony bankart ) ; seldom can it be associated with the impaction fracture of the humeral head or of the greater tuberosity . moreover
, anterior shoulder dislocation may be associated with rotator cuff tears , especially in elderly patients . in a very few cases ,
in contrast , brachial plexus injury is rare and complicated , and very few cases have been reported in the literature .
adult traumatic brachial plexus injuries are devastating , and they are occurring with increasing frequency .
patient evaluation consists of a focused assessment of upper extremity sensory and motor function , radiological studies and , most importantly , electrodiagnostic studies .
conservative management is usually successful , and recovery takes place after several months [ 68 ] .
we report a unique case of anterior dislocation of the shoulder with associated fracture of the greater tuberosity and brachial plexus palsy .
a 27-year - old , right - handed male was involved in a high - speed car accident , when his left arm was in abduction - extra rotation .
the clinical examination performed in the emergency department showed an asymmetric profile of the left shoulder , with pain and no neurological or vascular problems .
x - ray analysis of the shoulder revealed an anteromedial dislocation associated with a fracture of the greater tuberosity ( fig .
the shoulder was then immobilized in a sling ( ir-15 abd with a pillow).fig .
1a x - ray of the right shoulder revealed an antero - medial dislocation associated with a fracture of the greater tuberosity .
b at a 3-week follow - up , x - ray showed the prolapse of the humeral head , which appeared inferiorly subluxated a x - ray... | primary post - traumatic anterior dislocation of the shoulder with associated fracture of the greater tuberosity and brachial plexus injury is rare and , to our knowledge , has never previously been reported in the literature .
we present a case of this unhappy triad in which a brachial plexus injury was diagnosed and treated 3 weeks later .
the characteristics of this rare condition are discussed on the basis of our case and the published literature in order to improve early diagnosis and treatment of this lesion . |
7,593 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: over the past several decades , researchers understanding of the causes and treatment of diseases has grown exponentially .
apart from the financial issues , lack of access to providers , and cultural factors which are most often cited , literacy is one of the prime social determinants .
literacy has recently emerged as a key item on the research agenda in medicine and public health .
the growth in information technology and the rapid advances in scientific knowledge require that the public have an ever - increasing understanding of diseases to make good decisions about their health .
poor literacy can impede one 's ability not only to seek out the needed health information but also to process , understand and use it to make appropriate health care decisions .
health literacy is defined as the degree to which individuals have the capacity to obtain , process , and understand basic health information and services needed to make appropriate health decisions. as with general health , achieving and maintaining oral health requires one to be able to understand , interpret and act on various types of health information .
oral health communications ( brochures , forms , and providers explanations of procedures and treatments , for example ) are often dense , unnecessarily technical , and full of jargon , obscured by words like pharynx , orally , occlusal and contraindications instead of more familiar terms used in everyday speech . as a result , these communications are often difficult to understand , especially for individuals with limited literacy skills .
this situation creates a significant barrier to improved oral health , exacerbating other barriers such as those related to economics , insurance coverage , and access .
a survey is needed to determine the level of oral health literacy among members of the public and its effect on their ability to make good decisions about oral health .
an understanding of health literacy and how it differs among dental patients is an important beginning step in... | background : poor literacy can impede one 's ability not only to seek out needed health information but also to process , understand and use it to make appropriate health care decisions . the objective of the study was to assess the health literacy among adult patients seeking oral health care at in a private dental hospital in bangalore , karnataka , india.materials and methods : a cross sectional questionnaire survey was carried out on 500 subjects .
the questionnaire designed by chew and colleagues ( 2004 ) was modified and used as the survey instrument . to be eligible to participate in the study ,
the participants had to be aged above 18 years and able to read or write english / kannada ( local language ) .
analysis of variance ( anova ) and student 's t - test ( two tailed , independent ) was used to find the significance of study parameters at 95% confidence interval.results:about 60.4% of the subjects had low health literacy level , 29.4% average and only 10.2% had high health literacy levels .
age and educational qualification had a suggestive significant difference with the mean health literacy scores while gender did not have any significant difference .
subjects who had completed post - graduation ( 57.8% ) too had low health literacy levels.conclusion:a large number of patients have low levels of health literacy that may interfere with their ability to process and understand basic health information . |
7,594 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: dna in all eukaryotic organisms is bound by nucleosomes , forming a physiological chromatin context in which all molecular processes involving dna operate .
the integrity of the chromatin template is constantly compromised by fundamental biological processes , such as dna replication , repair , and transcription , following which the normal chromatin structure is restored with the help of histone chaperone proteins ( gurard - levin et al . , 2014 , ransom et al . , 2010 ) .
advances in recent years have shed light on some of the molecular players involved in chromatin assembly and maintenance , separating ( on the molecular level ) dna replication - dependent and -independent pathways ( burgess and zhang , 2013 ) .
histone proteins themselves are central to these processes : the expression and incorporation of canonical histones is tightly coupled to dna replication ; in contrast , histone variants can be incorporated into chromatin independent of the cell cycle ( maze et al . , 2014 ) . while it has become increasingly clear that the activity of histone chaperone proteins is of critical importance during dna replication and repair ( adam et al . , 2013 , hoek and stillman , 2003 , polo et al . , 2006 , ransom et al . , 2010 ) ,
studies that have attempted to dissect the importance of histone replacement in the interphase nucleus have revealed only a limited contribution of histone chaperones and/or variants to transcriptional regulation ( banaszynski et al . , 2013 ,
goldberg et al . , 2010 , hdl and basler , 2009 , sakai et al . , 2009 ) .
these studies , however , have been complicated by the use of proliferative cell systems that could ( at least partially ) restore chromatin integrity through replication - coupled chromatin assembly ( banaszynski et al .
, 2013 , hdl and basler , 2009 , sakai et al . , 2009 , wyrick et al . , 1999 ) .
thus , the extent to which basic physiological processes , such as transcription , are dependent on or regulated by histone replacement remains unclear . to... | summarythe integrity of chromatin , which provides a dynamic template for all dna - related processes in eukaryotes , is maintained through replication - dependent and -independent assembly pathways . to address the role of histone deposition in the absence of dna replication
, we deleted the h3.3 chaperone hira in developing mouse oocytes . we show that chromatin of non - replicative developing oocytes is dynamic and that lack of continuous h3.3/h4 deposition alters chromatin structure , resulting in increased dnase i sensitivity , the accumulation of dna damage , and a severe fertility phenotype . on the molecular level , abnormal chromatin structure leads to a dramatic decrease in the dynamic range of gene expression , the appearance of spurious transcripts , and inefficient de novo dna methylation .
our study thus unequivocally shows the importance of continuous histone replacement and chromatin homeostasis for transcriptional regulation and normal developmental progression in a non - replicative system in vivo . |
7,595 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 73 year - old patient with mild hemophilia b ( factor ix clotting activity 12% ) was referred to our department due to a left renal tumor incidentally discovered during ultrasonography performed as follow - up two years after prostate cancer brachytherapy . on admission
abdominal and pelvic ct scans revealed a multilocular tumor in the lower left kidney pole ( 57x52x52 mm ) with a solid mass of 3.5 cm in diameter ( figure 1 ) . other abdominal and chest imaging showed no abnormalities .
twelve hours before surgery , he was transfused with 4200 units of factor ix concentrate ( octanine , octapharma ag , switzerland ) , with the same dose administered one hour prior to the procedure .
on october 3 of 2014 , the procedure was performed with the patient positioned on his right side . following urinary catheterization
, a veress needle was introduced close to the umbilicus and an intraperitoneal pressure of 14 mmhg was created .
the descending colon was dissected and the fat renal capsule subsequently cut for access to the left renal artery .
the artery was then clipped with polymeric clips ( hem - o - lok xl ( teleflex , usa ) and cut in between . the same was done for the renal vein .
the kidney was excised , placed into a hemobag ( covidien , usa ) and removed through a small incision between the two ports .
a plastic drain was placed into the kidney bed and the abdominal wall was closed with layers of sutures .
peritoneal drainage was kept in place for two days with no significant output of blood or serous fluid .
substitution therapy was continued for 9 days with the level of factor ix clotting activity at 90130% of the normal value on days 13 , 6574% on days 46 and 3040% on days 79 .
the postoperative course was uneventful and the patient was discharged on 10 day after surgery .
histopathological investigation revealed renal carcinoma , clear cell type ( g2 ) , limited to the parenchyma , without capsule infiltration or angioinvasion .
no abnormalities were revealed in ultrasonography and ct scans .... | surgery in patients with hemophilia is a serious challenge .
it requires a comprehensive approach , as well as careful postoperative monitoring .
we present here the first case of a transperitoneal laparoscopic radical nephrectomy ( tlrn ) for renal cell carcinoma , of the clear - cell type , performed in a hemophilia b patient .
the level of factor ix clotting activity before surgery and on postoperative days 16 was maintained at 65130% and at 3040% on subsequent days until healing of the post - operative wound was achieved .
the intraoperative and postoperative courses were uneventful .
tlrn can therefore be considered safe and effective for renal cell carcinoma . in hemophilia patients ,
the tlrn procedure requires proper preparation , as well as adequate substitution therapy for the deficient coagulation factor provided by a multidisciplinary team in a comprehensive center . |
7,596 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: viruses are major pathogens in all kingdoms of life . single - stranded ( ss)rna viruses make up a significant fraction of these pathogens with detrimental impacts on human health
. their control via vaccination will only ever be possible for a limited subset of examples , so innovative routes to antiviral therapy are urgently required .
virion formation and uncoating are highly cooperative aspects of the viral lifecycle that are potential drug targets , but these have largely not been exploited thus far .
one reason for this , with respect to assembly , is the apparent lack of specificity for rna in in vitro assays of spontaneous co - assembly to form virus - like particles .
many viral coat proteins ( cps ) also seem able to assemble correctly in the absence of rna .
the lack of sequence specificity has been interpreted to mean that assembly is driven largely by electrostatics [ 14 ] .
rnas carry a large amount of negative charge that can be neutralized by the positively charged domains or surfaces seen on many viral cps .
however , these in vitro results do not reflect the apparent specificity of genome encapsidation seen in vivo , where there is a clear biological imperative to ( 1 ) form virions packed with cognate genomes and not cellular rnas ; and to ( 2 ) complete the assembly process efficiently before the host defense mechanisms can clear the infection .
we review here our recent data that suggest that while electrostatics clearly plays an important role in ssrna virus capsid assembly , it overlooks the vital cooperative roles by which the genomic rna facilitates efficient encapsidation in an environment in which capsid protein concentrations are much lower than in most in vitro studies .
thus the genome confers a distinct evolutionary advantage to assembly of these pathogens , as well as encoding their gene products .
the deeper understanding of these mechanisms provided by our research paves the way for novel antiviral strategies , targeting these additional roles of the genome in capsid... | the formation of a protective protein container is an essential step in the life - cycle of most viruses . in the case of single - stranded ( ss)rna viruses ,
this step occurs in parallel with genome packaging in a co - assembly process .
previously , it had been thought that this process can be explained entirely by electrostatics .
inspired by recent single - molecule fluorescence experiments that recapitulate the rna packaging specificity seen in vivo for two model viruses , we present an alternative theory , which recognizes the important cooperative roles played by rna coat protein interactions , at sites we have termed packaging signals .
the hypothesis is that multiple copies of packaging signals , repeated according to capsid symmetry , aid formation of the required capsid protein conformers at defined positions , resulting in significantly enhanced assembly efficiency .
the precise mechanistic roles of packaging signal interactions may vary between viruses , as we have demonstrated for ms2 and stnv .
we quantify the impact of packaging signals on capsid assembly efficiency using a dodecahedral model system , showing that heterogeneous affinity distributions of packaging signals for capsid protein out - compete those of homogeneous affinities .
these insights pave the way to a new anti - viral therapy , reducing capsid assembly efficiency by targeting of the vital roles of the packaging signals , and opens up new avenues for the efficient construction of protein nanocontainers in bionanotechnology . |
7,597 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: junn virus ( junv ) is a south american arenavirus , the etiological agent of a severe endemo - epidemic disease called argentine hemorrhagic fever ( ahf ) .
arenaviridae is a family composed of a growing number of enveloped viruses with a bipartite single stranded rna genome .
members of the arenaviridae family were subdivided into two groups based on the geographical site of isolation , serological cross - reactivity and genetic data .
the prototype of the family , lymphocytic choriomeningitis virus ( lcmv ) is a member of the old world arenavirus group , which also includes ippy ( ippv ) , lassa ( lasv ) , mobala ( mobv ) , and mopeia ( mopv ) viruses .
junv is a member of the new world arenavirus group , that also includes allpahuayo ( allv ) , amapari ( amav ) , bear canyon ( bcnv ) , flexal ( flxv ) , guanarito ( gtov ) , latino ( latv ) , machupo ( macv ) , oliveros ( olvv ) , paran ( parv ) , pichind ( picv ) , pirital ( pirv ) , sabi ( sabv ) , tacaribe ( tcrv ) , tamiami ( tamv ) , and whitewater arroyo ( wwavs ) viruses .
in addition , there are several recently described species that have not yet been classified by the ictv ( http://www.ictvonline.org/virustaxonomy.asp?version=2008 ) .
the two rna segments of the junn virus genome are designated l and s and have approximate sizes of 7.2 and 3.5 kb , respectively .
each rna segment directs the synthesis of two proteins ; their open reading frames are arranged in opposite orientations ( ambisense coding strategy ) and are separated by a noncoding intergenic region that folds into a stable stem - loop structure .
the s rna codes for the major structural proteins of the virion : the precursor of the envelope glycoproteins ( gpc ) and the viral nucleocapsid protein ( n ) .
posttranslational cleavage of gpc renders a signal peptide and the two viral glycoproteins ( gp1 and gp2 ) .
the l rna segment codes for the viral rna - dependent rna polymerase ( l ) and the small protein ( z ) .
z is a 94 residue long polypeptide , and its central portion... | arenaviridae comprises 23 recognized virus species with a bipartite ssrna genome and an ambisense coding strategy .
the virions are enveloped and include nonequimolar amounts of each genomic rna species , designated l and s , coding for four orfs ( n , gpc , l , and z ) .
the arenavirus junn ( junv ) is the etiological agent of argentine hemorrhagic fever , an acute disease with high mortality rate .
it has been proposed that z is the functional counterpart of the matrix proteins found in other negative - stranded enveloped rna viruses . here
we report the optimized expression of a synthetic gene of z protein , using three expression systems ( two bacterial and a baculoviral one ) .
one of these recombinant proteins was used to generate antibodies .
a bioinformatic analysis was made where z was subdivided into three domains .
the data presented contributes methodologies for z recombinant production and provides the basis for the development of new experiments to test its function . |
7,598 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in critical care , as in other areas of health care , clinicians are faced with rising health care costs and aging and increasingly complex patients .
furthermore , the rate of research knowledge production is outstripping our ability to incorporate this information into patient care .
these factors , as well as the increasing awareness of the risks of medical error , have highlighted the potential benefits of information technology to clinical care .
the paper by morrison and colleagues in the previous issue of critical care describes the impact of the introduction of an electronic patient record on interdisciplinary communication during intensive care unit ( icu ) ward rounds .
critical care is a data - rich environment where it appears obvious that computing technology would be of benefit in managing the large amount of data generated by each patient , but few studies have formally evaluated the effects of introducing an information system into the icu .
some studies have addressed the benefits of clinical information systems with automated data capture from icu devices , demonstrating a reduction in nursing workload , but this finding is certainly not uniform .
furthermore , the reduction in common errors of omission and commission may be replaced by new errors facilitated by the technology itself .
it is with this fairly limited background that the paper by morrison and colleagues provides an important insight into another potential problem introduced by computing technology in the icu .
these investigators evaluated the effect of the introduction of an electronic patient record on team interactions and communication during icu rounds . in a before - and - after study of the implementation of a fully integrated electronic patient record into their 25-bed icu
, they observed and video - recorded team interactions during daily rounds . in the physical setup after implementation , data were presented on a computer screen ( rather than on a large observation chart plus additional charts and folders ) and... | information and communication technology has the potential to address many problems encountered in intensive care unit ( icu ) care , namely managing large amounts of patient and research data and reducing medical errors .
the paper by morrison and colleagues in the previous issue of critical care describes the adverse impact of introducing an electronic patient record in the icu on multi - disciplinary communication during ward rounds .
the importance of evaluation and technology assessment in the implementation and use of new computing technology is highlighted . |
7,599 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: stroke patients are characterized by an asymmetric posture due to decreased movement , and
this asymmetric posture makes balance control in a standing posture difficult , as a result
of the center of pressure moving toward the lower limb of the unaffected side , triggering
problems with postural control ability1 .
loss of balance ability in stroke patients may cause increased postural sway , reduction of
weight on the lower limb of the affected side , and increased fall risk2
. in general , balance or postural stability refers to maintaining the center of mass within
the support surface to maintain static action and to perform desired motions .
balance
ability is essential for functional activities , as well as for actions such as sitting ,
standing , and walking3 . to maintain and
adjust balance , the proprioceptive , visual , and vestibular senses must interact4 . however , 65% of stroke patients experience
loss of tactile and proprioceptive senses , largely because of impaired in proprioception
resulting from lowered muscle tone5 .
these include
therapeutic exercises , such as weight shifting to the lower limb of the affected side ,
proprioceptive neuromuscular facilitation techniques , bobath techniques , neurodevelopmental
facilitation techniques , and task - oriented exercises6 ,
7 .
repetitive exercise is necessary to
improve balance , and ankle - foot orthoses are used for hours when there is excessive
spasticity or deformity .
ankle orthoses stabilize the ankle joint and compensate for
insufficient ankle dorsiflexion and mediolateral instability of the subtalar joint ,
increasing balance ability .
they also facilitate medial shift of the center of mass and
weight shift toward the foot of the affected side , reducing asymmetric body posture8 .
dysfunction of the foot and the ankle joint of stroke patients are closely associated with
functional and kinetic aspects of the lumbar region and lower limbs , inevitably triggering
overall body imbalance9 .
the ankle... | [ purpose ] this study examined the effects of an ankle - foot orthosis worn during balance
training on lower limb muscle activity and static balance of chronic stroke patients .
[ subjects ] the subjects were twenty - five inpatients receiving physical therapy for chronic
stroke .
[ methods ] the chronic stroke patients were divided into two groups : thirteen
patients were assigned to the ankle - foot orthosis group , while the remaining twelve
patients wore only their shoes .
each group performed balance training for 20 minutes ,
twice per day , 5 days per week , for 6 weeks .
the lower limb muscle activities of the
paralyzed side tibialis anterior , medial gastrocnemius , and the stability index were
measured before and after the 6-week intervention . [ results ]
comparison of the groups
indicated a significant difference in the muscle activity of the paralyzed side tibialis
anterior and the stability index of the eyes - open standing position .
after the
intervention , the ankle - foot orthosis group evidenced a significant difference in the
muscle activities of the paralyzed side tibialis anterior and paralyzed side medial
gastrocnemius as well as the stability index of the eyes - open standing position ,
eyes - closed standing position , eyes - open standing position on a sponge , and eyes - closed
standing position on a sponge .
the group that only wore their shoes showed significant
differences in the stability indexes of eyes - open standing and eyes - open standing on a
sponge .
[ conclusion ] using the ankle - foot orthosis was effective during the initial
training of lower limb muscle activities and the static balance training of chronic stroke
patients .
however , it was not effective for a variety of dynamic situations . |
7,600 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 76-year - old female presented to the emergency department with the main complaint of 7 days of dyspnea and 1 day of dysarthria and dizziness .
auscultation findings showed an irregular heart beat with a diastolic rumbling murmur in the apical region and crackles in both lower lung fields .
transthoracic echocardiography showed a moderate degree of aortic regurgitation with left ventricular ( lv ) ejection fraction of 70.8% and a 1.631.31-cm complex , echogenic , round , mass - like lesion attached to the left atrial side of the interatrial septum .
transesophageal echocardiography revealed the same mass finding with prominent spontaneous echo contrast in the left atrium and decreased emptying velocity of the left atrial appendage ( fig .
2 ) . the diagnostic coronary angiogram revealed a round , movable mass lesion in the left atrium with feeding arteries originating from the conus branch and atrioventricular nodal artery of the right coronary artery and no significant stenosis in either coronary artery ( fig .
3 ) . the patient was transferred to cardiac surgery and underwent removal of the mass and a maze operation .
macroscopic findings were compatible with myxoma , and the microscopic findings revealed an acid mucopolysaccharide - rich stroma composed of a myxoid matrix and polygonal cells with scant eosinophilic cytoplasm scattered throughout the matrix ( fig .
4 ) . after surgery , the atrial fibrillation was abolished and an electrocardiogram showed a normal sinus rhythm .
follow - up transthoracic echocardiography was performed after surgery and no remnant mass was observed in the left atrium ( fig .
, the patient is admitted to outpatient department regularly and has taken aspirin and angiotensin receptor blocker steadily without specific problems .
the presence of possible tumor vessels originating from coronary arteries may be helpful in the decision on an operative strategy for cardiac myxoma . about 52% of cardiac myxoma is visualized by coronary angiograms according to previous reports , but... | a 76-year - old female present to the emergency department with dysarthria , dizziness , dyspnea .
the patient had hypertension and atrial fibrillation .
brain mri revealed right cerebellar infarction .
transthoracic echocardiography showed a large round mass in the left atrium .
transesophageal echocardiography showed large complex echogenic round mass lesion attached on left atrial side of interatrial septum .
coronary angiogram revealed round movable mass lesion in left atrium with feeding arteries originated from right coronary artery .
she underwent removal of mass and maze operation , and pathologic finding was compatible with myxoma . |
7,601 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | akap79/150 is a protein scaffold thought to position specific kinases ( pka , pkc ) and phosphastases ( calcineurin ) in appropriate synaptic domains so that their activities can regulate excitatory synaptic strength . using a viral - mediated molecular replacement strategy in rat hippocampal slices
, we found that akap is required for nmda receptor - dependent ltd solely due to its interaction with calcineurin . |
7,602 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: traditionally , the major mechanism underlying parkinson 's disease was thought to be reduced dopaminergic synaptic transmission in the nigrostriatal system .
however , neurons may also communicate by extrasynaptic transmission , which was recently found to affect dopamine neurotransmitter delivery through diffusion in the extracellular matrix .
fibronectin , a ubiquitous extracellular matrix component , participates in the formation and regulation of anisotropic diffusion ( i.e. , diffusion facilitated in a certain direction ) of the extracellular matrix , and dynamically regulates neuronal functional activities , such as neuroactive substance diffusion and receptor activation , anti - neuroinflammation , and cell adhesion .
studies over the past two decades have demonstrated that there exist two major modes of neuron - glial communication in the central nervous system : synaptic transmission ( or wiring transmission ) and extrasynaptic transmission . in synaptic transmission ,
synaptically evoked astrocytes produce elevated ca signals , which can trigger the release of gliotransmitters and play neuromodulatory and information - integration roles in neuronal activity , synaptic transmission and plasticity .
extrasynaptic transmission involves secretion of a wide variety of bioactive substances by neurons and neuroglia that are released or leaked into the extracellular space .
these substances mediate bidirectional communication between neurons and neuroglia through molecular diffusion , resulting in a sustained neuromodulatory action on neuronal activity .
, volume transmission and intercellular communication , all of which reflect the specific function of extracellular space .
there are four types of extrasynaptic transmission in the central nervous system ( figure 1 ) : including the intercellular short distances , the cerebrospinal fluid , the long distances around nerve fibers , and long distances around blood vessels .
the latter two types of extrasynaptic transmission display the properties of... | most hypotheses concerning the mechanisms underlying parkinson 's disease are based on altered synaptic transmission of the nigrostriatal system .
however , extrasynaptic transmission was recently found to affect dopamine neurotransmitter delivery by anisotropic diffusion in the extracellular matrix , which is modulated by various extracellular matrix components such as fibronectin .
the present study reviewed the neuroprotective effect of fibronectin in extrasynaptic transmission .
fibronectin can regulate neuroactive substance diffusion and receptor activation , and exert anti- neuroinflammatory , adhesive and neuroprotective roles .
fibronectin can bind to integrin and growth factor receptors to transactivate intracellular signaling events such as the phosphatidylinositol 3-kinase / protein kinase b pathway to regulate or amplify growth factor - like neuroprotective actions .
fibronectin is assembled into a fibrillar network around cells to facilitate cell migration , molecule and ion diffusion , and even drug delivery and treatment .
in addition , the present study analyzed the neuroprotective mechanism of fibronectin in the pathogenesis of parkinson 's disease , involving integrin and growth factor receptor interactions , and discussed the possible therapeutic and diagnostic significance of fibronectin in parkinson 's disease . |
7,603 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: reagents were received from sigma aldrich chemical co. ( bangalore , karnataka , india ) and used without further purification .
solvents were purchased from commercial sources from hyderabad , telangana , indiabased companies and purified by reported protocols .
h and c nmr spectra were recorded on bruker 300 mhz and 500 mhz machines and calibrated against tetramethylsilane ( tms ) .
mass spectrometric data were acquired by an electrospray ionization ( esi ) technique on a qtofmicro quadruple mass spectrometer . the stock solutions ( 110
m ) of ndin and ndina were prepared in chcl3 .
an aliquot of it was transferred to various ratios of chcl3/mch in different volumetric flasks ( final volume of 2 ml ) and allowed to equilibrate for 2 h prior to the uv / vis absorption measurements .
all experiments were performed upon excitation at 350 nm in a quartz cell with a 1 cm path length .
the stock solutions were prepared in a similar manner as for the absorption study and employed for emission measurements .
the stock solutions were prepared in chcl3 in a similar manner as for the uv / vis study .
sem images of ndin and ndina were recorded on an fei nova nanosem ( hillsboro , or usa ) operating at high vacuum . for sem imaging
, the samples of ndia and ndina were sputtercoated with gold for 10 s at 0.016 ma ar plasma after dropcasting the solutions on glass coverslip and solvent evaporation at rt .
tem samples were prepared by the paper blotting method followed by solvent evaporation on a holey carboncoated copper grid .
the liquid sample in chcl3/mch ( 5:95 , v / v ) was dropcasted and solvent was allowed to evaporate on the surface naturally .
reagents were received from sigma aldrich chemical co. ( bangalore , karnataka , india ) and used without further purification .
solvents were purchased from commercial sources from hyderabad , telangana , indiabased companies and purified by reported protocols .
h and c nmr spectra were recorded on bruker 300 mhz and 500 mhz machines and calibrated against... | abstractin the present work , two new naphthalene diimide ( ndi ) amphiphiles , ndin and ndina , were successfully synthesized and employed to investigate their selfassembly and optical properties . for ndina , which contains an amide group , aggregationinduced emission enhancement ( aiee ) was demonstrated in the presence of various ratios of methylcyclohexane ( mch ) in chloroform , which led to the visual color changes .
this new amidecontaining ndina amphiphile formed nanobelt structures in chloroform / mch ( 10:90 , v / v ) and microcuplike morphologies in chloroform / mch ( 5:95 , v / v ) . the closure of these microcups led to the formation of vesicles and microcapsules .
the structural morphologies gained from the solvophobic control of ndina were confirmed by various complementary techniques such as infrared spectroscopy , xray diffraction , and scanning and transmission electron microscopy . in the absence of the amide moiety in ndin , no selfassembly was observed , indicating the fundamental role of hbonding in the selfassociation process . |
7,604 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: medical researchers also realized that treating only small areas originally involved by lymphoma with radiation was not good enough , if radiation had to be used as the only treatment .
a large area covering all lymph node areas in the upper or lower half of the body had to be treated .
when the upper half of the body was being treated , the efrt field was called the mantle field .
a high - dose radiation exposure on the thorax is mainly used in the context of adjuvant radiotherapy after conservative or radical breast surgery , adjuvant or exclusive radiotherapy of lung and esophageal cancer , and as a complement to systemic treatment in lymphoma .
irradiation of the heart increases the risk of the so - called radiation - induced heart disease ( rihd ) .
the incidence of rihd is 1030% by 510 years posttreatment ; the prevalence of rihd , in the setting of the modern protocols of delivering adjuvant radiotherapy , reduction in doses , and field radiation size , is still poorly defined .
we describe the case of a 66-year - old female with a history of hodgkin 's lymphoma ( type 1a ) treated with mantle radiotherapy in 1973 .
she was admitted for congestive heart failure in radiation - induced heart disease . a cardiac computed tomography angiography ( 64 dual - source , caredose , and electrocardiogram pulsing mindose ) showed calcified ascending aorta and pericardium calcification narrowing the right ventricle , bronchiectasis and fibrosis of the lungs , and esophagus [ figure 1a and b ] . ( a )
multidetector computed tomography short - axis view of the calcification in the ascending aorta and the nearest thickened pericardium , ( b ) multidetector computed tomography long - axis view of the thickened wall of the esophagus a cardiac magnetic resonance imaging ( 1.5 t ) revealed normal left ventricle size ( vts 17 ml , vtsi 10 ml / m ) , with ejection fraction of 0.87 , stroke volume ( sv ) of 70 ml , sv index 39 ml / m , aortic regurgitation and stenosis with aortic valve peak velocity of 163 cm / s and a... | the long - term sequelae of mantle therapy include , especially lung and cardiac disease but also involve the vessels and the organs in the neck and thorax ( such as thyroid , aorta , and esophagus ) .
we presented the case of 66-year - old female admitted for congestive heart failure in radiation - induced heart disease .
the patient had undergone to massive radiotherapy 42 years ago for hodgkin 's disease ( type 1a ) .
transesophageal echocardiography was performed unsuccessfully with difficulty because of the rigidity and impedance of esophageal walls .
our case is an extraordinary report of radiotherapy 's latency effect as a result of dramatic changes in the structure of mediastinum , in particular in the esophagus , causing unavailability of a transesophageal echocardiogram . |
7,605 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it has been reported that serious problems during general anesthesia occur in 0.4% of patients .
it may be difficult to detect anaphylactic reactions during anesthesia because various medications are administered in short periods of time , and transient interactions between drugs may take place .
there have been many reports on anaphylactic reactions due to propofol or muscle relaxants during anesthesia induction .
in contrast , cases on anaphylactic reactions before induction are rare , but in the absence of adequate monitoring and immediate treatment , can be fatal to the patients .
we report life - threatening conditions in a patient due to a severe anaphylactic reaction during transfer to the operating room before induction of anesthesia .
an 84-year - old woman , 148 cm in height and 61 kg in weight was scheduled for open reduction and internal fixation due to left calcaneous fracture with dislocation .
she had been taking hypertension medication for five years but had no previous history of asthma , allergic rhinitis , or atopic dermatitis .
however , one year ago she was treated with conservative management after experiencing dizziness and general weakness following injection of an unknown drug .
she received no premedication other than tridol , which was administered for pain control a day before the surgery .
her blood pressure , heart rate , and temperature were 130/80 mmhg , 68 beat / min , 36.8c , respectively .
after a negative intradermal skin test ( 2 mg / ml in normal saline with cefbuperazone ( tomiporan ) , 1 g of cefbuperazone ( tomiporan ) was injected before transfer to the operating room .
fifteen minutes later in the surgical waiting room , the patient had slight difficulty in breathing but had an alert mental state .
five minutes later , as the patient was being moved to the operation bed , the patient became incontinent of urine and unconsciousness .
her blood pressure was 105/65 mmhg , heart rate 62 beat / min , and arterial oxygen saturation 75% . intubation was performed... | although uncommon , anaphylactic reactions during surgery are very dangerous and can result in serious morbidity .
various anesthetics can trigger anaphylactic reactions , and incidents with cephalosporin antibiotics are on the rise . in the case
presented , an 84-year - old woman scheduled for calcaneus fracture surgery , was injected with cefbuperazone as a prophylactic antibiotic . on the way to the operating room ,
before induction of anesthesia , the patient lost consciousness and showed signs of hypoxemia , and anaphylactic reaction , which included hypotension , bronchospasm , and rash .
five hours after immediate intubation and fluid resuscitation , the patient was extubated and transferred to the general ward .
eight weeks later , the skin prick test confirmed a positive reaction to cefbuperazone . |
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