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6,206 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the setting was the kaiser permanente medical care program of northern california ( kpnc ) , a large group practice prepaid health plan where gdm is diagnosed in accordance with the american diabetes association ( ada ) guidelines ( 2,13 ) .
the study was conducted in collaboration with the kpnc regional perinatal service center , which provides supplemental prenatal care over the telephone to women with gdm .
women with gdm according to the ada criteria ( 13 ) were eligible to participate .
exclusion criteria included : age < 18 years ; multiple gestation ; diagnosis of diabetic retinopathy ; high - risk pregnancy ( i.e. , drug or alcohol abuse , chronic health problems , or pregnancy complications ) ; thyroid diseases diagnosed in the last 30 days ; and non - english speaker .
eligibility was assessed through the review of electronic medical records and telephone interviews ( fig .
women were randomly assigned to the lifestyle intervention condition or usual care control condition upon completion of their baseline clinic visit .
a computer randomization program was used to ensure that the conditions remained balanced with regards to the following characteristics : age ( < 30 and 30 years ) , parity ( 1 and > 1 ) , and pregravid bmi ( < 27.0 and 27.0 kg / m ) . the institutional review board at kpnc approved the study protocol .
the intervention was called diet , exercise and breastfeeding intervention ( debi ) for women with gdm .
two trained dietitians delivered the intervention , which was adapted from the dpp curriculum and incorporated behavioral constructs from social cognitive theory ( 14 ) and the transtheoretical model ( 15 ) of behavior change .
the prenatal phase started soon after the diagnosis of gdm and consisted of one in - person session and two individual telephone counseling contacts .
the dietitians explained to the women their elevated risk of developing type 2 diabetes and advised the women to comply with the iom guidelines ( 16 ) for gwg that were in place at the time . for obese... | objectiveto pilot , among women with gestational diabetes mellitus ( gdm ) , the feasibility of a prenatal / postpartum intervention to modify diet and physical activity similar to the diabetes prevention program .
the intervention was delivered by telephone , and support for breastfeeding was addressed.research design and methodsthe goal was to help women return to their prepregnancy weight , if it was normal , or achieve a 5% reduction from prepregnancy weight if overweight .
eligible participants were identified shortly after a gdm diagnosis ; 83.8% consented to be randomly assigned to intervention or usual medical care ( 96 and 101 women , respectively ) .
the retention was 85.2% at 12 months postpartum.resultsthe proportion of women who reached the postpartum weight goal was higher , although not statistically significant , in the intervention condition than among usual care ( 37.5 vs. 21.4% , absolute difference 16.1% , p = 0.07 ) .
the intervention was more effective among women who did not exceed the recommended gestational weight gain ( difference in the proportion of women meeting the weight goals : 22.5% , p = 0.04 ) .
the intervention condition decreased dietary fat intake more than the usual care ( condition difference in the mean change in percent of calories from fat : 3.6% , p = 0.002 ) and increased breastfeeding , although not significantly ( condition difference in proportion : 15.0% , p = 0.09 ) .
no differences in postpartum physical activity were observed between conditions.conclusionsthis study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight .
strategies to help postpartum women overcome barriers to increasing physical activity are needed . |
6,207 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: florid cemento - osseous dysplasia ( fcod ) refers to a group of fibro - osseous lesions ,
which are exuberant , multiquadrant and arise from the tooth - bearing area of the jaws
.
fcod is a benign jaw lesion and is
discovered most frequently in the mandible of middle - aged black female .
it usually presents a multiple radiopaque
bone / cemetum - like masses distributed throughout the jaw .
fcod lesions have a striking tendency towards bilateral , often quite symmetrical ,
location , and it is not unusual to find extensive lesions in all 4 posterior
( molar - premolar region ) quadrants of the jaw .
the word " florid " was introduced to describe the wide
spread , extensive manifestations of the disease in multiple quadrants of the jaws
.
the various synonyms used are
multiple enostoses , multiple cemento - ossifying fibromas , multiple periapical
osteofibromatosis , florid cement - osseous dysplasia and gigantiform cementom . in 2005 ,
world health organization
subdivided cemento - osseous dysplasias ( cods ) into periapical , florid and other cods
.
the definite diagnosis of these 3
diseases can not be reached by clinical ground , but only by histopathologic
examination .
although , the disease may be
totally asymptomatic , some patients present with pain , swelling , purulent discharge
and sequestrum formation .
rare reports of
its association with simple bone cysts ( sbc ) are present usually when the cases
reported are symptomatic .
melrose and co - workers were the first to observe this association in their series of 34
cases , where 14 patients had concurrent , biopsy - proven simple bone cyst .
fcod is not
associated with any other extragnathic abnormalities and there are no abnormalities
in blood chemistry of patients .
most benign fibro - osseous lesions of jaws are asymptomatic and slowly progressing
. those benign fibro - osseous lesions
that present as an atypical radiographic appearance require a detailed clinical ,
radiographic and laboratory... | abstractbackgroundthe purpose of this report is to present a rare case of co - occurrence of
florid cemento - osseous dysplasia with simple bone cyst in a middle aged
asian woman .
most of the reported cases are isolated cases of simple bone
cyst or florid cemento - osseous dysplasia , but co - occurrence of these two
entities is extremely rare.methodsthe authors report a 41 year old female patient with co - occurrence of
mandibular florid cemento - osseous dysplasia with simple bone cyst .
a
thorough clinical and radiological examination was carried out.resultsit was diagnosed mandibular cyst with possible co - occurrence of florid
cemento - osseous dysplasia .
surgical exploration of the multilocular lesion
was applied . since , the patient was symptomatic at the time of presentation
utmost caution was taken during the surgical procedure as florid
cemento - osseous dysplasia
is associated with hypo - vascularity of the
affected bone .
based on histopathological , as well as supporting
clinico - radiological findings a confirmative diagnosis of florid
cemento - osseous dysplasia co - occurring with simple bone cyst was made .
patient was followed - up for a period of six months and was reported to be
asymptomatic.conclusionstimely diagnosis and well planned treatment is important to obtain a good
prognosis when a rare co - occurrence of two or more bone lesions affects the
jaws . |
6,208 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gaucher disease ( gd ) is an autosomal recessive lysosomal glycolipid storage disorder characterized by the accumulation of glucocerebroside ( glucosylceramide ) in reticuloendothelial cells .
the gene coding for the deficient enzyme glucocerebrosidase ( acid beta - glucosidase ) is located on chromosome 1q21 .three phenotypes are traditionally recognized based on the absence ( type 1 ) or presence and severity ( types 2 and 3 ) of cns involvement .
specific mutations in the beta - glucocerebrosidase gene are associated with specific clinical presentations , for example , the l444p mutation produces neurologic involvement . the liver , the spleen , and long bones are the primary organs affected by the storage of glucosylceramide , mainly derived from the normal turnover of leukocytes and erythrocytes . the highly cytotoxic substance glucosylsphingosine ( the nonacyl derivative of glucosylceramide ) is also stored in excess in the viscera and in the brain , leading to cell death .
such neuronal destruction involves mainly the brain stem and deep cerebellar nuclei , but the thalamus , basal ganglia , and spinal cord are also affected .
type 3 ( gd3 ) represents the subacute , juvenile neuronopathic form , with onset in the teenage years and a chronic course .
the severity of gd3 is intermediate between type 1 ( gd1 ) and type 2 ( gd2 ) with milder neurological features .
the first symptoms are due to the massive visceral involvement , and disorders of eye movements are the usual presenting signs .
adult patients [ 4 , 5 ] in whom symptoms had begun in late childhood , adolescence , or early adult years present myoclonic epilepsy and a distinctive supranuclear eye movement disorder affecting primarily horizontal gaze and only occasionally vertical gaze [ 79 ] .
the early defect in horizontal gaze involves the saccadic system , and the disorder mimics closely congenital ocular motor apraxia .
ocular motor abnormalities include horizontal saccadic initiation failure ( sif ) , with blinking , strabismus , slow... | in gaucher disease ( gd ) the enzyme ( imiglucerase ) replacement therapy ( ert ) is not able to stop the progression of the neurological involvement , while the substrate reduction therapy ( srt ) , performed by n - butyldeoxynojirimycin ( miglustat ) , is an alternative that should be evaluated .
two sisters , presenting the same genotype ( r353g / r353 g ) , were diagnosed as suffering from gd ; one of them later developed neurological alterations identified by quantitative saccadic eye movements analysis .
the aim of the study was to quantitatively measure the miglustat effects in this gd neurological patient .
eye movement analysis during subsequent controls was performed by estimating the characteristic parameters of saccadic main sequence .
the study demonstrates that the srt alone can be effective in gd3 .
moreover , it confirms that quantitative eye movement analysis is able to precociously identify also slight neurological alterations , permitting more accurate gd classification . |
6,209 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: up to 10% of newborn infants require admission to the neonatal intensive care unit ( nicu ) for ongoing medical care [ 13 ] .
antibiotic administration is known to perturb the composition of the intestinal microbiota , resulting in suppression of anaerobic bacteria ( with the exception of clostridia , which remain at detectable levels ) and increased numbers of potentially pathogenic bacteria such as klebsiella , enterobacter , citrobacter , and pseudomonas [ 4 , 5 ] . since the pioneering microbiota of infancy probably create perpetual habitats for themselves , defining the life - long composition of the gut microbiota and consequently contributing to host health and well - being [ 6 , 7 ]
have several reported health - promoting effects , including inhibition of growth of harmful bacteria , stimulation of the immune system , alleviation of constipation , and prevention of intestinal infections [ 813 ] .
species commonly associated with humans include bifidobacterium infantis , b. longum , b. bifidum , b. breve , b. catenulatum , b. pseudocatenulatum , b. angulatum , b. gallicum , and b. adolescensis , of which the first four are prevalent in infants .
suppression of the bifidobacteria population as occurred following antibiotic exposure in children [ 5 , 15 , 16 ] may have negative effects on host well - being and can be associated with higher susceptibility to enteropathogenic bacterial infection . however , the impact , if any , of parenteral antibiotics prescribed shortly following birth on the developing bifidobacterial population has not been addressed .
the aim of this study was therefore to determine the impact of intravenous antibiotic treatment in the neonatal period on the evolution of bifidobacterial colonization over time .
faecal material was sampled , using swabs , from 18 infants , nine infants previously treated with antibiotics and nine healthy controls ( table 1 ) .
approval for the study protocol was obtained from the clinical research ethics committee of the cork teaching hospitals ,... | we investigated the impact of parenteral antibiotic treatment in the early neonatal period on the evolution of bifidobacteria in the newborn .
nine babies treated with intravenous ampicillin / gentamicin in the first week of life and nine controls ( no antibiotic treatment ) were studied .
denaturing gradient gel electrophoresis was used to investigate the composition of bifidobacterium in stool samples taken at four and eight weeks .
bifidobacteria were detected in all control infants at both four and eight weeks , while only six of nine antibiotic - treated infants had detectable bifidobacteria at four weeks and eight of nine at eight weeks .
moreover , stool samples of controls showed greater diversity of bifidobacterium spp . compared with antibiotic - treated infants . in conclusion , short - term parenteral antibiotic treatment of neonates causes a disturbance in the expected colonization pattern of bifidobacteria in the first months of life .
further studies are required to probiotic determine if supplementation is necessary in this patient group . |
6,210 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: night blindness occurs in response to a decrease in rhodopsin in retinal light - sensitive rod cells .
night blindness is usually due to retinitis pigmentosa , which is an inherited disorder ( 1 ) .
rhodopsin also decreases in response to vitamin a deficiency ( vad ) ( 2 ) . according to a world health organization (
who ) report , the prevalence of night blindness in iran is moderate ( more than 1% and less than 5% in pre - school age children ) . but this prevalence is highly variable in different areas of iran because of different nutritional situations ( 3 ) .
it is well known that vad is associated with a higher prevalence of night blindness and eye disorders ( 4 ) .
xerophthalmia is advanced form of vitamin a deficiency that is associated with dry and unclear conjunctiva ( 5 , 6 ) .
photosensitivity , decreased tearing , ulcers , and infection are also more prevalent in these patients .
studies in iran have shown a high prevalence of vad among pregnant women in hormozgan , which is an important health issue in this province ( 7 ) .
the prevalence of night blindness is classically an indicator of nutritional and vitamin a deficiency situations .
the aim of the current study is to assess the prevalence of night blindness in bashagard in 2011 .
this descriptive cross - sectional study was done in the winter of 2011 in the bashagard district , located in hormozgan province .
considering the prevalence of night blindness in different studies ( 2% ) and a confidence interval of 95% , a sample size of 819 was selected . considering the geographical diversity of the bashagard district , cluster sampling
therefore , the calculated sample size was divided between the covered populations of five health centers ( goharan , tisoor , tidar , sar dasht , and jakdan ) .
a checklist ( including demographic data such as name , family name , place of residence , covering health center , sex , age , and educational level ) was used to collect the data . in the second section
the data about the duration of the disease and... | background : night blindness is a visual disorder associated with unusual vision during the night or in darkness . vitamin a deficiency ( vad ) , which is easily preventable , is the main known etiology of night blindness .
malnutrition is a common health issue in bashagard and some other areas in the hormozgan province of iran .
the aim of the current study was to determine the prevalence of night blindness in bashagard.methods:this descriptive cross - sectional study was done on 814 bashagard residences .
data was analyzed using spss software and descriptive studies.results:about 60% of the study participants were uneducated people or people with low education .
thirty - two out of 814 people that were studied had problems with night vision .
therefore , the prevalence of night blindness in bashagard was 3.93%.conclusion : prevalence of night blindness in bashagard is three times higher than its prevalence in all of iran .
therefore , preventive interventions such as dietary regimes with vitamin a enrichments or supplementations are recommended . |
6,211 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: here we have reviewed the conventional definitions and fundamental
characteristics of the two basic types of stem cells , embryonic stem cells ( escs ) and somatic stem cells ( sscs ) . by taking into account the often - overlooked asymmetric cell kinetics of sscs , we consider the evidence that should sscs retain these growth kinetics in vitro , a natural kinetic barrier to ssc propagation exists .
recent discoveries showing that the tumor suppressor gene
p53 can act as a regulator of asymmetric cell kinetics provide a
target pathway for in vitro ssc propagation strategies . | abstracthere we have reviewed the conventional definitions and fundamental
characteristics of the two basic types of stem cells , embryonic stem cells ( escs ) and somatic stem cells ( sscs ) . by taking into account the often - overlooked asymmetric cell kinetics of sscs , we consider the evidence that should sscs retain these growth kinetics in vitro , a natural kinetic barrier to ssc propagation exists .
recent discoveries showing that the tumor suppressor gene
p53 can act as a regulator of asymmetric cell kinetics provide a
target pathway for in vitro ssc propagation strategies . |
6,212 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: horner 's syndrome , along with weakness and atrophy of upper limb , as well as anaesthesia to pain and temperature , is well recognized finding in patients with syringomyelia .
few cases have been reported regarding isolated horner 's syndrome as a presenting manifestation of a chiari i malformation with syringomyelia .
we report a 41 year old man with left side hemi hidrosis probably a part of horner 's syndrome who was found to have a chiari i malformation with holocord syrinx .
a 41-year - old man presented in medicine ward with a complaint of neck and back pain and loss of sweating in right side of the body that had begun eight months before .
there was no history of hypertension , diabetes , and immunocompromised status . on examination whole left side of body including face was dry , there was no evidence of sweating [ figures 1 and 2 ] .
this test is described as drawing a metal spoon across the surface of the skin after adequate physical exercise .
neurological examination was unremarkable with no limb weakness , wasting or numbness and temperature impairment on the side of anhidrosis .
this was done to rule out any mass in the upper lobe of the lung which may present as horner syndrome .
mri spine was performed which showed hyperintense signal ( red arrow head ) in t2-weighted sections extending whole spinal cord up to eighth thoracic cord level with herniation of cerebellar tonsil ( blue arrow head ) compatible with syringomyelia along with chiari i malformation [ figure 3 ] .
dry left nipple with anhyrosis holocord syrinx up to 8 spinal cord level ( red arrow head ) , herniation of cerebellar tonsil ( blue arrow head )
syringomyelia is the development of a fluid - filled cavity or syrinx within the spinal cord .
more than half of all cases are associated with chiari type 1 malformations in which the cerebellar tonsils protrude through the foramen magnum and into the cervical spinal canal .
it may occur after a trauma , secondary to a tumor , craniocervical or intracerebral pathology or idiopathic... | we present a 41-year - old man with chiari type 1 malformation and syrinx up to tenth thoracic level who presented with left side hemi anhidrosis . neurological findings of syrinx were absent in this case .
though horner 's syndrome is reported , this report is probably first . |
6,213 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: oxcarbazepine ( oxc ) , ( chemically known as 10,11-dihydro-10-oxo-5h - dibenzo[b , f]azepine-5-carboxamide ) , is a novel antiepileptic drug , which was developed as a second generation and a follow - up compound to carbamazepine .
clinically , it has been used to treat several types of epilepsy [ 13 ] and bipolar disorders .
the ever - increasing use of oxc in pharmaceutical formulations has necessitated its determination as a matter of foremost importance .
various analytical methods such as hplc [ 58 ] , hptlc , gc , microemulsion electrokinetic chromatography , capillary electrokinetic chromatography , voltammetry [ 12 , 13 ] and capillary electrophoresis have been reported for the determination of oxc in pharmaceuticals .
however , these methods involve the use of expensive instruments which are not available at most quality control laboratories in developing and underdeveloped nations .
titrimetry is still widely used in analytical chemistry for its superior speed and simplicity with little sacrifice in accuracy and precision .
oxc is present in relatively large amounts ( 150 to 600 mg per tablet ) in pharmaceutical formulations .
the simplicity and rapidity of titrimetry is more advantageous especially for macroanalysis over any instrumental methods .
since there is no stringent conditions to be maintained , more precise and accurate results are obtained from titrimetry . because of one or the other advantage of titrimetry , it is widely applicable for the assay of many pharmaceutical compounds in many pharmacopoeias . on the other hand , the spectrophotometric technique continues to be used in the assay of different classes of drugs in pure and in pharmaceutical formulations [ 1518 ] . despite being one of the
most widely used antiepileptic drugs , no titrimetric method has been reported for oxc , and even a few visible spectrophotometric methods reported [ 1921 ] suffer from one or another disadvantage .
of the two methods reported by gandhimathi and ravi , the first method uses folin - ciocalteu... | titrimetric and spectrophotometric methods are described for the determination of oxcarbazepine ( oxc ) in bulk drug and in tablets .
the methods use n - bromosuccinimide ( nbs ) and bromopyrogallol red ( bpr ) as reagents . in titrimetry
( method a ) , an acidified solution of oxc is titrated directly with nbs using methyl orange as indicator .
spectrophotometry ( method b ) involves the addition of known excess of nbs to an acidified solution of oxc followed by the determination of the unreacted nbs by reacting with bpr and measuring the absorbance of the unreacted dye at 460 nm .
titrimetry allows the determination of 618 mg of oxc and follows a reaction stoichiometry of 1 : 1 ( oxc : nbs ) , whereas spectrophotometry is applicable over the concentration range of 0.88.0 g ml1 .
method b with a calculated molar absorptivity of 2.52 104 l mol1 cm1 is the most sensitive spectrophotometric method ever developed for oxc .
the optical characteristics such as limits of detection ( lod ) , quantification ( loq ) , and sandell 's sensitivity values are also reported for the spectrophotometric method . the accuracy and precision of the methods
were studied on intraday and interday basis .
the methods described could usefully be applied to routine quality control of tablets containing oxc .
no interference was observed from common pharmaceutical adjuvants
. statistical comparison of the results with a reference method shows an excellent agreement and indicates no significant difference in accuracy and precision .
the reliability of the methods was further ascertained by recovery studies in standard addition procedure . |
6,214 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: life in the ocean is dependent on fixation of carbon ( c ) and nitrogen ( n ) by planktonic microalgae , ranging in diameter from < 1 to > 100 m .
these phytoplankton consist of eukaryotic algae , which photosynthetically fix carbon dioxide ( co2 ) into organic matter , and cyanobacteria that fix co2 and also fix di - nitrogen ( n2 ) to form ammonium .
they make up less than 1% of the plant biomass on earth , but account for almost 50% of global primary production ( field et al . , 1998 ) and are a major source of trace gases such as dimethylsulfide that influence climate ( charlson et al .
, 1987 ; andreae and crutzen , 1997 ) . up until the ground breaking experiments of john martin ( martin and fitzwater , 1988 ; martin et al . , 1991 )
, the growth of marine phytoplankton was thought to be primarily limited by the availability of the major nutrient nitrogen and to a lesser extent phosphorus .
however , numerous iron - addition experiments in bottles and in mesoscale patches of surface seawater in the ensuing decades have demonstrated that the trace metal nutrient iron limits the growth of phytoplankton and regulates their species composition in 3040% of the world ocean , especially in high nitrate - low chlorophyll ( hnlc ) regions : the southern ocean , the equatorial and subarctic pacific , and some coastal upwelling systems ( hutchins et al . , 2002 ;
in addition , there is substantial evidence that iron limits the fixation of n2 by cyanobacteria in the ocean , and thus , controls oceanic inventories of biologically available fixed nitrogen ( rueter , 1983 ; falkowski , 1997 ; wu et al .
several other trace metal nutrients ( zinc , cobalt , manganese , and copper ) have also been shown to stimulate phytoplankton growth in bottle incubation experiments with natural ocean water , but their effects are usually less substantial than those for iron ( coale , 1991 ; crawford et al . , 2003 ; franck et al . , 2003 ; saito et al . , 2005 ) .
however , these metals may play important roles in regulating the... | in addition to control by major nutrient elements ( nitrogen , phosphorus , and silicon ) the productivity and species composition of marine phytoplankton communities are also regulated by a number of trace metal nutrients ( iron , zinc , cobalt , manganese , copper , and cadmium ) . of these , iron is most limiting to phytoplankton growth and has the greatest effect on algal species diversity .
it also plays an important role in limiting di - nitrogen ( n2 ) fixation rates , and thus is important in controlling ocean inventories of fixed nitrogen . because of these effects
, iron is thought to play a key role in regulating biological cycles of carbon and nitrogen in the ocean , including the biological transfer of carbon to the deep sea , the so - called biological co2 pump , which helps regulate atmospheric co2 and co2-linked global warming .
other trace metal nutrients ( zinc , cobalt , copper , and manganese ) have lesser effects on productivity ; but may exert an important influence on the species composition of algal communities because of large differences in metal requirements among species .
the interactions between trace metals and ocean plankton are reciprocal : not only do the metals control the plankton , but the plankton regulate the distributions , chemical speciation , and cycling of these metals through cellular uptake and recycling processes , downward flux of biogenic particles , biological release of organic chelators , and mediation of redox reactions .
this two way interaction has influenced not only the biology and chemistry of the modern ocean , but has had a profound influence on biogeochemistry of the ocean and earth system as a whole , and on the evolution of marine and terrestrial biology over geologic history . |
6,215 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the human immunodeficiency virus ( hiv ) infection is a global pandemic , with cases reported from virtually every country . at the end of 2010
, an estimated 34 million people were living with hiv globally , including 3.4 million children less than 15 years . in 2010 ,
an estimated 250 000 children less than 15 years died from aids - related causes . in nigeria ,
an estimated 3.6 percent of the population is living with hiv and aids . unlike in adults where more than 90% of hiv infections occur through sexual route , in children
the kidney is one of the many organs involved with the progression of hiv infection .
renal involvement in hiv infected children is a common finding and hiv - associated nephropathy ( hivan ) is a type of kidney disease that occurs in patients who are infected with hiv .
highly active antiretroviral therapy ( haart ) has been found to be beneficial not only in long term patient survival but also slowing down renal involvement and rapid progression to end stage renal disease .
microalbuminuria refers to albumin excretion above the normal range , but below the level of detection by dipstick .
microalbuminuria is defined as urinary albumin excretion between 30 and 300 mg / day or in concentrations 20 to 200 g / min [ 4 , 5 ] .
microalbuminuria is also defined as 30 to 300 mg albumin / g creatinine on a first morning urine specimen [ 4 , 5 ] .
microalbuminuria has been studied in many diseases such as diabetic nephropathy , hypertension , obesity , hiv , and sickle cell disease .
microalbuminuria develops from progressive , subclinical , structural , and functional changes in the kidney and it is useful as an early biomarker in the detection of kidney disease .
microalbuminuria and proteinuria are believed to be precursors of hiv related renal disease ; early detection with intervention may prevent end stage renal disease ( esrd ) in hiv infected children .
chronic kidney disease and end stage renal disease pose enormous problems to patients and physicians alike for reasons which ,... | microalbuminuria has been reported to be a precursor of hiv related renal disease , which if detected early and coupled with appropriate intervention may slow or retard the progress of the disease .
one hundred and seventy - eight hiv infected children aged 15 years and below were recruited from the paediatric infectious disease clinic of aminu kano teaching hospital ( akth ) , kano , to determine the prevalence of persistent microalbuminuria using the albumin creatinine ratio ( acr ) .
early morning urine samples and spot urine samples were analyzed using a dipstick specific for microalbumin .
those who tested positive had their samples reanalyzed in the laboratory using immunometric assay and jaffe reaction method for albumin and creatinine , respectively .
patients that had acr of 30300 mg / g were said to have microalbuminuria and had their urine samples retested after 6 to 8 weeks .
twelve children ( 6.7% ) had persistent microalbuminuria and had a mean age of 7.5 3.3 years , with a male to female ratio of 1 : 1 .
there was no significant relationship between the finding of microalbuminuria and age , sex , duration of infection , and the use of highly active antiretroviral therapy .
periodic screening for microalbuminuria using albumin specific dipstick should be considered for children with hiv infection . |
6,216 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: lymphoma , malign melanoma and rhabdomyosarcoma are the most common tumors that metastasize to the breast tissue .
breast metastases in cases of leukemia are very rare and occur primarily in patients with acute myeloid leukemia .
we report the conventional and advanced magnetic resonance imaging ( mri ) findings of unilateral breast involvement of all and review the literature .
a 32-year - old woman with all under remission was admitted to the department of internal medicine in our institution .
this patient was first diagnosed with all in june 2004 and was treated between june and december 2004 .
the giant mass , involving the whole right breast at the time of presentation grew progressively in a period of 3 months .
the mass and contralateral breast tissue was further evaluated with mri , diffusion weighted imaging ( dwi ) and mr spectroscopy .
mri was done with a 1.5 tesla mr device ( signa hdx ; general electric , milwaukee , usa ) .
the routine sequences were axial short ti inversion recovery ( stir ) , sagittal fast spin echo ( fse ) , fat saturated t2w , sagittal 3d vibrant ( postcontrast fat saturated t1w ) .
we added dwi with b=0 and b=600 values and brease ( single voxel mr spectroscopy ) sequence .
the giant right breast mass was hyperintense - isointense on precontrast fat saturated t1w images ( figure 1a ) and heterogeneously hypointense - hyperintense on stir and fat saturated t2w images ( figure 1b and 1c ) .
in the vibrant sequence , there was a prominent enhancement of the solid components ( figure 1d and 1e ) .
time - signal intensity curves obtained by post - processing were classified as type 2 ( figure 1f ) .
the lesion was hyperintense on dwi ( figure 1 g ) , and hypointense in apparent coefficient diffusion ( adc ) maps ( figure 1h ) .
the adc value was extremely low ( 3.1210 mm / sec ) representing prominent restricted diffusion .
a prominent choline peak compatible with malignancy was detected at 3.2 ppm in the brease sequence ( figure 1i ) .
there was no sign of chest wall invasion... | breast metastases in cases of leukemia are rare . we aimed to report the conventional - advanced magnetic resonance imaging ( mri ) findings of unilateral breast involvement of acute lymphoblastic leukemia ( all ) and review the literature .
a 32-year - old woman was first diagnosed with all in treated in 2004 .
she did not continue the follow - up after 2008 .
she was presented with a giant , progressive right breast palpable mass in 2010 .
mass , contralateral breast tissue were evaluated with mri , diffusion weighted imaging and mr spectroscopy . with mri findings ,
lesion was evaluated as malignant , tru - cut biopsy revealed recurrence of all .
lymphoma , malignant melanoma , rhabdomyosarcoma are most common tumors metastase to breast .
breast metastases of leukemia are rare and occur primarily in patients with acute myeloid leukemia .
secondary all breast involvement is uncommon . in a patient with malignancy ,
any enlarging breast mass , even with benign radiologic appearance , should be investigated carefully and metastasis should not be forgotten . |
6,217 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: . advanced laparoscopic procedures are increasingly being utilized as an alternative for laparotomy in gynecologic surgery .
a metaanalysis of 27 prospective randomized trials has proven the benefits of laparoscopic - assisted vaginal hysterectomy ( lavh ) compared with abdominal hysterectomy ( ah ) : decreased pain , decreased surgicalsite infections ( decreased relative risk 80% ) , decreased hospital stay ( 2 days less ) , quicker return to activity ( 2 weeks sooner ) , and fewer postoperative adhesions ( decreased 60% ) . in a cost - effectiveness analysis of lavh versus ah for large uteri ,
current procedural terminology ( cpt ) codes characterize large uteri as uteri > 250 g , ( 4 times normal uterine weight ) .
several authors have described the use of lavh for uteri weighing 500 g. however , no authors have looked specifically at the use of lavh for uteri weighing 1000 .
the purpose of this study was to evaluate the safety and efficacy of lavh performed for uteri weighing 1000 g.
fifteen patients underwent attempted lavh for uteri > 1000 g. patients were identified through the senior author 's surgical log from january 2005 to may 2007 .
all patients requiring surgery for large leiomyoma 's were offered lavh ; no patients refused lavh , and no patients were excluded .
institutional review board approval was obtained , and a retrospective computerized chart review was performed .
a single lavh was converted to laparotomy due to extensive pelvic adhesions , and the patient and surgical characteristics were not included .
a minimally invasive , academic gynecological oncologist from our minimally invasive surgical institute performed all cases , assisted by a senior gynecologic resident and a junior gynecologic resident or medical student .
all patients received a preoperative bowel prep with 45 ml of fleets phosphosoda orally , a single dose of preoperative prophylactic antibiotics and external pneumatic cuffs .
on postoperative day 1 , patients were given bowel stimulation with 45 ml of fleets... | introduction : prospective randomized trials have proven the benefits of laparoscopic - assisted vaginal hysterectomy ( lavh ) compared with abdominal hysterectomy . the purpose of this study was to evaluate the safety and efficacy of lavh performed for uteri weighing 1000 grams.methods:fifteen patients underwent attempted lavh for uteri > 1000 g .
median age was 45 years old ( range , 31 to 57 ) , and median weight was 170 pounds ( range , 130 to 236 ) ; 64% had medical comorbidities , and 43% had prior pelvic surgery .
five ports ( 5 mm ) were used to allow maximum uterine manipulation .
uterine vessels were doubly coagulated.results:fourteen of 15 cases ( 93% ) were successfully completed laparoscopically .
median uterine weight was 1090 grams ( range , 1000 to 1650 ) .
median operative time was 3.5 hours ( range , 2 to 4.6 ) , and median blood loss was 400 ml ( range , 100 to 1200 ) .
all patients were discharged on postoperative day one , and no patients developed a postoperative complication.conclusion:we believe that lavh is a safe and effective approach for uteri larger than 1000 g. it is our opinion that 3 surgical techniques are required ; maximum trendelenburg position , adequate number of ports , and double coagulations of the uterine vessels . |
6,218 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the data deluge brought about by the genomic projects has fostered an unprecedented level of expectation for new medical , pharmacological , environmental and biotechnological discoveries .
proteins mediate the majority of the functions of an organism , and all these functions are , by and large , determined by the proteins ' 3d structure . despite the progress achieved so far by structural genomics projects ( 1 ) , the exploration of the complete protein structure space through experimental techniques such as x - ray crystallography and nmr spectroscopy is still out of reach , because these techniques are time and resource consuming and not necessarily successful in all cases .
consequently the gap between the numbers of known protein structures and sequences is steadily increasing .
natural proteins spontaneously assume a unique 3d structure that , by and large , only depends upon the protein sequence .
the problem of understanding the rules governing the folding process is very challenging and as yet unsolved .
however , approximate methods for inferring the structure of a protein from its amino acid sequence are flourishing ( 2 ) .
their results are of enormous relevance in many fields , from medicine to biology , from biotechnology to pharmacology .
information derived from protein models has indeed proven to be useful by itself and in combination with experiments .
protein models have been shown to be instrumental for the refinement of experimental structures ( 3,4 ) , the design of site - directed mutants ( 5 ) , the characterization of molecular function ( 6 ) and structure - based drug design ( 7 ) . not surprisingly , a growing number of scientific papers reporting the results of modelling experiments and their application to the design and interpretation of experiments are appearing in the literature .
unfortunately , the models described in these reports are rarely publicly available and , in general , only accessible via direct interaction with the authors .
the difficulty of mining the available... | the protein model database ( pmdb ) is a public resource aimed at storing manually built 3d models of proteins .
the database is designed to provide access to models published in the scientific literature , together with validating experimental data .
it is a relational database and it currently contains > 74 000 models for 240 proteins .
the system is accessible at and allows predictors to submit models along with related supporting evidence and users to download them through a simple and intuitive interface .
users can navigate in the database and retrieve models referring to the same target protein or to different regions of the same protein .
each model is assigned a unique identifier that allows interested users to directly access the data . |
6,219 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: autophagy is induced downstream of signaling by danger receptors including toll like receptors ( tlr ; xu et al .
, 2007 ; delgado et al . , 2008 ) , retinoic acid inducible gene i - like receptors ( rlr ; yano et al . , 2008 ; cooney et al . , 2010 ; travassos et al . ,
xenophagy describes the process by which intracellular microbes are selectively degraded by autophagy ( levine , 2005 ) .
xenophagy eliminates bacteria that access the cytosol including streptococcus pyogenes ( nakagawa et al . , 2004 ) and mycobacterium tuberculosis ( gutierrez et al . ,
guerin ( bcg ) , autophagy facilitates the fusion of mycobacteria containing vacuoles with late endosomes / lysosomes to promote mycobacteria degradation ( singh et al . , 2006 ) .
salmonella - containing vacuoles are targeted by lc3 ( birmingham et al . , 2006 ) and can be engulfed by autophagosomes ( kageyama et al . , 2011 ) .
interestingly , recruitment of autophagy machinery to damaged bacterial vacuoles involves the exposure of host sugar residues that attract receptor galectin 8 ( thurston et al . , 2012 ) .
one example is the degradation of the sindbis virus capsid by the autophagy pathway ( orvedahl et al . , 2010 ) .
autophagy can also impair viral replication by trafficking cytosolic viral replication products to the endolysosomal compartment where they are detected by tlr and a type i interferon ( ifn ) response is triggered .
this is the case for vesicular stomatitis virus ( vsv ) infection of plasmacytoid dendritic cells ( pdc ; lee et al . , 2007 ) .
given its role in anti - viral defense , many viruses encode proteins to disable autophagy .
gammaherpes virus 68 ( ku et al . , 2008 ) , influenza a virus ( gannage et al . , 2009 ) ,
herpes simplex virus-1 ( hsv-1 ; orvedahl et al . , 2007 ) , human cytomegalovirus ( chaumorcel et al . ,
2012 ) , and human immunodeficiency virus ( hiv;kyei et al . , 2009 ) are examples of viruses that encode proteins to block autophagy initiation by interfering with beclin 1 activity
. other interesting... | macroautophagy ( autophagy ) is a cellular pathway facilitating several critical functions .
first , autophagy is a major pathway of degradation .
it enables elimination of microbes that have invaded intracellular compartments .
in addition , it promotes degradation of damaged cellular content , thereby acting to limit inflammatory signals .
second , autophagy is a major trafficking pathway , shuttling content between the cytosol and the lysosomal compartment . given these two key roles , autophagy can have significant and sometimes unexpected consequences on mechanisms that initiate robust immunity . here , we will discuss the impact of autophagy on pathways of innate and adaptive immune responses including microbe elimination , inflammatory cytokine production , antigen processing and t and b lymphocyte immunity . |
6,220 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in response to a dynamic nutrient environment , cells must assess their metabolic state to decide whether to grow , survive , or die .
it has become evident that metabolites themselves must feed back to regulate gene expression , signal transduction , and various protein activities in cellular decision - making processes .
these small molecule metabolites play critical roles in relaying metabolic information to their protein and nucleic acid counterparts . however , despite increased recognition of such reciprocal interplay , many aspects of the mechanisms through which metabolites exert their influence on cellular regulatory mechanisms are still being unraveled . amongst the thousands of metabolites present in the cellular milieu at any given time , which might represent the sentinel
one well - known signature of metabolic state is amp , which indicates cellular energy charge and accumulates upon atp insufficiency .
amp regulates the activity of the amp - activated protein kinase ( ampk ) , which phosphorylates many proteins involved in cellular energy homeostasis .
another example is nad , which indicates the cellular redox status as a ratio of nad to nadh .
herein , we discuss the hypothesis that acetyl - coa represents an additional prominent gauge of the cell s metabolic state with substantial influence on numerous biological regulatory mechanisms .
acetyl - coa is a metabolite derived from glucose , fatty acid , and amino acid catabolism . during glycolysis , glucose is broken down into two three - carbon molecules of pyruvate .
the mitochondrial pyruvate dehydrogenase complex then catalyzes the oxidative decarboxylation of pyruvate to produce acetyl - coa , a two - carbon acetyl unit that is ligated to the acyl - group carrier , coa . in the mitochondria ,
citrate synthase then catalyzes the condensation of the acetyl moiety of acetyl - coa with oxaloacetate to yield a six - carbon citrate molecule .
citrate can proceed to be oxidized via the tca cycle , or alternatively it can be transported to the... | acetyl - coa represents a key node in metabolism due to its intersection with many metabolic pathways and transformations .
emerging evidence reveals that cells monitor the levels of acetyl - coa as a key indicator of their metabolic state , through distinctive protein acetylation modifications dependent on this metabolite .
we offer the following conceptual model for understanding the role of this sentinel metabolite in metabolic regulation .
high nucleocytosolic acetyl - coa amounts are a signature of a growth or fed state and promote its utilization for lipid synthesis and histone acetylation .
in contrast , under survival or
fasted states , acetyl - coa is preferentially directed into the mitochondria to promote mitochondrial - dependent activities such as the synthesis of atp and ketone bodies .
fluctuations in acetyl - coa within these subcellular compartments enable the substrate - level regulation of acetylation modifications , but also necessitates the function of sirtuin deacetylases to catalyze removal of spontaneous modifications that might be unintended .
thus , understanding the sources , fates , and consequences of acetyl - coa as a carrier of two - carbon units has started to reveal its underappreciated but profound influence on the regulation of numerous life processes . |
6,221 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the importance of evidence - based practice ( ebp ) in allied health is well documented in the literature.1,2 clinical decisions that are based on patients unique circumstances , sound clinical expertise , and the best available research evidence are known to deliver the best outcomes for patients and their families.35 allied health practitioners hold positive attitudes toward ebp and believe in the value of research evidence in informing their clinical decisions . however , applying research findings to clinical decisions is not a simple process and is often difficult to achieve .
one of the most commonly reported barriers to evidence uptake in allied health is the lack of knowledge of the ebp process and lack of skill in critically appraising research.68 teaching ebp is therefore an important step in promoting evidence - based clinical decision making .
allied health practitioners need to understand the principles of ebp before they can apply it .
early ebp educational programs include the development of clinical questions , literature searches , and critical appraisal.9 to evaluate the impact of such educational programs and document competence of individual practitioners , educators need objective and psychometrically sound instruments or assessment tools .
based on a review of the literature , the fresno test is the only available instrument that comprehensively assesses ebp competence across all relevant domains.10 the fresno test consists of two clinical scenarios and 12 short - answer questions that require respondents to formulate a focused question , identify the most appropriate research design that will address the question , show knowledge of electronic database searching , identify issues important for determining the relevance and validity of a research paper , and discuss the magnitude and importance of research findings.11 the test is scored by using a standardized grading rubric that describes explicit grading criteria . the fresno test has content validity , good - to - excellent interrater... | purposethe current versions of the adapted fresno test ( aft ) are limited to physiotherapists and occupational therapists , and new scenarios and scoring rubrics are required for other allied health disciplines .
the aim of this study was to examine the validity , reliability , and internal consistency of the aft developed for speech pathologists ( sps ) , social workers ( sws ) , and dieticians / nutritionists ( dns).materials and methodsan expert panel from each discipline was formed to content - validate the aft .
a draft instrument , including clinical scenarios , questionnaire , and scoring rubric , was developed .
the new versions were completed by ten sps , 16 sws , and 12 dns , and scored by four raters .
interrater reliability was calculated using intraclass correlation coefficients ( 2,1 ) for the individual aft items and the total score .
the internal consistency of the aft was examined using cronbach s .resultstwo new clinical scenarios and a revised scoring rubric were developed for each discipline .
the reliability among raters was excellent for questions 1 , 3 , and 6 across all disciplines .
question 7 showed excellent reliability for sps , but not for sws and dns .
all other reliability coefficients increased to moderate or excellent levels following training .
cronbach s was 0.71 for sps , 0.68 for sws , and 0.74 for dns , indicating that internal consistency was acceptable for all disciplines.conclusionthere is preliminary evidence to show that aft is a valid and reliable tool for the assessment of evidence - based practice knowledge and skills of sps , sws , and dns .
further research is required to establish its sensitivity to detect change in knowledge and skills following an educational program . |
6,222 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: embryonic development and later rejuvenation of adult tissue is regulated by a population of stem cells that , by undergoing self - renewal maintain their own pool and give rise to differentiated progenitors that replace cells used up during the life cycle ( 1 ) .
therefore , scs are guardians of tissue / organ integrity and regulate the life span of an adult organism .
the most important sc population , from a regenerative point of view , is pluripotent stem cells ( pscs ) ( 2 ) . such cells , according to their definition ,
must fulfill some in vitro as well as in vivo criteria , such as i ) they give rise to cells from all three germ layers , i.e. the ectoderm , mesoderm , and endoderm ; ii ) complete blastocyst development ; and iii ) form teratomas after inoculation into experimental animals ( 3 ) . during embryo development ,
pluripotent stem cells are established from the most primitive stem cells , i.e. fertilized zygote .
these cells are called totipotent and possess the ability to give rise to both embryo and placenta .
totipotent zygotes further develop into pscs in the inner cell mass ( icm ) of blastocysts and may give rise to all three germ layers of a developing embryo , however , they lose the ability to differentiate into placenta .
the pscs in this stage could be expanded ex vivo as embryonic stem cell ( escs ) lines ( 4 , 5 ) .
the pluripotency is inherited from fertilized zygote , cells from inner - cell mass in blastocysts , to epiblasts from primitive ectoderm after implantation ( 6 ) .
after gastrulation , almost all cells lose their pluripotency and are committed into specialized lineage .
however , primordial germ cells ( pgcs ) derived from proximal epiblast cells , germ - line stem cells maintain their pluripotency by expressing pluripotency - specific genes , such as oct4 and nanog ( 7 ) .
the pgcs also lose their pluripotency and initiate their commitment to gametes , i.e. oocytes and sperm cells , after migration into the genital ridge .
therefore , the pscs could be specific... | pluripotent stem cells ( pscs ) have been considered as the most important cells in regenerative medicine as they are able to differentiate into all types of cells in the human body .
pscs have been established from several sources of embryo tissue or by reprogramming of terminally differentiated adult tissue by transduction of so - called yamanaka factors ( oct4 , sox2 , klf4 , and cmyc ) .
interestingly , accumulating evidence has demonstrated the residence of pscs in adult tissue and with the ability to differentiate into multiple types of tissue - committed stem cells ( tcscs ) .
we also recently demonstrated that a population of pluripotent oct4 + ssea-1+sca-1+lincd45 very small embryonic - like stem cells ( vsels ) resides in the adult murine bone marrow ( bm ) and in other murine tissue .
these very small ( 36 m ) cells express pluripotent markers such as oct4 , nanog , and ssea-1 .
vsels could be specified into several tissue - residing tcscs in response to tissue / organ injury , and thus suggesting that these cells have a physiological role in the rejuvenation of a pool of tcscs under steady - state conditions . in this review article
, we discuss the molecular nature of the rare population of vsels which have a crucial role in regulating the pluripotency , proliferation , differentiation , and aging of these cells . |
6,223 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: abnormal involuntary movements may appear in any part of the body , and can be embarrassing , distressing , disfiguring or dangerous .
tremor is an involuntary rhythmic oscillation of one or more parts of body about a fixed plane in space .
tremors are observed with the use of various drugs , including tricyclic antidepressants , monoaminooxidase inhibitors , antipsychotics , lithium , valproate , lamotrigine , antihistamines , thyroxine and nicotine .
these tremors tend to disappear after withdrawal of the offending drug . in a young person receiving psychotropic medication , appearance of unilateral tremor
is unusual and various diagnostic possibilities need to be kept in mind . in this report
a 26-year - old young male , employed as a tailor , from rural background , presented with 6 months duration of symptoms suggestive of mania . at the time of admission , detailed clinical examination including bedside neurological examination revealed no abnormalities .
he was prescribed risperidone 2 mg / day and diazepam 30 mg / day on the first day of admission . as he remained aggressive even after this sodium valproate 500 mg / day
it was observed that he developed regular rhythmic movements of his neck and right hand , with no other extrapyramidal symptoms . for optimal control of his manic symptoms the dose of risperidone
was increased to a maximum of 8 mg and valproate to 1400 mg on day 46 of his admission .
trihexyphenidyl 2 mg / day was also added to his ongoing therapy , in view of tremors . however
, these movements became more prominent involving the neck along with head and right upper limb .
they were rhythmic and regular with 3 - 4 hz , and present at rest .
the tremor used to disappear as the target was approached , thus did not cause any difficulty in eating or writing .
as this symptom caused significant distress to the patient , valproate was stopped on day 60
. however , there was no improvement even after one week of this , and hence risperidone was also stopped .
two weeks after stopping... | identification and management of drug - induced movement disorders is a clinical challenge , more so when the clinical presentation is atypical .
a young male with acute mania was under treatment with sodium valproate and risperidone .
he developed tremors of right hand and neck .
these were present at rest and exacerbated by mental activity , when under observation and during voluntarily initiated activity .
there were no associated extra pyramidal symptoms or cerebellar signs .
investigations for other common causes of tremors did not reveal any evidence except for low value of serum vitamin b12 levels .
the tremors persisted after the withdrawal of valproate , but resolved following the withdrawal of risperidone .
it is a common dictum that drug - induced tremors are bilateral .
this may not be true always as we found out in our case .
these movements were probably induced by risperidone .
this atypical presentation could be due to concurrent use of valproate and low serum vitamin b12 levels . |
6,224 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: lobular carcinoma in situ ( lcis ) is a form of in situ neoplasia that develops within the terminal lobules of the breast .
it is extremely rare in males due to the lack of lobular development in the male breast .
furthermore , there is scarce data on the utility of screening mri for male patients who are known to have high risk lesions .
we herein report a rare case of lcis in a male breast discovered incidentally on pathologic analysis of the breast tissue , which had been removed during breast reduction surgery for gynecomastia .
invasive ductal carcinoma developed in the ipsilateral breast two years later , as was detected on screening mri .
the patient is a 55-year - old african american male who reported a brief history of anabolic steroid use and no family history of breast cancer .
the patient had a history of multiple surgical procedures for recurrent gynecomastia over the course of many years .
pathologic evaluation demonstrated a few foci of lcis within the left breast along with atypical duct cell hyperplasia in a background of gynecomastia . due to
the highly unusual finding of lcis in this male patient , genetic analysis was performed and the male xy genotype was confirmed .
the patient was subsequently referred to our breast imaging center for a screening bilateral breast mri .
this demonstrated mild diffuse background enhancement bilaterally without suspicious enhancing signal abnormalities in either breast .
screening annual breast mri was recommended in view of his highly unusual diagnosis of lcis .
screening mri of both breasts performed 15 months later demonstrated interval development of a 1.1 cm enhancing ill - defined mass at the 1 o'clock axis of the left breast ( figure 1 ) .
a corresponding solid hypoechoic mass with angulated margins was seen on targeted left breast ultrasound ( figure 2 ) .
no dominant mass or suspicious clustered microcalcifications were identified in either breast ( figure 3 ) .
physical exam at that time revealed that his gynecomastia had recurred and the... | lobular carcinoma in situ is a form of in situ neoplasia that develops within the terminal lobules of the breast .
it is an extremely rare finding in males due to the lack of lobular development in the male breast .
the authors herein report an unusual case of incidentally discovered lobular carcinoma in situ in a male patient with recurrent bilateral gynecomastia who was subsequently diagnosed with invasive ductal carcinoma of the left breast .
the pathology of lobular carcinoma in situ in a male as well as screening mri surveillance of male patients at high risk for breast cancer are discussed , emphasizing the importance of screening and imaging follow up in men who are at high risk for breast cancer . |
6,225 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the prevalence of obesity is 35.5% among men and 35.8% among women and in iran it has been reported 42.9% among men and 56.9% among women .
obesity is related to increased risk of hyper - tension , diabetes mellitus , cardiovascular disease , arthritis , gallbladder disease , and cancer .
mechanisms of physiological , psychological and behavioral are involved in the relationship between obesity and migraine .
the prevalence of vitamin d deficiency is 30 - 80% among children and adult world - wide . in iran ,
prevalence of vitamin d deficiency has been observed 72.1% in men and 75.1% in women . in isfahan , 19.6% , 23.9% and 26.9 of people
vitamin d deficiency is related to musculoskeletal disorders , cancer , autoimmune disorders , cardiovascular disorders , kidney disorders , mental disorders , and skin disorders .
evidence have determined an inverse relationship between vitamin d levels with headache.[5915 ] number of studies have found that serum vitamin d levels are associated with obesity among population health and patients.[1623 ] however , in some other studies , the relationship was not seen .
thus , the present study was conducted to investigate the association between serum levels of vitamin d with general and abdominal obesity among patients with migraine .
this is a cross - sectional study that was performed among 66 migraine patients aged 19 - 61 years in isfahan city , iran , in autumn 2012 .
informed consent was taken from all participants . at baseline , age , gender , weight , height , waist circumference ( wc ) ,
body mass index ( bmi ) , education level , medical history , the use of vitamin and mineral supplements were gathered .
weight was determined ( within 0.5 kg ) using analog scale in light clothes and without shoes .
overweight and obesity was defined as bmi 25 and bmi 30 , respectively .
bmi was obtained through weight ( kilogram ) divided into height ( meter squared ) .
bmi category was determined as : l0 ean ( values < 18.5 ) ; normal weight ( values 18.5 - 24.9 ) ; overweight... | background : obesity is a common health problem around the world .
studies have shown inverse relationship between serum vitamin d levels with obesity among patients and healthy population .
the aim of this present study is to examine the relationship between serum vitamin d levels with general and abdominal obesity among migraine patients.methods:the present study is a cross - sectional and 66 migraine patients aged 19 - 61 years were included for analysis .
partial correlation was performed to assess association between serum 25-oh - d with general and abdominal obesity .
adjustments were performed for age , sex , and education.results:no relationship was found between serum levels of vitamin d with general and abdominal obesity . however , a significant association was shown between waist circumferences ( wc ) with body mass index ( bmi).conclusions : serum levels of 25-oh - d were not associated with wc and bmi .
furthermore , after adjustment for confounder variables , no association was observed . |
6,226 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: refractory ascites can occur in patients with conditions such as liver cirrhosis , congestive heart failure , nephrotic syndrome , and lupus serositis1 and in many cases cause abdominal discomfort and respiratory distress to the patient .
the treatments for refractory ascites , eg , bed rest , salt and water restriction , diuretics , intravenous administration of albumin , and repeated paracentesis , are usually unsatisfactory .
several procedures based on the reinfusion of ascitic fluid have been performed for ascitic fluid removal.28 this report introduces the procedure flow control reinfusion of ascites into the dialyzer during hemodialysis ( hd ) ( figure 1a ) , by which a 34-year - old lupus patient with massive ascites , respiratory distress , and acute renal failure ( arf ) , who did not respond to diuretics , repeated paracentesis with intravenous albumin infusion , and hd , was successfully treated .
prophylactic fresh frozen plasma infusion , sequential ultrafiltration , and reduced dialysate temperature during hd in previous treatments did not prevent intradialytic hypotension . the patient s symptoms were remedied by seven sessions of flow control reinfusion of ascites during hd ( figure 1b , c ) .
a 34-year - old female with systemic lupus erythematosus was admitted due to progressive lower leg edema , massive ascites , and nausea after treatment of bed rest , salt and water restriction , diuretics , intravenous administration of albumin and methylprednisolone , and repeated paracentesis for 2 months . on physical examination , her blood pressure was 127/82 mm hg , pulse rate 84 beats / min , respiratory rate 20 breaths / min , and body temperature 37c .
the results obtained in laboratory investigations were as follows : white blood cells ( wbcs ) 5.8 10/l ( normal range 4.511 10/l ) , hemoglobin 89 g / l ( normal range 120160
range 150350 10/l ) , serum blood urea nitrogen ( bun ) 13.5 mmol / l ( normal range 2.57 mmol / l ) , creatinine 170 mol / l ( normal range 50110 mol / l ) , albumin... | refractory ascites can occur in patients with various conditions .
although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest , salt and water restriction , diuretics , intravenous administration of albumin , and repeated paracentesis , these procedures are performed for ascitic fluid removal without dialytic effect . in this study , a flow control reinfusion of ascites during hemodialysis ( hd )
was performed to demonstrate the efficacy of this method in a lupus patient with massive refractory ascites and respiratory and acute renal failure ( arf ) .
the alleviation of ascites and arf attests to the success of the flow control reinfusion of ascites during hd .
this procedure can control the rate of ascites and body fluid removal simultaneously during hd using the roller pump . in conclusion , with a normal coagulation profile , the procedure of flow control reinfusion of ascites during hd is an effective alternative treatment for the alleviation of refractory ascites with renal failure . |
6,227 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the behavior of oral health providers and their attitudes towards their own oral health reflect their understanding of the importance of preventive dental procedures and improving the oral health of their patients .
also , dental students should instruct their friends , family members , patients and their society to maintain good oral health.1,2 the basis for health care in countries with similar social systems is usually the same .
comparison of countries having different bases for health care and different languages is much more complicated and time - consuming.3 hiroshima university - dental behavioral inventory ( hu - dbi ) was developed by kawamura to investigate dental health behavior , attitudes and perceptions.4 oral health attitudes and behavior of dental and/or dental hygiene students were evaluated frequently by using this scale in several countries.58 but there is insufficient data for oral health attitudes and behavior among turkish dental students .
the purpose of this study was to evaluate self - reported oral health attitudes and behavior among a group of turkish dental students by using modified hu - dbi and to compare differences in oral health attitudes between years of study and gender .
this study included 267 dental students ( 153 female , 114 male ) in gazi university .
the data collection was conducted during the autumn semester of academic year 20072008 . a modified english version of hu - dbi survey ( table 1 ) which consists of twenty - eight dichotomous responses ( yes - no ) was used in this study .
while first 25 items of the inventory were related with oral health attitudes and behavior , last 3 items were related with smoking habit of dental students .
this inventory has good test - retest reliability as well as good translated validity.9 the translation was discussed with one expert who had experience with questionnaires and survey research .
the aim of this study was explained and the students completed the questionnaires in their classrooms during one lecture .
data analysis... | objectivesthe purpose of this study was to evaluate self - reported oral health attitude and behavior among a group of turkish dental students and to compare differences in oral health attitudes between years of study and gender.methodsthis study included 267 ( 153 female , 114 male ) dental students . a modified english version of hiroshima university dental - behavioral inventory ( hu - dbi ) which consists of twenty - eight dichotomous responses ( yes - no ) was used.resultstotally 141 preclinical ( 1 , 2 and 3rd years of study ) and 126 clinical students ( 4 and 5th years of study ) who were mean age of 21.16 participated in the study .
statistically significant differences were found between years of study for brushing each of teeth carefully , cleaning the teeth well without using toothpaste , using a toothbrush which has hard bristles and for having had their dentist tell that they brush very well .
there were statistically significant differences between females and males for using a toothbrush which has hard bristles and using tooth floss regularly .
statistically significant differences were found for brushing each of the teeth carefully and using mouth wash on regular basis between smokers and non-smokers.conclusionsthis study confirmed that oral and dental health behavior and attitudes and also their knowledge about oral and dental health care of dental students improved with increasing level of education while oral and dental health care of female students were better than males and oral and dental health care of non - smokers were better than smokers . |
6,228 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: treacher collins syndrome ( tcs ) is a severe congenital disorder of craniofacial development characterized by numerous developmental anomalies that are restricted to the head and face .
hypoplasia of the facial bones , particularly the mandible and zygomatic complex , is an extremely common feature of tcs .
although the condition was probably first described by thomson ( 1846 ) followed by toynbee ( 1847 ) and berry ( 1889 ) , it is named after e. treacher collins who described the essential components of the syndrome in 1900 .
the first extensive review of the condition was done by franceschetti and klein in 1949 , who coined the term mandibulofacial dysostosis to describe the clinical features . in england and in the american continent
this abnormality is described as the treacher collins syndrome and in the european continent as mandibulo - facial dysostosis or franceschetti syndrome .
an 18-year - old female reported to the department of oral medicine and radiology with the chief complaint of forwardly placed teeth in the upper anterior region of jaw .
family history revealed that her father and grandmother had typical signs of the treacher collins syndrome . on extra oral examination
, she presented with antimongloid slanting of the palpebral fissures with sparse eyelashes on the lower eyelid .
the maxillary incisors were proclined and there were spacing in the maxillary and mandibular anteriors .
radiographs revealed prominent antigonial notch , short ramus [ figure 3 ] , hypoplasia of the mandible , proclined upper anteriors [ figure 4 ] , hypoplasia of zygomatic bone , and maxillary sinus [ figure 5 ] .
front view of the patient showing hypoplasia of facial bones , downsloping palpabral fissures , with scanty lower eye lashes lateral view showing retruded mandible and prominent nose orthopantomogram showing prominent antigonial notch , short ramus lateral cephalogram showing hypoplastic mandible , prominent nose , and proclined upper anteriors pa water showing hypoplasia of zygomatic bone and... | franceschetti syndrome is an autosomal dominant disorder of craniofacial development with variable expressivity .
it is commonly known as treacher collins syndrome ( tcs ) .
it is named after e. treacher collins who described the essential components of the condition .
it affects both genders equally .
this article reports a case of tcs in an 18-year - old female . |
6,229 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: type 2 diabetes mellitus ( t2 dm ) is a progressive disease where hyperglycemia occurs when insulin secretion fails to keep pace with insulin resistance.1 therefore , long - term disease management warrants intensification of treatment over time , especially in step with declining beta - cell function.2 in general , t2 dm management commences with lifestyle and dietary advice , with an oral antidiabetic drug ( oad ) added if glycemic control remains or becomes suboptimal .
metformin is often recommended as the first - line pharmacotherapy given its well - established efficacy , as well as being weight - neutral and inexpensive.3 metformin can be used in combination with other oads or insulin , but the traditional oads ( sulfonylureas [ su ] and thiazolidinediones [ tzd ] ) and insulin are associated with weight gain , which can compromise patients ongoing attempts at weight reduction.4 at the point of introducing exogenous insulin , depending on national guidelines and individual preferences , oads other than metformin are often discontinued .
the ultimate level of intervention is to add mealtime bolus insulin to , typically , basal insulin plus metformin , or to substitute a premixed insulin regimen . over the last few years we have seen the advent of newer drugs in the form of incretin - based therapies .
these act primarily by increasing the physiological effects mediated via the hormone glucagon - like peptide-1 ( glp-1 ) , which is secreted along with glucose - dependent insulinotropic polypeptide ( gip ) by intestinal cells when food is ingested , probably via the neural and endocrine signals associated with feeding.5 glp-1 and gip have multiple actions that enhance beta - cell response in a glucose - dependent fashion . in t2 dm ,
the incretin response is diminished.6 however , the insulinotropic action of gip is diminished , while that of glp-1 is preserved , although the secretion of glp-1 appears to be diminished.7,8 nevertheless , as the tissue sensitivity to glp-1 is preserved7,9 restoration of... | type 2 diabetes mellitus ( t2 dm ) is a progressive disease warranting intensification of treatment , as beta - cell function declines over time .
current treatment algorithms recommend metformin as the first - line agent , while advocating the addition of either basal - bolus or premixed insulin as the final level of intervention .
incretin therapy , including incretin mimetics or enhancers , are the latest group of drugs available for treatment of t2 dm .
these agents act through the incretin axis , are currently recommended as add - on agents either as second - or third - line treatment , without concurrent use of insulin .
given the novel role of incretin therapy in terms of reducing postprandial hyperglycemia , and favorable effects on weight with reduced incidence of hypoglycemia , we explore alternative options for incretin therapy in t2 dm management .
furthermore , as some evidence alludes to incretins potentially increasing betacell mass and altering disease progression , we propose introducing these agents earlier in the treatment algorithm . in addition , we suggest the concurrent use of incretins with insulin , given the favorable effects especially in relation to weight gain . |
6,230 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: filters are publication dates from january 1 , 2008 , to december 31 , 2013 .
all of the titles were generated by the search , and the abstracts were reviewed for relevance , after which the full articles were obtained for those selected .
the articles were evaluated by level of evidence ( loe ) and strength of recommendation ( sor ) according to the classifications provided in tables 1 and 2 , respectively.10,11 earlier guideline articles and their references were also searched.4,8 the results of the literature search were structured according to the types of marker utility as presented in table 3 .
level of evidence used to grade the presented egtm guidelines10 strength of recommendation used to grade the presented egtm guidelines11 utility of cancer biomarkers as defined in the presented egtm guidelines
the prostate , lung , colorectal , and ovarian cancer trial in the united states was a randomized controlled trial in which 78,216 women aged 55 to 74 years were included between 1993 and 2001 .
there was no evidence of a shift to early - stage disease associated with screening using ca125 and transvaginal ultrasound .
furthermore , ovarian cancer mortality was equivalent in both groups.12 an earlier multicenter randomized controlled trial was conducted in japan between 1985 and 1999 , in which postmenopausal women were assigned to either a screening group ( n = 41,688 ) or a control group ( n = 40,799 ) .
the study showed a decrease in stage at detection ; however , analysis of mortality in the screening and control group has not yet been reported.13 in a single - arm prospective study , the university of kentucky ovarian cancer screening trial conducted from 1987 to 2011 , 37,293 women were screened annually with ultrasound and ca125.14 eligibility criteria included all asymptomatic women aged 50 years or older and women aged 25 years or older with a documented family history of ovarian cancer .
although there was no randomization against a control group , a historic control group was available ,... | objectiveto present an update of the european group on tumor markers guidelines for serum markers in epithelial ovarian cancer.methodssystematic literature survey from 2008 to 2013 .
the articles were evaluated by level of evidence and strength of recommendation.resultsbecause of its low sensitivity ( 5062% for early stage epithelial ovarian cancer ) and limited specificity ( 9498.5% ) , cancer antigen ( ca ) 125 ( ca125 ) is not recommended as a screening test in asymptomatic women .
the risk of malignancy index , which includes ca125 , transvaginal ultrasound , and menopausal status , is recommended for the differential diagnosis of a pelvic mass . because human epididymis protein 4 has been reported to have superior specificity to ca125 , especially in premenopausal women , it may be considered either alone or as part of the risk of ovarian malignancy algorithm , in the differential diagnosis of pelvic masses , especially in such women .
ca125 should be used to monitor response to first - line chemotherapy using the previously published criteria of the gynecological cancer intergroup , that is , at least a 50% reduction of a pretreatment sample of 70 ku / l or greater .
the value of ca125 in posttherapy surveillance is less clear .
although a prospective randomized trial concluded that early administration of chemotherapy based on increasing ca125 levels had no effect on survival , european group on tumor markers state that monitoring with ca125 in this situation should occur , especially if the patient is a candidate for secondary cytoreductive surgery.conclusionsat present , ca125 remains the most important biomarker for epithelial ovarian cancer , excluding tumors of mucinous origin . |
6,231 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recombinant atxa , atnl and its quadruple h28y / l31v / n33g / s49d mutant lw were prepared by in vitro refolding following expression in e. coli as described . all other chemicals were from sigma aldrich or gibco life technologies .
adult male balb / c mice ( 2025 g ) were maintained and humanely killed according to the guiding principles in the use of animals in toxicology ( society of toxicology , 1999 , guidelines are available at www.toxicology.org ) and the animals ( scientific procedures ) act 1986 .
hemidiaphragms and accompanying phrenic nerves were dissected and placed into 10 ml tissue baths containing krebs solution ( 118.4 mm nacl , 4.7 mm kcl , 25 mm nahco3 , 1.2 mm kh2po4 , 1.4 mm mgso4 and 2.5 mm cacl2 ) , maintained at 37c and oxygenated with a mixture 95% o2 and 5% co2 .
muscle contractions were evoked indirectly or directly . in the case of indirect neurally - evoked twitches ,
the attached phrenic nerve was stimulated at a frequency of 0.2 hz with rectangular pulses of 0.2 ms duration and a supramaximal voltage ( < 15 v ) from a grass force displacement transducer .
muscle twitches were recorded on a grass polygraph model 79 ( grass instruments ) . in order to reveal the triphasic effect of recombinant proteins on nm transmission ,
in some experiments the preparation was partially paralyzed ( to 1520% of control ) by reducing the concentration of ca to 0.380.50 mm and allowing the tissues to equilibrate for 3045 min . in these experiments
recombinant proteins were added to the tissue bath and changes in the amplitude of twitch tension responses were followed continuously .
the functionality of the muscle in the preparation at the end of the recordings was checked directly by acetylcholine stimulation or indirectly by 2.5 mm ca stimulation . in experiments with directly - evoked twitches the preparation was set up as described for the phrenic nerve - hemidiaphragm for recording neurally - evoked twitches .
in addition , one end of a bipolar stimulating electrode was sutured into the... | the molecular mechanism of action of presynaptically neurotoxic secreted phospholipases a2 ( spla2s ) has not been fully elucidated .
we have recently proposed a model to explain one of the hallmarks of their action the reduction in endocytosis leading to synaptic vesicle depletion in nerve terminals .
our results speak strongly in favor of a mechanism in which both specific protein - protein interactions and enzymatic activity of the neurotoxic spla2 ammodytoxin a ( atxa ) are necessary for impairment of clathrin - dependent endocytosis in yeast cells .
the reduction of endocytosis was strictly dependent on the enzymatic activity of spla2s expressed ectopically in our yeast model cells and was not observed with the catalytically inactive , non - neurotoxic atxa - homolog , ammodytin l ( atnl ) .
here we confirm the validity of the model in mammalian cells also , by demonstrating that the enzymatically active mutant of atnl , shown to inhibit endocytosis in yeast , acts as a presynaptically neurotoxic spla2 at the mammalian neuromuscular junction . |
6,232 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
porphyromonas gingivalis is a gram - negative oral anaerobe that is involved in the pathogenesis of periodontitis , an inflammatory disease that destroys the tissues supporting the tooth which eventually may lead to tooth loss . among the over 500 bacterial species living in the oral cavity , a bacterial
complex named red complex and composed of porphyromonas gingivalis , treponema denticola , and tannerella forsythia has been strongly associated with advanced periodontal lesions .
research on porphyromonas gingivalis , a periodontopathogen , has provided a tremendous amount of information in terms of phylogenetic as well as proteomic criteria over the last 20 years , which may exceed other closely related members , including bacteroides fragilis and bacteroides thetaiotaomicron , as major anaerobic , opportunistic pathogens in the dental field .
the microbiota of the human oral mucosa consists of a myriad of bacterial species that normally exist in commensal harmony with the host .
porphyromonas gingivalis , an etiological agent in severe forms of periodontitis ( a chronic inflammatory disease ) , is a prominent component of the oral microbiome and a successful colonizer of the oral epithelium .
the authors have used both latest as well as older reviews and studies to compile a comprehensive overview of this key periodontal pathogen .
special attention has been paid to clinically relevant properties of porphyromonas gingivalis , such as pathogenicity and its possible relation to certain systemic diseases .
the perturbation of epithelial cells by bacteria is the first stage in the initiation of inflammatory and immune processes which eventually cause destruction of the tissues surrounding and supporting the teeth which ultimately result in tooth loss .
porphyromonas gingivalis can locally invade periodontal tissues and evade the host defense mechanisms . in doing so
, it utilizes a panel of virulence factors that cause deregulation of the innate immune and inflammatory responses .
porphyromonas... | porphyromonas gingivalis is a gram - negative oral anaerobe that is involved in the pathogenesis of periodontitis and is a member of more than 500 bacterial species that live in the oral cavity .
this anaerobic bacterium is a natural member of the oral microbiome , yet it can become highly destructive ( termed pathobiont ) and proliferate to high cell numbers in periodontal lesions : this is attributed to its arsenal of specialized virulence factors .
the purpose of this review is to provide an overview of one of the main periodontal pathogens porphyromonas gingivalis .
this bacterium , along with treponema denticola and tannerella forsythia , constitute the red complex , a prototype polybacterial pathogenic consortium in periodontitis . this review outlines porphyromonas gingivalis structure , its metabolism , its ability to colonize the epithelial cells , and its influence upon the host immunity . |
6,233 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: bipolar disorders ( bd ) are of particular public health significance as they are prevalent , severe and disabling , and often associated with elevated risks of premature mortality , adverse medical outcomes , accidents , and complications from comorbid substance use disorders.1 the world health organization reported , in 2001 , that bipolar disorder was the fifth cause of years lived with disability among young adults .
bd is characterized by periods of mania , depression , or mixed episodes , often multiple times during a lifetime .
mania is the most characteristic phase of bipolar disorder , and a major cause of disability , stigma and cognitive impairment .
lithium is the traditional treatment option , but the majority of patients do not respond to lithium monotherapy .
other drugs have been introduced in recent years , such as the anticonvulsants valproate and carbamazepine , some typical antipsychotics ( eg , haloperidol , chlorpromazine ) , atypical antipsychotics ( such as quetiapine , olanzapine , risperidone , ziprasidone , aripiprazolo and clozapine ) , and benzodiazepines ( eg , lorazepam and clonazepam).2 therapy for mood disorders is a major problem in psychiatry despite the availability of effective treatments .
mood disorders frequently remain undiagnosed and , even if recognized , treatment duration and dosage are often inadequate and adherence to the medication regimen is poor.3 greater antidepressant adherence has been linked to greater response and remission among depressed subjects,3 whereas nonadherence has been shown to be related to less improvement of depressive symptoms and greater relapse / recurrence of depression.47 it is estimated that nonadherence ranges from 10% to 60% in mood disorders , with a median of 40%.8 however , according to lingam and scott,8 this topic is understudied , and only 1%2% of all publications on the treatment of affective disorders explore factors associated with medication nonadherence .
bd is associated with high levels of long - term morbidity ,... | background : bipolar disorders ( bd ) are of particular public health significance as they are prevalent , severe and disabling , and often associated with elevated risks of premature mortality .
the aim of this concise overview is to investigate the role of asenapine in the treatment of manic and mixed states associated with bd type 1 disorder.method:medline , excerpta medica and psycinfo searches were performed to identify papers in english published over the past 7 years .
search terms were asenapine , manic or mixed states ,
bipolar i disorder .
subjects included in this study suffered from bd type 1 disorder.results:to date , only four studies of asenapine for the treatment of manic or mixed episodes associated with bd type 1 have been published.conclusion:research indicates that asenapine is generally well - tolerated , and that asenapine is efficacious and not inferior to olanzapine in the treatment of mixed or manic episodes associated with bd type 1 in the short - term and long - term . |
6,234 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 3-month - old girl child presented to us with a history of swelling on back since birth .
she had a history of full term normal vaginal delivery with no significant family history .
there was complete flaccid paralysis of right lower extremity with normal anal tone . on local examination ,
an initial diagnosis of a myelomeningocele was made and patient was referred for magnetic resonance imaging ( mri ) of neuraxis .
mri spine revealed a bony spur at d11 level dividing the spinal cord into two halves suggesting pang type 1 split cord malformation ( scm ) or diastematomyelia .
right hemicord , along with meninges and cerebrospinal fluid was herniating through the defect in posterior element of same vertebra forming a large hemimeningomyelocele [ figures 1 and 2 ] .
t2-weighted sagittal ( a ) and coronal ( b ) magnetic resonance imaging of dorso - lumbar spine shows a hemivertebrae from d10 to d12 level along with a bony spur at d11 .
continuation of left hemicord is appreciable in coronal view ( b ) t2 weighted axial image shows a bony spur dividing the cord into two halves ( a and b ) .
herniation of right hemicord , meninges and cerebrospinal fluid is noted through the defect in posterior element , forming a large hemi - meningomyelocele ( c ) .
two hemicords are visible below the level of herniation ( d ) which reunites at d12 level to form a single cord ( e ) based on clinical examination and mri a final diagnosis of scm type 1 with right hemimyelomeningocele ( hmm ) was made and patient was prepared for surgery .
excision of bony spur along with microneurosurgical dissection and meticulous layered closure of myelomeningocele was achieved .
according to pang 's unified theory of embryogenesis , the whole spectrum of split cord syndrome originates from one basic ontogenic error occurring around the time of primitive neurenteric canal closure .
this basic error is the formation of accessory neurenteric canal between the amniotic cavity and the yolk sac .
this abnormal fistulous connection bisects the... | variations in split cord malformation ( scm ) have been described earlier . however , a true hemimyelomeningocele ( hmm ) as only congenital malformation is extremely rare and is reported infrequently in published literature .
we are reporting the case of a 3-month - old girl child who presented with a swelling on the lower back since birth .
magnetic resonance imaging revealed a type 1 scm with right hemicord forming a hmm . precise diagnosis and thorough anatomical detail of dysraphism is essential for optimal , individualized neurosurgical management . |
6,235 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: interact is a large , prospective , case - cohort study of 27,779 individuals from eight european countries ( denmark , france , germany , italy , the netherlands , spain , sweden , and u.k . ) nested within the european prospective investigation into cancer and nutrition ( epic ) ( 20 ) .
the objective of the study was to investigate the interplay between genetic and lifestyle factors and the effect on risk of type 2 diabetes ( 21 ) .
the sample was taken from a total cohort of 340,234 individuals comprising 3.99 million person - years of follow - up time ; 12,403 individuals ( 6,238 women ) with clinically incident type 2 diabetes were selected for interact together with a representative subcohort of 16,835 individuals ( 10,378 women ) .
after exclusion of those with prevalent diabetes ( n = 548 ) , those without information regarding diabetes status ( n = 129 ) , and individuals with postcensoring diabetes ( n = 4 ) , 16,154 subcohort members were available for analysis ( 10,043 women ) , 778 of whom were also incident cases ( 394 women ) .
all epic centers obtained written informed consent from participants and obtained approval from local ethics committees . as previously described ( 21 )
, cases of incident type 2 diabetes were ascertained using multiple sources of evidence , including self - report ( self - reported or doctor - diagnosed history of type 2 diabetes or diabetes drug use ) , linkage to primary or secondary care registers , medication use reported from drug registers , hospital admissions , and mortality data . in most centers ,
evidence of type 2 diabetes was sought from at least two independent sources from those listed or by reviewing individual medical records to verify incident cases .
the exceptions were danish and swedish centers where cases were ascertained through local and national diabetes and pharmaceutical registers rather than self - reported ; thus , all cases were considered to be verified .
information regarding diabetes status was used from any follow - up visit or... | objectiveyounger age at menarche , a marker of pubertal timing in girls , is associated with higher risk of later type 2 diabetes .
we aimed to confirm this association and to examine whether it is explained by adiposity.research design and methodsthe prospective european prospective investigation into cancer and nutrition ( epic)-interact case - cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from 26 research centers across eight european countries .
we tested the association between age at menarche and incident type 2 diabetes using prentice - weighted cox regression in 15,168 women ( n = 5,995 cases ) .
models were adjusted in a sequential manner for potential confounding and mediating factors , including adult bmi.resultsmean menarcheal age ranged from 12.6 to 13.6 years across interact countries .
each year later menarche was associated with 0.32 kg / m2 lower adult bmi .
women in the earliest menarche quintile ( 811 years , n = 2,418 ) had 70% higher incidence of type 2 diabetes compared with those in the middle quintile ( 13 years , n = 3,634 ) , adjusting for age at recruitment , research center , and a range of lifestyle and reproductive factors ( hazard ratio [ hr ] , 1.70 ; 95% ci , 1.491.94 ; p < 0.001 ) . adjustment for bmi partially attenuated this association ( hr , 1.42 ; 95% ci , 1.181.71 ; p < 0.001 ) .
later menarche beyond the median age was not protective against type 2 diabetes.conclusionswomen with history of early menarche have higher risk of type 2 diabetes in adulthood .
less than half of this association appears to be mediated by higher adult bmi , suggesting that early pubertal development also may directly increase type 2 diabetes risk . |
6,236 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cigarette butts and other tobacco product waste ( tpw ) items are the most ubiquitous form of litter worldwide , with an estimated 4.5 trillion of the estimated annual 6 trillion globally consumed cigarettes deposited as butts somewhere into the environment each year .
this material comprises the largest percentage of waste ( approximately 19 % 38 % of total waste products by count ) collected globally during the coastal cleanups each year ( see ocean conservancy data for 2012 , [ table 1 ] ) . at a local level , data from a city of san francisco street litter audit revealed that 24.6 % by count of all litter items collected were from tobacco products ( including butts , wrappers , and packages ) .table 1top 10 marine debris items collected , international coastal cleanuprankdebris itemnumber of debris itemspercentage of total debris items1cigarettes / cigarette filters2,117,93119 % 2food wrappers / containers1,140,22210 % 3beverage bottles ( plastic)1,065,17110 % 4bags ( plastic)1,019,9029 % 5caps , lids958,8939 % 6cups , plates , forks , knives , spoons692,7676 % 7straws , stirrers611,0486 % 8beverage bottles ( glass)521,7305 % 9beverage cans339,8753 % 10bags ( paper)298,3323 % top 10 total debris items collected8,765,87180 % total debris items collected worldwide10,957,338100 % source : ocean conservancy , 2012 : http://www.oceanconservancy.org/our-work/international-coastal-cleanup/top-10-items-found-1.html .
top 10 marine debris items collected , international coastal cleanup source : ocean conservancy , 2012 : http://www.oceanconservancy.org/our-work/international-coastal-cleanup/top-10-items-found-1.html .
although it is difficult to estimate what percentage of the trillions of cigarettes consumed globally each year are discarded as waste , bans on indoor smoking may have exacerbated the accumulation of tpw outdoors .
residents , business owners , and politicians have reported an increase in the quantity of cigarette butts littered after bans on indoor smoking took effect in local areas... | cigarette butts and other tobacco product wastes ( tpw ) are the most common items picked up in urban and beach cleanups worldwide .
tpw contains all the toxins , nicotine , and carcinogens found in tobacco products , along with the plastic nonbiodegradable filter attached to almost all cigarettes sold in the united states and in most countries worldwide .
toxicity studies suggest that compounds leached from cigarette butts in salt and fresh water are toxic to aquatic micro - organisms and test fish .
toxic chemicals have also been identified in roadside tpw . with as much as two - thirds of all smoked cigarettes ( numbering in the trillions globally ) being discarded into the environment each year ,
it is critical to consider the potential toxicity and remediation of these waste products .
this article reviews reports on the toxicity of tpw and recommends several policy approaches to mitigation of this ubiquitous environmental blight . |
6,237 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: astasia is a clinical postural disorder characterized by the inability to stand without
external support despite having sufficient muscle strength .
this symptom can be observed in
post - stroke patients who have experienced thalamic hemorrhage or ischemia1,2,3 , and it is frequently accompanied by falling
toward the contralesional side without exhibiting pushing behavior , which is a tendency to
actively push away from the ipsilesional side4 .
it has been reported that symptoms of astasia tend to spontaneously
disappear several days after stroke onset1,2,3 .
it is thought that vertical perception has a pivotal role in maintaining upright posture in
humans .
one of the important vertical perceptions is subjective postural vertical ( spv ) ,
defined as bodily vertical perception mainly derived from somatosensory information5 .
the authors of previous studies have
suggested that the functionality of spv influences the chance of postural disorders in
post - stroke patients6 .
indeed , in
post - stroke patients , the correlation between the degree of spv bias and that of falling
toward the contralesional side is very strong6 . based on these lines of evidence , it was hypothesized that abnormal
spv can be one of the functional mechanisms underlying postural disorders in astasia
patients . in the present study
, this hypothesis was tested in a single case study of a
post - stroke patient with prolonged astasia .
the patient was a 72-year - old man diagnosed with a right thalamic hemorrhage and
post - stroke astasia .
the patient s spv and ability to stand were assessed and confirmed an
abnormality , especially in spv .
then , to further elucidate the causal relationship between
the abnormal spv and the postural disorder , a 1 week program of standing training aimed at
regulating spv was applied and its effect on vertical perception and standing ability was
evaluated . during this training ,
the patient was asked to maintain his body orientation
vertical in reference to... | [ purpose ] post - stroke astasia is an inability to stand without external support despite
having sufficient muscle strength .
however , the dysfunction underlying astasia is unclear .
we tested the hypothesis that astasia is the result of an abnormal bias in vertical
perception , especially subjective postural vertical ( spv ) , mediated by somatosensory
inputs .
[ subjects and methods ] a patient with a right posterolateral thalamus hemorrhage
had a tendency to fall toward the contralesional side during standing after 8 weeks of
treatment .
spv , standing duration , and physical function were evaluated before and after a
1 week standard rehabilitation baseline period , and after a 1 week intervention period ,
where standing training requiring the patient to control his body orientation in reference
to somatosensory inputs from his ipsilateral upper limb was added .
[ results ] spv was
biased toward the contralesional side before and after the 1 week baseline period .
however , spv improved into the normal range and he could stand for a longer duration after
the intervention period .
[ conclusion ] this case suggests that abnormal spv is one of the
functional mechanisms underlying astasia , and it indicates the effectiveness of standing
training with somatosensory information to improve abnormal spv and postural
disorders . |
6,238 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 34-year - old male presented with proptosis of the left eye ( os ) in november 2014 since 2 years with occasional pain and blurred vision .
best - corrected visual acuity was 6/6 , n6 right eye ( od ) , 6/18 with pinhole improvement to 6/9 , n10 ( os ) .
axial proptosis was noted with hertel 's exophthalmometry measurement of 14 mm in the od and 20 mm in os .
there were no ocular motility restrictions in either eye . slit lamp and fundus examination revealed normal anterior and posterior segments in both the eyes ( ou ) .
computerized tomography scan of the orbit and brain in os revealed a retrobulbar mass , well delineated and intraconal in location , displacing the optic nerve medially [ fig . 1 ] .
( a ) computerized tomography scan of brain and orbit with intraconal orbital mass and ( b ) gross bluish black encapsulated cavernous hemangioma left sided lateral orbitotomy under general anesthesia was planned and carried out under proper consent .
the specimen was sent to ocular pathology laboratory where encapsulated bluish black mass measuring ( 22.1 mm 16.18 mm 12.24 mm ) was documented [ fig . 1 ] . grossly , the tumor showed surface vascularity over the capsule .
surface vessels were in different dimensions and were also seen piercing the capsule . after dissecting a small portion of capsule ,
numerous tecs were seen , some of which formed a pattern of endothelial podosome rosette which was documented .
sprouting of tec and the blood vessels with intracellular gap junctions among the tecs was observed .
endothelial cells on the surface of the blood vessels and tec were seen under high power objective illumination of microscope ( axioskop 40 with axiocam mrc camera ) .
microscopic appearance showed capsulated vascular tumor with numerous dilated blood vessels of varying sizes filled with red blood cells and lined by endothelial cells .
some of the endothelial cells showed sprouting of its extension , which were also documented under microscope [ figs . 2 and 3 ] . pericytes and fibrocytes with varied... | cavernous hemangioma is the most common orbital tumor in adult .
there is lot of literatures for clinicopathological features of this tumor .
these tumors had been studied for the model of angiogenesis in many of the experimental setups .
we present a case of 34-year - old male with this tumor in the left eye with computerized tomography evidence .
postsurgical laboratory findings gave interesting evidence of tumor angiogenesis with tumor endothelial cells and sprouting of the small vessels endothelial cells .
podosome rosette could be conceptualized from the characteristic patterns seen in the tumor . |
6,239 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the prevalence of placenta previa has been recently estimated to be approximately 0.5% of all pregnancies , and this increase correlates to the elevated cesarean section rate1 .
placenta previa is a major cause of maternal morbidity and mortality because of the associated massive antepartum and intrapartum hemorrhage 2 , 3 .
moreover , placenta previa is associated with preterm delivery , with the neonatal mortality increasing threefold as a result of prematurity 4 .
although placenta previa is associated with antepartum hemorrhage , massive hemorrhage necessitating preterm cesarean section is not observed in all women with the condition .
the ability to predict severe antepartum hemorrhage and emergency cesarean section is critical in the management of placenta previa . to date
, no consensus exists on the preterm delivery risk of different types and locations of placenta previa .
only a few reports have focused on the maternal and perinatal outcomes of different types of placenta previa 5 , 6 , 7 , 8 .
furthermore , the effect of anterior / posterior placental position on preterm delivery is unknown , although increased perinatal risks , including placenta accreta , excessive intraoperative blood loss , hysterectomy , and neonatal anemia , have been reported to be associated with anterior placenta previa 9 , 10 . in the present study , we evaluated whether different types and locations of placenta previa influence risk of antepartum hemorrhage - related preterm delivery .
we retrospectively analyzed the medical records of 164 women with singleton pregnancies presenting placenta previa whose deliveries were conducted at our institute between january 2004 and march 2012 .
informed consent was obtained from each patient and protection of personal data and confidentiality were prioritized .
institutional review board approval was obtained , and the study has been performed in accordance with the ethical standards laid down in the 1964 declaration of helsinki and its later amendments .
two women whose... | purpose : to evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage - related preterm delivery .
methods : we retrospectively studied 162 women with singleton pregnancies presenting placenta previa . through observation using transvaginal ultrasound
the women were categorized into complete or incomplete placenta previa , and then assigned to anterior and posterior groups .
complete placenta previa was defined as a placenta that completely covered the internal cervical os , with the placental margin > 2 cm from the os .
incomplete placenta previa comprised marginal placenta previa whose margin adjacent to the internal os and partial placenta previa which covered the os but the margin situated within 2 cm of the os . maternal characteristics and perinatal outcomes in complete and incomplete placenta previa were compared , and the differences between the anterior and the posterior groups were evaluated .
results : antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa ( 59.1% versus 17.6% ) , resulting in the higher incidence of preterm delivery in women with complete than in those with incomplete placenta previa [ 45.1% versus 8.8% ; odds ratio ( or ) 8.51 ; 95% confidence interval ( ci ) 3.59 - 20.18 ; p < 0.001 ] . in complete placenta previa , incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups . however , gestational age at bleeding onset was lower in the anterior group than in the posterior group , and the incidence of preterm delivery was higher in the anterior group than in the posterior group ( 76.2% versus 32.0% ; or 6.8 ; 95% ci 2.12 - 21.84 ; p = 0.002 )
. in incomplete placenta previa , gestational age at delivery did not significantly differ between the anterior and posterior groups .
conclusion : obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with... |
6,240 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: edcs are chemicals that interfere with the biosynthesis , metabolism , or action of endogenous hormones resulting in deviation from normal developmental programming and reproductive function .
the male sexual differentiation is entirely androgen - dependent and therefore highly susceptible to edcs that disrupt androgen action .
androgens such as testosterone and its metabolite 5--dihydrotestosterone ( dht ) exert their effect through the ar which is a ligand - induced transcription factor .
androgen binding causes the cytosolic ar to translocate into the nucleus , bind to the target regions of androgen - responsive genes , and influence their transcription .
antiandrogens , on the other hand , may bind to the ar but do not promote nuclear translocation or gene transcription .
recent findings indicate that an increasing number of natural products such as legumes , soybeans , flax , yams , and industrial chemicals , such as pesticides and fungicides , influence the activity of androgen and estrogen receptors .
these edcs may have a profound impact on male reproductive health and androgen action including deterioration of sperm quality , increase in cryptoorchidism and hypospadias cases , alteration in sex ratio , and testicular dysgenesis syndrome .
chemicals currently known to interfere with the androgen signalling pathway include dicarboximide fungicides such as vinclozolin , organochlorine - based insecticides such as p , p-ddt and p , p-dde , conazole fungicides such as prochloraz , phthalates , and urea - based herbicides such as linuron .
the toxicity induced by these and other chemicals can be minimized only through thorough screening and early detection of their hazardous nature .
the hazards of edc accumulation were first revealed by studies which demonstrated changes in sex lives of fish in duluth - superior harbor .
the chemicals in waste water accumulate in fish liver and also change egg production of female fish and mating behavior of male fish .
masculinized female mosquito fish was detected in... | endocrine disruptive chemicals ( edcs ) modulate hormone signaling and cause developmental and reproductive anomalies .
today , there is a global concern regarding endocrine disruption effects , particularly those mediated by the androgen receptor ( ar ) .
androgen or male hormones are critical for the development and maintenance of male characteristics and numerous edcs exist in the environment with the potential to disrupt androgen action .
the threat is more during critical developmental windows when there is increased sensitivity to these compounds .
timely screening and detection of the edcs is essential to minimize deleterious effects produced by these toxic chemicals . as a first line of screening , in vitro transcription assays
are very useful due to their speed , convenience , and cost effectiveness . in this paper ,
recent in vitro reporter assays for detecting androgenic or antiandrogenic activity of edcs have been reviewed .
two important cell systems used for this purpose , namely , the mammalian or yeast cell systems , have been discussed .
use of reporter genes such as bacterial luciferase ( lux ) and green fluorescent protein ( gfp ) has significantly improved speed and sensitivity of detection .
also , many of the current reporter assay systems can be used in a high throughput format allowing speedy evaluation of multiple potential edcs at a lower price . |
6,241 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: myostatin , encoded by the mstn gene ( previously referred to as gdf8 ) , is a member of the transforming growth factor superfamily that normally acts to limit skeletal muscle mass by regulating both the number and growth of muscle fibres [ 1 , 2 ] .
mstn is synthesized as precursor and upon proteolytic processing gives an n - terminal latency - associated peptide , termed myostatin propeptide or lap - fragment , and a smaller mature peptide at the c - terminus .
the mstn gene , composed of three exons and two introns , has been characterized in rodents , humans , and several livestock species [ 3 , 58 ] .
natural mutations that decrease the amounts of myostatin and/or inhibit its function have been identified in a human subject and in several cattle [ 2 , 3 , 1013 ] , sheep [ 1416 ] , and dog breeds . in belgian blue ,
piedmontese , marchigiana , and other cattle breeds , loss - of - function mutations within the coding sequence of the mstn gene determine increased skeletal muscle mass , relevant in shoulders and thighs , and the produced phenotype is known as
these polymorphisms have , in several cases , effects on growth , reproductive , performances , and carcass quality traits [ 3 , 18 , 19 ] . in the whippet dog
breed a mutation in the third exon determining a premature stop codon causes an increased muscle mass phenotype in homozygous state and enhanced racing performance in heterozygous dogs . in two norwegian sheep breeds , two different mutations in the mstn coding region are associated with carcass conformation and fatness [ 15 , 16 ] .
in addition , in other sheep and in pigs , mutations identified in non coding regulatory regions affect the level of mstn gene expression and/or are associated with growth , muscle mass , and other carcass traits [ 8 , 14 , 20 , 21 ] . in horse ( equus caballus ) ,
different horse breeds present a variety of morphological phenotypes that have been used to group breeds into a few classes .
however , no system provides a robust classification in which each breed... | myostatin ( mstn ) is a negative modulator of muscle mass .
we characterized the horse ( equus caballus ) mstn gene and identified and analysed single nucleotide polymorphisms ( snps ) in breeds of different morphological types .
sequencing of coding , untranslated , intronic , and regulatory regions of mstn gene in 12 horses from 10 breeds revealed seven snps : two in the promoter , four in intron 1 , and one in intron 2 .
the snps of the promoter ( gq183900:g.26t > c and gq183900:g.156t > c , the latter located within a conserved tata - box like motif ) were screened in 396 horses from 16 breeds .
the g.26c and the g.156c alleles presented higher frequency in heavy ( brachymorphic type ) than in light breeds ( dolichomorphic type such as italian trotter breed ) .
the significant difference of allele frequencies for the snps at the promoter and analysis of molecular variance ( amova ) on haplotypes indicates that these polymorphisms could be associated with variability of morphology traits in horse breeds . |
6,242 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: small cell lung cancer ( sclc ) represents 1320% of all new lung cancer diagnoses .
it is the most aggressive histological subtype of lung cancer , with a strong predilection for early metastases .
the brain is a common site of metastasis in sclc . at the initial diagnosis ,
at least 10% of the patients with sclc already have brain metastases , brain metastases signal stage iv disease and generally herald an ominous prognosis , but neuro- and radiosurgical therapeutic evolution has resulted in effective therapeutic approaches , leading to improvements in neurological status and survival [ 2 , 3 ] .
a 69-year - old caucasian man was admitted to the emergency unit , complaining of progressive exophthalmos over the past 15 days ( fig .
his medical history included heavy smoking ( 108 pack - years , until the day of admission ) .
the patient reported fatigue without loss of weight for the last 6 months . on physical examination ,
auscultation of the lungs revealed diminished breath sounds and dullness to percussion in the upper left lung field .
blood tests disclosed anemia , hematocrit 33.1% and hemoglobin 10.4 g / dl , with a pattern of chronic diseases . the serum chemistry findings were normal .
2a ) showed a sizable mass in the left upper lobe of the lung in contact with the pleura .
chest computed tomography ( ct ) revealed a large round solid tumor with hilar and pre - vascular lymph node enlargement .
the patient underwent magnetic resonance imaging ( mri ) of the brain and orbits to enable further evaluation .
the mri revealed a soft - tissue mass in the outer posterolateral wall of the right orbital cavity with infiltration of the subcutaneous fat , muscles and skin ( fig .
a ct of the upper and lower abdomen also showed no metastatic lesions . in an attempt to determine the exact histopathological nature of the lesion
the findings included a bleeding multilobar mass infiltrating the main carina and projection of the adjacent bronchial mucosa due to external pressure at the rising of the right main... | small cell lung cancer is characterized by rapid growth and early metastasis . despite its sensitivity to cytotoxic therapy , until now treatments have failed to control or cure this disease in most patients .
orbital metastases are a rare manifestation of systemic malignancies .
breast and lung cancers represent more than two thirds of the primary cancer sites .
metastases to the eye and orbit develop in approximately 0.712% of patients with lung cancer . here
, we report a rare case of exophthalmos as the first manifestation of a metastatic carcinoma due to small cell lung cancer , and a 6-months follow - up with complete exophthalmic response to chemotherapy . |
6,243 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in partnership with the government of bangladesh , the us centers for disease control and prevention ( cdc ) and the international centre for diarrhoeal disease research , bangladesh ( icddr , b ) established nationwide hospital - based surveillance to identify clusters of persons with life - threatening influenza virus infections ( 6 ) . additionally , icddr , b has had an urban field site in dhaka ( kamalapur ) , where population - based respiratory disease surveillance was begun in 1998 . in april 2004
the site and its surveillance system have been described ( 8) . as part of this surveillance , a blood culture for bacterial pathogens was collected from every child with acute respiratory or febrile illness , and from 1 in 5 ( 20% sampling frame ) a nasopharyngeal wash specimen was collected for influenza virus culture in mdck cells , and acute - phase and convalescent - phase serum samples were collected for detecting other respiratory viruses . on january 29 , 2008 , a 16-month - old boy was brought to the kamalapur clinic with a history of 7 days of fever , 5 days of cough and rhinorrhea , and 3 days of difficult / fast breathing and loss of appetite ( table ) .
she said he had not exhibited diarrhea , convulsions , or other signs of illness .
the child had been hospitalized 1 year earlier for acute watery diarrhea that resolved uneventfully .
no underlying illnesses had been diagnosed , and he had not received any medications before this clinic visit .
examination showed that the child had a fever , a mildly elevated respiratory rate , and a clear nasal discharge ( table ) .
blood for bacterial culture and viral serologic testing and a nasopharyngeal wash sample were collected according to accepted routine .
a chest radiograph showed scattered bilateral alveolar infiltrates . because of the duration of his fever
, he received a diagnosis of suspected typhoid fever , which is endemic to this community ( 9 ) , and was given oral amoxicillin and nystatin for oral thrush . at a follow - up visit to the... | we identified avian influenza virus a ( h5n1 ) infection in a child in bangladesh in 2008 by routine influenza surveillance .
the virus was of the same clade and phylogenetic subgroup as that circulating among poultry during the period .
this case illustrates the value of routine surveillance for detection of novel influenza virus . |
6,244 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is estimated that 4% to 7% of adults in the unites states have palpable nodules upon examination . with the advent of ultrasonographic ( us ) techniques for assessment of the thyroid gland
, it is now believed that a nodule can be detected in as many as 67% of the normal population .
the first and foremost obstacle for the clinician is to determine whether the nodule is of a benign or malignant nature , albeit malignant nodules are quite rare , comprising approximately 5% of all nodules .
fine needle aspiration ( fna ) of the thyroid nodule has become the standard procedure for evaluation of nodule histopathology and is recommended as the main diagnostic strategy in several guidelines and published consensus agreements .
nevertheless , fna has multiple drawbacks inherent in the procedure itself , including the technique employed and the experience of the physician performing the aspiration [ 5 , 6 ] . in an analysis of 4 703 fnas performed in centers in new york and texas , 10.4% of the fnas
a considerable number of patients with equivocal findings are referred for surgery despite histopathological evaluation of the nodule after surgery revealing no malignancy .
it is estimated that around 75 000 surgeries for nodules with undetermined diagnoses are performed each year in the united states alone ; therefore , with a sound systematic approach , at least one third of these operations could be avoided .
decision support systems that take advantage of computerized learning algorithms have been successfully applied in many areas of medicine and these have yielded diagnostic rates comparable or sometimes exceeding sophisticated diagnostic techniques and the clinical judgment of the physician [ 1013 ] .
decision trees extracted from machine - based data mining techniques offer an unprecedented utility by translating large datasets into algorithms that can be directly applied in clinical settings . in the present study
, we sought to investigate the utility of classification and regression trees ( cart )... | purpose . we sought to investigate the utility of classification and regression trees ( cart ) classifier to differentiate benign from malignant nodules in patients referred for thyroid surgery .
methods .
clinical and demographic data of 271 patients referred to the sadoughi hospital during 20062011 were collected . in a two - step approach ,
a cart classifier was employed to differentiate patients with a high versus low risk of thyroid malignancy .
the first step served as the screening procedure and was tailored to produce as few false negatives as possible .
the second step identified those with the lowest risk of malignancy , chosen from a high risk population .
sensitivity , specificity , positive and negative predictive values ( ppv and npv ) of the optimal tree were calculated .
results . in the first step , age , sex , and nodule size contributed to the optimal tree .
ultrasonographic features were employed in the second step with hypoechogenicity and/or microcalcifications yielding the highest discriminatory ability .
the combined tree produced a sensitivity and specificity of 80.0% ( 95% ci : 29.998.9 ) and 94.1% ( 95% ci : 78.999.0 ) , respectively .
npv and ppv were 66.7% ( 41.185.6 ) and 97.0% ( 82.599.8 ) , respectively .
conclusion .
cart classifier reliably identifies patients with a low risk of malignancy who can avoid unnecessary surgery . |
6,245 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: tullus et al . recently published an algorithm for the orderly investigation of renovascular hypertension in children , in which ultrasonography is one of the primary studies .
doppler ultrasound non - invasively assesses renal artery flow , but is less sensitive than angiography .
computed tomographic ( ct ) angiography and magnetic resonance angiography ( mra ) offer intermediate sensitivity .
digital subtraction angiography is the gold standard investigation for renovascular causes . in some children , hypertension accompanies congenital renal anomalies or an ectopic renal position . in some reports , magnetic resonance imaging ( mri ) or retrograde pyelography led to the diagnosis when ultrasound failed to do so [ 2 , 3 ] .
when ectopia does occur , the thorax is an unusual location to find the kidney .
hahn et al . described an intrathoracic kidney and postulated that contact with the diaphragm was the direct cause of malformation of the diaphragm .
the obstruction of urinary drainage is believed to cause dysplasia and is associated with well - described pathological findings .
obstruction , however , is not believed to play a role in ectopia ; yet , malformations often accompany ectopia . here , we report a child with hypertension and a malformed kidney in an unexpected location .
we describe the use of new modalities for imaging and surgical correction , as well as pathologic findings that have not previously been described in this context .
the 95th percentile pressure for her height and age were 108/70 . over the next few weeks , auscultated pressures ranged between 108128 mmhg ( systolic ) and 7688 mmhg ( diastolic ) .
the second , a twin gestation , was terminated at 17 weeks due to neural tube defects in both fetuses and cardiac anomalies in one of them . to treat a hypercoagulable state during this and a fourth pregnancy , the mother received low - molecular - weight heparin and aspirin .
growth and development were normal , with a height and weight at the 50th percentile .
peripheral renin... | standard initial assessment via ultrasound of a 4-year - old girl with hypertension revealed the absence of one kidney . instead of cross - sectional imaging of the retroperitoneal space , a functional ( nuclear ) study was performed .
this revealed a malformed kidney within the chest .
though systemic levels of renin and aldosterone were not elevated , removal of the malformed kidney normalized the blood pressure .
the presence of prominent smooth muscle nodules surrounding the arteries was seen in the malformed kidney .
initial attempts to avert surgery by pharmacologically reducing blood flow to the malformed kidney were unsuccessful .
the review of the literature offers little evidence to support such a strategy . |
6,246 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the spectrum of age - related , ebv - positive lymphoproliferative disorders ( aebvlpd ) was first described by oyama and coworkers and distinctively occurs in elderly patients without any history of immunosuppression 1 .
further analysis of aebvlpd cases revealed a heterogeneous group of diseases with very different clinical outcomes , leading to the subclassification into : reactive hyperplasia ( rh ) , mucocutaneous ulcer ( ebvmcu)/polyclonal extranodal ( polye ) , polyclonal nodal ( polyn ) , and diffuse large b - cell lymphoma ( dlbcl ) 2,3 . in this report , we present a case of age - related ebv - positive mucocutaneous ulcer that regressed completely in the course of 4 months without treatment .
an 81-year - old lady presented to her dentist with a 3-month history of a painful , nonhealing ulcer on the left hard palate . there was no history of trauma and the ulcer did not improve after her complete upper denture was removed .
she was a nonsmoker and did not consume alcohol . besides the presence of a painful oral ulcer , she was well and had no systemic complaints .
clinical examination revealed a round , well - circumscribed , deep ulceration measuring 3.5 3.5 cm located on the posterior left hard palate extending laterally from midline to alveolar ridge and posteriorly to the hard and soft palate junction .
the ulcer had a slightly raised indurated border and a tan - white granular base ( fig.1a ) .
the differential diagnoses of the ulcer included necrotizing sialometaplasia , squamous cell carcinoma , malignant salivary gland tumor , and lymphoma .
an incisional biopsy was performed and sent to the faculty of dentistry , university of toronto for oral pathology consultation .
the initial biopsy showed pieces of oral mucosa with large areas of predominantly necrotic tissue ( fig.2a ) .
there were scattered areas of viable tissue consisting of small blood vessels with fibrin deposits surrounded by a polymorphous infiltrate that included atypical cells ( fig.2b ) .
the atypical cells had a large... | key clinical messagethe oral manifestations of ebv - positive mucocutaneous ulcers have a worrisome clinical appearance but relatively benign clinical course , responding well to conservative treatment .
elderly patients who develop an unexplained , persistent ulcer of the oral mucosa should have the lesion examined for ebv . |
6,247 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: intracranial germ cell tumors ( gcts ) are rare neoplasms that typically arise in the pineal and suprasellar regions .
they account for 0.5 - 3% of all pediatric tumors of the central nervous system ( cns ) , germinomas being the most common histological type .
although the production of tumor - associated human chorionic gonadotropin ( hcg ) by a germinoma is a rare occurrence , it may lead to precocious puberty ( pp ) due to it 's structural and functional similarity to luteinizing hormone ( lh ) .
we report a case of hcg - producing tumor located in the suprasellar region and associated with sexual precocity .
a 10-year - old male patient was brought to our department with premature pubarche and onset of facial acne at the age of 8 years and increase in penis size at the age of 9 years .
concomitantly , he had a progressive , gradually worsening holocranial headache associated with drowsiness and loss of appetite .
previously , he was a healthy patient , born by spontaneous vaginal delivery at term weighing 3510 g and measuring 50 cm .
the patient had no family history of endocrine disorders , sexual precocity , or consanguinity .
the mother 's and father 's self - reported height was 155 cm and 175 cm respectively .
physical examination revealed height of 148 cm ( 90 - 95 percentile ) , weight of 39 kg ( 75 - 90 percentile ) , blood pressure of 90/60 mmhg , heart rate of 60 beats per minute , facial acne , abdominal fat deposition in the periumbilical region , bilateral , symmetrical and prepubertal sized ( 3 ml ) testes within the scrotum , 8-cm long penis , and tanner stage p3-g2 .
magnetic resonance imaging ( mri ) of the brain showed a large , hyperintense tumor in the suprasellar region , with hypodense areas inside the tumor , which was located in the anterior third ventricle , measuring 3 cm in the largest diameter and causing triventricular dilatation [ figure 1 ] .
radiographs of the hands and wrists revealed significant acceleration of bone age ( ba ) in relation to chronological age ( ca ) ( ba... | this study aims to report a rare case of precocious puberty ( pp ) due to a human chorionic gonadotropin ( hcg)-producing germinoma located in the suprasellar region . a 10-year - old male patient presented with sexual precocity , headache , drowsiness , loss of appetite , and papilledema .
significant acceleration of bone age in relation to chronological age , high serum total testosterone levels , and hypopituitarism ( unresponsiveness to stimulation test ) were observed . magnetic resonance imaging ( mri ) of the brain showed a large suprasellar tumor and triventricular dilatation .
high hcg levels were found in both blood and cerebrospinal fluid .
hormone replacement therapy and transcranial surgery associated with radiotherapy were performed , with complete regression of sexual characteristics and normal laboratory tests post - operatively .
clinical and laboratory findings , in addition to mri scans , led to the diagnosis of an hcg - producing tumor and pp , which represents a rare report in the literature . |
6,248 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: bacterial , parasitic , viral infections and almost all of the immunosuppressive drugs used can produce diarrhea ; however , inflammatory bowel disease ( ibd ) is rare in the transplant recipient .
a 46-year - old man who developed end - stage renal disease ( esrd ) of unknown etiology underwent live related renal transplantation , with his sister as the donor in 1996 .
he was started on cyclosporine , azathioprine , and prednisolone , with cyclosporine being withdrawn 1 year after transplantation because of financial constraints .
subsequently , he was only on azathioprine ( 125 mg daily ) and prednisolone ( 15 mg on alternate days ) .
he had no episodes of graft dysfunction , post - transplant diabetes mellitus , malignancies , or opportunistic infections .
he developed diarrhea in 2005 , with four to five episodes of semi - formed stools a day .
he took symptomatic treatment for the same for two years . in 2007 , he noticed blood streaking of stools and lost about 5 kg of weight .
multiple stool cultures and examinations were negative for salmonella , shigella , campylobacter , clostridium difficile toxin , yersinia , enterotoxigenic e. coli , cryptosporidium , giardia , and strongyloides larvae .
colonoscopy revealed multiple 5 to 8 mm size superficial ulcers with edematous surrounding mucosa , with clean base and hyperemic margins up to 20 cm from the anal margin .
on histological examination , the rectal and sigmoid mucosa showed mucosal hyperplasia with crypt abscesses and evidence of acute and chronic inflammation [ figures 1 and 2 ] .
a diagnosis of ulcerative colitis was made and he was started on mesalamine 2 gm / day .
the frequency of stools decreased to 1 to 2 a day , with no blood or mucus .
active colitis with muco - depletion , cryptitis with crypt abcessess ( arrow ) ( h and e , 40 ) crypt distortion , crypt loss ( arrow ) , and interstitial inflammation with lymphomononuclear and eosinophilic infiltration ( chronic colitis ) ( h and e , 20 )
diarrhea is a common complication after... | diarrhea is common after kidney transplantation and is usually related to immunosuppressive medication or is infective in etiology .
inflammatory bowel disease ( ibd ) is rare after kidney transplantation and is unexpected because the patient is already immunosuppressed .
specific immunomodulatory actions of calcineurin inhibitors have been hypothesized to play a role in the development of ibd in such patients .
we report a case of ibd developing de novo after kidney transplantation .
our case is unique in that the patient was not on calcineurin inhibitors for 8 years prior to the development of ibd . |
6,249 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the increasingly expanding biomedical and biophysical research areas trace back to the human genome project ( hgp ) founded and started in 1990 as a manhood 's big challenge for providing scientific findings to better understand biochemistry , molecular biology and medical sciences 1 . in the year 2001
the human 's genome decryption was first documented by the international human genome sequencing consortium and by greg venter 's founded celera corporation 2 , 3 simultaneously . with the release in 2003 of the genome 's complete decoding in 2003 , the hugo was considered as finished 4 , 5 .
it was then taken as the basis for the development of new diagnostic tools 6 - 8 and therapeutic approaches 9 , 10 with a previously unreached precision in sensitivity and sensibility .
this led to the gene ontology annotation ( goa ) project and the proteome 11 , 12 .
also important is on the combination of both which describes the new expanding research field in the development of theranostic tools 13 enabling a successful pharmacotherapy with a minimum of adverse reactions , realizing a perfect fit to the patient 's differential gene expression profile .. due to the lack of stability of natural dna and rna against nucleases their use as a drug is not possible till now , and modifications are inevitable .
derivatives like peptide nucleic acids ( pnas ) however , are not a substrate for the cell immanent enzymes and therefore they are resistant , highly sensitive and specific tools for antisense strategies 14 - 16 and can be applied both in cancer diagnostics and in therapy 23 - 25 . to increase their efficiency further they can be conjugated with cell penetrating peptides ( cpp ) and peptide - based sequences for subcellular targeting 17 - 19 and
this is carried out by coupling of building blocks combined with protection group chemistry 20 - 22 . despite the improvement in the pna syntheses ,
the success of synthesis strongly depends on different parameters , like activator 's quality and deproctection kinetics which... | the personalized medicine , also documented as individualized medicine , is an effective and therapeutic approach .
it is designed to treat the disease of the individual patient whose precise differential gene expression profile is well known .
the trend in the biomedical and biophysical research shows important consequences for the pharmaceutical drug and diagnostics research .
it requires a high variability in the design and safety of target - specific pharmacologically active molecules and diagnostic components for imaging of metabolic processes . a key technology which may fulfill the highest demands during synthesis of these individual drugs and diagnostics is the solid phase synthesis which is congenial to automated manufacturing .
additionally the choice of tools like resins and reagents is pivotal to synthesize drugs and diagnostics in high quality and yields .
here we demonstrate the solid phase synthesis effects dependent on the choice of resin and of the deprotection agent . |
6,250 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recent technological advances allow the rapid generation of vast quantities of molecular biological data . at the same time , the sequencing of the human genome and subsequent efforts to catalogue the variation within it have created opportunities for testing thousands of sequence variations for association with disease , behavioural traits and physiological markers .
such applications are appealing because of the relative lack of success , to date , of positional cloning strategies that start with family - based linkage mapping , most likely due to insufficient sample sizes to detect genes of modest effect .
the whole - genome association scan is an increasingly feasible study design in which the genotyped markers are sufficiently closely spaced to detect linkage disequilibrium ( ld ) with all aetiological variants , and well - powered sample sizes are more attainable .
some initial studies have been performed in special populations and in small samples of outbred populations ; genome - wide admixture scans are imminent and , ultimately , routine scans will be performed for common diseases in large cohorts of outbred populations .
array experiments measuring large numbers of transcription or expression levels are another form of genome - wide analysis that have become widespread .
although the effect sizes expected in these studies are large by comparison with disease association studies , the sample sizes are constrained by cost to be relatively small , so that both types of study encounter problems of statistical power ( table 1 ) .
expression levels can be regarded as quantitative traits under genetic control , so that both kinds of large - scale exploration can occur in genome scans for loci influencing expression levels , or phenome scans demarking the influence of genetic pathways .
primarily , there is the multiple testing problem , whereby the chance of an exceptional result increases with the number of tests performed , even when there is no true association . to alleviate this problem ,
two broad... | recent developments in the statistical analysis of genome - wide studies are reviewed .
genome - wide analyses are becoming increasingly common in areas such as scans for disease - associated markers and gene expression profiling .
the data generated by these studies present new problems for statistical analysis , owing to the large number of hypothesis tests , comparatively small sample size and modest number of true gene effects . in this review , strategies are described for optimising the genotyping cost by discarding promising genes at an earlier stage , saving resources for the genes that show a trend of association .
in addition , there is a review of new methods of analysis that combine evidence across genes to increase sensitivity to multiple true associations in the presence of many non - associated genes .
some methods achieve this by including only the most significant results , whereas others model the overall distribution of results as a mixture of distributions from true and null effects . because genes are correlated even when having no effect , permutation testing is often necessary to estimate the overall significance , but this can be very time consuming .
efficiency can be improved by fitting a parametric distribution to permutation replicates , which can be re - used in subsequent analyses .
methods are also available to generate random draws from the permutation distribution .
the review also includes discussion of new error measures that give a more reasonable interpretation of genome - wide studies , together with improved sensitivity .
the false discovery rate allows a controlled proportion of positive results to be false , while detecting more true positives ; and the local false discovery rate and false - positive report probability give clarity on whether or not a statistically significant test represents a real discovery . |
6,251 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: asbestos causes lung fibrosis known as asbestosis , a few benign pleural diseases such as pleural plaque and effusion , and malignant diseases such as mesothelioma and lung cancers [ 15 ] .
furthermore , cancers in other organs such as the gastrointestinal tract , larynx , kidney , liver , pancreas , ovary , and hematopoietic systems show ahigh prevalence in asbestos - inhaled people [ 69 ] . this issue has been tackled as a major medical and social problem throughout the world , especially since asbestos is very useful in various industries for its mineral characteristics such as resistance to heat , cold , chemicals , cheapness , easiness to obtain and weave , and so on [ 8 , 9 ] . in japan ,
the quantity of asbestos produced has increased since the mid-1950s and reached a peak in 1974 ( over 350,000 tons ) [ 1012 ] .
the peak level of usage continued until the late 1980s in construction , car , and other industries . in the summer of 2005 ,
kubota corporation , which mainly used asbestos to make water pipes in amagasaki city , hyogo prefecture , japan , acknowledged the prevalence of asbestos - related diseases among their workers , including several patients living near kubota 's asbestos - handling factory in amagasaki city [ 1012 ] . citizens in japan were suddenly made aware that asbestos causes malignancies in asbestos - handling workers and in residents living near these factories .
they were informed that mesothelioma is difficult to diagnose and cure and were angered that workers and neighborhood residents had not been notified that these factories had been handling this silent bomb , asbestos [ 1012 ] .
to reduce the anxieties of the japanese people , epidemiological analyses commenced regarding the amagasaki area , and clinical and basic research was conducted on the biological effects of asbestos and the early detection of mesothelioma .
comprehensive approach on asbestos - related diseases , supported by the special coordination funds for promoting science and technology ( headed by dr... | asbestos causes lung fibrosis known as asbestosis as well as cancers such as malignant mesothelioma and lung cancer .
asbestos is a mineral silicate containing iron , magnesium , and calcium with a core of sio2 .
the immunological effect of silica , sio2 , involves the dysregulation of autoimmunity because of the complications of autoimmune diseases found in silicosis .
asbestos can therefore cause alteration of immunocompetent cells to result in a decline of tumor immunity .
additionally , due to its physical characteristics , asbestos fibers remain in the lung , regional lymph nodes , and the pleural cavity , particularly at the opening sites of lymphatic vessels .
asbestos can induce chronic inflammation in these areas due to the production of reactive oxygen / nitrogen species . as a consequence
, immunocompetent cells can have their cellular and molecular features altered by chronic and recurrent encounters with asbestos fibers , and there may be modification by the surrounding inflammation , all of which eventually lead to decreased tumor immunity . in this paper ,
the brief results of our investigation regarding reduction of tumor immunity of immunocompetent cells exposed to asbestos in vitro are discussed , as are our findings concerned with an investigation of chronic inflammation and analyses of peripheral blood samples derived from patients with pleural plaque and mesothelioma that have been exposed to asbestos . |
6,252 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: this condition was defined by the international elbow working group ( iewg ) in 1993 to include fragmented medial coronoid process ( fmcp ) , osteochondrosis of the humerus ( oc ) , ununited anconeal process ( uap ) , articular cartilage injury , and incongruity of the elbow joint .
these disorders are associated with varying degrees of joint instability , inflammation , and loose fragments within the joint that result in lameness and osteoarthrosis ( oa ) .
several epidemiological studies have examined the genetic basis of ed , a condition that appears to be inherited differently among different breeds .
most cases of ed first present at 6 - 12 months of age as forelimb lameness although some dogs present later in life ( < 6 years old ) . under normal circumstances ,
radiography has been the standard - of - care imaging modality for the diagnosis , grading , and registry of ed .
because radiography is widely available , efficient , and cost - effective , comprehensive radiographic assessment will likely continue to be a valuable component for diagnosing ed .
classification of ed cases according to the iewg protocol is based on the existence and severity of arthritic changes on the joint surfaces as well as the presence of one or more of the following changes : uap , oc , fmcp , and joint malformation or incongruity .
treatment of ed should ideally involve correcting the underlying causes before significant joint damage has occurred . during the early stages of the disease
different non - surgical therapeutic measures such as analgesic therapy ( nsaids ) , weight loss , exercise restriction , functional food consumption , nutritional supplements , physiotherapy , and other complementary modalities can be considered .
in addition , numerous surgical procedures and chondroprotective formulations for managing established cases and the accompanying symptoms have been developed .
taking into account the data presented above , the current investigation focused on two different objectives .
first , an oral... | one hundred and five labrador dogs were randomly divided into two groups to determine the number of animals that develop elbow dysplasia when treated with an oral supplement compared to untreated ones .
efficacy of the oral treatment was also evaluated once illness was diagnosed .
the supplement ( hyaloral ) contained hyaluronic acid , hydrolysed collagen , glucosamine , chondroitin sulphate , and gamma oryzanol .
clinical evaluation of the elbow joints was completed at months 3 , 6 , 12 , and 20 by orthopaedic evaluations , radiography , serologic and blood analysis , and veterinarian evaluation of dysplasia symptoms .
all side effects were recorded . in the control group ,
33.3% of the dogs developed radiographic evidence of elbow dysplasia compared to 18.5% in the treated group .
symptoms of dysplasia at 12 months differed between the treated ( 12.5% ) and control ( 61.5% ) animals , and were significantly different at 20 months ( p < 0.05 ) .
differences in lameness along with movement and swelling of the elbows between groups were observed after 12 months .
the treated group had improved significantly by the last visit ( p < 0.05 ) .
no adverse side effects were reported . in conclusion , oral treatment with hyaloral may have a potential cumulative action that provides protection against dysplasia and significantly improves symptoms of elbow dysplasia . |
6,253 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: primary biliary cirrhosis ( pbc ) is an autoimmune disease in which the intrahepatic bile ducts are targeted by an immunemediated injury .
pbc is associated with a range of conditions , including sjgren 's syndrome in 70% of patients 2 , autoimmune thyroid disease in approximately 10% , and systemic sclerosis in 15% 3 .
however , pbc is suggested to only rarely be associated with rheumatoid arthritis ( ra ) , and the true prevalence of pbc in ra is not well known 4 . in this article
, we report an unusual case of a patient with pbc and ra , and discuss the association between these two diseases .
in 2013 , a 71yearold man with rheumatoid arthritis ( ra ) was admitted to our hospital with elevated transaminase levels .
he had been taking prednisone ( 6 mg / day ) and salazosulfapyridine ( 1000 mg / day ) for ra since 2012 ( fig .
1 ) . he reported no consumption of alcohol , recent travel , or sexual contact .
, he was icteric with mild pruritus . an abdominal ultrasound scan , computed tomography ( ct ) , and magnetic resonance cholangiopancreatography ( mrcp ) revealed neither biliary obstruction nor spaceoccupied lesions .
blood test results ( table 1 ) revealed the following : total bilirubin ( tbil ) , 3.76 mg / dl ; direct bilirubin ( dbil ) , 3.12 mg / dl ; aspartate aminotransferase ( ast ) , 167 iu / l ; alanine aminotransferase ( alt ) , 435 iu / l ; alkaline phosphatase ( alp ) , 2539 iu / l ; glutamyltranspeptidase ( gtp ) , 590 iu / l ; immunoglobulin g ( igg ) , 1322 mg / dl ; immunoglobulin m ( igm ) , 705 mg / dl ; antinuclear antibodies ( ana ) , 40 ; antimitochondrial antibodies ( ama ) , 20 ; amam2 antibodies , 34.1 ( normal ; < 6 ) ; antigp210 antibodies , 0.2 u / ml ( normal ; < 6 ) ; anticentromere antibodies , 55.6 u / ml ( normal ; < 9.9 ) . a liver biopsy at day 4 showed marked inflammatory cell infiltration surrounding and destroying the interlobular bile ducts in the portal area ( fig .
on the basis of these results , a diagnosis of pbc corresponding to sheuer 's stage i was... | key clinical messagethe true prevalence of pbc in ra is not well known .
herein , we report an unusual case of a patient with pbc and ra , and discuss the association between these two diseases .
pbc should be ruled out in the differential diagnosis of patients with ra having abnormal liver function tests . |
6,254 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
exercise - induced bronchoconstriction ( eib ) , also referred to as exercise - induced asthma ( eia ) , is a manifestation of bronchial hyperresponsiveness ( bhr ) that occurs in the majority of patients with current symptomatic asthma , especially in the patients with moderately to severely increased responsiveness [ 13 ] .
the current thinking about mechanisms by which eib develops emphasizes the loss of heat and/or water from the airways during exercise that leads to release of proinflammatory mediators .
airborne particles and pollutants , as well as airborne allergens , are considered as stimulants that contribute to eib .
a fish oil supplementation may have a protective effect on eib , which is probably attributed to its anti - inflammatory properties .
results from several studies indicated that bhr prevalence is higher in females than in males [ 7 , 8 ] .
the mechanisms responsible for a higher susceptibility of the airways in females to nonspecific stimuli include lower airway calibre , lower body weight , greater cholinergic irritability , and hormonal factors . on the other side , data from the studies carried out in the last two decades
suggest an increased risk for asthma among health care workers , yet only a few specific determinants have been elucidated [ 1013 ] . as delclos et al
. have suggested , the contribution of occupational exposures to respiratory impairment and asthma in health care professionals is not trivial , meriting both implementation of appropriate controls and further studies . to our knowledge , so far , there is no study assessing exercise - induced respiratory symptoms ( eirss ) and eib in health care professionals . in the present study , we assessed effects of occupational exposure on eirss and eib among health care workers by comparison of their prevalence and characteristics between females working as nurses in primary care settings and female office workers .
a cross - sectional survey was carried out in a university research laboratory , that... | in order to assess prevalence and characteristics of exercise - induced respiratory
symptoms ( eirss ) and exercise - induced bronchoconstriction ( eib ) in health care
workers , we performed a cross - sectional study including 48 female nurses from
primary care settings and an equal number of female office workers studied as a
control group .
the evaluation of examined groups included completion of a questionnaire , skin
prick tests to common inhalant allergens , spirometry , and exercise and histamine
challenge .
we found a similar prevalence of eirss and eib in both groups .
eib was
closely related to asthma , atopy , family history of asthma , and positive histamine
challenge in either group , while the association between eib and daily smoking in
nurses was of borderline statistical significance .
bronchial reaction to exercise was
significantly higher in nurses than in controls with eib . with the exception of exercise induced
wheezing ,
eirss were weakly associated with eib in both groups with a
large proportion of false positive results . |
6,255 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 74-year - old man presented with mild dyspnea and chest discomfort for 30 months .
trans - thoracic echocardiographic findings showed a left atrial echogenic mass ( 21.5 cm ) ( fig .
1 ) . a provisional diagnosis of a left atrial ( la ) myxoma was made , and the patient was admitted for the surgical excision of the tumor .
coronary angiography revealed a 50% stenosis on the mid - portion of the left anterior descending artery ( lad ) .
we planned the concomitant operation with mass excision and coronary artery bypass . under general anesthesia with supine position ,
conventional cannulation was performed , and the right atrial wall and the interatrial septum were incised .
further , we anastomosed the left internal thoracic artery to the distal portion of the lad .
the resected mass was oval and was made of a white jelly - like material .
we resected the mass including the myocardium , and the la wall was closed by a prolene suture .
hemangioma of the heart presenting as a primary cardiac tumor is extremely rare ; it accounts for approximately 2.8% of all primary resected heart tumors .
its histological subtypes are as follows : 1 ) cavernous hemangioma , 2 ) capillary hemangioma , and 3 ) arteriovenous hemangioma or cirsoid aneurysm .
the capillary hemangioma has lobules of endothelial cells forming small , capillary - like vessels .
the arteriovenous hemangioma consists of dysplastic thick - walled arterioles , venous - like vessels , and capillaries . in our case ,
the tumor is a capillary hemangioma that shows ill - defined aggregates of closely packed , thin - walled capillaries filled with blood cells ( fig .
further , tumors may be located in any heart chamber , the pericardium , the endocardium , or the myocardium .
, and the localization of cardiac hemangiomas was the right ventricle in 20 cases ( 35.7% ) , the left ventricle in 19 cases ( 33.9% ) , the right atrium in 13 cases ( 23.2% ) , the interatrial septum in 6 cases ( 10.7% ) , the interventricular septum in 6 cases ( 10.7% ) , and the left... | hemangioma of the heart , presenting as a primary cardiac tumor is extremely rare ; it accounts for approximately 2% of all primary resected heart tumors . in our patient ,
the tumor was located in the orifice of the right lower pulmonary vein .
few cases of cardiac hemangiomas have been reported to arise from the left atrial ( la ) wall . left atrial hemangiomas , especially those attached to the la wall , may be erroneously diagnosed as myxomas .
cardiac hemangioma is a rare disease ; furthermore , a tumor arising from the la wall and misconceived as a myxoma is extremely rare .
we removed a mass misdiagnosed as a myxoma ; it was pathologically confirmed to be a cardiac capillary hemangioma .
therefore , we report a rare case of a cardiac hemangioma misconceived as a myxoma ; the tumor was removed successfully . |
6,256 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: blunt trauma of the abdominal wall can lead to a traumatic abdominal wall hernia ( tawh ) .
defined tawh as the herniation through disrupted musculature and fascia associated with adequate trauma , without skin penetration , and no evidence of a prior hernia defect at the site of injury .
although this type of hernia is unusual , it has been described in some reviews [ 27 ] .
two reviews studied tawh , especially in the lumbar position [ 8 , 9 ] . the increased abdominal pressure and shearing forces likely cause disruption of the abdominal wall muscles and fasciae .
we describe the history and imaging of a patient with a traumatic abdominal wall hernia and the operative treatment .
a 59-year - old male sustained a fall from a height of 9 m onto a pile of steel bars , landing on his right flank . upon arrival of helicopter emergency medical services , the patient was alert and complained of pain in the abdomen . an advanced trauma life support ( atls ) survey revealed a right - sided pneumothorax , which was treated with a chest tube .
after this intervention , the patient was respiratorily and haemodynamically stable and transported to the emergency department . upon arrival ,
the initial assessment according to the atls protocol was performed without any new findings according to the a , b , c and d approaches . during the secondary survey ,
inspection revealed a large swelling at the right side of the abdomen , with abrasions of the overlying skin ( fig . 1 ) .
focussed assessment with sonography for trauma identified the presence of free intraperitoneal fluid around the spleen .
1patient after blunt abdominal trauma with swelling of the right hemi - abdomen patient after blunt abdominal trauma with swelling of the right hemi - abdomen in addition , a computed tomography ( ct ) scan of the abdomen showed a traumatic hernia of the right lateral abdomen , with protrusion of bowel and laceration of the spleen ( fig . 2 ) .
the patient was transported to the operating theatre , and exploration of the... | although blunt abdominal trauma is frequent , traumatic abdominal wall hernias ( tawh ) are rare .
we describe a large tawh with associated intra - abdominal lesions that were caused by high - energy trauma .
the diagnosis was missed by clinical examination but was subsequently revealed by a computed tomography ( ct ) scan .
repair consisted of an open anatomical reconstruction of the abdominal wall layers with reinforcement by an intraperitoneal composite mesh .
the patient recovered well and the results of a post - operative ct scan are presented . |
6,257 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: silicone intubation of the lacrimal system has become very popular in the treatment of congenital nasolacrimal duct obstructions ( cnldo ) resistant to conservative therapy and/or probing [ 16 ] .
bicanalicular intubation ( bci ) has been used since the 1970s , and various techniques have been described , whereas monocanalicular intubation ( mci ) was not popular until the early 1990s [ 1 , 68 ] .
each of these intubation systems has advantages and disadvantages [ 2 , 3 , 57 , 9 ] . whereas the bicanalicular system requires passing a tube through the inferior and superior puncta and through the lacrimal system into the nose , the monocanalicular system requires a single pass of the tube through the system [ 1 , 2 , 4 ]
nevertheless , a comparison of the two kinds of intubation to determine which is optimal has not been well - performed so far .
the objective of this study was to compare the success rate and complications of mci and bci in children treated for cnldo .
the aim of this prospective study was to compare the success rate of mci and bci silicone intubations in the treatment of children with cnldo .
the study was performed in accordance with the declaration of helsinki , good clinical practice , and applicable regulatory requirements .
informed written consent was obtained from all parents / guardians before the initiation of any procedure .
children aged between 12 and 36 months with severe cnldo symptoms resistant to conservative therapy and two probings were included in the study .
the diagnosis of cnldo was based on a history of tearing , the fluorescein dye disappearance test ( fdt ) , and diagnostic probing and/or irrigation tests .
the study was carried out from january 2006 to november 2009 , and a total of 70 eyes ( in 53 children ) were included .
children younger than 10 months of age were excluded because of known self - resolution during maturation of the nasolacrimal duct .
patients with previous eyelid and/or lacrimal surgery , punctal and/or canalicular obstructions , eyelid... | backgroundto compare the success rate of monocanalicular intubation ( mci ) compared with bicanalicular silicone intubation ( bci ) in congenital nasolacrimal duct obstruction ( cnldo ) in infants and toddlers.methodsin a prospective , nonrandomized , comparative study ,
mci ( n = 35 eyes ) through the inferior canaliculus or bci ( n = 35 eyes ) were performed under general anaesthesia in children aged 10 to 36 months with cnldo .
the tubes were removed 34 months after tube placement , and the children were followed up for 6 months after the removal of tubes .
therapeutic success was defined as the fluorescein dye disappearance test grade 01 , corresponding with a complete resolution of previous symptoms .
partial success was defined as improvement with some residual symptoms.resultscomplete and partial improvement was achieved in 31/35 ( 88.57% ) in the bci group and 34/35 ( 97.14% ) in the mci group .
the difference between the two groups was not significant ( p = 0.584 ) .
complications occurred in both groups .
dislodgement of the tube and premature removal was observed in four bci cases , and loss of the tube was observed twice in the mci group .
canalicular slitting was observed in five eyes in the bci group .
granuloma pyogenicum observed in 2 cases with mci revealed a few weeks after the tube removal .
corneal erosion in the inferior medial quadrant was observed in one mci eye and revealed in a few days after the local treatment without tube removal.conclusionsboth mci and the bci are effective methods for treating cnldo .
mci has the advantage of a lower incidence of canalicular slit and easy placement.electronic supplementary materialthe online version of this article ( doi:10.1007/s00417 - 011 - 1700 - 2 ) contains supplementary material , which is available to authorized users . |
6,258 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is the most common surgical operation throughout the world , and is one of the most common rituals in jewish and islamic cultures .
most circumcisions are performed for religious reasons as in islamic countries and few are performed for medical reasons .
although circumcision is considered to be a technically simple and safe surgical procedure , it can occasionally lead to serious complications such as partial or total penile amputation .
glans penis amputation is an extremely rare condition and its reconstruction is a challenge for surgeons .
amputation has resulted from incidents such as during circumcision , strangulation by hair coil , self- or non - self - mutilation , surgical resection for malignancy , and iatrogenic ischemia during hypospadias repair owing to vigorous dissection or tight bandaging .
immediate reconstruction at the time of amputation can be done by reattachment or replantation .
the first successful microsurgical replantation of an amputated penis was reported in 1977 by cohen and colleagues .
some authors reported proximal lengthening by use of gracilis muscle and scrotal and suprapubic flaps to cover the advanced penis .
others have reported distal lengthening by use of a rectus abdominis inferiorly based island fascial flap covered by a skin graft or a scrotal flap in two stages followed by depilation and a radial forearm free flap by use of a microvascular technique . in this study
, we describe a novel technique for reconfiguration of the glans penis by use of a buccal mucosal graft to cover the distal part of the penis to improve appearance and function in a patient who suffered from an amputated glans during circumcision .
a 2-year - old infant presented to our urology clinic at mayo hospital in hodiedah , yemen , with a lost glans penis that had occurred 1 year previously ( fig .
the parents complained that their infant could not pass urine freely and that the penis was disfigured .
examination of the penis revealed an outstretched length , normal consistency , and no... | penile amputation is a rare catastrophe and a serious complication of circumcision .
reconstruction of the glans penis may be indicated following amputation .
our report discusses a novel technique for reconfiguration of an amputated glans penis 1 year after a complicated circumcision . a 2-year - old male infant presented to us with glans penis amputation that had occurred during circumcision 1 year previously .
the parents complained of severe meatal stenosis with disfigurement of the penis .
penis length was 3 cm .
complete penile degloving was performed .
the distal part of the remaining penis was prepared by removing fibrous tissue .
a buccal mucosal graft was applied to the distal part of the penis associated with meatotomy .
the use of a buccal mucosal graft is a successful and simple procedure with acceptable cosmetic and functional results for late reconfiguration of the glans penis after amputation when penile size is suitable . |
6,259 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: they have significant effect on the synthesis , mobilization , and metabolism of lipids and lipoproteins .
dyslipidemia is a common metabolic abnormality in patients with thyroid disease , in either the overt or the subclinical forms of the disease .
it has been known that overt hypothyroidism is associated with premature coronary heart disease and one of the components of this assumed to be a deteriorated metabolism of atherogenic lipoproteins .
lipoprotein(a ) ( lp(a ) ) is a very large protein molecule wrapped around , and linked by a disulphide bond to , a ldl - like particle .
there is a strong relationship with lp(a ) and coronary heart disease , independent of the standard vascular risk factors .
autoimmune thyroiditis ( hashimoto thyroiditis ) is a very common disorder and it is the main reason for hypothyroidism .
there are considerable sufficient data between the overt hypothyroidism , dyslipidemia , and coronary heart disease , although there are conflicting reports on whether subclinical hypothyroidism or euthyroid autoimmune thyroid disease has any influence on the lipoprotein metabolism .
recently it was reported that thyroid autoimmunity may be an important mechanism for the occurrence of atherosclerosis and it is well known that lp(a ) is one of the main risk factors for the atherosclerosis .
the aim of this study was to investigate the relationship of lipid parameters , lp(a ) levels , and thyroid hormones in hashimoto thyroiditis patients .
one hundred and fifty - four premenopausal female hashimoto patients with a mean age of 37.19 7.98 sd years , followed up and treated in our outpatient clinic between july 2013 and october 2013 , were enrolled in this study .
forty - eight patients had overt hypothyroidism ( age : 35.79 7.29 sd years ) , fifty patients had subclinical hypothyroidism ( age : 36.8 8.19 sd years ) , and fifty - six patients were euthyroid ( 36.3 8.11 sd years ) .
the control group consisted of 50 healthy volunteers with a mean age of 35.42 7.64 sd years .
the... | objective .
the risk of atherosclerotic heart disease is increased in autoimmune thyroiditis , although the reason is not clear .
lipoprotein(a ) ( lp(a ) ) excess has been identified as a powerful predictor of premature atherosclerotic vascular diseases .
the aim of this study is to investigate the relationship between lp(a ) levels and thyroid hormones in hashimoto patients
. method .
154 premenopausal female hashimoto patients ( 48 patients with overthypothyroid ( oh ) , 50 patients with subclinical hypothyroid ( sh ) , and 56 patients with euthyroid hashimoto to ( eh ) ) were enrolled in this study .
the control group consists of 50 age matched volunteers . in every group , thyroid function tests and lipid parameters with lp(a ) were measured .
lp(a ) excess was defined as lp(a ) > 30 mg / dl .
results .
total - c , ldl - c , tg , and lp(a ) levels were increased in hashimoto group .
total - c , ldl - c , and tg levels were higher in sh group than in the control group .
total - c and ldl - c levels were also higher in eh group compared to controls .
lp(a ) levels were similar in sh and eh groups with controls .
however , excess lp(a ) was more common in subclinical hypothyroid and euthyroid hashimoto group than in the control group .
conclusion .
the total - c and ldl - c levels and excess lp(a ) were higher even in euthyroid hashimoto patients .
thyroid autoimmunity may have some effect on lp(a ) and lipid metabolism . |
6,260 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: parathyroid carcinoma is the least common endocrine malignancy , and accounted for only 0.005% of cases reported to the national cancer database ( ncdb ) between 1985 and 1995 .
roughly half of cases are diagnosed between ages 45 and 60 years , but the tumor arises over a wide age range . in the ncdb case series , overall 5- and 10-year survival rates were 85.5 and 49.5% , respectively .
most patients ( > 90% ) present with symptoms of hyperparathyroidism , including severe hypercalcemia , an elevated serum parathyroid hormone ( pth ) level , nephrolithiasis or nephrocalcinosis , osteopenia , gastrointestinal disturbances , depression , fatigue , or memory disturbance . despite this , parathyroid carcinoma remains a rare cause of primary hyperparathyroidism , accounting for only 0.52% of cases . in comparison ,
benign parathyroid adenomas account for approximately 85% of cases , with diffuse hyperplasia comprising the remainder .
parathyroid carcinoma has been associated with hyperparathyroidism - jaw tumor ( hpt - jt ) syndrome , familial isolated primary hyperparathyroidism , and multiple endocrine neoplasia syndromes ( men-1 and men-2a ) ; patients with hpt - jt have a 15% prevalence of the tumor .
the management of parathyroid carcinoma is primarily surgical , with en bloc resection of the tumor with involved adjacent structures being the recommended primary mode of therapy .
indeed , at least one report indicates that survival is largely dependent on margin status of the primary resection .
there has been a long debate in the literature about the effectiveness of adjuvant therapy , largely fueled by the paucity of cases .
however , three recent reports suggest that adjuvant radiation therapy may reduce tumor recurrence after resection [ 35 ] .
there is no systematic data to suggest a role for adjuvant chemotherapy . despite therapy , between one - third and three - quarters of patients have recurrence or metastasis of their tumors , causing recurrent hyperparathyroidism .
re - resection is the accepted... | parathyroid carcinoma is a rare malignancy , and only accounts for 0.52% of cases of primary hyperparathyroidism .
less than 10% of parathyroid carcinomas are non - functional , and as such , they have been rarely reported in the literature .
importantly , margin status at resection is related to prognosis , and only a handful of case reports of non - functional carcinoma note this important parameter . here
we report the first case of non - functional parathyroid carcinoma with negative margins , and review the literature on this rare entity .
whether functional or non - functional , parathyroid carcinoma can often be difficult to differentiate from benign parathyroid adenoma .
while diagnosis has been based on clinical and histological criteria , recent data concerning the molecular underpinnings of parathyroid carcinoma may allow for improved accuracy in distinguishing benign and malignant parathyroid tumors . |
6,261 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: furthermore , these molecules are involved in modulation of adhesion processes at the endothelium and thus promote the transendothelial migration of leukocytes ( haptotaxis ) .
in addition , some chemokines stimulate angiogenesis or angiostasis and thus may play a further role in the suppression of tumor growth or the establishment of an inflammatory response .
traditionally , chemokines and chemokine receptors have been classified into four families ( cxc , cc , c and cx3c ) .
several years ago , a new nomenclature was introduced in which each ligand and each receptor is identified as a member of a sub - family and carries a special number .
for example , a chemokine designated ccl5 is a member of the cc sub - family with the number 5 .
this special chemokine was formerly known as rantes . despite their essential importance for the immune system chemokines and chemokine receptors
these include autoimmune diseases , cancer , lung , and vascular diseases as well as transplant rejection [ 7 - 10 ] .
in addition , the human immunodeficiency virus ( hiv ) uses different chemokine receptors as co - receptors for entry into the cell .
they activate specific inflammatory cells such as monocytes or t lymphocytes and recruit them to the site of inflammation .
these cc chemokines bind to specific g protein - coupled receptors , thereby initiating activation and migration of cells .
the cc chemokines ccl3 ( mip-1 ) , ccl4 ( mip-1 ) , ccl5 ( rantes ) , and ccl3l1 are the natural ligands of the cc - chemokine receptor ccr5 ( ccckr5 , chemr13 or cmkbr5 ) .
the coding sequence for this receptor is located at position 21 on the short arm of chromosome 3 and has a coding sequence of 1056 base pairs , which is translated into a protein of 352 amino acid length .
based on their cytokine profile cd4-positive t - cells can be divided into different subclasses : th1 cells ( t helper cells type 1 ) secrete il-2 , ifn- and lymphotoxin , whereas th2 cells produce il-4 , il-5 , il-6 , il-9 , il-10 , and il-13 .
th1 cells primarily... | efficient recruitment and activation of immuno - competent cells is crucial for an effective immune response to hepatitis c virus ( hcv ) infection .
chemokines and chemokine receptors have been shown to be critically involved in these processes.the ccr5 chemokine receptor is expressed on several cells of the immune system and has been suggested to influence the susceptibility to hcv infection as well as natural course and progression of hepatitis c. however , these reports are still controversial.this review will summarize and discuss the available data regarding the potential role of ccr5 and its ligands in hepatitis c. |
6,262 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: echinococcosis in an important parasitic infection that is still a common health problem in undeveloped and developing countries ( 1 ) .
the right atrium , right ventricle , and liver have been reported as embolic origins of such cysts ( 4 ) . here ,
we present a case of embolism of a hydatid cyst inside the left main pulmonary artery .
the cyst was in the upper segmental branch of the lingular artery , and segmental and sub segmental branches of the lower lobe artery .
however , no hydatid cysts were found in other organs . this case is interesting because there are only a few cases in which isolated pulmonary artery hydatid cyst without other organ involvement has been reported in the literature .
we believe that this case is the first example of pulmonary artery hydatid cyst diagnosed by ebus .
she had no complaints of sputum , chest pain , or dyspnea , but she had a suspicious history of hemoptysis
she had a dog in her childhood and she also lived in the rural area .
no abnormal signs were observed on her chest radiograph . pulmonary function tests and laboratory test results were within normal limits except for eosinophilia and minimally elevated d - dimer in the blood test .
d - dimer level of the patient was 600 ng / ml , while normal limits are 0 - 500 . a negative d - dimer result may exclude pulmonary embolism , but there are many reasons that cause d - dimer elevation such as infection , trauma , deep venous thrombosis , and disseminated intravascular coagulation . in this case , the reason of elevated d - dimer was parasitic infection .
the patient was treated with 250-mg fluticasone dry powder twice daily in an inhaler and montelukast once daily under a suspicious diagnosis of allergic asthma ; she asked for a control examination 2 weeks later . at the control examination
thoracic computed tomography ( ct ) was performed to investigate the etiology of cough and her minimally elevated d - dimer level .
filling defects were observed inside the left main pulmonary artery , upper segmental branch of... | hydatid cyst ( hc ) is a parasitic disease that may involve many organs , especially the lung and the liver .
pulmonary artery location of the hydatid cyst is extremely rare , but it may cause life - threatening complications .
we report a case of a hydatid cyst that completely filled the left main pulmonary artery and its distal part without cardiac involvement .
thoracic computed tomography showed filling defects in the pulmonary arteries .
endobronchial ultrasound was performed for differential diagnosis and it showed a cystic lesion .
hydatid cyst - specific ige and hem agglutination test results were positive . in the literature ,
cases like this in which the diagnosis of pulmonary hydatid cyst is made by endobronchial ultrasound are not usually seen .
although many imaging modalities such as plain chest radiography , cross - sectional imaging ( mdct and mri ) , echocardiography and conventional pulmonary angiography have been used in the diagnostic approach , we recommend endobronchial ultrasound for the differential diagnosis of cases with cystic formation . |
6,263 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: they are usually originates from the frontal and ethmoid sinus and much less frequently seen in the maxillary and sphenoid sinuses .
although the lamina papyracea is a part of ethmoid bone , a giant osteoma originated from the lamina papyracea is very uncommon .
headache , proptosis , epiphora , diplopia , dizziness , facial deformity , face pain and cerebral complications are possible symptoms .
paranasal sinus tomography showed an osseous lesion , the size of 4x 3 cm , arising from the right lamina papyracea .
they can be treated successfully by endoscopic approaches without any recurrence and complication despite its size .
they are usually originates from the frontal and ethmoid sinus and much less frequently seen in the maxillary and sphenoid sinuses ( 2 ) .
however the giant osteomas of the ethmoid and frontal sinuses are very rare , with only a few dozen cases reported in the literature ( 4 ) .
an osteoma of the paranasal sinus is usually asymptomatic and found incidentally on imaging examinations .
ethmoid sinus osteomas often show symptoms at an early stage while osteomas range in size from 2 to 30 mm because of the limited anatomical space ( 4 ) .
most common symptoms are ; blunt face pain , congestion , rhinorrhea , anosmia , sinusitis and orbital symptoms include diplopia , proptosis , exophthalmos and changes in vision ( 5 ) .
osteomas may be associated with rhinosinusitis and mucoceles and these can increase the cranial and orbital complications ( 5 ) . while osteomas usually range in size from 2 to 30 mm , an osteoma with a diameter > 30 mm or weighing > 110 g is considered a
the symptomatic osteomas are treated surgically by external approach , endoscopic or both ( 1 , 2 ) . endoscopic approaches are preferred recently because of its advantages .
we report a case of a giant osteoma of ethmoid sinus and its treatment by endoscopically .
a 65 year old woman , presented with stuffiness and headache , referred to our clinic .
she has had these symptoms for three years and increasing for three... | introduction : osteomas are slow- growing , benign tumors .
they are the most common neoplasms of the paranasal sinuses .
they are usually originates from the frontal and ethmoid sinus and much less frequently seen in the maxillary and sphenoid sinuses .
although the lamina papyracea is a part of ethmoid bone , a giant osteoma originated from the lamina papyracea is very uncommon .
an osteoma of the paranasal sinus is usually asymptomatic .
headache , proptosis , epiphora , diplopia , dizziness , facial deformity , face pain and cerebral complications are possible symptoms .
the treatment of the paranasal osteomas are controversial.case report : a 65 year old patient that applied with stuffiness and headache to our clinic .
she has had a smooth mass in the right nasal cavity .
paranasal sinus tomography showed an osseous lesion , the size of 4x 3 cm , arising from the right lamina papyracea .
the mass excised endoscopically and reported as osteoma histopathologically .
there was no complication .
after 9 months , there was no recurrence.conclusion:giant osteomas of paranasal sinuses , especially originated from the lamina papyracea are rare .
they can be treated successfully by endoscopic approaches without any recurrence and complication despite its size . |
6,264 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is generally believed that nano - grained ceramics have their unique mechanical characteristics that are not commonly found in their coarse - grained counterparts .
strength is an important aspect of material for mechanical and particular applications under loading and static pressure . in some case , it is desirable to optimize strength to improve performance .
transparent mgal2o4 ceramic has received considerable attention and has been widely studied [ 3 - 6 ] because of its high melting point , good mechanical strength , high resistance against chemical attack , and extraordinary optical properties [ 7 - 11 ] .
presently , extensive work has been performed in studying the fabrication , micro - morphology and transparent mechanism of transparent mgal2o4 nano - ceramic . however , there is limited research on investigating one of the fundamental parameters of transparent mgal2o4 nano - ceramic the yield strength at high pressure and temperature .
the aim of this work is to study the yield strength of transparent mgal2o4 nano - ceramic at pressure up to 5 gpa and temperature up to 900c through the analysis of the shape of x - ray diffraction lines .
we carried out x - ray diffraction experiments on transparent mgal2o4 nano - ceramic using x - ray ( cuk ) diffractometer ( model dx-2500 ) .
the nano - mgal2o4 powder , with a median particle size of 30 nm , was prepared by a low - cost melted - salt technique .
two separated layers of nano - mgal2o4 and nacl cylinder were loaded inside a cubic pyrophyllite cell , which is a pressure - transmitting medium , and assembled to the press - standing piece with other modules including a carbon heater .
the temperature was measured by a nichrome - nisi thermocouple , which was passed through the press - standing piece in advance of calibrating the sintering temperature .
the samples were compressed from 1 to 5 gpa at room temperature and then heated from 300 to 900c under 4 gpa .
the samples peaks broaden asymmetrically , with a much more severe broadening on the... | we report here experimental results of yield strength and stress relaxation measurements of transparent mgal2o4 nano - ceramics at high pressure and temperature . during compression at ambient temperature ,
the differential strain deduced from peak broadening increased significantly with pressure up to 2 gpa , with no clear indication of strain saturation . however , by then , warming the sample above 400c under 4 gpa , stress relaxation was obviously observed , and all subsequent plastic deformation cycles are characterized again by peak broadening .
our results reveal a remarkable reduction in yield strength as the sintering temperature increases from 400 to 900c .
the low temperature for the onset of stress relaxation has attracted attention regarding the performance of transparent mgal2o4 nano - ceramics as an engineering material . |
6,265 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | abstractthe prevalence of diabetic nephropathy ( dn ) among diabetic patients seems to be overestimated .
recent studies with renal biopsies show that the incidence of non - diabetic nephropathy ( ndn ) among diabetic patients is higher than expected .
renal impairment of diabetic patients is frequently attributed to dn without meeting the kdoqi criteria or performing renal biopsy to exclude ndn . in this editorial
, we update the spectrum of renal disease in diabetic patients and the impact on diagnosis , prognosis and therapy . |
6,266 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 56-year - old korean woman presented with blurred vision in the right eye of two months duration .
she received a pdt treatment for cnv with angioid streaks in her right eye at another medical center one month before presentation .
she also had a history of two pdt treatments for cnv with angioid streaks in her other eye at another medical center four years prior .
ocular examination revealed a best corrected visual acuity ( bcva ) of 20 / 125 in the right eye and 20 / 800 in the left eye at the initial visit .
fundus examination revealed peripapillary angioid streaks in both eyes , a grayish subfoveal lesion with mild subretinal exudates in the right eye , and a large disciform scar at the macula in the left eye .
fluorescein angiography ( fag ) and icga were performed with a heidelberg retina angiograph using a scanning laser ophthalmoscope after an intravenous injection of 5 ml of 10% fluorescein sodium ( fluorescite injection ; alcon , fort worth , tx , usa ) and 25 mg of indocyanine green ( dong in dang pharm . ,
the last images were obtained at least 30 minutes after the injection of the dye .
fag showed subfoveal classic cnv associated with leakage and peripapillary hyperfluorescence corresponding to the angioid streaks in the right eye .
icga showed a more distinct margin of subfoveal cnv in early phase than fag and a peau d'orange appearance in the posterior pole with hyperfluorescent angioid streaks connected to the cnv lesion in late phase , which were not seen in fag . both fag and icga of the right eye revealed an increased cnv lesion size and progression to the center of the fovea despite the previous pdt treatment that was performed at another medical center .
optical coherence tomography ( oct ) was performed using oct 3 ( carl zeiss meditech , dublin , ca , usa ) , and a central macular thickness ( cmt ) was obtained using a fast macular map protocol .
oct scans of the right eye revealed a hyperreflective subfoveal choroidal neovascular membrane with cystoid macular edema and neurosensory... | a 56-year - old korean woman presented with decreased visual acuity of the right eye .
she had a history of two photodynamic therapy treatments for choroidal neovascularization ( cnv ) due to angioid streaks in her left eye with central scarring and low visual acuity .
she was diagnosed with subfoveal cnv due to angioid streaks in her right eye and treated with six intravitreal bevacizumab ( 1.25 mg / 0.05 ml ) injections over one year .
best corrected visual acuity improved from 20 / 125 at baseline to 20 / 50 at the final visit .
the area of cnv had changed into a fibrotic scar by the final visit , and fluorescein angiography and indocyanine green angiography revealed no evidence of leakage .
optical coherence tomography showed that central macular thickness decreased from 311 m at baseline to 203 m with complete resolution of subretinal and intraretinal fluid at the final visit .
intravitreal bevacizumab for cnv associated with angioid streaks prevented the progression of disease and resulted in the improvement of visual acuity after one year of follow - up in our patient . |
6,267 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: to replace a missing tooth with a dental implant , existence of the adequate bone is an essential prerequisite .
sometimes , there is a lack of available bone as a consequence of atrophy , trauma , failure to develop or surgical resection .
several grafting materials including autografts , allografts , xenografts and alloplasts have been used for bone augmentation . while autogenous bone is called as a gold standard
anorganic bovine bone ( abb ) has osteoconductive properties and is documented as a bio - compatible material .
although several clinical investigations have demonstrated its favorable results , [ 1 , 4 ] histological studies have shown variable degrees of residual material even after 3 years .
-tricalcium phosphate ( -tcp ) is a synthetic calcium phosphate ceramic used in regenerative therapy as an alloplastic material .
a number of reports have indicated good biodegradability and biocompatibility , while others have shown rapid degradation and weak mechanical properties [ 610 ] . to the best of our knowledge
, there is limited data comparing these two materials with regard to the amount of bone formation and graft resorption properties .
the aim of this study was to compare these two materials in experimentally induced defects in rabbit calvaria .
this study was approved by the animal care and use committee of tehran university of medical sciences and was performed strictly in accordance with the recommendations of the helsinki convention for the use and care of animals .
six white male new zealand rabbits weighing 2.53.5 kg were maintained on standard laboratory chow with free access to water for 2 weeks prior to the first day of the experiment .
the animals were anesthetized with intramuscular injections of 2% ( 5mg / kg ) xylazine and 10% ( 40mg / kg ) ketamin ( alafason , woeden - holland ) .
the surgical sites on the calvaria were shaved and scrubbed with 7% betadine for 5 minutes .
after isolation , an anterior - posterior ( craniocaudal ) incision was made with a no .
15 surgical blade... | objective : both anorganic bovine bone ( abb ) and -tricalcium phosphate ( -tcp ) are used in clinical practice as bone substitute materials , but there is limited data comparing these two materials in standardized defects.the aim of this study was to histologically evaluate the effectiveness of abb and -tcp in the healing of experimentally induced bone defects.materials and methods : eighteen bone defects were created on the calvaria of six rabbits . in each animal , one defect was left untreated and the other two were filled with abb and -tcp .
after one month , histological sections were prepared .
type and vitality of newly formed bone , percentage of new bone formation and residual material , thickness of trabeculae , inflammation and foreign body reaction were assessed.results:the newly formed osseous tissue was vital in all defects and consisted of woven and lamellar bone .
mean percentages of new bone formation were 30.8314.29% , 16.8311.07% and 14.008.17% in -tcp , abb and control groups , respectively and the mean percentages of residual biomaterial were 24.1714.01% and 36.508.43% in -tcp and abb groups , respectively
. however , the differences were not statistically significant ( all ps>0.05 ) .
inflammatory infiltration was statistically higher in -tcp compared to the control group ( p=0.025 ) , but the difference was not significant between -tcp and abb groups ( p=0.083 ) .
trabeculation thickness and foreign body reaction were not statistically different between -tcp and abb groups.conclusion:-tcp and abb were not different with regard to the quantity and quality of newly formed osseous tissue
. however , inflammatory infiltration was higher in sites filled with -tcp . |
6,268 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mycetoma pedis , or madura foot , was first described as a clinical entity by gill in 1842 , from a clinic in madurai , india . in 1880 , carter coined the term mycetoma .
the disease can be caused by one of two organisms , the eumyces , or true fungi ( eumycetoma ) , or actinomyces , filamentous bacteria of the order actinomycetales ( actinomycetoma ) .
it is a localized , chronic , suppurative infection characterized by exuberant granulation tissue and discharging sinuses and bone involvement later in the course of the disease .
early clinical diagnosis before the appearance of discharging sinuses is difficult as the entity may clinically mimic a low grade neoplasm or a chronic bacterial or tubercular infection .
the recently described dot in circle sign on magnetic resonance imaging ( mri ) is easy to recognize and specific to this condition and establishes the role of mri in early diagnosis.[35 ] we present a case of mycetoma foot that demonstrated the dot - in - circle sign on mri .
a 48-year - old man complained of painless swelling in the left foot that had been present for the past 6 years .
the patient had been treated with multiple courses of oral and intravenous antibiotics in a primary health center .
the patient did not respond to the treatment . at the peripheral hospital two attempts were made to incise and drain the lesion . for the past 1 month
, the patient had experienced mild dull aching pain in the foot , mainly during the night .
the patient did not mention a history of past discharge of granules from any area of the foot .
plain radiograph of the left foot showed mild soft tissue swelling with changes of chronic osteomyelitis involving the tarsal and metatarsals [ figure 1 ] .
mri was performed to characterize the lesion and to evaluate the extent of the disease .
multiple discrete , as well as , conglomerate small spherical hyperintense lesions with peripheral hypointense rim were seen .
few of these lesions showed a central tiny hypointense focus suggestive of dot in circle ... | mycetoma or maduramycosis is a localized chronic suppurative infection characterized by exuberant granulation tissue , discharging sinuses , and bone involvement later in the course of the disease .
early clinical diagnosis before the appearance of sinuses and grains ( aggregates of organism surrounded by granulation tissue , which are discharged from the draining sinuses ) is difficult .
delay in diagnosis may lead to amputation of the affected part .
definitive diagnosis is through biopsy and microbiological examination .
however , at times diagnosis may still be difficult .
the recently described dot in circle sign on magnetic resonance imaging ( mri ) is easy to recognize and highly specific .
we present a case of mycetoma foot with characteristic mri features . |
6,269 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recent guidelines for the management of hypertension have recognized the relevance of albuminuria and an estimated glomerular filtration rate ( egfr ) value < 60 ml min per 1.73 m on cardiovascular ( cv ) prognosis of hypertensive patients .
the presence or absence of albumin in urine and the level of egfr allow patients to be allocated to one of the five stages of chronic kidney disease ( ckd ) , described by the us national kidney foundation 's ( nkf ) kidney disease outcomes quality initiative ( k / doqi ) guidelines , which is the accepted classification of any renal disease .
the available information about the prevalence of renal dysfunction in arterial hypertension arises chiefly from clinical trials enrolling elderly hypertensive subjects or patients with high or very high cv risk .
little is known about the clinical correlates of the various stages of kidney disease in arterial hypertension , especially in patients without diabetes and free from cv complications .
we recently found that renal dysfunction is highly prevalent among non - diabetic middle - aged subjects with non - malignant arterial hypertension and without cv complications , participating to the redhy ( renal dysfunction in hypertension ) study .
the aim of this study was to analyse , in the same wide group of hypertensive subjects , the clinical correlates of different degrees of renal dysfunction .
the study population was selected from 2258 caucasian hypertensive patients consecutively attending our hypertension centre .
most of them had been referred to our institution by their general practitioners for specialist advice .
exclusion criteria :
age lower than 18 years and greater than 70 yearsknown diabetes or fasting glycaemia126 mg per 100 mlgrade ii iii ( world health organization classification ) obesity ( body mass index ( bmi)>35 kg / m)known renal , renovascular , malignant or endocrine hypertensionknown proteinuria and haematuriaprevious known nephritic diseases and hereditary renal diseasesheart failurepositive... | our study was aimed to assess the clinical correlates of different degrees of renal dysfunction in a wide group of non - diabetic hypertensive patients , free from cardiovascular ( cv ) complications and known renal diseases , participating to the redhy ( renal dysfunction in hypertension ) study .
a total of 1856 hypertensive subjects ( mean age : 4714 years ) , attending our hypertension centre , were evaluated .
the glomerular filtration rate ( gfr ) was estimated by the simplified modification of diet in renal disease study prediction equation .
a 24-h urine sample was collected to determine albumin excretion rate ( aer ) .
albuminuria was defined as an aer greater than 20 g min1 .
we used the classification proposed by the us national kidney foundation 's guidelines for chronic kidney disease ( ckd ) to define the stages of renal function impairment . in multiple logistic regression analysis ,
the probability of having stage 1 and stage 2 ckd was significantly higher in subjects with greater values of systolic blood pressure ( sbp ) and with larger waist circumference .
sbp was also positively related to stage 3 ckd .
stage 3 and stages 45 ckd were inversely associated with waist circumference and directly associated with serum uric acid .
age was inversely related to stage 1 ckd and directly related to stage 3 ckd .
the factors associated with milder forms of kidney dysfunction are , in part , different from those associated with more advanced stages of renal function impairment . |
6,270 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: an 18-year - old male reported to outpatient department of deepa nursing home on december 13 , 2013 with the complaint of fever , malaise , myalgia , and unilateral tenderness on the right side of the face with overlying facial edema since 2 days .
the pain and swelling were associated with earache and difficulty to eat , swallow , and talk with difficulty in opening the mouth [ figure 1 ] .
swelling on the right side of the face ( frontal view ) general physical examination revealed a well - built stature .
on intra oral examination , the orifice of stensen 's duct appeared red and swollen .
past medical history revealed that the patient was hospitalized for malaria and treated without any complications 5 years back .
the diagnosis was then confirmed with positive serologic test for igm antibody , and igg antibody with a 4-fold rise in titers .
seven days following the initial symptomatic treatment for fever and parotid swelling , the patient was hospitalized for fever with a temperature of 100.7f , nausea , vomiting , and painful left scrotal swelling [ figure 2 ] .
swelling on the right side of the face ( lateral view ) the patient denied any urinary complaints of dysuria or urethral discharge . considering the patient 's age and the history , there was no record to suggest a sexually transmitted illness . on examination ,
the left testis was enlarged measuring 8 cm 7 cm 7 cm , tender and hard in consistency [ figure 3 ] .
right scrotal swelling the right testis and cord were normal . in the routine laboratory investigations
, it was observed that white cell count was raised to 11,700/mcl , and c - reactive protein to 27 mg / l .
blood and urine cultures showed no significant growth . considering the clinical examination of the scrotum which showed a swollen and edematous right testis and epididymis , features exhibiting of epididymo - orchitis ,
the patient was treated with anti - inflammatory medications , pain medications , and bed rest with an elevated scrotum and ice packs applied to the area... | mumps is a relatively mild short - term viral infection of the salivary glands that usually occurs during childhood .
meningitis / encephalitis is a well - known complication of mumps , but involvement and infection of the testis in adolescent boys and adult men are rare .
we report a case of an 18-year - old male patient with mumps associated epididymo - orchitis on the left side .
the diagnosis was confirmed clinically and serologically by igg and igm titers .
the symptoms were resolved after the administration of anti - inflammatory and pain medications with bed rest and ice packs applied to the area . |
6,271 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: diabetic neuropathy is the most common neuropathy and is associated with a wide range of clinical manifestations .
it tends to occur after 50 years of age , and mostly in patients with long - standing diabetes mellitus .
it results from microvascular injury involving small blood vessels that supply nerves , but macrovascular pathogenesis is also involved .
the pathogenesis of sensorimotor neuropathy in diabetes mellitus type 2 is multifactorial and related metabolic disturbances , such as hyperglycemia , dyslipidemia , oxidative and nitrosative stress , and growth factor deficiency all contribute to the development of this complication .
several metabolic products , such as advanced glycated end products , activation of protein kinase c enzyme , and sorbitol aldose reductase ( polyol ) pathway flux are claimed to have a role in pathogenesis of neuropathy .
dyslipidemia is a significant contributor to the development of diabetic neuropathy via inducing oxidative stress in root ganglia sensory neurons .
reported that short - term glycemic control in patients with type 2 diabetes mellitus can improve vibratory sensation , metabolic changes in glucose and lipids ( total cholesterol , triglyceride , and free fatty acids ) being the factors responsible for impairment of peripheral nerve function . on the other hand
, a previous study showed that there was no significant difference in serum cholesterol of type 2 diabetic patients with negative and positive sensorimotor neuropathy .
atherogenic lipid indices including total cholesterol / high - density lipoprotein cholesterol , low - density lipoprotein
cholesterol , triglycerides / high - density lipoprotein and other ratios are predictors for atherosclerosis in type 2 diabetes mellitus but not for neuropathy .
this study aimed to explore the status of some atherogenic lipid indices in type 2 diabetes neuropathy assessed by neuropathy total symptom score ( ntss ) , neuropathy impairment score in the lower leg ( nis - ll ) , and electrophysiological studies of... | objectives : the pathogenesis of neuropathy in type 2 diabetes mellitus is multifactorial.dyslipidemia may contribute to the development of diabetic neuropathy .
this study aimed to assess the atherogenic lipid indices in type 2 diabetic patients with neuropathy.material and methods : fifty - one patients with type 2 diabetes mellitus and 31 healthy subjects were studied in the unit of neurophysiology at the university hospital of medical college , al - nahrin university in baghdad , iraq , from january 2002 to january 2003 .
neuropathy total symptom score ( ntss ) , neuropathy impairment score in the lower leg ( nis - ll ) , and electrophysiological study of sensory ( ulnar and sural ) and motor ( ulnar and common peroneal ) nerves were used to assess nerve function .
fasting venous blood was obtained from each participant for determination of lipid profile and atherogenic lipid ratios.results:the frequency of high blood pressure was significantly higher in neuropathic patients .
the electrophysiology study revealed significant decrease in conduction velocity of ulnar ( sensory and motor components ) , sural , and common peroneal nerves .
the minimum f - wave latency of motor nerve was significantly prolonged . among the lipid fractions , only high - density lipoprotein
cholesterol was significantly reduced by 14% of healthy participant 's value .
atherogenic lipid ratios were significantly higher in diabetic patients than corresponding healthy ratios.conclusion:metabolic lipid disturbances in terms of atherogenicity co - existwith neuropathy in type 2 diabetes mellitus , irrespective of duration of disease . |
6,272 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the age - old model of observation followed by attempt ( ie , see one , do one , teach one ) still exists and is still considered common in residency and fellowship training.1 other modalities available to today s medical learner include formal didactic lectures and multimedia learning ( eg , mobile devices , textbooks , and internet).24 traditionally , teaching methods have been introduced with minimal studies of efficacy , if any . today
, new methods are often held to a higher standard and are required to demonstrate superiority over some existing comparator .
those methods with proven efficacy may be integrated into medical education curricula , either individually or in combination with other methods as appropriate .
simulation can be defined as something that is made to look , feel , or behave like something else especially when applied to research or education.5 the use of simulation to mimic real life in the educational setting has arguably many origins but is closely tied to kolb s experiential learning theory.6 the educational experience provided by simulation is often hands - on , practical , provides immediate feedback , and allows for repetition .
training with simulation does no harm to patients ; errors can be allowed to occur , can even be scheduled , and can provide realistic experiences managing common and rare situations which differs to training by chance where exposure is limited to real life cases that may or may not occur for every trainee . in the medical education setting , simulation - based interventions are now mature with a wide variety of applications.7 for procedural skills , deliberate practice in a simulated - setting is one example of an effective teaching strategy that has been used for specific skills training in central venous catheter insertion , subarachnoid block placement , and laryngoscopy.8 medical residents trained to place central venous catheters in simulation improve their clinical performance in the intensive care unit.9 the translation of knowledge , skills... | the emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine . to date
, there have been a wide variety of simulation applications in this field , and efficacy has largely been assumed .
however , a thorough review of the literature reveals that effective teaching strategies , including simulation , in regional anesthesiology and acute pain medicine are not established completely yet .
future research should be directed toward comparative - effectiveness of simulation versus other accepted teaching methods , exploring the combination of procedural training with realistic clinical scenarios , and the application of simulation - based teaching curricula to a wider range of learner , from the student to the practicing physician . |
6,273 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: obesity is a well - established risk factor for obesity - related cancers , especially for crc .
the prevalence of obesity has doubled world - wide 1980 and at least 500 million people are classified as obese ( body mass index [ bmi ] 30 kg / m ) .
lifestyle - based behavioral and pharmacological interventions for weight loss remain the major approaches to obesity prevention and management [ 35 ] , but with limited success . surgical treatment for obesity ( bariatric surgery )
should be considered in patients with bmi > 40 kg / m or for those have other significant obesity - related comorbidities but bmi 3540 kg / m .
bariatric surgery has been shown to be successful in achieving significant sustained weight loss with low operative mortality and proven safety in older ( > 55 years ) obese patients [ 68 ] .
weight loss after bariatric surgery yields important health benefits , including resolution of type 2 diabetes in most treated patients and lower total mortality , attributed mainly to reduced incidence of major cardiovascular events and cancer overall . a meta - analysis of 21 observational studies from ma et al .
indicated that obesity is associated with increased thyroid cancer risk , except for medullary thyroid cancer .
given the role of overweight and obesity in increasing obesity - related cancers risk , one might expect that weight loss achieved through bariatric surgery would result in reduced risk of obesity - related cancers .
we performed a systematic review and meta - analysis aiming to summarize the relationship between bariatric surgery and incidence of obesity - related cancers .
our systematic review was conducted according to cochrane and the centre for reviews and dissemination guidelines and is reported according to prisma guidelines [ 1214 ] .
pubmed , embase , web of science , and google scholar were independently searched by 2 investigators ( xiang - wu yang and shai - hong zhu ) to identify potential eligible studies .
in addition , the reference lists of relevant reviews and... | backgroundthe aim of this meta - analysis was to investigate possible relationships between bariatric surgery and incidence of obesity - related cancers .
obesity is an established risk factor for obesity - related cancers but the effects of bariatric surgery on incidence of obesity - related cancers are uncertain.material/methodswe searched 4 electronic databases to identify eligible studies : pubmed , embase , web of science , and google scholar .
five observational studies were eligible and included in this meta - analysis .
random - effects or fixed - effects odds ratio ( or ) and its corresponding 95% confidence interval ( ci ) were pooled.resultsmeta-analysis of these 5 observational studies revealed that bariatric surgery was associated with a significantly ( p=0.0004 ) reduced incidence of obesity - related cancers ( or=0.43 , 95%ci , 0.270.69 ) when compared with control individuals .
pooled estimated data showed that bariatric surgery is associated with a 24% lower colorectal cancer ( crc ) risk .
no publication bias was detected by egger s or begg s tests.conclusionsalthough bariatric surgery may significantly reduce incidence of obesity - related cancers , considering the limitations of these included studies , these findings should be confirmed by further well - designed studies . |
6,274 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acyclovir and its congeners can rarely result in psychosis , mania and neurotoxicity in elderly , immunocompromised individuals.[14 ] however , there are no reports of acyclovir - associated hypomania in psychiatric population .
mrs a is a 55-yr - old lady with bipolar affective disorder for the last 33 years with hypothyroidism since 2 years .
her last episode was 10 months back , when she was diagnosed as mania with psychotic symptoms and subsequently was on treatment with tab .
she presented to us with a 3-day history of irritability , increased talkativeness and decreased need for sleep .
five days before the onset of these symptoms , patient had vesicular lesions over the body which was diagnosed as chicken pox by dermatologist ( she did not have past history of chicken pox ) .
the hypomanic symptoms were reported to have started after 24 hrs of starting acyclovir . on mental status examination , she was distractible , had irritable mood , emotional liability , increased psychomotor activity and decreased attention span .
she did not have any psychotic symptoms . on young mania rating scale ( ymrs )
her thyroid profile showed mild elevation of tsh-9.28 mciu / ml ( normal : 0.28 - 6.82 mciu / ml ) with normal t3 , t4 levels .
she was diagnosed as having bipolar affective disorder , current episode hypomania ( icd-10 ) .
she showed improvement in symptoms after 1 week ( ymrs score 7 ) and was discharged from hospital .
index patient had an episode of hypomania within a week of developing chicken pox and 24 hours after starting acyclovir .
previous reports have documented psychiatric manifestations due to acyclovir and its congeners in elderly individuals with immunocompromised state or physical illness.[25 ] although an earlier report reported resolution of symptoms after stopping acyclovir , we started her on olanzapine in view of her past history of severe manic episodes .
on naranjo adverse drug reaction probability scale she had a score of 4 indicating a possible association .
we did not find any... | acyclovir , a commonly used antiviral drug can rarely result in neuropsychiatric complications especially in elderly .
we for the first time report acyclovir associated hypomania in an elderly woman .
our report suggests that acyclovir is a risk factor for mood episode in vulnerable individual and one need to be cautious while using antiviral agents in patients with psychiatric disorders . |
6,275 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: diabetes mellitus is one of the main endocrine diseases , which is more prevalent in the worldwide . cardio - vascular disease , as one of several chronic disorders , is the major complication of type 2 diabetes mellitus ( t2 dm ) .
cardio - vascular disease may result from associated abnormalities of plasma lipid and lipoprotein metabolism .
there are some reports in literature suggesting that the insulin resistance has a central role in the development of dyslipidemia in diabetic patients . in insulin resistance status ,
free fatty acids flux from adipose tissue to liver and subsequently increase synthesis of very low density lipoprotein cholesterol and low density lipoprotein cholesterol ( ldl - c ) and decrease high density lipoprotein cholesterol ( hdl - c ) levels .
moreover , hyperglycemia in insulin resistance can lead to increase of advanced glycation end products density .
these products may directly promote atherosclerosis through changes in endothelial , macrophage , and smooth muscle cells functions .
therefore , improving dyslipidemia would be effective to prevent complications of diabetic patients . several treatments including consumption of herbal medicines , soy protein , w-3 fatty acids , and fiber
it is suggested that consumption of probiotics would be a novel approach to reduce the elevated levels of cholesterol .
probiotics are defined as live microorganisms which have beneficial health effects on their host , when enter the intestine with an adequate amount .
some of these health effects include : lowering hypercholesterolemia , prevention or management of diarrhea , constipation , lactose intolerance , diabetes mellitus , and colon cancer two main groups of probiotic bacteria , which are most commonly used , involve lactobacilli and bifidobacteria .
some studies indicated that probiotics may be able to prevent increased levels of total cholesterol ( tc ) , ldl - c and balance the ratio of ldl - c / hdl - c by de - conjugating of bile , hydrolysis of bile salts and increase cholesterol... | background : alteration in plasma lipid and lipoprotein profile has been documented in diabetic patients .
the purpose of this study was to compare the effect of probiotic and conventional yogurt on lipid profile in type 2 diabetes mellitus patients.materials and methods : a total of 44 patients with type 2 diabetes aged 30 - 60 years old who had low density lipoprotein cholesterol ( ldl - c ) 100 mg / dl enrolled in this randomized , double blind controlled trial and were assigned to two intervention and control groups .
the subjects in the intervention group consumed 300 g / d probiotic yogurt containing lactobacillus acidophilus la-5 and bifidobacterium lactis bb-12 and subjects in the control group consumed 300 g / d conventional yogurt for 8 weeks .
anthropometric indices , dietary intake , and serum lipid profile were evaluated at the beginning and end of the intervention .
independent - sample t - test , paired sample t - test , ancova , and repeated measures were used for statistical analysis.results:the consumption of probiotic yogurt caused significant decrease in ldl - c / high density lipoprotein cholesterol ( hdl - c ) ratio ( 3.13 1.00 - 2.07 0.71 , p = 0.016 ) .
the levels of hdl - c were increased significantly ( 43.66 6.80 - 50.42 6.64 , p = 0.023 ) in the intervention group postintervention .
however , there were no significant differences in triglyceride and total cholesterol levels between two groups postintervention ( p < 0.05).conclusion : it is suggested that probiotic yogurt consumption may be used as an alternative prevention approach and treatment method to improve dyslipidemia in patients with type 2 diabetes . |
6,276 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: iron deficiency anemia was present in 1% to 2% of adults who according to the third national health and nutrition examination survey ( nhanes iii).2 iron deficiency occurs in 11% of women , most often premenopausal , as well occurring in up to 4% of men .
iron deficiency anemia is one of the common anemias and is usually associated with reactive thrombocytosis.3 thrombocytosis , when presented with iron deficiency anemia , is suggested to be due to the stimulation of platelet production .
platelet production is induced by erythropoietin , whose levels are typically increased in patients with iron - deficiency anemia . augmented levels of iron deficiency
the decline in platelets may be related to the variation in the activity of iron - dependent enzymes in megakaryocytosis and thromboiesis.4 the pathogenesis of itp is presumed to be related to increased platelet destruction along with inhibition of platelet production via the production of specific autoantibodies.5 chronic heavy or prolonged uterine bleeding is a common gynecologic problem and can be classified further as ovulatory or anovulatory .
chronic heavy or prolonged uterine bleeding can result in severe anemia , where severe bleeding may lead to the necessity of immediate medical evaluation and treatment .
furthermore , uterine leiomyomas , arising from the smooth muscle cells of myometrium , are the most commonly presented pelvic tumor in female patients.6 we report a rare case of anaemia and immune thrombocytopenia in a 34-year - old african american woman who presented with menorrhagia and metrorrhagia secondary to multiple uterine fibroids .
her conditions were resolved with the introduction of packed red blood transfusion , platelets support , steroids , and iron therapy .
few documented cases of thrombocytopenia associated with bleeding secondary to uterine fibroids have been reported previously .
our case also establishes that thrombocytopenia can occur with anemia in a patient with menorrhagia and metrorrhagia .
moreover , in similar cases ,... | we report a rare case of anemia and thrombocytopenia as a result of uterine fibroid and adenomyosis , complicated by immune thrombocytopenic purpura ( itp ) .
symptoms were presented as menorrhagia and metrorrhagia in a 34-year - old african american woman , who was later treated with blood and platelet transfusion and iron therapy with steroids .
uterine fibroids are commonly found to cause hematologic disturbances such as anemia and reactive thrombocytosis and , less commonly , thrombocytopenia .
moreover , such hematologic disturbances are secondary to heavy and irregular uterine bleeding , which is typically presented .
a previous uterine fibroid diagnosis was made and reconfirmed by pelvic and transvaginal ultrasound to exclude other locoregional pathologies .
itp was suggested by coombs test and several other serologies , leading to confirmation via bone marrow biopsy . in a previous case study ,
we reported positive responses in hemotecrit and platelet count after the introduction of iron therapy to an iron - depleted middle - aged female presenting severe anemia and thrombocytopenia.1 |
6,277 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: computer - assisted surgery has been popularized in orthopedic surgery in the last 10 years . whilst a number of recent randomized control trials have shown some benefit in terms of implant position over conventional jig - based referencing,1
many navigation systems require the use of reference arrays , which are fixed to the tibia and femur with pins .
a 58-year - old man with a diagnosis of varus osteoarthritis ( oa ) of the right knee underwent navigated total knee arthroplasty ( tka ) using standard technique .
we use a passive reflector - based system ( brainlab , feldkirchen , germany ) with fixation of the femoral reference array using two 3-mm - diameter threaded pins .
these are inserted anteriorly through stab incisions , with the knee in flexion , as proximally as the tourniquet will allow .
tibial pins are inserted in the mid diaphysis into the subcutaneous surface of the tibia [ figure 1 ] .
all pins are bicortical in order to maintain secure fixation for the duration of surgery .
peroperative photographs ( a ) insertion of tibial and femoral reference arrays ( b ) the styloid used to map out the tibia and femur computer registration is performed with digitalization of the hip and ankle centers and specific landmarks of the knee . a size 6 generation ii cemented femoral implant and a size 6 generationii cemented tibial component were implanted with an 11-mm polyethylene insert .
the patient had some pain and thigh swelling postoperatively , but this was considered to be in keeping with recent surgery .
he was discharged on the third postoperative day , having satisfied physiotherapy and occupational therapy goals .
he reported 3 days later with increased right thigh pain , swelling , and a limited range of movement .
an ultrasound guided diagnosis of a quadriceps hematoma at the site of the femoral pins was made .
this was confirmed by computerized topography ( ct ) with intravenous contrast [ figure 2 ] , which showed a large quadriceps hematoma and active bleeding into the femoral canal from a... | the use of computer navigation has the potential to improve implant position in total knee arthroplasty ( tka ) , but pin fixation of reference arrays introduces an additional potential source of complications .
we report a case of vascular injury related to the insertion of a femoral pin during navigated tka . |
6,278 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in this issue of critical care , yildiz and colleagues reported the first randomized , controlled trial on the efficacy and safety of physiologic doses of steroids in severe sepsis . during the past 5 years , five phase ii trials and a phase iii placebo - controlled trial on cortisol replacement , i.e. prolonged treatment with physiologic doses of steroids , have been completed in patients with vasopressor - dependent septic shock ( table 1 ) .
two of them have already been published in peer - reviewed journals , three have been published in abstract form and will be published shortly in peer reviewed journals , and the results of a phase ii trial that has just been completed will be available very soon ( oppert and colleagues , personal communication ) .
these trials have consistently shown beneficial effects of cortisol replacement on the amount of vasopressors , on the duration of shock , on the duration and intensity of organ dysfunction , and on the intensity of the systemic inflammatory response .
the survival benefit observed with cortisol replacement in several phase ii trials was recently confirmed by the phase iii trial . in all these trials , cortisol replacement was never associated with even a trend toward serious side effects . a confirmatory phase iii , multinational , placebo - controlled trial ( the corticus study )
is under way , and results should be available within the next 3 years . in the meantime , given the consistency of the results across available trials , cortisol replacement should be considered as a standard of care for patients with vasopressor - dependent septic shock .
yildiz and colleagues found that , in patients with severe sepsis , irrespective of the need for vasopressors , treatment for 10 days with prednisolone given intravenously twice daily ( 5 mg at 6 a.m. and 2.5 mg at 6 p.m. ) was associated with a 20% absolute reduction in mortality within 28 days .
these findings are very challenging , because they suggest that cortisol replacement might be introduced in... | based on several recently completed randomized controlled trials , cortisol replacement is likely to become a standard of care for vasopressor dependent septic shock .
further studies are needed in order to accomplish whether this treatment should be limited to patients with a blunted cortisol response to corticotrophin . similarly , in patients with severe sepsis who do not need vasopressors , the benefit / risk ratio of cortisol replacement remains to be assessed . |
6,279 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gemination is an uncommon anomaly caused by the incomplete attempt of a single tooth bud to form two teeth.1 geminated teeth are found more frequently in primary dentition than permanent dentition.24 the prevalence in the latter ranges from 0.07% to 2.1%.57 maxillary central incisors were found to be the most commonly affected by gemination.6,7 gemination causes aesthetic problems , bad positioning , and impaction of adjacent teeth because of the greater volume of the geminated tooth crown.8 talon cusps are also uncommon dental anomalies manifesting as an accessory cusp - like structure projecting from the cingulum area or the cemento - enamel junction of a maxillary or mandibular anterior tooth in either primary or permanent dentition.9,10 the prevalence of talon cusps in permanent dentition differs among populations , ranging between 0.6% 7.7%.1116 the clinical problems associated with talon cusps include food stagnation ; caries periapical lesions ; tongue irritation ; breast feeding problems ; compromised aesthetics ; occlusal interference , which may lead to accidental cusp fracture ; displacement of the affected tooth ; dental sensitivity , temporomandibular joint pain ; and periodontal problems because of excessive occlusal force.10,11,17 even though talon cusp may occur in isolation , it may also be associated with other variations in crown anatomy , such as peg - shaped crown , supernumerary teeth , and dens invaginatus.10,1822 a talon cusp on a geminated tooth is a very rare finding .
five cases of unilateral geminated teeth with talon cusps20,2326 have been reported , and no cases of bilateral geminated teeth with talon cusps have been reported in the literature .
this article aims to describe an unusual case of bilateral geminated teeth with talon cusps and the multidisciplinary treatment administered in this case .
he had no history of any severe illness or orofacial trauma , and his physical development appeared normal for his age .
clinical examination revealed that the crowns of his maxillary... | talon cusps and gemination are rare dental anomalies that can cause significant aesthetic and clinical problems .
bilateral talon cusps on geminated teeth have not been reported so far .
the case of gemination with talon cusps on both maxillary central incisors was presented in this report .
the main complaints of the patient were tongue irritation and aesthetic problems .
the talon cusps were gradually reduced at 2 consecutive sittings and the exposed surface was treated with a fluoride gel .
the aesthetical appearance was improved using a composite resin .
fixed orthodontic treatment was initiated for repositioning the left maxillary lateral incisor .
a long term , multidisciplinary approach is necessary for the treatment of gemination with talon cusps . |
6,280 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: infection is probably the most dangerous and feared complication after total hip arthroplasty ( tha ) . since timely treatment is mandatory to increase the chance of success , careful patient monitoring and prompt irrigation and debridement of possibly infected wounds are essential .
absorbable sutures are widely used for wound closure after tha , and vicryl plus ( ethicon , johnson & johnson ) combines the features of a well known absorbable suture ( vicryl ) with a broad - spectrum antibacterial agent ( triclosan ) .
a few cases of adverse reactions to vicryl / vicryl plus have reported to date in contrast with the worldwide circulation of these products in most fields of surgery ; however , interestingly , three cases were described as mimicking infection after tha . the present paper aims to present another two cases , whose clinical history , histopathological and laboratory findings are so distinctive ( and consistent with previous reports ) as to define a novel , exceptional tha complication , the suture - related pseudoinfection ( srpi ) .
a 63-year - old woman with displaced femoral neck fracture of the left hip underwent cementless ceramic - on - ceramic tha through straight lateral approach .
the patient had no relevant risk factors for infection ( immunocompetent , non - diabetic with normal body mass index and no history of recent infections ) except light smoking ( less than 10 cigarettes per day ) , and surgery was completed within 80 min .
antibiotic prophylaxis was obtained with a short intravenous course of cefazolin ( 2 g before operation , followed by 1 g 61422 h later ) .
the trochanteric digastrics tendon split and the fascial incision were sutured with vycril plus # 2 , while subcutaneous tissue was sutured with vycril plus # 2 and # 0 in the deep layer and vycril plus # 2/0 in the superficial layer .
two deep suction drains were maintained for 48 h and removed at first dressing change .
the post - operative course was uneventful : body temperature normalized ( below 37 c ) 2 ... | absorbable sutures are widely used for wound closure after total hip replacement . here
we present two cases of suture - related foreign - body reaction that perfectly mimicked a periprosthetic joint infection , with sterile abscess formation and physical and laboratory signs of inflammation acutely presenting 78 weeks after surgery , at the time of suture absorption .
both recurred with analogous timing after irrigation and debridement , likely due to re - using the same suture material .
multiple negative microbiological samples and positive histological samples showing a foreign - body reaction are the fundamental steps towards the diagnosis of a suture - related pseudoinfection ( srpi ) .
only three other cases have been reported to date , but the recurrence , together with the self - healing course after relapse , represents a completely novel feature and possibly the strongest demonstration of the supposed aetiopathogenesis .
the knowledge of this possible complication leads to some clinical implications : all potential periprosthetic joint infections should routinely undergo not only microbiological but also histological sampling ; caution should be used when recommending prosthesis exchange for potential infections occurring in the time range of suture absorption ; lastly , if srpi is suspected , a suture with low propensity to induce foreign - body reactions should be chosen after irrigation and debridement and the volume of absorbable material left in the wound should be as small as possible . |
6,281 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | this study assesses whether deprived populations living close to industry experience greater mortality from lung cancer than populations with comparable socioeconomic characteristics living farther away . mortality data , census data , a postal survey of living circumstances , historic and contemporary data on air quality and a historic land - use survey were used .
analysis was based on two conurbations in england , teesside and sunderland .
housing estates in teesside were selected based on socioeconomic criteria and distinguished by proximity to steel and chemical industries ; they were grouped into three zones : near ( a ) , intermediate ( b ) , and farther ( c ) , with a single zone in sunderland .
we included 14,962 deaths in 27 estates .
standardized mortality ratios ( smr ) for lung cancer [ international classification of diseases # 9 ( icd-9 ) 162 ] and cancers other than lung ( icd-9 140 - 239 , excluding 162 ) , and sex ratios were calculated .
mortality from lung cancer was well above national levels in all zones .
for men , a weak gradient corresponding with proximity to industry at younger ages reversed at older ages . in women 0 - 64 years of age , stronger gradients in lung cancer mortality corresponded with proximity to industry across zones a , b , and c ( smr = 393 , 251 , 242 , respectively ) .
overall rates in teesside were higher than sunderland rates for women aged 0 - 64 years ( smr = 287 vs. 185 ) and 65 - 74 years ( smr = 190 vs. 157 ) .
the association between raised lung cancer mortality and proximity to industry in women under 75 years of age could not be explained by smoking , occupation , socioeconomic factors , or artifact .
explanations for differences between men and women may include gender - specific occupational experiences and smoking patterns .
our judgment is that the observed gradient in women points to a role for industrial air pollution.imagesfigure 1figure 2 |
6,282 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: neurofibromatosis type 1 ( nf1 ) is a common autosomal dominant genetic disorder with an incidence of approximately 1 in 3,000 - 3,500 individuals worldwide ( 1 ) .
nf1 is clinically characterized by the presence of well established phenotypic features , including caf - au - lait ( cal ) spots , neurofibromas , freckling of the axillary or inguinal region , lisch nodules , optic nerve gliomas , and bone dysplasias ( 1 ) .
nearly all nf1 patients have benign dermal neurofibromas , and approximately 30% of nf1 patients have benign plexiform neurofibromas which can undergo malignant transformation to malignant peripheral nerve sheet tumors ( mpnsts ) ( 2 ) .
malignant transformation into mpnsts was observed in 2 - 13% of nf1 patients with plexiform neurofibromas ( 3 ) and represents a major cause of mortality in nf1 patients ( 1 ) .
haploinsufficiency for neurofibromin has been suggested as the molecular basis of the disease ( 1 , 2 ) .
nf1 is caused by mutations in 1 of the 2 alleles of the nf1 gene , located at chromosome 17q11.2 , encoding neurofibromin , a gtpase activating protein ( gap ) .
approximately 5 - 20% of all nf1 patients have been reported to carry a heterozygous large ~1.5 mb deletion at chromosome 17q11 , where the entirety of the nf1 gene and several neighboring genes exist , mediated by homologous recombination between the nf1 repetitive sequences ( 4 ) .
it has been reported that a bi - allelic inactivation of nf1 , with one allele constitutionally inactivated and the other somatically mutated , is required for neurofibroma and mpnst formation ( 5 ) , indicating that the tumor progression of nf1 is most likely triggered by the complete loss of the nf1 gene in somatic cells .
somatic loss of heterozygosity ( loh ) at the nf1 locus has been described for neurofibromas and mpnsts in previous studies ( 5 ) . in a previous study
, we reported the case of a 24-yr old male nf1 patient with benign plexiform neurfiboromas and mpnsts ( 6 ) .
a whole gene expression comparison study was carried out... | neurofibromatosis type 1 ( nf1 ) is one of the most commonly inherited autosomal dominant disorders . in order to determine whether genomic alterations and/or chromosomal aberrations involved in the malignant progression of nf1 were present in a korean patient with nf1
, molecular and cytogenetic analyses were performed on the pathologically normal , benign , and malignant tissues and primary cells cultured from those tissues of the patient .
the comparative genomic hybridization ( cgh ) array revealed a y chromosome loss in the malignant peripheral nerve sheet tumor ( mpnst ) tissue .
g - banding analysis of 50 metaphase cells showed normal chromosomal patterns in the histopathologically normal and benign cultured cells , but a mosaic y chromosome loss in the malignant cells .
the final karyotype for the malignant cells from mpnst tissue was 45,x ,- y[28]/46,xy[22 ] .
the data suggest that the somatic y chromosome loss may be involved in the transformation of benign tumors to mpnsts . |
6,283 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 32-year - old male came to us with complaints of cystic lesions in both lids [ figs . 1 , 2a and b ] .
he was diagnosed to have lipoid proteinosis elsewhere and was completely screened for systemic involvement .
a buccal mucosal biopsy taken elsewhere showed deposition of pas - positive hyaline material [ fig . 3 ] .
there were verrucous lesions in both upper and lower lids with cauliflower shaped lesion in the lower puncta of both eyes .
. external photograph of the eye external photograph closer view ( a ) upper lid ( b ) lower lid histopathology picture depicting pas positive hyaline material
uws is an autosomal recessive disorder , first described by urbach and wiethe in 1929 .
the incidence of hyalinosis cutis et mucosae seems to be fairly high in south africa .
it is a multi - system disease caused due to mutations in the gene encoding extracellular matrix protein 1 on chromosome 1q21 .
skin lesions generally appear as nodules on the face , lips ( at earlier stages ) , and later become hyperkeratotic .
schirmer 's test in both eyes was normal suggesting no involvement of lacrimal gland in our case .
various ocular manifestations such as dry eyes , open angle glaucoma , drusen in the macula , retinitis pigmentosa , uveitis and subluxation of the lens has been reported along with lipoid proteinosis . however , our patient had no abnormality in his eyes .
the most common radiological hallmark is the presence of bean or comma shaped intracranial calcifications in the temporal lobes in the amygdala , which is more evident in the patients who have lipoid proteinosis for a long duration .
patients with neurological manifestations present with a migraine , seizures , mental retardation , anxiety , depression , and panic attacks .
though rare , systemic manifestations of lipoid proteinosis include life - threatening situations like acute respiratory distress or seizures . awareness among ophthalmologists about this rare entity is crucial for appropriate management of these patients . | urbach wiethe syndrome or lipoid proteinosis is a rare autosomal recessive disorder characterized histologically by infiltration of periodic acid schiff - positive hyaline material in the skin , upper aerodigestive tract , eyelids , and internal organs .
classical clinical features include scarring of the skin , beaded eyelid papules ( moniliform blepharosis ) and laryngeal infiltration leading to hoarseness of voice .
lipoid proteinosis can lead to life - threatening conditions such as acute respiratory distress and seizures .
awareness among ophthalmologists about this rare entity is crucial for appropriate management of these patients . |
6,284 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mayaro fever is a dengue - like acute viral disease that is usually self - limiting . its agent is an alphavirus that belongs to the togaviridae family within the semliki forest virus antigenic complex .
the first isolation of mayaro virus was made in august and september of 1954 in five febrile patients from mayaro county , trinidad island .
casals and whitman characterized it as an arbovirus closely related to the semliki forest virus .
the clinical manifestations of mayaro virus disease have been recorded during outbreak studies and documented sporadic cases . after an incubation period of 7 to 12 days
, the patient frequently presents with an abrupt fever accompanied by headache , arthralgias , myalgias , retro - orbital pain , vomiting , diarrhea , and maculopapular rash ; some patients may develop severe and prolonged arthralgias.[36 ] shorter incubation periods have also been observed , other symptoms reported less frequently include nausea , cough , sore throat , abdominal pain , nasal congestion and bleeding gums . in 20% of the cases , swelling of small joints , especially in the wrists , fingers , ankles , and toes , has been reported . usually the fever is between 39c and 40.2c .
presence of mayaro virus antibodies in human populations has been reported in bolivia , brazil , colombia , panama , peru , surinam , trinidad and tobago , venezuela , french guiana and mexico , suggesting the appearance and dissemination of this virus to other countries of the america continent.[36911 ] airborne virus infection of a laboratory worker has been also documented .
a mayaro virus outbreak was reported in belterra , para , brazil in 1978 , with an attack rate of 20% .
under apparently endemic and enzootic conditions , annual incidence rates between 1.6% to 7% were reported among okinawan colonists in bolivia in 1955 and among dutch military troops detached in surinam .
monkeys are suspected to be the principal reservoir for mayaro virus , maintaining the enzoonosis in the rainforest , with periodic epizootics... | objectives : the objectives of this report were to document the potential presence of mayaro virus infection in ecuador and to examine potential risk factors for mayaro virus infection among the personnel of a military garrison in the amazonian rainforest.materials and methods : the study population consisted of the personnel of a garrison located in the ecuadorian amazonian rainforest .
the cross - sectional study employed interviews and seroepidemiological methods .
humoral immune response to mayaro virus infection was assessed by evaluating igm- and igg - specific antibodies using elisa.results:of 338 subjects studied , 174 were from the coastal zone of ecuador , 73 from andean zone , and 91 were native to the amazonian rainforest .
seroprevalence of mayaro virus infection was more than 20 times higher among amazonian natives ( 46% ) than among subjects born in other areas ( 2%).conclusions : age and hunting in the rainforest were significant predictors of mayaro virus infection overall and among amazonian natives .
the results provide the first demonstration of the potential presence of mayaro virus infection in ecuador and a systematic evaluation of risk factors for the transmission of this alphavirus .
the large difference in prevalence rates between amazonian natives and other groups and between older and younger natives suggest that mayaro virus is endemic and enzootic in the rainforest , with sporadic outbreaks that determine differences in risk between birth cohorts of natives .
deep forest hunting may selectively expose native men , descendants of the shuar and huaronai ethnic groups , to the arthropod vectors of mayaro virus in areas close to primate reservoirs . |
6,285 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the capacity of drugs to inhibit the bile salt export pump ( bsep ) has been correlated with clinical drug induced liver injury ( dili ) .
furthermore , known inhibitors of bsep and other bile acid ( ba ) transporters have been implicated in the case studies of dili .
glibenclamide has been associated with lobular liver injury in the clinic , bosentan has been associated with many cases of hepatotoxicity and carries a black - box warning for hepatotoxicity , and troglitazone was withdrawn from the market due to idiosyncratic dili .
currently marketed bsep inhibitors , such as lapatinib , have been given black - box warnings due to issues with liver toxicity .
interestingly , bsep inhibitors often have additional proposed mechanisms for hepatotoxicity , and this can often confound our understanding of how these drugs cause dili . understanding the effects of bsep inhibitors on ba metabolism and processing will prove crucial in understanding the importance of bsep inhibition in clinical dili .
while much is understood qualitatively about the basics of ba homeostasis , there are still many aspects of ba transport about which little quantitative information exists . for example , regulation of transporter activity by the farnesoid - x receptor ( fxr ) and other nuclear receptors generally responsible for ba synthesis has been demonstrated , and chenodeoxycholic acid ( cdca ) and its amide conjugates have been shown to decrease ba synthesis and trigger fxr .
however , to our knowledge , fxr response and transporter activity have not been linked quantitatively to ba concentrations within hepatocytes .
secondary bas , such as lithocholic acid ( lca ) and deoxycholic acid ( dca ) , are synthesized in the gut by intestinal bacteria , but to our knowledge , the rates of synthesis and the population variability of this synthesis have not been quantified in any species .
transporter kinetic and inhibition studies have used ( or focused on ) taurocholic acid , a metabolically stable model ba , but similar studies rarely... | bile salt export pump ( bsep ) inhibition has been proposed to be an important mechanism for drug - induced liver injury ( dili ) .
modeling can prioritize knowledge gaps concerning bile acid ( ba ) homeostasis and thus help guide experimentation .
a submodel of ba homeostasis in rats and humans was constructed within dilisym , a mechanistic model of dili . in vivo experiments in rats with glibenclamide
were conducted , and data from these experiments were used to validate the model .
the behavior of dilisym was analyzed in the presence of a simulated theoretical bsep inhibitor .
bsep inhibition in humans is predicted to increase liver concentrations of conjugated chenodeoxycholic acid ( cdca ) and sulfate - conjugated lithocholic acid ( lca ) while the concentration of other liver bas remains constant or decreases . on the basis of a sensitivity analysis ,
the most important unknowns are the level of bsep expression , the amount of intestinal synthesis of lca , and the magnitude of farnesoid - x nuclear receptor ( fxr)-mediated regulation . |
6,286 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: straight back syndrome has been reported to be a pseudo - heart disease that can mimic congenital abnormalities , especially atrial septal defect ( asd ) ( 1 )
. however , three - dimensional anatomical recognition of this rare disease entity appears to be insufficient . in this case report
, we demonstrate the detailed anatomical background of straight back syndrome with a series of images obtained from low - dose dual - source computed tomography ( dsct ) .
a 23-year - old asymptomatic woman was referred to our hospital for a detailed examination of a systolic ejection murmur with fixed splitting of the second heart sound auscultated at the third left sternal border .
electrocardiography showed right axis deviation and an incomplete right bundle branch block . according to these findings ,
the patient was suspected of having left - to - right shunt disease , including asd .
contrary to expectations , transthoracic echocardiography did not indicate asd , but instead only showed the presence of trivial mitral valve regurgitation due to anterior mitral valve prolapse .
because the four pulmonary veins could not be adequately visualized , she underwent low - dose electrocardiogram - gated contrast - enhanced cardiac computed tomography ( ct ) using commercially available third - generation dsct ( somatom force , siemens healthcare , forchheim , germany ) for further differential diagnosis , including partial anomalous pulmonary venous return , unroofed coronary sinus , subvalvular pulmonary stenosis , and double - chambered right ventricle . a low - dose protocol ( acquisition mode , high - pitch dual spiral scan ; tube voltage , 70 kvp ; rotation time , 250 ms ; effective radiation dose , around 1 msv ) was performed with a contrast agent volume of only 20 ml . the dsct findings ruled out the possibility of any congenital heart diseases , whereas the axial images clearly showed a markedly shortened anteroposterior diameter of the chest ( fig .
1 ) , which led us to a diagnosis of straight back syndrome . a... | a 23-year - old asymptomatic woman was referred to our hospital for further examination of a systolic ejection murmur with fixed splitting of the second heart sound auscultated at the third left sternal border .
initial echocardiography could not detect the cause .
subsequently performed low - dose computed tomography , however , ruled out the possibility of any congenital heart diseases , but revealed a markedly shortened anteroposterior diameter of the chest , which led us to a diagnosis of straight back syndrome .
a vertically oriented pancake appearance of the heart , straight vertebral column , and compression of the right ventricular outflow tract were clearly demonstrated on the reconstructed images . |
6,287 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: primary duodenal tumors are rare , accounting for less than 1% among all gastrointestinal tumors [ 1 , 2 ] .
brunner 's gland adenoma , also known as brunner 's hamartoma is a rare benign small bowel neoplasm with an estimated incidence of less than 0.01% .
generally , it is an incidental finding discovered in an upper gastrointestinal endoscopy ( egd ) and presenting as a single pedunculated polyp , with an average size of 2 cm . occasionally , they may be larger than 5 cm , and located in the first section of the duodenum .
most duodenal tumors of brunner 's glands are demonstrated as hyperplastic or hamartomatous mucosal changes and their malignant transformation has been reported to be extremely rare [ 6 , 7 ] . in a recent study , dysplastic changes were seen in 2.1% and invasive carcinoma in 0.3% of all brunner 's gland hyperplasia .
most patients are asymptomatic , although they can present with common gastrointestinal symptoms like bleeding , nausea , vomiting , or chronic abdominal pain .
we present an illustrative case of a female patient with a duodenal polypoid mass of more than 6 cm who was admitted to our department with upper gastrointestinal bleeding .
a 47-year - old woman arrived at our emergency room with melena and anemia accompanied by epigastric pain .
physical examination on admission revealed normal vital signs ; she was afebrile with a soft and nontender abdomen .
however , melena was detected in the rectal examination and the laboratory data showed a hemoglobin concentration of 8.2 g / dl ( normal range : 12.016.0 ) , and mean corpuscular volume of 88 fl ( normal range : 8096 ) .
the emergency egd revealed a large pedunculated polyp ( 3 6 cm ) in the first section of the duodenum with stigmata of recent hemorrhage which almost occluded the duodenal lumen completely ( fig .
the patient was transferred to our intensive care unit and was administered pantoprazole intravenously at 10 mg / h after an 80-mg loading dose .
contrast - enhanced computed tomography scan showed a... | brunner 's gland adenoma is an extremely rare benign small bowel neoplasm , often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics . in few cases
, it tends to cause gastrointestinal hemorrhage or intestinal obstruction .
we report here our experience with a 47-year - old woman with a brunner 's gland adenoma of more than 6 cm in size , located in the first part of the duodenum and causing gastrointestinal bleeding .
initially , we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding . a rest endoscopic polypectomy with the submucosal dissection technique was planned . however , on request of the patient , an elective surgical duodenotomy with submucosal resection of the remaining small duodenal tumor was performed . to better define the patient 's characteristics and treatment options of such lesions
, we performed a systematic review of the available literature in pubmed .
recently , an endoscopic removal is being increasingly practiced and is considered as a safe treatment modality of such lesions . |
6,288 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: total knee arthroplasty ( tka ) malalignment is related to an unsatisfactory outcome , including patella maltracking , anterior knee pain , flexion instability and early loosening .
furthermore , inadequate positioning particularly of the femoral component is a common indication for revision [ 2 , 8 ] .
using the conventional and bony reference point methods , rotation of the femoral component can be determined intraoperatively by the use of the transepicondylar line , the posterior condylar line and/or the whiteside line [ 5 , 23 ] . with the need for more accurate alignment as an important outcome determinant in tka , prosthesis positioning has been facilitated in recent years by computer assisted orthopaedic surgery ( caos ) .
the ( intraoperative ) value of caos on coronal plane alignment of knee prostheses has been discussed in literature .
some showed improved alignment using caos [ 12 , 21 , 22 , 26 ] , while others showed little difference in alignment [ 3 , 31 ] and no significantly better results during follow - up .
the reason for the differences are both surgical and related to the intraoperative navigation using predetermined anatomical landmarks ; furthermore , the caos software program may be relevant . in caos ,
the planned rotational position of the components can be determined using the transepicondylar , the posterior condylar and the whiteside line .
although the caos systems have been developed in an attempt to align implants more accurately and more consistently , it is unknown if navigation systems improve the accuracy of femoral rotational alignment as compared to the traditional techniques using mechanical guiding devices [ 10 , 11 , 28 ] . whether the intraoperative positions of the knee prosthesis components , as shown on the caos screen , reflect
the goal of this study was to determine the validity of the intraoperative caos position of knee prostheses compared to the postoperative rotational position of the knee prosthesis using a postoperative ct scan evaluation method [ 7 , 15 ]... | rotation of the femoral component in total knee arthroplasty ( tka ) is of high importance in respect of the balancing of the knee and the patellofemoral joint . though it is shown that computer assisted surgery ( caos ) improves the anteroposterior ( ap ) alignment in tka , it is still unknown whether navigation helps in finding the accurate rotation or even improving rotation . therefore the aim of our study was to evaluate the postoperative femoral component rotation on computed tomography ( ct ) with the intraoperative data of the navigation system . in 20
navigated tkas the difference between the intraoperative stored rotation data of the femoral component and the postoperative rotation on ct was measured using the condylar twist angle ( cta ) .
this is the angle between the epicondylar axis and the posterior condylar axis .
statistical analysis consisted of the intraclass correlation coefficient ( icc ) and bland - altman plot .
the mean intraoperative rotation cta based on caos was 3.5 ( range 2.48.6 ) .
the postoperative ct scan showed a mean cta of 4.0 ( 1.77.2 ) .
the icc between the two observers was 0.81 , and within observers this was 0.84 and 0.82 , respectively .
however , the icc of the caos cta versus the postoperative ct cta was only 0.38 .
though caos is being used for optimising the position of a tka , this study shows that the ( virtual ) individual rotational position of the femoral component using a caos system is significantly different from the position on a postoperative ct scan . |
6,289 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the hypoxic pulmonary vasoconstriction ( hpv ) is physiologically and clinically important phenomenon to prevent systemic hypoxemia by diverting pulmonary blood flow from unventilated area to normoxic regions of lung . the oxygen ( o2 ) sensing mechanisms of pulmonary arteries have been long dispute .
although the o2-dependent regulations of ion channels , especially the hypoxic inhibition of k channel , are strong candidate mechanisms , it is still unclear whether ion channels by themselves are the o2 sensing molecule ( 1 - 3 ) .
twik - related acid - sensing k channel ( task ) is a member of two - pore domain k channel family , and has been suggested as a candidate of o2-sensing k channels in various types of tissues such as carotid body and pulmonary arterial smooth muscle ( 4 ) .
the hypoxic inhibition of task might explain , at least partly , the depolarization of pulmonary arterial smooth muscle and contractile responses under hypoxia ( 5 ) .
recently , we found that the hypoxic inhibition of task-1 channel is mediated by nadph oxidase type 4 ( nox-4 ) , which is mediated by the heme moiety and heme - binding domains of nox4 ( 6 ) . in that study
, it was found that the hypoxic inhibition of task-1 was prevented by a pretreatment with carbon monoxide ( co ) , which implicated that a high - affinity binding of co with hemoprotein ( nox-4 ) might have mimicked the o2-binding state in spite of the hypoxic conditions .
co has long been considered a toxic byproduct of incomplete combustion of coals and fuels .
the toxic effect of co is due to its strong affinity for hemoglobin and resultant impairment of o2 delivery by erythrocytes .
in contrast to this conventional idea , an endogenous production of co from heme metabolism by heme oxygenase ( ho ) has become well recognized .
the endogenously produced co is believed to play physiological roles such as anti - inflammatory and anti - apoptotic signals ( 7 ) . in this regard ,
an exogenous application of co at sub - lethal concentration has been suggested as a... | hypoxic pulmonary vasoconstriction ( hpv ) , a unique response of pulmonary circulation , is critical to prevent hypoxemia under local hypoventilation .
hypoxic inhibition of k+ channel is known as an important o2-sensing mechanism in hpv .
carbon monoxide ( co ) is suggested as a positive regulator of ca2 + -activated k+ channel ( bkca ) , a stimulator of guanylate cyclase , and an o2-mimetic agent in heme moiety - dependent o2 sensing mechanisms .
here we compared the effects of co on the hpv ( po2 , 3% ) in isolated pulmonary artery ( hpvpa ) and in blood - perfused / ventilated lungs ( hpvlung ) of rats .
a pretreatment with co ( 3% ) abolished the hpvpa in a reversible manner .
the inhibition of hpvpa was completely reversed by 1h-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one ( odq ) , a guanylate cyclase inhibitor .
in contrast , the hpvlung was only partly decreased by co. moreover , the partial inhibition of hpvlung by co was affected neither by the pretreatment with odq nor by no synthase inhibitor ( l - name ) .
the co - induced inhibitions of hpvpa and hpvlung were commonly unaffected by tetraethylammonium ( tea , 2 mm ) , a blocker of bkca . as a whole , co inhibits hpvpa via activating guanylate cyclase .
the inconsistent effects of odq on hpvpa and hpvlung suggest that odq may lose its sgc inhibitory action when applied to the blood - containing perfusate . |
6,290 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: traumatic brain injury ( tbi ) caused by a direct mechanical insult to the brain induces cerebral contusion and motor and cognitive dysfunction [ 14 ] .
recent studies have indicated that populations of damaged or destroyed neurons can be replenished by proliferation of neural stem cells ( nscs ) [ 5 , 6 ] or newly forming neurons .
doublecortin ( dcx ) , a microtubule - associated protein , is specifically expressed in all migrating neuronal precursors of the developing brain [ 7 , 8 ] .
dcx expression is retained mainly within areas of the subventricular zone ( svz ) of the lateral ventricles and the subgranular zone ( sgz ) at the dentate gyrus / hilus interface of hippocampus [ 8 , 9 ] in the adult brain . following an insult to the brain ,
the increased number of divided cells in the svz and sgz is newly formed immature neurons and expresses dcx [ 1 , 7 , 10 ] . because of its association with neurogenic processes , dcx expression levels in the adult brain reflect neurogenesis .
inhibiting tumor necrosis factor - alpha ( tnf- ) with etanercept is effective for attenuating tbi - induced cerebral contusion , motor and cognitive dysfunction , astrocytic and microglial activation , and activated inflammation [ 11 , 12 ] .
however , it is not known whether systemically administered etanercept penetrates injured brain tissue and attenuates the tbi - induced brain dysfunction by stimulating dcx - associated neurogenesis .
therefore , we examine the relationship between dcx - associated neurogenesis and the tbi - induced formation of cerebral contusions around a damaged brain area .
changes in 5-bromodeoxyuridine-(brdu- ) dcx double expression are analyzed using immunohistochemistry to investigate the relationship between dcx - associated neurogenesis and the formation of cerebral contusions and cognitive dysfunction in rats treated with and without etanercept .
quantitative enzyme immunoassays are used to analyze etanercept levels in the brain after its systemic administration to ascertain whether it had passed... | it remains unclear whether etanercept penetrates directly into the contused brain and improves the outcomes of tbi by attenuating brain contents of tnf- and/or stimulating newly formed neurogenesis .
rats that sustained tbi are immediately treated with etanercept .
acute neurological and motor injury is assessed in all rats the day prior to and 7 days after surgery .
the numbers of the colocalizations of 5-bromodeoxyuridine and doublecortin specific markers in the contused brain injury that occurred during tbi were counted by immunofluorescence staining .
enzyme immunoassay for quantitative determination of tnf- or etanercept in brain tissues is also performed .
seven days after systemic administration of etanercept , levels of etanercept can be detected in the contused brain tissues .
in addition , neurological and motor deficits , cerebral contusion , and increased brain tnf- contents caused by tbi can be attenuated by etanercept therapy .
furthermore , the increased numbers of the colocalizations of 5-bromodeoxyuridine and doublecortin specific markers in the contused brain tissues caused by tbi can be potentiated by etanercept therapy .
these findings indicate that systemically administered etanercept may penetrate directly into the contused brain tissues and may improve outcomes of tbi by reducing brain contents of tnf- and by stimulating newly formed neurogenesis . |
6,291 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: there are few evidences about type 2 diabetes mellitus ( t2 dm ) in frail elderly subjects and , specifically , in older patients living in long - term care residences [ 13 ] .
these patients have usually reduced life expectancy , poor general health , and at least some degree of functional dependence and/or cognitive impairment .
they represent those frail and vulnerable patients affected by t2 dm for whom recent international guidelines specifically recommended less stringent glycemic targets and prioritized well - being and quality of life [ 46 ] .
duration of diabetes and advancing age independently predict morbidity and mortality rates in elderly subjects .
recent observations , demonstrating that cardiovascular complications and hypoglycemia are common among older diabetic patients , support the reorientation of care of older patients with t2 dm away from intensive glycemic control as the core focus of management .
target goal for glycated hemoglobin ( hba1c ) in older adults generally should be 7.5% to 8% . although hba1c between 7% and 7.5% may be appropriate if it can be safely achieved in healthy older adults with few comorbidities and good functional status , higher hba1c targets ( 8%-9% ) are appropriate for older adults with multiple comorbidities , poor health , and limited life expectancy [ 46 ] .
moreover there is potential harm in lowering hba1c to less than 6.5% in older adults with type 2 dm . despite these recommendations for older vulnerable diabetic patients ,
there is little evidence on prevalence , clinical correlates , and treatment of t2 dm in elderly patients living in long - term care facilities . in the present study we aimed to comprehensively evaluate prevalence , clinical correlates , and use of glucose - lowering drugs among nursing home older patients with diabetes
in this prospective observational study , patients living in 83 long - term care facilities in piedmont , northern italy , were evaluated during the period of march august 2013 ; all patients aged > 65 and... | prevalence , clinical correlates , and use of glucose - lowering drugs were comprehensively evaluated among 863 nursing home older patients with diabetes ( mean age 82.9 2.1 years ) : functional dependence and cognitive impairment were present in 84.1% and 68% of patients , respectively , and 66.3% of patients had 24 comorbidities .
hba1c
values < 7.0% were documented in 54.9% of diabetic ; significantly lower hba1c levels were observed in demented patients than in nondemented subjects .
documented hypoglycemic episodes were reported for 57 patients ( 6.6% ) , without significant association with age , functional dependence , cognitive impairment , or hba1c levels .
about one - fifth of older long - term facilities residents have diabetes , with concomitant poor health conditions and high prevalence of cognitive impairment and functional dependence .
roughly three - fourths of these older and frail diabetic patients have hba1c values lower than optimal , suggesting a potential for hypoglycemic harm especially among patients with severe cognitive impairment . |
6,292 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a stroke is a disorder that results from a dysfunction in the brain anatomically due to
problems in the cerebrovascular blood supply and vessel hemorrhage . depending on the
location and seriousness of the damaged in the brain
, stroke patients can have sensory - motor
dysfunction , proprioception deficits and hypertonus1 .
the sensory - motor dysfunction in stroke patients includes not only muscle weakness and
abnormal muscle tone but also proprioception deficits .
proprioceptiors such as the
mechanoreceptor and free nerve ending , are found in the skin , facia , muscles , tendons , joint
capsules , and ligaments .
when active or passive movement occurs , receptors transmit the
mobility information to the central nervous system2 .
the proprioception provides the angles and angular speed of every
joint involved in body position or postural perception and movements .
it plays the largest
part in maintaining dynamic joint stability , induces normal movements , and protects joints
from external damages3 .
if proprioception
is degraded by a stroke , it could also undermine muscle strength , normal muscle tone ,
posture control , protective reflex ability , and joint motor ability .
clinically , the
proprioception level has emerged as an important assessment item used for stroke patient
assessment clinically together with treatment procedures4 . in the months following an upper motor neuron ( umn ) lesion in stroke patients , muscle tone
increases as a result of changes within the muscle , producing excessive resistance to muscle
stretch , which is usually called spasticity .
when a umn lesion interrupts descending motor
commands , the lower motor neuron ( lmn ) is affected and becomes temporarily inactive .
this
condition is called cerebral shock , depending on the location of the lesion . during nervous
system shock
, stretch reflexes can not be elicited , and the muscles are hypotonic ; that is ,
the muscles have abnormally low tone because facilitation of lmns has been... | [ purpose ] the purpose of this study was to investigate the relationship of knee
proprioception with muscle strength and spasticity in stroke patients . [ subjects and
methods ]
the subjects were 31 stroke patients .
the subjects received an explanation of the
procedures and methods and provided informed consent before the experiment .
a measurement
board was used to determine the the proprioception deficit of the knee as a proprioception
test .
the proprioception test consisted of a passive and active angle reproduction test . a
manual muscle test and modified ashworth scale were used to evaluate knee muscle strength
and spasticity level .
the data were analyzed using an independent t - test and spearman
correlation .
[ results ] the results of this study revealed a significant difference between
the affected side and non - affected side in the passive angle reproduction test and a
significant difference in the correlation of the proprioception level with muscle strength
and spasticity level .
[ conclusion ] this study indicates that the knee proprioception level
is associated with spasticity and muscle strength in stroke patients . |
6,293 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: bacterial meningitis is frequently accompanied by intracranial and systemic complications , such as septic shock , adult respiratory distress syndrome , or disseminated intravascular coagulation in children .
however , spinal cord involvement is an extremely rare complication of bacterial meningitis in adults5 ) .
recurrent bacterial meningitis is defined as repeated episodes of acute infection followed by periods during which signs and symptoms are absent and cerebrospinal fluid ( csf ) is normal , and is usually a complication of a cranial anatomical defect or the result of impaired humoral immunity , notably , a complement system defects or agammaglobulinemia2 ) .
recurrent bacterial meningitis can present a diverse range of symptoms in children , but no previous report has been issued of recurrent meningitis accompanied by a spinal intramedullary abscess in an adult2 ) . in this article ,
we report a rare and interesting case of recurrent bacterial meningitis in an adult presenting as a spinal intramedullary abscess .
a 63-year - old man was admitted to the emergency department complaining about severe suboccipital headache , fever , and neck pain lasting for 5 days . on physical examination , he was alert and fully oriented , but febrile ( 38.3 ) and had apparent nuchal stiffness with positive kernig and brudzinski signs .
his pupils were midsize and reactive to the light , and bilateral papilledema was not detected in the fundoscopic examination .
a laboratory examination revealed a white blood cell count of 13,100/mm and an erythrocyte sedimentation rate ( esr ) of 78 mm / hour .
for the diagnosis of bacterial meningitis , lumbar puncture ( lp ) was performed after emergent brain computed tomography ( ct ) scan , which ruled out any space - occupying lesion within brain parenchyma .
csf contained 792 cells/l ( 94% polymorphonuclear cells ) , protein level was 6.3g / dl , and his csf glucose level was less than 15% of the serum glucose level . from the csf gram - positive cocci were found , and... | bacterial meningitis is rarely complicated by an intradural spinal abscess , and recurrent meningitis is an uncommon presentation of a spinal intramedullary abscess . here , we report a 63-year - old patient with recurrent meningitis as the first manifestation of an underlying spinal intramedullary abscess . to the best of our knowledge ,
no previous report has been issued on recurrent meningitis accompanied by a spinal intramedullary abscess in an adult . in this article , the pathophysiological mechanism of this uncommon entity is discussed and the relevant literature reviewed . |
6,294 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: 99% of the 1,000 different mitochondrial proteins are produced on cytosolic ribosomes and are imported into the organelle ( sickmann et al .
dolezal et al . , 2006 ; van der laan et al . , 2006a ) .
the classic pathway of protein import into mitochondria involves n - terminal presequences on the precursor proteins ( fig .
1 ) . the presequences target the proteins to receptors of the translocase of outer mitochondrial membrane ( tom ) complex .
after translocation through the tom channel , the preproteins are directed to the tim23 ( presequence translocase of inner mitochondrial membrane ) complex .
the presequence translocase - associated motor ( pam ) completes preprotein translocation into the matrix . here
, the mitochondrial processing peptidase removes the presequences , and the proteins are folded to their mature forms .
presequence - carrying proteins are transported by the tim23 complex and the motor pam into the matrix , where mitochondrial processing peptidase ( mpp ) cleaves off the presequences .
small proteins of the intermembrane space ( ims ) are imported via the mitochondrial intermembrane space assembly machinery ( mia ) .
-barrel precursors of the outer membrane ( om ) are transferred by the tim9tim10 chaperone complex from tom to sam .
precursors of inner membrane ( i m ) carriers use tim9tim10 for transfer to the tim22 complex that drives insertion into the inner membrane . however , many mitochondrial precursor proteins are not synthesized with cleavable presequences but possess internal targeting signals .
although the tom complex functions as the central import site for most precursors , the subsequent transport of proteins to the four mitochondrial compartments is mediated by different machineries .
( 1 ) the precursors of outer membrane -barrel proteins are transferred by the tim9tim10 chaperone complex to the sorting and assembly machinery ( sam ) complex of the outer membrane ( wiedemann et al .
( 2 ) multispanning proteins of the inner membrane like the metabolite carriers also... | most mitochondrial proteins are synthesized in the cytosol and imported into one of the four mitochondrial compartments : outer membrane , intermembrane space , inner membrane , and matrix .
each compartment contains protein complexes that interact with precursor proteins and promote their transport .
these translocase complexes do not act as independent units but cooperate with each other and further membrane complexes in a dynamic manner .
we propose that a regulated coupling of translocases is important for the coordination of preprotein translocation and efficient sorting to intramitochondrial compartments . |
6,295 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the simultaneous or sequential development of autoimmune hemolytic anemia ( aiha ) and immune thrombocytopenia ( itp ) and/or immune neutropenia in the absence of any underlying cause was described as the evans syndrome ( es ) by evans et al . , in 1951 . since its first description ,
es was considered as an idiopathic condition , and mainly as a diagnosis of exclusion .
however , few case reports showed a common association of es with other diseases , such as , systemic lupus erythematous , lymphoproliferative disorders , and immunodeficiency , which warranted the classification of es into primary and secondary .
only three case reports of the association of evans syndrome with hashimoto 's thyroiditis were found in the literature review , and to the best of our knowledge , this is the fourth case , with a complete evaluation .
a 34-year - old female , who is a known case of hashimoto 's thyroiditis , on synthetic thyroid hormone intake ( 50 g / day ) since five years , presented with high - grade intermittent fever associated with chills and rigors , headache , and breathlessness .
there was no significant family history of thyroid disease and she was on no other medication except for the thyroxine intake . on examination ,
her blood pressure was 110/90 mm of hg , body temperature was 101f , and pulse rate was 120 per minute .
she had minimal , firm thyromegaly , tenderness in the right hypochondrium , and mild splenomegaly , on an ultrasound scan of the abdomen .
there were neither enlarged peripheral lymph nodes nor any enlargement of them on the abdominal ultrasound scan .
further investigations were negative for malaria , hepatitis b surface ( hbs ) antigen , hepatitis c virus ( hcv ) antibody , dengue , hiv , syphilis , and leptospirosis .
she had low hemoglobin , hematocrit , red blood cells ( rbc ) , and platelet count along with high mean corpuscular volume ( mcv ) .
peripheral blood smear examination showed a marked anisocytosis comprising of macrocytes , polychromatic cells , and microspherocytes... | evans syndrome is a rare combination of autoimmune hemolytic anemia and immune thrombocytopenia .
their association with autoimmune thyroid diseases has been reported by few authors ; however , a sequential development of the evans syndrome in cases of hashimoto 's thyroiditis is extremely rare .
the clustering of these autoimmune diseases might share a common pathogenic pathway .
we present the fourth such case in world literature , of a 34-year - old female diagnosed with hashimoto 's thyroiditis in 2006 , who has been taking synthetic thyroid hormone since then .
her condition is now clinically complicated with the development of the evans syndrome . |
6,296 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: biomarkers are tools that should aid the physician in diagnosis , in risk stratification with prediction of outcome , and , at best , in clinical decision - making . because the usual renal biomarkers ( for example , serum creatinine and/or urine output ) may fail to detect acute kidney injury ( aki ) at early onset , there is a current effort to search for and validate new diagnostic biomarkers .
neutrophil gelatinase - associated lipocalin ( ngal ) is one of the most promising candidates because its level of expression in renal tissue increases dramatically after ischemia - reperfusion injury but not in the case of pure pre - renal failure .
those data suggest the ability of ngal to detect renal structural damage . although first studies have highlighted that ngal monitoring would perform better than standard biomarkers in detecting or quantifying aki , other reports have yielded conflicting results and raised concerns regarding the accuracy of ngal for this purpose . in this context
, the study published by di somma and colleagues in critical care provides important additional insights .
the study included patients admitted to hospital from the emergency room , to assess the diagnosis and prognosis value of plasmatic ngal using a point - of - care method .
the authors attempted a multidimensional approach including the ngal level combined with the initial clinical assessment of risk of presumed aki by the caring physician . in a net reclassification improvement analysis ,
this improvement occurred mainly by moving patients from the aki to the no - aki subgroups .
ngal was confirmed to have a high predictive negative value in this population with low prevalence of aki . at first glance
, these results suggest that ngal has an additional diagnostic value to clinical suspicion , which is a crucial requirement for a new biomarker to improve the predictive accuracy of the standard of care .
looking deeper , this study highlights concerns regarding the clinical validation of biomarkers of renal injury... | neutrophil gelatinase - associated lipocalin ( ngal ) is one of the most promising candidate biomarkers of renal injury , with expression in renal tissue increasing dramatically after ischemia - reperfusion injury but not in the case of pure pre - renal failure . in a recent issue of critical care , di somma and colleagues reported that ngal could improve the classification of acute kidney injury compared with clinical assessment and showed that ngal was associated with poor prognosis .
ngal may therefore carry different information than biomarkers of renal function .
this study finally provides additional evidence for the highly complex relationship between renal function and renal injury . |
6,297 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cylindroma is a benign skin adnexal neoplasm that presents in the head and neck region .
the tumor may be single or multiple , and is commonly located on the scalp .
histopathology is diagnostic with characteristic ' jigsaw puzzle ' architecture and features of ductular differentiation .
a 58-year - old man presented to the outpatient department with the complaints of a painful swelling over the right side of the face and scalp that gradually increased in size since two years . on examination ,
the facial swelling appeared bosellated and fungating , with surface ulceration [ figure 1 ] .
a trucut biopsy was done from the face as well as the scalp nodule [ figure 2 ] .
histopathological examination from both the swellings were identical and revealed lobules of epithelial cells separated by thin acellular eosinophilic septae , which imparted a mosaic or jigsaw
the lobules comprised of a peripheral layer of dark staining basaloid cells and pale staining cells in the center .
the periodic acid schiff ( pas ) stain highlighted the acellular basement membrane like material surrounding the lobules as well as entrapped masses of hyaline material within the lobules [ figure 4 ] , thereby supporting a diagnosis of eccrine cylindroma .
there was no significant family history to support a diagnosis of brooke spiegler syndrome or familial cylindromatosis .
bosellated and ulcerated swelling on the face low - power view ( h and e 10 ) showing islands of epithelial cells giving a jigsaw puzzle appearance pas stain highlighting the eosinophilic ribbons surrounding the islands and hyaline globules ( h and e 40 )
the cell of origin is from the pluripotent stem cells in the folliculo - sebaceous - apocrine unit .
the tumor continues to incite the curiosity of dermatologists and dermatopathologists , due to its syndromic association as well as due to its unique histopathological appearance .
spiegler syndrome is an autosomal dominant cutaneous tumor syndrome , which presents with multiple skin adnexal neoplasms including... | cylindroma is a benign skin adnexal tumor of eccrine differentiation .
clinically , they are disfiguring lesions that can mimic a malignancy .
cylindromas can be single or multiple and commonly involve the scalp ( turban tumor ) and face .
multiple cylindromas can have a syndromic association as seen in brooke
spiegler syndrome and familial cylindromatosis .
we present a case of non familial cylindroma of the face that clinically mimicked a basal cell carcinoma .
the histopathology was confirmatory .
herein we also highlight the utility of a simple and inexpensive histochemical stain periodic acid schiff in supporting the diagnosis . |
6,298 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: embryonic stem cells have the ability to ultimately differentiate into all types of cells in our bodies , whereas tissue stem cells ( also known as adult stem cells ) serve as immediate sources of cell supply to their resident tissues .
stem cell research has offered the promise of effective cell - based therapies in treating many debilitating diseases such as diabetes , neurodegenerative diseases , and cancer .
the therapeutic potential of stem cells has inspired the imagination , intense interest , and targeted investment of scientists , clinicians , and the general public toward this fascinating area of biology . at present ,
human embryonic stem cell research is politically charged , with biologists engaging in ethical debates .
meanwhile , much of the research effort has been channeled to harnessing stem cells into desired cell types for clinical applications .
excitement notwithstanding , there is still a long way to go in understanding the fundamental mechanisms of stem cells before new therapies will be effectively established .
however , this aspect of stem cell research has not garnered as much attention . as evident from the three papers in this series of reviews ,
stem cell biology is , by and large , an integral part of cell biology and presents a vast new terrain of basic cell biology for exploration .
the hallmark of a stem cell is its ability to self - renew while generating many daughter cells that are committed to differentiation .
intimately related to this ability are a host of fundamental questions that await investigation : how can we definitively identify a stem cell ? what defines a stem cell in molecular terms ?
what signaling events control stem cell proliferation and differentiation ? how does a stem cell behave in its biological context ?
what happens to a differentiated cell when it is reprogrammed into a stem cell or vice versa ?
solutions to these wide - ranging and perplexing questions of cell biology are all related to understanding the single defining feature of stem cells ... | stem cells present a vast , new terrain of cell biology .
a central question in stem cell research is how stem cells achieve asymmetric divisions to replicate themselves while producing differentiated daughter cells .
this hallmark of stem cells is manifested either strictly during each mitosis or loosely among several divisions .
current research has revealed the crucial roles of niche signaling , intrinsic cell polarity , subcellular localization mechanism , asymmetric centrosomes and spindles , as well as cell cycle regulators in establishing self - renewing asymmetry during stem cell division .
much of this progress has benefited from studies in model stem cell systems such as drosophila melanogaster neuroblasts and germline stem cells and mammalian skin stem cells .
further investigations of these questions in diverse types of stem cells will significantly advance our knowledge of cell biology and allow us to effectively harness stem cells for therapeutic applications . |
6,299 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cardiovascular disease ( cvd ) is the main cause of death and it imposes a burden across the world.1 ) developed countries have already reduced the cvd mortality rate considerably through the identification and selection of high - risk groups , and the application of direct interventions , such as education and the prescription of medications.2 ) however , cvd has been gradually increasing in countries undergoing rapid economic development.2 ) in korea , where the ischemic heart disease ( ihd ) mortality rate is the highest among the cvd mortality rates , the ihd mortality rate has increased sharply from 11.6 persons per 100000 people in 1994 to 28.9 persons per 100000 people in 2012.3 ) this increase in the ihd mortality rate illustrates the need for an ihd prevention project to actively manage cvd risk factors in korea .
capitalizing on the improved diagnosis and cardiac surgery , 5250 cases of cardiac surgery are performed annually in korea and a low mortality rate of less than two percent after these surgeries has been recorded.4 ) as a result , more than 85% of domestic congenital heart disease ( chd ) patients , including cyanotic and complex chd patients , reach adult age,5 ) and it is estimated that there are already about 150000 to 200000 adults with congenital heart disease ( achd ) patients nationwide.6 ) however , prevention and management strategies for ihd are still required in these achd patients .
cardiovascular ( cv ) risk factors include age , hypercholesterolemia , diabetes , hypertension , smoking , drinking , exercise , and metabolic syndrome ( ms ) , and these risk factors are closely related to genetic and environmental predispositions.7 ) in particular , the identification and management of risk factors attract intense attention because the risk factors for developing ihd after middle age can be mostly prevented or managed by behavioral modifications , such as changes to the lifestyle or dietary habits.7 ) furthermore , the identification of risk factors for the specific disease... | background and objectivesthe objective of this study was to analyze cardiovascular risk factors in adults with congenital heart disease ( achd).subjects and methodsthe subjects for this study comprised 135 patients , aged 18 years and above , who visited the achd clinic at the samsung medical center and 135 adults with a structurally normal heart who were randomly selected from the center for health promotion during the same period . for the analysis ,
the achd group was further divided into an achd group that underwent correction by cardiac surgery and a cyanotic group.resultsthe mean ( standard diviation ) age ( years ) of patients in the surgically corrected group was 48.4 ( 10.9 ) years , while that of patients in the cyanotic group was 43.1 ( 9.0 ) years and that of patients in the control group was 47.1 ( 10.3 ) years ( p=0.042 ) .
the adjusted odds ratios ( ors ) for past smoking , hypertension , diabetes mellitus , hypercholesterolemia , obesity , and metabolic syndrome were significantly higher in the surgically corrected patients than in the controls .
however , the ors for all variables excluding past smoking were significantly lower in the cyanotic group compared with the control group .
after adjustment for age , gender , smoking , alcohol use , and exercise , the ors for metabolic syndrome were 0.46 ( 0.35 - 0.57 , p<0.001 ) and 1.48 ( 1.14 - 1.92 , p=0.003 ) in the cyanotic and surgically corrected groups , respectively.conclusioncardiovascular risk factors need to be considered in surgically corrected achd patients as well as in adults with a structurally normal heart . a further study with a long - term follow - up is needed for developing guidelines for prevention . |
6,300 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nowadays , health care has been transformed to a patient - centered model , so that the patient plays a more active role in care . in this model ,
the patients and their relatives attend caregiving process as the main partners and are involved in health providers decision making , treatment , and administration of procedures . in pediatric nursing ,
family - centered care is also a basic element , which emphasizes on dynamic relationship between the family members and treatment and care providing team , as well as involves the family in care .
parents should be clearly active in decision - making process in relation to taking care of children and participation in care .
some terms used to describe the concept of participation of the parents are parents participation , involvement of parents in care , participation in care , caring partners , being involved in mutual participation of care , family - centered care , and family participation .
application of synonyms for this term has confused the nurses , revealing the lack of a consensus on the concept of parents participation , so that nurses have no clear definition about parents participation .
coyne , quoting from darbyshie , states that the concept of parents participation is one of the most controversial issues which should be clarified , as its clarification leads to more efficient application and evaluation of its weak and strong points .
finally , it should be mentioned that understanding of this important concept increases its application in action and ultimately improves the quality of pediatric care in hospitals .
family unit has a great value in iranian traditions , and strong ties of family members and parents responsibility are highly valuable . in other words ,
parents participation in taking care of a hospitalized child is the symbol of families power , but despite the importance of this issue , limited research has been conducted on the concept of parents and health providers taking care of hospitalized children in developing countries... | background : although today parents participation in taking care of hospitalized children is considered as an indispensable principle , it is still among the concepts with no consensus about .
the main objective of this study is to define parents participation in taking care of hospitalized children.materials and methods : the concept of parents participation in taking care of hospitalized children was analyzed using a hybrid model in three phases : literature review ( theoretical phase ) , fieldwork , and combination of literature review and fieldwork ( analytical phase).results : based on the results of theoretical ( literature review ) , fieldwork , and analytical phases , the best definitions for the concept of parents participation in taking care of hospitalized children are mutual relationship and gaining parents trust toward nurses , giving the required information and education to the parents about care and treatment process , assigning the needed home care to the parents , involving the parents in caregiving process , and finally , defining their participation in decision making ( clarifying the parents role ) in order to improve the quality of care given to the children.conclusions:the findings of this study showed that the dimensions of parents participation can be applied in pediatric wards , and nurses can improve the quality of care through application of the obtained findings . |
6,301 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: pttm ( pulmonary tumor thrombotic microangiopathy ) , synonymously termed microscopic pulmonary tumor embolism , is a rare condition , and cancer - related pulmonary complications characterized by rapidly progression of dyspnea and pulmonary hypertension occasionally cause sudden death 1 .
pttm is observed in 3.3% of autopsies of patients with malignant tumors and is usually associated with gastric cancer , although it was reported to affect other sites in a few cases 1,2 .
rare cases of urothelial carcinoma of the urinary bladder associated with pttm have also been reported 1,3,4 .
most of the patients in these case reports were diagnosed as having pttm following postmortem examination at autopsy .
we report a valuable case of pttm associated with urothelial carcinoma of the urinary bladder in which pulmonary microvascular cytology ( pmc ) was a useful strategy that aided in the early antemortem diagnosis , permitting the patient to undergo chemotherapy , although the patient ultimately died .
the patient was a 77-year - old japanese man with a history of transurethral resection of a bladder tumor at the age of 75 years for urothelial carcinoma of the urinary bladder .
pathological findings of the surgical specimens obtained indicated a urothelial carcinoma ( g2 ) that had invaded the muscular layer ( fig.1 ) .
afterward , he underwent intravesical bacillus calmette - guerin therapy and radiation therapy that resulted in complete remission . in april 2014 , he developed a relapse with abdominal metastatic lymph nodes and bone metastasis found , so he underwent chemotherapy with carboplatin and gemcitabine .
after 2 cycles this chemotherapy , he developed dyspnea and was referred to our hospital in july 2014 . on admission , he had tachycardia ( 112 beats per minute ) , tachypnea ( 31 respirations per minute ) , and normotensive blood pressure ( 118/62 mmhg ) .
initial peripheral arterial oxygen saturation ( spo2 ) was 81% , and blood gas analysis showed a pao2 ( partial pressure of oxygen in arterial blood... | key clinical messagepttm ( pulmonary tumor thrombotic microangiopathy ) is very difficult to diagnose before death .
we report a case of urothelial carcinoma of the urinary bladder associated with pttm in which an antemortem diagnosis by pmc ( pulmonary microvascular cytology ) .
pmc may represent the only chance for diagnosis and achievement of remission in pttm . |
6,302 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: laparoscopic pyeloplasty has emerged as the most common and widely accepted minimally invasive surgery for ureteropelvic junction obstruction ( upjo ) .
this technique has advantages of a high success rate similar to open pyeloplasty and low morbidity similar to endopyelotomy .
schuessler et al were the first authors to report on transperitoneal laparoscopic dismembered pyeloplasty in 5 patients and concluded that the procedure , though time - consuming , was a feasible treatment option for upjo .
janetschek et al were the first authors to report on retroperitoneoscopic dismembered pyeloplasty and concluded that the procedure is too complicated to be a standard procedure .
since then , there have been many publications on both types of laparoscopic pyeloplasties , but the choice of whether to perform the procedure by the transperitoneal or retroperitoneoscopic route depends on the surgeon . in transperitoneal laparoscopic pyeloplasty ( tplp ) , the large peritoneal cavity allows for free movement of instruments and intracorporeal suturing , but the rate of bowel - related complications and pain are higher in comparison with retroperitoneoscopic laparoscopic pyeloplasty ( rplp ) . in rplp
limited retroperitoneal space restricts free movement of instruments and leads to difficulty in intracorporeal suturing , leading to a longer operating time , but postoperative pain and the rate of bowel - related complications are comparatively lower .
most of the published studies are either on tplp or rplp , and some have assessed a combination of both types with nonrandomized comparison and were retrospective in nature . however , the success rate for both procedures is comparable .
review of the literature shows only 1 prospective randomized study on the comparison of tplp and rplp for primary upjo . in view of the excellent outcome results of both techniques in isolation with advantages and disadvantages of both procedures
, we executed a prospective randomized trial of tplp versus rplp for primary upjo , aiming to... | background and objectives : to compare laparoscopic transperitoneal versus retroperitoneoscopic pyeloplasty for primary ureteropelvic junction obstruction in a prospective randomized manner and assess overall results with long - term follow-up.methods:in this prospective study , from 2008 to 2012 , 112 cases of primary ureteropelvic junction obstruction were randomized in a 1:1 ratio into 2 groups .
group i included patients who underwent transperitoneal laparoscopic pyeloplasty , and group ii consisted of patients who underwent retroperitoneoscopic laparoscopic pyeloplasty .
demographic and clinical characteristics and postoperative and operative data were collected and analyzed .
the statistical analysis was performed with the fisher exact test , 2 test , and mann - whitney u test for independent groups , and p < .05 was considered statistically significant.results:the total operative time and intracorporeal suturing time were significantly higher in group ii than in group i ( p < .001 ) . the visual analog scale score for pain on postoperative day 1 and the requirement for tramadol were significantly higher in group i than in group ii ( p = .004 ) . the hospital stay and the rate of temporary ileus were significantly greater ( p < .036 and p < .02 , respectively ) in group i than in group ii .
the success rate of transperitoneal laparoscopic pyeloplasty versus retroperitoneoscopic laparoscopic pyeloplasty was 96.4% versus 96.6% with a mean follow - up period of 30.75 4.85 months versus 30.99 5.59 months ( p < .88).conclusion : transperitoneal laparoscopic pyeloplasty is associated with significantly greater postoperative pain , a higher tramadol dose , a higher rate of ileus , and a longer hospital stay in comparison with retroperitoneoscopic laparoscopic pyeloplasty .
although the operative time for retroperitoneoscopic laparoscopic pyeloplasty is significantly longer , the success rate remains the same for both procedures . |
6,303 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: joint hypermobility is often described as an extreme variation of joint laxity causing a complex of musculoskeletal symptoms .
the most common criteria often used to identify individuals with joint hypermobility is a modification of the original score reported by beighton et al . , which developed based on the primary work of carter and wilkinson .
joint hypermobility with associated musculoskeletal symptoms such as osteoarthritis , joint derangements and instabilities , joint effusions and muscular pain is characterized as benign joint hypermobility syndrome ( bjhs ) but based on recent studies naming this syndrome as a benign
previous studies on generalized joint hypermobility , defined by the criteria of beighton , show an overall wide range of prevalence between 11.2% and 64.6% in children and adolescents .
the variability of these results can be due to various methods of evaluation and stringency of criteria among previous studies .
excessive joint laxity , or hypermobility , should be considered as a common finding of clinical importance in the management of musculoskeletal disorders .
hypermobility is common in young patients and in general is associated with an increased incidence of musculoskeletal injuries .
ankle sprains , knee ligament injuries , shoulder instabilities , and osteoarthritis of the hand have been implicated in joint hypermobility .
patients with hypermobility often complain of diffuse musculoskeletal pain and injuries with no specific inciting event .
orthopedic surgeons and other healthcare providers should be aware of the underlying relationship between hypermobility and musculoskeletal disorders to avoid unnecessary diagnostic tests and inappropriate management .
prolonged therapy and general conditioning are typically required , with special emphasis on improving muscle strength and proprioception to address symptoms and prevent future injury .
an effective management program may include medications including nonsteroidal anti - inflammatory drugs , acetaminophens , tri -... | background : hypermobile joints are joints with beyond normal range of motion and may be associated with joint derangements .
this study aimed to evaluate the prevalence of benign joint hypermobility syndrome ( bjhs ) among soldiers and effect of training courses on related joint instabilities.materials and methods : in a prospective cohort study on 721 soldiers of iran army in isfahan in 2013 the prevalence of joint hypermobility was obtained by using beighton criteria .
soldiers divided in two groups of healthy and suffered based on their scores . the prevalence of ankle sprain , shoulder and temporomandibular joint ( tmj ) dislocations identified before beginning service by history - taking and reviewing paraclinical documents . after 3 months of military training ,
a recent occurrence of mentioned diseases was revaluated in two groups .
the collected data were analyzed using spss-20 software using independent - t and chi - square tests.results:the frequency of bjhs before military training was 29.4% . after passing military training period , the incidence of ankle sprain was significantly higher in suffered group achieving the minimum beighton score ( bs ) of 4 ( 4.3% , p = 0.03 ) , 5 ( 5.5% , p = 0.005 ) and also 6 out of 9 ( 6.5% , p = 0.01 ) .
the incidence of tmj dislocation was not significantly different based on a minimum score of 4 , while it was higher in suffered group when considering the score of 5 ( 2.1% ) and 6 ( 2.6% ) for discrimination of two groups ( p = 0.03 ) .
there was no significant difference between two groups in case of shoulder dislocation anyway.conclusion:military training can increase the incidence of ankle sprains and tmj dislocations in hypermobility persons with higher bs in comparison with healthy people .
therefore , screening of joint hypermobility may be useful in identifying individuals at increased risk for joint instabilities . |
6,304 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chronic obstructive pulmonary disease ( copd ) is a progressive disease defined by an airflow limitation that is not fully reversible.1 patients with the disease exhibit pathologic features of emphysema and , to varying degrees , chronic bronchitis .
exacerbations , which can be life - threatening for certain patients , are characterized by an amplified inflammatory response and worsening of airflow .
these changes in symptoms are sufficient to warrant a change in management and occur an average of approximately three times per year for patients with moderate to severe copd.2 exacerbations are associated with diminished quality of life for copd patients,3,4 and their frequency and severity , as well as the presence of comorbid conditions and the number of medications needed to manage the disease , all contribute to copd severity.1 copd is highly prevalent in the us5,6 and worldwide.7,8 the us prevalence6 was estimated at 10 million adults in 2000 , and in 2007 , 5.8% of individuals aged 4564 years had physician - diagnosed copd.5 copd is a leading cause of death in the us , and related mortality has been reported to be greater for men than for women , and mortality rates are highest for white patients , followed by black , hispanic , and asian individuals.5 management of stable copd is intended to prevent and control symptoms and to reduce the frequency and severity of exacerbations.1,9,10 maintenance medications for copd include long- and short - acting bronchodilators , and inhaled corticosteroids for patients with repeated exacerbations .
fixed - dose combination therapies include short - acting beta agonist ( saba)/anticholinergic bronchodilator combinations , and long - acting beta agonist ( laba)/corticosteroid combinations.1 patients with very severe copd might receive oxygen therapy .
rescue medication can be started at home , but if the exacerbation is not well managed , hospitalization may be required.1,9 patients with severe exacerbations might be managed in the emergency department ( ed ) or... | purposeto estimate patient- and episode - level direct costs of chronic obstructive pulmonary disease ( copd ) among commercially insured patients in the us.methodsin this retrospective claims - based analysis , commercial enrollees with evidence of copd were grouped into five mutually exclusive cohorts based on the most intensive level of copd - related care they received in 2006 , ie , outpatient , urgent outpatient ( outpatient care in addition to a claim for an oral corticosteroid or antibiotic within seven days ) , emergency department ( ed ) , standard inpatient admission , and intensive care unit ( icu ) cohorts .
patient- level copd - related annual health care costs , including patient- and payer - paid costs , were compared among the cohorts .
adjusted episode - level costs were calculated.resultsof the 37,089 copd patients included in the study , 53% were in the outpatient cohort , 37% were in the urgent outpatient cohort , 3% were in the ed cohort , and the standard admission and icu cohorts together comprised 6% .
mean ( standard deviation , sd ) annual copd - related health care costs ( 2008 us$ ) increased across the cohorts ( p < 0.001 ) , ranging from $ 2003 ( $ 3238 ) to $ 43,461 ( $ 76,159 ) per patient . medical costs comprised 96% of health care costs for the icu cohort .
adjusted mean ( sd ) episode - level costs were $ 305 ( $ 310 ) for an outpatient visit , $ 274 ( $ 336 ) for an urgent outpatient visit , $ 327 ( $ 65 ) for an ed visit , $ 9745 ( $ 2968 ) for a standard admission , and $ 33,440 for an icu stay.conclusiondirect costs of copd - related care for commercially insured patients are driven by hospital stays with or without icu care .
exacerbation prevention resulting in reduced need for inpatient care could lower costs . |
6,305 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: other side effects of chemotherapy are alopecia , stomatitis , immunosuppression , anorexia , nausea , and vomiting which result in a decreased functional capacity and quality of life for cancer patients .
5-fluorouracil ( 5-fu ) is a chemotherapeutic agent used to treat gastrointestinal , breast , pancreatic , and head and neck cancer , among others .
the mechanism of cytotoxicity of 5-fu has been ascribed to the misincorporation of fluoronucleotides into rna and dna and to the inhibition of the nucleotide synthetic enzyme thymidylate synthase .
5-fu distributes readily into bone marrow , small intestine , kidney , liver , and spleen [ 5 , 6 ] . in the bone marrow 5-fu
, it is incorporated in the dna and induces oxidative stress , which is partly responsible for myelotoxicity [ 7 , 8 ] .
it is well known that patients treated with 5-fu are cursed with neutropenia , mucositis , leukopenia , and hematological toxicity [ 9 , 10 ] . because of these side effects , chemoprotective compounds have been used to reduce these problems [ 1119 ] .
bovine dialyzable leukocyte extract or immunepotent crp ( icrp ) is a dialysate of a heterogeneous mixture of low - molecular - weight substances released from disintegrated leukocytes of the blood or lymphoid tissue obtained from homogenized bovine spleen .
icrp was capable of stimulating the immune system in patients with non - small cell lung cancer and increasing their quality of life .
also , in vitro studies demonstrated that icrp was an effective therapeutic agent in process involving oxidative cellular damage and clinical inflammatory diseases , through ib / nf-b pathway . in this study , we examined the protector effect of icrp on myelosuppression caused by 5-fu in a mouse model .
nine - week - old male balb / c mice were obtained from the bioterium of the laboratorio de inmunologa y virologa de la facultad de ciencias biolgicas .
the mice were maintained on pelleted food and water ad libitum and housed in controlled environmental conditions ( 25c and a 12 h light /... | chemotherapy treatments induce a number of side effects , such as leukopenia neutropenia , peripheral erythropenia , and thrombocytopenia , affecting the quality of life for cancer patients .
5-fluorouracil ( 5-fu ) is wieldy used as myeloablative model in mice .
the bovine dialyzable leukocyte extract ( bdle ) or immunepotent crp ( icrp ) is an immunomodulatory compound that has antioxidants and anti - inflammatory effects . in order to investigate the chemoprotection effect of icrp on bone marrow cells in
5-fu treated mice , total bone marrow ( bm ) cell count , bone marrow colony forming units - granulocyte / macrophage ( cfu - gm ) , cell cycle , immunophenotypification , ros / superoxide and nrf2 by flow cytometry , and histological and hematological analyses were performed .
our results demonstrated that icrp increased bm cell count and cfu - gm number , arrested bm cells in g0/g1 phase , increased the percentage of leukocyte , granulocytic , and erythroid populations , reduced ros / superoxide formation and nrf2 activation , and also improved hematological levels and weight gain in 5-fu treated mice .
these results suggest that icrp has a chemoprotective effect against 5-fu in bm cells that can be used in cancer patients . |
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