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6,406 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: there is no definition of treatment - resistant bipolar depression in the literature . the international society for bipolar disorders ( isbd ) task force published their consensus definition of treatment response in bipolar depression1 and proposed a nomenclature for relapse , remission , and recurrence , but did not define treatment resistance .
treatment response is defined as > 50% improvement in the core dsm ( diagnostic and statistical manual of mental disorders ) criteria for depression .
treatment - resistant bipolar patients remain symptomatic despite the best available care . here , we propose that treatment resistance in bipolar depression be defined as failure of pharmacotherapy associated with failure of neuromodulation , such as electroconvulsive therapy and repetitive transcranial magnetic stimulation ( rtms ) .
the antidepressant effects of psychostimulant drugs have been underappreciated because of conflicting data concerning efficacy , tolerance , and dependence .
orr and taylor2 reported that methylphenidate reduced tiredness and enhanced attention and arousal , and recommended its use for treating depressive episodes .
candy et al3 reported that the main advantage of methylphenidate over antidepressants might be its rapid onset of action within one day , and highlighted that , unlike conventional antidepressants , methylphenidate reduces fatigue .
stoll et al4 and metz and shader5 showed that the combination of methylphenidate and a selective serotonin reuptake inhibitor antidepressant was effective . in a cochrane meta - analysis,3 candy
et al reported that psychostimulants ( excluding modafinil ) significantly reduced symptoms of depression in comparison with placebo .
emphasizing the role of psychostimulants in increasing dopamine production , stahl6 and nierenberg et al7 support the view that psychostimulants are preferable for the more biological depressive disorders ( melancholic and bipolar depression ) but not for the wider spectrum of depressive conditions ( especially... | adjunctive use of methylphenidate , a central stimulant , has been considered as a potential therapeutic choice for patients with refractory unipolar , geriatric , or bipolar depression , and depression secondary to medical illness .
we present a case of bipolar depression in which the patient responded significantly to augmentation with methylphenidate , without any side effects , after failure of adjunctive repetitive transcranial magnetic stimulation and electroconvulsive therapy .
mr u , a 56-year - old man with bipolar i disorder , had melancholic symptoms during his sixth episode of bipolar depression .
after failure of repetitive transcranial magnetic stimulation and electroconvulsive therapy , he was treated with fluoxetine 80 mg / day , duloxetine 360 mg / day , mirtazapine 60 mg / day , and sodium valproate 1,000 mg / day , with no improvement .
we added methylphenidate at a dose of 10 mg / day for one week , which resulted in mild clinical improvement , and then methylphenidate extended - release 20 mg / day for one week , with significant clinical improvement .
he tolerated his medications well .
his clinical recovery was stable over one year .
the patient s antidepressants and methylphenidate were gradually tapered and finally discontinued after one year with no withdrawal syndrome . to date , he remains well on sodium valproate as monotherapy and is being followed up at our bipolar department .
this case suggests that methylphenidate augmentation might be a therapeutic option when treating highly treatment - resistant patients with bipolar depression , even if they had not responded to adjunctive neuromodulation . in these clinical situations
, physicians might be interested in prescribing methylphenidate because of its efficacy and safety . |
6,407 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: since childers et al initially reported the laparoscopic surgical management of 2 cases of stage i endometrial cancer , many studies have advocated the advantages of laparoscopically assisted staging surgery ( lass ) compared with laparotomic staging surgery in women with endometrial cancer .
laparoscopic surgical management has comparable clinical outcomes to those of conventional laparotomy ; it results in less pain and bleeding , shorter hospital stay , and faster recovery to normal activities thus improving quality of life . of gynecologic malignancies ,
endometrial cancer is the third most prevalent following cervical cancer and ovarian cancer in korean women . in recent years
, the incidence of endometrial cancer has gradually increased . in the present study , to examine feasibility , effectiveness , and any complications of lass in korean women with endometrial cancer , we reviewed women who underwent lass and compared our operative data results with those of other studies .
of 39 women who were diagnosed with endometrial cancer at kangbuk samsung hospital between august 2003 and november 2007 , we excluded 4 women who refused to undergo laparoscopic surgery or were ineligible for laparoscopic surgery because of concurrent cardiopulmonary diseases ; a final number of 35 women were enrolled in the present study .
the preoperative workup included medical history , physical examination , pelvic examination , gynecologic ultrasonography , pap smear , endometrial biopsy , and mri .
the previous abdominal surgical history and body mass index ( bmi ) did not affect our decision to perform staging surgery in all women .
after being informed of the characteristics depending on the extent of surgery , such as complications and their incidence , and the necessity of staging surgery , each woman gave informed consent .
the operating time was defined as the period from trocar insertion to closure of the port site . before august 2005 ,
when american college of obstetricians and gynecologists ( acog ) clinical... | background and objective : in recent years , the incidence of endometrial cancer has gradually increased in korea , and the use of laparoscopically assisted staging surgery ( lass ) is increasing in this field .
we conducted this study to evaluate the feasibility of lass in korean women with endometrial cancer.methods:we conducted a retrospective review of 35 korean women with endometrial cancer who were managed laparoscopically.results:the median age and bmi were 57 years ( range , 28 to 81 ) and 25.8 kg / m2 ( range , 20.9 to 37.2 ) , respectively . the median operating time , estimated blood loss , and length of hospital stay were , respectively , 150 minutes ( range , 95 to 410 ) , 250 ml ( range , 50 to 1000 ) , and 8 days ( range , 3 to 20 ) .
no conversion to laparotomy was noted .
the median number of harvested lymph nodes was 22 ( range , 10 to 41 ) in pelvic lymph nodes and 7 ( range , 2 to 21 ) in paraaortic lymph nodes . no vault recurrence or port - site metastasis
was noted until the last follow-up.conclusions:lass can be performed without additional morbidity and complications , and might be feasible in korean women with endometrial cancer . |
6,408 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a literature search was performed up to march 2011 in 13 international databases : african index medicus , anthropology plus , british nursing index and archive , the cochrane library , embase , epoc , medline , pilots , popline , psycinfo , social services abstracts , sociological abstracts , and wholis .
it was supplemented with searches of the databases of six international organizations that are engaged in projects regarding fgm / c , the reference lists of relevant reviews and included studies , and communication with experts involved in fgm / c - related work .
study designs eligible for inclusion were cross - sectional quantitative studies , qualitative studies , and mixed - methods studies .
the population considered in scope was members of communities practicing fgm / c residing in a western country , defined as a country with a culture of european origin ( huntington , 1996 ) .
the outcome of interest was the practice of fgm / c ; specifically , the studies had to describe participants perspectives and understandings of the factors perpetuating or hindering the continuation of fgm / c .
all publication years and languages were acceptable and when considered likely to meet the inclusion criteria , studies were translated to english .
unpublished reports and brief and preliminary reports were considered for inclusion on the same basis as published articles .
the processes of literature screening , assessment of methodological quality , and data extraction were first done independently by two reviewers .
a final decision was agreed upon after discussing whether there was a discrepancy between the two reviewers .
for all processes , differences in opinion were few and were resolved through rereading the publications and consensus . in selecting literature , the reviewers read all titles , abstracts , or both resulting from the search process and obtained full text copies of studies considered relevant .
next , they read the full texts and determined whether they met all inclusion criteria . predesigned... | understanding the forces underpinning female genital mutilation / cutting ( fgm / c ) is a necessary first step to prevent the continuation of a practice that is associated with health complications and human rights violations . to this end , a systematic review of 21 studies was conducted .
based on this review , the authors reveal six key factors that underpin fgm / c : cultural tradition , sexual morals , marriageability , religion , health benefits , and male sexual enjoyment . there were four key factors perceived to hinder fgm / c : health consequences , it is not a religious requirement , it is illegal , and the host society discourse rejects fgm / c .
the results show that fgm / c appears to be a tradition in transition . |
6,409 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: overweight and obesity have been defined as abnormal or excessive accumulations of fat in the body that may impair health .
overweight and obesity results from an energy imbalance in the amount of calories consumed and the amount of calories expended .
the rise of overweight and obesity globally has been attributed primarily to a twofold process : ( 1 ) a global shift toward a diet richer in caloric sweeteners , animal source foods , and fats , and ( 2 ) decreased physical activity patterns due to changes in the nature of work , modes of transportation , and urbanization [ 2 , 3 ] .
overweight and obesity have been found to be major risk factors for chronic diseases , including cardiovascular disease , diabetes , musculoskeletal disorders , and some forms of cancer .
although higher levels of overweight and obesity and , by extension , chronic diseases have generally characterized developed countries such as the united states , the rates of overweight and obesity are increasing much faster in the developing world [ 4 , 5 ] . undernutrition is due to food intake that is continuously insufficient or poorly absorbed and retained in the body to meet and maintain energy requirements .
undernutrition is epidemic in parts of the developing world with its occurrence generally associated with high rates of infectious diseases and has been estimated to contribute to the deaths of 5 - 6 million children under 5 each year .
undernutrition affects all age groups and is especially common among the poor and those lacking clean water and good sanitation .
although earlier research on global undernutrition often suggested that national economic development would lead progressively to lower levels of undernutrition within developing countries , more recent research has highlighted the cooccurrence of high levels of under- and overnutrition within countries [ 4 , 9 , 10 ]
this paradoxical phenomenon places tremendous strains on the health systems of developing countries since national governments must confront the... | objective . to examine the association between socioeconomic factors and weight status across 53 countries
. methods . data are cross - sectional and from the long version of the world health survey ( whs ) . there were 172,625 whs participants who provided self - reported height and weight measures and sociodemographic information .
the international classification of adult weight status was used to classify participants by body mass index ( bmi ) : ( 1 ) underweight ( < 18.5 ) , ( 2 ) normal weight ( 18.524.9 ) , ( 3 ) overweight ( 25.029.9 ) , and ( 4 ) obese ( > 30.0 ) .
multinomial regression was used in the analyses .
results . globally
, 6.7% was underweight , 25.7% overweight ,
and 8.9% obese .
underweight status was least ( 5.8% ) and obesity ( 9.3% ) most prevalent in the richest quintile .
there was variability between countries , with a tendency for lower - income quintiles to be at increased risk for underweight and reduced risk for obesity .
conclusion .
international policies may require flexibility in addressing cross - national differences in the socio - economic covariates of bmi status . |
6,410 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: proliferating cell nuclear antigen ( pcna ) serves as a processivity factor ( sliding clamp ) , encircling dna at sites of replication and repair ( 15 ) .
the subunits come together to form a remarkable ring - like structure with characteristic pseudo 6-fold symmetry and a central hole large enough to accommodate double - stranded dna ( dsdna ) .
each domain forms a wedge shaped structure with two -helices packed in an antiparallel arrangement against the face of a -sheet wedge . in total
the -sheets forming the outer surface of the ring impart structural integrity to the protein assembly .
adjacent domains are packed in a head to tail arrangement , which necessitates a long inter - domain linker passing over the central -sheet . this overall architecture ( 1,2,4 )
is remarkably well preserved across bacterial and eukaryotic clamps despite the lack of sequence similarity .
pcna is known to interact with many components of the cell 's replication and signaling machinery ( 5 ) and in this context could facilitate exchange of dna repair enzymes that recognize a common dna intermediate ( 6 ) .
since the association of pcna and dna is topological in nature , it has not yet been possible to determine a structure of pcna loaded onto dsdna by crystallographic means . therefore , structural knowledge regarding the overall orientation as well as the precise contacts formed between a sliding clamp and the nucleic acid it encircles has been limited .
furthermore , the static pcna structures determined to date give little information about possible motions of the clamp that may assist in its translocation along dna .
much of the focus of recent structural work has been on determining interactions between pcna surface loops and peptides derived from known pcna binding proteins , such as flap endonuclease-1 ( fen-1 ) , dna polymerase and and cyclin - dependent protein kinase inhibitor p21(cip / waf1 ) ( 512 ) . since
no detailed computational modeling studies have been reported for this system , it would be of general... | proliferating cell nuclear antigen ( pcna ) acts as a biologically essential processivity factor that encircles dna and provides binding sites for polymerase , flap endonuclease-1 ( fen-1 ) and ligase during dna replication and repair .
we have computationally characterized the interactions of human and archaeoglobus fulgidus pcna trimer with double - stranded dna ( ds dna ) using multi - nanosecond classical molecular dynamics simulations .
the results reveal the interactions of dna passing through the pcna trimeric ring including the contacts formed , overall orientation and motion with respect to the sliding clamp .
notably , we observe pronounced tilting of the axis of dsdna with respect to the pcna ring plane reflecting interactions between the dna phosphodiester backbone and positively charged arginine and lysine residues lining the pcna inner surface .
covariance matrix analysis revealed a pattern of correlated motions within and between the three equivalent subunits involving the pcna c - terminal region and linker strand associated with partner protein binding sites . additionally , principal component analysis identified low frequency global pcna subunit motions suitable for translocation along duplex dna .
the pcna motions and interactions with the dna minor groove , identified here computationally , provide an unexpected basis for pcna to act in the coordinated handoff of intermediates from polymerase to fen-1 to ligase during dna replication and repair . |
6,411 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: patients admitted to kitunan hospital in suzenji , japan from may 1999 and april 2007 with acute psychomotor excitation were studied retrospectively .
the inclusion criteria were : ( i ) patients diagnosed with schizophrenia according to the diagnostic and statistical manual of mental disorders , 4th edition ( dsm - iv ) ; ( ii ) achieving a score of at least 20 on the excited component of the positive and negative syndrome scale ( panss - ec ) scale at hospital admission ; and ( iii ) with laboratory values recorded at hospital admission and 35 weeks later .
the panss - ec comprises five items from the panss:2 poor impulse control , tension , hostility , uncooperativeness , and excitement , each rated on a 7-point likert scale ranging from 1 ( not present ) to 7 ( extremely severe ) .
possible scores range from 5 to 35 ; mean scores 20 indicate severe agitation.3 patients with alcoholism and/or drug abuse were excluded .
values outside the reference range were defined as abnormal values , and the frequency of abnormal values was calculated for each parameter during the acute phase and during the recovery phase on medication , between 3 and 5 weeks later .
panss - ec scores between the acute and recovery phases were compared using paired t tests . for comparison between drugs for age , dose , and panss - ec score ,
unpaired t tests were used . for comparison of the frequency of abnormal values in the acute and recovery phases , as well as a comparison between drugs in the frequency of abnormal values ,
a total of 68 participants were included in the study ( 32 male , 36 female ) .
mean age standard deviation was 47.0 11.9 years , and the mean panss - ec score standard deviation at hospital admission was 21.4 1.5 .
of the 37 participants with detailed records of previous hospital visits , 31 ( 83.8% ) had interrupted their prescribed medication .
, treatment groups were defined according to the antipsychotic drug that had been used : risperidone group ( 14 participants ) , olanzapine group ( 16... | during treatment of acute - phase schizophrenia , attention needs to be given to physical as well as psychological symptoms .
it is often difficult , however , to obtain information on physical symptoms from patients with psychomotor excitation , and only laboratory examinations can provide objective data .
the results of laboratory parameters measured in 68 patients with schizophrenia during psychomotor excitation and approximately 1 month later during the medicated recovery phase have been analyzed retrospectively .
abnormal laboratory values during psychomotor excitation were frequent .
the most frequent ( 35% of patients ) were increased white blood cell count , low serum potassium levels , high levels of fasting blood sugar , lactate dehydrogenase and uric acid .
there were fewer abnormal values during the medicated recovery phase .
the most frequent ( 25% of patients ) were high serum levels of triglycerides , amylase , creatinine kinase , and low - density lipoprotein cholesterol .
abnormal triglyceride levels were found significantly more frequently in patients receiving olanzapine than those receiving risperidone .
abnormal values during the acute phase may be the result of excitation such as increased sympathetic tone and dehydration .
abnormal values during the recovery phase appeared to be related to the adverse metabolic effects of antipsychotic drugs .
the frequency of these abnormal values was particularly high in patients receiving olanzapine alone or in combination with other medications . |
6,412 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: however many people refuse it because of fear of needle and back pain.1 many techniques have been used to obtund pain of needle insertion including infiltration analgesia and emla patch .
local anesthetics themselves may produce pain on injection and many anesthetists are unsure that infiltration analgesia at the site of spinal puncture has any advantage over a straightforward puncture without analgesia . 2 , 3 , 4 the pain experienced during spinal puncture has both somatic and psychological components .
pharmacological measures , such as the application of local anesthetics , treat only the somatic component of pain , whereas attention - diverting measures ( pressing ball ) address only the psychological component of pain .
4,5,6 a literature search revealed laboratory studies showing that baroreceptor activation induces nociception but there were few clinical studies exploring the effect of the valsalva maneuver on pain.6 - 10 in a study by agrawal et al , valsalva maneuver performed before venous canulation could decrease the incidence and severity of pain associated with venipuncture in adult patients.7 in another study by gupta et al the efficacy of balloon inflation were evaluated on venipuncture pain in children aged 6 - 12 year and there was a significant reduction of pain in balloon group compared with distraction and control groups.8 this study evaluated the efficacy of valsalva maneuver on needle projection pain and hemodynamic responses during spinal puncture .
this randomized clinical trial was performed in dr.shariati hospital of tehran university of medical sciences from january to march 2010 .
the study protocol conformed to the ethical guidelines of the 1989 declaration of helsinki . to evaluate the effect of valsalva maneuver on pain , first , we searched medline , isi , and other databases .
this trial was then registered with and approved by the research ethics committee of tehran university of medical sciences and iranian registry of clinical trials .
ninety consecutive adults '... | this study evaluated the efficacy of the valsalva maneuver that can induce baroreceptor activation and nociception , on needle projection pain and hemodynamic responses associated with spinal puncture .
ninety adults , asa physical status i and ii undergoing elective surgeries were included .
patients were randomized into three equal groups .
group i ( c ) : control ; group ii ( b ) : ball ; pressed a rubber ball ( attention - diverting method ) ; group iii ( v ) : valsalva ; blew into sphygmomanometer tubing and hold the mercury column up to 30 mm hg for a period of at least 20s .
spinal needle projection pain was graded using numeric rating scale ( nrs ) : 1 - 10 , where scales of 1 - 3 were rated as mild , 4 - 6 as moderate , and > 6 as severe .
blood pressure and heart rate , five minutes before the procedure , during the spinal puncture and first and third minutes after that , were also recorded .
significant reduction in nrs was observed in the valsalva group compared with the control and the ball groups ( p=0.001 ) . there were statistical but no significant clinical differences in mean arterial blood pressure and heart rates between the study groups ( p=0.008 and p=0.016 respectively ) . in conclusion valsalva maneuver can decrease the skin puncture pain associated with spinal needle projection while observing hemodynamic changes . |
6,413 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the essential function of a classification system is as a navigation tool that helps direct research , evaluate outcomes , establish guidelines for best practices for prevention and care , and educate on all of the above .
diabetes mellitus ( dm ) subtypes as currently categorized , however , do not fit into our contemporary understanding of the phenotypes of diabetes ( 16 ) .
the inherent challenges of the current system , together with the limited knowledge that existed at the time of the crafting of the current system , yielded definitions for type 1 dm , type 2 dm , and latent autoimmune diabetes in adults ( lada ) that are not distinct and are ambiguous and imprecise .
discovery of the role played by autoimmunity in the pathogenesis of type 1 dm created the assumption that type 1 dm and type 2 dm possess unique etiologies , disease courses , and , consequently , treatment approaches .
there exists , however , overlap among even the most typical patient cases .
patients presenting with otherwise classic insulin resistance ( ir)-associated type 2 dm may display hallmarks of type 1 dm . similarly , obesity - related ir may be observed in patients presenting with textbook
the late presentation of type 1 dm provides a particular challenge for the current classification system , in which this subtype of dm is generally termed lada .
leading diabetes organizations have not arrived at a common definition for lada ( 5 ) .
there has been little consensus as to whether this phenotype constitutes a form of type 2 dm with early or fast destruction of -cells , a late manifestation of type 1 dm ( 8) , or a distinct entity with its own genetic footprint ( 5 ) . indeed
, current parameters are inadequate to clearly distinguish any of the subforms of dm ( fig .
1 ) . discussions and critiques of the current dm classification system are found in the literature ( 16 ) .
qualitative illustration of the spectrum of factors associated with different forms of dm , including the variable age at onset , lack of obesity ,... | the current classification system presents challenges to the diagnosis and treatment of patients with diabetes mellitus ( dm ) , in part due to its conflicting and confounding definitions of type 1 dm , type 2 dm , and latent autoimmune diabetes of adults ( lada ) .
the current schema also lacks a foundation that readily incorporates advances in our understanding of the disease and its treatment . for appropriate and coherent therapy
, we propose an alternate classification system .
the -cell centric classification of dm is a new approach that obviates the inherent and unintended confusions of the current system .
the -cell centric model presupposes that all dm originates from a final common denominator the abnormal pancreatic -cell .
it recognizes that interactions between genetically predisposed -cells with a number of factors , including insulin resistance ( ir ) , susceptibility to environmental influences , and immune dysregulation / inflammation , lead to the range of hyperglycemic phenotypes within the spectrum of dm .
individually or in concert , and often self - perpetuating , these factors contribute to -cell stress , dysfunction , or loss through at least 11 distinct pathways .
available , yet underutilized , treatments provide rational choices for personalized therapies that target the individual mediating pathways of hyperglycemia at work in any given patient , without the risk of drug - related hypoglycemia or weight gain or imposing further burden on the -cells .
this article issues an urgent call for the review of the current dm classification system toward the consensus on a new , more useful system . |
6,414 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: considering the rapidly burgeoning older population , increased attention is being given to an accurate assessment of older adults ' cognitive and neuropsychological functioning .
part of this process involves obtaining a viable estimate of their premorbid cognitive ability or their expected performance prior to any injury or relative decline in cognitive functioning .
these premorbid estimates are critical toward determining the nature , type , and severity of cognitive impairment .
it is vital when estimating the level of cognitive decline to account for variations in premorbid ability .
for example , an older adult might be performing in the average range relative to his or her peers , but this could be a potential decline if his or her previous premorbid abilities were in the high average or superior range .
it is also important to obtain a premorbid indicator in addition to age - based norms to account for other factors , such as formal education and occupation , that can contribute to one 's intellectual abilities . to this end
one approach to assessing premorbid functioning among older adults involves the use of demographic variables , such as education , sex , handedness , and occupation .
this approach can be useful because the data are gained without lengthy or invasive testing and independent of the patient 's current cognitive functioning and therefore remain constant throughout the patient 's adult life without being affected by any cognitive decline that may occur .
the use of demographic variables has been shown in some studies to be a good estimate of premorbid intelligence among healthy controls and has been recommended over other premorbid estimates for those with alzheimer 's disease .
demographic variables have been found in some cases to improve the accuracy of alternative approaches .
however , other studies have found that demographic indices involving education in particular are not always the most accurate estimates of premorbid intelligence in normal aging and alzheimer 's disease... | this study examines the utility of the american version of the national adult reading test ( amnart ) as a measure of premorbid intelligence for older adults . in a sample of 130 older adults , aged 56 to 104 ,
the amnart was compared to other tests of premorbid intelligence .
the results revealed that amnart - estimated iq was significantly higher than other premorbid estimates . across specific educational groups ( i.e. , 012 ,
1316 , and 17 or more years of education ) , amnart - estimated iq was inflated relative to all other premorbid estimates .
the amnart also declined as cognitive impairment increased , and there was a significant interaction between aging - related diagnostic group and premorbid estimate .
the amnart may therefore overestimate premorbid ability relative to other premorbid measures , particularly among those with greater cognitive impairment and lower levels of education .
these results suggest that the amnart should be used cautiously among older adults and in conjunction with other estimates of premorbid ability . |
6,415 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: reaching these niches is sometimes a challenging feat as pathogens have to travel long distances across organs , cross several cellular barriers , invade cells and travel inside the cell itself .
the talk by robert mnard ( pasteur institute , paris ) followed one of these journeys .
it travels the blood stream and reaches the liver where it divides , forms merozoites , infects other liver cells and finally enter the host 's bloodstream to invade erythrocytes and initiate disease . using intravital imaging , robert 's lab tracked the parasite from its injection site to the liver and came across several surprises .
first , a large number of parasites persist in the skin , multiply and even form merozoites .
a second surprise was that the exit step from the liver sinusoids occurs by endothelial cell traversal , a process that does not appear to require kpffer cells as was generally thought .
arriving in proximity with host cells , pathogens can exploit the specific morphology of host cells to enter them .
ari helenius ( eth , zurich ) described how vaccinia viruses use cellular extensions known as filopodia to reach the cellular body before entering host cells .
exposed phosphatidylserine groups in the vaccinia virus viral membrane mimic apoptotic bodies and are used by the virus to enter the host cell by macropinocytosis in an epidermal growth factor receptor ( egfr)-dependent manner .
bacterial pathogens on the other hand have at their disposal an arsenal of secretion systems to invade cells such as the needle - like type iii secretion system ( t3ss ) .
salmonella enterica , for example is an intracellular pathogen that replicates within host - cell vacuoles and delivers virulence factors ( effector proteins ) through a t3ss .
the process involves assembling the needle and shuttling the effector proteins across two bacterial membranes and the host vacuolar membrane in a highly coordinated sequential set of events .
david holden ( imperial college , london ) showed recent data from his laboratory that address... | the first embo workshop on emerging themes in infection biology was held last june in the south of france .
it gathered scientists working on various pathogens from viruses and bacteria to larger eukaryotic fungi and parasites .
topics included not only the crosstalk between pathogens and their hosts but also the tools researchers are using to study and image such cellular and molecular conversations.so it is said that if you know your enemies and know yourself , you can win a hundred battles without a single loss.the art of war , sun tzu |
6,416 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: intussusception of the appendix is an uncommon type of intussusception with an incidence of 0.01% ( 1 ) .
although it may clinically mimic more common acute and chronic abdominal conditions , it is an important entity to recognize since it could be discovered as cecal mass and mistaken for a neoplasm .
in korea , two cases of intussusception of the appendix were reported ; these were diagnosed by barium enema ( 2 , 3 ) .
a 17-yr - old female admitted with repeated periumbilical pain , nausea , vomiting and febrile sensation .
physical examination revealed mild periumbilical tenderness without rebound tenderness . in laboratory data , white blood cell count was 12,800/l and the other findings were normal .
simple abdominal radiography and abdominal computerized tomography revealed no abnormality except mild paralytic ileus . the following day
a colonoscopy was performed , which revealed a polypoid lesion in the cecum ( fig .
1 ) . an exploratory laparotomy was performed and it was seen dimple at cecum , the appendix invaginated into the cecum and an appendectomy was performed .
the appendix was 2.5 cm in length , and it showed a chronic inflammation pathologically ( fig .
intussusception of the appendix is a rare entity that is difficult to diagnose preoperatively . in 1858
mckid ( 4 ) first described a complete invagination of the appendix into the cecum of a 7 yr - old boy . in 1890 , the first operation for appendiceal intussusception in a 13-month - old child was reported ( 5 ) .
wright , renshaws , pitts and mcgraw reported successful operations for appendical intussusception ( 6 ) . in 1964 ,
collins ( 1 ) concluded a 40-yr study on 71,000 appendices obtained from surgical and autopsy material and reported prevalence of 0.01% for intussusception of the appendix ; the prevalence of the endometriosis and adenocarcinoma of the appendix were 0.05% and 0.08% , respectively .
intussusception of the appendix may occur at any age , however , the majority of the reported cases reviewed in the earlier literature... | intussusception of the appendix is an uncommon condition and the diagnosis is rarely made preoperatively .
intussusception of the appendix may mimic a neoplastic lesion .
colonoscopy is a valuable tool for diagnosis of the appendiceal intussusception .
a 17-yr - old female admitted with repeated abdominal pain , nausea , vomiting and febrile sensation .
we diagnosed as appendiceal intussusception by colonoscopy , which showed a polypoid tumor ( about 1.5 cm ) in the cecum .
this sessile polypoid mass looks like foreskin or glans .
we present colonoscopic finding of appendiceal intussusception and review the literature . |
6,417 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: an obvious example of a current debate within hoarding research is the question of where hoarding belongs within our diagnostic nosology .
the uncertainty regarding the most appropriate classification of compulsive hoarding syndrome has had important consequences for our understanding of hoarding , and in some ways has constituted an obstacle to hoarding research .
the lack of clear placement within dsm has led to an underestimation of the significance of the burden of disease associated with compulsive hoarding , inconsistencies with respect to an appropriate clinical comparison group in hoarding research , difficulties comparing findings across hoarding studies , and misconceptions regarding which assessment and treatment models are most relevant to hoarding . in the dsm - iv - tr
, hoarding is described as difficulty discarding items , and is listed as one of the eight diagnostic criteria for obsessive - compulsive personality disorder ( ocpd ) . accumulating evidence , however , suggests that it is misleading and invalid to classify hoarding as part of ocpd .
when studies examining the prevalence of ocpd in hoarding samples exclude the criterion describing difficulty discarding , most studies suggest that hoarding is no more associated with ocpd than it is with other axis ii disorders . in addition
, hoarding has been found to have the lowest specificity and predictive criteria of all eight of the diagnostic criteria for ocpd based on these findings , saxena et al argued convincingly that hoarding should be removed from the diagnostic criteria for ocpd . nevertheless , there is some evidence to suggest a link between hoarding and ocpd . a recent study of hoarding within a collaborative ocpd genetics study found that hoarders had a greater prevalence of certain ocpd traits , particularly miserliness and preoccupation with details . in addition ,
thus while the consensus appears to be that hoarding is inappropriately classified as a criterion of ocpd , the broader issue of the relation of hoarding to ocpd ,... | compulsive hoarding is a disabling psychological disorder characterized by excessive collecting and saving behavior .
this article reviews four key areas of recent advances in hoarding research .
first , we provide an overview of the evolving controversy regarding the diagnostic status of hoarding , highlighting accumulating evidence that it may be best conceptualized as a separate syndrome .
second , we describe advances in our understanding of the epidemiology , course , and demographic features of compulsive hoarding .
third , we review the latest findings regarding possible neuropsychological correlates of the disorder . finally , we discuss ongoing progress and future directions related to the clinical management of compulsive hoarding . |
6,418 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in middle - aged populations , differences between males and females are described in terms of various aspects of coronary artery diseases .
males , for example , have a higher rate of previous myocardial infarction ( mi).1,2 females , at least in some studies , have been reported to have a longer delay to reach hospital and less frequently to receive invasive therapy for acute myocardial infarction ( ami ) than males.3,4 in addition , females develop symptomatic cardiovascular disease about a decade later in life than males do.5 age is a demographic predictor of short- and long - term mortality in ami.6 an analysis from the american national registry of myocardial infarction7 noted an interaction between sex and age with regard to 30-day mortality .
there was a progressive decrease in the difference ( higher mortality in females ) with increasing age until the age of 75 years .
study results for sex differences in the prevalence of and outcome for ami among patients over 75 years of age have not been described as well as they have been described for middle - aged patients . both female sex and increasing age
have been reported to be risk factors for atypical symptoms and a less aggressive treatment in ami.8 therefore , it is of interest to compare females and males when both criteria are fulfilled , that is , to look at sex differences among the elderly patients .
this study analyzed age - adjusted sex differences among ami patients aged 75 years and above with regard to 7-year mortality ( primary end point ) and the frequency of angiograms and admission to the coronary care unit ( ccu ) as well as 1-year mortality ( secondary end points ) .
the hospital has facilities for emergency percutaneous coronary intervention at all hours of the week .
gothenburg is the second largest city in sweden and has 550,000 inhabitants , 7% of whom are aged 75 years and above.9 we collected data during two distinct periods , 2001/2002 and 2007 , to evaluate possible changes over time .
we have previously described these... | objectivesthis study analyzed age - adjusted sex differences among acute myocardial infarction ( ami ) patients aged 75 years and above with regard to 7-year mortality ( primary end point ) and the frequency of angiograms and admission to the coronary care unit ( ccu ) as well as 1-year mortality ( secondary end points).methodsa retrospective cohort study comprised 1,414 ami patients ( 748 females and 666 males ) aged at least 75 years , who were admitted to sahlgrenska university hospital in gothenburg , sweden , during two periods ( 2001/2002 and 2007 ) .
all comparisons between female and male patients were age adjusted.resultsfemales were older and their previous history included fewer amis , coronary artery bypass grafting procedures , and renal diseases , but more frequent incidence of hypertension . on the contrary , males had higher age - adjusted 7-year mortality in relation to females ( hazard ratio [ hr ] 1.16 with corresponding 95% confidence interval [ 95% ci 1.03 , 1.31 ] , p=0.02 ) .
admission to the ccu was more frequent among males than females ( odds ratio [ or ] 1.38 [ 95% ci 1.11 , 1.72 ] , p=0.004 ) .
there was a nonsignificant trend toward more coronary angiographies performed among males ( or 1.34 [ 95% ci 1.00 , 1.79 ] , p=0.05 ) , as well as a nonsignificant trend toward higher 1-year mortality ( hr 1.18 [ 95% ci 0.99 , 1.39 ] , p=0.06).conclusionin an ami population aged 75 years and above , males had higher age - adjusted 7-year mortality and higher rate of admission to the ccu than females .
one - year mortality did not differ significantly between the sexes , nor did the frequency of performed coronary angiograms . |
6,419 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: until recently , influenza a virus infection in indonesia did not cause much concern for the public due to the mild , self - limiting nature of seasonal influenza .
however , since the outbreaks of avian influenza a ( h5n1 ) in poultry in 2003 and the subsequent fatal human infections in 2005 , the risk of influenza caused alarm worldwide . until the beginning of 2012 , indonesia has 189 human h5n1 cases with a mortality rate at more than 80% . therefore , there is a growing concern that h5n1 became the
pandemic.1,2 the big influenza pandemics that caused huge death tolls in 1918 , 1957 , 1968 high morbidity in 2009 are still fresh in memory.3 laboratory assessment of influenza virus infection is an essential component for prompt and accurate diagnosis .
however , this task remains difficult to accomplish in indonesia , the largest archipelago in the world with a population of more than 235 million people .
there was a strong need to establish a reliable laboratory network throughout the country to provide prompt and accurate diagnosis of influenza in suspected sufferers . here
, we review our efforts and learnings in establishing a reliable laboratory network for influenza a diagnosis during the avian flu ( h5n1 ) outbreaks .
the republic of indonesia s territory extends 5120 kilometers from east to west , a similar distance as from san francisco to new york in the united states .
the archipelago lies from 6 north latitude to 11 south latitude and from 04 to 141 east longitude and consists of more than 17,500 islands .
the inclusion of indonesia s exclusive economic zone brings the total area to about 7.9 million square kilometers of sea area four times larger than the land area ( 1,992,579 km ) . based on the 2010 census ,
the total population of indonesia is 237,556,363 people , which are unevenly distributed among five major islands ( java , sumatra , kalimantan , sulawesi , and papua ) plus the islands of moluccas , of bali , of west and east nusa tenggara , and thousands of smaller islands... | indonesia has been part of the global influenza surveillance since the establishment of a national influenza center ( nic ) at the national institute of health research and development ( nihrd ) by the indonesian ministry of health in 1975 . when the outbreak of avian influenza a ( h5n1 ) occurred , the nic and us naval medical research unit 2 were the only diagnostic laboratories equipped for etiology confirmation .
the large geographical area of the republic of indonesia poses a real challenge to provide prompt and accurate diagnosis nationally .
this was the main reason to establish a laboratory network for h5n1 diagnosis in indonesia .
currently , 44 laboratories have been included in the network capable of performing polymerase chain reaction testing for influenza a. diagnostic equipment and standard procedures of biosafety and biosecurity of handling specimens have been adopted largely from world health organization recommendations . |
6,420 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: an estimated 569,490 americans are expected to die of cancer in 2010 , accounting for approximately 25% of the overall mortality 1 .
bone metastases are a common manifestation of advanced disease with autopsy studies showing an incidence of 33 - 36% in patients with lung cancer 2 , 3 , 68% in prostate cancer 3 , and 73% in breast cancer 2 , 3 . while many patients receive therapy at major cancer centers , numerous other patients choose local or regional hospitals , and most imaging studies include the skeleton secondarily if not primarily ( e.g. chest radiography , body computed tomography [ ct ] ) .
thus , the appearance and behavior of bone metastases can be detected on a wide variety of imaging studies that are performed for many different indications .
response criteria represent the standard by which the efficacy of new therapeutic agents is determined in cancer treatment trials .
the most commonly used set of criteria is the response evaluation criteria in solid tumors ( recist ) . these and similar anatomic criteria focus predominantly on the physical measurement of solid tumors .
disease that is not easily measurable with a ruler or calipers , such as most bone metastases , is designated as unmeasurable .
cancer patients with no measurable disease ( e.g. individuals with bone - only metastases following the resection of a primary tumor ) are often ineligible for clinical trials , which may be the only available source of therapy .
this article reviews anatomic ( recist 1.1 ) , bone ( md anderson [ mda ] ) , and metabolic ( positron emission tomography response criteria in solid tumors [ percist ] ) cancer response criteria , with a focus on the developing role of bone metastases and the interpretation of the treatment response of bone metastases seen on imaging studies .
change in tumor size following therapy , also known as objective response 4 , 5 , is a robust indicator of outcome in the treatment of numerous solid tumors 6 - 9 and forms the basis for anatomic response criteria .
recist 10 ,... | response criteria represent the standard by which the efficacy of therapeutic agents is determined in cancer trials .
the most widely used criteria are based on the anatomic measurement of solid tumors .
because bone metastases are typically located in irregularly shaped bones and are difficult to measure with rulers , they have been previously considered unmeasurable disease .
new developments in cancer response criteria have increased awareness of the importance of the response of bone metastases to therapy .
the recently updated response evaluation criteria in solid tumors ( recist 1.1 ) now consider bone metastases with soft tissue masses > 10 mm to be measurable disease .
response criteria specific to bone metastases have been developed at the university of texas md anderson cancer center ( mda criteria ) and can be used to assess therapeutic response in numerous types of bone metastases .
functional imaging criteria , such as the recently developed positron emission tomography response criteria in solid tumors ( percist ) allow response to be measured in the absence of anatomic change through assessment of metabolic activity . as monitoring tumor response of bone metastases becomes more important in the management of cancer , so does the demand on radiologists and nuclear medicine physicians for accurate interpretation of the behavior of these lesions .
this article reviews anatomic , bone , and metabolic response criteria , providing illustrations for the interpretation of therapy - induced change in bone metastases . |
6,421 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: most cellular functions are carried out by a complex network of genes , proteins , and metabolites that interact through biochemical and physical interactions ( gerstein et al , 2002 ; barabsi and oltvai , 2004 ; albert , 2005 ; basso et al , 2005 ; almaas , 2007 ; alon , 2007 ; yildrim et al , 2007 ) .
therefore , disease - causing defects may initiate cascades of failures that trigger the co - emergence of multiple diseases in a patient , such as diabetes and obesity . yet , given the environmental , lifestyle , or treatment - related factors that all contribute to comorbidity , it is not obvious whether these cellular network - based interdependencies manifest themselves at the individual or at the population level . discovering such systematic correlations between cellular networks and disease patterns could potentially open new avenues for understanding the human interactome , and may help uncover hitherto unknown disease mechanisms ( ergun et al , 2007 ; loscalzo et al , 2007 ; braun et al , 2008 ) .
the possibility that there may be systematic links between hereditary diseases , thanks to their common genetic origins , was postulated recently by goh et al , who created a human disease network ( hdn ) by connecting all hereditary diseases that share a disease - causing gene according to the online mendelian inheritance in man ( omim ) database ( goh et al , 2007 ; feldman et al , 2008 ) .
although some of the diseases connected in the hdn captured well - known comorbidity patterns , the functional relevance of the links in the network remains to be demonstrated , leaving open the question whether most diseases connected in the hdn exhibit significant comorbidity .
interestingly , the most disconnected disease class in the hdn is that of metabolic diseases .
however , lee et al recently showed that metabolic diseases can be also organized in a metabolic disease network if the enzymes and their associated diseases are linked through metabolic pathways ( lee et al , 2008 ) .
most importantly , the study... | the impact of disease - causing defects is often not limited to the products of a mutated gene but , thanks to interactions between the molecular components , may also affect other cellular functions , resulting in potential comorbidity effects . by combining information on cellular interactions , disease -- gene associations , and population - level disease patterns extracted from medicare data , we find statistically significant correlations between the underlying structure of cellular networks and disease comorbidity patterns in the human population .
our results indicate that such a combination of population - level data and cellular network information could help build novel hypotheses about disease mechanisms . |
6,422 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: bilateral sagittal split osteotomy ( bsso ) is one of the most common orthognathic surgical procedures for the correction of mandibular deformities .
the obwegeser - dal pont osteotomy and hunsuck modifications are widely used1 - 3 . when performing bsso , it is crucial to control the lingual split because it may result in an unfavorable fracture or inferior alveolar nerve ( ian ) damage .
conventional radiographs , such as panoramic views and cephalograms , have limitations in regard to evaluation of the lingual split pattern . using cone - beam computed tomography ( cbct ) and three - dimensional ( 3d ) reconstruction
plooij et al.4 and muto et al.5 evaluated the mandibular ramus split pattern in a symmetric mandible using 3d - ct . in an asymmetric mandible , the morphology and anatomy of each side differ .
the length of the ramus and body , the inclination of the ramus , and the ramal volume are significantly different between the deviated side and the contralateral side6,7 .
therefore , the aim of this study was to evaluate the lingual split line when performing bsso in asymmetric mandibular prognathism ; we used cbct and a 3d software program .
the study group comprised 40 patients with asymmetric mandibular prognathism ( 20 males and 20 females ) who had undergone bsso from january 2012 through june 2013 in pusan national university dental hospital .
patients ' age ranged from 18 to 31 years ( mean age : 23.2 years ) . the inclusion criterion comprised chin deviation > 3 mm compared to the facial midline ( mean deviation : 5.7 mm ; right / left : 17/23 ) .
this study protocol was approved by institutional review board of pusan national university dental hospital , yangsan , korea ( pnudh-2013 - 036 ) .
preoperative and postoperative cbct images were acquired using dct pro ( vatech co. , hwaseong , korea ) .
the images were post - processed to a digital imaging and communications in medicine ( dicom ) 3.0 file ( simplant ; materialise inc . , leuven , belgium ) .
the mandible was digitally isolated from... | objectivesthe aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy ( bsso ) for asymmetric prognathism .
this was accomplished with the use of cone - beam computed tomography ( cbct ) and three - dimensional ( 3d ) software program.materials and methodsthe study group was comprised of 40 patients ( 20 males and 20 females ) with asymmetric prognathism , who underwent bsso ( 80 splits ; n=80 ) from january 2012 through june 2013 .
we observed the pattern of lingual split line using cbct data and image analysis program .
the deviated side was compared to the contralateral side in each patient . to analyze the contributing factors to the split pattern
, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula.resultsthe lingual split patterns were classified into .
the true " hunsuck " line was 60.00% ( n=48 ) , and the bad split was 7.50% ( n=6 ) .
ramal thickness surrounding the lingual was 5.551.07 mm ( deviated ) and 5.661.34 mm ( contralateral ) ( p=0.409 ) .
the position of the lateral cortical bone cut end was classified into three types : a , lingual ; b , inferior ; c , buccal .
type a comprised 66.25% ( n=53 ) , type b comprised 22.50% ( n=18 ) , and type c comprised 11.25% ( n=9).conclusionin asymmetric prognathism patients , there were no differences in the ramal thickness between the deviated side and the contralateral side .
furthermore , no differences were found in the lingual split pattern . the lingual split pattern correlated with the position of the lateral cortical bone cut end .
in addition , the 3d - ct reformation was a useful tool for evaluating the surgical results of bsso of the mandible . |
6,423 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
despite the marked advances in the perioperative management of the liver transplant recipient , an assessment of clinically significant graft injury following preservation and reperfusion remains difficult .
the lack of a sensitive clinical marker of acute liver injury has a profound impact on clinical practice and the success of translational research in liver transplantation .
such a clinical marker could aid the management of graft dysfunction in early identification of recipients who will require retransplantation .
currently , posttransplant peak aspartate aminotransferase ( ast ) is a widely accepted clinical marker for graft damage in liver transplant practice [ 26 ] .
in fact , the united network for organ sharing ( unos ) suggests relisting criteria for the recipients with primary graft dysfunction ( pnf ) on the basis of the post - transplant peak ast .
ast is an enzyme that is involved in amino acid metabolism , primarily existing in hepatocytes . during transplantation graft hepatocytes
are inevitably injured , and intracellular enzymes are subsequently released into the systemic circulation of the recipient .
we theorized that the recipient ast serum concentration is a function of the total amount of ast released by the graft liver diluted by the total circulating blood volume at the time of blood sampling .
therefore , the ast value could be misleading or inaccurate , depending on the size of the graft ( total mass of injured hepatocytes ) and the volume of blood in the recipient 's circulation .
we have previously reported on the use of the ratio of donor to recipient body surface area ( bsai ) to predict donor - recipient graft size mismatch [ 8 , 9 ] .
we showed that size mismatch has a bidirectional impact on graft survival with a progressive increase in the risk of graft failure towards both ends of the size - mismatch spectrum , small - for - size to large - for - size 5 by generalized additive model .
bsai has an important value in deceased liver transplant to quickly and reliably... | background . despite the marked advances in the perioperative management of the liver transplant recipient ,
an assessment of clinically significant graft injury following preservation and reperfusion remains difficult . in this study , we hypothesized that size - adjusted ast could better approximate real ast values and consequently provide a better reflection of the extent of graft damage , with better sensitivity and specificity than current criteria .
methods .
we reviewed data on 930 orthotopic liver transplant recipients .
size - adjusted ast ( asti ) was calculated by dividing peak ast by our previously reported index for donor - recipient size mismatch , the bsai .
the predictive value of asti of primary nonfunction ( pnf ) and graft survival was assessed by receiver operating characteristic curve , logistic regression , kaplan - meier survival , and cox proportional hazard model . results .
size - adjusted peak ast ( asti ) was significantly associated with subsequent occurrence of pnf and graft failure . in our study cohort ,
the prediction of pnf by the combination of asti and pt - inr had a higher sensitivity and specificity compared to current unos criteria .
conclusions .
we conclude that size - adjusted ast ( asti ) is a simple , reproducible , and sensitive marker of clinically significant graft damage . |
6,424 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: heart function fails when the organ is unable to pump blood at a rate proportional to the body s need for oxygen or when this function leads to elevated cardiac chamber filling pressures ( cardiogenic pulmonary edema ) . despite our sophisticated knowledge of heart failure , even the so - called ejection fraction
up 175% over the past 25 years and costs of nearly $ 15.4 billion dollars , acute heart failure is a critically important health concern . furthermore , half of the patients discharged from the hospital are readmitted within half - a - year .
in - hospital mortality remains high between 4% and 7%.1,2 heart failure is a significant problem as the population ages .
the prevalence is 2.5% of the us population or 5 million patients ( from the national health and nutrition education survey).2
common etiological mechanisms of heart failure include coronary ischemia , valvular disease , hypertension , and diastolic dysfunction .
yet , other causes include : postpartum cardiomyopathy ; postinfectious , chronic tachycardia ; metabolic dysregulation ; adverse medication side effects ( particularly adriamycin chemotherapy ) ; orphan disease duchenne s muscular dystrophy ; infiltrative diseases ( such as amyloidosis ) ; and inflammatory / connective tissue diseases ( such as systemic lupus erythematosus ) . when known causes of heart failure
less often studied versus chronic heart failure , acute decompensated heart failure is associated with abrupt - onset symptoms associated with hospitalization .
nearly half of the admitted patients with heart failure have preserved ejection fraction.2,3 in order to appreciate the physiology of heart failure , a review of fundamental principles is on order .
the frank starling law states that the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart ( the end diastolic volume ) when all other factors remain constant .
the increased volume of blood stretches the ventricular wall , causing cardiac muscle to contract more... | heart function fails when the organ is unable to pump blood at a rate proportional to the body s need for oxygen or when this function leads to elevated cardiac chamber filling pressures ( cardiogenic pulmonary edema ) . despite our sophisticated knowledge of heart failure ,
even so - called ejection fraction - preserved heart failure has high rates of mortality and morbidity .
so , novel therapies are sorely needed .
this review discusses current standard therapies for heart failure and launches an exploration into emerging novel treatments on the heels of recently - approved sacubitril and ivbradine .
for example , vasoactive intestinal peptide ( vip ) is protective of the heart , so in the absence of vip , vip knockout mice have dysregulation in key heart failure genes : 1 ) force generation and propagation ; 2 ) energy production and regulation ; 3 ) ca+2 cycling ; 4 ) transcriptional regulators .
vip administration leads to coronary dilation in human subjects . in heart failure patients ,
vip levels are elevated as a plausible endogenous protective effect . with the development of elastin polymers to stabilize vip and prevent its degradation
, vip may therefore have a chance to satisfy the unmet need as a potential treatment for acute heart failure . |
6,425 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mutations of the gjb2 gene , encoding gap junction protein connexin 26 ( cx26 ) , are the most common cause of hereditary congenital hearing loss in many countries ( 2 ) .
cx26 is a member of the connexin family of gap junction proteins , which facilitate intercellular communication by encoding channels that directly link the cytoplasm of adjacent cells ( 3 , 4 ) . in spite of contribution of several different genes as causative agents of deafness , mutations in
one gene encoding connexin 26 ( genbank m86849 , mim 121011 ) with chromosomal location 13q11 - 12 known as dfnb1 ( omim 220290 ) responsible for half of severe to profound autosomal recessive non syndromic deafness in many populations ( 58 ) .
gjb2 is a small gene about 5500-bp length with two exons , of which only one ( exon 2 ) contains the coding region .
the coding region consists of 681 bp that encodes a gap - junction protein with 226 amino acids ( 6 ) . in the present study ,
we report a novel dominant mutation ( c202r ) in an iranian patient with bilateral non - syndromic sensorineural hearing loss .
a 40-year - old woman with bilateral hearing loss , for molecular analysis of deafness , was referred to welfare organization of marand , iran in august 2012 .
for molecular analysis , genomic dna was extracted from 1 ml of edta anticoagulated peripheral blood by rapid genomic dna extraction ( rgde ) method ( 9 ) .
polymerase chain reaction of coding region of cx26 gene was performed using cx26f : 5-tct ttt cca gag caa acc gc-3 as a forward primer and cx26r : 5-tgg gca atg cgt taa act ggc-3 as a reverse primer .
pcr reactions were carried out in 25 l reaction mixture containing 1 pcr buffer , 1.5 mm mgcl2 , 0.2 mm dntp , 10 pmoles of each primer , 0.5 u of taq dna polymerase and about 1g of genomic dna on a sensoquest ( labcycler / germany ) thermal cycler .
pcr was performed under the following conditions : initial denaturation at 95c for 5 min , 34 cycles of denaturation at 95c for 45 sec , annealing at 60c for 1 min , extension at 72c for 1... | mutations in the gjb2 gene are the most common known cause of hereditary congenital hearing loss .
rapid genomic dna extraction ( rgde ) method was used for genomic dna extraction .
after amplification of coding region of cx26 gene with specific primers , expected pcr products with 724bp length were subjected to direct sequencing in both directions .
we describe here a novel heterozygous -t to -c transition at codon 202 ( tgccgc ) of the gjb2 gene in a patient , 40-year - old iranian woman , which replaces a cysteine with an arginine residue ( c202r ) .
the dominant mutation c202r associated with non - syndromic sensorineural hearing loss .
this mutation has not previously been described in affected or control samples from other populations investigated for gjb2 mutations , indicating that it is a rare substitution .
this dominant mutation was recorded in ncbi genbank with accession number kf 638275 . |
6,426 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: linear growth retardation , or stunting , which is a manifestation of chronic malnutrition , is highly prevalent in under - developed and developing countries.[14 ] according to the world health organization , 215 million children were stunted in 2000 throughout the world . the national data from
iranian national study of malnutrition prevalence in 2005 has indicated that 4.7% of iranian children are affected by stunting .
earlier studies have shown that child 's stunting is associated with concurrent , and possibly later , delayed mental and motor development .
the adverse effects of stunting could affect the adulthood by limiting work capacity owing to reduced muscle mass and increasing obstetric risks in women .
although , several studies have identified determinants of stunting in different populations,[51015 ] limited data are available indicating its associates among iranian children .
earlier studies have identified low birth weight , inadequate child care , feeding practice and birth order as a probable correlates of stunting # 94 ; wamani , 2007 # 82 ) .
it also has been shown that birth weight , breast feeding status , mothers age , family size , socio - economic status and birth order are associated with a higher prevalence of stunting among iranian children.[51822 ] previous studies have been limited in sample size and their sampling procedure ; such that their findings can not be easily extrapolated to other parts of the country .
it remains unknown if the determinants of stunting in a metropolitan area like tehran are different from those in deprived regions of the country .
this study was , therefore , conducted to investigate determinants of stunting in first grade primary school children of tehran .
in this case - control study , participants were selected by multistage cluster random sampling method from 5 districts of tehran in 2007 .
first , 42 public schools ( 19 schools for girls and 23 for boys ) were randomly selected based on proportional to size method in each district . in each... | background : limited data are available indicating associates of stunting among iranian children .
this study was conducted to investigate determinants of stunting in first grade primary school children of tehran in 2007.method:in this case - control study , 3147 school children were selected by multistage cluster random sampling method from 5 districts of tehran .
anthropometric measurements were done and stunting was defined as height for age less than the 5th percentile of cdc2000 cut - off points .
eighty six stunted children were identified and considered as case group . after matching for age , sex and residence area ,
308 non - stunted children were randomly selected as control group .
required data were collected by trained nutritionists using questionnaires.results:stunting was prevalent among 3.7% of the study population ( girls 4.4% vs. boys 2.8% , p < 0.05 ) .
mean age of the studied children was 82.3 month .
children with a birth weight of > 3000 g were less likely to be stunted ( or : 0.25 : 95% ci : 0.11 - 0.54 ) compared with those with a birth weight of < 3000 g. being born to older mothers ( > 35 years ) was associated with greater odds of being stunted ( 3.01 ; 1.19 - 7.60 ) compared with being born to younger mothers ( < 35 years ) .
those with fathers height of > 160 cm were less likely to be stunted ( 0.04 ; 0.005 - 0.37 ) than those whose fathers height was less than 160 cm.conclusions:we found that birth weight , maternal age and fathers height are the major contributing factors to stunting in this group of iranian children . taking into account the determinants of stunting
might help policy makers designing appropriate interventions . |
6,427 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: already back in 1850 , ignatz semmelweis was able to demonstrate in a spectacular manner that hand hygiene could prevent infections , but since then very few studies have been able to attest to the importance of hand hygiene in everyday practice .
it is therefore all the more remarkable that in two studies of simple design , it has been possible to furnish proof of the influence of hand hygiene prior to insertion of peripheral venous catheters on the incidence of complications .
both studies were conducted as practical exercises within the framework of the training course for infection control nurses in austria . using a questionnaire , hans hirschmann had the persons placing peripheral venous catheters record anonymously the following data : patient data , data and time of insertion , localization of insertion site , professional status of person placing the catheter ( physician , nurse , medical student ) , place catheter fitted ( or , ward , outpatient department ) , type of skin antisepsis ( exposure time to an alcohol - based skin antiseptic < 15 s or > 15 s ) , type of hand hygiene practiced before placement of the catheter ( no hygienic measure , handwashing , hygienic hand disinfection with an alcohol - based product , donning of non - sterile disposable gloves ) and , finally , the reason for catheter placement . on removing the peripheral venous catheter the person doing so now entered the following information on the same questionnaire : date and time of removal , reason for removal as well as complications ( redness , swelling , pain , fever of unknown origin , pus at insertion site , other reason ) . for the first study , 1148 questionnaires were completed in an austrian hospital . on the basis of the average consumption of peripheral venous catheters ( approx . 600 per week ) a data registration quota of approx .
each patient received on average 1.4 peripheral venous catheters during their hospital stay , calculated on the basis of the number of patients and consumption of venous catheters... | using two studies of a simple design it has been possible to furnish proof of the influence of hand hygiene prior to insertion of peripheral venous catheters on the incidence of complications . in the first study detailed data were collected anonymously for each patient on the procedure used for catheter insertion or on any complications .
data were collected for around 64% of patients in one hospital .
evaluation of the questionnaires revealed that there was a significant increase in the incidence of complications in line with an increasing duration of the indwelling period of between 24 and 96 hours .
the unexpected finding of this evaluation study was that in the case of catheters with an indwelling period of more than two days there were highly significantly lower complication rates in those cases in which hand disinfection was carried out or gloves donned before catheter placement .
the second study , based on the former , documented the cases giving rise to complications .
the proportion of peripheral venous catheters implicated in complications was 24% . here ,
too , there was a sharp rise in the risk of complications in line with the duration of the indwelling period .
catheters placed in the or during the patient s hospital stay showed a significantly lower risk of complications than those inserted on wards , or even in the outpatient department .
conductance of hygienic hand disinfection or the wearing of disposable gloves resulted in significantly lower complication rates compared to normal handwashing or omission of a hand hygiene measure .
the most plausible explanation for this positive effect exerted by the wearing of disposable gloves or conductance of hygienic hand disinfection prior to catheter placement is that there was no recontamination during repalpation , as often seen , of the prepared venepuncture site . |
6,428 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: important factors determining the rate of tooth alignment include the bracket slot dimension , the associated inter bracket span , the choice of arch wire , and frictional forces generated between bracket and arch wire .
friction has been defined as the resistance to motion that occurs when two objects move tangentially to each other .
friction , which impedes sliding movements , is determined by multiplying the coefficient of friction of the materials in contact by the normal force , which is the force of ligation in orthodontic appliance .
an ideal ligation system for alleviation of crowding in orthodontic treatment primarily should ensure full bracket engagement of the arch wire and should exhibit low friction between brackets and arch wire .
currently , two main types of brackets are available for practicing orthodontists - conventional ( cl ) and self - ligating ( sl ) brackets . in a conventional tie wing bracket , wire ligatures and elastomeric ligatures
have been documented with higher frictional forces , which reach undesirable levels relative to those that are ideal for tooth movement .
sl brackets are considered a ligature - less bracket system with an inbuilt metal labial face , which provides the combination of low friction and full arch wire engagement .
. the claimed advantages of both types of sl bracket systems include increased patient comfort due to the absence of ligatures , improved oral hygiene , less chair time , and shorter overall treatment time . however , there are also certain disadvantages , including difficulty with the full expression of torque , frequent failure of the clips , and brackets that are bulkier and more expensive than conventional brackets . to address some deficiencies of sl brackets , novel ligatures such as the leone slide ligature ( ll )
leone slide ligatures ( ll ) have been developed with a polyurethane fourth wall , which allows the arch wire to slide freely in the slot while transmitting its full force to the tooth .
several retrospective and prospective in... | objectives : to conduct a prospective randomized study comparing the efficiency of 5 different ligation systems ( ell ; elastomeric ligature , ssl ; stainless steel ligature , ll ; leone slide ligature , psl ; passive self - ligation and asl ; active self - ligation ) over the duration of mandibular crowding alleviation.materials and methods : fifty consecutive patients ( 54.2% male , 45.8% female ; mean age : 16.69 years ) satisfying the inclusion criteria were randomly allocated to 5 ligation groups with an equal sample size of 10 per group .
the 5 groups received treatment with 0.022-inch mbt pre - adjusted edge - wise technique ( ell : gemini 3 m unitek , ssl : gemini 3 m unitek , ll : gemini 3 m unitek , psl : smartclip 3 m unitek and asl : in - ovation r euro gac international ) . the models and cephalograms
were evaluated for anterior arch alignment , extraction space closure , and lower incisal inclinations at pre - treatment t1 and at the end of initial alignment t2 .
analysis of variance ( anova ) and post - hoc tests were used for data analysis.results:forty-eight participants completed the study , and sl systems showed a significant difference over cl groups in time to alignment , passive space closure , and incisal inclination .
multiple regression showed a reduction of 5.28 days in time to alignment by changing the ligation group in the order of ell to asl group and 1 mm increase in initial irregularity index increases time to alignment by 11.68 days.conclusion:self-ligation brackets were more efficient than conventional ligation brackets during initial leveling and alignment . |
6,429 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mucinous carcinoma of the breast is uncommon , the reported incidence of pure mucinous carcinoma being 2% of all breast cancers .
pure mucinous carcinoma has a far better prognosis than the mixed variety noted in several studies .
we report a case diagnosed as pure mucinous carcinoma breast on fine needle aspiration cytology ( fnac ) in a female of reproductive age group .
a 30-year - old female presented with a large firm lump in upper quadrant of right breast for 4 years , which was gradually increasing in size and was associated with pain .
there were numerous moderately pleomorphic epithelial cells lying either discretely forming loose clusters or entrapped within stromal material [ figure 1 ] . at places ,
fnac smear showing abundant pink mucoid material ( arrow ) with entrapped tumor cells ( arrow head ) ( h and e , 400 ) right mastectomy specimen with axillary tail measuring 20 cm14 cm4 cm was received .
overlying skin measured 20 cm11 cm , and the axillary tail measured 9 cm6 cm2 cm .
cut surface revealed circumscribed mass with variegated appearance , grey brown in color , and solid to cystic with areas of necrosis and hemorrhage .
tumor mass measured 7 cm6 cm5 cm , and extended from subepidermal tissue to posterior resected margin .
four lymph nodes were identified in axillary tail , with the largest measuring 3 cm2 cm1 cm and the smallest measuring 1 cm0.5 cm0.5 cm . cut surface of the largest was gelatinous and necrotic .
three axillary lymph nodes with fibrofatty tissue received separately ranged from 0.5 to 1.5 cm , and had unremarkable cut surface . sections from different areas of specimen were studied .
sections from tumor mass revealed large areas of necrosis , myxoid degeneration and lakes of mucoid material [ figure 2 ] .
the tumor cells were round to polyhedral , exhibiting mild pleomorphism but frequent mitotic figures .
these cells were mostly arranged in thin trabeculae , single rows and few solid cellular areas .
tumor was reaching close to posterior resected margin but was separated... | mucinous carcinoma of the breast is a relatively rare , pure form accounting for 2% of all breast cancers
. pure mucinous carcinoma of the breast has a favorable prognosis .
the common age is postmenopausal group . here
, we report a 30-year - old female patient diagnosed on cytology as mucinous carcinoma of the breast with lymph node metastasis and subsequently confirmed by histopathology . in 1 year follow - up ,
the patient did not show pulmonary or distant metastasis and received adjuvant chemotherapy at every 3 weeks interval . |
6,430 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: for the pharmacometrician and the system pharmacologist , computer software is , quite simply , the equivalent of the laboratory for the molecular biologist , or of the research clinic for the practicing clinician .
it is the environment where tools are developed , observations and conjectures are made , hypotheses are formulated and tested , multiple scenarios are run , and discoveries are made for the betterment of science or patients .
it is only natural that cpt : psp , in its efforts to merge pharmacometrics and systems pharmacology , wishes to be the home to cutting - edge tutorial papers that can bring practitioners of one discipline closer to the other , spreading beyond the initiated to familiarize our audience with an ever - increasing number of tools .
such familiarity is expected to facilitate new findings , developments , and discoveries by indicating capabilities and potential applications of pharmacometrics and systems pharmacology software and helping with repeatability of the study , an essential element in any scientific discipline . in the words of umberto eco , thinking back to another powerful medium used to propagate information ,
if you want to use television to teach somebody , you must first teach them how to use television .
the cpt : psp designation for a tutorial , as stated in the journal 's guide to authors , is an educational article providing practical tutorial on tools , methodologies , and approaches in pharmacometrics and systems pharmacology .
this is of crucial importance for the continued health of both pharmacometrics and systems pharmacology because the pace of changes in these dynamic fields appears to outpace any concerted efforts to provide timely didactic needs by current higher education systems .
an integrated technical education on modeling and simulation tools has been sporadic , carried out individually in centers scattered around the globe .
as explained in the inaugural editorial and in a description of our disciplines foundational tutorials , cpt : psp... | in addition to methodological tutorials,1 cpt : psp has recently started to publish software tutorials.2,3 our readership and authors may be wondering what kind of format or product is expected , and the review of submissions we have already received prompted several discussions within the psp editorial team .
this editorial reflects on these discussions and summarizes their salient points .
it aims at providing some details about the current vision of cpt : psp for software tutorial articles .
in addition , it brings some clarity on the topic of what role commercial software tutorials can have in cpt : psp and how cpt : psp tutorials differ from publications which describe the software itself , as those which can be found in other computer science journals .
finally , the discussion includes reproducibility considerations and the general use of commercial and noncommercial software in cpt : psp publications .
we hope our thoughts , and especially a stated requirement to publish user input to the software to aid in reproducibility , will help in guiding our authors and will stimulate healthy debate among our readers about the evolving nature of our science , how it can be facilitated using software and associated databases as a conduit , and what role this journal can play in fostering both the best modeling and simulation practices and the best scientific approaches to computational modeling , to bring the advantages of modeling and simulation to all regular practitioners , and not to just a ( self ) selected few . |
6,431 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
the institute of medicine ( iom ) report to err is human revealed the number and significance of adverse events and errors that occur during hospitalization .
the report was a call to action to transform healthcare systems to ensure patient safety and higher quality care
. in one step toward healthcare transformation , the centers for medicare and medicaid ( cms ) no longer reimburses institutions for the care , or treatment , associated with certain hospital - acquired conditions . understanding what factors contribute to adverse incidents during hospitalization is essential to developing effective counter measures . in order to improve factors that are modifiable within a hospital structure or with healthcare delivery ,
there are a number of potential contributing factors that need to be considered such as the patient 's condition , the care the patient receives , and the environment in which they receive care [ 3 , 4 ] .
battles and lilford provide a conceptual model for patient safety that includes antecedent conditions , which would include the patient 's comorbid conditions , the primary reason the patient was admitted to the hospital , and characteristics the patient possessed before entering the hospital .
their model also includes the structure , or environment , in which the patient receives care such as the hospital , or nursing unit . also acting within the structure
are the processes of care ( the interventions or treatments ) delivered by the multidisciplinary team caring for the patient in the hospital .
none of these components exist in isolation , which is why it is important to examine all of these factors and how they interact .
the purpose of this study was to examine factors that contribute to adverse incidents that occur during hospitalization by creating a model that included patient characteristics , clinical conditions , nursing unit context of care variables , medical treatments , pharmaceutical treatments , and nursing treatments .
the research question addressed in this... | the purpose of this study was to examine factors that contribute to adverse incidents by creating a model that included patient characteristics , clinical conditions , nursing unit context of care variables , medical treatments , pharmaceutical treatments , and nursing treatments .
data were abstracted from electronic , administrative , and clinical data repositories .
the sample included older adults hospitalized during a four - year period at one , academic medical facility in the midwestern united states who were at risk for falling .
relational databases were built and a multistep , statistical model building analytic process was used . total registered nurse ( rn )
hours per patient day ( hppd ) and hppds dropping below the nursing unit average were significant explanatory variables for experiencing an adverse incident . the number of medical and pharmaceutical treatments that a patient received during hospitalization as well as many specific nursing treatments ( e.g. , restraint use , neurological monitoring ) were also contributors to experiencing an adverse incident . |
6,432 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: therefore , action must be taken immediately to diagnose and treat such intracranial complications before irreversible tissue damage has occurred , and both physicians and patients at putative risk should be aware . here , a case of sinusitis originating from an odontogenic focus leading to severe subdural empyema with subsequent neurological sequelae
a 45yearold man was admitted to the ophthalmological department with a periorbital swelling so severe it disabled him to open his left eye .
he was overweight ( bmi = 28 ) , without any known diabetes , was a smoker , and was undergoing treatment for rheumatoid arthritis ( ra ) ; methotrexate tablets ( 25 mg / week ) . at the time of admission the patient was febrile ( 38.7c ) and his state of consciousness was moderately affected . on inspection
the left periorbital region showed massive swelling ; the skin was warm , red , and sore ; and the left pupil was vaguely responsive equaling a small relative afferent pupillary defect .
the vital signs were as follows : pulse , 103 beats / min ; respiration , 16 breaths / min ; blood pressure , 118/71 mmhg ; hemoglobin , 7.3 gm / dl ; white blood cell count , 18.5 10/l ; neutrophils , 15.6 10/l ; creactive protein ( crp ) , 298 meq / l ; procalcitonin , 12.1 meq / l ; potassium , 3.3 meq / l ; and sodium , 133 meq / l . after ophthalmic examination a computed tomography ( ct ) scan of the orbit was performed and showed left orbital inflammation interpreted as postseptal cellulitis , exophthalmos , and
these findings led to the performance of an acute canthotomy in an effort to save the patient 's vision on the left eye . computed tomography scan in the axial plane showing exophthalmos and dirty fat ( arrow ) on the left eye . on the same day
large amounts of pus were evacuated from the left ethmoidal , frontal , and maxillary sinuses , and only a limited volume was present in and removed from the periorbita . simultaneously
two teeth ( 10 , 14 ) were extracted due to apical periodontitis with pus under pressure .
the... | key clinical messagesubdural empyema is a rare but potentially lifethreatening complication to sinusitis .
awareness of infection and early diagnosis is of the essence when dealing with a putatively immunosuppressed patient .
furthermore , patients at increased risk of infections due to immunosuppression need to be fully informed of risks associated with their treatment . |
6,433 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: establishing good communication , either verbal or nonverbal , with patient is an essential and important component to develop a good doctor - patient relation .
face - to - face interaction ( including facial expressions and eye contact ) , expressive touch , body language , paralinguistics ( vocal communication which is discrete from actual language ) , interpersonal proximity , physical appearance , and eloquent gestures all make verbal conversation more expressive and meaningful .
evidence shows that physician 's nonverbal behavior leads to higher patient satisfaction , but this is affected by a number of factors , including gender of the doctor as well as of the patient [ 3 , 4 ] .
a study , from switzerland , showed both male and female doctors should display different set of nonverbal behavior to maximize patients satisfaction .
nonverbal communication has been shown to be important in dealing with pediatric age groups and with those recovering from disabilities [ 79 ] .
eye contact and physical touch are commonly used as effective tools in nonverbal communication [ 1 , 10 ] .
general practitioners may feel reluctant to use touch other than procedural touch , because of the fear of misinterpretation of such behavior however , many patients believe that , particularly in distressing situations , expressive touch is acceptable .
a study conducted in canada on female patients concluded that , as compared to males , females were more tolerant of comforting touch .
eye contact is another important nonverbal behavior and is especially essential for building good rapport with elderly individuals .
it is mostly taken as a sign of respect , care , and attention from a doctor . however
, if eye contact is coupled with attentive listening it inclines the interaction towards more patient - centered communication . nowadays , the use of computers and especially the electronic health records ( her ) , during medical interviews , is a big obstacle in using eye contact as an effective way to communicate .
we... | background . nonverbal behaviors have a significant impact on patients during consultations .
this study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians , in a tertiary care hospital .
methods .
a questionnaire based cross - sectional study was carried out at the aga khan university hospital , karachi , pakistan , during the months of january to march 2012 .
all patients ( > 18 years of age ) coming for consultancy in the family medicine clinics were approached ; out of 133 , 120 agreed to participate .
the subjects were asked questions regarding physician 's comforting touch and eye contact and their responses were noted .
the data were analyzed using spss and chi - square test was used to identify corelations . results .
overall , 120 patients were enrolled .
about 58.3% were men and 41.7% were women with a mean age of 34.9
10.9 years .
95.8% were muslims and 57.6% had more than 12 years of education . among females 74% wanted supportive touch from doctors , used to comfort the patient ( 45% ) or to show respect ( 27.5% ) or as healing ( 30% ) .
86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his / her patient .
the eye contact should be brief but regular ( 54.1% ) and prolonged staring ( 36.7% ) makes them uncomfortable .
conclusion .
nonverbal communication helps to strengthen the doctor - patient relation as patients do appreciate positive touch and eye contact from their physicians . |
6,434 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: ischemic colitis usually develops due to arteriosclerosis , diabetes , hypovolemic shock , portal hypertension , malignant tumors , pancreatitis , or colonic obstruction .
it is very common in elderly people.1 phlebosclerotic colitis ( pc ) is a rare form of ischemic colitis that develops as a result of mesenteric venous calcification and calcification in the invaded colonic submucosal layer.23 pc is usually observed in the colons of elderly men.4 a young woman without any underlying diseases visited our hospital owing to abdominal pain .
colonoscopy revealed edematous dark - bluish colonic mucosa , a sclerotic colon wall , and multiple ulcers without clear boundaries from the ascending colon to the transverse colon .
the edematous dark - bluish colonic mucosa and sclerotic colon wall were observed only in the sigmoid colon .
abdominopelvic computed tomography ( ct ) revealed linear calcification on the colon wall from the terminal ileum to the transverse colon .
arterial phase superior mesenteric angiography revealed an irregular and convoluted marginal artery and vasa recta .
, we report a case of pc that showed symptomatic improvement with conservative treatment only .
a 36-year - old woman visited our hospital with a major complaint of acute pain in her lower right abdomen .
she had no history of tobacco , alcohol , or herbal medicine use , underlying diseases such as hypertension or diabetes , and surgery .
her vital signs were as follows : blood pressure , 100/70 mm hg ; pulse , 98 beats per minute ; respiratory rate , 18 breaths per minute ; and body temperature , 36.6. physical examination revealed mild oppressive pain and rebound tenderness in the lower right abdominal area .
peripheral blood examination yielded the following results : white blood cell count , 16,700/mm hemoglobin level , 14.0 g / dl ; platelet count 340,000/mm ; and neutrophil proportion , 91.1% .
biochemical testing revealed the following levels : aspartate aminotransferase / alanine aminotransferase , 21/14 iu / l ; total protein... | phlebosclerotic colitis is a rare disease of intestinal ischemia and differentiating it from the typical ischemic colitis .
it is caused by venous obstruction due to colonic and mesenteric venous calcification .
we report a 36-year - old woman presenting with intermittent abdominal pain .
initial radiologic findings showed multiple tortuous thread - like calcifications in the region of the right side of the colon and transverse colon on plain abdominal radiographs and computed tomography images . in the colonoscopy ,
edematous dark - bluish colonic mucosa , sclerotic colon wall , and multiple ulcers without clear boundaries were observed from the ascending colon to the transverse colon . in the sigmoid colon only showed the edematous dark - bluish colonic mucosa , sclerotic colon wall .
on the basis of these findings , we diagnosed the patient as having phlebosclerotic colitis .
we report a rare case of phlebosclerotic colitis in healthy young woman . |
6,435 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: soft tissue sarcomas are rare tumors ( 1% of all adult malignancies ) with a dismal prognosis .
approximately 70% of sarcomas occur in the extremities ( 49% in the lower and 19% in the upper limbs ) , while the remaining 30% occur in the trunk , abdomen or retroperitoneum ( 1,2 ) . among the most common histological types of sarcomas of the extremities , malignant fibrous histiocytoma ( mfh )
is the one exhibiting the highest incidence , followed by liposarcoma , fibrosarcoma and neurofibrosarcoma , with a peak incidence in the sixth decade of life . according to the world health organization 2002 classification of soft tissue tumors ( 3 )
, mfh may be categorized into three morphological subtypes : i ) storiform - pleomorphic mfh ( undifferentiated high - grade pleomorphic sarcoma ) ; ii ) giant - cell mfh ( undifferentiated pleomorphic sarcoma with giant cells ) ; and iii ) inflammatory mfh ( undifferentiated pleomorphic sarcoma with prominent inflammation ) ( 3 ) .
mfh is also considered by the american joint committee on cancer to be a high - grade sarcoma by definition and , therefore , exhibiting high local aggressiveness .
the typical histological appearance of mfh is that of a hypercellular neoplasm , with marked nuclear and cytological pleomorphism , bizarre appearance of stromal cells and a fascicular or storiform model growth ( 4 ) .
the presence of a lesion suspicious for soft tissue sarcoma should prompt the surgeon to perform diagnostic - instrumental tests .
x - ray may reveal ectopic calcifications in the surrounding tissues ( 520% ) , sclerosis or clear erosion of adjacent bone due to tumor compression .
magnetic resonance imaging ( mri ) may reveal a lobulated mass , with intermediate signal in both t1 and t2 images ( 5,6 ) .
there are also frequent intracapsular areas of tumor necrosis and hemorrhage , which are occasionally so extensive that the tumor is mistakenly diagnosed as hematoma of the soft tissues ( 7 ) .
a correct surgical approach is crucial in several tumors , as previously... | soft tissue sarcomas are rare tumors with a dismal prognosis . among the most common histological types of sarcomas of the extremities , malignant fibrous histiocytoma ( mfh )
is the one with the highest incidence .
surgery is considered to be the first choice of treatment for mfh . to the best of our knowledge ,
this is the first case report in the literature of a patient with mfh within the abductor pollicis longus ( apl ) muscle .
this unusual location was also unexpected by the treating surgeons , as the preoperative magnetic resonance imaging localized the tumor inside a different muscle . a 79-year - old caucasian man presented with a swelling in the middle third of the dorsal aspect of the left forearm .
mfh was diagnosed following biopsy and instrumental diagnostic examinations . surgical excision and simultaneous reconstruction
was performed by the same microsurgical team , achieving an excellent functional outcome .
the present case highlights the significance of microsurgical approach for improving strategic planning in oncologic surgery .
accurate surgical dissection , performed by a team of microsurgeons , allowed for the identification of the unusual and unexpected tumor localization within the apl muscle . for this reason , a change of surgical strategy allowed for preservation of the extensor digitorum communis muscle , which would otherwise have to be resected , with tendon transfer and successful restoration of the thumb abduction function . |
6,436 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
nevus depigmentosus is a hypomelanotic condition which is usually refractory to medical modalities of treatment.a few cases of surgical repigmentation have been reported.one case report from south korea described the recurrence of hypomelanosis at the surgically treated site after eight years .
nevus depigmentosus is a hypomelanotic condition which is usually refractory to medical modalities of treatment .
one case report from south korea described the recurrence of hypomelanosis at the surgically treated site after eight years .
nevus depigmentosus ( nd ) is a rare , congenital , stable hypomelanosis first described by lesser in 1884 .
the lesions usually present as dermatomal or quasidermatomal macules commonly on the trunk , lower abdomen , or proximal extremities .
they are off - white in colour and have irregular , serrated , feathered , or geographic margins .
the face , when involved , is a cause of social embarrassment for the patient . unfortunately , there is no effective treatment for this condition .
here we report a patient of nd treated successfully with suction blister grafting , in whom the pigment has been well maintained even after 10 years .
a 15-year - old female student presented with a hypopigmented asymptomatic macule on the left half of the upper lip [ figure 1 ] slightly extending to the left cheek , since birth .
examination of other areas of the skin did not reveal any similar lesions or any other type of skin lesions and the other systems particularly the skeletal and nervous system were within normal limits .
her investigation revealed normal blood counts ; liver function test ( lft ) , renal function test ( rft ) , clotting profile , and test for hiv were negative .
nevus depigmentosus distributed on the left half of the upper lip with extension to the chin in march 2002 , suction blister grafting was performed on her after taking informed consent .
multiple blisters were raised on the left thigh using a suction blister technique described by gupta et al .
then , the blister... | nevus depigmentosus is a congenital hypomelanotic condition for which no effective treatments are available .
the hypopigmentation is permanent and enlarges in proportion with growth in the person . here
, i report a patient of nevus depigmentosus on whom we performed suction blister grafting and the resultant pigmentation was satisfactory even at a follow - up after 10 years . |
6,437 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in bone , endogenous nucleotides , such as atp and utp , are released from many types of cells , including bone cells [ 1 , 2 ] .
nucleotides are released in response to a number of stimuli including inflammation [ 3 , 4 ] and mechanical stimulation [ 57 ] .
they act as autocrine and paracrine signaling molecules by activating purinergic ( p2 ) receptors .
bone cells express several types of p2 receptors , allowing them to respond differently to nucleotides , depending on the types of nucleotide present , their concentration , and the duration of exposure [ 8 , 9 ] .
the p2x7 receptor subtype is probably one of the most important p2 receptors in the regulation of bone turnover .
it is most abundant in cells of haematopoetic origin , including osteoclasts [ 8 , 11 ] , but also in osteoblasts that are of mesenchymal origin [ 1214 ] .
several roles of p2x7 have been suggested including atp - induced apoptosis [ 12 , 15 , 16 ] , maturation of interleukin-1 , and its subsequent release .
low agonist concentrations lead to low - level activation of p2x7 receptors and might initiate osteoclast formation through activation of pathways initiating production of transcription factors [ 18 , 19 ] . prolonged exposure to high agonist concentrations
induces the formation of large pores in the membrane , permeable to hydrophilic molecules as large as 900 da [ 20 , 21 ] .
p2x7 receptors are expressed in both osteoclast precursors and active osteoclasts [ 8 , 11 , 22 ] .
therefore , in addition to activating the apoptotic pathway , the p2x7 receptor could play a role in osteoclast development [ 23 , 24 ] and activation . to further explore the role of the p2x7 receptor in the regulation of the skeletal system , the bone phenotype of two mouse models with ablation of the p2x7 receptor was examined [ 13 , 22 , 26 ] .
. showed reduced total bone mineral content ( bmc ) , decreased periosteal bone formation , and increased bone resorption , which resembles the effects of disuse on the skeleton . in line with this
the effects... | the purinergic p2x7 receptor is expressed by bone cells and has been shown to be important in both bone formation and bone resorption . in this study we investigated the importance of the genetic background of the mouse strains on which the p2x7 knock - out models were based by comparing bone status of a new balb / cj p2x7/ strain with a previous one based on the c57bl/6 strain .
female four - month - old mice from both strains were dxa scanned on a piximus densitometer ; femurs were collected for bone strength measurements and serum for bone marker analysis .
bone - related parameters that were altered only slightly in the b6 p2x7/ became significantly altered in the balb / cj p2x7/ when compared to their wild type littermates .
the balb / cj p2x7/ showed reduced levels of serum c - telopeptide fragment ( s - ctx ) , higher bone mineral density , and increased bone strength compared to the wild type littermates . in conclusion , we have shown that the genetic background of p2x7/ mice strongly influences the bone phenotype of the p2x7/ mice and that p2x7 has a more significant regulatory role in bone remodeling than found in previous studies . |
6,438 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: we ascertained subjects with lada and type 2 diabetes from the lada china multicenter study ( 46 hospitals throughout china contributed ) ; type 1 diabetes , defined by who criteria ( 4 ) , from the type 1 diabetes collaboration net ( 18 hospitals in hunan province ) ; and normal subjects were screened by 75-g oral glucose tolerance test from 5,000 chinese in a population - based study .
definition of lada ( 57 ) was 1 ) gad antibody ( gada ) positive , 2 ) age > 30 years at diagnosis , 3 ) independence from insulin treatment 6 months postdiagnosis , and 4 ) without ketoacidosis .
subjects with hs - crp > 10 mg / l or taking anti - inflammatory drugs within 3 months were excluded .
metabolic syndrome was defined by national cholesterol education program - adult treatment panel iii criteria ( 8) .
this study was approved by ethics committees at second xiangya hospital of central south university and at each center and conducted according to the declaration of helsinki .
height , weight , waist circumference , hip circumference , and blood pressure were recorded locally , and fasting sera samples were processed centrally .
elisa determined high - sensitivity il-6 ( il-6 hs ; r&d systems , minneapolis , mn ) , 7% intraassay and 5% interassay coefficient of variation ( cv ) ; lcn2 ( 10 ) , 3.86.0% intraassay and 3.15.2% interassay cv ; adiponectin ( 11 ) 56% intraassay and 68% interassay cv .
hs - crp was measured by immunoturbidometric assay ( orine diagnostica ) with 2.13.3% intraassay and 3.44.6% interassay cv .
we used spss ( version 13 ; spss , chicago , il ) for statistical analysis .
data are expressed when normally distributed as means sd and when skewed as median ( 25th75th percentiles ) .
we used a general linear model of univariate analysis adjusted for age , sex , and bmi ; log - transformed cytokine value was the dependent variable , different diabetes groups were fixed , and age , sex , and bmi were covariates ( fig .
multivariate regression models investigated differences in log - transformed... | objectiveto determine the relationship between selected cytokines and diabetes in chinese subjects.research design and methodsadult patients with recent - onset type 1 diabetes ( n = 53 ) , latent autoimmune diabetes in adults ( lada ) ( n = 250 ) , and type 2 diabetes ( n = 285 ) from multiple centers were compared with normal subjects ( n = 196 ) .
we centrally tested serum gad antibodies ( gadas ) , interleukin-6 ( il-6 ) , lipocalin 2 ( lcn2 ) , high - sensitivity c - reactive protein ( hs - crp ) , and adiponectin.resultsafter adjustment for age , sex , and bmi , all diabetes types had increased il-6 and lcn2 ( p < 0.01 ) , and all four cytokines were increased in lada ( p < 0.01 ) . in type 1 diabetes , adiponectin but not hs - crp was increased ( p < 0.01 ) , whereas in type 2 diabetes , hs - crp but not adiponectin was increased ( p < 0.01 ) .
adiponectin was correlated positively with gada titer and negatively with hs - crp ( p < 0.01 for both).conclusionsin china , inflammatory markers are increased in all three major types of diabetes , but probably for different reasons , even in autoimmune diabetes . |
6,439 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: azathioprine is a prodrug of the purine mimic antimetabolite , 6-mercaptopurine , widely used in various autoimmune diseases and organ transplantation .
little is known about the pathogenesis and epidemiology of azathioprine - induced cholestatic hepatitis , a rare but dramatic iatrogenic complication .
a 73-year - old man presented to the emergency department at a tertiary center in south india with fever , vomiting , pruritus , and dark urine for seven days . before six weeks
graft rejection was subsequently diagnosed and 15 days prior to the presentation , he was started on azathioprine 50 mg and prednisone 40 mg once daily .
past medical history revealed chronic bronchitis , essential hypertension , dyslipidemia , and left ventricular diastolic dysfunction for two years .
the patient was on aspirin , atorvastatin , losartan , hydrochlorothiazide , and inhaled salmeterol plus fluticasone , ipratropium and salbutamol medications for the past two years with no history of adverse drug events or allergies .
examination revealed temperature 100.4f , pulse rate 100/min , blood pressure 106/70 mm hg , and respiratory rate 20/min .
cholangitis , sepsis with cholestasis , acute hepatitis ( of viral , drug or autoimmune aetiology ) , and systemic febrile illnesses like malaria , leptospirosis , and scrub typhus were considered as differential diagnosis .
investigations revealed conjugated hyperbilirubinemia , elevated transaminases and alkaline phosphatase , prolonged prothrombin time , and bilirubinuria [ table 1 ] .
blood smears for plasmodium and complete blood counts were unremarkable except for mild eosinophilia ( 549 cell/l ) .
blood cultures , hepatitis b surface antigen ( hbsag ) and serology for hepatitis a , c and e , human immunodeficiency virus , scrub typhus , and leptospirosis were negative .
the patient was discharged after 72 hours of intravenous antibacterials . selected serial hematologic and biochemical parameters
thirty - five days later , he again presented with persisting low - grade fever ,... | we report a case of cholestatic hepatitis developed one week after exposure to azathioprine .
the subsequent prolonged cholestatic phase was followed by full clinical remission .
current knowledge on pathogenesis and epidemiology and the diagnostic challenges presented by this rare complication are discussed , followed by recommendations for monitoring and management . |
6,440 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nocturia is defined as waking one or more times to void during the period between going to bed with the intention of sleeping and waking with the intention of arising ( 1 , 2 ) .
recent multinational population - based , cross - sectional survey ( epic ) of adults aged 18 yr using 2002 international continence society ( ics ) definitions showed overall prevalence of any lower urinary tract symptoms ( luts ) was 62.5% in men and 66.6% in women and nocturia ( 2 times / night ) was the most commonly reported storage symptom for both men ( 20.9% ) and women ( 24.0% ) ( 3 ) .
similarly , the epidemiological data in adult korean aged 40 - 89 yr national community showed that of 2005 subjects interviewed , 33.5% reported voiding once per night and 48.2% twice or more per night and in addition , the impact of nocturia on daily life was reported by 14.6% of subjects ( 4 ) .
nocturia is associated with sleep disruption and consequently impairs the quality of life ( qol ) and potentially increases mortality ( 5 , 6 ) .
although this condition should be evaluated and treated , it has only recently been recognized as a clinical entity in its own right , rather than just one of the features of luts .
relatively few patients with nocturia seek medical care because of a lack of awareness or misconceptions about nocturia .
furthermore , there is a general lack of knowledge about treatment options for nocturia ( 4 , 7 , 8) . because the pathophysiology of nocturia is multifactorial and complex , it is important to adopt a systematic approach to identify the possible causal factors of nocturia and to treat them accordingly .
patients with nocturia can be categorized as having one of the following three disorders : ( 1 ) nocturnal polyuria ( np ) in which the voided urine volume during the hours of sleep exceeds 33% of the 24-hr output ( 2 ) , decreased nocturnal bladder capacity ( nbc ) , which results in a nocturnal urinary volume greater than the maximum voided volume ( mvv ) , ( 3 ) or mixed nocturia , a combination of the... | to investigate the efficacy and safety of desmopressin in patients with mixed nocturia , patients aged 18 yr with mixed nocturia ( 2 voids / night and a nocturnal polyuria index [ npi ] > 33% and a nocturnal bladder capacity index [ nbci ] >
1 ) were recruited .
the optimum dose of oral desmopressin was determined during a 3-week dose - titration period and the determined dose was maintained for 4 weeks .
the efficacy was assessed by the frequency - volume charts and the sleep questionnaire .
the primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids ( nv ) compared with baseline . among 103 patients enrolled , 94 ( 79 men and 15 women ) were included in the analysis .
the proportion of patients with a 50% or greater reduction in nv was 68 ( 72% ) .
the mean number of nv decreased significantly ( 3.20 to 1.34 ) and the mean nocturnal urine volume , nocturia index , npi , and nbci decreased significantly .
the mean duration of sleep until the first nv was prolonged from 118.444.1 to 220.390.7 min ( p<0.001 ) .
the overall impression of patients about their quality of sleep improved .
adverse events occurred in 6 patients , including one asymptomatic hyponatremia .
desmopressin is an effective and well - tolerated treatment for mixed nocturia . |
6,441 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 38-year - old female from puerto rico with complaints of hypoxia was transferred to our facility .
she had been diagnosed 5 years earlier with hermansky - pudlak syndrome ( hps ) subtype 1 , complicated by pulmonary fibrosis .
she had experienced a slow deterioration in pulmonary function , manifesting as worsening dyspnea , cough , and increasing oxygen dependence .
in addition to pulmonary fibrosis , she had other manifestations of hps , including multiple major bleeding episodes requiring blood transfusions , and oculocutaneous albinism with legal blindness .
she required 24 h supplemental home oxygen with a baseline flow requirement of 6 l / min via nasal cannulae and was under evaluation for lung transplantation prior to her terminal hospital admission .
pulmonary function tests [ table 1 ] showed increasing severe restrictive ventilatory deficit over the 2 years prior to admission , with total lung capacity going from 64% in 2010 to 57% in 2011 and 44% in 2012 .
pulmonary function test results over a course of 2 years revealing progressive worsening of restrictive ventilatory deficit the patient presented with increasing dyspnea , pleuritic chest pain , and cough .
she was transferred to the intensive care unit due to hypoxia , with an oxygen saturation of 44% on 6 l nasal cannula .
she was started on empiric antibiotics and supported with noninvasive ventilation , but continued to desaturate and was subsequently intubated .
the patient developed multiorgan failure as evidenced by elevated creatinine , transaminitis , and right heart failure .
blood and urine cultures on admission were negative , and white blood cell count was normal at 10.9 10 cells / l .
chest x - ray upon terminal admission demonstrated diffuse reticular interstitial opacities throughout the lungs [ figure 1 ] .
baseline ct of the chest obtained 16 months [ figure 2a ] and 3 months before admission [ figure 2b ] demonstrated progressive worsening of pulmonary fibrosis , as evidenced by increasing traction bronchiectasis ,... | hermansky pudlak syndrome ( hps ) is a rare autosomal recessive disorder characterized by oculocutaneous hypopigmentation , platelet dysfunction , and in many cases , life - threatening pulmonary fibrosis .
we report the clinical course , imaging , and postmortem findings of a 38-year - old female with hps - related progressive pulmonary fibrosis , highlighting the role of imaging in assessment of disease severity and prognosis . |
6,442 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the incidence rates of oral cancer are 3.7% for men
and 2.6% for women in the sudan .
several lifestyle risk factors
for the development of oral cancer are familiar , including tobacco products , alcohol ,
infections , dietary factors , chemical irritants and frank carcinogens .
prevalence
of oral cancer is 3.2% in sudan and the disease is mainly attributed to n - nitrosamine
rich oral snuff consumption .
there are mainly 4 smokeless tobacco products : loose
leaf or chewing tobacco , snuff , plug tobacco and twist or roll tobacco .
chewing
tobacco and snuff are by far the most widely distributed types of smokeless tobacco .
however , snuff is now
habitually used orally by insertion it between lower gum and cheek or lip ( dipping )
.
the oral use of snuff in north america and western
europe is causally associated with an increased risk for cancer of the oral cavity
and pharynx .
snuff dipping has also been incriminated as being associated with cancer
of the nasal cavity , oesophagus , pancreas , kidney and urinary bladder [ 2 - 6 ] ,
and other pre - neoplastic changes such as leukoplakia
. however , all these risk factors are beyond the scope
of the present review .
the main goal of this paper was to review the studied risk
factors that linked to aetiology of oral cancer in sudan .
in this review 33 studies published up to august
2012 in the aetiology of oral cancer from sudan were included .
they were identified
through searches of the medline database , using the keywords : " sudan " , " toombak " ,
" infection " , " hpv " , " oral hygiene " , " alcohol " , " hot meals " , " cancer " , " oral squamous
cell carcinoma " and " risk factors " .
papers were also searched among those quoted
as references in the retrieved studies , as well as , in a few previous reviews . only
papers in english were considered .
in the sudan , oral snuff , known locally as toombak ,
is home - made from finely ground leaves of nicotiana rustica , a tobacco species with
a particularly... | abstractobjectivesto review the studied risk factors that
linked to aetiology of oral cancer in the sudan .
there have been numerous reports
in the increase in the incidence of oral cancer from various parts of the world .
a recent trend for a rising incidence of oral cancer , with the absence of the well
established risk factors ,
has raised concern .
although , there are inconsistent data
on incidence and demographical factors , studies suggest that the physiologic response
to risk factors by men and women vary in different populations.material and methodsthis review principally examines
33 publications devoted to aetiology of oral cancer in the sudan , in addition to
some risk factors that are commonly practiced in the sudan.resultsseveral studies examining risk factors for
oral cancer include tobacco use ( smoked and smokeless ) , alcohol consumption , occupational
risk , familial risk , immune deficits , virus infection and genetic factors.conclusionstoombak use and infection with high
risk human papilloma virus ( hpv ) were extensively investigated and linked to the
aetiology of oral cancer in sudan . |
6,443 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: understanding how the vertebrate nervous system develops from the embryonic ectoderm has been one of the most intensely investigated developmental processes .
the process of neural induction was discovered by hans spemann and hilde mangold ; when dorsal mesoderm was transplanted adjacent to ventral ectoderm that normally would give rise to skin instead it formed a neural tube ( spemann and mangold , 1923 , reprinted 2001 ) .
this result was interpreted to mean that dorsal mesoderm releases a signaling factor that converts the adjacent ectoderm into neural tissue . while the identity of this signal was sought for decades , only in recent years
have we come to appreciate the signaling and transcription factors that mediate neural induction and control neural differentiation .
recently it has been possible to place these factors in a gene regulatory network that controls the progression of cells from newly induced neural precursors , to proliferative , multipotent neural plate stem cells , to specified neural progenitors .
these early steps of neural development are critical for producing a pool of multipotent cells that later give rise to the multitude of neurons and glia in the central nervous system that have diverse and distinct functions , and are selectively affected in a number of human neurodegenerative diseases . research to produce a population of cells in vitro that recapitulate the differentiated progeny seen in the intact nervous system has defined a neural stem cell ( nsc ) , which is a self - renewing cell whose progeny can produce neurons , oligodendrocytes and astrocytes ( fujita , 2003 ) . in the embryonic neural tube these cells reside in the ventricular zone ( or subventricular zone in the developing cerebral cortex ) , and in both the embryo and in nsc cultures , these cells are activated to produce new progeny by the integration of a number of signaling pathways , such as sonic hedgehog , bmp , wnt/catenin , notch , and fgf ( fig . 1 ; brault et al . , 2001 ;
, 2008 ; mizutani et al . ,... | the early steps of neural development in the vertebrate embryo are regulated by sets of transcription factors that control the induction of proliferative , pluripotent neural precursors , the expansion of neural plate stem cells , and their transition to differentiating neural progenitors .
these early events are critical for producing a pool of multipotent cells capable of giving rise to the multitude of neurons and glia that form the central nervous system . in this review
we summarize findings from gain- and loss - of - function studies in embryos that detail the gene regulatory network responsible for these early events .
we discuss whether this information is likely to be similar in mammalian embryonic and induced pluripotent stem cells that are cultured according to protocols designed to produce neurons .
the similarities and differences between the embryo and stem cells may provide important guidance to stem cell protocols designed to create immature neural cells for therapeutic uses . |
6,444 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a total of 20 sedentary heart transplant recipients ( 18 men , 4911 years ) , 11 sedentary heart failure patients ( 8 men , 4310 years ) , and 7 sedentary healthy subjects ( 5 men 398 years ) were included in this study .
heart transplant recipients and heart failure patients with atrial fibrillation , a pacemaker , and noncardiovascular functional limitations like osteoarthritis were excluded from this study .
heart failure patients whose drug therapy was not optimized were also excluded from this study .
optimization was considered 50 mg / day or more of carvedilol for at least 3 months.18 healthy subjects did not have any risk factors for cardiovascular disease or noncardiovascular functional limitations .
this protocol was approved by the ethics committee of the heart institute , incor hcfmusp .
all patients were asked to refrain from both strenuous physical activity and the consumption of any stimulants ( eg , coffee , tobacco , alcohol ) 24 hours prior to the 6cwt .
the patients last meal was ingested at least 2 hours before the start of the test . before starting the 6cwt and blood sample collection
the 6cwt using the borg scale was performed on a treadmill with zero inclination and patient - controlled speed in a temperature - controlled room ( 2123c ) in the afternoon ( between 13:00 hours and 15:00 hours ) .
all patients were advised to keep walking during the test at a pace between relatively easy and slightly tiring ( between 11 and 13 on the borg scale ) .
the distance walked was recorded by the treadmill microprocessor ( series 2000 , marquette electronics , milwaukee , wi , usa ) .
encouragement was standardized with phrases like if you can walk faster , increase the speed ,
you are doing very well , and if it is tiring , you can reduce the speed .
blood pressure was measured at rest and at the sixth minute by the auscultation method .
the electrocardiography ( max 1 , marquette electronics ) , ventilatory and gas exchange variables were continuously evaluated breath - by - breath by a... | objective : we sought to evaluate the neurohormonal activity in heart transplant recipients and compare it with that in heart failure patients and healthy subjects during rest and just after a 6-minute walking test.introduction:despite the improvements in quality of life and survival provided by heart transplantation , the neurohormonal profile is poorly described.methods:twenty heart transplantation ( 18 men , 4911 years and 8.53.3 years after transplantation ) , 11 heart failure ( 8 men , 4310 years ) , and 7 healthy subjects ( 5 men 398 years ) were included in this study .
blood samples were collected immediately before and during the last minute of the exercise.results:during rest , patients norepinephrine plasma level ( 659225 pg / ml ) was higher in heart transplant recipients ( 463167 pg / ml ) and heathy subjects ( 512132 ) , p<0.05 .
heart transplant recipient s norepinephrine plasma level was not different than that of healthy subjects . just after the 6-minute walking test , the heart transplant recipient s norepinephrine plasma level ( 1248692 pg / ml ) was not different from that of heart failure patients ( 1174653 pg / ml ) .
both these groups had a higher level than healthy subjects had ( 54595 pg / ml ) , p<0.05.conclusion : neurohormonal activity remains increased after the 6-minute walking test after heart transplantation . |
6,445 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: we do not understand yet why some patients develop multiple myeloma and others a single plasmacytoma 1 , 2 , but that might be related to differences in the chemokine receptor expression profiles of the malignant plasma cells or cellular adhesion molecules 3 .
solitary extramedullary plasmacytomas ( sep ) are extremely rare tumors that arise outside of the bone marrow in the absence of any sign of multiple myeloma 4 , 5 .
they are solitary lesions , and are often seen in the head and neck regions 6 , 7 , mainly in the upper aerodigestive and to a lesser extent in the gastrointestinal tract ( gi ) tract , bladder , central nervous system ( cns ) , thyroid , breast , testes , parotid gland , lymph nodes , as well as in skin .
solitary extramedullary plasmacytomas tends to occur during the fifth and seventh decades of life , rarely in younger population 8 .
extramedullary plasmacytomas ( emps ) can arise in patients with multiple myeloma at any time during the course of the disease and in onethird of the cases , resulting in a worse clinical outcome that should not be confused with sep 9 , 10 .
this particular case involves a 40yearold hispanic male with past medical history of mental retardation , anxiety , and dyslipidemia who lives in a group home .
patient presented initially to his primary care physician ( pcp ) for an annual physical . during routine examination , a neck mass was identified on the base of the lateral right side of the neck anterior of the sternocleidomastoid that measured 3 cm by 3 cm nontender with slight mobility .
he denied any constitutional symptoms such as fever , chills , sweating , weight loss or change in diet or bowel habit , easy bruising , or hoarseness .
patient was referred to ent , and neck soft tissue ct scan with and without contrast was performed which showed enhancing 3.4 2.8 5.2 cm mass right retromandibular region just anterior to the sternocleidomastoid muscle with mass effect pushing the carotid vessels posteriorly with adjacent bony destruction ; metastasis was... | key clinical messageplasma cell neoplasms are characterized by a neoplastic plasma cell lineage which produces a monoclonal immunoglobulin .
these neoplasms can present as a single lesion ( solitary plasmacytoma ) or as multiple lesions ( multiple myeloma ) .
solitary plasmacytomas most frequently occur in bone ( plasmacytomas of bone ) , but can also be found outside bone in soft tissues ( extramedullary plasmacytomas ) . |
6,446 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: upper gastrointestinal bleeding ia a major emergency and represents a major public health problem , its prevalence being 100170:100000 people .
bleeding from esophageal varices is only 511% of all gastrointestinal bleeding and in the u.s .
approximately 30% of patients with compensated cirrhosis have esophageal varices when first diagnosed . in cirrhotic patients ,
life prognosis in a patient with upper gi bleeding from esophageal varices depends on the severity of the bleeding , the hepatic functional reserve ( stage of cirrhosis ) , the extent and location of the varices ( esophageal or gastric ) , their age , the existence of associated diseases and the treatment prescribed .
the aim of this study was to monitor the risk factors that trigger variceal bleeding in cirrhotic patients , to assess the severity of the bleeding and the efficacy of the endoscopic hemostasis techniques , to assess the relapses of bleeding episodes and the mortality rate .
the study was a prospective one , and it was conducted in the period 11.200412.2006 in the
o. fodor regional institute of gastroenterology and hepatology , cluj - napoca ; 273 patients with variceal bleeding underwent upper gastrointestinal endoscopy for diagnosis and treatment in emergency conditions , at the office of digestive endoscopy of the o. fodor regional institute of gastroenterology and hepatology , cluj - napoca ; the study included only patients who had upper gastrointestinal bleeding because of variceal rupture , which was assessed by emergency endoscopic examination , performed within 6 hours of the patient s admission ; after identifying the variceal source of the upper gi bleeding , endoscopic therapy was performed ( elastic ligatures or endoscopic sclerotherapy with hypertonic glucose solution , depending on the possibilities under emergency conditions ) ; during periodical check - ups , the risk factors for variceal bleeding were monitored in cirrhotic patients , along with the efficacy of endoscopic treatment techniques , the relapses of... | objectivesthe aim of this study was to monitor the risk factors that trigger variceal bleeding in cirrhotic patients , assess the severity of the bleeding and the efficacy of the endoscopic hemostasis techniques , as well as the recurrence of bleeding episodes and the mortality rate.materials and methodsthe current study was a prospective one , and it was conducted in the period november 2004 - december 2006 in the
o. fodor regional institute of gastroenterology and hepatology , cluj-napoca.it included 273 patients with upper gastrointestinal bleeding because of variceal rupture , assessed by emergency endoscopy .
the patients included in the study met the clinical , biochemical , endoscopic and ultrasound criteria for liver cirrhosis .
its etiology and staging were documented from the patients observation charts.resultsout of the 273 cases of variceal bleeding there were 255 ( 93.4% ) cases of bleeding from esophageal varices and 18 ( 6.6% ) from gastric varices .
variceal bleeding episodes were more frequent in patients with alcoholic liver cirrhosis ( 51.28% ) .
most patients with variceal bleeding were in child class b or c ( 77% ) .
mortality because of variceal hemorrhage was 2.93% in the study group .
a number of 148 patients were treated by sclerotherapy and 125 patients with elastic ligatures .
bleeding relapses occurred in 65 ( 23.8% ) patients within the study group , 43 men and 22 women .
variceal bleeding relapses were more frequent after sclerotherapy than after elastic ligatures.conclusionsvariceal bleeding occurred more frequently in patients with alcoholic cirrhosis stage child c. in the current study mortality was relatively low .
the treatment of bleeding recurrence is more difficult , hence variceal rupture prevention and application of elastic ligatures represent a therapeutic necessity . |
6,447 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
when ischemic stroke occurs , motor function is one of the most important brain functions to be protected together with language , sensory , visual , and hearing function .
since the most motor cortex and motor neuron pathway are located in the middle cerebral artery territory , infarction of this territory causes contralateral hemiplegia .
therefore , to treat acute cerebral infarction , recanalization of occluded blood vessels should be performed , and neuroprotective therapies that prevent reperfusion injury should be performed . nevertheless ,
if it could not be treated within limited times , neurons could not be restored permanently . in such manners ,
the regeneration capacity of neurons is very low , and thus methods that could substitute neurons are required .
therefore , studies that transplant diverse stem cells to the cerebral ischemic area and induce them to differentiate to neurons or to substitute neuronal function are ongoing .
several studies reported that in adult rats , bmscs transplanted after cerebral infarction accelerated neuroplasticity and facilitated neuronal regeneration as well as functional recovery [ 27 ] . in other words , it has been reported that intravenous injection of bmscs reduced the cerebral infarct volume and improved motor functions , and cerebral infarct size could be reduced noticeably by the injection within 3 hours after mca occlusion ( mcao ) . in addition , one - hour mcao rat models , similarly , when bmscs were injected to the ipsilateral carotid artery immediately after reperfusion , the cerebral infarct volume was reduced and motor function was improved .
all investigators reported that as the cerebral infarct volume became smaller , the neurobehavior was improved more [ 911 ] .
nevertheless , evaluation of the recovery of motor function was conducted with subjective neurobehavioral tests , determined and scored by examiners [ 911 ] .
objective evaluation studies on the recovery of motor function in cerebral ischemic animals... | this study investigated the effect of bone marrow mesenchymal stem cells ( bmscs ) on the motor pathway in the transient ischemic rat brain that were transplanted through the carotid artery , measuring motor - evoked potential ( mep ) in the four limbs muscle and the atlantooccipital membrane , which was elicited after monopolar and bipolar transcortical stimulation .
after monopolar stimulation , the latency of mep was significantly prolonged , and the amplitude was less reduced in the bmsc group in comparison with the control group ( p < .05 ) .
meps induced by bipolar stimulation in the left forelimb could be measured in 40% of the bmsc group and the i wave that was not detected in the control group was also detected in 40% of the bmsc group .
our preliminary results imply that bmscs transplanted to the ischemic rat brain mediate effects on the functional recovery of the cerebral motor cortex and the motor pathway . |
6,448 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: stroke refers to cerebrovascular bleeding and a neural disease caused by nontraumatic
reasons and is accompanied by brain damage or functional loss of lower body muscles on the
paretic side1 , 2 . despite the development of modern medicine , economic growth , and
widening interests in health , its occurrence is increasing quickly due to unbalanced
lifestyles , environmental pollution , and excess stress in fast - paced societies1 , 2 .
it
has been reported that loss of motor ability and balance due to stroke can limit some daily
living activities such as walking and may lead to secondary injury like falls . generally ,
gait in stroke patients
is characterized by reduced gait parameters3,4,5 , and decreased gait function following stroke in particular is known
as the fundamental reason why patients fail to safely return to society6,7,8 .
yang et al.9 reported that because
hemiplegia patients with lesions support more than 60% of the load on the non - paretic limb
during standing , it could result in an asymmetric gait pattern
. they also reported that a
stroke patient group showed lower gait velocity , stride time , stride length , and cadence
compared with a group of healthy elderly .
grasies10 and vattanasilp et al.11 showed that patients with stroke tend to reduce the range of motion
( rom ) of paretic lower limb joints during walking , while fonseca et al.12 reported that increased stiffness of the hip joint can
reduce energy efficiency , which results in limited walking and running movement . in
addition , turnbull et al.13 , who analyzed
the gait cycles of eight elderly hemiplegia patients for ten years , reported that the
patients showed increased double support time and decreased single support time during
walking , indicating that patients tended to walk as slowly and stably as possible to secure
stability .
as reported from previous studies , the predominant characteristic of hemiplegia patients
with stroke is the difficulty with walking due to weakened lower... | [ purpose ] the purpose of this study was to investigate the effects of an 8-week program
of pilates exercise on gait in chronic hemiplegia patients and to determine whether or not
it can be used for rehabilitation in postsrtoke patients . [ subjects and methods ] twenty
individuals with unilateral chronic hemiparetic stroke ( age , 66.1 4.4 yrs ; height , 162.3
8.3 cm ; weight , 67.4 12.3 kg ) participated in this study and were randomly allocated
equally to either a pilates exercise group or a control group . to identify the effects of
pilates exercise , a 3-d motion analysis with 8 infrared cameras was performed .
[ results ]
for the gait parameters , improvements were found in the pilates exercise group for all
variables , and statistical significance was observed for stride length , gait velocity ,
knee range of motion and hip range of motion . for the asymmetry indexes ,
insignificant
improvements were found for all variables in the pilates exercise group .
[ conclusion ] in
conclusion , an 8-week program of pilates exercise had a positive influence on improving
the gait ability of poststroke patients , and the intervention could be applied to
poststroke patients with various levels of physical disability by adjusting the intensity
of training . |
6,449 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: many women use natural health products for relief of menopausal symptoms and perceive these products as safe.phytotherapeutic products for menopausal complaints can contain plants with phytoestrogenic properties.the use of phytoestrogens can be related to endometrial hyperplasia and subsequent vaginal hemorrhage .
several treatment options exist for the treatment of menopausal symptoms in women . the use of hormone - replacement therapy ( hrt ) has decreased substantially after publication of the women s health initiative ( whi ) trial in 2002 [ 13 ] .
many post - menopausal women often perceive phytoestrogens in food supplements as a safer alternative than hrt , because these products are
phytoestrogens represent a diverse group of non - steroidal natural products that have some estrogenic effects and are often marketed as food supplements .
phytoestrogens are secondary metabolites that can mimic or modulate the actions of endogenous estrogens , usually by binding to estrogen receptors ( ers ) .
the three major classes of phytoestrogens found in typical human diets are isoflavones ( such as genistein and daidzein ) , which are concentrated in soybeans and soy products , but are also found in other legumes ; lignans , which are distributed in seeds , whole grains , berries , fruit , vegetables , and nuts ; and coumestans , which are found in broccoli and sprouts .
the flavonoid substance 8-prenylnaringenin ( hopein ) in hop also has phytoestrogenic properties . of all phytoestrogens , 8-prenylnaringenin has the strongest er activity [ 5 , 6 ] . in the period from november 2011
to april 2015 , the netherlands pharmacovigilance centre lareb received seven reports of vaginal hemorrhage caused by endometrial hyperplasia related to the use of the same hop - containing phytotherapeutic product ( menocool ) .
the first three cases were reported by the same gynecologist and published in a dutch medical journal in 2012 . since then , lareb has received four more cases concerning the same association : two from... | two 54-year - old women developed abdominal cramps and vaginal hemorrhage as a result of endometrial hyperplasia during treatment with a hop - containing phytotherapeutic product ( menocool ) for post - menopausal complaints .
the women used the hop - containing phytotherapeutic product ( 418 mg of hop per tablet ) twice daily ( 1 and 0.5 tablets by both patient a and b ) . patient a developed abdominal cramps and vaginal hemorrhage after 2 months of use .
after gynecological examination , she was diagnosed with endometrial hyperplasia .
the patient was treated with a curettage .
the hop - containing phytotherapeutic product was discontinued , and the patient recovered .
patient b developed abdominal pain / cramps and vaginal hemorrhage after 5 months of use .
a cervix smear , internal examination , and ultrasound were performed . due to the thickness of the endometrium , a pipelle endometrial biopsy was performed .
results showed no indication for cervix cancer .
the use of menocool was ceased ; follow - up information received from the patient shortly thereafter indicated that she had almost entirely recovered from the abdominal pain / cramps and vaginal hemorrhage .
hop ( humulus lupulus ) has phytoestrogenic properties that may be the cause of endometrial hyperplasia and subsequent vaginal hemorrhage .
a naranjo assessment score of 5 was obtained for both cases , indicating a probable relationship between the patient s endometrial proliferation and subsequent vaginal hemorrhage and their use of the suspect drug . |
6,450 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: inflammatory bowel disease ( ibd ) , cd , and uc are chronic relapsing inflammatory disorders of the intestine with unknown causes .
ibd develops upon the interaction between genetic predisposition leading to immunological abnormalities , environment , and microbiome .
none of these factors alone are sufficient to induce disease development.1 the occurrence of ibd is increasing in north america , europe , and worldwide.23 the incidence and prevalence of ibd in asia remain low compared with those in western countries , but a rising trend has been recognized in recent years , providing strong evidence in support of the effect of the environment.4567 the characteristics of western and asian patients with ibd differ in epidemiology , phenotype , clinical course , and genetic susceptibility.48910 korea has a relatively small land area and an ethnically homogeneous population .
since the 1960s , when the first ibd cases in korea were reported , the incidence and prevalence of ibd in korea has been lower than that in western countries but have demonstrated rapidly increasing trends .
several distinct characteristics of patients with ibd in korea have been reported , such as thiopurine - induced leukopenia and the risk of opportunistic tuberculosis ( tb ) infection in patients administered tumor necrosis factor- ( tnf- ) inhibitor.111213 these distinct characteristics can provide important clues about etiology and pathophysiology , and comprehensive population - based studies are required to clarify these differences.6 a cohort study is generally useful for estimating the incidence , prevalence , disease course , prognosis , and other clinically distinct features .
cohort studies conducted in western europe and america have described the ibd clinical course and identified its pathophysiology .
some unique features of patients with ibd in korea have been well demonstrated by cohort studies in korea , especially by members of the korean association for the study of intestinal diseases ( kasid ) .
however , most of the... | inflammatory bowel disease ( ibd ) is defined as a chronic and relapsing inflammatory disorder of the intestine . intestinal inflammation in ibd has been proposed to be attributable to the interplay between microbial , genetic , environmental , and immunological factors .
the incidence and prevalence rates of ibd are rapidly increasing apparently in other parts of the world , with dramatic increases especially in east asia .
generally , cohort studies are useful for estimating the incidence , prevalence , natural course , prognosis , and risk factors of diseases . in particular , cohort studies performed in western countries
have well described the prevalence , risk factors , and natural course of ibd and investigated its genetic pathophysiology
. however , the outcomes of ibd cohort studies performed in korea are not as persuasive as those of western studies because of the relatively low prevalence of ibd and short follow - up periods of the cohorts in korea . despite this critical limitation ,
members of the korean association for the study of intestinal diseases have demonstrated outstanding results .
some unique features of ibd patients in korea are well demonstrated , such as thiopurine - induced leukopenia or risks of opportunistic tuberculosis infection in patients receiving tumor necrosis factor- inhibitors . in this review
, the present authors summarized the key points of the results of the cohort studies performed in korea and explored future perspectives . |
6,451 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: breast cancer ( bc ) continues to remain the commonest cause of cancer death in women worldwide .
bc is increasing in regions that until recently had low rates of the disease . in asia , bc incidence peaks among women in their forties , whereas in the united states and europe , it peaks among women in their 60 's .
similarly , in iran , bc is most common cancer among females , which comprising 24.4% of all neoplasms .
the mortality rate of bc was 5.8/100,000 women in tehran in 1998 , 2.5/100,000 for a female population , and 7762 years life lost in the 18 provinces of iran in 2001 .
the latest data on age - specific incidence rate of bc showed that its crude incidence rate and asr are 17.4 and 23.1/100,000 , respectively .
data from the cancer institute show that bc highest rate is occurring in those aged between 35 and 44 years in iran .
it is suggested that bc incidence among iranian females is rising and affects at least one decade earlier than their western counterparts , with a mean age ranging from 47.1 to 48.8 years .
various risk factors for bc have identified , but a positive family history remains among the most important ones established for bc , with first - degree relatives of patients having an approximately two - fold elevated risk .
it is estimated that approximately 20 - 25% of this risk is explained by known bc susceptibility genes , mostly those conferring high risks , such as brca1 and brca2 .
germline mutations in the brca1 ( bc 1 , early onset ) and brca2 ( bc 2 , early onset ) genes are the most important cause of hereditary breast and ovarian cancer .
there is not a direct procedure to estimate the prevalence of brca1/2 mutations in the general population . in the absence of such measurement procedure
, it can be assumed that nearly 50% of the mutations would be in brca1 and 50% in brca2 . since the isolation of these two genes , more than 2000 different mutations have been identified .
the most common types of mutation are attributed to small insertion / deletion frameshift , non -... | background : brca1/2 genes mutation prevalence varies among ethnic groups and may be influenced by founder mutations .
understanding brca1/2 genes mutations is important for reducing breast cancer ( bc ) incidence , accurate risk assessment and counseling .
this systematic review of the literature was conducted to addressing brca1/2 mutations in iranian bc patients.materials and methods : a search for relevant articles was run on before january 2014 using medline , pubmed , science iranian database , google , and web sites related to the study topic .
the key words included : bc and iran with genes , brca genes , brca1 and brca2 ; cancer genes , and iran.results:thirteen articles retrieved from this search strategy were eligible for this review .
the overall brca1 mutation rate for iranian female bc patients was detected 31.8% ( 377/1183 ) .
although this gene mutation rate for male patients is < 0.01% .
eight brca1 mutations ( c. 4837a > g , c. 3419 g > a , c. 3119 g > a , c. 2612c > t , c. 3113a > g , c. 2311 t > c , c. 4301 t > c and c. 4308 t > c in brca1 , and one brca2 mutation ( c. 6494 g > c ) were found in multiple case subjects and represent candidate founder mutations.conclusion:according to these studies , there is heterogeneity in brca mutations in iranian bc patients . |
6,452 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the arterial stiffness is an index of vascular health and has been shown to confer additional independent predictive value for adverse cardiovascular outcomes in patients with uncomplicated essential hypertension as well as in the general population [ 2 , 3 ] .
the measurement of carotid to femoral pulse wave velocity ( pwv ) is considered the gold standard method for arterial stiffness assessment in daily practice because of its easy use , low cost , and high reproducibility .
reference values of pwv come mostly from multicenter registries obtained in asia , usa [ 6 , 7 ] , australia , and europe [ 9 , 10 ]
. however , several studies in latin and hispanic populations have shown significant differences in size , structure , and arterial stiffness of large and small arteries [ 1115 ] .
in addition , there are very few population - based studies that evaluate arterial stiffness from populations of south america [ 16 , 17 ] . at present , there are no reference values of pwv based on healthy normotensive argentinean population studies involving adolescents , young adults , and older people that take into account factors influencing pwv values such aging .
the aims of this work were ( a ) to establish normality values of carotid - femoral pwv in a large cohort of healthy and normotensive population with no cardiovascular risk factor according to age and ( b ) to determine the relationship of carotid - femoral pwv with aging and identify the rate of change of this parameter in a healthy population of a community - based study .
this project was part of an epidemiological study aimed at determining the prevalence of cardiovascular risk factors in a well - characterized population .
the present analysis is a descriptive , observational , and cross - sectional population - based study carried out in healthy people from the population of tandil city .
the first was focused on evaluating cardiovascular risk factors in the elementary , middle , and high school populations ( children and adolescents ) [ 18 , 19 ] .... | in medical practice the reference values of arterial stiffness came from multicenter registries obtained in asia , usa , australia and europe . pulse wave velocity ( pwv ) is the gold standard method for arterial stiffness quantification ; however , in south america , there are few population - based studies .
in this research pwv was measured in healthy asymptomatic and normotensive subjects without history of hypertension in first - degree relatives .
normal pwv and the 95% confidence intervals values were obtained in 780 subjects ( 39.8 18.5 years ) divided into 7 age groups ( 1098 years ) .
the mean pwv found was 6.84 m / s 1.65 .
pwv increases linearly with aging with a high degree of correlation ( r2 = 0.61 ; p < 0.05 ) with low dispersion in younger subjects .
pwv progressively increases 68% with each decade of life ; this tendency is more pronounced after 50 years .
a significant increase of pwv over 50 years was demonstrated .
this is the first population - based study from urban and rural people of argentina that provides normal values of the pwv in healthy , normotensive subjects without family history of hypertension .
moreover , the age dependence of pwv values was confirmed . |
6,453 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the human thumb is opposable and prehensile , making it the most unique digit of the hand , responsible for hand functions , grasp , manual dexterity , and fine motor skills .
the thenar eminence constitutes the intrinsic muscles of the hand that are responsible for complex movements of the thumb .
congenital anomaly of the thumb and/or of the thenar muscles can be quite a disabling condition . in 1979 , arminio was the first to report congenital absence of the flexor pollicis longus ( fpl ) tendon . since then , many cases have been published with congenital absence of the fpl tendon with or without associated anomalies of the thumb and thenar muscles . most of the reports have documented unilateral absence of fpl tendon ; bilateral absence is extremely rare .
only three cases of bilateral congenital absence of fpl tendon have been reported so far ; no thenar atrophy was seen in these cases .
we present a case of a 9-year - old female child with bilateral congenital absence of fpl tendon and associated thumb hypoplasia and thenar eminence atrophy .
a 9 year old female child presented to our hospital with difficulty in performing tasks like writing or holding an object .
there was absence of flexion movement at interphalangeal ( ip ) joints of bilateral thumbs .
local examination revealed minor hypoplasia of the thumbs and absence of dorsal wrinkles [ figure 1a ] and flexion creases [ figure 1b ] at the ip joints of both the thumbs .
minor hypoplasia of both the thumbs and absence of dorsal wrinkles are seen ( arrows ) .
( b ) palmar surface of the hands show absent flexion creases ( arrows ) of bilateral thumbs .
( c ) functional limitation in holding a pen ; note the absence of active flexion of the interphalangeal joints of both the thumbs radiograph of hands showed mild skeletal and soft tissue hypoplasia of bilateral thumbs [ figure 2 ] .
radiograph of both hands shows mild skeletal and soft tissue hypoplasia of bilateral thumbs magnetic resonance imaging ( mri ) of hands showed absence of bilateral fpl... | congenital absence of flexor pollicis longus with or without associated anomalies of thenar muscles and thumb is of rare occurrence .
inability to flex the interphalangeal joint of the thumb and absent dorsal wrinkles and flexion creases of the thumb are important clues to the diagnosis .
routine radiography and cross - sectional imaging help to confirm and document the condition .
this article presents an extremely rare case of bilateral congenital absence of flexor pollicis longus tendon with thumb hypoplasia and thenar atrophy . |
6,454 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nearly 200 cases of calcifying epithelial odontogenic tumor have been reported in literature since pindborg described it as a separate pathologic entity in 1955 .
it has been identified under different denominations , such as , ameloblastoma of unusual type with calcification , calcifying ameloblastoma , malignant odontoma , cystic complex odontoma , and has also been considered as a variant of simple ameloblastoma .
the eponym pindborg tumor was first introduced to the literature in 1967 , to describe this interesting and unique odontogenic tumor .
the calcifying epithelial odontogenic tumor is a benign odontogenic tumor of epithelial origin that accounts for approximately 1% of all odontogenic tumors .
it is more common in the posterior part of the mandible of adults in the fourth to fifth decades .
it is characterized by squamous epithelial cells , calcifying masses , and homogeneous acellular material admixed with the tumor epithelium and stroma that have been identified as amyloid .
the origin of this neoplasm is not clearly known , although it is generally accepted to be derived from oral epithelium , reduced enamel epithelium , stratum intermedium or dental lamina remnants.[13 ] the differential diagnosis for ceot should include adenomatoid odontogenic tumor ( aot ) , calcifying odontogenic cyst ( coc ) , ameloblastic fibro odontoma ( afo ) , odontoma , and in our case amyloidoma .
this article describes a case of ceot involving the left maxilla associated with multiple myeloma in a middle - aged patient .
the correlations between clinical , radiological , and histological patterns are discussed and a brief review of the literature is presented .
a 55-year - old man presented at the ent department of sri ramchandra university with a one - and - a - half year history of painless left nasal swelling .
it was hard in consistency , gradually increasing in size to attain the current size of 4 cm .
he was diagnosed to have multiple myeloma stage iiia in 2004 , for which he underwent chemotherapy for a year... | calcifying epithelial odontogenic tumor ( ceot ) , also known as pindborg tumor , is a rare benign odontogenic tumor of locally aggressive behavior .
it is more common in the posterior part of the mandible of adults , typically in the fourth to fifth decades .
its origin as well as its true malignant potential is not clearly known .
it usually starts as a painless swelling and is often concurrent with an impacted tooth .
a case of ceot in a 55-year - old man with multiple myeloma is presented .
clinical , radiological , and pathologic findings are discussed . |
6,455 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: 24-hour abpm plays an important role in determining cardiovascular prognosis and has been shown to be a better predictor of cardiovascular morbidity and mortality as compared to office blood pressure measurements [ 13 ] .
the objective was to study the relationship between 24 h abpm and cardiovascular outcomes in patients from chesterfield royal hospital .
over 12 months from the 1st of august 2002 , 1187 individuals had 24-hour abpm performed .
these individuals represented a typical spectrum of patients attending for 24 h abpm with blood pressure at different stages and with varying durations of hypertension .
cardiovascular outcomes were studied in a subset ( 297 ) of the original cohort , made up by every 4th consecutive subject .
individuals must have one of the recognized indications for 24-hour abpm , as outlined in table 1 .
every 4th consecutive patient was entered into the study , giving a total of 297 , patients .
table 2 outlines demographics and blood pressure criteria between the original cohort and the study cohort .
clinical case notes to study prognostic information were not available from 52 subjects and they were excluded leaving 245 patients .
the following abpm - related prognostic features were studied ( table 3 ) high day time systolic and diastolic bp ( 135 , 85 mmhg ) , high night time systolic and diastolic bp ( 120 mmhg , 75 mmhg ) , absence of nocturnal dip ( 10% fall in night time sbp ) , high early morning sbp ( 140 mmhg ) , and morning surge ( 20/15 mmhg rise in the first two morning readings from 7 am as compared to average night time bp ) .
the cardiovascular outcomes studied ( table 4 ) included fatal and nonfatal mi , new diagnosis of angina , acute coronary syndrome , sudden cardiac death , cardiac arrhythmias , acute lvf , cerebrovascular events , peripheral vascular disease , abdominal aortic aneurysm , and ckd stage 3 or above .
over a followup period of 2015 116 days ( 17202305 days ) 82 cardiovascular events occurred in 61 subjects... | introduction . 24-hour ambulatory blood pressure monitoring ( abpm ) plays an important role in assessing cardiovascular prognosis , through presence or absence of abpm - related prognostic features . objectives . to study relationship between 24-hour abpm and cardiovascular outcomes in patients from chesterfield royal hospital .
material and methods . over 12 months from the 1st of august 2002 ,
1187 individuals had 24-hour abpm performed .
cardiovascular outcomes were studied in a subset ( 297 ) of the original cohort , made up by every 4th consecutive subject .
the following abpm - related prognostic features were studied high day time systolic and diastolic bp ( 135 , 85 mmhg ) , high night time systolic and diastolic bp ( 120 mmhg , 75 mmhg ) , absence of nocturnal dip ( 10% fall in night time sbp ) , high early morning sbp ( 140 mmhg ) , and morning surge ( 20/15 mmhg ) .
the cardiovascular outcomes studied in the fourth table included fatal and nonfatal mi , new diagnosis of angina , acute coronary syndrome , sudden cardiac death , cardiac arrhythmias , acute lvf , cerbrovascular events , peripheral vascular disease , abdominal aortic aneurysm , and ckd stage 3 or above .
results . over a followup period of 2015
116 days ( 17202305 days ) 82 cardiovascular events occurred in 61 subjects .
cardiac arrhythmias were the most common cv outcome ( 34 events ) followed by cerebrovascular events ( 15 ) .
statistically significant associations found were between cerebrovascular events and absent nocturnal dip 10% ( p = .05 ) and high day time dbp ( p = .029 ) , peripheral vascular disease and morning surge 20/15 mmhg ( p = .014 ) , cardiac arrhythmias and high day time and night time dbp ( p = .009 and .033 , resp . ) .
conclusion .
significant associations were found between cerebrovascular events and absent nocturnal dip 10% and high day time dbp , peripheral vascular disease and morning surge 20/15 mmhg , cardiac arrhythmias and high day time and night time dbp . |
6,456 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acute renal failure ( arf ) is associated with adverse outcomes , especially in children admitted to the pediatric intensive care unit ( picu ) . due to usage of multiple definitions of arf in the literature , causing large variations in the reported incidence and outcome , the term arf was replaced by acute kidney injury ( aki ) recently , to provide the uniformity of definition and standardize the care of patients [ figure 1 ] .
many studies on the incidence of aki in critically ill - children have been conducted in developed countries and are often retrospective in nature . only a few retrospective studies
have been conducted to determine the incidence and profile of aki , in critically ill - children from the developing world in recent years .
this study was performed considering the paucity of data available on the incidence and determinants of aki in indian children and taking into account the retrospective nature of previous studies .
this prospective observational study was conducted over a period of 10 months from june 2010 to march 2011 .
informed consent was obtained from the parents prior to inclusion of subjects into the study . to determine the incidence of aki as defined by the acute kidney injury network ( akin ) classification in critically ill pediatric patients admitted to the picu ; aged 1 month to 13 years .
to determine the predictors of fatality in aki in critically ill - childrento study the etiology and short term outcome of aki in critically ill - childrento compare the demographic and clinical parameters among survivors and non - survivors in aki .
to determine the predictors of fatality in aki in critically ill - children to study the etiology and short term outcome of aki in critically ill - children to compare the demographic and clinical parameters among survivors and non - survivors in aki .
patients with known chronic kidney disease stage 5 ( estimated glomerular filtration rate < 15 ml / min/1.73 m)bilirubin level > 5 mg / dl .
patients with known chronic kidney... | background : although the term acute renal failure was replaced by acute kidney injury ( aki ) recently , there is a paucity of data on the incidence and profile of aki in critically ill children from the developing world.objectives:the objective of this study is to determine the incidence , etiology , short term outcome and predictors of fatality in critically ill children admitted to the pediatric intensive care unit ( picu ) with aki , aged 1 month to 13 years.materials and methods : in this prospective observational study , from june 2010 to march 2011 , 215 children admitted to the picu were screened for aki , defined according to the aki network criteria .
the patients with aki were followed - up until discharge / death .
their clinical and biochemical data were recorded.results:the incidence of aki among 215 patients screened was 54 ( 25.1% ) .
the common etiologies were infections , [ 34 ( 62.9% ) ] , acute glomerulonephritis ( 7.6% ) , snake envenomation ( 5.7% ) , hemolytic uremic syndrome ( 3.8% ) and congestive cardiac failures ( 3.8% ) . among infections , pneumonia and septicemia constituted 26.5% each , meningoencephalitis accounted for 23.5% , and dengue , scrub typhus , tuberculosis and malaria constituted 9.3% of children with aki .
27.8% of patients required dialysis .
overall mortality was 46.3% . on logistic regression analysis , requirement of mechanical ventilation was an independent predictor of fatality in aki.conclusions:besides the high incidence of aki in critically ill - children admitted to the picu ( 25.1% ) , the condition was associated with adverse outcomes , including high mortality ( 46.3% ) and need for dialysis ( 27.8% ) .
infections dominated the etiological profile .
requirement of mechanical ventilation predicted an adverse outcome in our patient population . |
6,457 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chronic heart failure ( chf ) is the common end - result of many cardiovascular diseases . despite the improvements in the methods of prevention and the new strategies in the treatment of patients , the incidence of chf is increasing in many countries.1 , 2 in recent years , the focus of research for the treatment of chf patients has been on drug therapies and devices , while other factors may affect the rise in the number of chf patients .
for example , oxidative stress may contribute to the pathogenesis of chf;3 , 4 and some clinical and experimental studies have shown that in chf patients , free radical formation is increased and antioxidant defenses are reduced.3 , 5 , 6 also , dietary trials that assessed the impact of high intakes of natural antioxidants showed that the incidence of chf was reduced.7 , 8 selenium ( se ) , an essential trace mineral , is mainly obtained from seafood , meat , and cereals .
se deficiency has been identified as a major contributing factor in the pathogenesis of certain chf syndromes .
for instance , in areas with low soil se contents such as eastern china and western africa , se deficiency is associated with cardiomyopathy.9 , 10 moreover , there are cases of cardiomyopathy associated with low se levels in malnourished hiv - infected patients in western countries11 and in patients on chronic parenteral nutrition.12 it has also been reported that serum levels of se were lower in idiopathic dilated and also ischemic cardiomyopathy patients compared with levels in healthy controls.13 on the other hand , in another report , the mean serum se levels in 30 patients with idiopathic cardiomyopathy did not show any difference from those of healthy individuals.14 it has been suggested that se may be involved in the deconditioning of skeletal and cardiac muscles and in chf symptoms such as fatigue and low exercise tolerance , rather than in ventricular dysfunction.15 , 16 regarding the controversy over the prevalence of se deficiency among chf patients , the present study aimed at... | backgroundselenium ( se ) is an essential trace element mainly obtained from seafood , meat , and cereals .
se deficiency has been identified as a major contributing factor in the pathogenesis of certain congestive heart failure ( chf ) syndromes . since there is controversy over the prevalence of se deficiency among patient with chf , the aim of this study was to assess the serum se concentrations in patients with chf and compared them with the se status of healthy controls.methods:the study included 77 patients ( age , 68.4 10.4 years old ; 40.3% female ) and 73 healthy volunteers ( 64.9 4.7 years old ; 35.6% female ) .
a complete medical / drug history and physical examination were performed for all patients and healthy volunteers .
all patients had symptoms and signs of chf and had a left ventricular ejection fraction ( ef ) of < 40% obtained by echocardiography .
the se concentration was assessed by atomic absorption spectrometer with the graphite tube atomizer .
the limit of measurement was 5 g / l.results : the se concentrations in chf patients did not show a significant difference from those of healthy controls ( 185.9 781.2 g /
l vs. 123.3 115.5 g / l , respectively ; p value = 0.499 ) .
there was no correlation between serum se concentrations and ef in both the normal group and the patients with heart failure ( p value = 0.96 and 0.99 ; r = 0.006 and 0.002 for patients and healthy volunteers ,
respectively).conclusion : in this study , serum se levels in chf patients were similar to those of controls and the se concentrations did not correlate with the degree of left ventricular dysfunction . |
6,458 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is a significant challenge even to the most experienced anaesthesiologist to intubate patients in whom the movement of the cervical spine is not desirable or restricted . in cases of cervical spine immobility or instability ,
the use of direct laryngoscopy is reserved : it requires flexion of the cervical spine and atlanto - occipital extension for alignment of the oral , pharyngeal and laryngeal axis to create a direct line of vision from the mouth to the vocal cords .
tracheal intubation in patients with suspected neck injuries should achieve two contradicting goals : sufficient laryngeal exposure and the least cervical spine movement .
as the former involves movement of the cervical vertebrae , intubation has to be performed using cervical spine immobilisation to prevent exacerbation of spinal cord injuries .
protective measures to avoid deleterious compression forces on the spinal column include application of rigid collar , a forehead tape and manual - in - line stabilisation ( mils ) .
application of cervical collars may reduce cervical spine movements , but it hinders tracheal intubation with the standard laryngoscope .
the cervical collar also significantly reduces the mouth opening , rendering laryngoscopy difficult . besides , the neck collar lifts up the chin and tips the larynx anteriorly .
removing the anterior portion of the collar can facilitate tracheal intubation . however , this jeopardises the safety of the cervical spine .
fibreoptic intubation is the most reliable method in patients with cervical trauma , but it may be difficult in patients with restricted neck movement .
the other drawbacks of fiberoptic intubation are lack of availability of equipment , requires lack of expertise in its use and difficulty in using it if the patient is not co - operative or if there is blood or secretions in the airway .
it possesses considerable advantages in the setting of cervical spine immobilisation when direct laryngoscopy is difficult or not recommended .
it provides a full view of the glottis... | background : it is difficult to visualise the larynx using conventional laryngoscopy in the presence of cervical spine immobilisation . airtraq provides for easy and successful intubation in the neutral neck position.objective:to evaluate the effectiveness of airtraq in comparison with the mc coy laryngoscope , when performing tracheal intubation in patients with neck immobilisation using hard cervical collar and manual in - line axial cervical spine stabilisation.methods:a randomised , cross - over , open - labelled study was undertaken in 60 asa i and ii patients aged between 20 and 50 years , belonging to either gender , scheduled to undergo elective surgical procedures . following induction and adequate muscle relaxation , they were intubated using either of the techniques first , followed by the other . intubation time and intubation difficulty score ( ids ) were noted using mc coy laryngoscope and airtraq .
the anaesthesiologist was asked to grade the ease of intubation on a visual analogue scale ( vas ) of 110 .
chi - square test was used for comparison of categorical data between the groups and paired sample t - test for comparison of continuous data .
ids score and vas were compared using wilcoxon signed ranked test.results:the mean intubation time was 33.27 sec ( 13.25 ) for laryngoscopy and 28.95 sec ( 18.53 ) for airtraq ( p=0.32 ) .
the median ids values were 4 ( interquartile range ( iqr ) 16 ) and 0 ( iqr 01 ) for laryngoscopy and airtraq , respectively ( p=0.007 ) .
the median cormack lehane glottic view grade was 3 ( iqr 24 ) and 1 ( iqr 11 ) for laryngoscopy and airtraq , respectively ( p=0.003 ) .
the ease of intubation on vas was graded as 4 ( iqr 35 ) for laryngoscopy and 2 ( iqr 22 ) for airtraq ( p=0.033 ) .
there were two failures to intubate with the airtraq.conclusion:airtraq improves the ease of intubation significantly when compared to mc coy blade in patients immobilised with cervical collar and manual in - line stabilisation simulating cervical spine injury . |
6,459 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: we obtained data on persons with hiv / aids and tb from the national databank at the centers for disease control ( cdc taiwan ) of the department of health , taiwan .
coinfection with hiv and tb was defined as hiv infection in persons in whom tb was later diagnosed . a total of 660 persons with both hiv and tb were reported during 19932006 .
we used microsoft excel xp spreadsheet ( microsoft , redmond , wa , usa ) and sas version 9.1 ( sas institute inc . ,
the goodness - of - fit test with type i error = 0.05 was used to examine differences in demographic , clinical , and behavioral characteristics of persons with hiv and tb coinfection during 19932006 .
multivariates for analysis were sex and age , results of sputum smear and sputum culture , pulmonary radiographic diagnosis , tb types ( extrapulmonary and nonextrapulmonary ) , mode of hiv transmission , sexual behavior , compliance with haart , and use of the surveillance system ( table 1 ) .
we used the kaplan - meier method ( 4 ) from sas to evaluate and compare the effect on survival rates of different factors in persons coinfected with hiv and tb 1 year after reported tb diagnosis . *
goodness - of - fit test with type i error = 0.05 used to examine differences in demographic , clinical , and behavioral characteristics .
kaplan - meier analysis yielded the following results : 63% of persons coinfected with hiv and tb survived during 19931996 ; 78% survived during 19982000 ; and 93% survived during 20022006 ( p<0.0001 ) ( figure ) .
we then applied cox proportional hazards modeling ( 5 ) to each variable to assess the effect on survival rates after implementation of haart and the surveillance system .
age < 45 years , negative sputum smear , availability of free haart , and implementation of the national surveillance system substantially increased survival rates of persons coinfected with hiv and tb ( table 2 ) .
kaplan - meier analysis of survival of hiv - infected patients with tuberculosis in taiwan during 3 different periods : before free... | in 1997 , taiwan made highly active antiretroviral therapy ( haart ) available without cost to hiv - infected persons ; in 2001 , a national web - based surveillance system was implemented .
healthcare workers use the system to monitor patients ' conditions and can intervene when necessary .
free haart , coupled with the surveillance system , appears to have increased survival rates of hiv - infected persons with tuberculosis in taiwan . |
6,460 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: small organic molecules with specific interactions with dna have become antitumor , antiviral , and antibiotic drugs [ 1 , 2 ] .
duplex dna - binding drugs interact in two main ways , through groove binding and through intercalation .
medicinal chemistry has made a considerable effort in searching for and testing of a large number of drugs with increased selectivity to a range of dna sequences or structures .
more recently , some of this interest has moved to the search of new ligands for g - quadruplexes .
this structure motif is formed by the planar association of four guanines in a cyclic hoogsteen hydrogen bonding tetrad .
guanine - rich sequences form g - quadruplex structures and have been found in telomeres and in transcriptional regulatory regions of critical oncogenes such as c - myc and c - kit [ 5 , 6 ] .
ligands that selectively bind and stabilize these structures have become anticancer drugs of interest .
the g - quadruplex stabilization occurs in most cases by - stacking and electrostatic interaction .
g - quadruplex ligands are normally planar aromatic molecules that are prone to stacking with g - tetrads . some of them are also positively charged or have hydrophilic groups to favor electrostatic interaction .
although there is a long way to go in the development of potent drugs that target g - quadruplexes , some promising lead compounds have been achieved .
several ligand structures have been studied , such as anthraquinones , cationic porphyrins , perylene derivatives , and a large number of compounds . among the acridine compounds , 3,6,9-trisubstituted acridines have inhibitory activity in the nanomolar range and they have entered preclinical studies [ 8 , 10 , 11 ] . in previous studies we described the preparation of sequence specific oligomers of dna - intercalating drugs using protocols based on solid - phase synthesis in an attempt to facilitate the preparation of compounds with improved dna - binding selectivity [ 12 , 13 ] .
it has been proposed that bis- and tris -... | the synthesis of oligomers containing two or three acridine units linked through 2-aminoethylglycine using solid - phase methodology is described .
subsequent studies on cell viability showed that these compounds are not cytotoxic .
binding to several dna structures was studied by competitive dialysis , which showed a clear affinity for dna sequences that form g - quadruplexes and parallel triplexes .
the fluorescence spectra of acridine oligomers were affected strongly upon binding to dna .
these spectral changes were used to calculate the binding constants ( k ) .
log k were found to be in the order of 46 . |
6,461 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: pseudohypoparathyroidism ( php ) was first reported in 1942 by albright who presented 3 cases of hypocalcemia with no response to parathyroid extract and albright hereditary osteodystrophy ( aho ) phenotype of short stature with round facies , obesity , brachydactyly , mental retardation , and subcutaneous calcification .
subsequently it was proved that php is caused by resistance to action of parathyroid hormone ( pth ) in selective organs with monoallelic expression of gs ( proximal renal tubules , thyroid , gonads , pituitary ) , later resistance to pth was reported in patients with php cases without aho phenotype and normal gs activity and it was classified as php type-1b ( php1b ) caused due to imprinting defects in gnas1 gene located on chromosome 20q13.3 .
classically , php1b is characterized by blunted nephrogenous cyclic - amp ( camp ) and phosphaturic response to exogenous pth . here
we report a case of php1b confirmed by blunted urinary camp response to exogenous pth but had normal phosphaturic response on treatment with calcium and vitamin d. we discuss possible mechanisms to explain normal phosphaturic response .
a 34-year - old male presented with recurrent carpopedal spasms of 4 years duration with perioral numbness , cramps , muscle twitching and generalized weakness for which he was evaluated 2 years back and found to have hypocalcemia , hyperphosphatemia , hypercalciuria , high pth without aho phenotype .
on examination he was 184 cm tall with weight of 78 kg ( bmi 23 kg / m ) .
latent signs of tetany in the form of positive chvostek 's sign and trousseau 's sign were present .
we decided to re - evaluate him in view of late age of onset of symptoms , absence of aho phenotype , and to confirm the diagnosis .
investigations revealed normal renal parameters ( serum creatinine , 88.4 mol / l ) and normal serum magnesium ( 0.86 mmol / l ) , 25(oh)d levels ( 137.2 nmol / l ) and raised pth ( 63 pmol / l ) .
his bone mineral density ( t score,0.5 at l1-l4 and 0.2 at femur neck ) and thyroid... | pseudohypoparathyroidism type-1b is a hereditary disorder of clinical hypoparathyroidism without aho phenotype , characterized by blunted nephrogenous cyclic - amp ( camp ) response to exogenous parathyroid hormone ( pth ) .
here we report a young adult presenting with hypocalcemic tetany with raised pth levels .
his urinary camp response to exogenous pth ( recombinant 1 - 34 ) was blunted ; however , phosphaturic response was normal . |
6,462 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a retrocaval ureter or pre - ureteric venacava is a rare anomaly which occurs in 1 per 1000 live births .
it is seen three times more often in males and is usually on the right side .
a left retrocaval ureter as such is very rare and is usually associated with situs inversus or ivc duplication .
these patients usually present in the third or fourth decades and symptoms depend on the degree of obstruction .
an 84-year - old male patient presented to us with dull , aching left flank pain of 6 months duration .
ct scan of the abdomen revealed transposed ivc to the left side and classic retrocaval ureter with proximal hydro - ureteronephrosis [ figures 13 ] .
intravenous urogram showing a sea - horse sign coronal ct image showing left retrocaval ureter with pre - caval ( arrowhead ) and post - caval ( arrow ) segments axial ct images with arrows showing ( a ) pre - caval ureter ( b ) post - caval ureter and ( c ) left renal vein
the embryogenesis of the ivc is a complex process of development involving the posterior cardinal , the subcardinal , and the supracardinal venous systems .
aberrant complexation of these veins can result into four anomalies : duplicated ivc , transposition of ivc to left , retroaortic left renal vein , and circum - aortic left renal vein . left retrocaval ureter is rare , and only eight cases have been reported in the literature so far .
left retrocaval ureter without situs and without ivc duplication is rarer with only four cases being reported in the literature .
pierro et al . reported a 0.2 to 0.5% prevalence of transposition of ivc to the left and a 0.1% prevalence of left retrocaval ureter . | retrocaval ureter ( pre - ureteral vena cava ) is an uncommon congenital anomaly that causes ureteral obstruction by external compression . although right retrocaval ureter is a common entity , left retrocaval ureter is extremely rare .
a left retrocaval ureter is usually associated with situs inversus or duplicated inferior venacava ( ivc ) .
an isolated left retrocaval ureter with single left - sided ivc is even rarer and only four cases have been reported in the literature .
we present images of a case with isolated left retrocaval ureter with a single left - sided ivc without situs inversus . |
6,463 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acute flaccid paralysis ( afp ) is a clinical entity characterized by areflexia and/or hyporeflexia and weakness which reaches a maximum within days or weeks .
polioviruses , enterovirus 71 , flavivirus , herpes virus , and rabies virus are well - known as viral etiologic agents . in this article , who presented with lower respiratory tract infection and afp , and
was detected to have co - infection of human coronavirus ( hcov ) 229e and oc43 is reported .
afp associated with hcov infections has not been reported previously in the literature , and has been reported for the first time in this article .
a 3-year - old girl hospitalized due to the development of shortness of breath and inability to walk 1-day after the beginning of fever , rhinorrhea , cough , and weakness . on the same day , respiratory distress increased , she was intubated , and mechanical ventilation started .
on physical examination , she was conscious but swallowing , chewing and speech functions damaged , muscle strength was 0/5 and deep tendon reflexes ( dtrs ) were absent , the plantar response was flexor .
complete blood count , electrolytes and blood biochemistry and urinalysis were normal , c - reactive protein was negative and erythrocyte sedimentation rate was 20 mm / h .
no abnormalities in the brain and spinal cord magnetic resonance imaging were detected - so intracranial and spinal pathologies were excluded .
after 48 h of hospitalization , a total of 2 g / kg intravenous immunoglobulin ( ivig ) in 3 days was given .
muscle strength improved to 23/5 , dtr became norm active , bulbar paralysis and respiratory distress had regressed . at the end of the 2 week , she could mobilize and walk with a guide .
lumbar puncture and enmg repeated in the 3 week did not reveal any pathological findings and gullian barre syndrome ( gbs ) was completely excluded .
real - time polymerase chain reaction ( pcr ) analysis of nasal swab samples was reported to be positive for hcov 229e and oc43 and hcov co - infection was diagnosed .
flaccid... | acute flaccid paralysis ( afp ) is a life - threatening clinical entity characterized by weakness in the whole body muscles often accompanied by respiratory and bulbar paralysis .
the most common cause is gullian barre syndrome , but infections , spinal cord diseases , neuromuscular diseases such as myasthenia gravis , drugs and toxins , periodic hypokalemic paralysis , electrolyte disturbances , and botulism should be considered as in the differential diagnosis .
human coronaviruses ( hcovs ) cause common cold , upper and lower respiratory tract disease , but in the literature presentation with the lower respiratory tract infection and afp has not been reported previously . in this study ,
pediatric case admitted with lower respiratory tract infection and afp , who detected for hcov 229e and oc43 co - infection by the real - time polymerase chain reaction , has been reported for the first time . |
6,464 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: vitamin d status is highly variable among european countries , largely due to variations in exposure to sunshine , dietary intake of vitamin d , and the use of supplements [ 1 , 2 ] .
vitamin d can be synthesized endogenously , and factors affecting its cutaneous synthesis include age , season , latitude , time of day , skin pigmentation , amount of skin exposed , and the use of sunscreen .
vitamin d status is normally defined according to the serum concentration of 25-hydroxyvitamin d [ 25(oh)d ] .
usually , vitamin d deficiency is defined as having a serum 25(oh)d concentration lower than 50 nmol / l ( 20 ng / ml ) .
nevertheless , an evaluation of satisfactory levels of vitamin d in healthy children has not yet been reported by adequate studies [ 35 ] .
based on the current literature , the prevalence of 25(oh)d deficiency varies from 2 to 30% in adults [ 2 , 6 ] .
however , in a small - scale italian study , more than 80% of children had insufficient or deficient levels of 25(oh)d .
two larger studies providing transversal data have confirmed that 25(oh)d deficiencies are very common among italian children [ 810 ] .
an adequate 25(oh)d status is very important because 25(oh)d deficiency is a risk factor for several chronic diseases in addition to having classic deleterious effects on bone .
vitamin d deficiency can cause secondary hyperparathyroidism , which may lead to high bone turnover and bone loss and ultimately increase the risk of fractures [ 25 ] .
emerging evidence suggests that vitamin d also plays an important role in immune system regulation .
vitamin d receptors are found on several immune cells , and vitamin d metabolites appear to modulate t - cell proliferation and dendritic cell function [ 11 , 12 ] .
vitamin d deficiency may also be a risk factor for the development of autoimmune and other chronic diseases [ 3 , 11 , 13 , 14 ] , loss of muscle mass , and muscle weakness .
finally , a number of studies have also suggested that vitamin d may confer protection against diabetes mellitus... | objective . this paper aims to assess 25(oh)d levels in italian children and adolescents identifying risk factors for 25(oh)d deficiency and to evaluate whether a normal 25(oh)d value can be restored in 25(oh)d - deficient patients
. methods .
we evaluated 25(oh)d levels in 679 italian children and adolescents ( 10 , 1120 , 2130 , and > 30 ng / ml were defined as severe deficiency , deficiency , insufficiency , and sufficiency , resp . ) .
of these , 365 25(oh)d - deficient were followed up for 1 year ; 205 were treated with cholecalciferol ( arm a : 400 i.u . ) and 160 by improving the environmental variables influencing 25(oh)d levels ( arm b ) .
results . at cross - sectional evaluation ,
11.3% showed sufficiency , 30.0% insufficiency , and 58.7% 25(oh)d deficiency .
mean 25(oh)d was 19.08 8.44 ng / ml . at the enrollment time
( t0 ) , no difference was found between arms a and b with respect to distribution and 25(oh)d levels . at end time
( t1 ) 26.0% ( 29.7% in arm a versus 20.6% in arm
b ) showed sufficiency , 38.4% ( 42.0% versus 34.4% ) insufficiency , and 35.6% ( 28.3% versus 45.0% ) 25(oh)d deficiency .
mean 25(oh)d level was 23.71 6.83 ng / ml . conclusions .
neither changes of lifestyle nor 400 i.u .
cholecalciferol supplementation alone appears to be sufficient to restore adequate 25(oh)d levels . |
6,465 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the functional asymmetry of the cerebral hemispheres has been reported in patients with many sorts of brain damage , who failed to orient , report , or respond to stimuli located in one hemispace 1 .
line bisection has been employed as a sensitive test for unilateral neglect 1,3 . in this task ,
lateral deviation from the true center indicate the relative inattention for the contralateral side of space , and a consistent leftward error has been reported in healthy subjects in the western world , indicating a relatively right cerebral dominance in them ( reviewed in ref 4 ) .
nonetheless , patients with right hemispheric lesions usually place the subjective midpoint to the right of the true center 4 . of interest to psychologists and psychiatrists
are the possible functional cerebral asymmetries represented in sorts of psychiatric patients and in different emotional states of healthy individuals , which might be due to the different strategies for processing specific stimuli . in healthy subjects ,
negative emotions are more likely to be associated with the activation of the right hemisphere 5,6 .
for instance , some studies have shown that the induced anxiety in normal subjects selectively impaired their spatial , but not verbal performance 7,8 , other studies in both infants and adults have found that negative affects , such as anxiousness and depression , are more relatively associated with the right hemisphere activation , particularly the frontal lobe 6,9 - 11 . moreover
, the greater right hemisphere activation in depression patients has been demonstrated in studies that used the consonant - vowel task12 , and the electroencephalogram measurements 13,14 .
individuals with generalized anxiety disorder ( gad ) are found to be intolerant of uncertainty and perceive more potentially negative situations than the healthy subjects 15 - 17 , and people with depression also employ a maladaptive problem - solving method , which contributes to the maintenance of negative emotions they perceived 18,19 .
one question... | background and objectives the line bisection error to the left of the true center has been interpreted as a relative right hemisphere activation , which might relate to the subject 's emotional state . considering that patients with generalized anxiety disorder ( gad ) or treatment - resistant depression ( trd ) often have negative emotions
, we hypothesized that these patients would bisect lines significantly leftward .
methods we tried the line bisection task in the right - handed healthy volunteers ( n = 56 ) , gad ( n = 47 ) and trd outpatients ( n = 52 ) .
subjects also completed the zuckerman - kuhlman personality questionnaire , the zuckerman sensation seeking scales , and the plutchik - van praag depression inventory .
results gad patients scored highest on the neuroticism - anxiety trait , trd patients scored highest on depression , and both patients scored lower on the sociability trait . patients with
gad also bisected lines significantly leftward compared to the healthy subjects .
the frequency of the bisection error was negatively correlated with disinhibition - seeking in the healthy subjects , and with total sensation - seeking and experience - seeking in gad patients , while the magnitude of the line bisection error was negatively correlated with depression in trd patients .
conclusions the study suggests a stronger right hemispheric activation , a weaker left activation , or both in the gad , instead of trd patients . |
6,466 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: uterine leiomyomata , the most common solid pelvic tumors , occur in approximately 20% of women aged 35 years or more . because of the significant operative risk associated with abdominal myomectomy
, the operation has been reserved for women who want to preserve or enhance their fertility potential . however , with the general trend towards conserving the uterus and because many women currently choose delayed childbearing , patient demand for this procedure has increased .
furthermore , with the improvement in laparoscopic techniques and their associated low morbidity , resection of myomas is now a valid alternative for women suffering from any serious symptoms related to the presence of myomas in the uterus .
the only surgical treatment available for intramural and subserous myomas in the past was laparotomy .
laparoscopic myomectomy has since been shown to be an effective means of reducing postoperative morbidity , and it expedites recuperation .
however , it quickly became apparent that the laparoscopic operation was associated with the prolonged time of anesthesia , increased blood loss , and possibly a higher risk of postoperative adhesion formation .
laparoscopic myomectomy was described 2 decades ago and has since been repeatedly shown to provide the recognized benefits of the laparoscopic approach . however , with increasing experience , it has become apparent that the technique demands a high degree of training and skill from the laparoscopic operator .
it has been suggested that at present these factors limit the application of laparoscopic myomectomy . despite significant improvements in endoscopic instrumentation , laparoscopic
myomectomy remains a technically demanding and time - consuming procedure . in the easiest cases ,
pedunculated myomas may be simply transected , and some enucleated myomas will pop out through an incision in the uterine wall .
the operation is time - consuming , usually because of the difficulty in morcellating and removing the myoma from the abdominal cavity through... | laparoscopic myomectomy has recently gained wide acceptance . however , this procedure remains technically highly demanding and concerns have been raised regarding the prolonged time of anesthesia , increased blood loss , and possibly a higher risk of postoperative adhesion formation .
laparoscopic - assisted myomectomy ( lam ) is advocated as a technique that may lessen these concerns regarding laparoscopic myomectomy while retaining the benefits of laparoscopic surgery , namely , short hospital stay , lower costs , and rapid recovery . by decreasing the technical demands , and thereby the operative time , lam may be more widely offered to patients.in carefully selected cases , lam is a safe and efficient alternative to both laparoscopic myomectomy and myomectomy by laparotomy .
these cases include patients with numerous large or deep intramural myomas .
lam allows easier repair of the uterus and rapid morcellation of the myomas . in women who desire a future pregnancy ,
lam may be a better approach because it allows meticulous suturing of the uterine defect in layers and thereby eliminates excessive electrocoagulation . |
6,467 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: one of the most frequently asked questions to those of us at june is what kinds of manuscripts are appropriate for inclusion in the journal .
any manuscript with the aim of enabling others to enhance their teaching of neuroscience to undergraduates is appropriate ; those with empirically - tested protocols of innovative pedagogy are particularly welcomed and prioritized for publication in june . beyond manuscripts devoted to new classroom approaches and laboratory exercises ,
a variety of manuscripts in other aspects that are relevant to undergraduate neuroscience education are welcomed , such as :
editorials .
june welcomes book reviews ranging from popular press volumes relevant to neuroscience to textbooks.media reviews .
june welcomes reviews of media such as films , television shows , websites , and software that may have particular value to neuroscience education.commentaries .
june welcomes reviews of media such as films , television shows , websites , and software that may have particular value to neuroscience education .
manuscripts must be properly formatted according to the instructions to authors available at the june website ( http://funjournal.org ) .
manuscripts should be carefully proofread , and attention should be given to both the flow and appearance of information and positioning of tables , figures , and captions . to facilitate indexing ,
authors are welcome to provide a list of suggested reviewers , which may or may not be used in the review of their article .
the first step in the process is an initial screen by the editors to ensure that the manuscript is appropriate for the journal .
if not , a notification indicating why the manuscript does not fit the criteria for inclusion in june is sent to the author(s ) . sometimes , an editor may provide suggestions of how the manuscript may be modified to better fit the criteria .
once the initial reviews are received , the editors make a decision to accept , request revisions and resubmissions , or reject .
often times the difference... | in the fall of 2002 , the faculty for undergraduate neuroscience ( fun ) began publication of its flagship journal , the journal of undergraduate neuroscience education ( june ) .
for the past ten years , june has been a major forum for the free exchange of information among undergraduate neuroscience educators .
numerous articles on laboratory exercises , media , pedagogy , curriculum , and issues pertinent to neuroscience educators have been published in june during the past decade .
given the vast expertise in pedagogy amongst the fun membership and within the undergraduate neuroscience education community at large , we strongly encourage all fun members and june readers to become actively involved in june by contributing manuscripts and/or by offering your services as a reviewer . |
6,468 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the disease known as pneumocystis carinii pneumonia ( pcp ) is one of the leading causes of illness and death in persons with impaired immunity .
the disease has been described in immunocompromised patients for many years , including outbreaks in malnourished young children in orphanages in iran in the 1950s ( 16 ) .
the aids epidemic , however , marked the beginning of the disease s impact on a substantial number of patients .
pcp has long been the most common serious aids - defining opportunistic infection in the united states .
the introduction of highly active antiretroviral therapy ( haart ) for the treatment of hiv infection has been accompanied by substantial reductions in mortality and the incidence of opportunistic infections , including pcp ( 7 ) . despite these advances ,
pneumocystis remains a major pathogen in hiv - infected persons who either are not receiving or are not responding to haart and among those who are unaware of their hiv status .
pcp is also of clinical importance in people immunocompromised for reasons other than hiv , such as organ transplantation or chemotherapy for malignant diseases ( 8) .
in addition , pneumocystis infection has been documented recently in persons who are mildly immunocompromised , including those with chronic lung disease ( 9 ) .
pneumocystis organisms were first reported by chagas in 1909 ( 10 ) , but he mistook them for a morphologic form of trypanosoma cruzi . within a few years of this first report , further studies established that the microbe in question was not a trypanosome but a new species altogether , named pneumocystis carinii
( 11 ) . from the time of its discovery , until late in the 1980s , pneumocystis
these views were based on several criteria : 1 ) strong similarities in microbe morphology and host pathology , 2 ) absence of some phenotypic features typical of fungi , 3 ) presence of morphologic features typical of protozoa , 4 ) ineffectiveness of antifungal drugs , and 5 ) effectiveness of drugs generally used to treat protozoan... | the disease known as pneumocystis carinii pneumonia ( pcp ) is a major cause of illness and death in persons with impaired immune systems .
while the genus pneumocystis has been known to science for nearly a century , understanding of its members remained rudimentary until dna analysis showed its extensive diversity .
pneumocystis organisms from different host species have very different dna sequences , indicating multiple species . in recognition of its genetic and functional distinctness , the organism that causes human pcp
is now named pneumocystis jiroveci frenkel 1999 . changing the organism s name
does not preclude the use of the acronym pcp because it can be read pneumocystis
pneumonia .
dna varies in samples of p. jiroveci , a feature that allows reexamination of the relationships between host and pathogen . instead of
lifelong latency , transient colonization may be the rule . |
6,469 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: pruritus is an unpleasant feeling that can cause the desire of scratching in a person and can be the symptoms of systemic , infectious , and neurological diseases .
causes and treatments of pruritus have been described by traditional persian medicine scientists . the aim of this study was to derive general principles of the proposed treatment to reduce or relieve pruritus .
this descriptive study , review traditional medicine books including al canon fil tibb , al - hawi , makhzan ul - adviyyah , al - abniyah an - haghyegh el - adviyah , tuhfat ul - momineen and exir - e - azam .
the above - mentioned documents were derived and classified by keywords such as pruritus , hakka , jarab and sherry .
in traditional persian medicine , there are different causes for pruritus such as accumulation of vapors or acute humors in subcutaneous tissue or weakness of expulsive ( dafia ) faculty and its treatment is based on removing the causes .
proper nutrition , bathing , and removing pathogenic humors are involved in the treatment . according to this study
, some plants such as cassia fistula , purslane , violets , fumaria , barley , coriander , rose and terminalia chebula are anti - itching .
proper nutrition is the most important point in health and treatment of humors production with appropriate quality and quantity .
it could be concluded that traditional persian medicine therapies can be effective in the treatment of pruritus with mild side effects . by further investigation and research
, we can reach more effective treatment methods in the field of traditional persian medicine along with other new medical therapies . | background : pruritus is an unpleasant feeling that can cause the desire of scratching in a person and can be the symptoms of systemic , infectious , and neurological diseases .
pruritus is the most common clinical manifestation of skin diseases .
pruritus prevalence is 8 - 38% in the general population . causes and treatments of pruritus
have been described by traditional persian medicine scientists .
the aim of this study was to derive general principles of the proposed treatment to reduce or relieve pruritus.methods:this descriptive study , review traditional medicine books including al canon fil tibb , al - hawi , makhzan ul - adviyyah , al - abniyah an - haghyegh el - adviyah , tuhfat ul - momineen and exir - e - azam .
the above - mentioned documents were derived and classified by keywords such as pruritus , hakka , jarab and sherry.results:in traditional persian medicine , there are different causes for pruritus such as accumulation of vapors or acute humors in subcutaneous tissue or weakness of expulsive ( dafia ) faculty and its treatment is based on removing the causes .
proper nutrition , bathing , and removing pathogenic humors are involved in the treatment . according to this study
, some plants such as cassia fistula , purslane , violets , fumaria , barley , coriander , rose and terminalia chebula are anti-itching.conclusion:proper nutrition is the most important point in health and treatment of humors production with appropriate quality and quantity .
pruritus can be treated by lifestyle modification and using medicinal plants .
it could be concluded that traditional persian medicine therapies can be effective in the treatment of pruritus with mild side effects . by further investigation and research
, we can reach more effective treatment methods in the field of traditional persian medicine along with other new medical therapies . |
6,470 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in june 2006 , a 74-year - old woman residing in a house in rural new orleans was bothered by a considerable number ( > 50 ) of insect bites .
the woman observed many bugs in the house and showed them to a fumigator , who identified them as triatomines .
an internet search showed the potential for transmission of chagas disease , and the woman sought help from a local health sciences center .
serum samples from both residents of the house were tested for antibodies to t. cruzi at the centers for disease control and prevention ( cdc ) by an indirect fluorescent antibody ( ifa ) test .
samples were also tested at loyola university ( new orleans , la , usa ) and then at cdc . by using an experimental dipstick assay ( trypanosoma detect ; inbios international inc . ,
the woman resident was positive for antibodies to t. cruzi by ifa at dilutions of 1:128 ( 4 weeks after being bitten ) and 1:64 ( 10 weeks after being bitten ) and by dipstick assay .
she was positive for trypanosomes by hemoculture testing with 10 ml blood and coculture in macrophages ( 13 ) 4 months after being bitten .
trypanosomes consistent with t. cruzi were observed in culture beginning on day 46 of culture , and amplification of a t. cruzi specific 24s rrna gene target confirmed that the isolate was t. cruzi .
the index resident had a history of 5 trips to areas endemic for chagas disease : zacatecas , mexico ( 1970 ) ; cozumel , mexico ( 1990 ) ; belize ( 1991 ) ; guatemala ( 19988 ) ; and costa rica ( 1998 ) , each of < 2 weeks duration , with stays in improved tourist hotels ( less likely to harbor triatomines ) except for the belize trip , which included an 1-week stay in a palm thatch - roofed cabin .
she had not used intravenous drugs or had a blood transfusion or organ transplant , and she is not the daughter of latin american immigrants . except for fatigue ,
cardiac evaluation that included an electrocardiogram showed normal results , and she decided not to take medication .
her residence of 29 years was located on 7.66 acres of... | autochthonous transmission of the chagas disease parasite , trypanosoma cruzi , was detected in a patient in rural new orleans , louisiana .
the patient had positive test results from 2 serologic tests and hemoculture .
fifty - six percent of 18 triatoma sanguisuga collected from the house of the patient were positive for t. cruzi by pcr . |
6,471 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 2.5 kb vec promoter sequence was cloned between insulators from the chicken -globin gene 29 and used to drive cre expression .
r26r - lacz/+;vec - cre or r26r - yfp/+;vec - cre conceptuses were generated by crossing vec - cre/+ males with r26r - lacz/+ or r26r - yfp/+ females .
runx1;vec - cre and runx1;vec - cre conceptuses were generated by crossing runx1 ; vec - cre/+ males with runx1 females .
runx1;r26r - yfp/+;vec - cre or runx1;r26r - yfp/+;vec - cre conceptuses were generated from crossing runx1;r26r - yfp/+ ; vec - cre/+ males with runx1 females .
conceptuses were suspended in phosphate - buffered saline or in a 1:2 mixture of benzyl alcohol / benzyl benzoate and visualized with a stereomicroscope .
x - gal ( sigma ) staining was performed as described previously 4 . in some cases the conceptuses
were also incubated with rat anti - mouse pecam1 and abc reagent at 4c 30 , then treated with dab peroxidase substrate .
conceptuses were embedded in paraffin , sectioned , and counterstained with nuclear fast red . to analyze intra - aortic clusters , embryos were fixed and stained with anti - c - kit and anti - pecam1-antibodies .
a 1:2 mix of benzyl alcohol / benzyl benzoate was used to increase the transparency of tissues .
three - dimensional reconstructions were generated from z - stacks ( 6287 serial sections ) .
methylcellulose colony forming assays were performed as described previously 4 and colonies counted after 7 days .
immuno - staining was performed with phycoerytherin , allophycocyanin , or alexa fluor 647 conjugated antibodies stained cells were analyzed on a becton dickinson facscalibur flow cytometer .
a 2.5 kb vec promoter sequence was cloned between insulators from the chicken -globin gene 29 and used to drive cre expression .
r26r - lacz/+;vec - cre or r26r - yfp/+;vec - cre conceptuses were generated by crossing vec - cre/+ males with r26r - lacz/+ or r26r - yfp/+ females .
runx1;vec - cre and runx1;vec - cre conceptuses were generated by crossing runx1 ; vec - cre/+ males with runx1... | hscs are the founder cells of the adult hematopoietic system , and thus knowledge of the molecular program directing their generation during development is important for regenerative hematopoietic strategies .
runx1 is a pivotal transcription factor required for hsc generation in the vascular regions of the mouse conceptus - the aorta , vitelline and umbilical arteries , yolk sac and placenta 1 , 2 .
it is thought that hscs emerge from vascular endothelial cells through the formation of intra - arterial clusters 3 and that runx1 functions during the transition from
hemogenic endothelium to hscs 4 , 5 . here
we show by conditional deletion that runx1 activity in vascular endothelial cadherin ( vec ) positive endothelial cells is indeed essential for intra - arterial cluster , hematopoietic progenitor , and hsc formation .
in contrast , runx1 is not required in cells expressing vav , one of the first pan - hematopoietic genes expressed in hscs .
collectively these data show that runx1 function is essential in endothelial cells for hematopoietic progenitor and hsc formation from the vasculature , but its requirement ends once or before vav is expressed . |
6,472 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the main study sample included 190 women aged 33 to 68 years recruited through the elective surgery schedule of the gynecology unit at the laval university medical research center , qubec , canada .
surgeries were scheduled for total ( n = 184 ) or subtotal ( n = 6 ) abdominal hysterectomies sometimes accompanied by a salpingo - oophorectomy of one ( n = 27 ) or two ( n = 71 ) ovaries . reasons for surgery included one or more of the following : myoma ( n = 90 ) , menorrhagia / menometrorrhagia ( n = 83 ) , endometriosis ( n = 30 ) , fibroids ( n = 29 ) , benign cyst ( n = 28 ) , incapacitating dysmenorrhea ( n = 18 ) , pelvic pain ( n = 11 ) , endometrial hyperplasia ( n = 8) , polyp (
n = 7 ) , pelvic adhesions ( n = 5 ) , adenomyosis ( n = 3 ) , severe premenstrual syndrome ( n = 2 ) , and/or ovarian thecoma ( n = 1 ) .
menopausal status determination was based on follicle - stimulating hormone levels , menstrual history questionnaires , and medical files .
thirty - three women were identified as postmenopausal , whereas the remaining women were identified as pre- or peri - menopausal ( n = 157 ) .
severely obese women ( n = 17 ) undergoing biliopancreatic diversion were recruited at the laval university cardiology and pulmonology institute .
they were aged 47 years on average , and their bmi ranged from 39.9 to 70.5 kg / m .
severe obesity was defined using the bmi cutoff of the world health organization ( who ) ( 40 kg / m ) . written informed consent
the project was approved by the ethics committees of laval university cardiology and pulmonology institute and laval university medical research center . within a few days before or after the surgery
, measurements of total adiposity and body fat distribution were performed in most women ( n = 150 ) .
classification of normal weight , overweight , and obese women was performed using bmi cutoff points of who .
total body fat mass and lean body mass were determined using dual - energy x - ray absorptiometry .
abdominal subcutaneous and visceral adipose tissue... | objectivewe assessed whether subcutaneous and omental adipocyte hypertrophy are related to metabolic alterations independent of body composition and fat distribution in women.research design and methodsmean adipocyte diameter of paired subcutaneous and omental adipose tissue samples was obtained in lean to obese women .
linear regression models predicting adipocyte size in both adipose tissue depots were computed using body composition and fat distribution measures ( n = 150 ) . in a given depot ,
women with larger adipocytes than predicted by the regression were considered as having adipocyte hypertrophy , whereas women with smaller adipocytes than predicted were considered as having adipocyte hyperplasia.resultswomen characterized by omental adipocyte hypertrophy had higher plasma and vldl triglyceride levels as well as a higher total - to - hdl cholesterol ratio compared with women characterized by omental adipocyte hyperplasia ( p < 0.05 ) .
conversely , women characterized by subcutaneous adipocyte hypertrophy or hyperplasia showed a similar lipid profile .
in logistic regression analyses , a 10% enlargement of omental adipocytes increased the risk of hypertriglyceridemia ( adjusted odds ratio [ or ] 4.06 , p < 0.001 ) independent of body composition and fat distribution measures . a 10% increase in visceral adipocyte number also raised the risk of hypertriglyceridemia ( adjusted or 1.55 , p < 0.02 ) .
associations between adipocyte size and homeostasis model assessment of insulin resistance were not significant once adjusted for adiposity and body fat distribution.conclusionsthese results suggest that omental , but not subcutaneous , adipocyte hypertrophy is associated with an altered lipid profile independent of body composition and fat distribution in women . |
6,473 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 20-year - old incarcerated indigenous australian male , with a history of hepatitis c and intravenous drug abuse , was admitted to the intensive care unit with fulminant hepatic failure following a 5-day history of jaundice , nausea , and vomiting .
the patient was opioid dependent but had been previously well with no relevant medical history .
investigations at the time of presentation revealed a severe acute hepatitis with marked synthetic dysfunction .
his arterial lactate was 5.6 mmol / l , ph was 7.5 and serum ammonia was 132
viral serology revealed positive hepatitis c virus ( hcv ) antibodies and evidence of immunity to hepatitis b virus .
corroborative history from prison medical staff revealed that the patient had thrice injected buprenorphine 1 day prior to the onset of his symptoms .
the patient developed life - threatening multiorgan failure as a consequence of the fulminant hepatic failure and met listing criteria for liver transplantation .
the patient was managed as per the american association for the study of liver diseases acute liver failure guidelines 1 .
he was commenced on broad - spectrum antibiotics , antifungal prophylaxis , an n - acetyl - cysteine infusion and continuous veno - venous hemofiltration .
the patient survived with supportive intensive care management and was discharged from hospital after 42 days . upon discharge , his liver function was improving with an alt of 278 u / l , inr of 1.2 , albumin of 24 g / l and serum bilirubin of 367 mol / l , having peaked at 450 mol / l .
buprenorphine is a potent semisynthetic opioid derivative that is prescribed for the treatment of opioid dependence or for analgesic purposes .
it undergoes extensive first pass hepatic metabolism utilizing the p450 ( cyp 3a4 ) system 2 .
acute liver injury from the misuse of sublingual buprenorphine has been described in several case reports and case series .
almost all cases of significant hepatocellular injury have been associated with hepatitis c viremia 37 .
it has been postulated that... | key clinical messagea 20-year - old indigenous australian male was admitted to the intensive care unit with fulminant hepatic failure secondary to intravenous use of buprenorphine , which had been prescribed sublingually for opioid dependence .
intravenous buprenorphine - induced hepatitis is well recognized , however , life - threatening fulminant hepatic failure has not previously been reported . |
6,474 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gemcitabine - induced hemolytic uremic syndrome ( hus ) is rare but can often be fatal .
early detection of hus is critical so that contributing chemotherapeutic agents , such as gemcitabine , can be discontinued . in clinical trials ,
hus is characterized by renal failure , microangiopathic hemolytic anemia ( maha ) , and thrombocytopenia.1 in addition , the onset of new and uncontrolled hypertension can be diagnostic for hus.2 while a few cases of gemcitabine - induced hus have been reported globally , but only a single korean case of hus in a lung cancer patient is known.3 with the increase in gemcitabine use in pancreatobiliary cancer , early detection of gemcitabine - induced hus is essential .
herein , we describe the first case of hus in a pancreatic cancer patient , associated with gemcitabine use in a korean hospital .
in june 2011 , a 56-year - old male visited a local hospital complaining of dyspepsia and back pain .
contrast - enhanced computed tomography ( ct ) revealed a 4.4 cm mass at the head of his pancreas ( fig .
he was referred to our hospital , where we found the mass had invaded the main portal vein , common hepatic artery , and stomach .
laboratory tests showed serum hemoglobin level of 14.9 g / dl , platelet count of 166,000/l , blood urea nitrogen of 21.3 mg / dl , and serum creatinine level of 1.28 mg / dl .
the carcinoembryonic antigen level was 2.34 ng / ml ( normal range , 0 to 5 ng / ml ) and carbohydrate antigen 19 - 9 was 798 u / ml ( normal range , 0 to 37 u / ml ) .
concurrent chemoradiotherapy ( ccrt ) with original gemcitabine weekly ( 1,000 mg / m per week , day 1 , 8 , 15 , 22 , and 29 ) and 25 radiation therapy ( total radiation dose , 4,500 cgy ) was performed from june 30 to august 3 , 2011 .
one month after ccrt , a repeat abdominal ct showed that the pancreatic mass had decreased from 4.4 to 3.0 cm but remained unresectable .
on october 21 , 2011 , gemcitabine therapy was administered weekly ( 1,000 mg / m per week , day 1 , 8 , and 15 ) for 3 out of 4 weeks .
a... | hemolytic uremic syndrome ( hus ) is a rare thrombotic complication characterized by a triad of microangiopathic hemolytic anemia , thrombocytopenia , and acute renal failure .
hus may be caused by several different conditions , including infection , malignancy , and chemotherapeutic agents , such as mitomycin , cisplatin , and most recently , gemcitabine .
the outcome of gemcitabine - induced hus is poor , and the disease has a high mortality rate .
this study reports a case of gemcitabine - induced hus in a patient with pancreatic cancer in korea . |
6,475 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: health related quality of life ( hrqol ) includes not only physical functioning but also emotional and social functioning dimensions . to assess effectiveness of clinical trials , hrqol measuring instruments
hrqol instruments assist healthcare services in creating better relationship between patients and their physicians and improving patient 's outcome .
in addition , the obtained results help the health system to distribute their assets and facilitate risk assessment . in pediatric field ,
an instrument to measure hrqol must be able to evaluate cognitive development and viewpoints of both child and parents .
it has been shown that using instrument appropriate to age development would make hrqol reports more reliable.[47 ] the pediatric quality of life inventory ( pedsql 4.0 ) that has been invented to determine hrqol is one of the most competent measures in this field .
the pedsql 4.0 is designed to integrate the relative merits of generic and disease specific hrqol measuring instruments .
adding some constructs and items to the previous pedsql 2.0 and 3.0 matches the pedsql 4.0 generic core scales to dimensions described by who .
the pedsql 4.0 generic core scales have been designed to assess child self report for ages 518 and parent proxy report for ages 218 .
furthermore , disease - specific modules have been invented for chronic conditions and children with cancers by varni .
the feasibility , reliability and validity of the original version of the pedsql 4.0 ( american english ) have been widely demonstrated.[37912 ] considering the capability of pedsql 4.0 in assessing child and parents and its simplicity in applying and scoring , various translations of different languages has been validated.[1321 ] iran has one of the youngest populations in the world .
we were the first iranian group obtaining the inventor 's approval ( dr . james varni ) . even though , a persian version of the pedsql 4.0 has been published before our study , according to our best knowledge we carried out translation and... | introduction : to evaluate the reliability , validity and feasibility of the persian version of the pediatric quality of life inventory ( pedsql 4.0 4.0 ) generic core scales in iranian healthy students ages 7 - 15 and chronically ill children ages 2-18.methods:we followed the translation methodology proposed by developer to validate persian version of pedsql 4.0 4.0 generic core scales for children .
six hundred and sixty children and adolescents and their parents were enrolled .
sample of 160 healthy students were chosen by random cluster method between 4 regions of isfahan education offices and 60 chronically ill children were recruited from st .
alzahra hospital private clinics .
the questionnaires were fulfilled by the participants.results:the persian version of pedsql 4.0 4.0 generic core scales discriminated between healthy and chronically ill children ( healthy students mean score was 12.3 better than chronically ill children , p<0.001 ) .
cronbachs alpha internal consistency values exceeded 0.7 for children self reports and proxy reports of children 5 - 7 years old and 13 - 18 years old .
reliability of proxy reports for 2 - 4 years old was much lower than 0.7 .
although , proxy reports for chronically ill children 8 - 12 years old was more than 0.7 , these reports for healthy children with same age group was slightly lower than 0.7 .
constructive , criterion face and content validity were acceptable .
in addition , the persian version of pedsql 4.0 4.0 generic core scales was feasible and easy to complete.conclusion:results showed that persian version of pedsql 4.0 4.0 generic core scales is valid and acceptable for pediatric health researches .
it is necessary to alternate scoring for 2 - 4 years old questionnaire and to find a way to increase reliability for healthy children aged 8 - 12 years especially , according to iranian culture . |
6,476 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the use of female human resources is highlighted as an important factor in the aging korean
society , especially as married women have started entering the labour market .
in addition , a
wide range of fields utilize female labour and the distribution ratio of women in each field
is increasing , with female participation in social and economic activities reaching 50.2% in
2013 , 51.3% in 2014 and 51.8% in 20151 .
office jobs
in particular are experiencing a greater influx of female resources than any
other area , accompanied by the risk of various diseases due to poor working posture and
environments , long - term use of computers , task over - load , mental stress , etc2 . the stress that female office workers
experience in the male - centred organizational culture in korea seems to have more
significant implications3 .
in general , moderate stress plays a positive role in physical and mental vitality while
achievement motivation elicits feelings of tension
. however , undue stress caused by task
over - load might have negative effects on the mind and body , for example , personal anxiety ,
reduced concentration , loss of drive to work , stress - related diseases , etc .
it might also
have direct or indirect negative effects on organizational performance , for example ,
occurrence of negligent accidents , expansion of healthcare expenses , a decrease in
productivity and loss of employment4 .
thus , a stress therapy program with easy applicability during busy business hours can
improve the health of female office workers .
one of the easily applicable stress therapy
options , in terms of time and space , is massage .
not only does it have therapeutic effects
on various bodily functions including the nervous , musculoskeletal , cardiovascular and
integumentary systems , it is also recognized as a type of aerohydropathy as it helps to
promote local and general circulation , increases immunologic function , optimizes natural
healing ability and helps maintain body... | [ purpose ] a scalp massage was conducted on female office workers divided into a 15 minute
group and 25 minute group and its effect on stress hormone , blood pressure and heart rate
was analyzed in order to provide a theoretical rationale to apply scalp massage as stress
therapy .
[ subjects and methods ] a scalp massage was applied to 34 female office workers
twice a week for a total of 10 weeks ; the subjects were classified into 15 min .
, 25 min .
and control groups , and their stress hormone levels , blood pressure and heart rate were
evaluated .
[ results ] significant differences in norepinephrine , cortisol and blood
pressure ( sbp & dbp ) were found in terms of interaction by time interval and between
groups .
[ conclusion ] as a result of applying scalp massage to female office workers for 15
and 25 minutes , positive effects were observed on stress hormone , blood pressure and heart
rate .
therefore , scalp massage can be used for stress control with no spatial or time
limit . |
6,477 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chitin is plentiful in the structural coatings of fungi , insects , and parasitic nematodes , but it is not produced in mammals .
chitin , the linear polymer of -1,4 linked -n - acetyl - glucosamine ( glcnac ) , is the most abundant biopolymer in marine ecosystems and , after cellulose , the second most copious polysaccharide in nature . since chitin seems not to be made in mammals , it was initially assumed that chitinases would also be absent , being restricted to species that do contain the polymer .
however , the host defense against chitin - containing pathogens includes the production of chitinases .
chitinases are endo--1,4 linked -n - acetyl - glucosaminidase , and recently , two distinct chitinases have been identified in humans , chitotriosidase ( chit ) expressed in phagocytes , and an acidic mammalian chitinase ( amcase ) expressed in gastrointestinal tract , in lung , and conjunctiva .
amcase , 50 kda protein , is a member of the glycosyl hydrolase 18 family ( ec 3.2.1.14 ) and has structural similarity ( figure 1 ) with other glycosyl hydrolase 18 family members , including the lectins ym1 and ym2 , which are expressed in macrophages , human cartilage glycoprotein-39 ( hc - gp39 ) , and chitotriosidase ( muzzarelli , 2008 ) .
chit and amcase show chitinase enzymatic activity , whereas other mammalian chitinases do not possess this activity .
characteristically , the resistance to acidic ph distinguishes amcase from chit , which has its optimum at ph 6 . on the contrary
, amcase has its optimum at ph 2 and 4 in rodents and humans , respectively ; amcase is expressed in different tissues such as stomach , lung , and salivary glands , and appears to be associated with inflammatory diseases ( chou et al . , 2006 ) .
chit , has been shown to be expressed together with lysozyme in the human lacrimal gland ( hall et al . , 2008 ) .
this chitinase produced by macrophages and neutrophils also has a role in innate immunity ( van eijk et al . , 2005 ) .
since this chitinase was considered more active in... | chitinases have an important role in the defense of organisms against chitin - containing parasites .
an acidic mammalian chitinase ( amcase ) has been detected in epithelial cells in lung tissue samples taken from patients with asthma as well as in conjunctival epithelium of patients with inflammatory ocular diseases .
particularly , elevated amcase activity has been observed in ocular tissues of patients with vernal keratoconjunctivitis , seasonal allergic conjunctivitis , and in patients affected by dry eye syndrome . this enzyme is induced via a th2-specific , il-13-dependent pathway .
amcase may thus be a key mediator of il-13-induced responses in th2-driven inflammatory ocular diseases . |
6,478 | 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 ) is highly malignant neoplasm , derived from neuroendocrine cells .
it represents approximately 15% of all bronchial carcinomas , and this percentage is tending to decrease recently . in most cases , sclc arises in the larger airways and grows rapidly , becoming quite large .
it also has propensity to metastasize widely throughout the body at an early stage in its clinical course .
tonsillar metastasis from sclc is extremely rare , and clinically apparent cases are even less common .
idiopathic pulmonary fibrosis ( ipf ) is a chronic , progressive form of interstitial lung disease with poor prognosis and is a clinical term of usual interstitial pneumonia of unknown cause .
it has been reported to be associated with increased risk of lung cancer . in a study ,
the incidence of lung cancer was increased 7-fold in the ipf group compared with healthy subjects .
although the features of the lung cancer with ipf are similar to the general features of lung cancer , sclc is not common in fibrotic area of ipf .
the present case report describes sclc in ipf - associated lesion and its tonsillar metastasis , which is rarely seen .
a 77-year - old man admitted to our hospital with 1-month history of cough and dyspnea .
he had personal history of pulmonary tuberculosis 1 year ago . on physical examination of the thorax
, inspiratory dry crackles were heard on both lower lung fields . in observation of oral cavity , a large oval mass composed of soft tissue was detected in his throat .
the mass was arising from the right palatine tonsil and extending across the midline of the oropharynx ( figure 1a ) .
( a ) in physical examination , a large oval mass composed of soft tissue arose from the right palatine tonsil and extended across the midline of the oropharynx .
( b ) whole - body magnetic resonance revealed intraluminal protruding mass in the right peritonsillar region with heterogeneous enhancement , suggesting malignancy of palatine tonsil .
high - resolution computed tomography of chest... | abstractsmall cell lung cancer ( sclc ) metastasizes widely , but palatine tonsil is an extremely unusual site for metastasis .
idiopathic pulmonary fibrosis ( ipf ) is associated with increased risk of lung cancer .
however , the most common histological findings among patients of lung cancer with ipf are known as non - sclc such as adenocarcinoma and squamous cell carcinoma .
in addition , the majority of them are located in ipf - associated fibrotic peripheral lesions.a 77-year - old man visited for 1-month persistent cough and dyspnea , with inspiratory dry crackles on both lower lung fields and a large oval mass in his throat .
chest computed tomography revealed 2 masses in the left lower lobe , 1 mass in the right upper lobe , and multiple enlarged mediastinal lymph nodes of the lung accompanying with ipf , which were diagnosed as sclc pathologically .
very interestingly , the tonsillar mass was also confirmed as the metastatic lesion of sclc .
chemotherapy for sclc and medical treatment for ipf were applied . however , in following - up , he expired due to respiratory failure by an acute exacerbation of ipf 3 months after the diagnosis.in this current report , we describe , for the first time , a case of tonsillar metastasis of sclc with ipf detected simultaneously in a 77-year - old man . |
6,479 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: almost all countries , irrespective of economic status , are currently experiencing an obesity epidemic.13 residence area , occupation , and lifestyle significantly modify the body fat composition , and thus affect the prevalence of obesity.4,5 as a country undergoing economic transition , the people s republic of china has its own characteristics , such as the rapid economic growth and huge rural urban disparity , leading to the corresponding disparities in work and lifestyle .
whether or not these disparities in the residence area , occupation , and lifestyle increase the risk of obesity in the people s republic of china is a new issue and worthy of further study .
obesity is a fundamental pathology of cardiometabolic abnormalities , such as hypertension , type 2 diabetes , and dyslipidemia.6,7 in the people s republic of china , obesity contributes to an increased risk for cardiovascular disorders , the leading cause of death , especially in rural areas.8 therefore , early prevention , identification , and treatment of obesity are recognized as a major public health issue , emphasizing the importance of developing methods and criteria for establishing an accurate diagnosis.9 the excess and abnormal distribution of body fat are the primary defining characteristics of obesity , and various alternative methods of the measurement of obesity , such as the body mass index ( bmi ) and waist circumference ( wc ) , have been proposed and applied in clinical practice as easy to use and noninvasive .
the bmi is often used to reflect total body fat , whereas the wc is used as a surrogate marker of body fat centralization . in recent years
, it has been proposed that central rather than overall obesity can serve as an important identifier of cardiometabolic abnormalities.10 accordingly , the wc has been suggested to be a more useful tool in measuring abdominal fat.11 nevertheless , the wc has been criticized for not taking into account differences in the height and hip circumference ( hc ) , thus the waist - to - hip... | objectivethe study aimed to investigate the prevalence of overweight , obesity , and cardiometabolic abnormalities , the influence of residence area , occupation , and lifestyle on new anthropometric indices , and the relationship between anthropometric indices and cardiometabolic abnormalities in a chinese community - dwelling population.methodsthe study included 4,868 residents through a large health check - up program in beijing.resultsoverall obesity existed in 22.2% of men and 28.1% of women .
67.1% of men and 65.2% of women were overweight .
65.99% of men and 65.97% of women had central obesity .
residents of rural areas , manual workers , and smokers had significantly higher anthropometric indices .
the power of each anthropometric index varied for identifying different cardiometabolic abnormalities , and the ability of the waist - to - height ratio to identify participants with greater than one or two cardiometabolic abnormalities was optimal .
the appropriate cut - off values of all anthropometric indices for cardiometabolic abnormalities were obtained.conclusionoverweight is common for both sexes in the people s republic of china , as are general and central obesity .
residents of rural areas , manual workers , and smokers have significantly higher anthropometric indices .
waist - to - height ratio has the ability to reflect the compound risk of different cardiometabolic abnormalities and the greatest potential to be widely applied in clinical practice . |
6,480 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: isolated pauci - immune pulmonary capillaritis ( ipipc ) is a rare disorder of unknown etiology .
it is characterized by small vessel vasculitis confined to lungs , and systemic manifestations are typically absent .
it is considered as a subset of microscopic polyangiitis ( mpa ) but is mostly sero - negative for anti - neutrophilic cytoplasmic antibodies ( anca ) .
, the disorder was fully characterized by jenning et al . since then only sporadic case reports of the disorder are available in the english literature .
we are reporting such a case which , to the best of our knowledge and belief , is the first case report of the disorder in indian medical literature .
rd , a 28-year - old housewife from narnaul , haryana , was referred to the outpatient department of respiratory medicine on 23.08.2013 with low grade fever , cough , hemoptysis and shortness of breath ( sob ) for about 40 days duration .
she was a multi - para with normal vaginal deliveries , last being 11 years back . prior to this ,
she reported to a private practitioner with sudden onset of intermittent fever , cough and sob for which she was put on oral amoxiclav along with symptomatic treatment but after a bout of severe hemoptysis , she was rushed to a general hospital on 18.07.2013 where she was investigated .
her x - rays [ figure 1a and b ] , contrast enhanced computerized tomography ( cect ) and high - resolution computerized tomography ( hrct ) thorax [ figure 2a and b ] revealed diffuse bilateral cavitating nodular lesions and consolidation in right lower lobe along with small pleural effusion but without any remarkable changes in the mediastinal lymph nodes or the vasculature .
echocardiography revealed trivial tricuspid regurgitation without any clot or vegetation , normal pericardium and an ejection fraction of 60% .
she was kept on intravenous ( iv ) meropenem and levofloxacin along with other symptomatic treatment but the patient continued to deteriorate and she was referred to this hospital .
laboratory investigations before... | a young house wife presented with low grade fever , cough , haemoptysis and sob of unknown aetiology for 40 days duration .
respiratory system examination revealed diffuse crepts and rhonchi .
other organ system examination did not reveal any abnormality .
x - ray chest pa view and ct thorax showed diffuse bilateral necrotising nodular lesions of various sizes with small pleural effusion .
she also had low resting oxygen saturation with falling haematocrit .
her serum was week positive for p - anca and negative for mpo - anca .
bronchoscopy revealed continuous bloody aspirates .
we could not isolate any organisms in any of the specimens from her and she was unresponsive to any of the antibiotics either . based on the clinical , laboratory data , radiological features and positive outcome to pulse therapy of methylprednisolone and cyclophosphamide , she was diagnosed as a case of ipipc . |
6,481 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: when oxygen supply to the fetus is significantly disrupted , tissue oxygenation deprivation develops , acids begin to accumulate and acidemia develops . umbilical cord blood gas measurement in comparison with the fetal scalp ph monitoring could better detect a hypoxic baby . in 1952 ,
virginia apgar , proposed a scoring system to assess the condition of newborns during the first minutes of life , and to evaluate anesthetic and obstetrical practices .
she proposed five objectives and easily - measured clinical signs : heart rate , respiratory effort , muscle tone , reflex irritability , and color .
it has been used to assess asphyxia , predict neurological damage and vitality of a neonate during the first minute of life .
umbilical cord blood gas assessment seems to be the most objective determination of the fetal metabolic condition at the time of birth [ 47 ] .
manganaro and colleagues suggested that the 5 minute apgar score is useful for immediate clinical assessment and care of the neonate .
they found 5 minute apgar score had a high concordance with metabolic acidemia , but anyaegbunam and colleagues ' study revealed that in 20.7% of neonates delivered had an abnormal ph ( less than 7.20 ) and normal apgar .
the present study was carried out to determine the correlation between umbilical cord ph and apgar score in high - risk pregnant mother .
this was a prospective cross sectional study conducted in a teaching hospital during february 2004 to september 2005 .
the study was approved by the research ethics committee of babol university of medical sciences .
study population consisted of mothers who came with labor pain according to the sample size . at the time of admission
, they were assigned to high or low risk group according to whether or not they had any perinatal risk factor that categorized them as high - risk pregnancy .
high - risk pregnancy was defined as a pregnant mother who is at risk to deliver a neonate with birth asphyxia according to the definition by american academy of pediatrics .
all... | objectivethe apgar score as a proven useful tool for rapid assessment of the neonate is often poorly correlated with other indicators of intrapartum neonatal well - being .
this study was carried out to determine the correlation between umbilical cord ph and apgar score in high - risk pregnancies.methodsthis is a prospective cross - sectional , analytic study performed on 96 mother - fetal pairs during 2004 - 2005 at shahid yahyanejad hospital , which is affiliated to babol university of medical sciences .
apgar score at 1 and 5 minutes after birth was taken and an umbilical cord blood gas analysis was done immediately after birth in both groups .
mothers came with a labor pain and were divided into high - risk and low risk if they have had any perinatal risk factors .
other data like gestational age , birth weight , need for resuscitation and admission to the newborn ward or neonatal intensive care unit was gathered by a questionnaire for comparison between the two groups .
p - value less than 0.05 was considered being significant.findingsthe gestational age and birth weight were the same in high - risk and low risk mothers . mean umbilical artery blood ph in high - risk mothers was significantly lower than in low risk mothers ( p=0.004 ) .
mean apgar scores at 1 and 5 minutes were significantly lower in high - risk mothers than in low risk mothers ( p<0.05 ) .
according to the kendal correlation coefficient there was no significant correlation between apgar score at 1 and 5 minutes and umbilical cord ph in low risk group ( r=0.212 , p=0.1 ) .
but in high - risk group there was significant correlation between apgar score at 1st and 5th minute and the umbilical cord ph ( r=0.01 , p=0.036 and r=0.176 , p=0.146 , respectively).conclusioncombination of apgar score and umbilical cord ph measurement in high - risk pregnant mother could better detect jeopardized baby . |
6,482 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: vaccination has been one of the most effective measures to control infectious diseases in the 20th century .
most of the viral ( mumps , rubella , measles , varicella and rotavirus ) and bacterial ( tetanus , diphteria , haemophilus influenzae , streptococcus pneumoniae , meningococcus group c ) diseases traditionally affecting childhood all over the world are now preventable with vaccines ( givs 20062015 at http://www.who.int/vaccinesdocuments ) .
besides paediatric and adult population , vaccination has been successfully extended to adolescents , elderly , immunocompromised subjects and pregnant women .
although therapeutic vaccines targeting ongoing chronic infectious diseases have not yet been developed , effective vaccines exist that prevent chronic infections by human papilloma virus ( hpv ) and hepatitis b virus ( hbv ) , which in some cases cause cancer . in summary vaccination
has been and continues to represent a success story ( plotkin et al . , 2008 ; levine et al . , 2009 ) .
however , there is still a long list of viruses [ e.g. hepatitis c virus ( hcv ) , human immunodeficiency virus ( hiv ) , dengue , respiratory syncytial virus ( rsv ) and cytomegalovirus ( cmv ) ] ; parasites ( e.g. plasmodium , leishmania , schistosoma , trypanosoma ) and bacteria [ e.g. mycobacterium tuberculosis ( tb ) , group a streptococcus ( gas ) , group b streptococcus ( gbs ) , staphylococcus aureus , meningococcus group b ( menb ) , shigella , pathogenic escherichia coli ] that are not preventable by vaccination , and infectious diseases are still a major cause of death and disability worldwide .
thirtythree million people are currently infected by hiv that causes 1.8 million deaths per year ( who global summary of aids epidemic : http://www.unaids.org/globalreport ) .
malaria and tuberculosis together kill almost 3 million people every year ( who report 2010 : http://www.who.int ) .
the total number of deaths increases even more if we include those caused by vaccine preventable infections in areas of the world... | summaryconventional vaccines have been extremely successful in preventing infections by pathogens expressing relatively conserved antigens through antibodymediated effector mechanisms .
thanks to vaccination some diseases have been eradicated and mortality due to infectious diseases has been significantly reduced . however , there are still many infections that are not preventable with vaccination , which represent a major cause of mortality worldwide . some of these infections are caused by pathogens with a high degree of antigen variability that can not be controlled only by antibodies , but require a mix of humoral and cellular immune responses . novel technologies for antigen discovery , expression and formulation allow now for the development of vaccines that can better cope with pathogen diversity and trigger multifunctional immune responses .
in addition , the application of new genomic assays and systems biology approaches in human immunology can help to better identify vaccine correlates of protection .
the availability of novel vaccine technologies , together with the knowledge of the distinct human immune responses that are required to prevent different types of infection , should help to rationally design effective vaccines where conventional approaches have failed . |
6,483 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: suicide is an important health challengeand one of the main leading causes of premature death worldwide ( 1 , 2 ) .
suicide rate is among the top three causes of death in people aged 1544 yr old ( 3 ) .
the rate of suicide ideation is reported to be highest among elderly ( 1 ) .
completed suicide is 5% to 10% of suicide attempts including one attempt in every 3 and one death from suicide in every 40 sec ( 5 ) . according to the report of iranian ministry of health and medical education in 2004 ,
suicide is the 13 cause of death ( 6 ) and the second cause of death from external causes of morbidity(7 ) , the rate of suicide attempt is 3 times in women , while , the rate of completed suicide is 4 times more common in men ( 8) . among iranian population at 2012 ,
3216 suicide attempts occurred including 6 suicide attempts per 100,000 populations with the highest rate in the second decade of life ( 9 , 10 ) .
classification is defined as an approach to determine a class for a new object applied using different methods such as data mining ( machine learning ) techniques ( 11 ) .
decision tree ( dt ) , k - nearest neighbor , logistic regression ( lr ) , naive bayes , c4.5 , support vector machine ( svm ) and linear classifier are among conventional classification methods ( 1214 ) .
classification methodsinclude two main steps : first , a training sample of the dataset is determined randomly to find the model and the second step tests the resulted model ( 12 ) .
according to the kind of dataset , different methods result in different accuracy of prediction .
the comparison among the methods can be applied using different criteria such as area under curve , which measures the accuracy of the prediction ( 13 ) . among different classification methods ,
lr is the most popular predicting the presence or absence of an attribute using covariates .
however , dt is preferable when there are predetermined set of attributes , the response is discrete and disjunctive and graphical results are required ( 15 ) . artificial neural... | background : we aimed to assess the high - risk group for suicide using different classification methods includinglogistic regression ( lr ) , decision tree ( dt ) , artificial neural network ( ann ) , and support vector machine ( svm).methods : we used the dataset of a study conducted to predict risk factors of completed suicide in hamadan province , the west of iran , in 2010 . to evaluate the high - risk groups for suicide , lr , svm , dt and ann were performed .
the applied methods were compared using sensitivity , specificity , positive predicted value , negative predicted value , accuracy and the area under curve .
cochran - q test was implied to check differences in proportion among methods . to assess
the association between the observed and predicted values , coefficient , contingency coefficient , and kendall tau - b were calculated.results:gender , age , and job were the most important risk factors for fatal suicide attempts in common for four methods .
svm method showed the highest accuracy 0.68 and 0.67 for training and testing sample , respectively .
however , this method resulted in the highest specificity ( 0.67 for training and 0.68 for testing sample ) and the highest sensitivity for training sample ( 0.85 ) , but the lowest sensitivity for the testing sample ( 0.53 ) .
cochran - q test resulted in differences between proportions in different methods ( p<0.001 ) .
the association of svm predictions and observed values , coefficient , contingency coefficient , and kendall tau - b were 0.239 , 0.232 and 0.239 , respectively.conclusion:svm had the best performance to classify fatal suicide attempts comparing to dt , lr and ann . |
6,484 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: amyotrophic lateral sclerosis ( als ) is a common progressive , neurodegenerative disorder of the voluntary motor system that affects motor neurons in the cerebral cortex , brain stem , and spinal cord .
the latter rapidly leads to pulmonary compromise requiring mechanical ventilation and represents the major cause of mortality .
eighty - four percent of als patients die of respiratory complications and respiratory insufficiency in 2 - 3 years after diagnosis . on a retrospective chart review
, it was found that 2.7% of patients with als had respiratory symptoms as their first symptom and that the average survival period of these patients was only 2 months [ 3 , 4 ] .
hence , reduced ventilation results , in part , from progressive motor neuron degeneration , which leads to respiratory muscle weakness . respiratory muscle weakness is defined as the inability of the respiratory muscles to generate normal levels of pressure and air flow during inspiration and expiration .
this leads to respiratory insufficiency , which is defined as inadequate pulmonary ventilation to the point that gas exchange is impaired , resulting in carbon dioxide retention , hypoxemia , and respiratory failure [ 5 , 6 ] .
als patients are able to withstand respiratory muscle weakness by using other muscles at the initial stage , but the symptoms progress gradually to respiratory insufficiency and eventual respiratory failure . in the majority of cases , death is related to respiratory events .
the time of progression and the degree of respiratory muscle weakness are , therefore , important prognostic factors for als patients .
hypoventilation in als patients is due to respiratory muscle weakness and is associated with poor survival , cognitive impairment , and a poor quality of life ; this has led to an increase in concern about the respiratory problems faced by als patients and a dramatic increase of relevant knowledge .
several studies have shown that treatment of als patients with noninvasive positive pressure ventilation ( nippv )... | respiratory dysfunction and complications are the most common causes of death in amyotrophic lateral sclerosis .
this is a pilot study to observe the changes in respiratory physiology parameters after sa - am acupuncture treatment .
eighteen als patients received sa - am acupuncture treatment twice a day for 5 days .
the etco2 , spo2 , rr , and pulse rate were measured for 15 min before and during treatment , using capnography and oximetry .
correlation of k - alsfrs - r scores against measured parameters showed that patients who had high k - alsfrs - r scores had greater changes in pulse rate after acupuncture stimulation ; they also showed a decrease in etco2 , rr , and pulse rate and an increase in spo2 .
a comparison of the mean values of these different parameters before and after sa - am acupuncture stimulation revealed statistically significant differences ( p < 0.05 ) in spo2 and pulse rate , but none in etco2 and rr .
sa - am acupuncture treatment on als patients seems to be more effective in the early stages of the disease . in light of increased spo2 values
, sa - am acupuncture appears to have a greater effect on inspiration rather than on expiration . as a pilot study of acupuncture on als patients , this study could be used as a basis for future research . |
6,485 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: technological advances in industrial societies have led to sedentary lifestyles at home and at work .
inactivity and the excess intake of calorie - rich foods are the main culprits in the twin epidemics of obesity and type 2 diabetes - associated cardiovascular disease , disproportionately affecting women , especially those of african descent . skeletal muscle
, the major site of glucose disposal , increases with body weight with steeper slopes of the regression lines in black women compared with white women and is associated with decreased insulin sensitivity . on the other hand , chronic elevation in insulin levels as a result of deceased insulin sensitivity may have direct effects on skeletal muscle mass by stimulating contractile protein synthesis , as has been shown in animal models , possibly due to structural homology with insulin - like growth factor . increased muscle mass -- especially in the lower extremities -- might be adaptive for accommodating an increased body mass during ambulation . increased muscle mass however , may be maladaptive if muscle function is compromised by lipid - induced interference with mitochondrial oxidative metabolism , with greater imbalance between myofibrillar contractile units and energy supply for activation .
we addressed this hypothesis by : 1 ) analyzing cross - sectional insulin and muscle mass data from overweight women entering a worksite wellness program , and 2 ) determining changes in insulin and body composition following 6 months of participation in the diet and exercise program .
as black women are reported to have greater skeletal muscle mass than white women in relation to body size , as a secondary analysis we examined racial differences in associations between extremity muscle mass and insulin .
overweight ( body mass index [ bmi ] 25 to 30 kg / m ) and obese ( bmi 30 kg / m ) non - diabetic ( fasting glucose < 126 mg / dl ) female employees of the national institutes of health , who self - identified as healthy and not active participants in exercise... | obesity disproportionately affects women , especially those of african descent , and is associated with increases in both fat and muscle masses . although increased extremity muscle mass may be compensatory to fat mass load , we propose that elevated insulin levels resulting from diminished insulin sensitivity may additionally contribute to extremity muscle mass in overweight or obese women .
the following measurements were performed in 197 non - diabetic women ( 57% black , 35% white ; age 4611 years [ meansd ] , bmi range 25.0 to 57.7 kg / m2 ) : dual - energy x - ray absorptiometry for fat and extremity muscle masses ; exercise performance by duration and peak oxygen consumption ( vo2 peak ) during graded treadmill exercise ; fasting insulin and in 183 subjects insulin sensitivity index ( si ) calculated from the minimal model .
si ( range 0.5 to 14.1 liter / mu1min1 ) was negatively , and fasting insulin ( range 1.9 to 35.6 u / ml ) positively , associated with extremity muscle mass ( both p<0.001 ) , independent of age and height .
sixty - seven percent of women completed 6 months of participation in a weight loss and exercise program : we found a significant association between reduction in fasting insulin and a decrease in extremity muscle mass ( p=0.038 ) , independent of reduction in fat mass or improvement in exercise performance by vo2 peak and exercise duration , and without association with change in si or interaction by race .
thus , hyperinsulinemia in overweight or obese women is associated with increased extremity muscle mass , which is partially reversible with reduction in fasting insulin concentration , consistent with stimulatory effects of insulin on skeletal muscle . |
6,486 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: target of rapamycin ( mtor ) is an evolutionarily conserved serine / threonine kinase that regulates cell growth and division in response to energy levels , growth signals , and nutrients .
control of mtor activity is critical for the cell since its dysregulation leads to cancer , metabolic disease , and diabetes . in cells
, mtor exists as two structurally distinct complexes termed mtor complex 1 ( mtorc1 ) and mtor complex 2 ( mtorc2 ) , each one with specificity for different sets of effectors .
mtorc1 couples energy and nutrient abundance to cell growth and proliferation by balancing anabolic ( protein synthesis and nutrient storage ) and catabolic ( autophagy and utilization of energy stores ) processes .
although different cellular locations for mtorc1 and mtorc2 have been reported ( these studies were recently summarized in an excellent review by betz and hall ) , there is a consensus that the localization of mtorc1 to lysosomes is critical for its ability to sense and respond to variations in the levels of amino acids .
when amino acid levels are high , mtorc1 is recruited to the lysosomal surface , where it is activated by the guanosine-5-triphosphate ( gtp)-loaded form of the small gtpase rheb ( ras homolog enriched in brain ) .
the amino acid - dependent translocation of mtor to the lysosome requires active rag gtpases and a ragulator , a pentameric protein complex that anchors the rag gtpases to lysosomes [ 6 - 8 ] .
the rag proteins function as heterodimers in which the active complex consists of gtp - bound raga or b complexed with guanosine diphosphate ( gdp)-bound ragc or d. it has been proposed that amino acids trigger the gtp loading of raga / b proteins , thus promoting the binding to raptor and assembly of an activated mtorc1 complex .
however , it is important to mention that this model was recently challenged by a study suggesting that the activation of mtorc1 is not dependent on the rag gtp charging .
therefore , further studies will be required to solve this apparent discrepancy and... | lysosomes are key cellular organelles that play a crucial role in catabolism by degrading extracellular and intracellular material .
it is , therefore , very intriguing that mtorc1 ( mechanistic target of rapamycin complex 1 ) , a major promoter of anabolic processes , localizes in its active form to the surface of lysosomes . in recent years
, many exciting observations have revealed a tightly regulated crosstalk between mtorc1 activity and lysosomal function .
these findings highlight the complex regulatory network that modulates energy metabolism in cells . |
6,487 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: there are several medical and surgical [ 2 , 3 ] treatment options for obstructive sleep apnea ( osa ) .
patients who use continuous positive airway pressure ( cpap ) devices have been shown to have nasal obstruction as a common complaint ( estimated prevalence : 2545% ) [ 46 ] .
as described by poiseuille 's law , airflow resistance is proportional to the length and is inversely proportion to the radius to the fourth power .
because the radius is such an important variable , small changes , such as a 10% increase in the cross - sectional area of the nasal cavity airway , can result in a 21% increase in airflow .
although surgery on the nose has not been shown to dramatically improve osa , it can improve cpap device use . a recent systematic review and meta - analysis also demonstrated that isolated nasal surgery reduces cpap device therapeutic treatment pressures by 2 - 3 centimeters of water pressure ( cwp ) .
therefore , surgically increasing the size of the nasal airway decreases nasal resistance and reduces cpap device pressure requirements . however , to our knowledge , for patients who have not undergone nasal surgery it is unknown whether patients with smaller turbinates have lower cpap therapeutic treatment pressure requirements when compared to patients with larger turbinates .
a recently published systematic review did not identify any study in the international literature that used inferior turbinate size as a variable in mathematical equations to predict cpap .
for this study we hypothesized that , in patients who have not had nasal surgery , large turbinates would require higher cpap therapeutic treatment pressures than small inferior turbinates . because it has previously been shown that nasal surgery can reduce cpap therapeutic treatment pressures , we planned to exclude patients with prior nasal surgery in order to remove this confounding variable .
the objective of this study is to evaluate the effect of turbinate sizes on the cpap titration based therapeutic treatment pressures ( in... | objective . to evaluate the effect of turbinate sizes on the titrated continuous positive airway pressure ( cpap ) therapeutic treatment pressures for patients with obstructive sleep apnea ( osa ) who have not had nasal surgery
. study design .
retrospective case series . methods .
a chart review was performed for 250 consecutive patients .
results .
45 patients met inclusion criteria .
the mean standard deviation ( m sd ) for age was 54.6 22.4 years and for body mass index was 28.5 5.9 kg / m2 .
the spearman 's rank correlation coefficient ( rs ) between cpap therapeutic treatment pressures and several variables were calculated and were weakly correlated ( age rs = 0.29 , nasal obstruction rs = 0.30 ) , moderately correlated ( body mass index rs = 0.42 and lowest oxygen saturation rs = 0.47 ) , or strongly correlated ( apnea - hypopnea index rs = 0.60 and oxygen desaturation index ( rs = 0.62 ) ) .
no statistical significance was found with one - way analysis of variance ( anova ) between cpap therapeutic treatment pressures and inferior turbinate size ( right turbinates p value = 0.2012 , left turbinate p value = 0.3064 ) , nasal septal deviation ( p value = 0.4979 ) , or mask type ( p value = 0.5136 ) . conclusion . in this study ,
cpap titration based therapeutic treatment pressures were not found to be associated with inferior turbinate sizes ; however , the cpap therapeutic treatment pressures were strongly correlated with apnea - hypopnea index and oxygen desaturation index . |
6,488 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in november 2009 , a bat was found on the ground in bokeloh , lower saxony , germany ( 522513.99n ; 92331.56e ) .
it was given mealworms and water ad libitum supplemented with minerals and vitamins . in february 2010 , the bat began to act aggressively , directly approaching any moving object , vigorously trying to bite , and screaming ferociously .
this agitated stage lasted for 7 days and was followed by general weakness , lethargy , and paralysis . after the first 3 days of the clinical course
the bat was submitted for testing , and rabies diagnosis was performed by using immunohistochemical analysis .
lyssavirus antigen was detected in numerous neurons of the cerebral cortex , cerebellum , and especially the nucleus funiculi lateralis and the nucleus olivaris of the medulla ( figure 1 ) .
organs other than the central nervous system , e.g. , the salivary glands , did not contain lyssavirus antigen . after the first cell passage in rabies tissue culture infection test ( 9 ) , virus was isolated from brain tissue .
antigenic typing performed with a panel of 10 antinucleocapsid monoclonal antibodies ( 10 ) clearly differentiated the isolated virus from all other tested lyssavirus species ( table ) .
immunohistochemical analysis of brain of natterer s bat for lyssavirus antigen by using the avidin biotin complex method .
cytoplasmic granular - to - diffuse staining for rabies antigen is visible in the perikarya and neuronal processus .
b ) medulla and neurons of the nucleus funiculi lateralis showing strong cytoplasmic staining for rabies antigen .
bblv , bokeloh bat lyssavirus ; rabv , rabies virus ; lbv , lagos bat virus ; mokv , mokola virus ; duvv , duvenhage virus ; eblv , european bat lyssavirus ; ablv , australian bat lyssavirus ; + + + , strongly positive ; , negative .
results of discriminatory reverse transcription pcr results for eblv-1 and eblv-2 ( 11,12 ) were negative , and only a generic reverse transcription pcr ( 13 ) yielded a 605-bp amplification product similar to that of the positive... | a virus isolated from a natterer s bat ( myotis nattererii ) in germany was differentiated from other lyssaviruses on the basis of the reaction pattern of a panel of monoclonal antibodies .
phylogenetic analysis supported the assumption that the isolated virus , bokeloh bat lyssavirus , may represent a new member of the genus lyssavirus . |
6,489 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: however , its administration is associated with problems , such as the
adjustments needed to maintain an effective blood concentration .
in addition , dietary
restrictions are necessary , because vitamin k levels influence warfarin s efficacy . in
recent years , novel oral anticoagulants ( noacs )
those have demonstrated
encouraging outcomes , as well as effects comparable to those of warfarin .
noacs are increasingly being used for primary and secondary
prevention with respect to cardiogenic embolisms . with the aging of society ,
elderly
patients suffering from atrial fibrillation make up a growing population . as a result ,
the
prevention of cardiogenic embolisms is becoming a major issue for social and health
economics .
since warfarin
has a long half - life , controlling intracranial bleeding is very difficult .
there are some
reports that the incidence of intracranial bleeding after noac administration is not as
frequent as in patients treated with warfarin .
other reports indicate that the clinical course following intracranial hemorrhage is better
in noac patients than in warfarin patients .
we investigated the progress and prognosis of cases at our
institute in which conservative therapy was selected , with intracranial bleeding as a
complication during noac administration .
noacs were administered to 313 patients ( dabigatran : 173 , rivaroxaban : 140 ) at our
institute between 2011 and july 2014 .
all patients were diagnosed with non - valvular atrial
fibrillation and noac medication was started for the prevention of cardiogenic embolization .
patients were allocated to dabigatran or rivaroxaban on the basis of their application time ,
medication compliance , and other factors . random assignment was not performed . among these
patients ,
an 85-year - old man with a history of high - blood pressure , diabetes , and episodic atrial
fibrillation ( cardiac pacemaker ) was staying at a health and welfare institution for the
elderly because of dementia .
he... | objective : oral anticoagulants are widely administered to patients with
atrial fibrillation in order to prevent the onset of cardiogenic embolisms . however ,
intracranial bleeding during anticoagulant therapy often leads to fatal outcomes .
accordingly , the use of novel oral anticoagulants ( noacs ) , which less frequently have
intracranial bleeding as a complication , is expanding . a nationwide survey of intracranial
bleeding and its prognosis in japan reported that intracranial bleeding of advanced
severity was not common after noac administration .
in this report , two cases from our
institute are presented.patients : case 1 was an 85-year - old man with a right frontal lobe hemorrhage
while under dabigatran therapy .
case 2 was an 81-year - old man who had cerebellar
hemorrhage while under rivaroxaban therapy.result : in both patients , the clinical course progressed without aggravation
of bleeding or neurological abnormalities once anticoagulant therapy was discontinued.conclusion : these observations suggest that intracranial hemorrhage during
noac therapy is easily controlled by discontinuation of the drug .
noac administration may
therefore be appropriate despite the risk of such severe complications .
further case
studies that include a subgroup analysis with respect to each noac or patient background
will be required to establish appropriate guidelines for the prevention of cardiogenic
embolisms in patients with atrial fibrillation . |
6,490 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: many people are not aware of the harmful effects of radiofrequency waves ( rf ) and their role in cancer and other serious risks .
scientific evidence suggests that cancer is not only linked to mobile phone radiation and that other factors also may be involved in its development .
most mobile operators use from radiofrequency waves in the range up 300 mhz to 3 ghz that can be harmful for human health ( 1 ) .
many scientific studies have been done on the radiobiological effects of rf waves , and most of them have reported the rare relationship between rf exposure and risks posed by mobile phones on the body in the last 15 years ( 2 ) .
however , they could lead to increased body temperature , especially in the head and neck , who have a low threshold dose and increases the probability of injury if there is long - term exposure to these waves .
when using mobile phones , various factors should be considered , such as the duration , location , and method of use , in order to reduce the possible effects of exposure to radiation in the rf .
because of the risk of mutation and sexual trauma and to prevent infertility due to the effect on male sexual cells , the mobile phone should be away from the waist . in this study , we measured the emitted dose from a radiofrequency device at different frequencies using a scintillation detector .
the results of this study and international commission of non ionization radiation protection ( icnirp ) reports show that people who use cell phones more than 50 minutes a day face early dementia or other thermal damage due to the burning of glucose in the brain ( 3 ) . currently , the ranges of subjects related to occupational and public exposure of electromagnetic fields have been increased . due to the possibility of adverse effects on human health , performance study of these devices
there are two types of electromagnetic fields based on the frequency range , i.e. , extremely low frequency ( elf ) and very low frequency ( vlf ) fields .
elf and vlf fields frequency ranges are... | introductionpublic and occupational exposure to electromagnetic fields due to the growing trend of electronic devices may cause adverse effects on human health . this paper describes the risk of mutation and sexual trauma and infertility in masculine sexual cell by mobile phone radiations.methodsin this study , we measured the emitted dose from a radiofrequency device , such as switching high voltage at different frequencies using a scintillation detector .
the switching high voltage power supply ( hvps ) was built for the single photon emission computed tomography ( spect ) system . for radiation dosimetry
, we used an alnor scintillator that can measure gamma radiation .
the simulation was performed by matlab software , and data from the international commission on non - ionizing radiation protection ( icnirp ) were used to verify the simulation.resultswe investigated the risks that result from the waves , according to a report by international commission on non ionizing radiation protection ( icnirp ) , to every organ of the body is defined by the beam and electromagnetic radiation from this electronic device on people .
the results showed that the maximum personal dose over a 15-min period working at the mentioned hvps did not exceed 0.31 sv / h ( with an aluminum shield ) .
so , according to other sources of radiation , continuous working time of the system should not be more than 10 hours . finally , a characteristic curve for secure working with modules at different frequencies was reported .
the rf input signal to the body for maximum penetration depth ( ) and electromagnetic energy absorption rate ( sar ) of biological tissue were obtained for each tissue.conclusionthe results of this study and international commission of non ionization radiation protection ( icnirp ) reports showed the people who spend more than 50 minutes a day using a cell phone could have early dementia or other thermal damage due to the burning of glucose in the brain . |
6,491 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the transforming growth factor - beta ( tgf ) was discovered more than two decades ago and was isolated as a secreted factor from sarcoma virus - infected cells [ 13 ] .
tgf was shown to transiently confer on normal fibroblasts phenotypic properties of transformed cells , as demonstrated by their acquired ability to grow in soft agar in an anchorage - independent manner . since then , more than 40 different family members have been identified , including the activin / inhibin subfamily , the bone morphogenetic proteins ( bmps ) , nodal , myostatin , and the mullerian inhibitory substance ( mis ) [ 47 ] . as for the tgf
subfamily , three distinct isoforms have been identified ( tgf-1 , -2 , -3 ) , each encoded by a different gene [ 4 , 810 ] .
of the three different types of tgf , which share around 70% homology within their sequence , tgf-1 has been the most studied isoform and will hereinafter be referred to as tgf. the active tgf molecule is a homodimer stabilized by hydrophobic interactions strengthened by a disulfide bond .
this active form of tgf is synthesized from a large inactive precursor molecule , called latent tgf. as shown in figure 1 , latent tgf is composed of a tgf dimer in a noncovalent complex with the tgf propeptide or latency - associated peptide ( lap ) that remains bound to tgf after secretion , retaining tgf in an inactive form and the latent tgf-binding protein ( ltbp ) which is linked to lap by a disulfide bond .
this precursor molecule is stored in the extracellular matrix that acts as a reservoir for tgf. the activation of the tgf precursor is controlled by multiple processes , such as proteolytic enzymatic activity ( furins , plasmin , calpain , etc . ) but also acid , alkali , and heat - induced proteolysis .
moreover , tgf can be activated by glycosidases , thrombospondin , and by some therapeutic molecules , such as antiestrogens and retinoic acid [ 13 , 14 ] .
the mature tgf is a homodimeric protein composed of two monomeric subunits linked by a single disulfide bond... | the transforming growth factor - beta ( tgf ) superfamily encompasses widespread and evolutionarily conserved polypeptide growth factors that regulate and orchestrate growth and differentiation in all cell types and tissues .
while they regulate asymmetric cell division and cell fate determination during early development and embryogenesis , tgf family members play a major regulatory role in hormonal and immune responses , cell growth , cell death and cell immortalization , bone formation , tissue remodeling and repair , and erythropoiesis throughout adult life .
the biological and physiological functions of tgf , the founding member of this family , and its receptors are of central importance to human diseases , particularly cancer . by regulating cell growth , death , and immortalization , tgf signaling pathways exert tumor suppressor effects in normal cells and early carcinomas .
thus , it is not surprising that a high number of human tumors arise due to mutations or deletions in the genes coding for the various tgf signaling components .
as tumors develop and progress , these protective and cytostatic effects of tgf are often lost .
tgf signaling then switches to promote cancer progression , invasion , and tumor metastasis .
the molecular mechanisms underlying this dual role of tgf in human cancer will be discussed in depth in this paper , and it will highlight the challenge and importance of developing novel therapeutic strategies specifically aimed at blocking the prometastatic arm of the tgf signaling pathway without affecting its tumor suppressive effects . |
6,492 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: intersphincteric resection ( isr ) is a procedure that aims to preserve anal function in patients with very low rectal cancer . since the introduction of laparoscopic rectal surgery for rectal cancer
first described laparoscopic isr ( lap isr ) in 2000 , and a number of cases have since been reported .
we present our clinical experience with lap isr performed using needlescopic instruments in two patients with very low rectal cancer .
the first port for the camera is placed at the umbilicus using the open technique .
two 5-mm ports for the operator are inserted through the right upper and lower quadrants , and the upper port is placed where a diverting stoma would be created .
two needlescopic forceps ( endo - relief hope denshi co. , chiba , japan ) for the assistant are inserted into the left upper , and lower quadrants , such that a total of 5 ports are placed [ figure 1 ] .
the port placement ( schema and external view ) the endo - relief is a new type of needlescopic forceps .
the tip of this new forceps has the same shape and size as that of the conventional 5-mm forceps ; however , the new forceps type has a shaft measuring 2.4 mm in diameter . during the operation ,
this needlescopic forceps is assembled from five parts , including the tip which has the same size and shape as the conventional 5-mm forceps and a shaft measuring 2.4 mm in diameter assembling and use this forceps as follows .
the shaft guide plus ( hope denshi co. , chiba , japan ) is directly inserted into the abdominal cavity through the abdominal wall.the top of the guide is passed through a 5-mm port extra - corporeally , and the inner needle is removed.the forceps end is connected to the shaft guide outer sheath.the handle parts are finally assembled , and the forceps top is then intra - corporeally pulled through a 5-mm port [ figure 3 ] .
the shaft guide plus ( hope denshi co. , chiba , japan ) is directly inserted into the abdominal cavity through the abdominal wall .
the top of the guide is passed through a 5-mm port extra... | intersphincteric resection ( isr ) is a procedure designed to preserve anal function in cases with very low rectal cancer .
we report our clinical experience with laparoscopic isr ( lap isr ) performed using needlescopic instruments .
first , a camera port is created at the umbilicus .
two 5-mm ports are then inserted at the right upper and lower quadrants .
two needlescopic forceps ( endo - relief hope denshi co. , chiba , japan ) are inserted at the left upper and lower quadrants .
we then perform the following procedures ; ligation of the inferior mesenteric artery and vein , total mesorectal excision and dissection of the intersphincteric space . after the transanal intersphincteric dissection
, the specimen is extracted through the anus and a hand sewn coloanal anastomosis is performed .
the covering ileostomy is finally created at the right upper port .
we performed lap isr using needlescopic forceps in two patients with very low rectal cancer . in both cases
, we were able to perform this procedure without insertion of an additional port or to change the needlescopic forceps to conventional 5-mm forceps .
lap isr with needlescopic instruments is a feasible procedure for minimally invasive surgery . |
6,493 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is well known that the main phenomenon of hypoxemia in acute lung injury / acute respiratory distress syndrome ( ali / ards ) is the high shunt fraction caused by the nonaerated areas of the lungs . during the disease process ,
the volume of extravascular lung water and the lung weight increase and promote the collapse of peripheral airways and lung parenchyma , mainly in the gravitation - dependent lung regions ( fig .
the relationship between the nonaerated , poorly aerated , normally aerated and hyperinflated lung regions depends on the degree of heterogeneity of the ali / ards and the net result of the interaction of the pressure applied to the lung parenchyma ( airway pressure / end expiratory pressure ) and chest wall mechanics , as illustrated in the report by henzler and colleagues appearing in this issue of critical care .
the most important force is not the airway pressure or tidal volume itself but the stress and strain that this airway pressure / tidal volume generates and the duration of these stresses and strains . at the bedside ,
the rough equivalent of stress is transpulmonary pressure , and the rough equivalent of the strain is tidal volume / end expiratory lung volume .
this modern and complex mechanical ventilatory approach of ali / ards recruitment maneuvers and positive end - expiratory pressure ( peep)/tidal ventilation titration is a meshwork of interdependent but heterogeneously affected lung subunits that are behave according to different and multiple pressure volume envelopes of the respiratory system during mechanical ventilation , which in some cases can be represented by respiratory mechanics ( depending on the heterogeneity and etiology of the ali / ards and the net results of the mechanical configuration of the respiratory system and the applied inspiratory / expiratory pressure along the mechanical ventilatory support duration ) . in 1998 , a brazilian prospective , randomized and controlled trial of mechanical ventilation in patients with ards demonstrated that a lung... | recruitment maneuvers and positive end - expiratory pressure ( peep)/tidal ventilation titration in acute lung injury / acute respiratory distress syndrome ( ali / ards ) are the cornerstone of mechanical ventilatory support .
the net result of these possible adjustments in ventilatory parameters is the interaction of the pressure applied in the respiratory system ( airway pressure / end expiratory pressure ) counterbalanced by chest wall configuration / abdominal pressure along the mechanical ventilatory support duration .
refinements in the ventilatory adjustments in ali / ards are necessary for minimizing the biotrauma in this still life - threatening clinical problem . |
6,494 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: fast
quantum - chemical methods are indispensable for computationally
demanding calculations of electronic properties of large molecules .
in the 1970s and 1980s , semiempirical quantum - chemical ( sqc ) methods
were the workhorse in computational studies of ground - state properties .
since the 1990s , they have largely been replaced in such studies by ab initio and density functional theory ( dft ) approaches ,
which are typically slower by at least 3 orders of magnitude but also
generally more accurate and robust . however , even nowadays ,
sqc methods often remain the only practical
choice when treating huge molecules or very large numbers of molecules
or when performing extensive molecular dynamics ( md ) simulations , e.g. , in the context of quantum mechanics / molecular mechanics
( qm / mm ) studies on large biomolecular systems .
examples
of recent sqc applications include the calculation of electronic properties
used in 3d - qsar models ( 3d - quantitative structure activity
relationship ) , qm - based computer - aided
drug design , the study of band gaps , uv / vis spectra , and charge - transfer processes
in systems relevant for molecular nanoelectronics and organic photovoltaics , the investigation of local properties used to understand electron
and hole transport mechanisms in transistors , gas - phase md simulations of electron impact mass spectra , ground - state qm / mm md simulations of enzymes , excited - state
nonadiabatic dynamics simulations of organic chromophores , and studies of organic and enzymatic reactions
in solution .
most of the widely used sqc methods are variants of the mndo
model which is based on the nddo ( neglect of diatomic
differential overlap )
integral approximation .
these mndo - type
methods include am1 , pm3 , mndo / d , am1 * , rm1 , pddg / mndo and pddg / pm3 , pm6 , and pm7 ( see the cited references for details and the meaning of the acronyms ) .
a common feature of these approaches is that they attempt to... | the semiempirical
orthogonalization - corrected omx methods ( om1 , om2 ,
and om3 ) go beyond the standard mndo model by
including additional interactions in the electronic structure calculation .
when augmented with empirical dispersion corrections , the resulting
omx - dn approaches offer a fast and
robust treatment of noncovalent interactions . here
we evaluate the
performance of the omx and omx - dn methods for a variety of ground - state properties using
a large and diverse collection of benchmark sets from the literature ,
with a total of 13035 original and derived reference data .
extensive
comparisons are made with the results from established semiempirical
methods ( mndo , am1 , pm3 , pm6 , and pm7 ) that also use the nddo ( neglect
of diatomic differential overlap ) integral approximation .
statistical
evaluations show that the omx and omx - dn methods outperform the other methods for most
of the benchmark sets . |
6,495 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: electroconvulsive therapy ( ect ) is one of the most efficacious treatment of major depressive disorder ( mdd ) .
it is used as a rapid and efficacious treatment in emergent and/or treatment resistant forms of other psychiatric disorders .
the cognitive aspects which are influenced immediately after ect are : orientation , information processing , retrograde and anterograde amnesia , visuospatial capacity and word finding .
donepezil in a case report study galantamine in study without control group , a glucocorticoid antagonist ( cort108997 ) in another study , thyroid hormones , antihypertensive , poropofol , physosigmine , naloxone , piracetam showed some benefits in preventing ect - induced cognitive impairment ; but many of those have not enough reliability because were not statistically significant , or were case reports , unblanded , uncontrolled or on animals .
the other studies did not show efficacy of the used drugs in prevention of memory impairments . considering these non sufficient and controversial data , more structured studies with control group on human samples are necessary .
so , we chose the so - called memoral herbal for our this preventive new study , which has never been used for this propse .
the memoral herbal capsules , each contains 360 mg of boswellia oleo - gum resin and 36 mg of zimgiber rhizome . the most important constituent of boswellia is gum resin 60% , mosilage 20 - 23% and essence 5 - 9% , which contains a - b - thujon , p - cymen and linanol .
boswellia serrata has boswellic acid and acetyl- 11- keto - beta boswellic acid too , which are responsible for many therapeutic effect .
the volatile oils in boswellia dilate the vasculator of the brain thus can increase the blood passage through the brain .
boswellia extract has been demonstrated by a battery of rigorous tests to have anti - inflammatory effect .
the mechanism by which boswellia can improve memory is through its anti - inflammatory effect on the brain .
the aim of this study is to compare memoral herbal with... | background : electroconvulsive therapy ( ect ) is one of the most efficacious treatment for major depressive disorder ( mdd ) , it is also used as a rapid and efficacious treatment for other psychiatric disorders , especially treatment resistant ones .
the cognitive impairment is one of the most important side effects of ect .
this study examined the memoral herbal efficacy in prevention of ect - induced memory impairment.methods:in a randomized clinical trial , 70 patients with mood disorders who were candidates for ect enrolled in either memoral or control group , and received either memoral or placebo .
the memory was assessed by addenbrook cognitive examination ( ace ) , and the findings were analyzed by anova under spss18.results:the memoral group patients showed significantly higher total ace scores than placebo group ( p < 0.001 ) .
the scores of attention and orientation , verbal fluency and memory subscales not only never decreased during the study in memoral group , but also increased .
there was no significant difference between these scores of memoral and placebo groups for the subscales of language and visuospacial ability.conclusion:the memoral herbal is an efficacious and safe choice in prevention of ect- induced cognitive impairment . |
6,496 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the off - season period ( i.e. transition period ) has taken a relevant role across the soccer s world .
considering the growing economic importance of soccer competitions and the increase of the number of matches around the world ( regardless of the competitive - level ) , soccer referees have been involved in officiating during most of the year ( da silva et al . ,
subsequently , the transition period is shorter and soccer referees have only few weeks to prepare to the competitive season . given that refereeing is a very demanding activity both physically and physiologically ( mallo et al . , 2008 ) , soccer referees must ensure a high level of physical fitness .
indeed , field referees ( fr ) were reported to cover a total distance of 10 - 12 km ( krustrup and bangsbo , 2001 ; weston et al . , 2007 ) and assistant referees ( ar ) of 6 - 8 km during competitive matches ( krustrup et al . , 2002 ; mallo et al . , 2008
) . furthermore , fr and ar may perform as much as 1,269 and 1,053 activity changes during a match , respectively , with fr undertaking 21.3 - 30.5 sprints at a speed above 25.2 kmh-1 ( krustrup and bangsbo , 2001 ) ,
whereas ar run up to 20 sprints per match ( krustrup et al . , 2002 ) .
given that match officials must be physically fit to keep up with the game tempo to make appropriate decisions ( weston et al . , 2012 ) ,
referees international and national governing boards require the evaluation of fr and ar s physical fitness at the start of the competitive season with the pass of set limits to be included in the seasonal match appointment list . as a result ,
the seasonal evolution of the physical fitness of match officials is currently considered as a key methodological issue in modern soccer ( castagna et al .
, only few studies have examined seasonal variations in physical performance of elite level frs with no research report addressing ar ( weston et al .
furthermore , no study has focused on the training transition period or the part of the season that spans from the end of the... | abstractthe evolution of referees physical fitness has been studied over one or several seasons , however , the variation of the physical performance between the end of the competitive season ( t1 ) and the start of the following pre - season ( t2 ) has not been ascertained .
therefore , the aim of this study was to analyze the effects of the transition period on physical performance variables ( i.e. linear straight sprint , change of direction ability and endurance ) in national soccer division referees .
forty - five spanish referees volunteered to participate in this study .
participants were classified according to competitive status , field referees ( fr , n = 23 ) and assistant referees ( ar , n = 22 )
. a loss of performance ( p < 0.05 ) was observed in the 20 and 30 m linear straight sprint between t1 and t2 in both fr ( 1.64 - 1.56% , d = 0.29 to 0.32 ) and ar ( 2.01 - 3.41% , d = 0.33 to 0.60 ) . in t2
the fr significantly improved the distance covered ( p < 0.05 , 13.11% , d = 0.39 ) in the yo - yo intermittent recovery test ( yyir1 ) .
besides , significant differences were observed between fr and ar in the distance covered ( p < 0.05 , 23.55% , d = 0.97 ) in the yyir1 test in t2 .
more research may be necessary to focus on the off - season period in order to implement specific training programs and consequently reduce the loss of sprint ability in field and assistant referees and the decrease in cardiovascular fitness in assistant referees . |
6,497 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: prevalence and risk of overweight were assessed in 232 children who were enrolled in the prospective german gdm offspring study between 1989 and 2000 .
all children were from singleton births , had a mother with gdm diagnosed according to criteria of the german diabetes association using an oral glucose tolerance test ( ogtt ) with a 75-g glucose load .
women were considered to have gdm if two of three capillary blood glucose values exceeded the following limits : > 5 mmol / l ( fasting ) before an oral glucose tolerance test , > 10.0 mmol / l after 60 min , and 8.6 mmol / l after 120 min .
prevalence of overweight was compared with that of a cohort of ot1d ( n = 757 ) and offspring of nondiabetic mothers ( ondm ) ( n = 431 ) followed in the babydiab study ( 6 ) . in both
the gdm and babydiab studies , mothers and their offspring were recruited between 1989 and 2000 germany - wide through the same network of collaborating obstetric departments and pediatricians and entered into the study before the offspring reached the age of 3 months .
all children were followed with similar follow - up visits until the age of 14 years . in both studies ,
> 98% of the families were caucasian . in families with more than one offspring participating in the study ,
data on weight and height were collected at birth and at age 2 , 8 , and 11 years by physicians . at birth ,
length was measured on a measuring board and weight on a calibrated scale by health care professionals .
weight and height were obtained for 215 children at age 2 years , 89 children at age 8 years , and 74 children at age 11 years .
birth weight was adjusted for sex and gestational age and is expressed as a percentile of the german reference population ( 8) .
offspring less than the 10th percentile were defined as small for gestational age , those 90th percentile as large for gestational age and those between > 10th and < 90th percentile as appropriate for gestational age . from age 2 years
, height and weight were measured by physicians at regular clinical... | objectivegestational diabetes mellitus ( gdm ) is associated with high birth weight in the offspring .
this may lead to overweight and insulin resistance during childhood .
the aim of the study was to assess the impact of gdm on overweight risk and insulin resistance in offspring.research design and methodsbmi measurements were collected at age 2 , 8 , and 11 years from 232 offspring of mothers with gdm ( ogdm ) and compared with those from 757 offspring of mothers with type 1 diabetes ( ot1d ) and 431 offspring of nondiabetic mothers ( ondm ) born between 1989 and 2000 .
insulin resistance ( homeostasis model assessment of insulin resistance [ homa - ir ] ) was determined at age 8 and 11 years in 751 children ( 74 ogdm ) .
overweight was defined as bmi percentile 90 ; insulin resistance was defined by homa-ir.resultsoverweight prevalence was increased in ogdm compared with ot1d and to ondm throughout childhood ( age 11 years 31.1 , 15.8 , and 15.5% ; p = 0.005 ) .
maternal obesity was an important predictor of overweight risk in children ( age 11 years odds ratio 7.0 [ 95% ci 1.827.7 ] ; p = 0.006 ) ; birth size and maternal smoking during pregnancy were inconsistently associated with and treatment of gdm during pregnancy did not affect overweight risk .
homa - ir was increased in ogdm compared with offspring of ondm mothers ( p = 0.01 , adjusted for sex and age ) and was associated with the child 's bmi ( p = 0.004).conclusionsoverweight and insulin resistance in children is increased in ogdm compared with ot1d or ondm .
the finding that overweight risk is associated mainly with maternal obesity suggests that familial predisposition contributes to childhood growth in these offspring . |
6,498 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: talc pleurodesis ( tp ) is a procedure first described by bethune 1 in 1935 as a means to anchor the lung during lobectomy 2 . ever since then , tp has been employed worldwide in the management of recurrent pneumothorax and malignant pleural effusion , with a success rate in excess of 90% 3 - 5 .
tp is performed by instillation of sterile talc into the pleural cavity ( chemical pleurodesis ) , with chemical irritation leading to pleuritis , and ultimately to pleural fibrosis .
computed tomography ( ct ) and f - fluorodeoxy - glucose ( fdg ) positron - emission tomography ( pet ) are important imaging techniques for the detection and staging of cancers that , used together , may provide a more accurate tumor staging tool 6 . however , tp treatment has been reported to increase fdg uptake in thickened pleura , making it difficult to distinguish between benign inflammatory processes and malignancies , with the potential for false positive results 7 - 16 .
malignant pleural mesothelioma ( mpm ) is a thoracic neoplasm originating from the pleural lining , where an increased fdg uptake has been observed 17 , and several studies have reported on the use of pet to monitor chemotherapeutic response 18 - 21 . in this setting ,
the concomitant presence of a disease such as mpm , and the application of a procedure like tp , may produce an increase in suv that underestimates the tumor response to chemotherapy . in clinical practice
, the distinction of responding patients by those with stable or progressive disease has a prognostic implications and this is confirmed by some reports 22 , 23 .
the distinction of these two categories of disease may allow to recognize patients with better prognosis which may benefit by trimodality therapy by those with a resistant disease where it may be suggested a conservative approach .
the aim of this retrospective mpm case series was to analyze tp - induced pleural changes by fdg pet / ct and to verify the concordance between metabolic and radiologic response after chemotherapy... | purpose : talc pleurodesis ( tp ) is employed worldwide for the management of persistent pneumothorax or pleural effusion , particularly of malignant origin . however , there are very little available data on 18f - fluorodeoxyglucose positron - emission tomography / computed tomography ( 18f fdg pet / ct ) response evaluation in malignant pleural mesothelioma ( mpm ) patients treated with tp and chemotherapy.methods : patients with histologically confirmed mpm underwent tp and fdg pet / ct staging and restaging after 3 - 4 courses of chemotherapy .
all patients fasted and received a dose of 5.18 mbq 18f - fdg per kilogram of body weight .
whole - body emission scans were acquired with and without ordered subset expectation maximization ( osem ) iterative reconstruction algorithm.results : from january 2004 to march 2010 , 8 patients with biopsy confirmed mpm ( 7 epithelial , 1 biphasic ) , with a median age of 65 years ( range : 54 - 77 ) , were evaluated .
median follow - up was 31 months ( range : 4 - 44 ) .
after tp treatment , there was a mean interval of 14 days ( range : 9 - 22 ) and 125 days ( range : 76 - 162 ) between fdg pet / ct staging and restaging . according to modified recist and eortc criteria
, there was a concordance between the radiologic and metabolic suvmean and suvmax responses in 6 ( 75% ) and 3 ( 37.5% ) patients , respectively.conclusion : tp produces an increased fdg pet uptake which may interfere with the post - chemotherapy disease evaluation . in our case series , the metabolic response measured by suvmean seems to be in better agreement with the radiologic response compared to the suvmax . |
6,499 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the united states department of defense and department of veteran affairs are dedicated to providing superior rehabilitation care for veterans and service members who have suffered combat - associated traumatic limb loss .
current literature reports that 70% of amputees with multiple limb loss are bothered by sweating and skin irritation inside of the prosthesis socket .
we present a review of the literature examining the effectiveness of botulinum toxin a ( btx - a ) and btx - b for the treatment of hyperhidrosis related to prosthesis use .
while both btx - a and btx - b are approved by the food and drug administration ( fda ) , indications for use are limited .
hyperhidrosis continues to be a significant barrier to prosthesis comfort , and treatment with btx has the potential to address this concern .
a review of the literature was conducted using the pubmed database , focusing on hyperhidrosis treatment after a traumatic limb amputation .
we used the key search words : btx ; hyperhidrosis ; amputation ; trauma - related amputation ; prosthesis comfort .
articles discussing hyperhidrosis treatment for axillary , palmar , plantar and amputations secondary to chronic medical conditions were excluded .
botulinum toxin a is currently approved by the fda as botox ( allergan , inc . ,
irvine , california , usa ) supplied in 50 and 100 unit vials , and dysport ( ipsen , berkshire , united kingdom ) supplied in 300 and 500 unit vials , to treat cervical dystonia , severe primary axillary hyperhidrosis , strabismus , blepharospasm , and for temporary improvement of moderate to severe glabellar lines .
the benefits of using btx - a for these conditions is well - established and it has few adverse effects at their respective therapeutic doses , which range from 20 to 360 units .
the most common adverse effects reported are muscle weakness , fatigue , flu - like symptoms , dry mouth , dizziness , discomfort at the injection site and skin rash
. large volume injections of btx - a > 600 units have been associated with... | hyperhidrosis - related to prosthesis use in patients who have suffered a traumatic limb amputation presents itself as a barrier to comfort , prosthesis use and overall quality of life .
this review intends to encourage dermatologists to consider the use of botulinum toxin a or b for the treatment of hyperhidrosis in the residual limb and may serve as a stimulus for a modern , in - depth , and more comprehensive study .
a review of the literature was conducted using the pubmed database , focusing on hyperhidrosis treatment after traumatic limb amputation .
articles discussing hyperhidrosis treatment for amputations secondary to chronic medical conditions were excluded .
seven case studies published over the last 12 years have demonstrated positive outcomes of this treatment strategy .
overall , there is little data examining this topic and current publications focus primarily on small case series .
a larger , double - blind , placebo - controlled study would likely benefit veterans , service members , and civilians . |
6,500 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in the previous issue of critical care , williams and colleagues provide an overview of the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories . over the past decades
there has been a significant decrease in mortality and morbidity in severe burns due to improved burn wound management and approaches in critical care [ 2 - 4 ] .
many advances have been made , not only concerning the pathophysiology of burns but also concerning burn management .
survival from severe burns is no longer the exception , but unfortunately death still occurs .
owing to the fact that the burn injury is multifaceted , the advances cross many injury processes .
these issues range from the management of the catabolic state to modern wound care .
one important aspect is that burn treatment has become more proactive , by searching out new technologies to solve old problems . now
the treatment approach is altering its focus on manipulating the course of a burn and its final outcome .
the survival rate is still of course the most important issue , but not the only issue .
the question of whether and to what degree the patient is able to enjoy a normal quality of life becomes more and more essential in how the outcome of the burn treatment is evaluated .
restoring function and esthetics are crucial in the difficult process of social reintegration and the return to a normal life .
great efforts were made in the past to develop epidermal and dermal replacements to overcome the problem of poor skin quality and scar contraction . in large and deep burns ,
the approach has changed to rapid excision and lesion - specific coverage of the burn wound , eliminating the burn as a source of complications .
rapid and effective wound coverage and closure are of utmost importance , but infection control and the preservation of active and passive motion are also essential for optimal recovery .
nonviable burn tissue is well recognized to be the driving force behind wound... | many advances have been made in the understanding and treatment of burns .
advances in burn surgery and critical care have decreased mortality and morbidity . survival from severe burns
is no longer the exception , but unfortunately death still occurs .
williams and colleagues have determined in their recent paper the predominant causes of death in order to develop new treatment avenues and future trajectories suitable to increase survival and overall outcome .
a lot of burn deaths may be preventable with better airway management and a more precise and adequate volume management , but the leading cause of death in patients suffering from severe burns , which has to be faced , is sepsis .
sepsis due to multidrug - resistant organisms will continue to impede efforts to increase survival , and new strategies that go beyond the surgical and clinical techniques , which are already implemented , have to be developed in order to fight these organisms and their related complications . |
6,501 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: global expansion of dengue virus ( denv ) has lead to endemicity in several regions , including central and south america.1,2 each year , returning travelers from these and other locations introduce the virus into a largely naive population in the united states.3 with the exception of self - limited chains of local transmission in florida , there has yet to be a sustained outbreak in the us.48 however , the threat remains as global travel , trade , and transport increase.1 to establish local transmission when virus is introduced , competent mosquito vectors need to be present . the primary vector , aedes aegypti , is present year - round throughout the southern us , including seasonally in subtropical and more temperate areas.9 vector competence is the ability of a mosquito population to become infected with and ultimately transmit an arbovirus . the vector competence of denv in a. aegypti is known to be affected by both intrinsic and extrinsic factors , such as viral strain and temperature / humidity , respectively.1013 the influence of temperature on vector competence is multifaceted and influences the rate of dissemination through the mosquito to the salivary glands , as well as the lifespan of the mosquito.14 the extrinsic incubation period ( eip ) is an important epidemiological measure and is defined as the time it takes for a virus to disseminate through a mosquito from the midgut where virus enters the mosquito after blood feeding to the salivary glands where it is then expectorated upon subsequent feeding .
the eip , while often reported as an average , discrete value , is a continuous process and is therefore tied to the mortality rate of a mosquito . if , for example , a specific strain of virus takes seven days ( on average ) to disseminate through a mosquito vector , the lifespan of that mosquito will determine how many days of infectiousness results from exposure ( fig .
1 ) . in a mosquito that is known to have multiple blood meals per gonotrophic cycle , such as a. aegypti ,
this is especially... | the extrinsic incubation period is a critical component in the assessment of arboviral transmission potential .
it defines the time it takes for a mosquito to become infectious following exposure to an arbovirus . since this is a temporal process , the lifespan of a mosquito is intimately tied to the extrinsic incubation period and thus transmission potential of these viruses .
temperature is a known effector of both vector competence ( the ability of a vector to transmit a pathogen ) and mosquito mortality , but the interaction among temperature , vector competence , and mosquito mortality is not well characterized .
herein , we investigate this interaction for dengue virus , serotype 2 , and its primary vector aedes aegypti where we found that at 30 c , infection and/or dissemination shortened the average lifespan of the mosquito and that when considering only mosquitoes with a disseminated infection , those incubated at 26 c lived significantly longer . |
6,502 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: when peritoneal cavity is opened , in whatever type of surgery , bowel obstruction may develop due to bands or adhesions .
the release of such adhesions results in serosal injury to the bowel and is a potential threat for re - adhesion and obstruction .
use of intraluminal tube stenting of the bowel after release of adhesions precludes recurrent small bowel obstructions .
over a period of 14 years , six children needed intraluminal stenting of the bowel to prevent recurrent obstruction .
four of these children needed two surgeries in the immediate postoperative period . in two other children who developed adhesive obstruction in the postoperative period ,
release of dense adhesions resulted in raw areas in peritoneum and the bowel , and stenting of the bowel was done to prevent re - adhesion .
of the six children , three were following surgery for hirschsprung 's disease , while the other three were due to intestinal duplication , meckel 's diverticulum and meconium ileus . in the absence of the availability of pediatric size baker 's type of tube which has a bulb distally for easy passage across the bowel , we used two 10f ryle 's tubes of 100 cm each , stitched together and guided through a jejunostomy in two children .
the tubes were stitched with 2/0 silk twice and tested to see that it does not break before passing across the bowel .
the tubes were guided upward through the base of the appendix after appendicectomy to the jejunum . in children with gross distension of bowel
, a 10f ryle 's tube with side holes was inserted through a purse string in upper jejunum and the bowel was decompressed by suction , and then the second tube was stitched to the first and guided toward the cecum .
similar procedure was done when the tubes were guided from the base of the appendix after appendicectomy .
the stenting through the base of the appendix after appendicectomy and subsequent fixation of the tube through right iliac fossa results in natural lie of the bowel .
the four children in whom the above method was done... | aim : six children with adhesive obstruction in the postoperative period were treated with stenting the small bowel with long intestinal tube.materials and methods : in two children the stenting was done through jejunostomy , and in the other four through the base of appendix.results:during a follow - up period of 2 - 14 years , there had been no recurrence.conclusions:use of an intraluminal tube stent in preventing recurrent small bowel obstruction due to adhesions is safe and effective when used on appropriately selected patients . |
6,503 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the spine can be involved in most inflammatory disorders encompassing rheumatoid arthritis ( ra ) , seronegative spondyloarthritides ( spa ) , juvenile arthritides and less frequent disorders such as pustulotic arthro - osteitis and sapho ( synovitis , acne , pustulosis , hyperostosis , osteitis ) syndrome . during the last decade
the diagnostic use of magnetic resonance imaging ( mri ) and computed tomography ( ct ) has increased considerably , although radiography is still the recommended initial examination .
it is therefore important to know the characteristic radiographic findings in arthritides in addition to the advantages of supplementary mri and ct .
this review will focus on the different imaging features and be concentrated on the most frequent inflammatory spinal changes seen in ra and spa , respectively .
involvement in ra is usually located in the cervical spine where erosive changes are predominantly seen in the atlanto - axial region . inflamed and thickened synovium ( pannus )
can occur around the odontoid process ( dens ) and cause bone erosion and destruction of surrounding ligaments , most seriously if the posterior transverse ligament is involved .
laxity or rupture of the transverse ligament causes instability with a potential risk of spinal cord injury .
cervical ra involvement is a progressive , serious condition with reduced lifetime expectancy , and its diagnosis is therefore important [ 2 , 3 ] .
it should always include a lateral view in a flexed position compared with a neutral position in addition to special views of the dens area to detect any lesions and/or instability ( fig . 1 )
. a supplementary lateral view during extension can be useful to assess reducibility of atlanto - axial subluxation possibly limited by pannus tissue between the anterior arc of the atlas and dens .
( a ) lateral radiographs in neutral position and ( b ) during flexion in addition to ( c ) lateral and ( d ) anterior - posterior ( ap ) open - mouth view of the atlanto - axial region ( 45-year - old... | spinal involvement is frequent in rheumatoid arthritis ( ra ) and seronegative spondyloarthritides ( spa ) , and its diagnosis is important .
thus , mri and ct are increasingly used , although radiography is the recommended initial examination .
the purpose of this review is to present the typical radiographic features of spinal changes in ra and spa in addition to the advantages of mri and ct , respectively .
ra changes are usually located in the cervical spine and can result in serious joint instability .
subluxation is diagnosed by radiography , but supplementary mri and/or ct is always indicated to visualise the spinal cord and canal in patients with vertical subluxation , neck pain and/or neurological symptoms .
spa may involve all parts of the spine .
ankylosing spondylitis is the most frequent form of spa and has rather characteristic radiographic features . in early stages
it is characterised by vertebral squaring and condensation of vertebral corners , in later stages by slim ossifications between vertebral bodies , vertebral fusion , arthritis / ankylosis of apophyseal joints and ligamentous ossification causing spinal stiffness .
the imaging features of the other forms of spa can vary , but voluminous paravertebral ossifications often occur in psoriatic spa .
mri can detect signs of active inflammation as well as chronic structural changes ; ct is valuable for detecting fracture . |
6,504 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
the house dust mites ( hdm ) are major sources of indoor allergens for humans , which induce asthma , rhinitis , dermatitis , and other allergic diseases .
their major allergens ( dermatophagoides pteronyssinus [ der p ] and dermatophagoides farinae [ der f ] ) coexist in most geographical regions with a high proportion ( up to 85% ) of asthmatics being typically hdm allergic ; hence , sensitization is attributed as a risk factor for developing asthma .
recently , a birth cohort study showed that sensitization to hdm at age of 2 years was associated with current wheeze at age of 12 years in both monosensitized and polysensitized hdm - sensitized children . in previous studies , fourteen d. farinae allergens
( der f 13 , 6 , 7 , 10 , 11 , 1318 , and 22 ) were reported before other seventeen allergens belonging to twelve different groups were identified by a procedure of proteomics combined with two - dimensional immunoblotting from d. farinae extracts [ 3 , 4 ] . among the novel identified d. farinae allergens , der f 25 is a triosephosphate isomerase ( tpi ) with a molecular weight of 34 kda , showing 75.6% by immunoblotting and 60% by skin prick positive reaction to dust mite allergic patients , respectively .
tpi is an enzyme ( ec 5.3.1.1 ) that catalyzes the reversible interconversion of the triose phosphate isomers dihydroxyacetone phosphate and d - glyceraldehyde 3-phosphate .
it has been found in nearly every organism searched for the enzyme , including animals such as mammals and insects as well as in fungi , plants , and bacteria .
moreover , some tpis have been identified as an allergen in fish , midges , crustaceans , and various plants [ 612 ] . currently , specific immunotherapy is the only allergen - specific approach for its treatment of mite allergy .
the administration of increasing doses of allergen extracts to patients is the method most commonly applied .
. it could induce severe anaphylactic side reactions or lead to sensitization towards new allergens present in the mixture [ 13 , 14 ]... | the house dust mites are major sources of indoor allergens for humans , which induce asthma , rhinitis , dermatitis , and other allergic diseases .
der f 25 is a triosephosphate isomerase , representing the major allergen identified in dermatophagoides farinae .
the objective of this study was to predict the b and t cell epitopes of der f 25 . in the present study
, we analyzed the physiochemical properties , function motifs and domains , and structural - based detailed features of der f 25 and predicted the b cell linear epitopes of der f 25 by dnastar protean system , bpap , and bepipred 1.0 server and the t cell epitopes by netmhciipan-3.0 and netmhcii-2.2 . as a result , the sequence and structure analysis identified that der f 25 belongs to the triosephosphate isomerase family and exhibited a triosephosphate isomerase pattern ( ps001371 ) .
eight b cell epitopes ( 1118 , 3035 , 7177 , 99107 , 132138 , 173187 , 193197 , and 211224 ) and five t cell epitopes including 2634 , 3854 , 6674 , 142151 , and 239247 were predicted in this study . these results can be used to benefit allergen immunotherapies and reduce the frequency of mite allergic reactions . |
6,505 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: takayasu arteritis ( ta ) , also known as aortoarteritis and pulseless disease , is a rare condition .
it is a form of granulomatous arteritis , which affects large- and medium - sized arteries , primarily the aorta and its large branches as well as proximal portions of pulmonary , coronary , and renal arteries .
initially , there are mononuclear cell infiltrations in the adventitia and granulomas with langerhans cells in the media , followed by disruption of the elastin layer and subsequent massive medial and intimal fibrosis
. these lesions result in segmental stenosis , occlusion , dilatation , and aneurysmal formation in the affected vessels .
ta is predominantly a disease of young adults in the second and third decades of life , but it has also been reported in childhood and in adults older than 40 years [ 20 , 28 , 44 ] .
the youngest patient described was 6 months old , and the oldest one was 75 years .
females are more likely to be affected than males . in adults approximately 80% of patients with ta
are women , although the female - to - male ratio varied from 9:1 in reports from japan , 6.9:1 in mexico to 1.2:1 in israel . in the pediatric population ,
a series of studies of ta in childhood from india and south africa report a 2:1 female - to - male ratio [ 16 , 46 ] .
although the disease has a worldwide distribution , the incidence is considered to be substantially greater in regions such as india and east asia than europe or north america . unfortunately , there are no worthwhile epidemiological studies from these supposedly high incidence countries to support this assertion . according to the published reports ,
the worldwide incidence of ta is estimated at 2.6 cases per million population per year .
the incidence of ta is estimated to be 2.6 persons per million population per year in minnesota olmsted county . however , the applicability of this number to the diverse population of the usa as a whole is uncertain .
the incidence in europe overall is reported at one case per million persons... | we report a 16-year - old girl in whom takayasu arteritis ( ta ) was manifested mainly by severe arterial hypertension on her right arm , which was detected during a routine examination at school .
her systolic blood pressure on the right arm was significantly higher than that on the left one .
there was also a pressure difference between the right arm and legs .
the pulse of the left external carotid artery and that of the left radial artery was absent .
vascular bruits over interscapular and right supra- and subclavian areas were heard on auscultation .
the diagnosis of ta was confirmed by a spiral computed tomography angiography , which showed a thickened thoracic aortic wall and narrowing of its lumen .
in addition , complete occlusion of the left common carotid artery and the left subclavian artery was observed .
conclusion : the rarity of the disorder and the heterogeneous nature of its clinical manifestation predispose to a late diagnosis and delayed treatment .
our report highlights the fact that the condition can and does occur in a pediatric population in europe and hence must be considered in patients presenting with suggestive symptoms and signs , especially in young patients with unexplained hypertension . clinical suspicion and proper imaging
are crucial for the correct diagnosis and management of patients with ta .
a brief review of literature completes this report . |
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