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7,006 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: , several natural and synthetic compounds are tested for various anti - cancer activities . medicinal chemistry deals with synthesis of new agents for treating cancer by higher selectivity and lower side effects ( 1 ) .
dacarbazine ( dtic ) and temozolomide ( tmz ; figure 1 ) are two members of triazenes used in the clinical treatment of metastatic melanomas , soft tissue sarcoma , hodgkin s and non - hodgkin s lymphoma .
studies show that the antitumor activities of the desired drugs are dependent on three adjacent nitrogen atoms ( 2 - 6 ) .
structures of dacarbazine and temozolomide used in clinical treatment methylation of o - methylguanine is the main mechanism responsible for the cytotoxicity and methyldiazonium cation is a highly reactive derivative of these compounds that can react with dna o - methylguanine ( 7 - 11 ) .
recently , the inhibition of tyrosine kinase receptor was suggested as a novel mechanism for triazene agents ( 12 - 14 ) .
the uses of these compounds are limited because they have highly toxic adverse effects such as skin toxicity , myelosuppression , cardiac and hepatic toxicity , severe nausea , and vomiting ( 2 , 11 , 15 , 16 ) .
many attempts have been made for increasing the selectivity and decreasing these adverse effects including the use of aryl and heteroaryl rings in the structure of the mentioned triazenes ( 17 - 18 ) . in the present study
we have replaced the imidazole ring with different aryl groups and investigated the cytotoxicity of the synthesized triazenes against eight cancer cell lines ( pc3 , ht29 , hela , hl60 , jurkat , k562 , mcf7 , and hepg2 ) and a non - cancerous cell line ( huvec ) .
1h nmr and c nmr spectra were recorded on bruker drx 300 avance spectrophotometer in dmso - d6 as the solvent and all chemical shifts are reported in units downfield from tms as internal standard .
1,3-bis(2-methoxyphenyl)triazene f , 1 , 3-bis(2-cyanophenyl ) triazene d , and 1 , 3-bis(2-ethoxyphenyl ) triazene c were synthesized according to reported literatures ( 19 - 20... | compounds containing triazene ring structure are cytotoxic agents and clinically used as antitumor alkylating agents . in this study ,
a series of triazene derivatives holding alkyl and aryl moieties were synthesized and proved to be potent cytotoxic agents in - vitro particularly against eight cancer cell lines ( pc3 , ht29 , hela , hl60 , jurkat , k562 , mcf7 , hepg2 ) and a non - cancerous cell line ( huvec ) .
the cytotoxic activity was assessed using two methods , ldh assay , and trypan blue exclusion . some of the triazene derivatives showed cytotoxic activity more than temozolomide ( tmz ) as the reference drug .
the synthesized triazenes showed marked cytotoxicity effects on all eight cancer cell lines . among the compounds
synthesized , 1,3-bis(2-ethoxyphenyl)triazene c had unique efficacy and selectivity so that it had ic50 between 0.560 - 3.33 m on cancer cell lines and 12.61 m on normal cell line ( huvec ) .
1-(4-nitrophenyl)-3-(2-hydroxyethyl)triazene e shows weaker effect on cancer cell lines than the other compounds having ic50 between 3 - 15.54 m . |
7,007 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: epithelial na channels ( enac ) are of importance in na - absorptive epithelium , such as in the airway , the alveolus , the kidney , and the distal colon , and control the overall rate of transapical na transport .
enac proteins are mainly located in the apical membrane of polarized epithelial cells and have four homologous subunits ( i.e. , the , , and subunits ) 1 , 2 . the or enac subunit , which is essential for acting as a sodium channel , forms the channel pore , whereas the and enac subunits are critical for amplifying the efficiency of na influx . in mouse ,
the gene scnn1d , which encodes enac , is assumed to be a pseudogene 2 . in the lungs ,
alveolar lining fluid is critical for efficient gas exchange , and enac complexes play a crucial role in alveolar fluid clearance to maintain homeostasis of the luminal liquid . pulmonary diseases , including acute lung injury , cystic fibrosis , chronic obstructive pulmonary disease , and asthma result from or are associated with the dysfunction or dysregulation of enac , and the regeneration of epithelial cells and the restoration of ion transport are two key steps in recovery from those diseases . in this article , we review the progress of research on enac - mediated lung injury repair , in particular the role of enac proteins in re - epithelialization by endogenous and allogeneic stem / progenitor cells .
the mammalian pulmonary epithelium , a multilevel , branched network , can be functionally divided into the proximal conducting airways and the distal gas - exchange domain .
the development of the airways and the lung is the result of specification and separation of a group of progenitor cells from the ventral region of the anterior foregut . in humans , the development of the airways and alveoli from fetal to adult stage
, the airway epithelium consists of undifferentiated columnar cells , and then ciliated cells , secretory cells , club cells , alveolar type i ( ati ) and type ii ( atii ) cells differentiate from these progenitor cells at... | regeneration of the epithelium of mammalian lungs is essential for restoring normal function following injury , and various cells and mechanisms contribute to this regeneration and repair .
club cells , bronchioalveolar stem cells ( bascs ) , and alveolar type ii epithelial cells ( atii ) are dominant stem / progenitor cells for maintaining epithelial turnover and repair .
epithelial na+ channels ( enac ) , a critical pathway for transapical salt and fluid transport , are expressed in lung epithelial progenitors , including club and atii cells .
since enac activity and expression are development- and differentiation - dependent , apically located enac activity has therefore been used as a functional biomarker of lung injury repair .
enac activity may be involved in the migration and differentiation of local and circulating stem / progenitor cells with diverse functions , eventually benefiting stem cells spreading to re - epithelialize injured lungs .
this review summarizes the potential roles of enac expressed in native progenitor and stem cells in the development and regeneration of the respiratory epithelium . |
7,008 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: transrectal ultrasound ( trus)-guided prostate biopsy is the most commonly used procedure for detecting prostate cancer .
however , pain is the main morbidity and the main hindrance to the acceptance of trus - guided prostate biopsy by patients .
several studies have shown that 19 to 30% of patients experience moderate to severe pain during prostate biopsy .
there has been a shift recently from the standard sextant biopsy to a 10- to 12-core biopsy protocol to increase the cancer detection rate .
two factors usually responsible for pain during prostate biopsy are anal pain due to the ultrasound probe and insertion pain of the needle through the prostate .
currently , there is no universally accepted method of anesthesia for prostate biopsy as evidenced by the numerous methods that have been tried and published in the literature [ 6 - 9 ] . among the various methods of periprostatic anesthesia
ozden et al . reported that the effectiveness of periprostatic anesthesia did not differ between basal injection and apical injection .
furthermore , in their study , patients were randomly assigned into three groups depending on the doses of 1% lidocaine applied during periprostatic anesthesia at the basal lesion : 2.5 ml ( group 1 ) , 5 ml ( group 2 ) , and 10 ml ( group 3 ) . in that study ,
injection of 2.5 or 5 ml did not result in a significant difference in pain control , whereas use of 10 ml of 1% lidocaine produced better pain control . because higher doses seem to result in better pain control , at least according to this single study
, the effect of doses exceeding 10 ml by basal injection needs to be discerned .
to address this shortcoming , we conducted a prospective randomized controlled study to evaluate the efficacy for pain control and tolerability of periprostatic lidocaine injection according to lidocaine doses of more than 10 ml by basal injection during trus - guided prostate biopsy .
this prospective randomized controlled trial comprised a series of 92 consecutive men ( median age , 65.4 years ;... | purposethe aim of this study was to evaluate the efficacy of periprostatic lidocaine injection according to lidocaine dose during transrectal ultrasound - guided prostate biopsy.materials and methodsthe subjects of this study were 92 patients who had undergone transrectal ultrasound - guided 12-core biopsy of the prostate .
the patients were randomly assigned to three groups : group 1 ( n=31 , no lidocaine injection ) , group 2 ( n=30 , periprostatic injection of 10 ml 1% lidocaine ) , and group 3 ( n=31 , periprostatic injection of 20 ml 1% lidocaine ) .
the patients were assessed for pain by use of a 10-point visual analogue scale ( vas ) and for other complications after the procedure.resultsthe mean vas scores of groups 1 through 3 were 0.930.89 , 1.321.37 , and 1.131.10 , respectively .
there were no statistically significant differences between the three groups .
however , the mean vas score of the biopsy pain was 5.01.48 , 3.931.94 , and 3.602.15 , in the same groups , respectively , with statistically significant differences between group 1 and the other groups .
patients in groups 2 and 3 reported significantly less biopsy pain than did group 1 patients ( p=0.004 , 0.021 ) , with no statistically significant difference in vas score between groups 2 and 3 ( p=0.533 ) .
with respect to post - biopsy complications , there were no significant differences in the incidence of hematuria , hematospermia , rectal bleeding , or infection among the three groups.conclusionsperiprostatic injection of local anesthesia with lidocaine was associated with significantly less pain than in the absence of anesthesia .
furthermore , a 20-ml dose of lidocaine produced no better pain control than did a 10-ml lidocaine dose for prostate biopsy . |
7,009 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a critical structure in interaction of the human body with the environment represents the skin surface with the stratum corneum . without the horny layer a terrestrial life would be impossible .
on the other hand the stratum corneum becomes impaired in any kind of superficial or deep injuries . to retain body homeostasis recovery of stratum corneum
other important protective functions of skin are protection against infection and irradiation , in particular ultraviolet ( uv ) irradiation . in the following chapters
the epidermal thickness of an -immature newborn is about 29 m , in mature newborns and adults the thickness is about 50 m .
the skin surface of the newborn is covered by protective gelatinous vernix caseosa whereas the skin surface of adults is rather dry .
about 20 layers of nucleus - free corneocytes densely packed with keratin filaments are surrounded by a matrix .
the matrix is composed of filaggrin and -derivates , and lipid - rich lamellar bodies .
ceramides stand for about 50% of horny layer lipids and are essential for the lamellar structure of the epidermis .
the free fatty acids are mostly long chained molecules with more than 20 c atoms .
the water exchange is realized by migrating pores , i.e. polar transport pathways within the lipid mosaic .
the matrix develops under influences of ph gradients , sodium ions and enzymes ( synthetases , reductases , hydrolases , lipases ) . in a simplistic
more recent studies discovered subunits of octaeders of corneocytes within the horny layer which may migrate .
the horny layer is covered on its surface by a thin amorphous film contributing to stratum corneum structure and function . in newborns
there is an almost neutral skin surface ph of 6.6 that changes within days or weeks into an acidic ph of 5.9 ( acid skin surface film ) .
this leads to activation of ph - dependent hydrolytic enzymes like -glucocerebrosidase and stratum corneum secretory phospholipase a2 , .
skin surface ph is modulated by microbial harvest , eccrine and sebaceous gland... | skin exerts a number of essential protective functions ensuring homeostasis of the whole body . in the present review barrier function of skin and its expression of antimicrobial peptides
are discussed .
barrier function is provided by the dynamic stratum corneum structure composed of lipids and corneocytes .
stratum corneum is a conditio sine qua non for terrestrial life .
impairment of barrier function can be due to injury and inflammatory skin diseases .
therapeutic options are discussed with special emphasis of radiodermatitis and irritant contact dermatitis in patients with hearing device .
the use of antimicrobial peptides is illustrated by facial inflammatory skin diseases . in wound healing
new developments include biotechnological developments of matrix- and growth factors and tissue - engineered skin substitutes . in everyday wound care of chronic wounds
the concept of wound bed preparation ( time ) constitutes the base of successful treatment . |
7,010 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
acute bronchiolitis is the most frequent reason for lower respiratory tract infection and hospitalization due to respiratory disease in infancy .
about 50000 - 80000 hospitalizations of the infants under the age of one are attributed to this disease in the usa ( 1 ) .
the severe form of this disease is much more prevalent in one- to three - month - old infants and responsible for more than 50% of its incidence , causing respiratory syncytial virus , inflammationand small airway obstruction ( 1 ) .
clinical symptoms of acute bronchiolitis are similar to those of viral pneumonias , with fever , wheezing , and increased respiratory rate as the most important ones ( 2 ) .
the treatment is often supportive therapy , including fluid therapy , anti - fever drugs , and oxygen ( 3 ) .
some investigations have been recently conducted on the therapies like bronchodilators including salbutamol and epinephrine as nebulized ( 2,4 ) . in infants particularly under age of six months ,
edema and inflammation in bronchioles could lead to respiratory distress because of small diameter of airways ( 1 ) .
there is no consensus on use of bronchodilators and/or beta - agonists ( 5,6 ) .
most works have indicated that bronchodilators have no role in treating these patients ( 7 ) . today , inhaled salbutamol ( ventolin ) is used for treating bronchiolitis patients in iran s hospitals while several studies have indicated that this drug does not work ( 8 - 12 ) .
in many studies , the positive effect of hypertonic saline has been observed on recovering bronchiolitis symptoms ( 9,10 ) .
for example , comparative study of hypertonic saline 3% and 7% indicated a greater therapeutic effect of hypertonic saline 3% than that of hypertonic saline 7% in treating bronchiolitis symptoms and decreasing duration of treatment ( 13,14 ) .
hypertonic saline 3% was also found as better and more efficient than normal saline and hypersaline 3% nebulizer ( 15,16 ) .
in addition , a research conducted to compare hypertonic saline 3% with the... | background : complications of ventolin as the most common drug used for bronchiolitis are widely
known .
the present study was conducted to determine the efficacy of hypertonic saline 3% , compared
with ventolin , for treatment of acute bronchiolitis in children .
methods : this double - blinded clinical trial study was conducted in hajar hospital , shahrekord ,
iran , from 2011 to 2012 .
a total of 70 patients under the age of two years with bronchiolitis were
divided into two groups of 35 each .
ventolin nebulizer and hypertonic saline 3% nebulizer three
times per day were administered in the first ( ventolin ) and second ( hypersaline ) group , respectively .
the length of recovery was compared between the two groups .
the data were analyzed by spss
software ( version 22 ) using chi - square , t - test , paired t - test , and mann - whitney .
results : the meansd length of recovery was 4.140.9 and 3.060.6 in the ventolin and hypersaline
groups , respectively .
the mean duration of recovery was significantly lower in the hypersaline
group ( p<0.001 ) .
conclusion : hypertonic saline 3% nebulizer has more pleasant therapeutic effects on acute bronchiolitis
than ventolin .
therefore , use of hypertonic saline 3% nebulizer is recommended for the
treatment of acute bronchiolitis in children under two years old . |
7,011 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: childhood cancer is a rare disease affecting 1 in 70,000 children aged 14 years and younger [ 1 , 2 ] .
lymphoid malignancy , including leukemia and lymphoma , is the most common childhood cancer , accounting for 40% of all pediatric malignancies . during the last 20 years , survival rates for pediatric acute lymphoblastic leukemia ( all ) and
non - hodgkin 's lymphoma ( nhl ) have improved dramatically , mostly due to improvement of chemotherapy , allogeneic hematopoietic stem cell transplantation , and diagnostic techniques , with expected cure rates higher than 80% for pediatric lymphoid malignancy [ 13 ] .
methotrexate ( mtx ) is one of the key drugs for cancer treatment and a proven critical component for pediatric all and nhl [ 1 , 4 , 5 ] .
firstly , as an analog of folate , mtx is a powerful competitive inhibitor of dihydrofolate reductase ( dhfr ) [ 6 , 7 ] .
dhfr is responsible for converting folates to their active form tetrahydrofolate , a substrate of thymidylate synthase ( ts ) , to convert deoxyuridine monophosphate to deoxythymidine-5-monophosphate resulting in dna synthesis .
secondly , the polyglutamated forms of mtx inhibit the activity of ts directly [ 6 , 8 ] .
high - dose mtx ( hd - mtx ) treatment has been proven for its efficacy for the treatment of all and nhl [ 4 , 5 ] .
however , mtx often causes toxicity such as renal failure , hepatotoxicity , and severe mucositis requiring a dose reduction and cessation of treatment or hemodialysis , and it is well known that large interindividual mtx kinetic variability exhibits .
therefore , it is beneficial to find patients with a high risk of developing adverse events before the initiation of the treatment [ 9 , 10 ] . in folate metabolism ,
methylenetetrahydrofolate reductase ( mthfr ) is a key molecule to convert 5,10-methylenetetrahydrofolate ( 5,10-methylene - thf ) to 5-methyltetrahydrofolate ( 5-methyl - thf ) , and 5,10-methylene - thf is a substrate of ts .
there are two extensively examined mthfr polymorphisms , rs1801133 ( c.677c >... | backgrounds . outcome of childhood malignancy has been improved mostly due to the advances in diagnostic techniques and treatment strategies . while methotrexate ( mtx )
related polymorphisms have been under investigation in childhood malignancies , many controversial results have been offered . objectives . to evaluate associations of polymorphisms related mtx metabolisms and clinical course in childhood lymphoid malignancies
. method .
eighty - two acute lymphoblastic leukemia and 21 non - hodgkin 's lymphoma children were enrolled in this study .
four single nucleotide polymorphisms in 2 genes ( mthfr ( rs1801133/c.677c > t / p.ala222val and rs1801131/c.1298a > c / p.glu429ala ) and slco1b1 ( rs4149056/c.521t > c / p.v174a and rs11045879/c.1865 + 4846t > c ) ) were genotyped by taqman pcr method or direct sequencing .
clinical courses were reviewed retrospectively .
results .
no patient who had the ac / cc genotype of rs1801131 ( mthfr ) had relapsed or died , in which distribution was statistically different among the aa genotype of rs1801131 ( p = 0.004 ) .
polymorphisms of slco1b1 ( rs11045879 and rs4149056 ) were not correlated with mtx concentrations , adverse events , or disease outcome .
conclusions .
polymorphisms of mthfr ( rs1801131 ) could be the plausive candidate for prognostic predictor in childhood lymphoid malignancies . |
7,012 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: diagnosis is one of the principal tasks of primary care , yet incident - reporting systems typically receive very low rates of diagnostic errors ( 1 ) . more targeted techniques , such as record screening or interviewing gps about their most memorable errors have been more successful at identifying diagnostic error but have been retrospective in their approach ( 2,3 ) .
they can not recreate the diagnostic process that resulted in an error and can not reliably determine patient features at presentation , information elicited by the clinician ( due to incomplete records and selective memory ) , other diagnoses considered , how clinical information was interpreted and what inferences were made at the time of the diagnosis ( 4 ) .
a us study of closed malpractice claims in the ambulatory setting estimated that cognitive factors ( e.g. judgment errors , vigilance and memory lapses , lack of knowledge ) were implicated in virtually all diagnostic errors , either alone ( in 55% of errors ) or in association with patient and / or system - related factors ( 5 ) .
a recent study of difficult diagnoses in general practice , funded by the uk department of health , identified information gathering as the most important determinant of diagnostic accuracy ( 6 ) . in agreement with other studies , it found no effect of experience ( years in practice ) on diagnostic accuracy or the gathering of critical information , but did find that there was a reduction in the overall amount of information elicited with increasing experience ( 7,8 ) . computerized diagnostic decision support systems ( cddss ) may be able to play an important role in assisting information gathering , yet previously , cddss required clinicians to either enter the clinical features observed or tick them off on a list in order to receive diagnostic suggestions .
when ( i.e. type of diagnostic problem , timing during the consultation ) and what type of support would be useful .
suggesting differential diagnoses at the start of the consultation ( on the... | abstract
background : computerized diagnostic decision support systems ( cddss ) have the potential to support the cognitive task of diagnosis , which is one of the areas where general practitioners have greatest difficulty and which accounts for a significant proportion of adverse events recorded in the primary care setting .
objective : to determine the extent to which cddss may meet the requirements of supporting the cognitive task of diagnosis , and the currently perceived barriers that prevent the integration of cddss with electronic health record ( ehr ) systems
.
methods : we conducted a meta - review of existing systematic reviews published in english , searching medline , embase , psycinfo and web of knowledge for articles on the features and effectiveness of cddss for medical diagnosis published since 2004 .
eligibility criteria included systematic reviews where individual clinicians were primary end users .
outcomes we were interested in were the effectiveness and identification of specific features of cddss on diagnostic performance .
results : we identified 1970 studies and excluded 1938 because they did not fit our inclusion criteria . a total of 45 articles were identified and 12 were found suitable for meta - review .
extraction of high - level requirements identified that a more standardized computable approach is needed to knowledge representation , one that can be readily updated as new knowledge is gained .
in addition , a deep integration with the ehr is needed in order to trigger at appropriate points in cognitive workflow .
conclusion : developing a cddss that is able to utilize dynamic vocabulary tools to quickly capture and code relevant diagnostic findings , and coupling these with individualized diagnostic suggestions based on the best - available evidence has the potential to improve diagnostic accuracy , but requires evaluation . |
7,013 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in may 2009 , a 7-year - old female dog was admitted to a veterinary clinic in bijilo , the gambia , for elective ovariohysterectomy . the owner of the dog , a snake farm operator , reported late abortions during several pregnancies of the animal .
the dog had been kept on the farm premises , where adult snakes ( african rock pythons , python sebae ) had died several months before of infection with adult a. armillatus pentastomes ( figure 1 , panel a ) . during the dog
s surgery , hundreds of pentastomid larvae were seen on the enteral serosa , bladder , uterus , and in the omentum ( figure 1 , panels b , c ) . in april 2010
, a male stray dog , 6 months of age , was admitted to the veterinary clinic for elective neutering .
adult and larval parasite specimens were preserved in 100% ethanol for further parasitologic , histologic , and molecular examinations .
a ) ventral view of 2 adult a. armillatus parasites recovered from the lungs and trachea of a deceased rock python ; a gravid female ( bottom ) and a pre - adult female ( top ) are shown .
the parasites showed 20 and 18 marked body rings , and had a length of 10 cm and 9 cm and a body width of 58 mm and 35 mm , respectively .
b ) heavily parasitized omentum of a female stray dog , showing typical encapsulated c - shaped larval stages of a. armillatus parasites .
the larvae had a length of 1819 mm and a body width of 2 mm and showed 2022 rings .
scale bars = 1 cm . to investigate the extent of infection and determine whether transmission to humans on the snake farm grounds had occurred , we collected serum specimens from the 46-year - old male caucasian snake farm owner , his 28-year - old wife , his 3 children , and the infected female dog .
serum samples were transferred to the institute of hygiene and microbiology ( university of wrzburg , wrzburg , germany ) for analysis by elisa and western blot based on larval parasite antigens .
dna of the pentastome specimens ( 2 adults from the snakes , 1 larva from each dog ) was extracted by using the qiagen... | visceral pentastomiasis caused by armillifer armillatus larvae was diagnosed in 2 dogs in the gambia .
parasites were subjected to pcr ; phylogenetic analysis confirmed relatedness with branchiurans / crustaceans .
our investigation highlights transmission of infective a. armillatus ova to dogs and , by serologic evidence , also to 1 human , demonstrating a public health concern . |
7,014 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the mechanisms involved in the generation of migraine attack are probably multifactorial and are not fully understood .
the neurogenic inflammation is generated by the release of neuropeptides such as calcitonin gene - related peptide ( cgrp ) from trigeminal neurons terminals and leads to inflammation with the release of cytokines such as interleukin-6 ( il-6 ) and tumor necrosis factor - alpha ( tnf- ) .
some studies demonstrated elevated levels of these cytokines in jugular vein during acute migraine attacks , however , there were discrepant results with respect to the determination of serum levels of cytokines in migraine patients [ 36 ] .
brain - derived neurotropic factor ( bdnf ) is a neurotrophin that has been implicated in the generation and modulation of pain .
some studies have found that bdnf levels are altered in migraine patients when compared to controls .
therefore , it is unknown whether there is any change in the serum level of bdnf during migraine attacks .
the aim of this study was to investigate the levels of tnf- , soluble tnf receptors 1 and 2 ( stnf - r1 and stnf - r2 ) , and bdnf during migraine attack and in headache - free period in adult patients with episodic migraine .
nine patients with established diagnosis of episodic migraine without aura were included in this study .
the diagnosis of migraine was done by a headache specialist according to the international headache criteria .
all patients signed informed consent form before inclusion in the study and this study was approved by the local ethics research committee .
the impact of migraine was evaluated with migraine disability assessment ( midas ) and headache impact test ( hit ) .
the first evaluation was during a migraine attack when the patients sought medical attention . at this time
the second evaluation was performed 1 week later if the patient reported to be completely pain free in the last 72 h. in both evaluations blood samples were collected for the determination of serum markers .
serum was separated within 30 ... | there is a growing body of evidence implicating inflammatory cytokines and brain - derived neurotropic factor ( bdnf ) in the generation of migraine pain .
no previous study evaluated bndf levels during migraine attacks and there are conflicting results regarding tumor necrosis factor - alpha ( tnf - alpha ) serum levels . this study compared serum levels of tnf - alpha , soluble tnf receptors 1 and 2 ( stnf - r1 and stnf - r2 ) , and bdnf during migraine attacks and in headache - free periods .
nine patients with episodic migraine were clinically evaluated during a migraine attack and in a headache - free period .
blood sample of each patient in both occasions was collected and all serum was submitted to tnf - alpha , stnf - r1 , stnf - r2 , and bdnf determination by elisa .
there was no significant difference in the serum levels of tnf - alpha , stnf - r1 and stnf - r2 in migraine attack period and headache - free period .
bdnf serum levels were significantly higher during migraine attack than in pain - free period .
this is the first report showing that bdnf serum levels increase during migraine attack .
this reinforces the view that bdnf may be implicated in the physiopathology of migraine . |
7,015 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: iran is geographically located in the thalassemia belt , extending from the mediterranean basin through the middle - east , indian subcontinent , and the southeast asia .
according to the available record , number of thalassaemia cases in this region is well over 150 million cases . in iran 26,000 cases of major thalassaemia have been officially documented , and the total estimated prevalence of this disorder is 24.91/100,000 , which places iran in the list ofthe most affected countries in the world . the first screening program for prevention of thalassaemia was initiated in 1991 in the fars province located in the south of iran . the next major screening program formed in 1995 by the joint contribution and efforts of the iranian thalassaemia society and the iranian blood transfusion organization , where all the high - school students in tehran , the capital of iran , were screened for thalassaemia disorder in cooperation with the local high - schools . by 1996 , under the direction of the genetic department of centre for disease control and prevention of the ministry of health ( moh ) and guidance of an academic advisory committee , screening for the identification of this disorder became a national program .
the initial national prevention program included : ( 1 ) pre - marital screening ; ( 2 ) counseling parents with thalassaemic children ; ( 3 ) evaluating the impact of thalassaemia on individuals who married before the implementation of the national screening program . in 2003 , genetic counseling for at - risk couples at the time of pregnancy was added to the program .
for example , while abortion for any reason was illegal and prohibited in iran as a muslim country but the islamic clergies declared a fatwa to permit the abortion of homozygote beta - thalassaemic fetuses , even after 16 weeks of gestational age .
another protective measure of the program , which led to nearly 80% decrease in the incidence of major beta - thalassemia within the first eight years include prohibition of marriage in... | background : thalassaemia is one of the most common mendelian disorders in mediterranean area .
iran has about 26,000 thalassaemic patients , so it is one of the most affected countries .
the aim of this study was to evaluate the screening program and cost analysis of thalassaemia prevention program in west - azerbaijan province of iran.methods:this study evaluated the efficacy of health system 's thalassaemia prevention program with a sensitivity analysis for its costs .
the second five years of the program was evaluated .
the economic burden of thalassaemia is determined by the birth prevalence of the affected infants and the cost that is accrued to treat the infected individuals and was compared with the total cost of screening the couples for thalassemia trait.results:the average incidence rate of major thalassaemia was 19.8 per 100,000 live births and mean coverage rate of program was 74% .
the rate of canceling the marriage among carrier couples was 53% .
cost analysis showed that the cost of screening and prenatal diagnosis program was much lower than the cost of treatment in potential thalassaemic patients.conclusions:the prevention program of thalassaemia including a premarital and pre - natal screening in west azerbaijan province is demonstrated to be cost - effective . taking some actions in order to increase the coverage of pre - marital screening , providing pre - natal diagnosis in private and public sector , complete insurance coverage for the high - risk couples to perform the investigations more easily ,
were recommended . |
7,016 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: as an occupation or past - time , fishing is widely practiced around the world .
however , surprisingly , despite such extensive prevalence , injuries to the eyes from fish - hooks are rarely reported .
a literature search provided less than a dozen cases of fish - hook injuries to the ocular structures .
so far , there has been no reported case of actually using the cut - it - out technique for fish - hook removal , even though , it is reported in the literature as an option .
thus , this case report focuses on a rather uncommon , though devastating form of injury and on an unusual technique to manage this situation .
when they do occur , they can be associated with corneal lacerations and scars , traumatic cataracts , choroidal hemorrhage , vitreous hemorrhage , retinal detachment , and even endophthalmitis .
once the fish - hook is impaled in the ocular structures , extraction can become a challenge for the attending surgeon .
however , we report a case where the uncommon technique of cut - it - out was successfully employed to remove the fish - hook out of the patient 's eye .
an 11-year - old boy was referred to our clinic with a history of injury to the right eye while fishing the day before .
apparently while pulling the line , the fish - hook flew to the patient 's right eye and got embedded in the cornea .
someone had cut the line and the dangling hook was taped to the cheek [ figures 1 and 2 ] .
patient on initial presentation the fish - hook on closer inspection on examination , the visual acuity was a perception of light ( pl ) ; with projection accurate in all quadrants in the affected right eye and 20/20 unaided vision in the left eye . the fish - hook had penetrated the cornea and impaled itself in the deeper tissues .
there was a settled hyphema and the deeper tissues were obscured by it and corneal edema .
a written consent was obtained from the parents for the removal of the fish - hook under general anesthesia .
we planned to use the commonly employed method of advancement of the fish -... | an 11-year - old boy was involved in an injury with a fish - hook to his eye .
the hook had impaled itself to the cornea and deeper structures .
there was associated corneal edema and hyphema , making visualization difficult . in this case
, we performed the unusual cut - it - out technique to remove the hook from the eye . |
7,017 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: adaptive immunity is a highly differentiated biological system composed of b and t lymphocytes that play a critical role in the fight against infections and malignancies .
appropriate function of the immune system critically depends on the fine - tuned control of signals from cell - surface receptors and their activation threshold governing downstream cellular events such as cell differentiation .
the signaling threshold is vital for ensuring efficient cell activation , but only when required , such as upon pathogen invasion .
diminished lymphocyte activation leads to a variety of immune deficiencies , whereas a lowered activation threshold can lead to autoimmune disorders and cancerogenesis , emphasizing the importance of refined mechanisms ensuring correct threshold for cell activation ( tsubata , 1999 ; hermiston et al . ,
2003 ) . emerging evidence implicates the actin cytoskeleton as a key regulator of cell signaling .
the cellular cytoskeleton is a continuously remodeled dynamic network that provides force and support to cellular structures and also serves as tracks for vesicle and organelle movement .
the actin cortex underlies the plasma membrane , where it has been traditionally thought to mainly act as support to the membrane .
however , the cortical actin cytoskeleton is in intimate interaction with both lipid and protein components of the plasma membrane . indeed , cortical actin participates in various cellular events occurring proximal to the membrane , such as endocytosis , focal adhesions , and regulation of membrane protein diffusion and organization ( le clainche and carlier , 2008 ; mooren et al . , 2012 ; trimble and grinstein , 2015 ) .
the multifunctional and dynamic quality of actin impart it with characteristics that make it a potent mechanism for controlling and/or tuning receptor signaling ; this may be particularly important for receptors that need to be tightly regulated , such as immune receptors .
indeed , mutations in genes that encode actin regulatory proteins are associated... | recent evidence implicates the actin cytoskeleton in the control of receptor signaling .
this may be of particular importance in the context of immune receptors , such as the b cell receptor , where dysregulated signaling can result in autoimmunity and malignancy . here
, we discuss the role of the actin cytoskeleton in controlling receptor compartmentalization , dynamics , and clustering as a means to regulate receptor signaling through controlling the interactions with protein partners .
we propose that the actin cytoskeleton is a point of integration for receptor cross talk through modulation of protein dynamics and clustering .
we discuss the implication of this cross talk via the cytoskeleton for both ligand - induced and low - level constitutive ( tonic ) signaling necessary for immune cell survival . |
7,018 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: progeroid syndromes ( pss ) are a group of fatal , severe and rare genetic disorders characterized by various clinical features and phenotypes of physiological ageing prematurely .
these syndromes include clinically and genetically heterogeneous diseases such as ataxia - telangiectasia , bloom syndrome , cockayne syndrome , fanconi anaemia , hutchinson - gilford syndrome , rothmund - thomson syndrome , trichothiodystrophy , xeroderma pigmentosum , and werner syndrome ( also known as adult progeria)1 . among the different forms of progeria ,
the classical and most extensively studied type is the hutchinson gilford progeria syndrome ( hgps ) , named after the two scientists ( jonathan hutchinson in 1886 and hastings gilford in 1897 ) who independently delineated and described the syndrome .
as of now , the prevalence of this syndrome is one in 4 - 8 million new births2 .
incidence of progeria is uniform throughout the world showing no gender , geographical or ethnic predisposition , and hence mostly considered as sporadic . presently , there are about 114 children across 39 countries diagnosed with hgps2 . the average age of survival is 13.5 years ( with life expectancy about 8 - 21 years ) and death occurs due to stroke , myocardial infarction3 , heart failure or atherosclerosis ( cardiovascular disease ) . of the clinical symptoms of various pss like growth retardation , skin
atrophy , alopecia , lipodystrophy , osteolysis and an augmented susceptibility for malignant tumours , the notable thing in hgps is that the cognitive abilities remain unaffected45 .
classical hgps is usually caused by a sporadic autosomal dominant mutation ( except unique inheritable variety such as werner 's syndrome)6 .
there are a few atypical forms of progeria , also called non - classical progeria in which growth is less retarded , scalp hair fall off slowly , progression of lipodystrophy is delayed , osteolysis is more visible with exception in face and survival is observed mostly till adulthood4 .
mostly , hgps occurs as a... | progeria is characterized by clinical features that mimic premature ageing .
although the mutation responsible for this syndrome has been deciphered , the mechanism of its action remains elusive .
progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions .
various experimental models , both in vivo and in vitro , have been developed in an effort to understand the cellular and molecular basis of a number of clinically heterogeneous rare genetic disorders that come under the umbrella of progeroid syndromes ( pss ) .
as per the latest clinical trial reports , lonafarnib , a farnesyltranferase inhibitor , is a potent drug of hope for hutchinson - gilford progeria syndrome ( hgps ) and has been successful in facilitating weight gain and improving cardiovascular and skeletal pathologies in progeroid children .
this can be considered as the dawn of a new era in progeria research and thus , an apt time to review the research developments in this area highlighting the molecular aspects , experimental models , promising drugs in trial and their implications to gain a better understanding of pss . |
7,019 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: benign prostatic hyperplasia ( bph ) is a pathological symptom frequently found in the elderly population .
treatment options for men with symptomatic bph include active monitoring , phytochemical treatment , medical therapy with -blockers or 5--reductase inhibitors , and surgery ( barry et al . , 1997 ; watson et al . , 2004 ) .
the use of complementary and alternative medicine ( cam ) for the treatment of bph patients has a long history , especially in european countries ( ortiz , 1998 ; pathak et al . , 2003 ) .
nevertheless , there is still a considerable degree of skepticism from the urologic community about the efficiency and safety of these cam products .
this is mainly due to the lack of an established mechanism of action for cam ( melo et al . , 2002 ;
the cam used in this trial was pumpkin seed oil , saw palmetto oil and a combination of pumpkin seed oil and saw palmetto oil ( ernst , 2002 ; hirsch , 2000 ) .
for these materials , the mechanisms of action may include alteration of cholesterol metabolism , anti - androgenic activity ( including 5--reductase inhibitor activity ) , anti - inflammatory effects , and a decrease in available sex hormone binding globulin ( cristoni et al . , 2000 ) .
although the mechanisms of action of these materials have been investigated in many in vitro and indirect in vivo studies , they have yet to be clearly defined ( shoskes , 2002 ; wilt et al . , 2000 ) .
nevertheless , many bph patients are currently taking these cam materials everyday without apparent adverse effects ( vickers , 2000 ) . yet
, long - term treatment of bph patients with cam is necessary in order to assess the occurrence of side effects .
therefore , the objective of this study was to carry out a long - term study to determine the effectiveness and the potential side effects of pumpkin seed oil and/or saw palmetto oil in the treatment of korean men with symptomatic bph .
bph patients with an international prostate symptom score ( ipss ) of 8 or more participated in a randomized , double - blind... | this study was to investigate the role of complementary and alternative medicine in the prevention and treatment of benign prostatic hyperplasia .
for this purpose , a randomized , double - blind , placebo - controlled trial was performed over 12 months on 47 benign prostatic hyperplasia patients with average age of 53.3 years and international prostate symptom score over 8 .
subjects received either sweet potato starch ( group a , placebo , 320 mg / day ) , pumpkin seed oil ( group b , 320 mg / day ) , saw palmetto oil ( group c , 320 mg / day ) or pumpkin seed oil plus saw palmetto oil ( group d , each 320 mg / day ) . international prostate symptom score , quality of life , serum prostate specific antigen , prostate volume and maximal urinary flow rate were measured . in groups
b , c and d , the international prostate symptom score were reduced by 3 months .
quality of life score was improved after 6 months in group d , while those of groups b and c were improved after 3 months , compared to the baseline value .
serum prostate specific antigen was reduced only in group d after 3 months , but no difference was observed in prostate volume in all treatment groups .
maximal urinary flow rate were gradually improved in groups b and c , with statistical significance after 6 months in group b and after 12 months in group c. none of the parameters were significantly improved by combined treatment with pumpkin seed oil and saw palmetto oil . from these results , it is suggested that administrations of pumpkin seed oil and saw palmetto oil are clinically safe and may be effective as complementary and alternative medicine treatments for benign prostatic hyperplasia . |
7,020 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | their
high oscillator strength and large exciton binding energies make single - walled
carbon nanotubes ( swcnts ) highly promising materials for the investigation
of strong light
matter interactions in the near infrared and
at room temperature . to explore their full potential ,
high - quality
cavities possibly with nanoscale field localization are
required . here
, we demonstrate the room temperature formation of plasmon
exciton
polaritons in monochiral ( 6,5 ) swcnts coupled to the subdiffraction
nanocavities of a plasmonic crystal created by a periodic gold nanodisk
array .
the interaction strength is easily tuned by the number of swcnts
that collectively couple to the plasmonic crystal .
angle- and polarization
resolved reflectivity and photoluminescence measurements combined
with the coupled - oscillator model confirm strong coupling ( coupling
strength 120 mev ) .
the combination of plasmon
exciton
polaritons with the exceptional charge transport properties of swcnts
should enable practical polariton devices at room temperature and
at telecommunication wavelengths . |
7,021 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the estrogen deficiency or hypoestrogenism associated with menopause is one of many factors that influence the aging process in women .
although urothelium sensitivity to estrogenic hormone action has long been known , the urinary bladder being a target organ for the actions of estrogens , the pathophysiologic changes of the urotheluim resulting from menopause is poorly elucidated .
because of this , the therapeutic usage of the estrogen - like hormone replacement therapy in the atrophic process of the urinary bladder associated with menopause is still controversial .
for the experiment we used thirty young adult wistar female albino rats ( weight 23050 g ) housed in a conventional animal facility .
then the animals were randomly divided into three equal experimental groups : first group which underwent sham operation , representing the reference group ( sham group ) , estrogen group ( bov+e ) whice received estrogen hormones and untreated ovariectomized group ( bov ) which received no medication after ovariectomy . in order to observe the effects of the hexestrol diacetate on the urinary bladder urothelium at 14 days after oophorectomy , time required for appearance of the postoperative ovarian hormonal insufficiency ,
the estrogenic replacement therapy was carried for six weeks by intramuscular administration of 10 g hexestrol diacetate , twice weekly .
after this interval the animals were euthanized and necropsied . during necropsy tissue samples were harvested and fixed in 10% neutral buffered formalin . all the experimental protocol
used in this study had been approved by the ethics committee of the iuliu haieganu university of medicine and pharmacy ( number 621.04/2010 ) .
tissue samples after complete aldehyde fixation were routinely processed into paraffin embedded blocks . from each paraffin block multiple sections were cut and stained according to standard protocols by hematoxylin - eosin ( he ) .
the tissue processing and analyses followed the international recommendation of the inhand (... | aimsin this study we followed the effect of menopause and estrogenic replacement therapy on the proliferative and apoptotic activity of the bladder urothelial cells.methodsthe experimental model of menopause was reproduced using a standard protocol of bilateral ovariectomy in rats , estrogen replacement therapy being achieved by systemic administration of hexestrol diacetate for six weeks .
proliferative and apoptotic activity was monitored by quantifying the urothelium imunoexpression for pcna antigen as a marker of s phase of the cell cycle and cleaved caspase 3 for monitoring apoptotic activity.resultsfollowing ovariectomy , the main changes were urothelial atrophy associated with intensification of the apoptotic activity at these level .
estrogen therapy managed to improve the urothelium activity by reducing the apoptotic index and by increasing urothelial proliferative activity.conclusionsthe results show the important role of estrogens in maintaining urothelial activities , highlighting their potential use in the treatment of urothelium atrophic and degenerative processes associated with menopause . |
7,022 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: tuberculosis is the major cause of skeletal infection in the developing countries . skeletal tuberculosis accounts for 10 35 % of extra pulmonary tuberculosis and only 2 % of all cases of tuberculosis . less than one percent of skeletal tuberculosis occurs in the shoulder .
we reviewed all the previous reports of scapular tuberculosis in english literature to analyse the common clinical presentation , the site of occurrence in scapula and radiographic appearance .
a 17-year - old male presented with dull aching pain and gradually progressive swelling over the left scapular region since five months .
physical examination revealed a swelling of 3 x 3 cm which was located in the left supraspinous region .
terminal range of motion was restricted with pain especially during the last 15 of abduction .
his blood investigations were unremarkable with esr of 15 mm / hr . anteroposterior radiograph of left shoulder revealed a well defined , 4 x 3 cm osteolytic lesion at the superomedial aspect of body of scapula , with surrounding sclerosis [ fig.1 ] .
his chest radiograph was normal . since appearance was similar to a bone tumor , differentiation was important and work up on same lines was planned .
whole body bone scan showed abnormal increase in tracer uptake in the body of scapula with the rest of the skeleton being normal .
computer tomography ( ct ) showed erosions involving the supero - medial aspect of the body of scapula and along the base of the spinous process of scapula [ fig . 2 and fig.3 ] .
magnetic resonance imaging ( mri ) scan revealed a well- defined lobulated lesion [ fig.4 ] .
a ct guided biopsy was done tissue and fluid were sent for cultures and histopathology .
biopsy revealed granulomas composed of epithelioid cells , lymphocytes and a few multinucleate giant cells suggestive of tuberculosis .
preoperative anteroposterior radiograph of the left shoulder showing osteolytic lesion in the superomedial aspect of scapula with surrounding sclerosis computer tomograph 3d reconstruction images showing... | introduction : isolated tuberculosis of the scapula is rare . the presentation mimics the tumors of scapula .
hence it is important to know the clinical presentation and when to suspect tubercular osteomyelitis of scapula .
few cases have been described before .
we have analyzed all reports with isolated scapular tuberculosis so far and described the varied presentations.case report : we report two cases of isolated scapular tuberculosis .
one patient underwent aspiration and was started on antituberculous drugs ( att ) and the other underwent debridement , drainage of abscess and then was started on att .
both had excellent outcomes at the end of one year follow up .
we reviewed previous published literature of isolated scapular tuberculosis .
the most common presentation of scapular tuberculosis is as follows : age less than 30 years and there is no difference with respect to gender .
swelling and pain are the commonest symptoms .
lytic areas with surrounding sclerosis is the commonest radiological finding .
body of the scapula is affected most commonly .
prognosis is excellent with adequate treatment.conclusion:to conclude , clinicians should have high index of suspicion for diagnosing this condition as it mimics tumors .
pain and swelling is the most common presentation of scapular tuberculosis .
radiography shows lytic lesion with marginal sclerosis .
the prognosis is excellent with appropriate treatment . |
7,023 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chyle is composed of albumin , emulsified fat and fibrin . in tropical country like india , chyluria is a chronicsequelae of filariasis .
up to 10% patient with filariasis may experience chyluria in tropical countries ( 1 ) .
chyluria has no sex predilection ; but young adult male from poor socio - economic background are mainly affected ( 2 ) .
it is recognized as tropical disease associated with spontaneous remissions and exacerbation ( 3 ) . in our state , it is not uncommon to find pregnant females with chyluria .
the study aims to present our experience of managing 43 cases with chyluria during pregnancy over a period of ten years from july 2003 to june 2014 .
forty three pregnant female patients , who presented to the department of urology , igims , patna , from july 2003 to june 2014 , were evaluated for chyluria ( tables 1 - 3 ) .
all the patients were evaluated by history , physical examination , routine examination of urine for chyle and chylomicron , culture sensitivity of urine , complete blood count ( cbc ) tests , blood sugar , renal function test , post prandial glucose test for chyle in urine , zeihl - nelson staining for acid fast bacilli , ultrasonography , cystourethros copy for lateralization and to exclude other pathology . all the patients were managed initially by conservative means - bed rest , high protein diet , and avoidance of fat , oil , milk , and milk product .
all patients were administered isoxsuprine hydrochloride ( 10 mg ) 1 tab twice daily for two days prior to the procedure and continued two days after completion of procedure .
ceftriaxone l gwas injected just before the procedure . under local an aesthesia ( 2% xylocaine jelly instilled in urethra ) , cystoscope was passed into the bladder , bladder washed and cleared of clots and side of chylus efflux determined . with the help of ureteric catheter 10 ml solution of sclerosant ( 5 ml of 10% povidone iodine was mixed with normal saline in equal amount to make it 10 ml ) instilled slowly into renal pelvis .
after eight... | background : chyluria i.e. passage of chyle in urine , giving it milky appearance , is common in many parts of india but rare in west .
very few case of chyluria in pregnant female has been reported in literature .
persistence of this condition may have deleterious effects on health of child and mother . in the present study
43 cases of chyluria during pregnancy and their management seen over a period more than 10 years have been presented.objectives:the study aims to present our experience of managing 43 cases with chyluria during pregnancy over a period of ten years from july 2003 to june 2014.patients and methods : forty three pregnant patients with chyluria , who presented between july 2003 to june 2014 to the department of urology , indira gandhi institute of medical sciences , patna were included .
patients underwent conservative management and/or sclerotherapy after evaluation .
follow - up of all patients was done by observation of urine color , routine examination of urine and test for post prandial chyle in urine up to 3 months after delivery.results:conservative management by dietary restriction of fat and physical rest was successful in six patients .
thirteen patients improved after first course of sclerotherapy with 10% povidone iodine and 25% dextrose and 19 patients improve after second session . in non - responders ,
three patients who were near term underwent caesarian section while two patients opted for medical termination of pregnancy at their own will .
after sclerotherapy , minor complications like clot retention , fever , hematuria , and abdominal pain were observed in small number of patients and managed symptomatically.conclusions:sclerotherapy for symptomatic relief of chyluria during pregnancy showed high response rate ( 86.2% ) in short term follow - up .
sclerotherapy with 10% povidone iodine and 25% dextrose combination have been proved safe and effective during pregnancy .
medical termination of pregnancy and cesarean section ( those near term ) may be the... |
7,024 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gingival recession , due to trauma , inflammatory conditions or anatomic factors is defined as partial denudation of the root surface due to apical migration of the gingival margin .
indications including esthetics , defect progression , hypersensitivity , or difficulties with oral hygiene support the use of periodontal plastic surgical procedures .
current case reports introduce a novel , minimally invasive approach , i.e. vestibular incision subperiosteal tunnel access ( vista ) .
this entails making an access incision in the maxillary anterior frenum , followed by elevation of a subperiosteal tunnel .
a case of millers class i and class ii multiple gingival recession in the maxillary anterior region extending from 13 to 23 was reported to the department of periodontics [ figure 2 ] , the oxford dental college and hospital , bangalore . at the initial visit , thorough
scaling and root planing was performed , patient was put on strict oral hygiene maintenance and recalled after 1-week .
the vista approach began with a vestibular access incision in the midline of the maxillary frenum [ figure 3 ] , which provided access to the entire anterior maxilla [ figure 4 ] .
subperiosteal tunnel was created by passing the incision through the periosteum and inserting a periosteal elevator between the periosteum and bone through the vestibular access incision . to mobilize gingival margins and facilitate coronal repositioning ,
the tunnel was extended at least one or two teeth beyond the teeth requiring root coverage . in order to achieve a low - tension coronal repositioning of the gingiva ,
the tunnel was sufficiently elevated beyond the mucogingival junction as well as through the gingival sulci of the teeth being augmented .
subperiosteal tunnel extension was carried out interproximally also below each papilla without making any surface incisions .
freshly prepared platelet - rich fibrin ( prf ) membrane was then trimmed to fit the dimensions of the recipient site and the width was adjusted to extend at least 3 - 4... | gingival recession is a common manifestation in most populations .
gingival recession is clinically manifested by an apical displacement of the gingival tissues , leading to root surface exposure .
gingival recession may be a concern for patients for a number of reasons such as root hypersensitivity , erosion , root caries , and esthetics ( wennstrom 1996 ) .
recently , new techniques have been suggested for the surgical treatment of multiple adjacent recession type defects . these are mainly derived from the coronally advanced flap , a supraperiosteal envelope technique in combination with a subepithelial connective tissue graft , or its evolution as a tunnel technique .
the current case reports introduce a novel , minimally invasive approach applicable for both isolated recession defects as well as multiple contiguous defects in the maxillary anterior region .
access to the surgical site is obtained by means of an approach referred to as vestibular incision subperiosteal tunnel access . |
7,025 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gorham 's syndrome ( gs ) is characterized by proliferation of vascular channels that results in destruction and resorption of osseous matrix . since its initial description by jackson as a case of massive osteolysis of the humerus in a 12-year - old boy in 1838 and then by gorham and stout in 1955,[24 ] the precise aetiology of the disease is largely unknown .
the osteolytic process can affect any bone , although shoulder and pelvis are commonly affected .
, we report the uneventful perioperative care of a 21-year - old patient with gs , for decompression and fusion of upper thoracic spine .
a 21-year - old , 78 kg male patient presented with pain in the upper back . since the last 1 month
, he was having weakness of both lower limbs leading to inability to walk and sit for a long duration .
past history revealed disappearance of right clavicle between 3 and 12 years of age and , subsequently , he was diagnosed as gs by biopsy of right clavicle . physical examination and vital signs were within normal limits .
magnetic resonance imaging of the spine revealed increasing kyphosis at the upper thoracic level centering at d1 - 2 , and cord compression mainly at the d1 - 2 level .
therefore , he was planned for decompression and fusion of c3 d5 spine . just before shifting to the operating room ( or ) , his pulse rate ( pr ) was 78 beats / min , blood pressure ( bp ) was
he was premedicated with butorphanol 1 mg , promethazine 12.5 mg and glycopyrrolate 0.2 mg intramuscular 45 min prior to surgery .
the patient was shifted to the or and standard monitors were attached and midazolam 1.5 mg was given intravenously ( iv ) , followed by 100% inspired oxygen administration for 5 min .
after loss of consciousness , manual in - line stabilisation ( mils ) of the neck was provided by a second anaesthesiologist , and after confirming adequate mask ventilation , iv rocuronium 50 mg was given following which trachea was intubated with 8.5 mm i d cuffed flexometallic tube .
anaesthesia was maintained with 40% oxygen in... | gorham 's syndrome ( gs ) is a rare disorder characterized by proliferation of vascular channels resulting in destruction and resorption of osseous matrix leading to bone loss .
bone loss leads to joint instability and problems during airway management and positioning for surgery .
respiratory involvement further complicates anaesthesia management .
we report the anaesthetic care of a 21-year - old male patient of known gs for spine decompression and fusion in prone position .
airway management , induction technique , pathophysiology of the disease , drug selection and other concerns of anaesthesia for major spine surgery has been discussed reviewing the sparse literature available . |
7,026 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: elevated serum alkaline phosphatase ( alp ) level is an essential marker for the diagnosis of vitamin d deficiency ( 1 ) .
some cases of vitamin d deficiency are diagnosed accidentally on the basis of elevated alp levels .
therefore , cases without high alp may be excluded from a diagnosis of vitamin d deficiency .
hypophosphatasia is a congenital skeletal disease caused by mutation of the alpl gene , which encodes the alp isozyme , tissue - nonspecific alkaline phosphatase ( tnsalp ) ( 2 ) .
hypophosphatasia is characterized by severe reduction of alp as well as various skeletal abnormalities such as rickets . since most cases are transmitted as an autosomal recessive trait , those heterozygous for alpl mutation are carriers who exhibit a low or normal alp level ( 3 ) .
here , we describe a case of vitamin d deficiency without an elevated alp level in a patient that proved to be a heterozygous carrier of hypophosphatasia .
a 1-year - old japanese girl was referred to our hospital for the evaluation of genu varum . she had no history of bone fractures . at her initial visit , her serum intact pth level was elevated ( 273 pg / ml , normal range : 1065 pg / ml ) while her serum alp , calcium , and inorganic phosphate levels were normal ( 527 u / l , normal range : 3951289
u / l ; 9.5 mg / dl , normal range : 8.810.6 mg / dl ; 5.9 mg / dl , normal range : 3.86.2 mg / dl , respectively ) . her percentage of tubular reabsorption of phosphate ( % trp ) was elevated ( 96.9% , normal range : 8095% ) .
her urine calcium / creatinine level was reduced ( 0.019 , normal range : 0.0350.80 ) , and her urine cross - linked n - telopeptide of type i collagen ( ntx ) level was 1340 nmol bce / mmol creatinine ( normal range : 3692385 nmol bce / mmol creatinine ) .
additional measurement of serum 25-hydoxyvitamin d ( 25-ohd ) was not performed , because of normal serum alp levels . on limb radiography ,
calcification of epiphyses was detected , and both flaring and fraying of metaphyses were also detected slightly ( fig... | elevated serum alkaline phosphatase ( alp ) is a screening marker for the diagnosis of vitamin d deficiency , which may fail to be diagnosed if serum alp is not elevated . here
, we describe a case of vitamin d deficiency without elevation of serum alp .
a 1-year - old japanese girl was referred to our hospital for the evaluation of genu varum .
her serum intact pth level was elevated , while her serum alp level was normal .
furthermore , her serum 25-hydroxyvitamin d level was reduced , and her urine phosphoethanolamine ( pea ) level was mildly elevated .
alpl gene analysis revealed she was a heterozygous carrier of hypophosphatasia ( c.1559delt ) .
serum intact pth and urine pea evaluations were helpful for diagnosing vitamin d deficiency and hypophosphatasia carrier status , respectively .
therefore , the possibility of vitamin d deficiency without elevation of serum alp should be considered . |
7,027 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: percutaneous transhepatic biliary drainage ( ptbd ) is an established nonsurgical procedure for the management of biliary obstruction , especially in patients in whom an endoscopic approach to the biliary system is impossible.1,2 compared with endoscopic biliary drainage , ptbd secures more stable drainage because it allows for serial monitoring of the quality and quantity of bile discharge .
duodenobiliary or jejunobiliary reflux of intestinal contents through a ptbd catheter , however , sometimes causes recurrent catheter obstruction or cholangitis .
here , we report a novel technique to prevent jejunobiliary reflux through a ptbd catheter : " antireflux ptbd technique . "
a 64-year - old female patient was referred to our department with a 1-day history of abdominal pain and fever .
she had a history of choledochojejunostomy with roux - en - y reconstruction for common bile duct injury during laparoscopic cholecystectomy for cholecystolithiasis 2 years earlier .
laboratory data on admission were as follows : white blood cells , 13,900/mm ( normal , 3,700 to 8,000/mm ) ; total bilirubin , 3.6 mg / dl ( normal , 0.2 to 1.2 mg / dl ) ; alkaline phosphatase , 868 iu / l ( normal , 104 to 338 iu / l ) ; -glutamyltranspeptidase , 320 iu / l ( normal , 0 to 59
iu / l ) ; and c - reactive protein , 6.12 mg / l ( normal , 0.00 to 0.29 mg / dl ) . a contrast - enhanced computed tomography scan of the abdomen revealed marked dilatation of the bile duct of the left liver without evidence of bile duct stones or tumors . based on these findings , a diagnosis of acute cholangitis due to biliary obstruction was made . after obtaining informed consent from the patient and her family members ,
a 0.035-inch polymer - coated guidewire ( radifocus ; terumo co. , tokyo , japan ) was passed successfully through the obstruction . at the end of the procedure , an 8-fr balloon - tipped internal - external drainage catheter ( create medic co. , kanagawa , japan )
however , the occlusion of the ptbd catheter due to reflux of... | percutaneous transhepatic biliary drainage ( ptbd ) is an established procedure for biliary obstruction .
however , duodenobiliary or jejunobiliary reflux of the intestinal contents through a ptbd catheter sometimes causes recurrent catheter obstruction or cholangitis .
a 64-year - old female patient with a history of choledochojejunostomy was referred to our department with acute cholangitis due to choledochojejunal anastomotic obstruction .
emergent ptbd was performed , but frequent obstructions of the catheter due to the reflux of intestinal contents complicated the post - ptbd course .
we therefore introduced a catheter with an antireflux mechanism to prevent jejunobiliary reflux .
a commercially available catheter was modified ; side holes were made at 1 cm and 5 to 10 cm ( 1 cm apart ) from the tip of the catheter , and the catheter was ligated with a nylon thread just proximal to the first side hole . using this novel " antireflux ptbd technique , " jejunobiliary reflux
was prevented successfully , resulting in a longer patency of the catheter . |
7,028 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: isolated dislocations of the trapezio metacarpal joint without associated fracture has been reported very rarely in the literature .
there are reports of associated injuries like fracture of the trapezium , dislocation of the metacarpophalangeal joint and fractures of the base of the thumb metacarpal .
authors report a case of isolated carpometacarpal dislocation of the right thumb , in an adult , successfully managed conservatively . at 15 months follow up the patient had full function of the hand without any clinical or radiological evidence of instability or posttraumatic arthritis .
isolated dislocations can be successfully managed by closed reduction and immobilization in a back slab , with unstable dislocations requiring surgical intervention .
isolated dislocations of the trapezio metacarpal joint [ tm ] without associated fracture is a very rare injury[1 - 4 ] , with few reports in the literature .
associated injuries reported include , fractures of the trapezium [ 5 - 7 ] , dislocation of the metacarpophalangeal joint ( mp ) [ 4,8 - 10 ] , and associated fracture of the base of the metacarpal .
there is debate over optimal management of the dislocation , with reports suggesting conservative management [ 1 , 9 ] , to aggressive surgery , including ligament reconstruction [ 11 - 13 ] . however , if the joint is stable after a closed reduction , immobilization in a thumb spica can result in a stable joint .
36 year old patient presented in the accident and emergency of a regional referral hospital with pain and deformity of the right thumb , following an alleged road traffic accident .
the patient was unable to move the right thumb , and had a prominence over the dorsal aspect of the right hand .
radiographs of the right hand revealed a dorsal dislocation of the carpo - metacarpal joint of the right thumb without any associated fracture ( fig.1a , b ) .
following reduction , the tm joint was found stable , and hence it was decided to treat the dislocation in a thumb spica . he was followed up every week... | introduction : isolated dislocations of the trapezio metacarpal joint without associated fracture has been reported very rarely in the literature .
there are reports of associated injuries like fracture of the trapezium , dislocation of the metacarpophalangeal joint and fractures of the base of the thumb metacarpal.case report : authors report a case of isolated carpometacarpal dislocation of the right thumb , in an adult , successfully managed conservatively . at 15 months
follow up the patient had full function of the hand without any clinical or radiological evidence of instability or posttraumatic arthritis.conclusion:isolated dislocations can be successfully managed by closed reduction and immobilization in a back slab , with unstable dislocations requiring surgical intervention . |
7,029 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in recent years , successive changes in mental health care systems have made them evolve from classical institutionalized care based on hospitalization to community health care with psychosocial rehabilitation .
these changes have re - established patients and their caregivers at the center of health care programs . caregivers are usually unpaid nonprofessionals , often family and friends who have significant input in the care and support of people affected by severe psychiatric illnesses . in the uk ,
the national service framework for mental health recognized the vital role caregivers play in delivering health care .
patients and their caregivers are more and more involved in decision making when it comes to their care , the rehabilitation process , and preventing relapses , as well as research programs .
this cooperation between patients , caregivers , and physicians has become the foundation of a participatory health care system in which the relationships between each of the parties are considerably reinforced .
this is the context in which patient - reported outcomes ( pros ) have been developed and become standard practice in recent years for evaluating the effectiveness of health care .
pros also help the clinician understand how patients experience their illness , by evaluating aspects such as their quality of life , disability , satisfaction , or level of functioning .
in addition to taking into account the patient 's viewpoint with pros , it is necessary to pay more attention to the expectations and the constraints of the caregivers who have become key players in today 's health care system .
it is currently accepted that mental disorders have a much larger impact than what was assumed before the advent of community psychiatry ; this impact is especially large on the caregivers to the patients .
as the health care systems evolve , relatives have become the main caregivers for patients with severe mental disorders .
they must provide support to their relatives with mental disorders while... | patient - reported outcomes ( pros ) are increasingly important in health care and mental health research . furthermore , caregivers become partners in care for patients with mental disorders , and health workers are more attentive to the expectations and needs of caregivers .
a number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers .
this paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders , raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use .
finally , we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care . |
7,030 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cyclin - dependent kinase inhibitor 1a ( p21 , cip1 ) mitochondria - associated membrane nuclear localization signal
maintenance of genome stability requires mobilization of the dna damage response ( ddr ) , both to repair the day - to - day chemical nicks and bruises and resolve acute damage following exposure to ionizing radiation ( ir ) or chemotherapeutics .
cells respond to these chemical mishaps and overtly acute genotoxic insults by inducing the tumor suppressor protein p53 ( tp53 , known as p53 ) , whose role in the regulation of the ddr is complex , involving changes in the expression of more than 3,000 genes and activation of cell cycle checkpoints to allow dna repair .
the most intensively studied p53 target genes include cyclin - dependent kinase inhibitor 1a ( cdkn1a , known as p21 ) , which promotes cell - cycle arrest or senescence , and p53 upregulated modulator of apoptosis ( puma , also known as bcl2-binding component 3 [ bbc3 ] ) and bcl2-associated x protein ( bax , also known as bcl-2-like protein-4 ) , which are activated to induce apoptosis when cellular damage is irreparable .
the transcriptional activity of p53 requires post - translational modifications , including phosphorylation and acetylation , to stabilize p53 and enhance its transactivation functions , respectively .
the class iii histone deacetylase sirtuin 1 ( sirt1 ) represses p53 transcriptional activation by deacetylating p53 following dna damage .
sirt1 can be regulated transcriptionally and post - transcriptionally and through interactions with other cellular proteins in diverse pathways .
the complexity of these functions suggests that regulation of sirt1 activity probably requires additional cellular factors .
we recently identified the multifunctional sorting protein phosphofurin acidic cluster sorting protein-2 ( pacs-2 ) as a novel mediator of p53 action in response to genotoxic insult ( fig .
pacs-2 was initially identified by its cytoplasmic roles in mediating mitochondria - associated membrane ( mam ) formation ,... | sirt1 regulates p53 transcriptional activation in response to genotoxic insult by deacetylating key lysine residues .
we recently identified the multifunctional protein pacs-2 as a sirt1 inhibitor . after dna damage , pacs-2 binds and inhibits sirt1 to increase p53-dependent transactivation of the cdk inhibitor p21 ( cdkn1a ) and induce cell cycle arrest . |
7,031 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the transcription factor p53
plays vital roles in the regulation of cellular processes and suppression
of tumor development .
mice lacking p53 develop normally but are prone to the development
of a variety of tumors.tp53 , the gene encoding the p53 protein , is mutated or deleted in nearly
50% of human cancers , rendering p53 nonfunctional as a tumor suppressor .
although p53 retains wild - type status in the
remaining 50% of human cancers , its function is effectively inhibited
by a variety of mechanisms .
one major inhibitory mechanism is through
overexpression of mdm2 ( also called hdm2 in humans ) . the role of mdm2
as a primary negative endogenous regulator of p53
is supported by
evidence that mdm2-null is embryonically lethal in
mice which can only be rescued by concurrent deletion of the tp53 gene .
mdm2 and p53 regulate
each other mutually through the
autoregulatory feedback loop shown in figure 1 . the autoregulatory feedback loop of the
p53mdm2 interplay operates as follows : upon activation , p53
transcribes mdm2 , leading to an increase of mdm2 mrna and protein
and in turn , mdm2 protein binds to p53 directly through their n - termini
and inhibits p53 function through three major mechanisms : ( 1 ) upon
binding , mdm2 ubiquitinates p53 by functioning as an e3 ligase promoting
proteasomal degradation of p53 ; ( 2 ) interaction of mdm2 with p53 blocks
the binding of p53 to its targeted dna , rendering p53 ineffective
as a transcription factor ; ( 3 ) mdm2 promotes export of p53 out of
the cell nucleus , leaving p53 inaccessible to targeted dna and reducing
its transcriptional ability . through these three inhibitory
mechanisms , mdm2 functions as an effective antagonist of wild - type
p53 .
consistent with its role as an efficient inhibitor of p53
tumor
suppressor , mdm2 in cells , when overexpressed , is oncogenic .
an analysis of 28 different types of cancers
involving nearly 4000 human tumor samples shows that in 7% of human
cancers , the... | design of small - molecule inhibitors
( mdm2 inhibitors ) to block
the mdm2p53 protein
protein interaction has been pursued
as a new cancer therapeutic strategy . in recent years
, potent , selective ,
and efficacious mdm2 inhibitors have been successfully obtained and
seven such compounds have been advanced into early phase clinical
trials for the treatment of human cancers . here , we review the design ,
synthesis , properties , preclinical , and clinical studies of these
clinical - stage mdm2 inhibitors . |
7,032 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: lupoid cutaneous leishmaniasis ( cl ) is a rare form of cl having a striking resemblance to other granulomatous cutaneous conditions of infectious or inflammatory origin .
the authors present a patient with a facial lupoid cl and discuss the diagnostic tools of this parasitological infection , the main differential diagnosis , and treatment .
a 54-year - old tunisian woman , with no past medical history of lupus erythematosus or infectious disease , presented with a 3-month history of a slowly enlarging erythematous and infiltrated plaque , extending over the nose , the right cheek , and the internal aspect of the right lower eyelid . microscopic examination of a parasitological smear showed numerous leishmania in their amastigote form , inside monocytes , confirming the diagnosis of cl .
the patient was cured by fluconazole 200 mg / day for 6 weeks after pancreatic intolerance with intramuscular meglumine antimoniate ( 60 mg / kg / day for 7 days ) , and no response to doxycycline ( 200 mg / day for 6 weeks ) .
lupoid cl is easily suspected in countries in which there is an endemic of leishmaniasis . in countries where there is nt an endemic ,
although rarely observed , this diagnosis should also be kept in mind in front of an infiltrated facial lesion of a tuberculoid aspect on histology , especially when there is a positive travel history to an area in which there is an endemic .
cutaneous leishmaniasis ( cl ) is a widespread parasitic disease in tunisia with numerous clinical presentations .
lupoid leishmaniasis is the most common cl among patients with unusual presentations.1 the authors present its clinical feature , the diagnostic tools , differential diagnosis , course , and treatment of this uncommon long - lasting form of cl .
a 54-year - old tunisian woman , with no past medical history , presented with a 3-month history of a slowly enlarging erythematous plaque of the central face .
cutaneous examination showed a large solitary erythematous and infiltrated plaque , extending over the nose , a... | backgroundlupoid cutaneous leishmaniasis ( cl ) is a rare form of cl having a striking resemblance to other granulomatous cutaneous conditions of infectious or inflammatory origin .
the authors present a patient with a facial lupoid cl and discuss the diagnostic tools of this parasitological infection , the main differential diagnosis , and treatment.case reporta 54-year - old tunisian woman , with no past medical history of lupus erythematosus or infectious disease , presented with a 3-month history of a slowly enlarging erythematous and infiltrated plaque , extending over the nose , the right cheek , and the internal aspect of the right lower eyelid .
microscopic examination of a parasitological smear showed numerous leishmania in their amastigote form , inside monocytes , confirming the diagnosis of cl .
clinical aspect was in favor of lupoid cl .
the patient was cured by fluconazole 200 mg / day for 6 weeks after pancreatic intolerance with intramuscular meglumine antimoniate ( 60 mg / kg / day for 7 days ) , and no response to doxycycline ( 200 mg / day for 6 weeks).discussionlupoid cl is easily suspected in countries in which there is an endemic of leishmaniasis . in countries where there is nt an endemic ,
although rarely observed , this diagnosis should also be kept in mind in front of an infiltrated facial lesion of a tuberculoid aspect on histology , especially when there is a positive travel history to an area in which there is an endemic . |
7,033 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: thus , taxane formulations with surfactants such as polysorbate 80 and ethanol have been approved for the management of several cancers , including prostate adenocarcinoma ( 14 ) .
however , ethanol and polysorbate 80 have the tendency to cause infusion - related toxicities and hypersensitivity reactions ( 57 ) . to avoid these adverse events , premedication with corticosteroids and antihistamines
furthermore , several new drug delivery systems have been researched , such as liposomes , polymeric micelles , protein and nanospheres ( 814 ) .
nanotechnology for drug delivery has achieved significant improvements in the efficacy and safety of drugs ( 1517 ) .
these nanoparticles are composed of organic substances , such as lipids , phospholipids , dextran and chitosan .
the drug particles are occasionally reduced in size to nanoparticles in order to avoid use of other substances as carriers ( 1820 ) .
we herein present the case of a patient with adenocarcinoma of the prostate with bone metastasis , who developed an allergic reaction to conventional docetaxel and was later started on doceaqualip , a nanosomal docetaxel lipid suspension ( ndls ) .
doceaqualip , which is devoid of polysorbate 80 and ethanol , was developed with lipids generally recognized as safe ( gras ) by the us food and drug administration .
doceaqualip has achieved a higher systemic availability of docetaxel when compared with conventional docetaxel in patients with solid tumors .
furthermore , the increased efficacy of doceaqualip compared with that of conventional docetaxel has been proven in patients with breast cancer without requirement for any premedication ( 18 ) .
a 65-year - old male patient from nairobi , kenya , initially presented with severe back pain in august , 2015 .
the patient was evaluated and diagnosed with adenocarcinoma of the prostate with bone metastasis after undergoing fluorodeoxyglucose ( fdg ) positron emission tomography / computed tomography ( pet / ct ) .
prostate needle biopsy revealed adenocarcinoma of the... | docetaxel has been widely used in the treatment of several cancers , including adenocarcinoma of the prostate gland .
as docetaxel is insoluble in water , it must be administered with polysorbate 80 and ethanol , which are known to cause hypersensitivity reactions .
premedication with corticosteroids and antihistamines is advocated prior to docetaxel administration ; however , toxicities , occasionally fatal , have been reported , even with corticosteroid premedication .
we herein report the case of a patient with adenocarcinoma of the prostate , with bone metastasis and an eastern cooperative oncology group performance status of < 2 , who developed an allergic reaction to conventional docetaxel ( taxotere ) , despite being premedicated with corticosteroids and antihistamines .
the patient was managed with corticosteroids and antihistamines , and was later started on doceaqualip , a nanosomal docetaxel lipid suspension .
doceaqualip was well - tolerated by the patient and 5 cycles were subsequently administered , without any adverse reactions .
adenocarcinoma also regressed , as evidenced by positron emission tomography / computed tomography . |
7,034 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: oral mucocutaneous conditions are a group of disorders which are observed in the dental practice .
oral mucosal manifestations may be the initial feature , or the only sign of such diseases .
in other cases , lesions occur in both the skin and mucosae , with severe clinical manifestations involving the tissues .
correct diagnosis is critical , since proper treatment and follow - up will depend on which disease is involved .
however , vesiculo - bullous lesions frequently present diagnostic problems because the lesions often resemble each other clinically and routine histological examination sometimes can not differentiate between them .
thus immunohistology particularly immunofluorescence is increasingly being used with routine histology to accurately diagnose vesiculo - bullous lesions .
these conditions are caused by a genetic mutation or are due to an autoimmune response .
this study was carried out in the department of oral pathology , sri ramachandra dental college & hospital , chennai .
the study population consisted of 26 patients with oral mucocutaneous diseases who were selected randomly .
of the 26 patients,6 patients were under pulse therapy who were clinically and histopathologically diagnosed as pemphigus .
these patients were free of active lesions and their disease activity was assessed by indirect immunofluorescence ( iif ) who were grouped separately . based on the clinical and provisional diagnosis ,
the remaining 20 patients who had active lesions were subjected to both direct immunofluorscence ( dif ) and iif and were divided into four groups .
we carried out histopathology study with subsequent immunofluorescent technique to study the pattern of immunofluorescence in each group .
they were immediately washed in normal saline and placed in michel 's medium and transported to the laboratory within 24 hours .
whole blood was allowed to clot , centrifuged , and the serum was separated and transported to the laboratory .
the study consisted of 26 patients of pemphigus , pemphigoid , lichen... | aim : to study the immunofluorescence pattern and to assess its reliability as a confirmatory diagnostic test in patients with pemphigus , pemphigoid , lichen planus , and lupus erythematosus and also to assess the disease activity by indirect immunofluorscence ( iif ) in patients with pemphigus only.materials and methods : twenty - six patients were included in the study group , out of which , 6 patients were clinically and histopathologically diagnosed as pemphigus , completely free of active lesions were subjected to iif only to assess the disease activity and were grouped separately .
based on the clinical and provisional diagnosis , the remaining 20 patients who had active lesions were subjected to direct immunofluorscence ( dif ) and iif and were divided into four groups .
biopsy specimens were taken from the periphery of the lesions and were examined by both conventional light microscopic and dif methods .
five milliliters of venous blood was collected from each patient and were subjected to iif.results:histopathological diagnosis was consistent with direct immunofluorescence study in 15 cases ( 75% ) .
the various immunofluorescence patterns observed in our study were consistent with those described by various authors in standard textbooks and articles.conclusion:histopathology remains gold standard for most of the diseases , it is recognized from this study that not all lesions are amenable to definitive histopathological diagnosis thus ; dif can provide a valuable additional criterion in diagnosis . |
7,035 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: neurosteroids ( ns ) , a term proposed by the physiologists baulieu and robel ( 1990 ) , is widely used to refer to the steroids synthesized in the brain . through their interaction with neuronal membrane receptors and ion channels ,
they are capable to modify the brain excitability ( lambert et al . , 2003 ;
depending on its chemical structure , the steroids interactions with the gabaa receptor may produce positive or negative modulations ( majewska , 1992 ; reddy , 2003 ) . among the positive modulators of this receptor are two progesterone 's metabolites : the 5-pregnane-3-ol-20-one ( allopregnanolone ) and its isomer 5-pregnane-3-ol-20-one ( pregnanolone ; gasior et al . , 1999 ) .
the interest on these steroids arises from their potential activity as anticonvulsants , anesthetics , anxiolytic or sedative - hypnotic agents ( akk et al . , 2007 ) useful for the treatment of several neurological and psychiatric disorders ( gasior et al . , 1999 ) .
also , various physiological and pathophysiological conditions have been associated with changes in allopregnanolone and pregnanolone levels ( akk et al . , 2007 ) .
although the natural ns can be used in epileptic patients ( herzog , 1999 ) , certain properties , like their short biological half - life , avoid their clinical use .
for that reason , synthetic steroids ( ss ) , that exhibit better bioavailability and efficacy , have an important therapeutic potential in brain disorders , becoming an alternative for this kind of pathologies ( reddy and kulkarni , 2000 ; morrow , 2007 ) .
the medicinal chemistry of neuroactive steroids ( nas ) has been focused in the development of ss analogues preserving the absolute configuration of naturally occurring steroids .
structure / activity studies indicate that the 3-hydroxyl configuration is required for binding and activity ( purdy et al . ,
for example , the 3-methylated synthetic analog of allopregnanolone , ganaxolone ( 3-hydroxy-3-methyl-5-prengan-20-one ) is capable to overcome these limitations , showing... | neurosteroids , like allopregnanolone and pregnanolone , are endogenous regulators of neuronal excitability . inside the brain , they are highly selective and potent modulators of gabaa receptor activity .
their anticonvulsant , anesthetics and anxiolytic properties are useful for the treatments of several neurological and psychiatric disorders via reducing the risks of side effects obtained with the commercial drugs .
the principal disadvantages of endogenous neurosteroids administration are their rapid metabolism and their low oral bioavailability .
synthetic steroids analogues with major stability or endogenous neurosteroids stimulation synthesis might constitute promising novel strategies for the treatment of several disorders .
numerous studies indicate that the 3-hydroxyl configuration is the key for binding and activity , but modifications in the steroid nucleus may emphasize different pharmacophores .
so far , several synthetic steroids have been developed with successful neurosteroid - like effects . in this work ,
we summarize the properties of various synthetic steroids probed in trials throughout the analysis of several neurosteroids - like actions . |
7,036 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in vertebrates , numerous processes occur in a rhythmic manner . during the course of evolution
, animals have evolved biological rhythms that are associated with changes in the lighting and temperature of their environment .
one of the most important biological rhythms is the circadian rhythm generated by endogenous oscillators , termed the
circadian clock , which has a period very close to 24 hours and is synchronised with environmental light conditions .
the hormonal signal used to reliably reflect environmental light conditions is melatonin ( n - acetyl-5-methoxytryptamine ) , which is synthesised in the pineal gland .
this gland is localised in a third ventricle ( iiiv ) evagination called the pineal recess .
it stays in contact with the cerebrospinal fluid ( csf ) from the iiiv , which results in the local concentration of melatonin in the iiiv being approximately 20 times higher in the csf than in blood . in all mammalian species studied ,
melatonin secretion is regulated by norepinephrine ( ne ) , which is released from sympathetic nerve fibres exclusively at night .
the biosynthesis of melatonin is a well - characterised multistep sequence of reactions that starts with the hydroxylation of tryptophan to 5-hydroxytryptophan ( 5-htp ) by the enzyme tryptophan hydroxylase ( tph ) .
next , aromatic amino acid decarboxylase ( ddc ) converts 5-htp to 5-hydroxytryptamine ( 5-ht ; serotonin ) .
then , 5-ht is transformed to n - acetylserotonin by arylalkylamine - n - acetyltransferase ( aanat ) .
finally , n - acetylserotonin is converted to melatonin by the enzyme hydroxyindole - o - methyltransferase ( hiomt ) .
the circulating level of melatonin reflects pineal secretory activity because it is not stored within the pinealocytes but freely diffuses out of the cells into blood capillaries immediately after its formation .
a conservative feature of vertebrates is that the plasma level of melatonin increases at night , whereas diurnal levels of this hormone are relatively low .
one of the most significant... | in vertebrates , numerous processes occur in a rhythmic manner .
the hormonal signal reliably reflecting the environmental light conditions is melatonin .
nocturnal melatonin secretion patterns could be disturbed in pathophysiological states , including inflammation , alzheimer 's disease , and depression .
all of these states share common elements in their aetiology , including the overexpression of interleukin- ( il- ) 1 in the central nervous system .
therefore , the present study was designed to determine the effect of the central injection of exogenous il-1 on melatonin release and on the expression of the enzymes of the melatonin biosynthetic pathway in the pineal gland of ewe .
it was found that intracerebroventricular injections of il-1 ( 50 g / animal ) suppressed ( p < 0.05 ) nocturnal melatonin secretion in sheep regardless of the photoperiod .
this may have resulted from decreased ( p < 0.05 ) synthesis of the melatonin intermediate serotonin , which may have resulted , at least partially , from a reduced expression of tryptophan hydroxylase .
il-1 also inhibited ( p < 0.05 ) the expression of the melatonin rhythm enzyme arylalkylamine - n - acetyltransferase and hydroxyindole - o - methyltransferase .
however , the ability of il-1 to affect the expression of these enzymes was dependent upon the photoperiod .
our study may shed new light on the role of central il-1 in the aetiology of disruptions in melatonin secretion . |
7,037 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
staphylococcus aureus is one of the most significant bacterial pathogens and can cause diseases ranging from minor and surgical site infections to potentially life - threatening endocarditis [ 24 ] and bacteraemia [ 58 ] .
it is a particular problem in hospitals as a consequence of the emergence and dissemination of multidrug - resistant forms such as methicillin - resistant s. aureus ( mrsa ) , vancomycin intermediate susceptibility s. aureus ( visa ) , and heterogenous visa ( hvisa ) .
the prevalence of these antibiotic resistant forms means that the discovery of novel chemotherapeutic agents to combat these pathogens is of key importance [ 9 , 10 ] .
the lantibiotics ( lanthionine - containing antibiotics ) are a group of posttranslationally modified antimicrobial peptides of which nisin and lacticin 3147 are among the most extensively investigated .
a number of lantibiotics have been noted to exhibit potent antimicrobial activity against staphylococci of clinical relevance . in agar
diffusion assays , the type i lantibiotics epidermin , pep5 , epicidin k7 , and epilancin 280 display impressive levels of activity against coagulase negative staphylococci ( cns ) , and it has been suggested that their potential could be exploited to prevent the colonization of medical devices .
nisin has also been shown on several occasions to possess significant anti - staphylococcus activity . when tested against 20 mrsa strains
, one study revealed that the minimum inhibitory concentration ( mic ) of nisin a ranged between 1.5 and 16 mg / l , while a more recent investigation revealed mics of 0.54.1
the in vitro activity of other forms of nisin ( nisin f , q , and z ) against mrsa has also recently been highlighted .
the in vivo activity of a number of lantibiotics against staphylococci has also been investigated .
the effectiveness of the epidermin - like mutacin b - ny266 was tested on mice infected by intraperitoneal ( ip ) injection with 3.1 10 cfu of s. aureus smith / mouse . immediately after injection... | the objective of this study was to investigate the in vivo activity of the lantibiotic lacticin 3147 against the luminescent staphylococcus aureus strain xen 29 using a murine model .
female balb / c mice ( 7 weeks old , 17 g ) were divided into groups ( n = 5 ) and infected with the xen 29 strain via the intraperitoneal route at a dose of 1 106 cfu / animal .
after 1.5 hr , the animals were treated subcutaneously with doses of phosphate - buffered saline ( pbs ; negative control ) or lacticin 3147 .
luminescent imaging was carried 3 and 5 hours postinfection .
mice were then sacrificed , and the levels of s. aureus xen 29 in the liver , spleen , and kidneys were quantified .
notably , photoluminescence and culture - based analysis both revealed that lacticin 3147 successfully controlled the systemic spread of s. aureus in mice thus indicating that lacticin 3147 has potential as a chemotherapeutic agent for in vivo applications . |
7,038 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: during recent years , the trend toward laparoscopic approach for hernia repair in children has been increasingly justified . the ability to detect and repair the contralateral opening of internal rings simultaneously , along with safe high ligation of the hernia sac without injury of the vas deference or the spermatic vessels , make laparoscopic approach a reliable alternative to the conventional open techniques
( 1 ) most of these methods employ a laparoscope inserted via an umbilical incision and two lateral ports for instruments to ligate the hernia defect . the necessity for intra - abdominal skills , such as intracorporeal suturing , knot tying , and
( 2 ) recurrence rate after laparoscopic surgery is generally known to be higher than after open surgery . with the increase in laparoscopic inguinal hernia repair
, several treatment techniques have developed over the past two decades , aimed at improving the outcome ; the various techniques differ in their approach to the inguinal internal ring , suturing and knotting techniques , number of ports used in the procedures , endoscopic instruments used , mode of dissection of the hernia sac , and extracorporeal and intracorporeal suturing and knotting techniques .
i used two 5 mm ports which reduce the port numbers and size , the purse string suturing , and extracorporeal knotting of the hernia sac .
the main outcome measurements were correlation between clinical diagnosis , abdominal ultrasound results and the laparoscopic evaluation of contralateral hernia , feasibility of two ports laparoscopic repair of the inguinal hernia , conversion rate , need for additional port , operative time , postoperative pain and requirement of analgesia , hospital stay , recurrence rate , and fat of nonexcised hernia sac and development of postoperative hydrocele .
written consent was obtained from the family after getting full information about the surgery and the postoperative squeal .
all patients received one dose of antibiotic prophylaxis in the form of ceftriaxone 50 ... | introduction .
several laparoscopic treatment techniques were designed for improving the outcome over the last decade .
the various techniques differ in their approach to the inguinal internal ring , suturing and knotting techniques , number of ports used in the procedures , and mode of dissection of the hernia sac .
patients and surgical technique .
90 children were subjected to surgery and they undergone two - port laparoscopic repair of inguinal hernia in children . technique feasibility in relation to other modalities of repair was the aim of this work .
90 children including 75 males and 15 females underwent surgery . hernia in 55 cases was right - sided and in 15 left - sided .
two patients had recurrent hernia following open hernia repair .
70 ( 77.7% ) cases were suffering unilateral hernia and 20 ( 22.2% ) patients had bilateral hernia . out of the 20 cases
5 cases were diagnosed by laparoscope ( 25% ) .
the patients ' median age was 18 months .
the mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes .
there was no conversion .
the complications were as follows : one case was recurrent right inguinal hernia and the second was stitch sinus . discussion .
the results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment . |
7,039 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hospital - acquired pneumonia ( hap ) is the second most common nosocomial infection , occurring in 0.5%2% of general hospital admissions1,2 and in 15%20% of patients in intensive care units,3 likely because of the prevalent use of mechanical ventilation .
hap is a life - threatening condition that is associated with increased in - hospital mortality of 22%60%.4 with extended hospital length of stay and an increasing number of patients with multidrug - resistant hap , treating hap is expensive .
one episode of hap has been shown to increase hospitalization costs by up to usd 40,000 in the usa.5 the incidence of hap in chinese tertiary care hospitals ranges from 5.9% in general hospitalized patients6 to 28.2% in critically ill patients.7 overall mortality in chinese patients with diagnosed hap was reported as 25.3%.8 of the reported deaths , pseudomonas aeruginosa and staphylococcus aureus infections accounted for 70.6% and 66.7% of cases , respectively .
differences have been observed in the causative pathogens patterns associated with hap in the people s republic of china compared to western countries , with more than half of chinese patients with hap caused by gram - negative pathogens.7,8 as a result , it is expected that chinese patients might respond differently to the empirical use of different antibiotics .
vancomycin and linezolid are the first - line treatments for methicillin - resistant s. aureus ( mrsa),1 and with the increasing risk of hap caused by mrsa,9 the empirical use of vancomycin and linezolid for hap is becoming commonplace in the people s republic of china . however , because the hap causative pathogen(s ) is not routinely identified in chinese tertiary care hospitals , the empirical use of vancomycin and linezolid for suspected mrsa infection is common .
there is a paucity of evidence concerning the use of vancomycin and linezolid in the people s republic of china for the treatment of difficult hap under routine clinical practice .
thus , to address the current evidence gap , this... | aimsto evaluate clinical outcomes and allocation of hospital costs associated with empirical use of vancomycin or linezolid for hospital - acquired pneumonia ( hap ) in the people s republic of china.methodshospital episodes including hap treated by vancomycin or linezolid between 2008 and 2012 in a chinese tertiary care hospital were retrospectively identified from hospital administrative databases .
propensity score methods created best - matched pairs for the antibiotics .
the matched pairs were used for adjusted comparisons on clinical response and allocation of hospital costs .
multiple regression analyses adjusting residual imbalance after matching were performed to confirm adjusted comparisons.resultssixty matched pairs were created . adjusted comparisons between vancomycin and linezolid showed similar clinical response rates ( clinical cure : 30.0% versus 31.7% , respectively ; p=0.847 ; treatment failure : 55.0% versus 45.0% , respectively ; p=0.289 ) but a significantly lower in - hospital mortality rate for vancomycin ( 3.3% versus 18.3% , respectively ; p=0.013 ) . after further adjusting for the imbalanced variables between matched treatment groups , the risks of treatment failure associated with the two antibiotics were comparable ( odds ratio : 1.139 ; p=0.308 ) and there was a nonsignificant trend of lower risk of in - hospital mortality associated with vancomycin ( odds ratio : 0.186 ; p=0.055 ) .
the total hospital costs associated with vancomycin had a nonsignificant trend of being lower , likely because of its significantly lower acquisition costs ( median : rmb 2,880 versus rmb 8,194 ; p<0.001 ; 1 rmb = 0.16 usd).conclusionin tertiary care hospitals in the people s republic of china , empirical treatment of patients with hap with vancomycin had a comparable treatment failure rate but likely had a lower in - hospital mortality rate when compared with linezolid .
vancomycin also costs significantly less for drug acquisition than linezolid when treating hap empirically . |
7,040 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: allostery
plays a fundamental role in most biological processes
and has been suggested to be present in nearly all proteins .
one of the best - studied allosteric phenomena
is the activation of a receptor , which we will denote as r , by a ligand ,
denoted as l. the most common model for allostery in this system is
the allosteric two - state model ( atsm ) .
we can construct
a thermodynamic cycle for the process of ligand - induced activation
of the receptor:1we refer to this as an allosteric
cycle . to describe the allostery in this system , the allosteric
efficacy , , can be calculated from the cycle as2where
( assuming the volume is constant ) ,
each
equilibrium constant is a function of the difference in helmholtz
free energy , a , for the two states:3thus,4for convenience , we will
discuss the allosteric
efficacy in terms of the quantity a , which we will call
the thermodynamic coupling .
a
is symmetric at equilibrium , that is , a
for receptor activation conditional on ligand binding is equivalent
to the a for ligand binding conditional on activation .
thus , the following two definitions of a are equivalent:5however , there is
no reason
to assume that the receptor activation is a two - state process . in
fact
, nmr experiments have revealed a multimodal activation process
in the 2-adrenergic receptor ( 2ar ) , and quantitative mass spectroscopy
experiments have revealed ligand - specific states in the same system .
these results , along with other evidence for
additional states in 2ar and other receptors , indicate that activation must be treated as either involving more
than two discrete states , or even as involving a continuous conformational
space .
. the complex behavior of an allosteric receptor
is thus unlikely to be well described by a single reaction coordinate ;
instead , the large number of potential conformational states may be
best described by multiple collective variables ( cvs ; variables that
are functions of the atomic... | allostery plays a fundamental role
in most biological processes .
however , little theory is available to describe it outside of two - state
models . here
we use a statistical mechanical approach to show that
the allosteric coupling between two collective variables is not a
single number , but instead a two - dimensional thermodynamic coupling
function that is directly related to the mutual information from information
theory and the copula density function from probability theory . on
this basis , we demonstrate how to quantify the contribution of specific
energy terms to this thermodynamic coupling function , enabling an
approximate decomposition that reveals the mechanism of allostery .
we illustrate the thermodynamic coupling function and its use by showing
how allosteric coupling in the alanine dipeptide molecule contributes
to the overall shape of the / free energy surface , and
by identifying the interactions that are necessary for this coupling . |
7,041 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: to integrate all available data regarding the fatty acid ethanolamide metabolism and distribution in the human body , we created a mechanistic ordinary differential equation - based model as shown in figure 2 . to account for the known mutually exclusive binding of ethanolamides to faah and to enable the use of all clinical biomarker data for parameter estimation , the model included not only aea , but also oea , pea , sea , and lea .
the resulting model was fit to the individual clinical data for a single oral dose of 10 mg of pf-04457845 .
supplementary table s1 and model s1 show the ordinary differential equations , parameters , and data sources .
values were estimated from the clinical trial data with the remainder fixed , based on literature or in - house laboratory data .
it was found that a good fit to the data could be achieved , provided faah - independent clearance was included in the model ( figure 3 ) .
figure 3 also illustrates that removal of the faah - independent clearance from the model ( for example , assuming maximal rate of the process equal to zero ) resulted in both substantial changes in the shape of the time response curve and a significant increase of more than 10-fold the maximal biomarker concentration .
response kinetics of faah activity in human plasma at 1 and 10 mg of pf-04457845 .
furthermore , this model also accurately simulated the observed human dynamics of aea , lea , pea , and oea at both 1 and 10 mg of pf-04457845 ( figure 4 ) .
we used this model to simulate the brain cb1 occupancy in hypothetical patients at doses of 0.140 mg .
these simulations showed that the projected occupancy saturated at ~25% , independent of the drug dose .
however , increasing dose did prolong the time at peak receptor occupancy ( figure 5 ) . to obtain insight into the most influential parameters in the model
, we carried out a sensitivity analysis . integrating the resulting values yielded a representation of the influence of each parameter on the cb occupancy in brain .
the results are... | the level of the endocannabinoid anandamide is controlled by fatty acid amide hydrolase ( faah ) . in 2011 ,
pf-04457845 , an irreversible inhibitor of faah , was progressed to phase ii clinical trials for osteoarthritic pain .
this article discusses a prospective , integrated systems pharmacology model evaluation of faah as a target for pain in humans , using physiologically based pharmacokinetic and systems biology approaches .
the model integrated physiological compartments ; endocannabinoid production , degradation , and disposition data ; pf-04457845 pharmacokinetics and pharmacodynamics , and cannabinoid receptor cb1-binding kinetics .
the modeling identified clear gaps in our understanding and highlighted key risks going forward , in particular relating to whether methods are in place to demonstrate target engagement and pharmacological effect .
the value of this modeling exercise will be discussed in detail and in the context of the clinical phase ii data , together with recommendations to enable optimal future evaluation of faah inhibitors . |
7,042 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the majority of mastocytosis appears in the childhood in which urticaria pigmentosa and mastocytoma are the most common types .
some variant of diffuse cutaneous mastocytosis like pseudoxanthomatous mastocytosis or xanthelasmoid are extremely rare , especially in the adult .
mastocytosis is a group of disease that characterized by increased the population of mast cells in many organs such as skin , bone marrow , liver , spleen , and lymph nodes which among the skin is the most common involved organ .
the majority of mastocytosis appears in childhood and urticaria pigmentosa ( up ) , and mastocytoma are the most common types .
the most presentation in adults are red - brown macules and papules on the trunk and proximal limbs .
other presentation such as telangiectasia macularis eruptive perstans and diffuse cutaneous mastocytosis ( dcm ) are rare in adults .
the term xanthelasmoid , nodular , and pseudoxanthomatous mastocytocytosis describe all the same clinical condition with slight variations , therefore , could be considered as synonyms and have been introduced to describe the presence of yellowish papular or nodular lesion .
herein , we describe an adult male with cutaneous mastocytosis showing multiple pruritic widespread skin colored to yellow ovoid papules like eruptive xanthoma .
a 60-year - old male visited our outpatient clinic with a 1-year history of generalized yellowish ovoid , and skin color papular eruption located on the trunk , groin , and extremities .
he first noticed pruritic papules , and 23 months later many yellow and ovoid pruritic papules emerged .
medical history , family history , and social history of the patient were all negative .
he denied taking any medications before admission and there was no apparent episode of any infection before the onset of the eruption .
patient 's adverse drug reaction history was also negative . on skin physical examination firm ,
well - defined ovoid skin colored to yellow papules were seen on the distal and proximal of upper and lower extremities ,... | xanthelasmoid or pseudoxanthomatous mastocytosis is an extremely rare variant of diffuse cutaneous mastocytosis .
herein , we describe an adult male with cutaneous mastocytosis showing multiple widespread yellowish ovoid papules like eruptive xanthoma .
a 60-year - old male visited our outpatient clinic with a 1-year history of generalized yellowish , ovoid , and skin color papular eruption located on the trunk , groin , extremities , with the modest pruritus .
vital signs were stable , and darier 's sign was negative .
no other subjective and objective signs were detected during the examination .
no abnormality was detected in his diagnostic laboratory tests .
skin biopsy was taken , and histopathologic examination revealed proliferation of mast cells with ovoid and spindle nuclei with distinct cytoplasm borders around the capillaries , which was compatible with mastocytosis .
antihistamine was prescribed for pruritus control which was successful , but eruptions were persistent , and even 1-year phototherapy was not useful . |
7,043 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: consolidation
refers to the idea that , following the experience of an event , the memory for
that event undergoes a process of stabilization that renders the memory more
resistant to brain injury or interference from similar experiences .
building on the
work of marr [ 1 , 2 ] , squire et al .
suggested that a memory representation or memory trace was dependent upon both
medial temporal lobe ( in particular , the hippocampus proper ) and neocortical
structures , and that consolidation was the process by which cortical - cortical
connections within the trace were strengthened until eventually the memory
could be retrieved in the absence of the hippocampus .
the
question of whether a consolidated autobiographical memory , dependent primarily
on neocortex rather than hippocampus , is qualitatively unchanged from the
memory that was first encoded was not addressed explicitly in the squire et al .
proposal .
indeed , the consolidation
view inherently assumed that memories over time remained a faithful record of
the original event .
this assumption was
previously questioned by bartlett
, who demonstrated that memory retrieval was a constructive process rather
than a mere replay of the past . using
the now famous war of the ghosts story and what he called the method of
repeated reproduction , he showed that there was considerable variability in how
a story was recalled over time .
repeated
reproduction of the story typically led to a shortened , more stereotyped
version of it , with details either discarded , transformed , or added anew .
bartlett 's
study implied that changes in a memory after initial learning affected not only
the strength , but the content of that memory as well . in
recent years
one version
emphasizes that the role of the hippocampus in retrieval is time - limited and
that the informational components of memories are represented solely in
cortical regions this has become known as the standard theory
of memory consolidation... | multiple trace theory ( mtt ) predicts that hippocampal memory traces expand and strengthen as a function of repeated memory retrievals .
we tested this hypothesis utilizing fmri , comparing the effect of memory retrieval versus the mere passage of time on hippocampal activation . while undergoing fmri scanning , participants retrieved remote autobiographical memories that had been previously retrieved either one month earlier , two days earlier , or multiple times during the preceding month .
behavioral analyses revealed that the number and consistency of memory details retrieved increased with multiple retrievals but not with the passage of time . while all three retrieval conditions activated a similar set of brain regions normally associated with autobiographical memory retrieval including medial temporal lobe structures , hippocampal activation did not change as a function of either multiple retrievals or the passage of time .
however , activation in other brain regions , including the precuneus , lateral prefrontal cortex , parietal cortex , lateral temporal lobe , and perirhinal cortex increased after multiple retrievals , but was not influenced by the passage of time .
these results have important implications for existing theories of long - term memory consolidation . |
7,044 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: pluripotent cells have the capacity of differentiating towards cell types from the three germinal layers of the body while holding a high replication potential . in this way ,
embryonic stem cells derived in the 1980s ( mouse ) and 1990s ( human ) revolutionized biomedical research , offering the possibility to produce de novo tissues that could be used to replace or regenerate diseased organs ; however , ethical concerns and host / donor immunological mismatch have contributed to the hurdles that challenge clinical applications . a paradigm shift within the field of regenerative medicine occurred in 2006 with the derivation of pluripotent cells from somatic fibroblasts by transduction with a set of four transcription factors .
uniquely , this platform eliminates the need for embryonic tissue and opens a new avenue for personalized drug testing , diagnosis , and therapy [ 4 , 5 ] .
studies that followed have optimized the derivation of induced pluripotent stem ( ips ) cells from human somatic sources [ 613 ] and have refined this process to increase reprogramming efficiency [ 1417 ] . also , numerous protocols have been described to guide differentiation of these bioengineered pluripotent cells into diverse cell types useful for broad applications in discovery and translational science [ 1826 ] .
notably , specialized cardiovascular lineages derived through the process of nuclear reprogramming of healthy and/or diseased somatic tissues have been applied across the continuum of biomedical applications [ 2730 ] . the opportunity to refine tissue - specific differentiation protocols by identifying the appropriate somatic tissue source and reprogramming strategy would accelerate the field of cardiovascular regenerative biology . based on the epigenetic and transcriptional carryover that follows reprogramming
, a residual memory may be influenced by both tissue of origin and the reprogramming process [ 32 , 33 ] .
the impact of this memory will likely be dependent on the use or application of the... | bioengineered by ectopic expression of stemness factors , induced pluripotent stem ( ips ) cells demonstrate embryonic stem cell - like properties and offer a unique platform for derivation of autologous pluripotent cells from somatic tissue sources . in the process of nuclear reprogramming
, somatic tissues are converted to a pluripotent ground state , thus unlocking an unlimited potential to expand progenitor pools
. molecular dissection of nuclear reprogramming suggests that a residual memory derived from the original parental source , along with the remnants of the reprogramming process itself , leads to a biased potential of the bioengineered progeny to differentiate into target tissues such as cardiac cytotypes . in this way ,
ips cells that fulfill pluripotency criteria may display heterogeneous profiles for lineage specification .
small molecule - based strategies have been identified that modulate the epigenetic state of reprogrammed cells and are optimized to erase the residual memory and homogenize the differentiation potential of ips cells derived from distinct backgrounds . here
, we describe the salient components of the reprogramming process and their effect on the downstream differentiation capacity of the ips populations in the context of cardiovascular regenerative applications . |
7,045 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: epithelial cells in gastrointestinal ( gi ) tract are continuously exposed to a lot of stressful antigens because we eat different meals 3 times a day and swallow air pollutant into gi tract .
moreover , they are harassed to several kinds of gas produced by commensal bacteria colonized in gi tract . to cope with this very stressful organization and environment ,
gi mucosa wisely developed various strategies to tolerate stresses , such as generating antioxidant enzymes , increasing level of immune - tolerance , and regulating mechanisms to cope with stress like chaperone genes including heat shock proteins ( hsps ) .
hsps are groups of stress - response proteins which are either constitutively expressed or induced through the transcriptional action of heat shock factor ( hsf ) .
hsps are classified into four major families according to their biological activities and apparent molecular weights ; hsp90 , hsp70 , hsp60 , and small hsps including hsp27 .
while hsp60 , hps70 , and hsp90 are constitutively expressed , hsp70 and hsp27 are induced by various conditions , including heat , oxidative stress , or drug exposure .
the type of hsp induced and its level of expression can determine the fate of a cell in response to stress or stimulus , by which hsps may play a cytoprotective role in gastrointestinal tract . for instances , oral administration of geranylgeranylacetone ( gga ) ,
an antiulcer drug , rapidly induced hsp70 in rat gastric mucosal cells and the induced hsps contributed to the suppression of inflammation accompanied with accelerated healing of ulcer induced by water immersion restraint stress .
animal studies have consistently demonstrated that though h. pylori infection delays gastric mucosal healing by disrupting the balance in cell apoptosis and proliferation , decreasing migration of epithelial cells , and decreasing blood flow and angiogenesis within the gastric mucosa , hsps could reverse these limitation and inferiorities in mucosal healing .
the general roles of hsp are intracellular... | heat shock proteins ( hsps ) have core housekeeping functions in the cells where they are built - in components of folding , signal transduction pathways , and quality control functions for which they proofread the structure of proteins and repair misfolded conformers .
helicobacter pylori ( h. pylori ) infection leads to significant inflammations in the gastric mucosa , which is closely associated with development of either precancerous lesion including chronic atrophic gastritis or gastric cancer in addition to , peptic ulcer disease , and mucosa - associated lymphoid tissue ( malt ) lymphoma .
therefore , the association between h. pylori infection and role of hsp has been focused as an important issue because there had been rather conflicting publications showing that hsps as a good worker for defense against h. pylori infection , whereas hsps as a bad offender contributing to the progression of h. pylori - associated gastric carcinogenesis in addition to aggravation of gastric inflammation . in this paper regarding proteomic discovery of hsps related to h. pylori - associated gastric diseases ,
we introduce several evidences obtained from proteomic analysis dealing with friend or foe role of hsp in h. pylori infection from a cellular level to human diseases .
the implication of hsps in alcoholic or nsaids - induced gastritis and the intervening of hsps in biological changes exemplified with tgf- signaling , key tumor suppressor growth factors regulating inflammation , immune function , and carcinogenesis were further introduced . |
7,046 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: small cell carcinoma of the prostate ( scpca ) , also termed neuroendocrine scpca , was first described by wenk et al . in 1977 .
its incidence has been estimated at slightly less than 2% of de novo prostate cancer .
small cell carcinomas usually present together with adenocarcinomas . in some cases , neuroendocrine differentiation occurs sequentially , with an initial pattern of conventional adenocarcinoma , which thereafter presents with focal neuroendocrine differentiation while in recurrence after androgen deprivation therapy . in approximately 35% of scpca cases ,
the clinical phenotype of scpca may be distinguishable from that of typical adenocarcinoma by the common initial presentation of rapidly symptomatic , locally advanced or metastatic disease , occurring frequently with visceral and lytic bone metastases , marked prostatic enlargement and disproportionately low or absent prostate - specific antigen ( psa ) levels as well as resistance to androgen ablation .
these tumors are highly aggressive , with a median survival of 910 months and a 5-year survival of less than 1% .
the most typical age at diagnosis is 6170 years , although an age range from 24 to 90 years has been reported .
prostatic malignant neuroendocrine cells tend to produce ectopic peptides , with adrenocorticotropic hormone ( acth ) and calcitonin being detected most frequently in serum .
approximately 10% of small cell carcinoma cases present with paraneoplastic syndromes [ 2 , 6 ] .
the most common immunohistochemical markers used to diagnose scpca are neuron - specific enolase ( nse ) , chromogranin a ( chra ) , synaptophysin ( syn ) , cd56 and thyroid transcription factor-1 ( ttf-1 ) .
serum acth , calcitonin , and parathyroid hormone levels may be elevated regardless of the presence of paraneoplastic syndromes .
tumor markers such as carcinoembryonic antigen ( cea ) and cancer antigen 19 - 9 ( ca 19 - 9 ) are also often elevated [ 3 , 6 ] .
psa is a more complicated marker of the disease . generally , in the case of... | primary small cell carcinoma of the prostate ( scpca ) is a rare pathologic entity with unique clinical features and a poor prognosis .
we present a case of a patient diagnosed with pure scpca treated with a combined chemo - radiotherapeutic approach .
pathological findings showed that the neoplastic cells exhibited positivity for pancytokeratin , synaptophysin , thyroid transcription factor-1 and cd56 .
immunostaining for prostate - specific antigen was negative , while serum prostate - specific antigen was within normal limits .
we review the available literature to gain additional information about diagnosis , treatment and prognosis of pure scpca . |
7,047 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: congenital heart anomalies ( cha ) are the most common congenital anomalies and emerge with a fairly constant incidence from 0.8 to 1% per 1000 live births ( 1,2 ) .
given that the cha are leading cause of death among congenital anomalies , their early detection would greatly enhance the therapeutic procedures , and therefore the ultimate outcome of the disease ( 3 ) .
previous methods of cha screening ( ultrasonography in the second trimester of pregnancy , postnatal clinical examination ) had a low rate of cha detection , and a significant number of children have been released from the maternity hospital with unrecognized cha ( 4,5,6 ) .
this information is even more important if it is seen in the light of today s trend of earlier discharge from the maternity hospital ( before 24h ) , when most of the cha is not manifested .
according to data from previous studies , the routine clinical examination fails to diagnose more than half of the children with the cha ( 5 ) . for diagnostics of cha , in addition to clinical examination , so far have been used electrocardiography and chest radiogram . although electrocardiography and radiogram does not contribute much to diagnosing heart murmur ( 7,8,9 ) .
ultrasonography is a unique approach in the diagnosis of cardiac anomalies , but is considered to be limiting to be used as a screening method for the detection of cha due to the cost of that service . although wrongly considered the leading sign of heart disease , a heart murmur is still in the highest percentage a reason for cardiac treatment ( 10 ) .
the physiological bases of these are benign causes that do not endanger the child . in organic noises in the background
auscultation is performed at certain points ( ictus , mesocardia , second intercostal space , right and left ) .
the examiner assesses the intensity of the murmur . for the evaluation of the intensity of the murmur
is commonly used levine harvey scale . by the same scale as the first stage murmur
the murmur of the second degree is the audible also... | introduction : heart murmurs can be functional ( innocent ) and pathological ( organic ) . although it is not considered a major sign of heart disease , it may be a sign of a serious heart defect . in most cases
the noise is initiation for cardiac treatment .
is it possible to differentiate on the basis of auscultation innocent from pathological heart murmur ? in this article we present the results of ultrasonography of newborns with positive auscultation finding of the heart in the neonatal and early infancy period.goal:to determine the role of murmurs in the heart detected by routine clinical examination in the neonatal period and early infancy , and to establish the legitimacy of cardiology consultation and ultrasound of the heart.methods:a retrospective review of medical records in the period from january 1 to december 31 , 2011 at the maternity ward of cantonal hospital in bihac 1899 children was born . in 32 neonates
was registered a heart murmur , in the period from birth up to 6 weeks of life .
all children with positive auscultation finding of the heart were examined echocardiography by ultrasound aloca 2000 , multifrequency probe from 3.5 to 5 mhz , and used m - mode , 2-d , continuous , pulsed and color doppler.results:of the 32 examined children regular echocardiographic findings had two children ( 6.25% ) , aberrant bunch of left ventricle 11 ( 34.37% ) , patent foramen ovale 5 ( 15.62% ) , atrial septal defect 3 children ( 9.37% ) , ventricular septal defect 8 children ( 25% ) , cyanogen anomaly 2 children ( 6.25% ) , stenosis of the pulmonary artery 1 child ( 3.12% ) .
we see that 14 children ( 43.75% ) had a structural abnormality of the heart that requires further treatment and monitoring.conclusion:echocardiography is necessary to set up or refute the diagnosis of structural heart defect in children with positive auscultation finding in the neonatal period . |
7,048 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: according to the world health organization , 2010 report , cardiovascular diseases are the first among the top 10 causes of death . an estimated 16.7 million people or 29.2% of total global deaths are due to the various forms of cardiovascular disease ( cvd ) [ 1 , 2 ] . the direct relation between high blood cholesterol and cvd has been proved .
cholesterol is a typical animal sterol ; for example , its content in milk fat is 95%98% .
the main source of cholesterol in food comes from animal origin , such as meat , milk , and eggs .
milk and dairy products contain relatively high level cholesterol that can elevate the blood cholesterol . first attempts on reducing cholesterol in food go back to early twentieth century .
denis and minot determined the cholesterol content of animal and human milks and they suggested the relation between blood plasma cholesterol and food intake .
although so many papers were published about the relation of food intake and increasing of blood plasma cholesterol , no serious attempt took place on reducing cholesterol in food until 1960 . since the 1960s ,
large number of physicochemical methods was recommended to reduce cholesterol in food as well as blood cholesterol .
cholesterol could be removed in an efficient manner from milk fat up to 90% using supercritical co2 technology .
bobby and joseph jr . developed and patented a process for the production of cholesterol - free milk based on extraction of cholesterol from the milk fat globule membranes using an organic polar solvent and without substantial loss of solid milk fat .
solvent - free and low cholesterol products were recovered from the reseparated and washed cream fractions .
cholesterol removal from dairy product using saponin and diatomaceous earth also was patented by richardson et al . .
they suggested that the process could be useful particularly for raw and pasteurized milks , cream , and butter . in spite of effectiveness of the mentioned methods ,
some complications exist because of the organic solvents and... | various concentrations ( 0% , 0.5% , 1% and 1.5% ) of -cd were mixed with different fat contents ( 1% , 2.5% and 3% ) of raw ( unhomogenized ) and homogenized milk at two mixing temperatures of 8 and 20c .
the cholesterol residue , fat , protein , lactose , solid nonfat ( snf ) , density , and ash content of milk were measured for each treatment .
the results statistically analysed and showed that the cholesterol content of milk remarkably decreased as the -cd was increased particularly in homogenized milk at 20c .
however , the reduction rate of cholesterol was decreased when extra -cd was added due to its intermolecular reactions .
the maximum cholesterol reduction was achieved at the level of 1% -cd .
the fat content , snf , protein , lactose , and density content were decreased with increasing -cd whereas it did not affect ash content . |
7,049 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | key clinical messagealthough rare , eagle syndrome should be always considered in the differential diagnosis in patients with chronic orofacial pain refractory to conventional treatments .
treatment is surgery and exeresis of the styloid process via a transoral or cervical approach depending on clinical and radiological features . |
7,050 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: replication in e. histolytica is inhibited by aphidicolin [ 2 , 3 ] , a specific inhibitor of mammalian , and dna polymerases .
additionally , ehmcm2 , ehmcm3 and ehmcm5 genes , whose products are part of the helicase complex , have been cloned and characterized [ 4 , 5 ] .
although nuclear and dna polymerase sequences are present in e. histolytica genome , dna polymerase encoding genes have not been isolated or characterized and dna replication processes are poorly understood in this parasite . in eukaryotes ,
replicative dna polymerases are grouped in two families : ( 1 ) family a , which includes dna polymerases of animals and fungi , and pol i - like dna polymerases responsible for mitochondrial dna replication in plants and slime mold .
( 2 ) family b comprises the , and dna polymerases involved in nuclear dna replication [ 79 ] , archaebacterial , viral , bacteriophage dna polymerases such as those present in phages t4 and rb69 and dna polymerases encoded in fungi and plant mitochondrial plasmids .
commonly , the fungal plasmids are linear and they have been frequently found in filamentous fungi .
transcription and replication of linear plasmids are initiated in terminal inverted repeats by a plasmid encoded phage - like single subunit rna polymerase and by a dna polymerase of the family b , respectively .
replication in these plasmids is thought to occur by a protein - primed mechanism , similar to that described for bacillus subtilis phage phi29 .
the b dna polymerases are distinguished by the presence of up to six common regions in their amino acid sequences ( boxes i to vi ) .
the most conserved regions ( i and ii ) include aspartic acid residues essential to catalytic polymerase activity .
although it has been reported that e. histolytica had a secondary mitochondrial lost , no genes encoding dna polymerase responsible for mitochondrial dna replication have been detected .
however , trophozoites carry mitosomes , a mitochondrial cytoplasmic remnant organelle lacking dna [ 15 , 16 ] ,... | we report the identification of a family of four active genes ( ehodp1 , ehodp2 , ehodp3 , and ehodp4 ) encoding putative dna polymerases in entamoeba histolytica , the protozoan parasite responsible of human amoebiasis .
the four ehodp genes show similarity to dna polymerases encoded in fungi and plant mitochondrial plasmids .
ehodp polypeptides conserve the 3-5 exonuclease ii and 5-3 polymerization domains , and they have the i , ii , and iii conserved boxes that characterize them as dna polymerases of family b. furthermore , we found in ehodp polymerases two novel a and b boxes , present also in dna polymerases encoded in fungi mitochondrial plasmids . by in situ pcr ,
ehodp1 gene was located in nuclei and in dna - containing cytoplasmic structures .
additionally , using polyclonal antibodies against a recombinant rehodp1 - 168 polypeptide , and confocal microscopy , ehodp1 was located in cytoplasmic dna - containing structures . |
7,051 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: exfoliation syndrome ( xfs ) is an age - related generalized disease of the extracellular matrix , characterised by the production and progressive accumulation of fibrillar extracellular material in many ocular and extraocular tissues , and is often associated with glaucoma .
xfs causing an increase in trabecular outflow resistance is the most common cause of open - angle glaucoma .
extracellular fibrillar material is widely present in the skin , lungs , liver , heart , gallbladder , blood vessels , and cerebral meninges .
xfs has been reported to be associated with systemic vascular diseases such as hypertension , angina , stroke , myocardial infarction , and abdominal aortic aneurysm [ 4 , 5 ] .
xfs also has nonophthalmic manifestations such as hyperhomocysteinemia and sensorineural hearing loss [ 69 ] .
while there are two different epidemiological studies available from the eastern mediterranean ( adana province ) and middle black sea ( tokat province ) regions of turkey , no study has been conducted in central anatolia [ 10 , 11 ] .
in addition , the relationship of xfs with systemic diseases such as diabetes mellitus ( dm ) , hypertension ( ht ) , coronary artery disease ( cad ) , smoking , and alcohol intake has not been investigated in these previous two studies from turkey .
the relationship between cardiovascular diseases and xfs in turkey has been investigated , but there are no relevant epidemiological studies [ 12 , 13 ] .
this study was carried out in sivas , a province in the central anatolia region of turkey , with a population of 623,000 .
sivas has the highest number of villages in the country and is the second largest city of turkey in terms of surface area . besides
, it is the second highest city of central anatolia ( altitude : 1285 m ) .
the central anatolia region receives one of the lowest amounts of rainfall in the country and has a continental climate .
the primary aim of this hospital - based study was to investigate the xfs frequency and its relationship with systemic diseases... | aim .
the aim of this study was to investigate the frequency of exfoliation syndrome in the central anatolia region of turkey and to evaluate its relationship with cardiovascular and ocular diseases .
methods .
patients over the age of 45 years who presented to the clinic were included in the study .
all cases underwent a comprehensive ophthalmology examination .
exfoliation syndrome was diagnosed with the presence of exfoliative material on the lens anterior capsule or iris on slit lamp examination .
the patients were divided into two groups as the exfoliation syndrome group and nonexfoliation syndrome group according to the presence of exfoliative material . results .
exfoliative material was found in one or both eyes of 212 of the 2103 patients ( 10.1% ) evaluated within the scope of the study .
a significant relationship was found between exfoliation syndrome and increasing age and male gender .
a significant relationship was found between exfoliation syndrome and glaucoma , cataracts , age - related macular degeneration , and phacodonesis . while no relationship was found between exfoliation syndrome and hypertension or diabetes mellitus , a significant relationship was found with coronary artery disease .
conclusion .
the unilateral or bilateral exfoliation syndrome frequency was 10.1% in this hospital - based study .
a statistically significant relationship was found between exfoliation syndrome and advancing age , gender , and coronary artery disease . |
7,052 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cartap is a pesticide that was first introduced into the market in japan in 1967 .
its commercial names include padan , kritap , ag - tap , thiobel , and vegetox .
its basic chemical structure is s , s-[2-(dimethylamino)-1 , 3-propanediyl ] dicarbamothioate [ figure 1 ] .
it is used for the control of chewing and sucking pests and results in insect paralysis .
it has been categorized as a high - effectiveness , low - toxicity , and low - residue pesticide used in rice and sugarcane fields .
it is generally considered to be a safe compound with oral ld50 in the monkey of 100 - -200 mg / kg body weight .
however , subsequent studies have shown that ocular instillation can result in diaphragmatic contracture and death in rabbits .
we report a case of intentional ingestion of cartap hydrochloride as a suicidal attempt in a farmer which subsequently resulted in severe respiratory failure .
a 27-year - old male agricultural laborer from tamil nadu , india , presented with alleged consumption of 50 ml of an unknown poison as an act of deliberate self - harm following a quarrel with his spouse .
subsequently , he developed twitching movements of his limbs , urinary incontinence , and altered sensorium .
he had a systolic blood pressure of 80 mm of hg , a heart rate of 120/min , and a respiratory rate of 32/min .
a gastric lavage was administered followed by a single dose of activated charcoal instilled through the nasogastric tube .
the provisional diagnosis made in the emergency department was of an organophosphate poisoning with acute cholinergic syndrome .
basic blood investigations including serum electrolytes , creatinine , liver function tests , and complete blood counts were normal .
the patient was admitted into the semi - intensive care unit and managed conservatively with fluids and cardiac monitoring .
the plan was to use atropine if the patient developed bradycardia or miosis and to repeat serum pseudo - cholinesterase levels after 24 hours .
twenty - four hours after presentation , the relatives were... | cartap hydrochloride , a nereistoxin analog , is a commonly used low toxicity insecticide .
we describe a patient who presented to the emergency department with alleged history of ingestion of cartap hydrochloride as an act of deliberate self - harm .
the patient was managed conservatively . to our knowledge
this is the first case report of cartap hydrochloride suicidal poisoning .
cartap toxicity has been considered to be minimal , but a number of animal models have shown significant neuromuscular toxicity resulting in respiratory failure . it is hypothesized that the primary effect of cartap hydrochloride is through inhibition of the [ 3h]-ryanodine binding to the ca2 + release channel in the sarcoplasmic reticulum in a dose - dependent manner and promotion of extracellular ca2 + influx and induction of internal ca2 + release .
this results in tonic diaphragmatic contraction rather than paralysis .
this is the basis of the clinical presentation of acute cartap poisoning as well as the treatment with chelators namely british anti lewisite and sodium dimercaptopropane sulfonate . |
7,053 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: briefly , ten american women participated in a randomised cross - over
trial , consuming the following treatments : 100 g biofortified cassava ; 100 g biofortified
cassava with 15 ml added oil ; and 100 g typical white cassava with 15 ml oil plus a
retinyl palmitate ( rp ) tracer , with 2-week washouts between treatments .
rp and bc
concentrations in the tag - rich layer ( trl ) of plasma increased with both biofortified
cassava treatments .
changes in rp in the trl plasma fraction were combined with fao
consumption data to model the daily bc intake and rp formation of african women that could
be expected if all of the cassava in their diet was replaced with the variety of
biofortified cassava used in our study .
cyanide data from the second and third soaking
procedures were used to simulate the effects of marginal processing , such as occurs during
drought or in populations unfamiliar with cassava , and was also combined with fao
consumption data to model the daily cyanide exposure of african women from consumption of
the current variety of biofortified cassava .
the following
procedures were conducted for each woman : height , weight and blood pressure measurements ;
pregnancy prescreening ; and administration of health questionnaires .
subject demographics
and inclusion and exclusion procedures are described in more detail
elsewhere
.
as expected , rp formation from biofortified cassava in these women
varied greatly . also as usual , this variation did not depend on demographic
characteristics of the subjects such as body weight , bmi or age .
this study was conducted
according to the guidelines laid down in the declaration of helsinki and all procedures
involving human subjects were approved by the university of california , davis
institutional review board no .
biofortified cassava ( gm 905 - 69 ) bred to contain elevated bc concentrations was provided
by the international center for tropical agriculture .
typical white cassava , which
contained... | vitamin a ( va ) deficiency causes disability and mortality .
cassava can be crossbred to
improve its -carotene ( bc ) content ; typical white cassava contains negligible amounts of
bc .
however , cassava contains cyanide and its continued consumption may lead to chronic
disability .
our objective was to estimate the risk benefit of consuming bc - enhanced
cassava to increase va intake .
a total of ten american women were fed white and
bc - enhanced cassava .
bc and cyanide data from the feeding study were combined with african
cassava consumption data to model the potential daily bc , va and cyanide intakes of
african women . if bc - enhanced cassava replaced white cassava in the diets , it could
theoretically meet recommended va intakes for the following percentages of individuals
from six african countries that consume cassava as a staple crop : angola ( 95 % ) , central
african republic ( 95 % ) , congo ( about 100 % ) , ghana ( 99 % ) , mozambique ( 99 % ) and nigeria
( 92 % ) .
cyanide intake after minimal preparation of cassava could be thirteen to
thirty - two times the reference dose ( rfd ) , a toxicological exposure reference , but could
be completely removed by extensive soaking .
this study demonstrates that consumption of
bc - enhanced cassava , processed to maintain bc and remove cyanide , theoretically increases
va intakes for african populations and other areas of the world where cassava is a staple
crop . |
7,054 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: adipokines are produced mainly by adipose tissue , a dynamic endocrine organ involved in the regulation of various endocrine processes such as glucose and fatty - acid metabolism , energy expenditure , inflammatory response , cardiovascular function , and reproduction [ 1 , 2 ] . in recent years , adipokines have been found to be produced by other organs also , that is , placenta , ovaries , peripheral - blood mononuclear cells , liver , muscle , kidney , heart , and bone marrow [ 3 , 4 ] , and have been related mainly to insulin sensitivity , inflammation , and other functions [ 57 ] .
insulin sensitivity and inflammation have been shown to influence both growth [ 810 ] and ovarian function ; in particular there is wide evidence that polycystic ovarian syndrome ( pcos ) originates from insulin resistance [ 1114 ] and from excessive exposure to insulin .
excessive exposure to insulin is related to overgrowth and skin lesions , such as acanthosis nigricans , and changes in adipokines , including reduced adiponectin and leptin levels [ 1 , 3 ] .
interestingly , certain conditions such as being born small for gestational age are associated with an increased risk of insulin resistance , metabolic syndrome , and poor growth [ 15 , 16 ] . since barker 's theory on the fetal origin of adult disease , it has become clear that the programming of endocrine and metabolic systems is set in utero . in this review
we shall focus mainly on adiponectin , leptin , resistin , and visfatin whose functions are to date better studied compared to other adipokines , considering findings in placenta and newborns , and further described knowledge related to childhood and adolescence .
adiponectin is a 30 kda secretory protein , which is produced mainly by adipocytes , but also by the placenta , osteoblasts , and cardiomyocytes [ 8 , 1720 ] .
it is expressed as a full - length protein or as a smaller and globular fragment ; this latter form is generated by proteolytic cleavage by leukocyte elastase secreted by activated monocytes and... | adipokines are cytokines produced mainly by adipose tissue , besides many other tissues such as placenta , ovaries , peripheral - blood mononuclear cells , liver , muscle , kidney , heart , and bone marrow .
adipokines play a significant role in the metabolic syndrome and in cardiovascular diseases , have implications in regulating insulin sensitivity and inflammation , and have significant effects on growth and reproductive function .
the objective of this review was to analyze the functions known today of adiponectin , leptin , resistin , and visfatin from placenta throughout childhood and adolescence .
it is well known now that their serum concentrations during pregnancy and lactation have long - term effects beyond the fetus and newborn . with regard to puberty
, adipokines are involved in the regulation of the relationship between nutritional status and normal physiology or disorders of puberty and altered gonadal function , as , for example , premature pubarche and polycystic ovarian syndrome ( pcos ) .
cytokines are involved in the maturation of oocytes and in the regular progression of puberty and pregnancy . |
7,055 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the author reports the following conflict of interest : investigator for , consultant for , and/or speaker on behalf of sanofi , merck , boehringer ingelheim , janssen , pfizer , bristol myers squibb . | advances in the therapy of atrial fibrillation ( af ) have not come easily or quickly , despite the recognized need for significantly better antiarrhythmic agents for af termination and prevention as well as for more user - friendly anticoagulants for the prevention of emboli in patients with af .
rather , the road has been only slowly progressive and bumpy .
this manuscript will introduce the recent issues with dronedarone , the complex development story for vernakalant , and the appearance of the new oral anticoagulants .
each of these three considerations will then be explored in more depth by the invited experts for this mini - thematic issue in current cardiology reviews . |
7,056 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the economic impact of rising medical malpractice premiums and the cost of associated litigation had reached a crisis level by 2002 in many regions of the united states , including texas.1 the financial and emotional impact of malpractice claims were driving physicians and surgeons away from high - risk specialties as well as from high - risk , litigious , geographic environments.2 in 2003 , the texas state legislature enacted comprehensive tort reform laws that included a cap on noneconomic damages in most medical malpractice cases at $ 250,000.3 texas voters subsequently approved a state constitutional amendment supporting this legislation.4 multiple reports have documented dramatic decreases in the cost of medical malpractice premiums across the state for all specialties , along with a decrease in the incidence of medical malpractice claims and lawsuits.1,58 in our own practice , we witnessed a 5-fold decrease in the risk of general surgical malpractice lawsuits and a 55 % decrease in premiums after the implementation of comprehensive tort reform in texas in 2003.7 less evident is whether tort reform achieved its intended goal of increasing access to health care for texas citizens.8,9 we hypothesized that comprehensive tort reform led to significant increases in the total number of physicians practicing in texas and the number of physicians relative to the texas population . to test this hypothesis ,
we compared the number of licensed physicians by both specialty and geographic location before and after the implementation of comprehensive tort reform .
the study was performed using publicly accessible data from the texas medical board ( tmb ) , the united states census bureau / texas state library and archives commission and the texas department of state health services.1012 the tmb is the statutorily directed authority that regulates the practice of medicine in texas .
the tmb maintains detailed data with respect to physician demographics , status of practice , location of practice by county , complaints... | introductiontexas implemented comprehensive tort reform in 2003 .
we hypothesized that tort reform was followed by a significant increase of physicians practicing in texas.methodsto test this hypothesis , we compared the rate of physician growth prior to and following tort reform , and the number of licensed physicians and physicians per 100,000.resultscomparing before and after tort reform , the rate of increase in texas physicians per 100,000 population increased significantly ( p < 0.01 ) . from 2002 to 2012 , the texas population increased 21 % . the number of actively practicing texas physicians increased by 15,611 a 44 % increase ( 46 % metro areas vs. 9 % non - metro areas ) , an increase of 30 physicians per 100,000 population ( p < 0.01 ) .
non - metropolitan texas had a net increase of 215 physicians ; however , there was no change in the number of physicians per 100,000 .
examining the data by trauma service areas ( tsas ) , 20 of 22 tsas had an increase in both number of physicians and physicians per capita , five greater than 50 % .conclusionsthe post - tort reform period in texas was associated with a significantly increased growth rate of physicians relative to the texas population .
tort reform , as implemented in texas , provides a needed framework for improving access to health care . |
7,057 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: endometriosis is one of the most common benign diseases affecting quality of life and fertility of women .
endometriosis is diagnosed by visual inspection of the pelvis during laparoscopy and positive histology confirms the diagnosis , but negative histology does not exclude it .
the most important one is regurgitation of menstrual blood , but cytokines play a critical role in facilitation of the implantation of ectopic endometrial tissues .
numerous data indicate that eutopic endometrial glandular and stromal cells may be functioning differently in women with endometriosis compared to normal endometrium in disease - free women .
expression of importin13 , a possible marker for endometrial stem cells , compared to secretory endometrium , might support the hypothesis that this disease originates from stem cells .
the most prominent symptoms of endometriosis are dyspareunia , dysmenorrhea , pelvic pain , and infertility .
some medical treatments have been suggested for endometriosis , including oral contraceptive pills , medroxy progesterone acetate , and gonadotropin - releasing hormone agonists ( gnrha ) . in some studies statins were effective in prevention of endometriotic cells proliferation in vitro .
statins are potent inhibitors of cholesterol biosynthesis to reduce serum cholesterol in patients with hyperlipidemia .
statins act by inhibiting 3-hydroxy-3-methyl glutaryl coenzyme a ( hmg - coa ) reductase to block the conversion of hmg - coa to l - mevalonate , a rate - limiting step in cholesterol synthesis .
statins were effective in inhibiting the mechanisms of cell proliferation and angiogenesis in experimental models for the development of endometriosis - like tissue [ 57 ] . in 1 study using a nude mouse model ,
simvastatin induced a dose - dependent decrease of the number and size of endometrial implants in mice . at the highest dose of simvastatin ,
the number of endometrial implants decreased by 87% and the volume by 98% . in another study on endometriotic cyst walls and endometrial biopsy in... | backgroundto compare efficacy of simvastatin with gnrha ( decapeptyl 3.75 mg ) on endometriosis - related pains following surgery for endometriosis.material/methodssixty women with pelvic endometriosis , after laparoscopic diagnosis and conservative laparoscopic surgery , were treated with either simvastatin ( n=30 ) for 16 weeks or decapeptyl ( n=30 ) every 4 weeks for 4 doses.resultsusing vas , the score of dyspareunia , dysmenorrhea , and pelvic pain 6 months after laparoscopic surgery declined significantly in both groups ( p=0.001 ) , but the difference between results of the 2 groups was not significant ( p>0.05).conclusionsboth treatment modalities showed comparable effectiveness in the treatment of pains related to endometriosis . |
7,058 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: their incidence is rising due to improvements in survival and diagnosis ; nevertheless , our patient is the fourth case reported up to date .
therefore , treatment choice is made based on clinical experience and case reports ; notably , the largest case report series was prior to the approval for using tyrosine - kinase inhibitors in thyroid cancer .
a 73-year - old lady had dedifferentiated papillary thyroid cancer with ongoing sorafenib . after 9 months on this treatment
differential diagnosis included infection , progression of disease and cardiotoxicity . after a comprehensive assessment ( echocardiography , computed tomography , pet , magnetic resonance ) , we found progression of lung disease , and the appearance of heart metastases .
after recovering from the basal status , she started on second - line treatment with sunitinib , which was well - tolerated .
we should include cardiac metastases in the differential diagnosis of heart failure in cancer patients .
sorafenib is the mainstay of the first - line therapy in metastatic thyroid cancer , achieving long - term disease control with good tolerance .
sunitinib could be a safe second - line treatment option ( not cardiotoxicity related ) with promising results .
therefore , our report presents a sequence of treatment with tyrosine - kinase inhibitors in metastatic thyroid carcinoma with an encouraging outcome , which deserves further investigation .
cardiac metastases from thyroid cancer are a rare entity ; in fact , its frequency reported in historical series ranges from 0 to 2% .
the improvements in survival of thyroid cancer patients and current advances in imaging diagnoses have contributed to increase its incidence .
nevertheless , after a comprehensive literature review , we found only 15 case reports in the last 35 years [ 3 , 4 ] .
thyroid cancer histologic subtypes more prone to develop cardiac metastases are anaplastic thyroid cancer , follicular thyroid cancer , and hrthle cell cancer . to date
, there are only 3 case reports of cardiac... | backgroundcardiac metastases from papillary thyroid carcinoma are very uncommon .
their incidence is rising due to improvements in survival and diagnosis ; nevertheless , our patient is the fourth case reported up to date .
there are no clinical trials available in this scenario .
therefore , treatment choice is made based on clinical experience and case reports ; notably , the largest case report series was prior to the approval for using tyrosine - kinase inhibitors in thyroid cancer.patienta 73-year - old lady had dedifferentiated papillary thyroid cancer with ongoing sorafenib . after 9 months on this treatment
, she presented with dyspnea and heart failure .
differential diagnosis included infection , progression of disease and cardiotoxicity . after a comprehensive assessment ( echocardiography , computed tomography , pet , magnetic resonance ) , we found progression of lung disease , and the appearance of heart metastases.resultsafter recovering from the basal status , she started on second - line treatment with sunitinib , which was well - tolerated .
she achieved stable disease with a decrease in tumor marker levels.conclusionswe should include cardiac metastases in the differential diagnosis of heart failure in cancer patients .
magnetic resonance imaging is the gold standard for assessment .
sorafenib is the mainstay of the first - line therapy in metastatic thyroid cancer , achieving long - term disease control with good tolerance .
sunitinib could be a safe second - line treatment option ( not cardiotoxicity related ) with promising results .
therefore , our report presents a sequence of treatment with tyrosine - kinase inhibitors in metastatic thyroid carcinoma with an encouraging outcome , which deserves further investigation . |
7,059 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: globally , each year , there are in excess of an estimated 120 million cases of gastrointestinal disease and in excess of an estimated 50 million cases of more severe respiratory diseases associated with swimming and bathing in wastewater - polluted coastal waters . since the 1950s , epidemiologic studies have been designed to evaluate the relationship between swimming in point source - impacted beaches and health risks ( i.e. , gastrointestinal disease , respiratory , eye , nose , and throat illnesses ) ; they have concluded that symptoms for all these illnesses were increased in swimmers compared to nonswimmers [ 2 , 3 ] .
outbreak reports from the cdc also confirm that illnesses in the usa are occurring from swimming in contaminated waters .
the excess illnesses associated with coastal water pollution can also result in substantial economic burdens .
a study in orange county , ca , estimated 3.3 million us dollars per year in excess illness costs for newport and huntington beaches associated with bathing in marine waters .
swimming - related illness is predominately associated with exposure to microbial pathogens , which may enter the water through point sources such as sewage outfalls .
however , recent studies have demonstrated that swimming - related illnesses can occur at nonpoint source beaches [ 6 , 7 ] and even possibly from beach sand contact [ 810 ] .
these developments highlight the ongoing challenge to beach managers and public health professionals in monitoring the beach environment and protecting the health of its users [ 11 , 12 ] . to address this challenge
, we provide background information about existing regulations ; describe a possible alternative approach given the existing regulations ; and then apply this alternative approach to a well - studied south florida recreational marine beach to illustrate one possible outcome of the alternate approach . at the us federal level , jurisdiction over recreational waters
the cwa provides the us epa with jurisdiction over two approaches for the... | new approaches should be considered as the us environmental protection agency ( epa ) moves rapidly to develop new beach monitoring guidelines by the end of 2012 , as these guidelines serve as the basis by which states and territories with coasts along the oceans and great lakes can then develop and implement monitoring programs for recreational waters .
we describe and illustrate one possible approach to beach regulation termed as the comprehensive toolbox within an approval process ( ctbap ) .
the ctbap consists of three components .
the first is a toolbox consisting of an inventory of guidelines on monitoring targets , a series of measurement techniques , and guidance to improve water quality through source identification and prevention methods .
the second two components are principles of implementation .
these include first ,
flexibility to encourage and develop an individualized beach management plan tailored to local conditions and second , consistency of this management plan to ensure a consistent national level of public health protection .
the results of this approach are illustrated through a case study at a well - studied south florida recreational marine beach .
this case study explores different monitoring targets based on two different health endpoints ( skin versus gastrointestinal illness ) and recommends a beach regulation program for the study beach that focuses predominately on source prevention . |
7,060 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: more robust estimates of daily climate characteristicsstatistical fitting approachbased on a perfect model approach more robust estimates of daily climate characteristics statistical fitting approach based on a perfect model approach
climate indices are widely used across a number of disciplines . they have become an important impact parameter in climate change studies [ christenson et al . , 2006 ; zubler et al . ,
fischer et al . , 2013 ; sillmann et al . , 2013a , 2013b ] . indices offer the possibility to get a more direct quantification of what implications for the environment or certain economic sectors can be expected [ della - marta et al . , 2009 ] .
many of these indices are based on daily values such as daily maximum temperature or different daily percentiles .
for example , wet days are defined as the number of days with a precipitation amount larger than the 90th percentile of the long - term precipitation climatology of this calendar day [ klein tank et al . , 2009 ] .
hence , for each calendar day the percentile - based thresholds need to be estimated to count the number of events . in order to evaluate the changes of such indices over time due to climate forcings ,
the number of events in the reference period is compared to the numbers of some future period [ zubler et al . ,
a nice example of an index that gives the user information about its own comfort today and compares it to the comfort in a future climate is the following : the heat stress index combines temperature and precipitation information to draw conclusions about human comfort in a warmer climate , which is more informative than a simple temperature increase [ fischer et al . ,
2012 ] . furthermore , depending on the index the seasonal forecast of it can be more skillful than simple seasonal means [ brands , 2013 ] . often , 30 years ( as reference period or hindcast length ) or less are available to compute such indices .
when calculating such indices based on daily data of about 30 years ( e.g. , the 90th percentile of... | climate indices help to describe the past , present , and the future climate .
they are usually closer related to possible impacts and are therefore more illustrative to users than simple climate means .
indices are often based on daily data series and thresholds .
it is shown that the percentile - based thresholds are sensitive to the method of computation , and so are the climatological daily mean and the daily standard deviation , which are used for bias corrections of daily climate model data .
sample size issues of either the observed reference period or the model data lead to uncertainties in these estimations .
a large number of past ensemble seasonal forecasts , called hindcasts , is used to explore these sampling uncertainties and to compare two different approaches . based on a perfect model approach
it is shown that a fitting approach can improve substantially the estimates of daily climatologies of percentile - based thresholds over land areas , as well as the mean and the variability .
these improvements are relevant for bias removal in long - range forecasts or predictions of climate indices based on percentile thresholds .
but also for climate change studies , the method shows potential for use.key pointsmore robust estimates of daily climate characteristicsstatistical fitting approachbased on a perfect model approach |
7,061 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: prevention of dental caries is one of the main strategies in contemporary pediatric dental practice .
the dental plaque is a structure of vital significance as a contributing factor to at least the initiation of the carious lesion .
the major strains of streptococci present in plaque are : streptococcus mutans , streptococcus sanguis , streptococcus mitior , streptococcus milleri and streptococcus salivarius . of these ,
although mechanical plaque control by tooth brushing is the most dependable and commonly practiced oral hygiene measure , numerous anti - plaque agents have been tried for improving oral health .
these agents are capable of preventing bacterial adhesion , colonization and metabolism , and thus affect the bacterial growth .
the efficacy of these antimicrobial agents depends on factors like vehicle used , concentration of active agents , substantivity of the agent and duration of the treatment .
an ideal anti - plaque agent for regular use in children should not interfere with biologic processes occurring in the mouth , be harmless to oral mucosa , should have low toxicity if accidentally swallowed , and should be both sugar and alcohol free .
fluoride is one of the most important and effective components of preventive dental programs in children .
sodium fluoride mouth rinses are effective in reducing caries and inhibit carbohydrate utilization of oral microorganisms by blocking enzymes involved in the bacterial gylcolytic pathway .
xylitol is a naturally occurring non - cariogenic sugar substitute that can not be metabolized by oral bacteria .
xylitol reduces the amount of adherent extracellular polysaccharides , lipoteichoic acids , resulting in the formation of loosely attached bio - films to the tooth surfaces .
most in vivo studies have focused on the application of xylitol chewing gums , inextricably combining physicochemical with mechanical effects .
although it is incorporated in certain toothpastes , data available on mouth rinses containing triclosan are limited .
thus , the aim of... | introduction : prevention of dental caries is one of the main strategies in contemporary pediatric dental practice .
mouth rinses are widely used as an adjunct to maintain oral hygiene .
it is important for these products to be effective and safe for regular use in children.objective:the aim of the study was to investigate the efficacy of a newly introduced xylitol , sodium fluoride and triclosan containing mouth rinse in reducing levels of plaque streptococcus mutans and to compare it with that of a 0.12% chlorhexidine mouth rinse.materials and methods : thirty children were randomly divided into two groups of 15 children each .
group i ( study group ) was given a mouth rinse containing xylitol ( 5% ) , sodium fluoride ( 0.05% ) and triclosan ( 0.03% ) and group ii ( control group ) was given a chlorhexidine ( 0.12% ) mouth rinse .
both mouth rinses were alcohol free .
mouth rinsing was carried out twice daily , half an hour after breakfast and half an hour following dinner , for a period of 21 days under the supervision of the investigator.results:in both groups , there was a significant reduction in the mean s. mutans count at the end of 21 days ( p < 0.001 ) .
no significant difference was observed between the two mouth rinses.conclusion:the use of a low fluoride xylitol based mouth rinse appears to be a suitable choice for regular use in children . |
7,062 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: we report two cases - one a fifteen year old child with swelling distal humerus and another a case of a thirteen year old child with pain and swelling proximal tibia .
a fifteen year old child presented to department of orthopedics of our institute with complaint of difficulty in moving upper limb and swelling distal humerus .
another patient who was a 13 years old male had painful ambulation and swelling in upper tibia .
mri followed by core needle biopsy was done in both the patients confirming the mass to be giant cell tumor which is quite rare in this age group .
first patient was managed by wide excision and total elbow replacement and second one by curettage , cementation and augmentation with plate - screw construct .
it should be considered as one of the differential diagnosis of epiphyseo metaphyseal lesions in pediatric population in spite of its rarity .
giant cell tumor ( gct ) of bone is one of the most common bone tumors of adults encountered by an orthopedic surgeon and radiologist alike .
it is a benign aggressive tumor of skeletally mature individuals with incidence peaking in third decade of life [ ] . in skeletally immature individuals
giant cell tumour is extremely rare ( .8% to 7.5% ) with slight female preponderance and epi - metaphyseal location .
we hereby report two cases of giant cell tumor in pediatric age group , one of which was managed by wide excision and total elbow replacement and another by extended curettage - cementation and plate - screw augmentation followed by good functional outcome in both the patients .
in our orthopaedic oncology clinic we have come across two pediatric patients having giant cell tumor of bone in last two years .
first patient was a 15 years old male child presenting to us with history of pain , swelling in right distal humerus for last three months .
second patient was thirteen years old male who came with a history of swelling proximal tibia and painful ambulation for last four months .
radiologically features of epiphyseometaphyseal lesion ,... | introduction : giant cell tumors of skeleton are very rare in pediatric and adolescent population . here
we report two cases - one a fifteen year old child with swelling distal humerus and another a case of a thirteen year old child with pain and swelling proximal tibia.case report : a fifteen year old child presented to department of orthopedics of our institute with complaint of difficulty in moving upper limb and swelling distal humerus .
another patient who was a 13 years old male had painful ambulation and swelling in upper tibia .
mri followed by core needle biopsy was done in both the patients confirming the mass to be giant cell tumor which is quite rare in this age group .
first patient was managed by wide excision and total elbow replacement and second one by curettage , cementation and augmentation with plate - screw construct.conclusion:giant cell tumour of skeleton is highly uncommon in pediatric age group .
it should be considered as one of the differential diagnosis of epiphyseo metaphyseal lesions in pediatric population in spite of its rarity . |
7,063 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: communication in health can contribute to all aspects of disease prevention and health promotion . in order to become successful pharmacists
this study was conducted at the university of lagos to assess communication skills of pharmacy students .
questionnaires were used for data collection . the questionnaire had two sections - the bio data section and pre - formulated questions on communication skills which has three options and one of these is the best option .
a total number of 125 respondents were involved in the study which included 25 students from 200level , 50 from 300level and 50 from 500 level .
, about 62% picked the best options as their answer while the rest picked other options .
there was no statistical difference in the choice of best options between the different levels of study .
it can be concluded from the results of this study that majority of pharmacy students at the university of lagos had good communication skills and they will be able to discharge their duties as pharmacists when they eventually graduate . | background : communication skill is the bridge between the pharmacists and the patient .
communication in health can contribute to all aspects of disease prevention and health promotion . in order to become successful pharmacists
, one needs to possess excellent communication skills to serve clients.this study was conducted at the university of lagos to assess communication skills of pharmacy students.method:the study was descriptive and cross sectional .
it was carried out between may and july 2009 .
questionnaires were used for data collection .
the questionnaire had two sections - the bio data section and pre - formulated questions on communication skills which has three options and one of these is the best option.results:a total number of 125 respondents were involved in the study which included 25 students from 200level , 50 from 300level and 50 from 500 level .
majority of them were between 18 - 25 years old ( 89.6% ) .
there were more females ( 71.2% ) than males ( 28.8% ) .
also most of them were christians ( 71.2%).among the respondents , about 62% picked the best options as their answer while the rest picked other options .
there was no statistical difference in the choice of best options between the different levels of study.conclusions:it can be concluded from the results of this study that majority of pharmacy students at the university of lagos had good communication skills and they will be able to discharge their duties as pharmacists when they eventually graduate . |
7,064 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: paediatric patients often present to the emergency department with different painful conditions that require immediate surgical interventions .
the choice of anaesthetic agent to provide deep sedation and analgesia in these patients varies highly .
ketamine has already played a safe and effective role as a sole anaesthetic agent with a few limitations like delayed recovery , emergence phenomenon and nausea and vomiting .
subsequently , there is an increase in the use of propofol due to its favourable pharmacokinetics .
however , propofol is associated with dose - dependent respiratory depression , hypotension and no intrinsic analgesic property .
concomitant opioid use reduces the dose requirements of each other , but the respiratory depression is supposed to be heightened .
theoretically , the combination of ketamine and propofol would allow a reduction in dose requirement of each agent , like the combination of fentanyl and propofol . despite a plethora of articles on the ketamine
propofol combination , a comprehensive evidence is still lacking probably due to heterogeneity of clinical studies and various study designs.[310 ] among these , a few authors have studied the mixture of ketamine
propofol[3510 ] in the form of infusion . to the horizon of our knowledge , only one case series ( of four patients ) has compared continuous infusion of the ketamine
propofol versus fentanyl propofol , where the investigators used propofol infusion alone throughout the procedure in both the groups after the bolus administration of the respective mixtures in the designated groups .
this study was carried out to compare the effectiveness and safety of intravenous infusion of the ketamine
propofol combination would have more favourable haemodynamics and a better recovery profile than the infusion of the fentanyl
propofol combination in case of emergency short surgical procedures in the healthy paediatric patient population .
this prospective , randomized , double - blind , active - controlled trial was conducted after... | background : paediatric patients often present with different painful conditions that require immediate surgical interventions . despite a plethora of articles on the ketamine
propofol combination , comprehensive evidence regarding the suitable sedoanalgesia regime is lacking due to heterogeneity in study designs.methods:this prospective , randomized , double - blind , active controlled trial was conducted in 100 children , of age 314 years , american society of anesthesiologist physical status ie - iie , posted for emergency short surgical procedures .
patients were randomly allocated to receive either 2 ml of normal saline ( pre - induction ) plus calculated volume of drug from the 11 ml of ketamine propofol solution for induction ( group pk , n=50 ) or fentanyl 1.5 g / kg diluted to 2 ml with normal saline ( pre - induction ) plus calculated volume of drug from the 11 ml of propofol solution for induction ( group pf , n=50 ) . in both the groups , the initial bolus propofol 1 mg / kg i.v .
( assuming the syringes contained only propofol , for simplicity ) was followed by adjusted infusion to achieve a ramsay sedation scale score of six .
mean arterial pressure ( map ) was the primary outcome measurement.results:data from 48 patients in group pk and 44 patients in group pf were available for analysis .
hypotension was found in seven patients ( 14.6% ) in group pk compared with 17 ( 38.6% ) patients in group pf ( p=0.009 ) .
intraoperative map was significantly lower in group pf than group pk when compared with baseline.conclusion:the combination of low - dose ketamine and propofol is more effective and a safer sedoanalgesia regimen than the propofol
fentanyl combination in paediatric emergency short surgical procedures in terms of haemodynamic stability and lesser incidence of apnoea . |
7,065 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the neck pain and disability scale ( npad ) was developed in the usa as a comprehensive measure of neck pain and related disability .
the 20-item scale measures problems with neck movements , neck pain intensity , effect of neck pain on emotion and cognition , and the level of interference with daily life activities .
it has been found easy to complete for patients and simple to score , and it provides a validated measure to evaluate outcomes in patients with neck pain .
originally developed in the usa , the npad was translated in various other languages [ 39 ] including a recently introduced german version .
although high levels of reliability and construct validity of the npad original version and translated versions were reported , there is very rare data on the sensitivity to change ( the capacity of a measure to detect change in patient status at interest over time ) of the npad .
when the npad is intended to measure patient change over time , sensitivity to change is a central property , as it is essential to rate the clinical meaningfulness of changes in scores .
the aim of this study was to assess sensitivity to change of the npad in a sample of german - speaking subjects from a primary care setting .
this is a follow - up survey of patients from a primary care setting in germany with at least one onset of neck pain between march 2005 and april 2006 .
the study was approved by the local research ethics committee . as part of a project on the quality of medical care in general practice ( medvip ) , a network of 104 general practices has been established .
fifteen of these practices within a radius of 30 km around gttingen , a medium - sized town in the middle of germany , were selected for participation and provided anonymised electronic patient data ( year of birth , sex , diagnosis ) .
patients were identified via electronic patient records in general practices and included in a list of potentially eligible persons if at least one consultation because of neck pain was documented during the study... | the neck pain and disability scale ( npad ) is a 20-item instrument to measure neck pain and related disability .
the aim of this study was to assess sensitivity to change of the npad .
a total of 411 participants from 15 general practices in the middle of germany completed a multidimensional questionnaire including the german version of the npad and self - reported demographic and clinical information .
sensitivity to change was analysed by linear regression analysis of the npad at follow - up and educational level , age class , depression , anxiety , and deficits in social support , respectively , and by pearson s correlation analyses between mean change in npad at follow - up and mean change in prognostic markers .
those having more than basic education ( regression coefficient 7.2 , p < 0.001 ) and/or being in a younger age class ( 2.9 , p = 0.020 ) consistently reported significantly lower average npad scores at follow - up compared to those with basic education and/or a older age class .
in contrast , those who were classified to be depressed ( regression coefficient 2.1 , p < 0.001 ) , anxious ( 1.9 , p < 0.001 ) , or having deficits in social support ( 5.5 , p = 0.004 ) reported significantly higher npad scores .
change in depression , anxiety , and social support scale between baseline and follow - up was significantly correlated with change in the npad score .
hence , these data are in the direction anticipated across all baseline factors investigated . in conclusion
, the npad seems to be a sensitive measure for use in clinical practice and future studies of neck pain and related disability . |
7,066 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | dna repair enzymes are essential for maintaining the integrity of the dna sequence .
unfortunately , very little is known about how these enzymes recognize damaged regions along the helix .
structural analysis of cellular repair enzymes bound to dna reveals that these enzymes are able to recognize dna in a variety of conformations .
however , the prevalence of these deformations in the absence of enzymes remains unclear , as small populations of dna conformations are often difficult to detect by nmr and x - ray crystallography . here , we used time - resolved fluorescence spectroscopy to examine the conformational dynamics of linear , nicked , gapped , and bulged dna in the absence of protein enzymes .
this analysis reveals that damaged dna is polymorphic in nature and able to adopt multiple individual conformations .
we show that dna repair intermediates that contain a one - nucleotide gap and bulge have a significant propensity to adopt conformations in which the orphan base resides outside the dna helix , while dna structures damaged by a nick or two - nucleotide gap favor intrahelical conformations . because changes in dna conformation appear to guide the recognition of dna repair enzymes
, we suggest that the current approach could be used to study the mechanism of dna repair . |
7,067 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: five areas which were found to have the most sex workers included : one in the north , one in the city center , one in the west , one in the east , and one in the south of city . in addition to the city
hot spots , subjects were recruited from all districts and areas of tehran to ensure a representative sample .
subjects included all female persons of all ages willing to participate , who identified themselves as sex workers ( willing to perform sexual acts for monetary compensation ) . only those who did not complete the interview , for any given reason , were excluded from the study .
this sample was calculated with the assumption that 60% have adequate knowledge and acceptable practice towards aids and other stis ( based on previous studies , although figures were vaguely presented16 ) ; with a margin of error of 6% and 95% confidence interval . the sampling method of choice for this study
was initially intended to be a respondent driven sampling ( rds ) method , one of which the initial participants ( seeds ) are asked to introduce further subjects and the wave propagates . however , after identifying seeds by a variety of methods , such as driving by common meeting places for sex workers in a vehicle , or contacting sex workers that have been previously identified , it was found that most were either reluctant to introduce new subjects , or were not part of a network .
this phenomenon forced us to change the sampling technique into a simple convenience sampling method , where 60% of the cases were new seeds .
the other 40% were introduced by the known cases , but were less than the number required to engage rds analysis .
it was initially intended that different locations and different methods be used to find the initial seeds to engage a wider variety of sex workers of different socio - economical and personal backgrounds . however , after the sampling method was converted to simple convenience method , the diversity of the samples became more important than before .
it had to be rationally... | background : the female at - risk population represents a subgroup that is both a crucial determining factor in acquired immune deficiency syndrome ( aids ) transmission and a gap in the existing literature in iran . the objective of this study was to evaluate the level of sex workers knowledge towards to safe procedures of sexually transmitted infection and aids prevention as well as attitudes towards aids.methods:a sample of 256 female sex workers working in tehran was obtained by a variety of methods .
appropriate questions for the assessment of knowledge and attitude were developed based on previous studies.results:the mean age of the subjects was 26.8 6.1 years ( ranging from 16 to 45 ) .
methods of transmission were widely recognized , despite the exception that few realized oral ( 23.4% ) and anal ( 44.9% ) intercourse as methods of human immunodeficiency virus ( hiv ) transmission .
most subjects knew that aids currently has no cure ( 81.2% ) and no vaccine ( 73.4% ) .
most also acknowledged that hiv is transmissible from people who do not know they are hiv positive ( 59.4% ) , proper condom use can reduce the possibility of infection ( 78.1% ) , and so can having a single sexual partner ( 68.8% ) .
of the participants , 43.4% knew that an hiv - positive person can seem perfectly healthy.conclusions:knowledge towards sexually transmitted infections ( stis ) and condom use is still inadequate , especially regarding risky behaviors such as anal sex , and attitudes are mainly negative .
identifying at - risk populations , hiv - positive sex workers , education and campaigns to change the attitudes towards aids should be regarded a high priority in iran . |
7,068 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in this study , 20 healthy volunteers with no history of seizures , significant head trauma or other neurologic abnormalities , formed the normal control group .
fifteen were male and five were female , and their ages ranged from 24 to 38 ( mean , 29 ) years .
twenty - five patients with intractable temporal lobe epilepsy , whose mr imaging diagnosis was unilateral hippocampal sclerosis , comprised the patient group .
thirteen were male and 12 were female , and they were aged between 19 and 55 ( mean , 30 ) years .
an mr imaging diagnosis of hippocampal sclerosis was based on the presence of either unilateral atrophy or high t2 signal intensity of the hippocampus , or both , by visual assessment .
patients with bilateral hippocampal abnormalities or any other abnormalities in addition to hippocampal lesion were excluded .
for all mr imaging procedures , a clinical 1.5-t system ( signa advantage ; general electric medical systems , milwaukee , wi ) was used . for control subjects ,
the procedure involved conventional spin - echo t1-weighted sagittal and fast spin - echo t2-weighted axial and oblique coronal sequences . for patients , a t2-weighted fast spin - echo sequence with 3-mm - thick sections , and a t1-weighted 3-d spoiled gradient - echo ( spgr ) sequence with 1.5-mm - thick sections
the angle of oblique coronal imaging was perpendicular to the long axis of the hippocampus .
in - plane spatial resolution was approximately 1.01.0 mm ( matrix , 256256 ; fov , 25 cm ) .
single - voxel h-1 mrs was carried out immediately after acquisition of routine mr imaging , using the same 1.5-t unit . in each control
subject , four spectra were obtained from two different sizes of the volume of interest ( voi ) ( 6.0 cm = 2.02.01.5 cm , and 2.25 cm = 1.51.51.0 cm ) .
the voi included most of the hippocampal head and parts of its body , the amygdala , the parahippocampal gyrus and csf in the temporal horn .
in addition , spectra with voi of 1.0 cm ( 1.01.01.0 cm ) mostly confined to the hippocampal head were obtained... | objectivethe purpose of our study was to determine the ability of h-1 mr spectroscopy ( mrs ) to lateralize the lesion in patients with hippocampal sclerosis.materials and methodstwenty healthy volunteers and 25 patients with intractable temporal lobe epilepsy whose mr imaging diagnosis was unilateral hippocampal sclerosis were included .
this diagnosis was based on the presence of unilateral atrophy and/or high t2 signal intensity of the hippocampus .
single - voxel h-1 mrs was carried out on a 1.5-t unit using press sequence ( te , 136 msec ) .
spectra were obtained from hippocampal areas bilaterally with volumes of interest ( vois ) of 6.0 cm3 and 2.25 cm3 in healthy volunteers , and of either 6.0 cm3 ( n = 14 ) or 2.25 cm3 ( n = 11 ) in patients .
metabolite ratios of naa / cho and naa / cr were calculated from relative peak height measurements .
the capability of mrs to lateralize the lesion and to detect bilateral abnormalities was compared with mr imaging diagnosis as a standard of reference.resultsin healthy volunteers , naa / cho and naa / cr ratios were greater than 0.8 and 1.0 , respectively . in patients ,
the mean values of these ratios were significantly lower on the lesion side than on the contralateral side , and lower than those of healthy volunteers ( p < .05 ) .
the overall correct lateralization rate of mrs was 72% ( 18/25 ) ; this rate was lower with a voi of 6.0 cm3 than of 2.25 cm3 ( 64% versus 82% , p < .05 ) .
bilateral abnormalities on mrs were found in 24% ( 6/25 ) of cases.conclusionalthough its rate of correct lateralization is low , single - voxel h-1 mrs is a useful and promising diagnostic tool in the evaluation of hippocampal sclerosis , particularly for the detection of bilateral abnormalities . to improve the diagnostic accuracy of h-1 mrs , further investigation , including the use of a smaller voi and measurement of the absolute amount of metabolites , are needed . |
7,069 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: balance is the ability to maintain one s center of gravity with minimum shaking within the
basal plane , while postural balance is the ability to continuously maintain equilibrium
within the basal plane according to one s center of mass ( com ) and maintain postural control
to cope with diverse motions and external swaying1 .
balance abilities are complicated functions derived from
integration of the nervous and musculoskeletal systems that involve diverse functional
factors such as integration of the stimuli emanating from the visual , hearing , and
vestibular organs ; proprioceptors and sensory receptors in the central nervous system ;
visual spatial cognitive ability ; muscle tone that responds to environmental changes both
quickly and accurately ; muscular endurance ; and joint flexibility2 . mental practice , which is frequently used to improve balance ability ,
was recently
presented in diverse areas for the purpose of mastering motor skills and improving motor
learning3 .
mental practice is a motor
learning method that imparts and improves motor skills and involves imagining movement
scenes without making any body movements .
gerardin et al.4 reported that imagining movement scenes and performing exercises
identically activated the frontal lobe .
although diverse studies on mental practice have
been conducted to date , most addressed improving the upper limb functions of stroke
patients , while few have examined mental practice as an approach to improving balance
ability .
therefore , the purpose of the present study was to examine the effects of mental
practice on the balance abilities of normal individuals .
thirty subjects were randomly assigned to an experimental or control group ( n=15 each ) .
the
selection criteria utilized were as follows : no history of orthopedic surgery on a lower
limb , never taken any drug due to a neurologic problem , and no musculoskeletal system
disease .
the general characteristics of the study subjects are summarized in table... | [ purpose ] this study aimed to examine the effects of mental practice on the balance
abilities of normal individuals .
[ subjects and methods ] thirty subjects were randomly
assigned to an experimental or control group ( n=15 each ) .
participants in both groups
performed balance training in a seated position on a gym ball for 20 minutes per session ,
five sessions per week , for 4 weeks .
members of the experimental group also performed
mental practice for 10 minutes before the balance training .
after the intervention ,
balance measuring equipment ( good balance , metitur , finland ) was used to quantitatively
measure balance ability .
[ results ] significant post - training gains were observed in the
mediolateral , index of balance function , and time variables of participants of the
experimental group .
[ conclusion ] the application of mental practice with balance training
positively affected balance ability . |
7,070 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a search for the biological factor responsible for energy balance and signal transduction to the hypothalamus was initiated by studies on animal models . in 1994 , a molecular defect in the obese gene ( ob ) , a gene responsible for the obesity phenotype in ob / ob mice was identified using a positive cloning method . ob gene has found on chromosome 6 in mice and on chromosome 7q31.3 in humans and has been shown to encode 4.5 kb - long mrna . the protein encoded by the ob gene has been isolated and named leptin - from the greek " leptos " meaning thin . it has been demonstrated that leptin biological activity strongly depends on its proper interactions with ob - r receptors .
ob - r receptor , encoded by db gene has been identified for the first time in a murine vascular plexus using a cloning technique .
it is a member of class i cytokine receptors family that , apart from , ob - r consist of gp130 subunit of il-2r , il-3 , il-4 , il-6 , il-7 , lif ( leukemia inhibitory factor ) , g - csf ( granulocytecolony stimulating factor ) , growth hormone , prolactin , and erythropoietin receptors .
ob - r expressed in six isoforms , is the product of alternative rna splicing of db gene ( diabetes gen ) . according to its structural differences
, the receptor 's isoforms were divided into three classes : long , short and secretory .
all ob - r isoforms have a similar , extracellular ligand- binding domain located in n - terminus of the protein .
the domain is constituted by 816 amino acids and contains four cysteine residues , wsxws motif ( trp - ser - x - trp - ser ) and a different number of fibronectin iii domains .
five isoforms , including the long isoform ob - rb and short ones - ob - ra , ob - rc , ob - rd , and ob - rf , have a transmembrane domain consisting of 34 amino acids .
the intracellular domain of the long isoform consists of 303 amino acids at carboxyl terminus , while intracellular domains of short isoforms are shorter and consists of 32 - 40 amino acids .
apart from identical extracellular and... | leptin or obesity receptor ( ob - r ) is a member of class i cytokine receptor family .
ob - r , expressed in six isoforms , is the product of alternative rna splicing of db gene . according to its structural differences ,
the receptor 's isoforms are divided into three classes : long , short , and secretory isoforms .
a long , fully active isoform of ob - rb is expressed mainly in the hypothalamus , where it takes part in energy homeostasis and in the regulation of secretory organs ' activity .
ob - rb is also present on all types of immune cells , involved in innate and adaptive immunity .
short leptin isoforms ( ob - ra , ob - rc , ob - rd , and ob - re ) that contain box 1 motif are able to bind jak kinases ( janus kinases ) as well as to activate some other signal transduction cascades .
a soluble isoform ( ob - re ) can regulate serum leptin concentration and serve as a carrier protein delivering the hormone to its membrane receptors and is able to transduce the signal into the cell .
jak / stat pathway plays the major role in leptin signal transduction through membrane receptors . among all ob - r isoforms , only full - length isoform ( ob - rb ) is able to fully transduce activation signal into the cell . |
7,071 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: widely accepted standard therapy for high - risk nb includes 5 to 7 cycles of intensive cytotoxic chemotherapy , surgery , consolidative autologous stem cell transplantation ( sct ) , radiation therapy , and maintenance immunotherapy with anti - gd2 antibodies .
such therapy carries considerable toxicity while survival remains generally poor as nb accounts for 15% of deaths attributable to cancer in childhood .
immunotherapy , in particular the use of tumor cell - based vaccines , is an attractive way of generating antineuroblastoma immunity and does not increase the toxicity of concurrent radio- or chemotherapy [ 2 , 3 ] .
we have generated a series of cell - based vaccines by combining tumor cells with replication - competent hsv oncolytic virus , which have demonstrated a host immune response following intratumor injection .
based on these findings , we sought to determine the feasibility of an oncolytic hsv - based whole cell peripheral vaccine against an intracranial tumor .
we designed a whole cell tumor vaccine to incorporate the oncolytic il-12-expressing replication - competent hsv-1 m002 into the neuro 2a ( n2a ) neuroblastoma cell line derived from a / j mice .
we have previously described the m002 hsv-1 in detail [ 2 , 4 ] . in brief
, the virus is an attenuated human herpes virus mutant deleted for both copies of the 1 - 34.5 gene , restricting virus replication to tumor cells . a genetically concatenated copy of murine il-12 ( p35 and p40 subunits , connected by an ires ) cdna was inserted into each of the 134.5 loci under an egr1 promoter .
cells infected with this virus make physiologic concentrations of il-12 , a potent antitumor cytokine that has been shown to enhance the cytolytic activity of natural killer cells and cytotoxic t lymphocytes as well as the development of a th-1-type immune response [ 511 ] .
il-12 has also been shown to produce antiglioma immune activity in two different rodent models and also possesses antiangiogenic properties , an additional potential mechanism for... | we designed multimodal tumor vaccine that consists of irradiated tumor cells infected with the oncolytic il-12-expressing hsv-1 virus , m002 .
this vaccine was tested against the syngeneic neuroblastoma mouse model neuro 2a injected into the right caudate nucleus of the immunocompetent a / j mice .
mice were vaccinated via intramuscular injection of multimodal vaccine or uninfected irradiated tumor cells at seven and 14 days after tumor establishment .
while there was no survival difference between groups vaccinated with cell - based vaccine applied following tumor injection , a premunition prime / boost vaccination strategy produced a significant survival advantage in both groups and sustained immune response to an intracranial rechallenge of the same tumor .
the syngeneic but unrelated h6 hepatocellular tumor cell line grew unrestricted in vaccinated mice , indicative of vaccine - mediated specific immunity to neuro 2a tumors .
longitudinal analyses of tumor - infiltrating lymphocytes revealed a primary adaptive t cell response involving both cd4 + and cd8 + t cell subsets .
spleen cell mononuclear preparations from vaccinated mice were significantly more cytotoxic to neuro 2a tumor cells than spleen cells from control mice as demonstrated in a four - hour in vitro cytotoxicity assay .
these results strongly suggest that an irradiated whole cell tumor vaccine incorporating il-12-expressing m002 hsv can produce a durable , specific immunization in a murine model of intracranial tumor . |
7,072 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hughes - stovin syndrome is an exceedingly rare disorder characterized by the combination of multiple pulmonary artery aneurysms and deep venous thrombosis ; the cause is unknown .
we present a case of a middle - aged man in whom multiple pulmonary aneurysms were demonstrated by ct angiography and dsa .
a 40-year - old man was evaluated for bilateral hilar opacities on radiographs by a contrast - enhanced ct of chest .
the patient had significant history of bilateral femoral vein thrombosis two years back for which the patient was hospitalized ; the patient also had recurrent episodes of hemoptysis for last one and a half year for which he did not undergo any imaging and which was managed conservatively with antibiotics .
the patient had also developed aphthous ulcers in the past year that lasted for two to three weeks .
there was no evidence of genital ulcers , uveitis , or skin lesions either historically or on physical examination .
cect chest revealed large saccular aneurysms involving the segmental branches of lower lobe arteries bilaterally and right upper lobe artery [ figure 1 ] .
the bronchial arteries were hypertrophied ; eccentric , organized thrombi were seen in few aneurysms [ figure 2 ] .
pulmonary angiography was performed through the jugular vein as transfemoral cannulation was not possible because of bilateral femoral vein thrombosis which confirmed the presence of multiple pulmonary artery aneurysms .
the possibility of incomplete behcet was also considered as the patient did not fulfill the diagnostic criteria of the complete behcet 's syndrome .
the patient was put on topical steroids ( as mouth paint for oral ulcers ) , systemic steroids , and azathioprine ( in view of pulmonary vasculitis and aneurysm formation ) ; the steroids were subsequently tapered and withdrawn after 6 months ( aspirin and anticoagulation were avoided in view of hemoptysis ) .
more than one year of follow up has documented the resolution of oral ulcers without any fresh recurrence ; there has been no fresh episode... | multiple pulmonary artery aneurysms are seen along with venous thrombosis in hughes - stovin syndrome , which many investigators believe is an incomplete form of behcet 's disease .
we present a case of hemoptysis with multiple pulmonary artery aneurysms , femoral vein thrombosis , and oral ulcers with emphasis on its ct features . |
7,073 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the incidence of cervical cancer has shown a continuous decrease in developed countries , including korea , however the worldwide burden of cervical cancer remains critical [ 1 - 4 ] .
most cervical cancer survivors face several challenging issues after completion of their primary treatment ; in particular , second primary cancers have become a critical issue for cervical cancer survivors as treatment outcomes have improved .
a second primary cancer may be related not only to a shared etiology but also to a late effect of treatment .
treatments for cervical cancer have been continuously evolving , leading to improvements in radiotherapy and surgery in terms of instrumentation and minimally invasive surgical approaches .
therefore , updated data on second primary cancers are needed to determine the order of priorities in health care policy and post - treatment surveillance programs .
recent reports on second primary cancers after treatment of cervical cancer have focused on the increased risk of cancer .
however , premature ovarian failure due to treatment of cervical cancer and the shared radiotherapy field has not been considered or adequately discussed , as this complication may result in a decreased incidence of hormone - dependent cancers and pelvic tumors within the radiotherapy field .
poorer survival outcomes in women with a second primary cancer after the diagnosis and treatment of cervical cancer has been documented , although additional investigation regarding detailed survival outcomes according to the type of second primary cancer and survival outcomes from the onset of the second primary cancer is needed in order to obtain better clinical information for such patients .
therefore , the objective of this study was to investigate the incidence and survival outcomes of second primary cancers after the diagnosis and treatment of cervical cancer in a recent study cohort .
data from the korea central cancer registry from 1993 to 2010 identified 72,805 patients with cervical cancer ; patients within 2... | purposethis study was conducted to investigate the incidence and survival outcomes of second primary cancers after the diagnosis of cervical cancer.materials and methodsdata from the korea central cancer registry between 1993 and 2010 were reviewed and analyzed .
standardized incidence ratios ( sirs ) of second primary cancers among women with cervical cancer were analyzed .
kaplan - meier survival curves were constructed for cervical cancer patients with or without a second primary cancer.resultsamong 72,805 women with cervical cancer , 2,678 ( 3.68% ) developed a second primary cancer within a mean follow - up period of 7.34 years .
the overall sir for a second cancer was 1.08 ( 95% confidence interval , 1.04 to 1.12 ) .
the most frequent sites of second primary cancers were the vagina , bone and joints , vulva , anus , bladder , lung and bronchus , corpus uteri , and esophagus .
however , the incidence rates of four second primary cancers ( breast , rectum , liver , and brain ) were decreased .
the 5-year and 10-year overall survival rates were 78.3% and 72.7% in all women with cervical cancer , and for women with a second primary cancer , these rates were 83.2% and 65.5% from the onset of cervical cancer and 54.9% and 46.7% from the onset of the second primary cancer , respectively.conclusionthe incidence rates of second primary cancers were increased in women with cervical cancer compared to the general population , with the exception of four decreasing cancers .
the 10-year overall survival rates were decreased in cervical cancer patients with a second primary cancer . |
7,074 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is produced in the central auditory pathway.[15 ] this symptom is a common phenomenon disturbing millions of individuals worldwide .
study of tinnitus has resulted in a number of hypothetical mechanisms and suspected origins in the auditory pathways .
most hypotheses postulate that the generation of tinnitus is related to cochlear or acoustic nerve disorders , or central auditory cortices dysfunction and their interactions.[39 ] surgical destruction of the cochlea or the cochlear nerve has been ineffective ; therefore , tinnitus is described as an auditory phantom perception .
the perception of tinnitus sensation is thought to trace back to the central mechanism in most cases .
it has been speculated that the tinnitus may be a consequence of maladaptive cortical reorganization after an injury in the periphery , analogous to the pathophysiologic model of chronic pain .
numerous investigations showed that tinnitus is associated with an increased activity in central auditory system as demonstrated by electrophysiology and neuroimaging studies and with vascular pathogenic changes detected by ultrasonography .
single photon emission computed tomography ( spect ) scanning of the brain reflects regional cerebral blood perfusion .
brain blood perfusion scanning has a role in diagnosis , therapeutic management , and follow - up of patients and in researches .
spect scanning of the brain with the radioisotope technetium 99 m ( tc-99 m ) is a nuclear imaging technique providing an objective analytical detection of regional cerebral blood perfusion of the brain .
spect was introduced into the medical audiologic tinnitus patient diagnostic protocol ( matpp ) firstly , as an investigative tool to objectify tinnitus .
spect imaging of brain in patients with disabling tinnitus has revealed responsible loci by indicating perfusion asymmetries in cortical areas . in some studies ,
adjacent perfusion asymmetries involving the frontal , temporal and parietal lobes have suggested an inter - neural network resulting in the... | background and purpose : tinnitus is associated with an increased activity in central auditory system as demonstrated by neuroimaging studies .
brain perfusion scanning using single photon emission computed tomography ( spect ) was done to understand the pattern of brain blood perfusion of tinnitus subjects and find the areas which are mostly abnormal in these patients.materials and methods : a number of 122 patients with tinnitus were enrolled to this cross - sectional study .
they underwent spect and magnetic resonance imaging ( mri ) of brain , and the images were fused to find the regions with abnormal perfusion.results:spect scan results were abnormal in 101 patients ( 83% ) .
most patients had bilateral abnormal perfusion ( n = 65 , 53.3% ) , and most subjects had abnormality in middle - temporal gyrus ( n = 83 , 68% ) and temporoparietal cortex ( n = 46 , 37.7% ) . patients with multifocal involvement had the least mean age than other 2 groups ( patients with no abnormality and unifocal abnormality ) ( p value = 0.045).conclusions : brain blood perfusion pattern differs in patient with tinnitus than others .
these patients have brain perfusion abnormality , mostly in auditory gyrus ( middle temporal ) and associative cortex ( temporoparietal cortex ) .
multifocal abnormalities might be due to more cognitive and emotional brain centers involvement due to tinnitus or more stress and anxiety of tinnitus in the young patients . |
7,075 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: terminal restriction fragment length polymorphism ( t - rflp ) analysis is a microbial fingerprinting technique capable of discriminating microbial communities quickly and relatively inexpensively ( 13 ) .
t - rflp is increasingly used in high - throughput studies of microbial communities in combination with or even in lieu of clone library analysis ( 4,5 ) .
briefly , the method involves pcr amplification of a gene of interest ( often 16s rrna genes ) with fluorescent dye - labeled primers , followed by multiple single restriction digests done in parallel .
the resulting fragments are then separated by capillary electrophoresis with an internal size standard to determine the lengths of the terminal ( fluorescently labeled ) fragments .
each distinct terminal restriction fragment is considered an operational taxonomic unit ( otu ) , thus the choice of restriction enzymes can impact the number of otus observed in each sample and the calculation of diversity statistics .
when analyzing uncharacterized and very diverse bacterial communities , sufficient community discrimination can often be accomplished with multiple randomly - chosen tetrameric restriction enzymes ( 6 ) . however
, a brief review of the literature indicates that there is still no standard in even this simplified case .
we examined 26 papers ( 15,726 ) that were published between 1997 and 2007 and used t - rflp .
of those papers , 38% used universal bacterial primers combined with a single restriction enzyme , but the choice of enzyme was not consistent .
mspi was used most frequently ( four studies ) , followed by taqi ( two studies ) , and one study each used alui , cfoi , hhai and haeiii .
overall , only three of the 26 papers included a rationalization of enzyme selection ( 1,2,17 ) .
an alternate approach to t - rflp can be taken if the microbial community has been characterized ( by clone library analysis or by prediction from previous studies ) or if a particular taxonomic group is being targeted with specific primers . in this case , a... | terminal restriction fragment length polymorphism ( t - rflp ) analysis is a widespread technique for rapidly fingerprinting microbial communities .
users of t - rflp frequently overlook the resolving power of well - chosen restriction endonucleases and often fail to report how they chose their enzymes .
repk ( restriction endonuclease picker ) assists in the rational choice of restriction endonucleases for t - rflp by finding sets of four restriction endonucleases that together uniquely differentiate user - designated sequence groups . with repk
, users can provide their own sequences ( of any gene , not just 16s rrna ) , specify the taxonomic rank of interest and choose from a number of filtering options to further narrow down the enzyme selection .
bug tracking is provided , and the source code is open and accessible under the gnu public license v.2 , at http://code.google.com/p/repk .
the web server is available without access restrictions at http://rocaplab.ocean.washington.edu/tools/repk . |
7,076 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recently it has been evaluated in metastatic melanoma patients with braf v600e mutation after progression of earlier systemic treatment ( phase 2 trial brim2 ) .
vemurafenib was also tested in a phase 3 trial ( brim3 ) in previously untreated patients .
food and drug administration ( fda ) in august 2011 and the european medicines agency ( ema ) in february 2012 for the treatment of metastatic melanoma with braf mutation .
updated overall survival ( os ) results of the brim3 study have been presented at the asco meeting this year .
the overall response rate in patients treated with vemurafenib was 57% [ 5.6% complete response ( cr ) , 51.3 partial response ( pr ) ] compared with 8.6% ( 1.2% cr , 7.4% pr ) observed in patients receiving dacarbazine ( dtic ) .
median progression - free survival ( pfs ) was also longer in patients treated with the study drug ( 6.9 vs. 1.6 months ; hr 0.38 ; 95% ci : 0.320.46 ; p <
0.001 ) as well as median os ( 13.6 vs. 9.7 months ; hr 0.70 ; 95% ci : 0.570.87 ; p < 0.001 ) . in patients treated with vemurafenib , adverse cutaneous skin carcinoma , keratoacanthoma and skin papilloma
james larkin presented results of an open - label , multicenter safety study of vemurafenib in patients with metastatic melanoma .
of 1964 screened patients , 914 were enrolled in the study and 834 evaluable for toxicity analysis .
70% of patients received prior systemic treatment due to metastatic melanoma ( 14% ipilimumab , 2% mek and braf inhibitors ) .
adverse events ( aes ) were observed in 66% of patients ( 88% were related to vemurafenib ) .
the most frequently observed any grade aes were arthralgia ( 31% ) , rash ( 29% ) , fatigue ( 22% ) , photosensitivity ( 21% ) and nausea ( 15% ) .
the most common were rash ( 3.6% ) , arthralgia ( 3.1% ) and cutaneous cell carcinoma / keratoacanthoma ( 4.3% ) . in 6% of patients
treatment was discontinued due to aes ( mainly arthritis and abdominal pain ) . at the time of study analysis 302
patients were evaluable for tumor assessment at week 8 of... | the 2012 asco ( american society of clinical oncology ) annual meeting has been held once again at the mccormick conference center in chicago , illinois , where asco has booked a 10-year run for the meeting .
the meeting was attended by more than 30,000 oncology professionals from around the world . of more than 4500 abstracts published at the meeting ,
310 were related to melanoma . here
we report the results of the most interesting clinical trials presented at the meeting . apart from updated overall survival ( os )
results of a phase 3 study evaluating the efficacy of vemurafenib and some new data on ipilimumab ( expanded access program [ eap ] and treatment of patients with brain metastases ) we report on practice changing trials : a phase 3 ( break ) trial evaluating efficacy of dabrafenib and a phase 3 study ( metric ) assessing trametinib in the treatment of metastatic melanoma patients .
another encouraging treatment strategy is combination of dabrafenib and trametinib evaluated in a phase i / ii study .
results of new immune checkpoint targeting by monoclonal antibody anti - pd1 ( bms-936558 ) in an early phase trial in monotherapy or in combination with a multipeptide vaccine in metastatic melanoma patients are presented .
also , results of dendritic cell - based vaccine ( randomized phase ii trial ) immunization in patients with high risk resected melanoma are shown .
furthermore , results of other melanoma immunotherapy strategies evaluated in early phase studies are reported . |
7,077 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: wandering spleen ( ws ) is a rare condition in which the spleen is located anywhere in the abdomen other than in its usual place ; however , other terms are used to describe this clinical entity , including displaced spleen , drifting spleen , floating spleen , pelvic spleen , splenic ptosis , splenoptosis ,
although it remains enigmatic , the abnormal location of the spleen may be attributed to malformation or total agenesis of the splenic suspensory ligaments because of abnormal development of the dorsal mesogastrium .
therefore , the spleen may either drop into the abdominal cavity and be suspended only by extremely flexible ligaments , or float in the abdominal cavity suspended only by its pedicle .
in addition , wandering spleen may occasionallyoccur as a result of weakening of the suspensory splenic ligaments by clinical processes such as trauma , pregnancy , and connective tissue diseases .
splenic torsion , the major complication of ws , was first mentioned in the german literature in 1885 . since then
, ws and its clinical aspects have been fully identified , and ws has gradually become a well - known clinical entity.1,2 in this article we report two cases of ws , one of whom presented with torsion .
a 21-year - old female was admitted to our emergency department with an acute abdomen . apart from abdominal pain continuing for 36 hours , her medical history was insignificant .
physical examination revealed a giant mass located in the left abdominal quadrant , and generalized abdominal tenderness .
routine biochemical parameters were normal except for a moderate leukocytosis ( 16,500/mm ) and high c - reactive protein ( crp ) ( 80 mg / l ) .
combined abdominal sonography and contrast - enhanced abdominopelvic computed tomography ( ct ) demonstrated the absence of a spleen in its normal position , with a 15 7 cm solid mass extending from the stomach to the pelvis in the left abdomen that was consistent with ws , and no contrast enhancement within the splenic parenchyma ( figure 1 ) .
an... | wandering spleen is a rare clinical condition which presents with a variety of symptoms with abdominal pain , abdominal mass , and acute abdomen .
it may also remain silent until diagnosed by a routine imaging study .
treatment options may differ depending on the presenting clinical picture .
herein we present two cases of wandering spleen treated by splenectomy , with one of them admitted to our emergency clinic with torsion . |
7,078 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: suppression of menstrual periods to provide relief of menstrual - related symptoms has been used in a variety of medical conditions since the availability of steroid hormone therapy .
this option has gained legitimacy through its use in treating symptoms , but is now being used more frequently by women for personal preference . a recent cochrane review of trials comparing 28-day and extended cycles found comparable contraceptive efficacy and safety.1 the review found overall discontinuation rates and discontinuation for bleeding problems to be similar .
extended cycling resulted in improved headaches , genital irritation , tiredness , bloating , and menstrual pain.1 the term
therapeutic amenorrhea was first used in the mid-1960s to describe the suppression of menstrual bleeding in women with hematologic disorders and coagulation defects leading to heavy menstrual bleeding.2,3 a small randomized trial in 1971 in the us compared a high - dose combination oral contraceptive pill , given continuously , with depot medroxyprogesterone acetate ( dmpa ) or dmpa plus daily conjugated estrogens.3 the differences among these regimens were not significant .
when oral contraceptives containing a synthetic estrogen and a progestin were initially developed , an arbitrary regimen comprising 21 days of hormonally active pills followed by 7 days of placebo or a hormone - free interval were devised to mimic the natural menstrual cycle ( the pill ) .
it was even the belief of one of the original developers of oral contraceptives , john rock , md , that this cycling would provide a regimen that was acceptable to the pope , as he reasoned that the pill was simply a natural variant of the rhythm method of contraception.4 pope pius xii had approved the pill in 1958 for the treatment of medical conditions such as menstrual pain , given that its contraceptive actions were an
john rock s argument that the pill was natural , by virtue of mimicking the normal menstrual cycle,4 was ultimately rejected by pope paul vi in 1968.5... | menstrual suppression to provide relief of menstrual - related symptoms or to manage medical conditions associated with menstrual morbidity or menstrual exacerbation has been used clinically since the development of steroid hormonal therapies .
options range from the extended or continuous use of combined hormonal oral contraceptives , to the use of combined hormonal patches and rings , progestins given in a variety of formulations from intramuscular injection to oral therapies to intrauterine devices , and other agents such as gonadotropin - releasing hormone ( gnrh ) antagonists .
the agents used for menstrual suppression have variable rates of success in inducing amenorrhea , but typically have increasing rates of amenorrhea over time .
therapy may be limited by side effects , most commonly irregular , unscheduled bleeding .
these therapies can benefit women s quality of life , and by stabilizing the hormonal milieu , potentially improve the course of underlying medical conditions such as diabetes or a seizure disorder .
this review addresses situations in which menstrual suppression may be of benefit , and lists options which have been successful in inducing medical amenorrhea . |
7,079 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the piercing on the middle of the helix in both ears resulted in keloids formation . | key clinical messageear lobe keloids are common following ear piercing and these lesions are conspicuous and cosmetically unappealing .
multiple methods including surgery , radiotherapy , anti mitotic agents , silicone sheet , pressure clips , and cryotherapy have been used .
the challenge is to have a good cosmetic outcome with minimal recurrence . |
7,080 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: alcohol consumption is a well - known part of the nigerian culture and frequently part of festivals and celebrations and , within the past decade , there are indications that there has been a rapid increase in alcohol production and importation as well as its consumption across all age groups . for the year after 1995 ,
the unrecorded alcohol consumption was estimated to be 3.5 litres pure alcohol per capita for population older than 15 in nigeria .
alcoholic consumption continues to experience strong growth in nigeria as a result of the aggressive marketing activities of leading players , and drinking is widely considered a part of social activities ; therefore , most consumers drink unaccompanied .
the entry of several new local brews whose alcohol concentration and ingredients are not yet clearly identified has emerged as another public health issue .
nigeria 's population of about 160 million continues to grow at an annual rate of 3% .
similar to the western world , alcohol is also a factor in a large proportion of injuries and road accidents in nigeria and is also associated with physical health problems .
prospective studies among european and north american populations show that alcohol consumption , especially heavy drinking , is associated with pancreatitis , liver cirrhosis , tuberculosis , pneumonia , injuries , malignancies , and psychiatric morbidity [ 6 , 7 ] .
therefore , the estimation of prevalence and correlates of alcohol consumption is a systematic prerequisite step in the direction of planning an effective intervention program for the target drinking population .
however , there is limited large - scale evidence on prevalence and the correlates of alcohol use in nigeria , particularly in rural provinces where majority of nigerians live . while a review of different local studies conducted in primary health care settings in urban areas highlighted high prevalence of alcohol use and associated factors such as male gender , increasing age , low educational level , and marital status [ 1... | objective . to determine the prevalence and correlates of alcohol use among a sample of nigerian semirural community dwellers in nigeria
. methods . in a single arm
nonrandomized intervention study , the assessment of baseline hazardous and harmful alcohol use and associated risk factors was conducted in two semirural local government areas of oyo state , nigeria , with the alcohol , smoking and substance involvement screening test ( assist ) .
participants included 1203 subjects 15 years and older , recruited between october 2010 and april 2011 .
assist score of 010 was classified as lower risk scores , 1126 as moderate risk , and 27 + as high risk .
results .
prevalence of lifetime alcohol use was 57.9% and current alcohol use was 23.7% .
current alcohol use was more prevalent among the younger age group p = 0.02 , male gender p = 0.003 , unmarried p
< 0.01 , low educational level p = 0.003 , low socioeconomic class p = 0.01 , unemployed p < 0.001 , and the christians p < 0.01 . of the current drinkers , the majority ( 69.1% ) were at either moderate or high health risk from alcohol use .
conclusion .
alcohol consumption is prevalent in semirural communities in nigeria and the majority of these drinkers are at moderate or high health risk . screening , brief intervention , and referral for treatment for unhealthy alcohol use should be integrated into community care services in nigerian rural communities . |
7,081 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: augmented contractility of postextrasystolic heartbeats has been described almost 130 years ago and later termed postextrasystolic potentiation ( pesp ) . for almost 1 century , pesp was thought to reflect normal cardiac function .
however , during the second half of the previous century , an increasing number of reports showed that , measured at the blood pressure ( bp ) level , pesp is a typical finding in heart failure ( hf ) patients .
there have been attempts to use pesp as a diagnostic test to identify ischemic , but viable , myocardium and elicit pesp by paired pacing to augment cardiac contractility in hf , but these approaches have not led to broad clinical application .
the magnitude of systolic calcium transient is primarily determined by the amount of calcium stored in the sarcoplasmic reticulum and by the availability of sarcoplasmic reticulum calcium release channels ( ryanodine receptors ) .
pesp and its augmentation in hf can be understood on the basis of the interplay of calciumhandling processes in cardiomyocytes : a premature beat leads to a cellular depolarization and influx of trigger calcium through ltype channels at a time point when a relevant fraction of ryanodine receptor channels is still refractory .
resequestration of cytoplasmic calcium into the sarcoplasmic reticulum takes place during the postectopic pause , resulting in a higherthannormal sarcoplasmic reticulum calcium content to be released during the first postectopic beat .
thus , the contractility of the first postectopic beat is augmented . in the failing myocardium ,
the sarcoplasmic reticulum contains less calcium , mostly because of leaky ryanodine receptors and a reduced capacity of the calcium uptake mechanism and partly compensated by upregulation of the plasma membrane sodium calcium exchanger .
starting from this lower steady state , the relative increase in sarcoplasmic reticulum calcium content during the postectopic pause is even more pronounced , resulting in a greater amount of pesp than in a normal heart... | backgroundpostextrasystolic blood pressure potentiation ( pesp ) , the pulse wave augmentation after an extrasystolic beat , is typically enhanced in heart failure ( hf ) patients .
this study prospectively tested the association of pesp and mortality in cardiac patients.methods and resultsconsecutive patients ( n=941 ; mean age , 61 years ; 19% female ) presenting with acute myocardial infarction were enrolled between may 2000 and march 2005 and followed up until august 2010 .
the main study outcome was 5year allcause mortality .
patients underwent noninvasive 30minute recordings of ecg and continuous blood pressure .
pesp presence was based on the ratio between the first postectopic pulse wave amplitude and the mean of the subsequent 9 pulse wave amplitudes .
a ratio above 1 was prospectively defined as pesp present .
ventricular premature complexes ( vpcs ) suitable for pesp quantification were present in recordings of 220 patients .
pesp was present in 62 of these patients .
patients without suitable vpcs were classified as pesp absent.during the followup , 72 patients died . among the 220 patients in whom pesp was measurable , 27 died . under univariable analysis , pesp was a significant predictor of death ( p<0.001 ) as were grace score ( p<0.001 ) , left ventricular ejection fraction ( lvef ) ( p<0.001 ) , and the number of recorded vpcs ( p<0.001 ) . under multivariable analysis ,
pesp ( p<0.001 ) , grace score ( p<0.001 ) , and lvef ( p=0.001 ) were independently associated with outcome .
the combination of pesp presence and lvef 35% identified a subgroup of patients with a particularly high mortality of 46.7% .
separate validation reproduced the finding in an unrelated population of 146 hf patients.conclusionspesp , which likely reflects abnormalities of myocardial calcium cycling , predicts the mortality risk in postinfarction patients.clinical trial registrationurl : clinicaltrials.gov .
unique identifier : nct00196274 . |
7,082 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: ( 1907 ) , is one of over 60 endogenous enzymes present in raw bovine milk ( schlimme et al . ,
1997 ) . since alp is inactivated by thermal treatment , reduced levels of alp activity are an indicator of adequate milk pasteurization ( rankin et al . , 2010 ) . the alp assay is widely used and recognized as the most appropriate indirect method for verifying complete milk pasteurization due to its rapidity and sensitivity ( rankin et al . , 2010 ) .
the united states food and drug administration ( fda ) outlines quantitative criteria for alp levels in cheese products ( united states food and drugs administration , 2001 ) ; the levels can be measured with a spectrophotometer and are expressed as micrograms of phenol per gram of cheese ( united states food and drugs administration , 2001 ) .
in contrast , korea uses a qualitative standard for determining alp levels in pasteurized milk products ( korea food and drug administration , 2015 ) , and the results are compared visually against a set of standards ( korea food and drug administration , 2015 ) .
the results of such a visual colorimetric method can be easily misinterpreted , which poses a huge public health risk , since contaminated milk is an important vehicle for the foodborne transmission of numerous pathogens ( klotz et al . , 2008 ) .
therefore , the interpretation of the results of alp assays for milk samples should be improved .
the aim of this study was to establish quantitative standards for alp in pasteurized milk by using a spectrophotometric method .
raw bovine milk was kindly provided by a cow farm located in gyeonggi province and stored at 4 for 1 h. the raw milk was divided into conical tubes in 10 ml aliquots and subjected to heat treatment for 0 , 10 , 20 , 30 , and 40 min at 63 using a heat block .
the heat - treated milk samples were used to determine alp cut - off values in properly pasteurized milk .
the determined cut - off value was verified using seven low - temperature and five ultra - high temperature ( uht ; heat treated for 3 sec... | the alkaline phosphatase ( alp ) assay is a rapid and convenient method for verifying milk pasteurization .
since colorimetric alp assays rely on subjective visual assessments , their results are especially unreliable near the detection limits . in this study
, we attempted to establish quantitative criteria for residual alp in milk by using a more objective method based on spectrophotometric measurements .
raw milk was heat - treated for 0 , 10 , 20 , 30 , and 40 min and then subjected to alp assays .
the quantitative criteria for residual alp in the milk was determined as 2 g phenol / ml of milk , which is just above the alp value of milk samples heat - treated for 30 min .
these newly proposed methodology and criteria could facilitate the microbiological quality control of milk . |
7,083 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the online version of this article ( doi:10.1007/s13555 - 016 - 0096 - 7 ) contains supplementary material , which is available to authorized users .
skin has recently been shown to be a cortisol - producing organ and the cortisol controls the skin itself by regulating differentiation process from basal cells to corneal cells [ 1 , 2 ] .
topical corticosteroids ( tcs ) may have some influence on the production of cortisol in the skin and its influence can be associated with some side effects of tcs .
there have been many reported side effects with tcs ; topical corticosteroid addiction ( tsa ) [ 4 , 5 ] which is discussed mainly in atopic dermatitis ( ad ) [ 6 , 7 ] is one such side effect . as the difference between original ad and tsa is little in the skin manifestation , the conception of tsa has not been widely recognized even among dermatologists .
the diagnosis of tsa has been done by the clinical course including ineffectiveness of tcs after prolonged use and severe rebound phenomenon after withdrawal which subsides in months or years without any treatment .
the author built a hypothesis that tsa is caused by the suppressed self - production of cortisol in the keratinocytes and conducted an immunohistological study using anti - cortisol antibody in patients with ad .
the specimen was fixed by formaldehyde and sent to the laboratory ( morphotechnology , co. , ltd , sapporo japan ) .
the paraffin - embedded specimens were treated by ph 6 citrate buffer solution for 20 min at 9598 c for the purpose of antigen retrieval .
the monoclonal antibody against human cortisol from byorbyt co. , ltd ( catalogue number : orb79379 ) was used as the primary antibody .
all procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation ( institutional and national ) and with the helsinki declaration of 1964 , as revised in 2013 .
cortisol in the epidermis was stained homogeneously in healthy individuals by the preliminary study and in all three patients... | introductionthough topical steroid addiction ( tsa ) in patients with atopic dermatitis ( ad ) has been recently discussed as a clinical problem , there are very few studies about its mechanism .
the purpose of this study was to elucidate histological and immunohistological characteristics of tsa using anti - cortisol antibody.methodsskin biopsy specimen from eight patients with ad was stained by anti - cortisol antibody ( biorbyt , orb79379 ) .
subjects consisted of a child patient with a short history of topical corticosteroids ( tcs ) application , an adult patient with a long history of tcs application , and six adult patients who have experienced topical steroid withdrawal ( tsw ) and the rebound phenomenon.resultsthe staining in the epidermis by anti - cortisol antibody presented patchy defects in the child patient , the patient with a long history of tcs application , and two patients at the rebound period .
parakeratosis with poor formation of corneal layer was obvious in the child patient , the patient with a long history of tcs application , two patients recovered from tsa , and two patients at the rebound period.conclusionprolonged application of tcs might suppress the cortisol production of keratinocytes which is poorly developed at the early ages before childhood and completed naturally as to growth . rebound phenomenon after tsw can occur due to the relative insufficiency of cortisol in the epidermis and the immature corneal layer formation.electronic supplementary materialthe online version of this article ( doi:10.1007/s13555 - 016 - 0096 - 7 ) contains supplementary material , which is available to authorized users . |
7,084 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: resonance light scattering ( rls ) is
an elastic scattering and occurs when an incident beam in energy is close to an
absorption band .
first established the rls technique to study
the biological macromolecules by means of an ordinary fluorescence spectrometer
. due to its high sensitivity , selectivity , and convenience ,
rls studies
have attracted great interest among researchers . in recent years , rls technique
has been used to determine pharmaceutical [ 25 ] , ion
, bacteria , and various biological macromolecules , such as nucleic acids [ 810 ] , proteins [ 1115 ] , and peptide
. over the years
, numerous analytical methods for cl in a variety of samples have been developed , such as ion chromatography
[ 17 , 18 ] , near - infrared spectrometry ,
spectroscopy , ion - selective electrode method , turbidimetric
method , and so on . among these methods ,
the turbidimetric method was
popular and regarded relatively reliable for the quantification of cl .
although it often
provided very accurate results , it suffered from the long experimental time , lower
sensitivity , and complexity .
partly , because of the lower sensitivity , few
of the above methods were applied to determine cl in biological
systems .
the classical ion - selective electrode method is currently used in food
analysis of cl in drinks . nevertheless , these
methods similarly suffered from the drawbacks of low sensitivity and
inapplicability to low chloride - containing samples .
the objectives of this report are to establish a rapid , sensitive , and selective rls analytical method
to determine of cl and to develop an alternative standard method for determination of cl in marketing
drink .
the obtained results were compared with that of the ion - selective
electrode method .
rls spectra were recorded on a jasco fp-6500 spectrofluorophotometer equipped with a thermostated cell
compartment using quartz cuvettes ( 1.0 cm ) ( japan ) . the width of excitation and
emission slits was set at 3.0... | a resonance light scattering ( rls ) technique to determine chloride ions in drinks was developed .
chloride ions were found to bind ag+ forming agcl aggregates that produced intense resonance scattering light .
effects of factors such as acidity , ionic strength , and coexistent interferents on the rls of agcl aggregates were investigated .
the ph of solution almost did not affect the production of rls and few foreign species interfered with the detection of chloride ions .
the resonance scattering light intensity at the maximum peak of 571 nm was linear to the concentration of chloride ions in the range of 1.428.52 ng ml1 with a detection limit of 0.71 ng ml1 . to determine the feasibility of the proposed method
, some samples of water and drinks were analyzed .
the attained results were in agreement with that of ion - selective electrode method .
good recovery results were also obtained with the range of 94.08105.63% .
the sensitivity and selectivity of the rls method are high enough to determine trace amounts of chloride ions without any significant interference from high concentration of other components such as common anions and cations . |
7,085 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in sweden , the prevalence of diabetes mellitus has recently been estimated to be 4.4% among the adult population , with type 2 diabetes accounting for approximately 90% of all cases . as diabetes is a major cause of morbidity and premature mortality
, the disease has a significant impact on healthcare costs and quality of life ( qol ) [ 2 , 3 ] .
it is well established that adequate glycemic control [ glycosylated hemoglobin ( hba1c ) below 6.57% ] reduces the risk of diabetes - related complications , and this is therefore the key goal in management of type 2 diabetes .
insulin is one of the most effective hba1c - lowering interventions and , due to the progressive nature of type 2 diabetes at higher hba1c - levels , insulin may be the only treatment option for many patients . according to the swedish national board of health and welfare s clinical guidelines on management of type 2 diabetes ,
the first preventive measure to decrease hba1c is lifestyle intervention and later initiation of metformin .
when these measures fail to control glucose levels and the hba1c - level rises to 7.5% , treatment with a sulfonylurea ( su ) or insulin should be initiated . there are alternative approved treatment options that may be initiated before prescribing insulin , if hba1c levels are < 7.5% and the patient does not respond to metformin , including sitagliptins and glp-1 receptor antagonists .
however , many physicians choose to initiate insulin before the patient has reached an hba1c level of 7.5% .
insulin treatment has a number of disadvantages , such as weight gain , reaction from the injection and hypoglycemia , and in particular during the early period of initiating insulin , patients most likely show psychologic insulin resistance resulting in complications and increased healthcare costs .
although there are a number of published studies evaluating the costs of swedish patients with type 2 diabetes [ 911 ] , there are to our knowledge no swedish studies comparing the costs of pre- and post - initiation of... | introductionalthough insulin is one of the most effective interventions for the treatment of type 2 diabetes , its disadvantages incur substantial medical cost .
this study was designed to evaluate the medical costs of swedish type 2 diabetic patients initiating insulin on top of metformin and/or sulfonylurea ( su ) , and to evaluate if costs before and after insulin initiation differ for patients where insulin is initiated above or below the recommended glycosylated hemoglobin ( hba1c ) level ( 7.5%).methodsthis was a register - based retrospective cohort study in which patients were identified from the srmland county council diabetes register .
patients being prescribed at least one prescription of metformin and/or su from 2003 to 2010 , and later prescribed insulin , were included.resultsone hundred patients fulfilled the inclusion criteria and had at least 1 year of follow - up .
the mean age was 61 years and 59% of patients were male .
mean time since diagnosis was 4.1 years , and since initiation of insulin was 2.2 years .
the mean hba1c level at index date was 8.0% .
total mean costs for the whole cohort were sek 17,230 [ standard deviation ( sd ) 17,228 ] the year before insulin initiation , and sek 31,656 ( sd 24,331 ) the year after insulin initiation ( p < 0.0001 ) .
when stratifying by hba1c level , patients with hba1c
< 7.5% had total healthcare costs of sek 17,678 ( sd 12,946 ) the year before the index date and sek 35,747 ( sd 30,411 ) the year after ( p < 0.0001 ) .
patients with hba1c levels 7.5% had total healthcare costs of sek 16,918 ( sd 19,769 ) the year before the index date and sek 28,813 ( sd 18,779 ) the year after ( p < 0.0001).conclusiondespite the small sample size , this study demonstrates that mean annual medical costs almost double the year after patients are initiated on insulin .
the costs increased the year after insulin initiation , regardless of the hba1c level at initiation of insulin , and the largest increase in costs were due to increased... |
7,086 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: voltage - gated sodium
( nav ) channels are the fundamental generators of electrical
impulses ( action potentials ) in the membranes of excitable cells .
these drugs are primarily used in the treatment
of central nervous system ( cns ) disorders , such as epilepsy and neuropathic
pain , but are increasingly being scrutinized as potential treatments
for neurodegenerative conditions occurring acutely , such as in ischemic
stroke , or chronically , as in multiple sclerosis ( ms ) .
it exerts a voltage - dependent
and frequency - dependent block of na currents .
this selectivity
is suggested to be the reason for its lack of significant cognitive
side effects .
other first - generation antiepileptics
that act on nav channels include lamotrigine 2 , and carbamazepine 3(4 ) ( figure 1 ) .
recently ,
lacosamide 4 was approved for use in partial - onset seizures
and neuropathic pain .
lacosamide is proposed to act via an unique
mechanism of state - dependent blockade of nav channels :
stabilizing channels in a slow inactivated state without effects on
fast inactivation . compounds with sodium
channel modulatory activity .
nine nav channel isoforms have been identified ,
of which ,
nav1.1 , 1.2 , 1.3 , and 1.6 are predominately found within
the cns , whereas nav1.7 , 1.8 , and 1.9 are located in the
peripheral nervous system .
nav1.4 is found within skeletal
muscle , and nav1.5 is found in the heart .
recently , the first x - ray crystal structure of
a voltage - gated sodium channel was solved : initially in the closed
state and subsequently in two presumed inactivated states . under normal physiological conditions ,
the channels interconvert
between different functional states : the resting state in which the
channel pore is closed , an open state in which the channel pore is
open and permeable to na , and one or more inactivation
states where the pore is open but blocked .
recent studies have highlighted the importance of nav1.3 , 1.7 , 1.8 , and 1.9 in various... | a series of imidazol-1-ylethylindazole
sodium channel ligands were
developed and optimized for sodium channel inhibition and in vitro
neuroprotective activity .
the molecules exhibited displacement of
a radiolabeled sodium channel ligand and selectivity for blockade
of the inactivated state of cloned neuronal nav channels .
metabolically stable analogue 6 was able to protect retinal
ganglion cells during optic neuritis in a mouse model of multiple
sclerosis . |
7,087 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: as stated by fdration dentaire internationale , forensic odontology is the branch of dentistry which , in the interest of justice , deals with proper handling and examination of dental evidence and with the proper evaluation and presentation of dental findings .
forensic dentistry is important for human identification , especially when conventional methods can not be applied , usually due to advanced decomposition , carbonization or fragmentation of the body . in accidents or natural disasters involving severe trauma and fire ,
the use of fingerprints , facial recognition methods can be difficult or even impossible . in such cases ,
a post - mortem record is created by a forensic dentist to identify the victim by determining the age , stature , ancestry , sex and socio - economic class , where the body has been mutilated and the extremities or head amputated from the trunk .
one of the main goals of forensic anthropology is to determine the identity of a person from the study of some skeletal remains . in the last few decades , anthropologists have focused their attention on improving those techniques that allow a more accurate identification . before making a decision on the identification ,
it is necessary to follow different processes that let them assign a sex , age , human group and height to the subject from the study of bones found .
different methodologies have been proposed , according to the features of the different human groups of each region . in the identification of unknown human remains , stature and
the method of using teeth and skull measurements has several advantages as the anatomical landmarks are standard , well developed and easy to locate .
an estimate must then be made based on the known relationship of the remains to stature and gender .
teeth form an excellent material for anthropological , genetic , odontologic and forensic investigations . amongst all the teeth ,
the mandibular canines are found to exhibit greatest sexual dimorphism . with this background in concern with the... | background : when the body has been mutilated , it is common to have the extremities or head amputated from the trunk . in concern with forensic odontology ,
an estimate must have been made based on the correlation of osteometry along with odontometry in determining sex , race and stature.objective:the objective of this study is to investigate and correlate height and gender from odontometry and anthropometric data of the skull.materials and methods : the study was conducted in the department of oral and maxillofacial pathology and microbiology , i.t.s center for dental studies and research , muradnagar , ghaziabad ( up ) with the representative study subjects of 60 patients as 30 males and 30 females in the age group of 15 - 25 years .
the selected parameters were measured and then correlated to investigate stature and gender from odontometry and anthropometric data of the skull.results:on linear regression analysis , the selected parameters were found to be statistically significant predictor of height .
it was also established by karl pearson 's coefficient correlation that the left mandibular canine index for female was statistically significant to show sexual dimorphism.conclusion:in the emerging field of forensic odontology , skull anthropometry , odontometry exhibits stature determination and strong sexual dimorphism . |
7,088 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
medullary thyroid carcinoma ( mtc ) is a neuroendocrine tumor derived from parafollicular cells of the thyroid gland .
the first description of its major histological features and characterization as a separate entity was done in 1959 by hazard et al . .
it was then rapidly recognized that this carcinoma had distinctive clinical features , in that mtc was found to be associated with pheochromocytomas and other tumors , an association now known as multiple endocrine neoplasia type 2 ( men2 ) .
the identification of familial cases led to the conclusion that many mtcs were probably hereditary . in 1966 ,
subsequently , calcitonin provocation tests with calcium and/or pentagastrin were used to identify individuals susceptible to familial mtc , and those individuals were offered prophylactic thyroidectomy . activating mutations of the rearranged during transfection ( ret ) proto - oncogene
were described for the first time in patients with familial forms of mtc in 1993 [ 8 , 9 ] . since then , several germline ret proto - oncogene mutations have been found in almost 100% of hereditary mtcs . additionally , somatic ret proto - oncogene mutations have been found in approximately 40% of patients with sporadic mtc [ 10 , 11 ] .
these discoveries created new paradigms for the management of mtc : ( 1 ) the identification of germline ret proto - oncogene mutation carriers would allow the removal of the thyroid cells at risk for transformation early in life ( this paradigm is perhaps the most perfect example of primary cancer prevention in humans to date ) , ( 2 ) the identification of several hidden familial medullary thyroid cancers , and ( 3 ) the abnormally activated ret gene might become a target to treat patients with advanced sporadic and hereditary mtc .
our goal in this paper is to describe the molecular pathways associated with mtc tumorigenesis and emerging therapies against this disease ( figure 1 ) .
malignant neoplasms have the capacity to invade the surrounding normal tissue and... | research on medullary thyroid carcinoma ( mtc ) over the last 55 years has led to a good understanding of the genetic defects and altered molecular pathways associated with its development .
currently , with the use of genetic testing , patients at high risk for mtc can be identified before the disease develops and offered prophylactic treatment . in cases of localized neck disease
, surgery can be curative .
however , once mtc has spread beyond the neck , systemic therapy may be necessary .
conventional chemotherapy has been shown to be ineffective ; however , multikinase inhibitors have shown promise in stabilizing disease , and this year will probably see the approval of a drug ( vandetanib ) for advanced unresectable or metastatic disease , which represents a new chapter in the history of mtc . in this paper , we explore newly understood molecular pathways and the most promising emerging therapies that may change the management of mtc . |
7,089 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: an association among obesity , high levels of fasting triglycerides , elevated fasting plasma insulin levels , impaired glucose tolerance , hypertension , and cardiovascular disease ( cvd ) has been recognized since the early 1960s .
these major risk factors tend to cluster in many individuals , suggesting a common etiology that has been variously termed syndrome x , insulin - resistance syndrome , and metabolic syndrome ( ms ) .
current estimates indicate that the age - adjusted prevalence of metabolic syndrome is roughly 24% among u.s .
although it has been studied extensively in adults , much less is known about metabolic syndrome in youth .
current estimates indicate that roughly 4% of us adolescents have a metabolic syndrome , based on the results of a previous study .
a recent study showed a prevalence of 6.8% among the us college - aged students .
the prevalence of obesity is increasing substantially , and obesity is one of the major contributors to the incidence of various diseases due to its pathophysiological link to other cardiovascular risks such as hypertension and diabetes .
a recent study in nepal reported that a high incidence of dyslipidemia and abdominal obesity could be a major contributor to ms .
studies from eastern mediterranean countries indicate that obesity has reached an alarming level among children and adults .
consequently , the incidence of noncommunicable diseases ( ncd ) is very high and accounts for more than 50% of total death in the east mediterranean region ( emr ) [ 6 , 7 ] .
a study of saudi children and adolescents concluded that obese saudi children and adolescents have multiple risk factors associated with metabolic syndrome .
this study aimed to estimate the prevalence of metabolic abnormalities among saudi college students in riyadh , saudi arabia , and to investigate the association between different indicators of body composition and these abnormalities .
a cross - sectional study was conducted with a total of 501 college students aged 1826 years ( 383 males and... | aim . ( i ) to estimate the prevalence of the metabolic abnormalities among saudi college students in riyadh , saudi arabia , and ( ii ) to investigate the association between different indicators of body composition and these abnormalities . methods .
a total of 501 college students participated in a cross - sectional study .
anthropometric assessments , bp measurements , and biochemical assessment were done .
metabolic abnormalities were identified . results . applying bmi , 21.9 % and 20.6% of students
were classified as overweight and obese , respectively .
central obesity was prevalent in 26.9% and 42.2% of students based on wc and whtr , respectively .
other metabolic abnormalities were hypertension ( 23.6% ) and abnormal fpg level ( 22.6% ) .
three or more abnormalities were prevalent in 7.8% of students and increased significantly to 26.4% , 20% , and 17.6 in obese subjects based on bmi , wc , and whtr , respectively . with the exception of abnormal fpg , prevalence of individual metabolic abnormalities as well as
the number of these abnormalities significantly increased with increasing bmi , wc , and whtr ( p < 0.001 each ) .
conclusion .
our findings provide evidence for the presence of ms in saudi college students .
central adiposity contributes to the high incidence of individual ms components .
college health programs that promote healthful lifestyle and avoidance of adult weight gain are recommended . |
7,090 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: patients suffering from chronic kidney disease can be classified according to kidney function along a continuum from mild renal dysfunction to irreversible kidney failure .
patients with kidney failure require renal replacement therapy ( rrt ) , either a kidney transplant or dialysis , to maintain life .
worldwide , at the end of 2004 , 1 800 000 patients were receiving rrt .
of those patients 77% were on dialysis and 23% were living with a functioning kidney transplant .
the global average prevalence for dialysis was 215 patients per million population , although significant regional variations existed . by the year 2010 , it is expected that the number of dialysis patients will approach two million . because the worldwide incidence of kidney failure continues to rise and treatment is costly , the global burden of illness is growing .
while kidney transplantation has important economic implications , it is beyond the scope of this review .
a large volume of literature exists on the topic of kidney transplantation and its economic impact .
readers are referred to other review articles for more information [ 24 ] . for patients treated with dialysis , alternative modalities
are haemodialysis ( hd ) and peritoneal dialysis ( pd ) . in the united states , the incidence of hd has increased sevenfold since 1978 , while the incidence of pd peaked in 1995 and has since declined . in 2005 , there were over 97 000 incident hd patients and 7000 incident pd patients . the prevalent population of hd patients was over 314 000 and the prevalent population of pd patients approached 26 000 . in other parts of the world , the utilization of dialysis modalities varies . among large nations ,
the highest utilization of pd around the world is in mexico , where it is estimated that 72% of prevalent dialysis patients were on pd in 2005 ( based on data from state of jalisco ) .
in contrast , in luxembourg , no prevalent dialysis patients are reported to receive pd . among large nations ,
worldwide , at the end of 2004 , hd was... | the worldwide incidence of kidney failure is on the rise and treatment is costly ; thus , the global burden of illness is growing .
kidney failure patients require either a kidney transplant or dialysis to maintain life .
this review focuses on the economics of dialysis .
alternative dialysis modalities are haemodialysis ( hd ) and peritoneal dialysis ( pd ) .
important economic factors influencing dialysis modality selection include financing , reimbursement and resource availability . in general , where there is
little or no facility or physician reimbursement or payment for pd , the share of pd is very low . regarding resource availability
, when centre hd capacity is high , there is an incentive to use that capacity rather than place patients on home dialysis . in certain countries ,
there is interest in revising the reimbursement structure to favour home - based therapies , including pd and home hd .
modality selection is influenced by employment status , with an association between being employed and pd as the modality choice .
cost drivers differ for pd and hd .
pd is driven mainly by variable costs such as solutions and tubing , while hd is driven mainly by fixed costs of facility space and staff .
many cost comparisons of dialysis modalities have been conducted . a key factor to consider in reviewing cost comparisons
is the perspective of the analysis because different costs are relevant for different perspectives . in developed countries ,
hd is generally more expensive than pd to the payer .
additional research is needed in the developing world before conclusive statements may be made regarding the relative costs of hd and pd . |
7,091 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: participants were selected from the cardiovascular health study ( chs ) , a large , prospective , population - based study in the united states designed to investigate the underlying causes of cardiovascular disease in older men and women .
the chs recruited participants from 4 communities : forsyth county , nc ( 36.1 north , 80.3 west ) ; sacramento county , ca ( 38.5 north , 121.4 west ) ; washington county , md ( 39.6 north , 77.8 west ) ; and pittsburgh , pa ( 40.4 north , 80.0 west ) .
the cohort consisted of 5,201 adults recruited in 19891990 and an additional 687 african - american participants recruited in 19921993 . of these 5,888 participants ,
4,692 ambulatory participants had complete exam data in 19921993 ( the baseline assessment for the current study ) .
serum 25-hydroxyvitamin d ( 25(oh)d ) concentrations were not measured in 1,424 participants who had prevalent cardiovascular disease or stroke ( one or more of the following : coronary heart disease , congestive heart failure , claudication , atrial fibrillation , pacemaker , implantable cardioverter defibrillator , stroke , or tia ) , determined by medical records , ecg findings , and self - report .
further exclusions were insufficient serum volumes for vitamin d assay to be performed ( < 500 l ; n = 945 ) and missing adjudicated dementia status ( n = 596 ) . participants with prevalent dementia at the time of the vitamin d collection ( n = 69 ) were excluded from the main analyses but included in secondary analyses of prevalent dementia .
this resulted in a final sample of 1,658 participants for the main prospective analyses and 1,727 participants for the secondary baseline analyses .
those lost to follow - up ( defined as participants with serum 25(oh)d measured but no diagnostic assessment of incident dementia ) were older ( mean [ sd ] , 74.3 [ 5.4 ] years vs 73.8 [ 4.6 ] years , p = 0.03 ) , were more likely to be nonwhite
( 20.0% vs 13.1% , p < 0.001 ) , and had lower serum 25(oh)d concentrations ( mean [ sd ] , 61.2 [ 39.4 ] nmol / l... | objective : to determine whether low vitamin d concentrations are associated with an increased risk of incident all - cause dementia and alzheimer disease.methods:one thousand six hundred fifty - eight elderly ambulatory adults free from dementia , cardiovascular disease , and stroke who participated in the us population based cardiovascular health study between 19921993 and 1999 were included .
serum 25-hydroxyvitamin d ( 25(oh)d ) concentrations were determined by liquid chromatography - tandem mass spectrometry from blood samples collected in 19921993 .
incident all - cause dementia and alzheimer disease status were assessed during follow - up using national institute of neurological and communicative disorders and stroke / alzheimer 's disease and related disorders association criteria.results:during a mean follow - up of 5.6 years , 171 participants developed all - cause dementia , including 102 cases of alzheimer disease . using cox proportional hazards models , the multivariate adjusted hazard ratios ( 95% confidence interval [ ci ] ) for incident all - cause dementia in participants who were severely 25(oh)d deficient ( < 25 nmol / l ) and deficient ( 25 to < 50 nmol / l ) were 2.25 ( 95% ci : 1.234.13 ) and 1.53 ( 95% ci : 1.062.21 ) compared to participants with sufficient concentrations ( 50
nmol / l ) .
the multivariate adjusted hazard ratios for incident alzheimer disease in participants who were severely 25(oh)d deficient and deficient compared to participants with sufficient concentrations were 2.22 ( 95% ci : 1.024.83 ) and 1.69 ( 95% ci : 1.062.69 ) . in multivariate adjusted penalized smoothing spline plots , the risk of all - cause dementia and alzheimer disease markedly increased below a threshold of 50 nmol / l.conclusion : our results confirm that vitamin d deficiency is associated with a substantially increased risk of all - cause dementia and alzheimer disease .
this adds to the ongoing debate about the role of vitamin d in nonskeletal conditions . |
7,092 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: halitosis is the general term used to describe any disagreeable odour in expired air , regardless of whether the odorous substances originate from oral or non - oral sources .
other names used are fetor ex ore , fetor oris , bad or foul breath , breath malodour , and oral malodour .
results from previous studies suggested that even though there are several causes of bad breath including those resulting from a systemic or nasopharyngeal pathology or condition , the main source of most halitosis is the oral cavity .
non - oral sources of breath odour are generally related to systemic problems and/or medications including conditions such as diabetes , liver and kidney disorders , and pulmonary disease .
some medications , especially those that reduce salivary flow such as antidepressants , antipsychotics , narcotics , decongestants , antihistamines , and antihypertensive drugs contribute towards non - oral sources of breath odor .
systemic conditions and medications can contribute to breath problems , but the majority of bad breath originates in the oral cavity .
bacterial putrefaction by gram - negative anaerobic bacteria , particularly those residing on the posterior dorsum of the tongue , utilize sulphur containing amino acids , primarily cysteine and methionine to produce volatile sulphur compounds ( vscs ) which lead to halitosis .
other organic components e.g. , organic acids , indole / skatole , putrescine , cadaverine may be involved in the production of halitosis .
hydrogen sulphide ( h2s ) , methyl mercaptan ( ch3sh ) , and dimethyl sulphide [ ( ch3 ) 2s ] have been identified as the predominate vscs responsible for oral malodor .
while the tongue is considered the primary source of vsc production , other dental problems can generate these offensive gases .
dental conditions such as gingivitis , periodontal disease , gross carious lesions , and poor oral hygiene have been shown to contribute to bad breath . however
, when dental disease is the source of oral malodour , treatment of the condition will... | objective : the present study was undertaken to determine the prevalence of oral hygiene practices , smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices , oral health conditions to the prevalence of self perceived oral malodour.materials and methods : a self - administered questionnaire was distributed among 277 male and female students .
a questionnaire was developed to assess the self - reported perception of oral breath , awareness of bad breath , timing of bad breath , oral hygiene practices , caries and bleeding gums , dryness of the mouth , smoking and tongue coating.results:the results indicate female students had better oral hygiene practices . significantly less self - reported oral bad breath ( p = 0.007 ) was found in female dental students ( 40% ) as compared to their male counterparts ( 58% ) . it was found that smoking and dryness of mouth had statistically significant correlation with halitosis ( p = 0.026 , p = 0.001 ) .
presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students.conclusion:a direct correlation exists between oral hygiene practices and oral health conditions with halitosis .
females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students . |
7,093 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the 21st century will witness even more rapid ageing than did the century just past and governments , private sector as well as civil society should work together to give answers to the social and economic challenges we will all be facing .
edad&vida ( age and life ) ( http://www.edad-vida.org ) is from 2001 the meeting point of private companies , elderly associations and academic institutions , who work together to give an answer to the needs of elderly people and to promote initiatives to improve their quality of life in a responsible and sustainable way .
our raison dtre is promoting the joint responsibility and balance between the public sector and the private initiative , with the aim of responding to the economic and social challenges of an ageing population . in this sense ,
some of the recommendations of edad&vida to the public administrations are : a stable and clear legal frame - work for the private initiative to make the necessary investment efforts ; the health and social care integration ; an offer of quality services to the elderly people and the accreditation system to guarantee this quality ; a fair correlation between costs and prices paid ; the long - term care system sustainability through co - payment etc .
edad&vida foundation is a reference and pioneer institution in spain and in europe and fosters the dialogue and co - operation among public and private sector as well as elderly associations and academic institutions with the aim of improving the quality of life of elderly people . | introductiondemographic change and population ageing are global processes without precedent .
the 21st century will witness even more rapid ageing than did the century just past and governments , private sector as well as civil society should work together to give answers to the social and economic challenges we will all be facing.descriptionedad&vida ( age and life ) ( http://www.edad-vida.org ) is from 2001 the meeting point of private companies , elderly associations and academic institutions , who work together to give an answer to the needs of elderly people and to promote initiatives to improve their quality of life in a responsible and sustainable way . our raison dtre is promoting the joint responsibility and balance between the public sector and the private initiative , with the aim of responding to the economic and social challenges of an ageing population . in this sense ,
some of the recommendations of edad&vida to the public administrations are : a stable and clear legal frame - work for the private initiative to make the necessary investment efforts ; the health and social care integration ; an offer of quality services to the elderly people and the accreditation system to guarantee this quality ; a fair correlation between costs and prices paid ; the long - term care system sustainability through co - payment etc.conclusionsedad&vida foundation is a reference and pioneer institution in spain and in europe and fosters the dialogue and co - operation among public and private sector as well as elderly associations and academic institutions with the aim of improving the quality of life of elderly people . |
7,094 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: calcific uremic arteriolopathy ( cua ) or calciphylaxis is a syndrome of painful skin necrosis and vascular calcification with high morbidity and mortality .
it occurs primarily in patients with end - stage renal disease [ 1 , 2 ] .
though generally a rare syndrome , it is increasingly described in subjects undergoing renal dialysis .
calciphylaxis has also been described in subjects with normal renal function including primary and secondary hyperparathyroidism [ 3 , 4 ] .
a common factor linking non - renal - failure - related presentation of the same disease is elevated parathyroid hormone with or without elevated calcium - phosphate product leading to calcification of small vessels .
the consequences of these are significant mortality of 80% principally from multiple end organ damage due to ischemia and infarction commonly complicated by infection ; sepsis being the principal cause of death [ 13 ] .
thus , traditional care addresses the calcium - phosphate - pth axis : substituting calcium with non - calcium as phosphate binders , strict dietary phosphate control , cautious vitamin d analogs , calcimimetics , and surgical parathyroidectomy if necessary .
newer approaches focus on intravascular and tissue mineralization : dissolution of calcium deposits with the use of sodium thiosulfate , altering osteoprotegerin , and nf-b pathways with bisphosphonates [ 4 , 5 ] . recently ,
single agent treatment such as sodium thiosulphate and hyperbaric oxygen has yielded various successes in care of calciphylaxis [ 57 ] .
furthermore , favourable outcome was recorded in limited reports on cua using cinacalcet or parathyroidectomy to achieve targeted normalised calcium , phosphate , and parathyroid hormone levels [ 8 , 9 ] . yet
usefulness of these agents in the form of combination therapy has not been fully explored [ 10 , 11 ] .
the aim of the study was to review all cases of cua seen in the last five years and determine its clinical course in the setting of multimodality care .
all patients diagnosed to have cua at... | background . calcific uremic arteriolopathy ( cua ) or calciphylaxis though generally noted for its high mortality , recent case reports have shown promising results using single agent therapies .
however , it is not clear whether combination therapeutic agents will improve course of the disease . objective . to determine clinical outcome in subjects with cua on multimodal treatment .
methods .
all patients with end - stage renal failure ( esrf ) at the townsville hospital , australia , from april 1 , 2006 , to march 31 , 2011 , with diagnosis of cua were retrospectively studied . results .
six subjects with cua ( 4 females and 2 males ) were on various combination therapeutic agents comprising sodium thiosulphate , hyperbaric oxygen , prednisolone , cinacalcet , and parathyroidectomy in addition to intensified haemodialysis , specialist local wound care , and antibiotics .
the wounds failed to heal in 3 patients while 5 of the 6 subjects died ; cause of death being sepsis in 3 and myocardial infarction in 2 .
conclusion .
prognosis of cua remains poor in spite of multimodal combination therapy .
further prospective studies on a larger population are needed to verify our findings . |
7,095 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: iodine is an essential component of
thyroid hormones and critical to normal brain development in newborn infants
and children .
iodine nutrition in the united states is
considered to be sufficient for most populations despite significant reductions
in urinary iodine values between the early 1970s and the early 1990s .
the 2001 - 2002 us national health and
nutrition examination survey ( nhanes ) results suggest that iodine nutrition has
stabilized , but levels are barely above the recommendation for the average
which means that a significant number of people remain at risk .
women of childbearing age and pregnant women
are widely accepted as high - risk groups for inadequate iodine intake , but there
is valid concern that additional high - risk groups remain [ 3 , 4 ] .
three cases of iodine deficiency as a result
of restrictive diets in children have been reported in the literature [ 57 ] .
this case report illustrates a unique case of
iodine deficiency in the us and suggests the need for a greater emphasis on promoting and evaluating the
nutritional adequacy of the diets of children with multiple food allergies or
perceived food allergies or sensitivities .
he had developmental delay diagnosed at
approximately 2 years of age and was thought to have some form in the autism
spectrum .
his family history was
positive for a brother with life - threatening peanut allergies .
his past medical
history was significant for multiple food allergies , including four
anaphylactic episodes .
he was tested at
6 months of age and was found to be allergic to peanuts and soy .
additional allergy tests determined allergies
to soy , eggs , dairy , wheat , seafood , peanuts , legumes , white potatoes , corn ,
spinach , and strawberries .
the patient had a nutrition evaluation with a
registered dietitian at this time , which did not reveal any significant
nutrition concerns . at age 10 , due to
concerns about iodized table salt containing cornstarch , the family switched to
... | severe iodine deficiency results in impaired thyroid hormone synthesis and thyroid enlargement . in the united states ,
adequate iodine intake is a concern for women of childbearing age and pregnant women . beyond this high risk group iodine deficiency
is not considered to be a significant problem .
this case report describes a 12-year - old male with severe iodine deficiency disorder ( idd ) resulting from restricted dietary intake due to multiple food allergies .
we describe iodine replacement for this patient and continued monitoring for iodine sufficiency .
children with multiple food allergies , in particular those with restrictions to iodized salt and seafood , should be considered high risk for severe iodine deficiency . |
7,096 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: risk factors for development of gastrointestinal ( gi ) toxicity in patients receiving non - steroidal anti - inflammatory drugs ( nsaids ) for arthritis or other musculoskeletal diseases include1 - 5 ) prior history of complicated or uncomplicated ulcers ; increased age ; multiple nsaid use ; high nsaid dose ; concomitant use of corticosteroids or anticoagulants including acetylsalicylic acid6 ) ; concomitant helicobactor pylori ( h. pylori ) infection7,8 ) ; comorbidities , such as significant cardiovascular disease ; female gender9 ; and severe rheumatoid arthritis .
most global and domestic guidelines for clinical practitioners recommend the use of either a cyclooxygenase-2 ( cox-2 ) selective agent or a nonselective nsaid with co - prescription of gastroprotective agents in patients with the risk factors3 - 5 ) .
the aim of this study was to describe the patterns of use of nsaids for arthritic knees in clinical practice in korea , particularly focusing on the co - prescription of gastroprotective agents for patients with or without the risk factors for gi toxicity or adverse gi events .
a survey was performed in the ambulatory of 82 hospitals ( 62 university and 20 general hospitals ) where 111 physicians , members of the korean knee society , had prescribed nsaids to relieve symptoms and signs of arthritic knees for more than three consecutive months .
this cross - sectional observational study was performed on a single day between august and october 2009 , although the exact date of study was different among the survey sites .
all the patients were 20 years old , had been taking oral nsaids for more than three consecutive months , and required additional prescription of nsaids for symptomatic relief of their arthritic knees .
a self - administered questionnaire was completed by each of the 2,000 patients who fulfilled those inclusion criteria and by the physicians to get the information of the recent and current prescriptions .
the questionnaire for the patient included questions on the risk factors... | purposethe aim of this study was to describe the patterns of use of non - steroidal anti - inflammatory drugs ( nsaids ) for arthritic knees in clinical practice , particularly focusing on the co - prescription of gastroprotective agents for patients with risk factors for adverse gastrointestinal ( gi ) events.materials and methodseach cross - sectional cohort was a group of outpatients visiting 111 physicians who had prescribed nsaids for the patients ' arthritic knees for more than three consecutive months .
a self - administered questionnaire was completed by each patient and physician.resultsnine hundred and forty five patients ( 48% ) of the whole 1,960 patients belonged to the group with a high or very high risk for nsaid - induced gastropathy determined by northern california health maintenance organization guidelines .
overall , only less than half of the patients were given co - prescription of gastroprotective agents , regardless of the presence or absence of gi symptoms and irrespective of the level of risk for nsaid - induced gastropathy.conclusionsthe physician prescribing nsaids for arthritic knees should monitor any gi symptoms and the patient monitor anylevel for nsaidinduced gastropathy , and be willing to add gastroprotective agents as necessary in order to prevent serious adverse gi events . |
7,097 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: interleukin-29 ( il-29 ) is the main cytokine among three members of interferon lambda family ( ifn-s ) , also known as type iii ifns , including ifn-1 , ifn-2 , and ifn-3 ( or il-29 , il-28a , and il-28b , resp . ) .
the activity of il-29 is determined in part by the distribution and expression of its specific il-28 receptor alpha chain ( il-28ra ) .
il-28ra is widely expressed by ranges of cells including epithelial cells , hepatocytes , fibroblasts [ 1 , 2 ] , and immune cells , such as plasmacytoid dcs , macrophages , th17 cells , and nk cells [ 36 ]
. the most studied biological role of ifn-s is its antiviral activity , but recent investigation starts to uncover a unique role of ifn-s in and beyond innate antiviral immunity [ 4 , 7 ] .
il-29 can induce antiproliferative and antitumor properties [ 8 , 9 ] , inhibit il-13 release in t cells , and stimulate il-6 , il-8 , and il-10 production in macrophages and il-4 and il-13 in mast cells .
a recent study showed that il-29 is able to indirectly affect nk cells by regulating il-12 in macrophages .
moreover , our recent studies have demonstrated that il-29 levels are higher in peripheral blood mononuclear cells ( pbmcs ) and serum and synovium from rheumatoid arthritis ( ra ) patients when compared to healthy individuals .
recombinant il-29 enhances il-6 , il-8 , and matrix - metalloproteinases ( mmps ) production in ra fibroblasts and promotes ra inflammation .
il-29 has also been shown to contribute to other immune diseases , such as systemic lupus erythematosus ( sle ) [ 11 , 12 ] , asthma , and psoriasis .
however , the role of il-29 in inflammatory diseases remains largely unexplored and whether il-29 is involved in the pathogenesis of osteoarthritis ( oa ) is unclear .
oa is one of the most common disorders and has traditionally been classified as a noninflammatory arthritis ; however , increasing evidence shows that synovitis and the immune system are also active players in oa development and progression . for examples , oa synovial fibroblasts ( fls... | we have recently shown that il-29 was an important proinflammatory cytokine in pathogenesis of rheumatoid arthritis ( ra ) .
inflammation also contributes to the pathogenesis of osteoarthritis ( oa ) .
the aim of this study was to investigate the effect and mechanism of il-29 on cytokine production and cartilage degradation in oa .
the mrna levels of il-29 and its specific receptor il-28ra in peripheral blood mononuclear cells ( pbmcs ) were significantly increased in oa patients when compared to healthy controls ( hc ) . in the serum ,
il-29 protein levels were higher in oa patients than those in hc .
immunohistochemistry revealed that both il-29 and il-28ra were dramatically elevated in oa synovium compared to hc ; synovial fibroblasts ( fls ) and macrophages were the main il-29-producing cells in oa synovium .
furthermore , recombinant il-29 augmented the mrna expression of il-1 , il-6 , il-8 , and matrix - metalloproteinase-3 ( mmp-3 ) in oa fls and increased cartilage degradation when ex vivo oa cartilage explant was coincubated with oa fls .
finally , in oa fls , il-29 dominantly activated mapk and nuclear factor-b ( nf-b ) , but not jak - stat and akt signaling pathway as examined by western blot . in conclusion , il-29 stimulates inflammation and cartilage degradation by oa fls , indicating that this cytokine is likely involved in the pathogenesis of oa . |
7,098 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: patients with chronic obstructive pulmonary disease ( copd ) experience significant overall symptom burden , comparable to that observed in patients diagnosed with cancer.1 this symptom burden can be associated with impairments in health - related quality of life ( hrqol),24 impaired functioning,5,6 and higher direct7 and indirect costs.79 copd treatments have shown effectiveness in reducing breathlessness and improving hrqol.1017 however , some patients continue to experience dyspnea despite treatment.18,19 moreover , this is critical given that recent studies suggest that the copd - associated burden is increasing globally and costs are increasing in tandem.20,21 the european lung white book estimates that , copd is responsible for 150,000 deaths and 1,691,000 disability - adjusted life years lost in europe , thus reinforcing the tremendous burden that copd exerts on society at large.22 in europe , copd is estimated to be responsible for 48.4 billion in health care costs and lost productivity each year , including an estimated 25.1 billion in indirect costs alone.22 of all the symptoms of copd , dyspnea is the most dominant and defining one.1 dyspnea is defined as a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.23 the discomfort associated with dyspnea has been shown to affect hrqol and health status.2427 in recognition of the prominent role of dyspnea in the assessment and management of copd , the global initiative for chronic obstructive lung disease ( gold ) strategy recommends the use of patient - reported severity of dyspnea as part of the patient classification system .
the international group recommends the routine use of screening measures , such as the copd assessment test28 or the modified medical research council ( mmrc)29 scale , to assess dyspnea among patients .
such assessments require individuals to report the degree of activity that results in breathlessness ( eg , walking up a flight of stairs ) and correlate well... | objectivedyspnea is a defining symptom in the classification and treatment of chronic obstructive pulmonary disease ( copd ) .
however , the degree of variation in burden among symptomatic copd patients and the possible correlates of burden remain unclear .
this study was conducted to characterize patients in europe currently being treated for copd according to the level of dyspnea in terms of sociodemographics , health - related quality of life , work productivity impairment , and health care resource use assessed by patient reports.methodsdata were derived from the 5-eu 2013 national health and wellness survey ( n=62,000 ) .
respondents aged 40 years who reported currently using a prescription for copd were grouped according to their level of dyspnea as per the global initiative for chronic obstructive lung disease guidelines and compared on health status ( revised short form 36 [ sf-36]v2 ) , work impairment ( work productivity and activity impairment questionnaire ) , and number of health care visits in the past 6 months using generalized linear models with appropriate distributions and link functions.resultsof the 768 respondents who met the inclusion criteria , 245 ( 32% ) were considered to have higher dyspnea ( equivalent to modified medical research council score 2 ) .
higher dyspnea was associated with decrements ranging from 3.9 to 8.2 points in all eight domains of the sf-36 health profile after adjustment for sociodemographics , general health characteristics , and length of copd diagnosis ; mental component summary scores and short form-6d health utility scores were lower by 3.5 and 0.06 points , respectively . adjusted mean activity impairment ( 55% vs 37% , p<0.001 ) and number of emergency room visits ( 0.61 vs 0.40 , p=0.030 )
were higher in patients with greater dyspnea.conclusionmany european patients with copd continue to experience dyspnea despite treatment and at levels associated with notable impairments in the patients ability to function across a multitude of domains .
... |
7,099 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in stroke patients with upper extremity paralysis , the affected arm can remain
nonfunctional even at 6 months after disease onset in 66% of the surviving stroke
patients1 , 2 .
inappropriate motor unit recruitment appearing after stroke onset
reduces the motor neuron firing rate , and increased muscle tone may cause severe
paralysis3 , 4 . limited motor function of the upper extremity , and subsequent
non - use and contracture may cause changes in the mechanics and biomechanics of the muscles
over time5,6,7 .
nuclear chain fibers of the
muscle spindle , responsible for the changes in muscle velocity , depend on the velocity of
movement and hyperexcitability during a quick passive stretch to increase the tension level
more and more .
in contrast , the tendon , which softens the muscle contraction and adjusts the
excessive muscle tone , is unable to function normally8 . excessive muscle tone may affect the gross movement patterns caused
by abnormal motor control .
in addition , increased muscle tone significantly correlates with
the limit of upper extremity motor function9 , reduction in daily living activities10 , and prolonged length of hospital stay11 .
data obtained by the biomechanical investigation of
increased muscle tone would not only identify prognostic variables of functional recovery in
stroke patients , but would also be helpful for promoting self - exercise to reduce the risk of
hypertonia8 .
in addition , increased muscle tone has been identified as predicting the motor function of
the upper extremity within 12 months after stroke onset12 .
a study of the correlation between recovery and increased muscle
tone of the upper extremity in stroke patients suggested that the patients whose motor
function of the upper extremity became relatively weaker within 48 hours after stroke onset
would be 12.8 times more likely to experience hypertonia within 6 months than the patients
with normal motor function8 .
in addition ,
the patients with severe arm paresis were... | [ purpose ] muscle tone is known to predict the motor function of the upper extremity
within 12 months after onset in stroke survivors .
the aim of this study was to investigate
whether motor function of the upper extremity can predict the risk of hypertonia in
chronic stroke survivors , and to analyze the correlation between the two variables to
determine the predictive validity .
[ subjects and methods ] forty - three chronic stroke
survivors were assessed using the modified ashworth scale ( mas ) for elbow flexor tone , the
fugl - meyer assessment of the upper extremity ( fm - ue ) , and the action research arm test
( arat ) for upper extremity motor recovery and function .
[ results ] elbow flexor tone
( mas1 + ) increased by 0.246 compared with the baseline muscle tone even at
month 12 and appeared to negatively affect the motor function of the upper extremity . the
cutoff value for predicting muscle tone
( mas1 + ) was 24 for fm - ue and 15.5 for
arat .
fm - ue had the biggest impact on elbow flexor tone ( mas1 + ) , and the risk
of elbow flexor hypertonia ( mas1 + ) increased 0.764-fold for a cutoff value of
fm - ue24 compared with a cutoff value of fm - ue>24 .
[ conclusion ] the results show that
the most important variable for predicting muscle tone of the elbow flexor in stroke
survivors is the fm assessment of the upper extremity . |
7,100 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the available evidence suggests that a sizable proportion of undergraduate health sciences students lack good study skills and habits , and that introducing a study skills program could significantly improve students confidence and academic achievement .
the undergraduate pharmacy degree programs of the university of zambia comprise a regular five - year bachelor of pharmacy ( b. pharm . )
degree that primarily admits young high school graduates who have little or no clinical experience , and a parallel program that mostly enrols mature students with a diploma in pharmacy and clinical experience , or similar qualifications .
candidates with diploma in pharmacy or first degree qualifications in relevant fields could be admitted to advanced standing in the b. pharm programs . in light of the different student demographics and differences in academic achievement that have been observed between these two programs ,
this study was designed to analyse the study skills of undergraduate pharmacy students of the school of medicine of the university of zambia , with the goal of identifying areas of deficiency in the domains of time management , note taking , test / examination preparation , motivation , concentration / memory , information processing , reading , and writing skills .
the results of this study may help in the design of tailor - made study skills intervention courses to assist individual students .
the study population consisted of undergraduate bachelor of pharmacy students in years 3 , 4 , and 5 of both the regular and parallel programs of the school of medicine , university of zambia , lusaka , zambia .
since the parallel program has no year 1 and year 2 students , these levels were omitted from the study .
a sample size of 66 was calculated according to yamane formulae based on a total student enrolment of 243 in both programs for the years studied .
a demographic questionnaire was used to gather demographic information , while hard copies of the study skills assessment questionnaire ( ssaq )... | it aimed to compare the study skills of two groups of undergraduate pharmacy students in the school of medicine , university of zambia using the study skills assessment questionnaire ( ssaq ) , with the goal of analysing students study skills and identifying factors that affect study skills .
a questionnaire was distributed to 67 participants from both programs using stratified random sampling .
completed questionnaires were rated according to participants study skill .
the total scores and scores within subscales were analysed and compared quantitatively .
questionnaires were distributed to 37 students in the regular program , and to 30 students in the parallel program .
the response rate was 100% .
students had moderate to good study skills : 22 respondents ( 32.8% ) showed good study skills , while 45 respondents ( 67.2% ) were found to have moderate study skills .
students in the parallel program demonstrated significantly better study skills ( mean ssaq score , 185.414.5 ) , particularly in time management and writing , than the students in the regular program ( mean ssaq score 17525.4 ; p<0.05 ) .
no significant differences were found according to age , gender , residential or marital status , or level of study .
the students in the parallel program had better time management and writing skills , probably due to their prior work experience .
the more intensive training to students in regular program is needed in improving time management and writing skills . |
7,101 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
establish a database of ent , audiology , and speech therapy services in sub - saharan africa.create an awareness in the first world about the status of these services.plan and promote effective , targeted support for these services.gather data to lobby african governments , donor countries , and aid organizations.determine the need for a developing world forum for ent surgery , audiology , and speech therapy .
establish a database of ent , audiology , and speech therapy services in sub - saharan africa .
plan and promote effective , targeted support for these services . gather data to lobby african governments , donor countries , and aid organizations . determine the need for a developing world forum for ent surgery , audiology , and speech therapy .
establish a database of ent , audiology , and speech therapy services in sub - saharan africa.create an awareness in the first world about the status of these services.plan and promote effective , targeted support for these services.gather data to lobby african governments , donor countries , and aid organizations.determine the need for a developing world forum for ent surgery , audiology , and speech therapy .
establish a database of ent , audiology , and speech therapy services in sub - saharan africa .
plan and promote effective , targeted support for these services . gather data to lobby african governments , donor countries , and aid organizations . determine the need for a developing world forum for ent surgery , audiology , and speech therapy .
a questionnaire was distributed by email to an ad hoc group of ent surgeons and audiologists in sub - saharan african countries in which there were known to be ent services .
participants were traced through personal contacts and the pan african federation of oto - rhino - laryngological societies ( pafos ) database , and proved to be challenging or impossible in some countries .
questions were asked about the availability of ent , audiology , and speech therapy services and equipment ( nil / poor / good... | backgroundburden of disease ( bod ) is greatest in resource - starved regions such as africa . even though hearing disability ranks third on the list of non - fatal disabling conditions in low- and middle - income countries , ear , nose , and throat ( ent ) disorders are not specifically coded for within the framework governing global bod estimates , and in discussions about health challenges ,
non - communicable diseases receive scant attention . implementing cost - effective interventions to address conditions largely neglected by global estimates of bod such as hearing loss are important contributors to health and economic development.objectivesestablish a database of ent , audiology , and speech therapy services in sub - saharan africa ; create awareness about the status of these services ; propose effective intervention ; gather data to lobby african governments , donor countries , and aid organizations ; determine need for developing world forum for ent , audiology , and speech therapy services.designsurvey of ent , audiology , and speech therapy services and training in 18 sub - saharan africa countries.resultsthere is an alarming paucity of services and training opportunities , and there is a large gap between higher technology , expensive health care in high - income countries and lower technology , low - cost practice in low - income countries.conclusionslower technology and lower cost developing world medical practice should be recognized and fostered as a field of medical practice , teaching , and research . developing world centers of excellence must be fostered to take a lead in teaching , training , and research . a developing world forum for ent surgery , audiology , and speech therapy , directed and driven by africa and the developing world , supported by the first world ,
should be established , to develop a comprehensive intervention to turn around the severe shortage of services and expertise in the developing world .
global health policies and practices should include new norms and... |
7,102 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the online version of this article ( doi:10.1007/s12576 - 014 - 0350 - 7 ) contains supplementary material , which is available to authorized users .
after muscle injury or change of use , repair starts with an initial acute inflammatory response ( typically from 0 to 48 h ) followed by a repair and regeneration phase , typically lasting from 48 h to 10 days .
ccaat / enhancer - binding protein - beta ( c / ebp- , encoded for by cebpb mrna ) is a pleiotropic transcription factor that regulates several immune cell functions .
c / ebp- has been shown to be central to post - injury muscle repair since cebpb expression is markedly increased during macrophage differentiation towards an anti - inflammatory ( m2 )
repair phenotype that governs the integration of newly formed myoblasts into regenerating muscle tissue . in a murine model of repair
after a muscle injury , deletion of camp response element - binding protein ( creb ) binding sites in the c / ebp- promoter ( thereby reducing cebpb expression ) in macrophages prevented the transition to an m2 regrowth and repair phenotype and inhibited muscle regeneration , resulting in fibrosis and muscle fibre loss , compromising muscle function .
satellite progenitor cells proliferate as myoblasts and fuse into myotubes at the site of damage , where they differentiate into fully regenerated muscle fibres .
this sequence is mediated by a cascade of myogenic regulatory factors , which are subject to signalling from resident or infiltrating macrophages , and systemic factors originating in t lymphocytes .
the proliferative phase of myoblasts is promoted by pro - inflammatory ( m1 ) macrophages .
we have previously demonstrated that the expression of the cebpb gene in blood was the most strongly transcript associated with grip strength in 698 mostly older people in the inchianti study in a transcriptome - wide analysis of human circulating blood leukocytes . a potential mechanism explaining the strength - blood cebpb association may be the role of c / ebp- in muscle... | in mouse models , ccaat enhancer - binding protein beta ( cebpb ) is necessary for m2 macrophage - mediated regeneration after muscle injury . in humans , cebpb expression in blood
was strongly associated with muscle strength . in this study
we aimed to test whether cebpb expression in blood in people is increased 2 days after exercise designed to induce muscle damage and subsequent repair .
sixteen healthy male volunteers undertook elbow flexor exercises designed to induce acute muscle micro - damage .
peripheral blood samples were collected at baseline and days 1 , 2 , 4 and 7 following exercise .
expression of cebpb and related genes were analysed by qrt - pcr .
extent of muscle damage was determined by decline in maximal voluntary isometric torque and by plasma creatine kinase activity .
nine subjects had peak ( day 4 ) creatine kinase activity exceeding 10,000 u / l . in this subgroup ,
cebpb expression was elevated from baseline to 2 days post exercise ( paired - samples t(1,8 ) = 3.72 , p = 0.006 ) . related expression and selected cytokine changes after exercise did not reach significance .
muscle - damaging exercise in humans can be followed by induction of cebpb transcript expression in peripheral blood .
associations between cebpb expression in blood and muscle strength may be consistent with the cebpb - dependent muscle repair process.electronic supplementary materialthe online version of this article ( doi:10.1007/s12576 - 014 - 0350 - 7 ) contains supplementary material , which is available to authorized users . |
7,103 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: biomarkers are molecules that represent a pathological signature that is easily identified and quantified for a particular disease or disorder . in recent years
biomarkers have proven essential in identifying individuals at risk for disease , tracking disease progression , and selection of therapeutic intervention . despite their clinical importance and extensive genetic studies ,
there are currently no definitive biomarkers for pd available for use in research or diagnostics .
it is estimated that by the time a patient with pd sees a physician for the hallmark motor symptoms of rigidity , resting tremor , bradykinesia , and postural instability , up to 70% of the patient s dopaminergic neurons have already been lost .
one of the major aims of biomarker research in pd is to provide both medical professionals and researchers with tools that enable accurate diagnosis before extensive neuronal death has occurred .
in addition to monitoring at - risk individuals for early diagnosis , biomarkers may expedite drug discovery and development .
current clinical trials for pd use relatively subjective measures such as motor activity , behavior , and mood to assess treatment efficacy .
this makes such trials extremely expensive and labor - intensive , especially considering that more than 90% of drugs entering clinical trials for brain diseases do not yield marketable compounds . adding biomarkers to clinical trials may reduce this drug failure rate . in clinical trials for cancers ,
biomarker - based studies have had considerable success , to the point that there are now biomarker - driven basket
trials underway , which enroll patients based on genetic biomarkers independent of tumor histology [ 5 , 6 ] .
the use of biomarkers rather histopathological diagnosis in these basket trials has generated enormous interest , because they implement a hypothesis - driven strategy for incorporating precision medicine into clinical trials . in pd ,
accurate and measurable biomarkers have the potential to add great value to... | parkinson s disease ( pd ) is a prevalent neurodegenerative illness that is often diagnosed after significant pathology and neuronal cell loss has occurred .
biomarkers of pd are greatly needed for early diagnosis , as well as for the prediction of disease progression and treatment outcome . in this regard ,
the epigenome , which is partially dynamic , holds considerable promise for the development of molecular biomarkers for pd .
epigenetic marks are modified by both dna sequence and environmental factors associated with pd , and such marks could serve as a unifying predictor of at - risk individuals .
epigenetic abnormalities have been detected in pd and other age - dependent neurodegenerative diseases , some of which were reported to occur early on and were reversible by pd medications .
emerging reports indicate that certain epigenetic differences observed in the pd brain are detectable in more easily accessible tissues . in this review , we examine epigenetic - based strategies for the development of pd biomarkers . despite the complexities and challenges faced , the epigenome offers a new source of biomarkers with potential etiological relevance to pd , and may expand opportunities for personalized therapies . |
7,104 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: pancreatic cancer is a common gastrointestinal cancer , and the incidence and mortality has been increasing in recent years . in the usa , it has been the fourth leading cause of death . in 2009 ,
approximately 42 000 new patients were diagnosed , and 35 000 americans died of pancreatic cancer . .
early diagnosis is difficult because of the lack of clinical symptoms in the early stages , and the 5-year survival rate ranges from 4% to 6% or less .
although the incidence and mortality of pancreatic cancer are remarkably high , few treatment options are effective .
the primary option is to reduce pancreatic cancer risk by taking preventive measures . in humans ,
free radicals , which result from polyunsaturated fatty acids reacting with oxygen in the lipid membranes , might be essential for the occurrence of tumors .
vitamin e is an effective antioxidant that prevents the occurrence of some tumors by protecting cells and dna from free radical damage .
whether vitamin e , as an antioxidant , could reduce the incidence of pancreatic cancer has been under consideration . in 2000 , heisler et al .
reported the results from an in vitro study showing that vitamin e could inhibit pancreatic cancer cell line growth .
another animal study showed that vitamin e increased the activity of superoxide dismutase ( sod ) and decreased the level of thiobarbituric- acid - reactive substances ( tbars ) , which might be a mechanism of decreasing liver metastasis in pancreatic cancer .
many epidemiological studies have assessed the relationship between vitamin e and the risk of pancreatic cancer . in the 1990s
, 1 of 2 case - control studies showed that vitamin e intake was linked to a decreased risk of pancreatic cancer ; however , the other study showed a null association .
subsequent epidemiological studies , including case - control and cohort studies , have suggested an inconsistent association between vitamin e intake and the risk of pancreatic cancer [ 1017 ] .
the sample size of each original study was smaller and original... | backgroundsome epidemiological studies have suggested that vitamin e intake reduces the risk of pancreatic cancer ; however , this conclusion has not been supported by all the published studies .
we conducted a meta - analysis to assess the relationship between vitamin e intake and the risk of pancreatic cancer by combining the results from published articles.material/methodswe searched the published studies that reported the relationship between vitamin e intake and pancreatic cancer risk using the pubmed , web of science , and embase databases through december 31st , 2014 .
based on a fixed - effects or random - effects model , the rr and 95% ci were used to assess the combined risk.resultsin total , 10 observational studies ( 6 case - control studies and 4 cohort studies ) were included .
the overall rr ( 95% ci ) of pancreatic cancer for the highest vs. the lowest level of vitamin e intake was 0.81 ( 0.73 , 0.89 ) .
we found little evidence of heterogeneity ( i2=19.8% , p=0.255 ) . in the subgroup analyses
, we found an inverse association between vitamin e intake and pancreatic cancer risk both in the case - control and cohort studies .
additionally , this inverse association was not modified by different populations.conclusionsin our meta - analysis , there was an inverse association between vitamin e intake and the risk of pancreatic cancer .
a high level of vitamin e might be a protective factor for populations at risk for pancreatic cancer . |
7,105 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acquired pure red cell aplasia ( prca ) is a rare , generally chronic condition of profound anemia characterized by a severe reduction in the number of reticulocytes in the peripheral blood and the virtual absence of erythroid precursors in the bone marrow .
these include :
drugs - phenytoin , trimethoprim , zidovudine , chlorpropamide , recombinant erythropoietin , and mycophenolate mofetilinfections - parvovirus b19 , hiv , and viral hepatitisautoimmune disorders - systemic lupus erythematosus , rheumatoid arthritis , hemolytic anemia , and allogeneic stem cell transplantlymphoid malignancies - chronic lymphocytic leukemia , large granular leukemia , non - hodgkin lymphoma , hodgkin lymphoma , and myelomamyeloid malignancies - chronic myeloid leukemia , myelofibrosis , and prodrome of myelodysplastic syndromeother causes - thymoma , pregnancy , idiopathic , etc .
drugs - phenytoin , trimethoprim , zidovudine , chlorpropamide , recombinant erythropoietin , and mycophenolate mofetil infections - parvovirus b19 , hiv , and viral hepatitis autoimmune disorders - systemic lupus erythematosus , rheumatoid arthritis , hemolytic anemia , and allogeneic stem cell transplant lymphoid malignancies - chronic lymphocytic leukemia , large granular leukemia , non - hodgkin lymphoma , hodgkin lymphoma , and myeloma myeloid malignancies - chronic myeloid leukemia , myelofibrosis , and prodrome of myelodysplastic syndrome other causes - thymoma , pregnancy , idiopathic , etc .
a number of cases of coexisting myasthenia gravis ( mg ) and prca have been described in the literature ; all were thymoma associated except for one with thymic hyperplasia .
as the onset of anemia in prca is insidious , patients may have little signs and symptoms until the anemia becomes severe .
extreme pallor or decreased exercise tolerance may be the first sign of this disorder in a previously healthy individual .
bone marrow examination shows normal overall cellularity , with complete or virtually complete absence of red cell precursors .... | pure red cell aplasia ( prca ) is a known entity in clinical medicine .
patients are often transfusion dependent for their whole life .
ascertaining its etiology is always a herculean task .
we received a similar transfusion - dependent patient , who on evaluation was found to have thymoma as an etiological factor .
thymoma presenting as prca is seen in 2%5% patients and evaluating prca for thymoma is seen in 5%13% patient . as per the who histopathological classification ,
thymoma has six types and type a is associated with prca and type b is associated with myasthenia gravis .
this correlation was not seen in our patient , who had type b thymoma .
surgical resection of thymus improves 30% of prca and rest needs immunosuppression .
our patient was not the surgical candidate , and hence he was put on chemotherapy . |
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