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[ "anxiety affects quality of life in those living with parkinson 's disease ( pd ) more so than overall cognitive status , motor deficits , apathy , and depression [ 13 ] . although anxiety and depression are often related and coexist in pd patients , recent research suggests that anxiety rather than depression is t...	research on the implications of anxiety in parkinson 's disease ( pd ) has been neglected despite its prevalence in nearly 50% of patients and its negative impact on quality of life . previous reports have noted that neuropsychiatric symptoms impair cognitive performance in pd patients ; however , to date , no study has directly compared pd patients with and without anxiety to examine the impact of anxiety on cognitive impairments in pd . this study compared cognitive performance across 50 pd participants with and without anxiety ( 17 pda+ ; 33 pda ) , who underwent neurological and neuropsychological assessment . group performance was compared across the following cognitive domains : simple attention / visuomotor processing speed , executive function ( e.g. , set - shifting ) , working memory , language , and memory / new verbal learning . results showed that pda+ performed significantly worse on the digit span forward and backward test and part b of the trail making task ( tmt - b ) compared to the pda group . there were no group differences in verbal fluency , logical memory , or tmt - a performance . in conclusion , anxiety in pd has a measurable impact on working memory and attentional set - shifting .
[ "small non - coding rnas are transcribed into mrna but remain untranslated in eukaryotic cells . they include sirna ( small interfering rna ) , mirna ( microrna ) , pirna ( piwi - interacting rna ) and snorna ( small nucleolar rna ) . mirnas are a class of multifunctional singled - stranded small rna which are ~20 ...	small non - coding rnas include sirna , mirna , pirna and snorna . the involvement of mirnas in the regulation of mammary gland tumorigenesis has been widely studied while the role for other small non - coding rnas remains unclear . here we summarize the involvement of mirna in breast cancer onset and progression through regulating the cell cycle and cellular proliferation . the regulation of breast cancer stem cells and tumor regeneration by mirna is reviewed . in addition , the emerging evidence demonstrating the involvement of pirna and snorna in breast cancer is briefly described .
[ "ohss is a serious complication of ovulation induction , occurring in 1 - 10% of in vitro fertilization patients ( rizk and aboulghar , 1991 ; brinsden et al . , 1995 ) . this iatrogenic condition has a spectrum of clinical and laboratory manifestations ranging from mild to severe , even life - threatening conditi...	objective : to evaluate the efficacy and safety of outpatient management of severe ovarian hyperstimulation syndrome ( ohss ) requiring placement of a pigtail catheter.methods : retrospective analysis of thirty - three consecutive patients who underwent in - vitro fertilization ( 2003 - 2009 ) and developed severe / critical ohss requiring placement of a pigtail catheter . patients who were managed on outpatient basis were monitored by frequent office visits , daily phone calls , and received iv normal saline for hydration when required.results : in 3 patients ( 9.1% ) ohss started early , requiring placement of a pigtail catheter 4.3 + 0.6 days after retrieval . in 30 patients ( 90.9% ) ohss started late ( 14 4 days after retrieval ) . the mean amount of ascitic fluid drained immediately after placement of the catheter was 2085 1018 cc . the pigtail catheter was removed after 7.8 5.3 days . of the 31 patients who had embryo transfer ( two had total freeze ) , 84% conceived . twenty - nine patients ( 88% ) were managed on outpatient basis without any complications . four patients required hospital admission for 1 - 7 days ( 3.0 2.7 ) . one patient with severe ohss was admitted for work up for chest pain . three patients with critical ohss with severe pleural effusion requiring thoracentesis were admitted for supportive measures.conclusion : the placement of a pigtail catheter resulted in safe and effective outpatient management for the majority of patients with severe ohss .
[ "congenital adrenal hyperplasia ( cah ) refers to a group of autosomal recessive disorders caused by an enzyme deficiency which leads to defects in biosynthesis of steroid precursors . depending on the severity and degree of 21 hydroxylase deficiency , the clinical spectrum may vary from mild form of non classical ...	congenital adrenal hyperplasia is a group of autosomal recessive disorders caused by enzyme deficiency which leads to defects in biosynthesis of steroid precursors . most common is 21 hydroxylase deficiency . clinical spectrum varies from non - classical cah to classic cah , and it may be simple virilising form or salt - wastinfg type . 29 patients were included in our study from january 2012 to october 2012 . 76% were females . male babies typically presented with adrenal crisis between 3rd to 6th week of life . around 20% of females were identified and appropriately treated only after late adolescence . short stature was seen in 1/3rd of patients . 1/3rd of patients had suppressed 17 ohp levels suggestive of over - replacement therapy which may contribute to final reduction in adult height .
[ "type 1 diabetes ( t1d ) results from the destruction of insulin producing pancreatic cells by a cell specific autoimmune process ( 1 ) . chronic pancreatic inflammation ( insulitis ) and destruction of islet -cells in type 1 diabetes is mediated by the immune cells , particularly autoreactive cd4 and cd8 t lymph...	objective(s):pentoxifylline is an immunomodulatory and anti - inflammatory agent and is used in vascular disorders . it has been shown that pentoxifylline inhibits proinflammatory cytokines production . the purpose of this study was to investigate the therapeutic effects of pentoxifylline on the treatment of autoimmune diabetes in mice.materials and methods : diabetes was induced by multiple low dose of streptozotocin ( mlds ) injection ( 40 mg / kg / day for 5 consecutive days ) in male c57bl/6 mice . after induction of diabetes , mice were treated with pentoxifylline ( 100 mg / kg / day ip ) for 21 days . blood glucose levels and plasma levels of insulin were measured . splenocytes were tested for proliferation by mtt test and cytokine production by elisa.results:pentoxifylline treatment prevented hyperglycemia and increased plasma insulin levels in the diabetic mice . aside from reducing lymphocyte proliferation , pentoxifylline significantly inhibited the production of proinflammatory interleukin 17 ( il-17 ) as well as interferon gamma ( ifn- ) , while increased anti - inflammatory cytokine il-10 as compared with those in mlds group ( diabetic control group).conclusion : these findings indicate that pentoxifylline may have therapeutic effect against the autoimmune destruction of the pancreatic beta - cells during the development of mlds - induced type 1 diabetes in mice .
[ "determinar a presena de anticorpos ige especficos para superantgenos estafiloccicos e o grau de sensibilizao mediada por esses , assim como se esses esto associados gravidade da asma em pacientes adultos .", "estudo transversal incluindo asmticos adultos em acompanhamento ambulatorial em um hospital universitri...	abstractobjective : to determine the presence of staphylococcal superantigen - specific ige antibodies and degree of ige - mediated sensitization , as well as whether or not those are associated with the severity of asthma in adult patients . methods : this was a cross - sectional study involving outpatients with asthma under treatment at a tertiary care university hospital in the city of rio de janeiro , brazil . consecutive patients were divided into two groups according to the severity of asthma based on the global initiative for asthma criteria : mild asthma ( ma ) , comprising patients with mild intermittent or persistent asthma ; and moderate or severe asthma ( msa ) . we determined the serum levels of staphylococcal toxin - specific ige antibodies , comparing the results and performing a statistical analysis . results : the study included 142 patients : 72 in the ma group ( median age = 46 years ; 59 females ) and 70 in the msa group ( median age = 56 years ; 60 females ) . in the sample as a whole , 62 patients ( 43.7% ) presented positive results for staphylococcal toxin - specific ige antibodies : staphylococcal enterotoxin a ( sea ) , in 29 ( 20.4% ) ; seb , in 35 ( 24.6% ) ; sec , in 33 ( 23.2% ) ; and toxic shock syndrome toxin ( tsst ) , in 45 ( 31.7% ) . the mean serum levels of ige antibodies to sea , seb , sec , and tsst were 0.96 u / l , 1.09 u / l , 1.21 u / l , and 1.18 u / l , respectively . there were no statistically significant differences between the two groups in terms of the qualitative or quantitative results . conclusions : serum ige antibodies to sea , seb , sec , and tsst were detected in 43.7% of the patients in our sample . however , neither the qualitative nor quantitative results showed a statistically significant association with the clinical severity of asthma .
[ "the family is the cornerstone of human social support network and its presence is essential in everyone s life . changes inevitably occur in families with illness and hospitalization of a family member . in other words , among the sources of stress for families are accidents leading to hospitalization particularly...	background : since the family is a social system , the impairment in each of its component members may disrupt the entire family system . one of the stress sources for families is accidents leading to hospitalization particularly in the intensive care unit ( icu ) . in many cases , the families needs in patient care are not met that cause dissatisfaction . since the nurses spend a lot of time with patients and their families , they are in a good position to assess their needs and perform appropriate interventions . therefore , this study was conducted to determine the effectiveness of nursing interventions based on family needs on family satisfaction level of hospitalized patients in the neurosurgery icu.materials and methods : this clinical trial was conducted in the neurosurgery icu of al - zahra hospital , isfahan , iran in 2010 . sixty four families were selected by simple sampling method and were randomly placed in two groups ( test and control ) using envelopes . in the test group , some interventions were performed to meet their needs . in the control group , the routine actions were only carried out . the satisfaction questionnaire was completed by both groups two days after admission and again on the fourth day.findings:both of the intervention and control groups were compared in terms of the mean satisfaction scores before and after intervention . there was no significant difference in mean satisfaction scores between test and control groups before the intervention . the mean satisfaction score significantly increased after the intervention compared to the control group.conclusions:nursing interventions based on family needs of hospitalized patients in the icu increase their satisfaction . attention to family nursing should be planned especially in the icus .
[ "development of human societies and industrialization as well as changes in stress sources has changed disease pattern in civilized societies . as a result , the disease pattern has changed from traditional diseases such as infectious diseases and malnutrition to diseases such as heart disease , diabetes , accident...	background and objective : anxiety and depression are among the psychological disorders in heart surgeries . establishing a simple communication is essential to reduce anxiety and depression . hence , the objective of the present studywas to examine the impact of peplau therapeutic communication model on anxiety and depression in patients , who were candidate for coronary artery bypass in al - zahra heart hospital , shiraz during 2012 - 2013 . methods : this is a clinical trial in which 74 patients were randomly divided into intervention and control groups , each consisted of 37 patients . anxiety and depression levels were assessed before , and two and four months after intervention using the hospital anxiety and depression scale ( hads ) . seven therapeutic communication sessions were held in four stages . data were analyzed with the spss ( version 16 ) using analysis of covariance . results : the mean anxiety and depression levels decreased in the intervention group after the therapeutic communication ( p<0.01 ) . anxiety scores in the intervention group before and after intervention were 10.23 and 9.38 , respectively . while the corresponding scores in the control group were 10.26 and 11.62 , respectively . depression scores in the intervention group before and after intervention were 11 and 9.13 , respectively . the corresponding scores in the control group were 11.30 and 12.08 , respectively . conclusion : the results demonstrated the positive role of therapeutic communication in reducing anxiety and depression of the patients . therefore , the therapeutic communication is recommended as a simple , cost effective and efficient method in this area .
[ "sixty - four patients in nepal that met us department of defense enrollment criteria ( 9 ) for influenzalike illness were evaluated by using onsite rapid influenza tests ( optical immunoassay rapid diagnostic tests , thermo electron corp . throat swab specimens were collected within the first 72 hours of onset of ...	worldwide emergence of variant viruses has prompted a change in the 20052006 h3n2 influenza a vaccine strain .
[ "rising levels of obesity are becoming a worldwide phenomenon and are increasingly identified as a health problem across the globe [ 14 ] . higher weight has been associated with adverse health indicators and outcomes , including cardiovascular disease [ 512 ] , stroke [ 5 , 13 ] , cognitive and functional decline ...	excess weight has generally been associated with adverse health outcomes ; however , the link between overweight and health outcomes may vary with socioeconomic , cultural , and epidemiological conditions . we examine associations of weight with indicators of biological risk in three nationally representative populations : the us national health and nutrition examination survey , the english longitudinal study of ageing , and the social environment and biomarkers of aging study in taiwan . indicators of biological risk were compared for obese ( defined using body mass index ( bmi ) and waist circumference ) and normal weight individuals aged 54 + . generally , obesity in england was associated with elevated risk for more markers examined ; obese americans also had elevated risks except that they did not have elevated blood pressure ( bp ) . including waist circumference in our consideration of bmi indicated different links between obesity and waist size across countries ; we found higher physiological dysregulation among those with high waist but normal bmi compared to those with normal waist and normal bmi . americans had the highest levels of biological risk in all weight / waist groups . cross - country variation in biological risk associated with obesity may reflect differences in health behaviors , lifestyle , medication use , and culture .
[ "male macroprolactinomas ( mprl ) are usually revealed by headaches , visual troubles and gonadal insufficiency . suppurative meningitis ( sm ) , a life - threatening condition , is scarcely observed in subjects with macro tumors secreting prolactin ( prl ) and in other pituitary tumors ( pt ) . however , in some v...	background : suppurative meningitis ( sm ) or bacterial meningitis is a life - threatening condition , which is exceptionally due to pituitary tumors ( pt ) . our aim was to analyze its frequency among male macroprolactinomas ( mprl ) deemed to be aggressive , to report the cases we observed in our practice and describe the circumstances under which sm appeared.materials and methods : we retrospectively analyzed 82 male mprl in order to look for a history of well proved sm and the circumstances under which sm appeared . we also took into account the possibility of sm relapsing.results:four out of 82 male mprl had sm = 4.87% . three consulted for sm symptoms . sm was confirmed in infectious diseases department , but only one had rhinorrhea . hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas . after antibiotics , sm was sterilized . then , mprl were treated with bromocriptine , which normalized prolactin and reduced pt . sm never relapsed . the 4th case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base . he was operated on 3 times and then he was given bromocriptine . after 3 months , he had rhinorrhea and then sm which was successfully treated by antibiotics . sm never relapsed after tumor reduction.conclusion:sm was demonstrated in 4.87% . sm has revealed mprl in 3 cases and appeared after bromocriptine intake in the 4th one . endocrinologists should be aware of this severe condition , which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors , unless it is clogged by fibrosis : what probably happened in our cases .
[ "many studies have not been reported in literature for lumbar discectomy by destandau endospine system . we report a series of 300 patients operated for lumbar dissectomy by destandau endospine system .", "a total of 300 patients suffering from lumbar disc herniations were operated between january 2002 and decemb...	background : posterior endoscopic discectomy is an established method for treatment of lumbar disc herniation . many studies have not been reported in literature for lumbar discectomy by destandau endospine system . we report a series of 300 patients operated for lumbar dissectomy by destandau endospine system.materials and methods : a total of 300 patients suffering from lumbar disc herniations were operated between january 2002 and december 2008 . all patients were operated as day care procedure . technique comprised localization of symptomatic level followed by insertion of an endospine system devise through a 15 mm skin and fascial incision . endoscopic discectomy is then carried out by conventional micro disc surgery instruments by minimal invasive route . the results were evaluated by macnab 's criteria after a minimum followup of 12 months and maximum up to 24 months.results:based on modified macnab 's criteria , 90% patients had excellent to good , 8% had fair , and 2% had poor results . the complications observed were discitis and dural tear in five patients each and nerve root injury in two patients . 90% patients were able to return to light and sedentary work with an average delay of 3 weeks and normal physical activities after 2 months.conclusion:edoscopic discectomy provides a safe and minimal access corridor for lumbar discectomy . the technique also allows early postoperative mobilization and faster return to work .
[ "medical tourism is illustrated as occurrence in which individuals travel abroad to receive healthcare services ( 1 ) . it is a multi - billion dollar industry and countries like india , thailand , singapore , malaysia , belgium , costa rica , cuba , dubai , hungary , israel , jordan , south africa and many others ...	background : role of information source , perceived benefits and risks , and destination image has significantly been examined in travel and tourism literature ; however , in medical tourism it is yet to be examined thoroughly . the concept discussed in this article is drawn form well established models in tourism literature.methods:the purpose of this research was to identify the source of information , travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well - established theory . thorough database search ( science direct , utmj.org , nih.gov , nchu.edu.tw , palgrave - journals , medretreat , biomedcentral ) was performed to fulfill the objectives of the study.results:international patients always concern about benefits and risks related to travel . these benefits and risks form images of destination in the minds of international patients . different sources of information make international patients acquaint about the associated benefits and risks , which later leads to development of intention to visit . this conceptual paper helps in establishing model for decision - making process of international patients in developing visit intention.conclusion:ample amount of literature is available detailing different factors involved in travel decision making of international patients ; however literature explaining relationship between these factors is scarce .
[ "squamous cell carcinoma of the head and neck ( hnscc ) is a heterogeneous disease that includes tumors arising from the mucosal epithelial surface of the oral cavity , oropharynx , hypopharynx , and larynx . although these tumors originate within different anatomic sites within the upper aerodigestive tract , they...	molecular therapeutics for treating epidermal growth factor receptor-(egfr- ) expressing cancers are a specific method for treating cancers compared to general cell loss with standard cytotoxic therapeutics . however , the finding that resistance to such therapy is common in clinical trials now dampens the initial enthusiasm over this targeted treatment . yet an improved molecular understanding of other receptor tyrosine kinases known to be active in cancer has revealed a rich network of cross - talk between receptor pathways with a key finding of common downstream signaling pathways . such cross talk may represent a key mechanism for resistance to egfr - directed therapy . here we review the interplay between egfr and met and the type 1 insulin - like growth factor receptor ( igf-1r ) tyrosine kinases , as well as their contribution to anti - egfr therapeutic resistance in the context of squamous cell cancer of the head and neck , a tumor known to be primarily driven by egfr - related oncogenic signals .
[ "this in vitro study was conducted in the chemistry and biochemistry institute , university of veterinary medicine , vienna , austria between june and august 2013 in accordance with the guidelines of the european union council ( 86/609/eu ) for the use of laboratory animals . the work does not require approval from...	objectives : to investigate potential mechanisms mediating the neuroprotective effect of thymoquinone ( tq ) on dopaminergic neurons.methods:this study was conducted in the chemistry and biochemistry institute , university of veterinary medicine , vienna , austria between june and august 2013 . primary cultures were prepared from embryonic mouse mesencephala ( ofi / spf ) at gestation day 14 . four sets of cultures were kept untreated , treated with tq on the eighth day in vitro ( div ) for 4 days , treated with 1-methyl-4-phenylpyridinium ( mpp+ ) on the tenth div for 48 hours and co - treated with thymoquinone and mpp+ . on the twelfth div , cultures were subjected to immunohistochemistry against tyrosine hydroxylase and fluorescent staining using lysotracker deep red , 5,5,6,6-tetrachloro-1,1,3,3-tetraethyl benzimidazolylcarbocyanine ( jc-1 ) and 4,6-diamidino-2-phenylindole stains.results:the mpp+ decreased the number of dopaminergic neurons by 40% , and increased the release of lactate dehydrogenase ( ldh ) into the culture medium . the tq significantly rescued dopaminergic neurons and decreased the release of ldh at the concentrations of 0.1 and 1 m . the tq significantly shifted the red fluorescent intensity of the lysotracker deep red , increased the mitochondrial membrane potential as it increased the red : green florescent ratio of jc-1 , and decreased mpp+-induced apoptotic cell death.conclusion:the tq protects dopaminergic neurons in primary mesencephalic culture by enhancing lysosomal degradation that clears damaged mitochondria and inhibits mitochondria - mediated apoptotic cell death .
[ "the femoral head often leads to healing complications , while the more predictable prosthetic replacements are associated with poorer function and significant complications . the treatment of these fractures depends on the age of the patient , fracture displacement , bone quality , timing of surgery and activity l...	fracture of the femoral neck continues to be a vexing clinical and therapeutic challenge for the orthopedic surgeon . the fracture has a propensity for non - union and avascular necrosis . it is a challenge for the orthopedic surgeon to decide when to intervene in a case with non - union where the implant continues to be in place . we present a case with persistent clinical and radiological non - union signs where the fracture eventually united after 32 months . the case bolsters the view that a continued conservative regime might entail good results in such situations .
[ "granuloma faciale ( gf ) is an uncommon , benign , inflammatory skin disorder of unknown etiology . it is characterized by single or multiple , grey - brown or violaceous nodules or plaques primarily occurring on the face and occasionally at extra - facial sites . the disease is notoriously resistant to therapies ...	granuloma faciale ( gf ) is a chronic condition characterized by red - brown plaques with follicular accentuation present usually on the face . we present a case of 35-year - old female with 5 year history of plaques over cheek and extra facial sites consistent with gf and its response to topical tacrolimus . this case supports previous reports of successful treatment of gf with topical tacrolimus .
[ "chronic myelomonocytic leukaemia ( cmmol ) is a rare disease with an incidence of 0.370.72 per 100 000 population . the median age at diagnosis varies between 65 years and 75 years [ 14 ] . the radical treatment is allogeneic stem cell transplantation , although this treatment is unsuitable for most patients becau...	we report a case of chronic myelomonocytic leukaemia ( cmmol ) in a 68-year - old man who developed osteomyelitis of the mandible . at the initial visit , he reported uncontrolled gingival bleeding , despite self - administered haemostasis . he complained of severe pain in the socket , despite potent opioid analgesia . after consultation with the internal medicine specialists , we undertook a surgical anti - inflammatory approach that included sequestrectomy with massive blood transfusion . his physical condition was ameliorated after the surgical procedure , and he was discharged from the hospital . however , 3 months later , he died because of cardiac arrest after haemorrhagic shock and cardiovascular failure because his cmmol had developed to an acute blastic crisis . this experience demonstrates that the most important goal in such cases is to alleviate a patient 's discomfort by applying minimally invasive actions to eliminate infection and improve the quality of life without causing deterioration in the cmmol status .
[ "in a recent issue of critical care , we presented a series of 13 patients undergoing post - cardiotomy extracorporeal membrane oxygenation ( ecmo ) with bivalirudin - based anticoagulation . after this series , we satisfactorily continued this experience , reaching about 20 patients treated . however , we think th...	bivalirudin has been proposed as the sole anticoagulant in patients under extracorporeal membrane oxygenation ( ecmo ) or cardiopulmonary bypass . owing to the pharmacodynamic properties of bivalirudin , areas of blood stagnation should be carefully avoided in order to limit the risk of thrombosis . the ecmo circuit has no reservoir and is usually devoid of blood stagnation areas . conversely , under some circumstances , intracardiac blood stagnation areas may exist . in this case , there is a potential risk for the spontaneous formation of an intracardiac thrombus . we suggest that , under bivalirudin anticoagulation , a minimal degree of intracardiac blood flow with left heart valve movement is allowed .
[ "global and regional left ventricular ( lv ) functions are well - known indicators of cardiac disease . quantitative values of ventricular volumes and of myocardial mass are independent predictors of morbidity and mortality in patients with coronary artery disease . classically , echo has been used to evaluate lv v...	background : coronary computed tomography angiography ( ccta ) is a frequently performed examination for coronary artery disease . when performed with retrospective gating , there is an opportunity to derive functional parameters of left ventricle utilizing automated software . complementary information , if validated with established standards , will enhance the total value of study.objective:study evaluates the usefulness of fully automated software for the assessment of left ventricular ejection fraction ( lvef ) using 64-slice ccta data and to correlate ct results with echocardiography ( echo ) . role of ct derived lv function is reviewed in the light of emerging technologies and recent developments in multidetector ct ( mdct).materials and methods : a total of 113 patients referred for mdct ccta for evaluation of coronary artery disease . all patients were scanned on 64 slice ge - helical ct scanner and had an echo done within 1 week of the ct scan . retrospectively electrocardiogram ( ecg)-correlated image reconstruction was performed with the reconstruction at 10% r - r interval increment . axial image sets were analyzed with advanced workstation using a program - auto ejection fraction , circulation : ge medical solutions.results:the mean lvef calculated by clinical echo was 58.6 4.5% and by fully automated software based on cta data was 58.9 5.4% . the pearson 's regression analysis showed a large correlation , with a correlation coefficient of 0.503 ( p < 0.001 ) . bland - altman analysis showed a trend towards mdct resulting in slightly higher values for lvef when compared with echo.conclusion:the fully automated software is simple , reliable , and user - friendly , and can provide rapid assessment of lv functional parameters with good reproducibility . despite of good correlation , fewer patients are likely to benefit , in future , from this function due to smaller number of patients undergoing ccta with retrospective gating .
[ "\n moraxella catarrhalis is a gram - negative , aerobic diplococcus human mucosal pathogen which causes middle ear infections in infants and children [ 13 ] , and it is one of the three major causes of otitis media along with streptococcus pneumonia and haemophilus influenzae . although moraxella catarrhalis is fr...	a bioassay - guided fractionation of methanol extract of aristolochia bracteolata whole plant was carried out in order to evaluate its antimicrobial activity and to identify the active compounds in this extract . antibacterial and antifungal activities of methanol extract against gram - positive , gram - negative , and fungal strains were investigated by the agar disk diffusion method . among the strains tested , moraxella catarrhalis and sea urchin - derived bacillus sp . showed the highest sensitivity towards the methanol extract and hence they are used as test organisms for the bioassay - guided fractionation . from this extract , aristolochic acid 1 ( aa-1 ) has been isolated and has showed the greatest antibacterial activity against both standard strain and clinical isolates of moraxella catarrhalis with equal minimum inhibitory concentration ( mic ) and minimum bactericidal concentration ( mbc ) values of 25 and 50 g / ml . modification of the aa-1 to aa-1 methyl ester completely abolished the antibacterial activity of the compound and the piperonylic acid moiety of aa-1 which suggested that the coexistence of phenanthrene ring and free carboxylic acid is essential for aa-1 antibacterial activity .
[ "anti - neutrophil cytoplasmic antibodies ( ancas ) correlate well with a wide spectrum of vasculitis manifestations , including wegener 's granulomatosis , microscopic polyangiitis , and churg - strauss syndrome , all of which are commonly referred to as anca - associated vasculitis ( 1 ) . several infections , pa...	we herein report an unusual case of an infected descending aortic pseudoaneurysm with luminal pathognomonic oscillating vegetation with serological findings and clinical features mimicking anti - proteinase 3-antineutrophil cytoplasmic antibody - associated vasculitis . the positive blood cultures and imaging findings , including a pseudoaneurysm and vegetations in the aorta , suggested the presence of an infected aortic aneurysm . the patient was successfully treated with antibiotics and endovascular aortic repair . a precise diagnosis is crucial in order to avoid inappropriate therapy such as immunosuppressive treatment , which could result in life - threatening consequences in a patient with an infected aortic aneurysm .
[ "endometriosis is a prevalent cause of infertility , pelvic pain , dysmenorrhea , and dyspareunia in reproductive - age women . its diagnosis is by inspection of the pelvis during laparoscopy . in women with pelvic pain and infertility , endometriosis mimics some autoimmune and malignant diseases , including famili...	backgroundendometriosis is a disabling disease of reproductive - age women . dysmenorrhea , dyspareunia , and pelvic pain are the main symptoms of endometriosis . its etiology is not clear . endometriosis may have various causes , including vitamin d deficiency , but its effect is controversial.material/methodsin this double - blind clinical trial , we enrolled patients with endometriosis diagnosed and treated by laparoscopy , with scores of at least 3 for of dysmenorrhea and/or pelvic pain at 8 weeks after surgical treatment . they were randomly prescribed vitamin d ( 50 000 iu weekly for 12 weeks ) or placebo . severity of pain in the 2 groups ( placebo and treatment ) was compared by vas test at 24 weeks after surgical treatment.resultsthere were 19 patients in the vitamin d group and 20 in the placebo group . baseline characteristics in the 2 groups were similar . following the treatment with vitamin d or placebo , we did not find significant differences in severity of pelvic pain ( p=0.24 ) and dysmenorrhea ( p=0.45 ) between the 2 groups . mean pelvic pain at 24 weeks after laparoscopy in the vitamin d group was 0.841.74 and in placebo group it was 0.681.70 ( p=0.513 ) . mean dysmenorrhea was 2.102.33 in the vitamin d group and 2.732.84 in the placebo group ( p=0.45).conclusionsafter ablative surgery for endometriosis , vitamin d treatment did not have a significant effect in reducing dysmenorrhea and/or pelvic pain .
[ "it is generally accepted that microleakage between the filling materials and root canal \n walls might adversely affect the outcome of root canal treatment . therefore , it is critical the complete \n sealing of the root canal system after cleaning and shaping in order to avoid the \n bacterial penetration and re ...	objectivethe aim of this study was to compare the correspondence between gap formation and apical microleakage in root canals filled with epoxy resin - based ( ah plus ) combined or not with resinous primer or with a dimethacrylate - based root canal sealer ( epiphany ) . material and methodsthirty - nine lower single - rooted human premolars were filled by the lateral condensation technique ( lc ) and immersed in a 50-wt% aqueous silver nitrate solution at 37c ( 24 h ) . after longitudinal sectioning , epoxy resin replicas were made from the tooth specimens . both the replicas and the specimens were prepared for scanning electron microscopy ( sem ) . the gaps were observed in the replicas . apical microleakage was detected in the specimens by sem / energy dispersive spectroscopy ( sem / eds ) . the data were analyzed statistically using an ordinal logistic regression model and analysis of correspondence ( =0.05 ) . resultsepiphany presented more regions containing gaps between dentin and sealer ( p<0.05 ) . there was correspondence between the presence of gaps and microleakage ( p<0.05 ) . microleakage was similar among the root - filling materials ( p>0.05 ) . conclusionsthe resinous primer did not improve the sealing ability of ah plus sealer and the presence of gaps had an effect on apical microleakage for all materials .
[ "neonatal diabetes mellitus ( ndm ) presenting within the first 6 months of life includes permanent neonatal diabetes mellitus ( pndm ) , which require lifelong therapy , and transient neonatal diabetes mellitus ( tndm ) where the condition shows remission during infancy but relapses in adolescence . almost all cas...	permanent neonatal diabetes mellitus refers to diabetes that occurs before the age of 6 months and persists through life . it is a rare disorder affecting one in 0.2 - 0.5 million live births . mutations in the gene kcnj11 , encoding the subunit kir6.2 , and abcc8 , encoding sur1 of the atp - sensitive potassium ( katp ) channel , are the most common causes of permanent neonatal diabetes mellitus . sulfonylureas close the katp channel and increase insulin secretion . kcnj11 and abcc8 mutations have important therapeutic implications because sulfonylurea therapy can be effective in treating patients with mutations in the potassium channel subunits . the mutation type , the presence of neurological features , and the duration of diabetes are known to be the major factors affecting the treatment outcome after switching to sulfonylurea therapy . more than 30 mutations in the kcnj11 gene have been identified . here , we present our experience with a patient carrying a novel p.h186d heterozygous mutation in the kcnj11 gene who was successfully treated with oral sulfonylurea .
[ "radiocontrast - induced nephropathy ( rin ) can lead to acute renal failure ( arf ) , which may require dialysis therapy . arf increases treatment cost due to sepsis , hemorrhage , respiratory failure , and a long hospitalization.[13 ] rin is an important cause of hospital - acquired arf and is responsible for 12%...	radiocontrast administration is an important cause of acute renal failure . in this study , compared the plasma creatinine levels with spot urine il-18 levels following radiocontrast administration . twenty patients ( 11 males , 9 females ) underwent radiocontrast diagnostic and therapeutic - enhanced examinations . the rin mehran risk score was low ( 5 ) . the radiocontrast agents used were 623 mg / ml iopromid ( 1.5 ml / kg ) , and 100 ml of 650 mg / ml meglumine diatrizoate as three - way oral and rectal contrast material for abdominal computed tomography ( ct ) scans . serum blood urea nitrogen , creatinine , na , k , cl , ca , p , creatinine clearance , and spot urine il-18 levels were analyzed before and repeated at 24 , 48 , and 72 h after radiocontrast administration . six and 24-h urinary il-18 levels were measured with a human il-18 elisa kit following radiocontrast administration . an increase in plasma creatinine 24 and 48 h following radiocontrast administration was observed compared with precontrast values , but it was not statistically significant ( p=0.052 and p=0.285 , respectively ) . a statistically significant increase in il-18 levels was observed at 6 and 24 h , compared with precontrast values ( p=0.048 and p=0.028 , respectively ) . a tendency for postcontrast 24-h urinary il-18 levels to increase was observed compared with 6 h , but the increase was not statistically significant ( p=0.808 ) . our results show that plasma creatinine starts to increase at 24th hour ; however , spot urine il-18 levels go up at 6th hour following radiocontrast administration implying urine il-18 to be an earlier parameter for kidney injury .
[ "according to the u.s . national institutes of health , up to 80% of human bacterial infections involve biofilm - associated microorganisms 1 . among these , implant - related infections do still have a tremendous impact in orthopaedics and trauma 2 , with high social and economic costs 3 , 4 , posing challenging d...	living in biofilms is probably the most common condition for bacteria and fungi and biofilm - related infections account for the majority of bacterial infectious diseases worldwide.among others biofilm - related infections , those associated with implanted biomaterials have an enormous and still largely underestimated impact in orthopaedics and trauma , cardio - surgery and several other surgical disciplines.given the limited efficacy of existing antibiotics in the prevention and treatment of bacterial biofilms , new strategies are needed to protect implants and host tissues , overcoming the striking ability of the microorganisms to adhere on different surfaces and to immediately protect themselves by forming the biofilm matrix.adhesion is a necessary first step in microbial colonization and pathogenesis and provides a potential target for new preventive and treatment approach.among various polymers , tested as antibacterial coatings , hyaluronic acid and some of its composites do offer a well - established long - term safety profile and a proven ability to reduce bacterial adhesion and biofilm formation.aim of the present review is to summarize the available evidence concerning the antiadhesion / antibiofilm activity of hyaluronic acid and some of its derivatives to reduce / prevent bacterial adhesion and biofilm formation in various experimental and clinical settings .
[ "in 2011 , who declared combat drug resistance : no action today , no cure tomorrow . . in recent years presently , antimicrobial resistance ( amr ) poses a major threat to patient 's treatment as it leads to increased morbidity and mortality , increased hospital stay , and severe economic loss to the patient and...	background and objective . antimicrobial resistance is now a major challenge to clinicians for treating patients . hence , this short term study was undertaken to detect the incidence of multidrug - resistant ( mdr ) , extensively drug - resistant ( xdr ) , and pandrug - resistant ( pdr ) bacterial isolates in a tertiary care hospital . material and methods . the clinical samples were cultured and bacterial strains were identified in the department of microbiology . the antibiotic susceptibility profile of different bacterial isolates was studied to detect mdr , xdr , and pdr bacteria . results . the antibiotic susceptibility profile of 1060 bacterial strains was studied . 393 ( 37.1% ) bacterial strains were mdr , 146 ( 13.8% ) strains were xdr , and no pdr was isolated . all ( 100% ) gram negative bacterial strains were sensitive to colistin whereas all ( 100% ) gram positive bacterial strains were sensitive to vancomycin . conclusion . close monitoring of mdr , xdr , or even pdr must be done by all clinical microbiology laboratories to implement effective measures to reduce the menace of antimicrobial resistance .
[ "ureterocele is a congenital urinary abnormality characterized by the presence of an intrabladder hernia or cystic ballooning of the lower end of a ureter lying between the mucosa and muscle of the bladder . the abnormality leads to urinary retention and recurrent urinary tract infection ( uti ) , which can cause i...	ureterocele is a common ureteric anomaly detected in pediatric population . ureterocele diagnosis and evaluation need a variety of radiological methods . we report a case of 5-year - old female child sent for 99mtc - diethylene triamine pentaacetic acid scan for evaluation of glomerular filtration rate and excretory function of kidneys in view of right - sided hydroureteronephrosis and pyonephrosis with percutaneous tube in situ . incidental photopenia was noted in the urinary bladder . on ultrasonography of abdomen cause of this photopenia was found to be an intravesical ureterocele .
[ "health - related quality of life ( hrqol ) is a multidimensional concept that defines a person 's health based on specific aspects , such as physical , emotional , and social functioning and general welfare ( 1 ) . the assessment of hrqol consists of an evaluation of the degree to which these aspects are decreased...	objectives : the aim of this study was to investigate the impact of asymptomatic vertebral fractures on the quality of life in older women as part of the sao paulo ageing & health study.methods:this study was a cross - sectional study with a random sample of 180 women 65 years of age or older with or without vertebral fractures . the quality of life questionnaire of the european foundation for osteoporosis was administered to all subjects . anthropometric data were obtained by physical examination , and the body mass index was calculated . lateral thoracic and lumbar spine x - ray scans were obtained to identify asymptomatic vertebral fractures using a semi - quantitative method.results:women with asymptomatic vertebral fractures had lower total scores [ 61.4(15.3 ) vs. 67.1(14.2 ) , p = 0.03 ] and worse physical function domain scores [ 69.5(20.1 ) vs. 77.3(17.1 ) , p = 0.02 ] for the quality of life questionnaire of the european foundation for osteoporosis compared with women without fractures . the total score of this questionnaire was also worse in women classified as obese than in women classified as overweight or normal . high physical activity was related to a better total score for this questionnaire ( p = 0.01 ) . likewise , lower physical function scores were observed in women with higher body mass index values ( p<0.05 ) and lower physical activity levels ( p<0.05 ) . generalized linear models with gamma distributions and logarithmic link functions , adjusted for age , showed that lower total scores and physical function domain scores for the quality of life questionnaire of the european foundation for osteoporosis were related to a high body mass index , lower physical activity , and the presence of vertebral fractures ( p<0.05).conclusion : vertebral fractures are associated with decreased quality of life mainly physical functioning in older community - dwelling women regardless of age , body mass index , and physical activity . therefore , the results highlight the importance of preventing and controlling asymptomatic vertebral fractures to reduce their impact on quality of life among older women .
[ "the majority of women with menorrhagia , postcoital bleeding , intermenstrual bleeding , or postmenopausal bleeding ultimately undergo diagnostic hysteroscopy with endometrial sampling as part of their assessment , particularly if symptoms persist or pelvic imaging suggests a uterine abnormality . dilatation and c...	aims . our aim is to compare the adequacy and diagnostic yield of samples obtained by the endometrial explora sampler i - mx120 with endometrial specimens obtained by conventional dilatation and curettage ( d&c ) . methods . a total of 1270 endometrial samples were received in the histopathology laboratories at the king khalid university hospital , riyadh , saudi arabia , between 2007 and 2010 . in the outpatient clinic , the uterine explora model i was used to obtain 996 samples . the remaining 274 samples were obtained by conventional d&c . sample adequacy and the clustering of inadequate specimens according to age groups by the two different techniques were compared and statistically analyzed . results . out of 1270 endometrial samples , 253 ( 19.9% ) were inadequate . the uterine explora was used in 88.5% of these inadequate samples ( 253 samples ) , and the remaining 11.5% were obtained by d&c . the insufficient tissue incidence was higher with the explora ( 17.6% ) than with the d&c ( 2.2% ) and the difference was statistically significant ( p < 0.0001 ) . the ages of the patients , as well as the clinical indications for the procedures , were recorded . conclusion . this retrospective study demonstrated better specimen adequacy when d&c was used compared to the higher rate of sample insufficiency obtained with the explora .
[ "the geological and ( palaeo-)biological evolution of lowland amazonia during neogene and quaternary times remains fascinating since the early days of natural sciences ( for summaries of research history see e.g. , loczy , 1963 and wesselingh , 2008 ) . many , but partly highly controversial models have been introd...	in miocene times a vast wetland existed in western amazonia . whereas the general development of this amazing ecosystem is well established , many questions remain open on sedimentary environments , stratigraphical correlations as well as its palaeogeographical configuration . several outcrops located in a barely studied region around eirunep ( sw amazonas state , brazil ) were investigated to obtain basic sedimentological data . the observed deposits belong to the upper part of the solimes formation and are biostratigraphically dated to the late miocene . vertically as well as laterally highly variable fine - grained clastic successions were recorded . based on the lithofacies assemblages , these sediments represent fluvial deposits , possibly of an anastomosing river system . sand bodies formed within active channels and dominant overbank fines are described ( levees , crevasse splays / channels / deltas , abandoned channels , backswamps , floodplain paleosols ) . lacustrine environments are restricted to local floodplain ponds / lakes . the mollusc and ostracod content as well as very light 18o and 13c values , measured on ostracod valves , refer to exclusively freshwater conditions . based on palaeontological and geological results the existence of a long - lived lake ( lake pebas ) or any influx of marine waters can be excluded for that region during the late miocene .
[ "with increasing availability , widened indications , and technical refinements of computed tomography ( ct ) and magnetic resonance imaging ( mri ) , the number of incidentally discovered adrenal lesions , such as adrenal incidentalomas and incidental adrenal enlargement , is increasing . in a recent study by tang...	aim . to investigate incidental adrenal enlargement clinical characteristics and functional status and analyze functional lesion risk factors . materials and methods . this retrospective study included 578 patients with adrenal imaging features showing enlargement . incidental adrenal enlargement cases ( 78 ) were considered eligible . demographics , functional diagnosis , adrenal imaging features , and concomitant diseases were analyzed . results . the number of adrenal enlargements and proportion of incidental adrenal enlargement increased each year . mean patient age was 50.32 years . thirty - nine cases had unilateral enlargement on the left side and 3 on the right side ; 36 had bilateral enlargement . routine medical checkup was found to have the greatest chance ( 43.59% ) of revealing clinical onsets leading to discovery . biochemical and functional evaluation revealed 54 ( 69.23% ) cases of nonfunctional lesions , 12 ( 15.38% ) of subclinical cushing syndrome , 6 ( 7.69% ) of primary hyperaldosteronism , 1 ( 1.28% ) of metastasis , and 5 ( 6.41% ) of unknown functional status . nodular adrenal enlargement ( or , 7.306 ; 95% ci , 1.72728.667 ; p = 0.006 ) was a risk factor for functional lesions . age and lesion location were not significant factors . conclusion . incidental adrenal enlargement is a frequent radiographic finding and is accompanied by diverse clinical factors that require proper evaluation and management . nodular adrenal enlargement was a risk factor .
[ "pursuing the goal of improved health literacy requires more alliances between health and education sectors to improve literacy levels in the population . it is important for health educators to know about knowledge transfer to meet their needs in transferring their knowledge to public . knowledge transfer , which ...	objectivethe purpose of this study is to propose an innovative method of knowledge transfer that aims to improve health literacy about pediatric infectious diseases prevention in families . children have an appreciable role in this scheme.methodsthis study is a before and after trial that has been conducted in hamedan in 2009 . after changing seven infectious disease topics into childish poems , we selected five kindergartens randomly and taught these poetries to the children . teaching process held after a pretest containing 24 questions that examined 103 of parents about mentioned topics . the same post - test was given after 4 months of teaching process.findingsthe mean of correct answers to the pretest was 59.22% comparable with 81.00% for post - test ( p<0.00 ) . gender and knowledge degree could not change the results significantly . assuming one 's correct answers to the questions as his / her knowledge mark , the mean of this variable increased to 5.32 by this method.conclusionthis cost - effective and joyful method had successful results in promoting health knowledge . children are able to play an active role in family 's health situation . learning within family atmosphere without any obligations makes our scheme a solution for paving the knowledge transferring way .
[ "septic arthritis of the shoulder is uncommon in adults . it is a surgical emergency as joint destruction occurs rapidly and can lead to significant morbidity and mortality .", "a 43 years old male came to our outpatient department with complaints of pain and stiffness of his left shoulder . on examination , his ...	introduction : septic arthritis of the shoulder is uncommon in adults . it is a surgical emergency as joint destruction occurs rapidly and can lead to significant morbidity and mortality . accurate diagnosis can be particularly challenging in patients with underlying liver disease . mri is a useful adjunct in early detection of atypical causes of shoulder pain.case report : a 43 years old male came to our outpatient department with complaints of pain and stiffness of his left shoulder . on examination , his shoulder movements were severely restricted . further evaluation with mri revealed septic arthritis of left gleno - humeral joint for which emergency arthroscopic debridement was done.conclusion:septic arthritis of shoulder may not present with classical clinical features . hence , a through clinical and radiological evaluation will help us prognosticate and treat accordingly thereby preventing complications like septic shock , osteomyelitis .
[ "split - liver transplantation ( slt ) is an attractive alternative procedure to expand the donor pool in patients waiting for liver transplantation . the standard split - liver procedure for a child and an adult ( adult / pediatric split liver ttransplantation , a / p slt ) , by splitting segment ii - iii for ...	biliary complications continue to be a major cause of morbidity after split - liver transplantation ( slt ) . in this report we describe an uncommon late biliary complication . one year after slt the patient showed an intrahepatic bile dicy dilatation with severe cholangitis episodes . the segmentary bile duct of hepatic segment vi - vii draining in the left duct was unidentified and tied at the time of the in situ split - liver procedure . we perform a permanent obliteration of the dilated intrahepatic ducts by a percutaneous embolization using an n - butyl cyanoacrylate ( nabc ) . the management of biliary complications after slt requires a multidisciplinary approach . the use of nbca in obliteration of a dilated bile duct seems to be a safe procedure with good results providing a less invasive option than hepatic resection and decreasing the morbidity associated with chronic external biliary drainage . further studies are needed to determine whether this approach is effective and safe and whether it could reduce hospital stay and cost .
[ "ribonucleotide reductase ( rr ) inhibitors have been studied as radiation sensitizers for over 30 years in both the lab and the clinic . the first of these , hydroxyurea , has been studied in both cervical and head and neck cancers , among others . although initially promising , many of the clinical trials produc...	ribonucleotide reductase ( rr ) , the rate limiting enzyme in the synthesis and repair of dna , has been studied as a target for inhibition in the treatment of cancer for many years . while some researchers have focused on rr inhibitors as chemotherapeutic agents , particularly in hematologic malignancies , some of the most promising data has been generated in the field of radiosensitization . early pre - clinical studies demonstrated that the addition of the first of these drugs , hydroxyurea , to ionizing radiation ( ir ) produced a synergistic effect in vitro , leading to a large number of clinical studies in the 19701980s . these studies , mainly in cervical cancer , initially produced a great deal of interest , leading to the incorporation of hydroxyurea in the treatment protocols of many institutions . however , over time , the conclusions from these studies have been called into question and hydroxyurea has been replaced in the standard of care of cervical cancer . over the last 10 years , a number of well - done pre - clinical studies have greatly advanced our understanding of rr as a target . those advances include the elucidation of the role of p53r2 and our understanding of the temporal relationship between the delivery of ir and the response of rr . at the same time , new inhibitors with increased potency and improved binding characteristics have been discovered , and pre - clinical and early clinical data look promising . here we present a comprehensive review of the pre - clinical and clinical data in the field to date and provide some discussion of future areas of research .
[ "the study of long bones and the cells of the bone marrow is central to a myriad of research disciplines , including , but not limited to , bone biology , cancer biology , immunology , hematology , and biomechanics . the bone is a highly dynamic organ that together with the cartilage forms the skeleton to provide m...	investigation of the bone and the bone marrow is critical in many research fields including basic bone biology , immunology , hematology , cancer metastasis , biomechanics , and stem cell biology . despite the importance of the bone in healthy and pathologic states , however , it is a largely under - researched organ due to lack of specialized knowledge of bone dissection and bone marrow isolation . mice are a common model organism to study effects on bone and bone marrow , necessitating a standardized and efficient method for long bone dissection and bone marrow isolation for processing of large experimental cohorts . we describe a straightforward dissection procedure for the removal of the femur and tibia that is suitable for downstream applications , including but not limited to histomorphologic analysis and strength testing . in addition , we outline a rapid procedure for isolation of bone marrow from the long bones via centrifugation with limited handling time , ideal for cell sorting , primary cell culture , or dna , rna , and protein extraction . the protocol is streamlined for rapid processing of samples to limit experimental error , and is standardized to minimize user - to - user variability .
[ "tuberculosis ( tb ) is a major health issue in developing countries with over two billion people being infected with tuberculosis bacilli world wide ( 1 ) . although tb was recently regarded primarily as a disease of the developing countries it is now also on the increase in developed countries such as the united ...	tuberculosis ( tb ) is a major health issue in both developing and developed countries such as the uk . healthy individuals who contract the infection have only 5 - 10% chance of converting to the active disease over their lifetime . we present the clinical history of a 76 year old female who attended the emergency department complaining of wrist pain , and was only diagnosed with tb after three years . this case report emphasises the importance of including tb in the differential diagnosis when treating patients with an infection resistant to conventional antibiotics , even though risk factors for tb may not be evident or special stains for tb are negative .
[ "the value of the ketogenic diet ( kd ) has been recognized in the treatment of epilepsy , although the exact mechanisms by which it exerts its effect remain an enigma . they seem to be different from those of regular antiepileptic medications ( aeds ) , and discovering what they are may lead to its use in clinical...	although the ketogenic diet ( kd ) has been widely accepted as a legitimate and successful therapy for epilepsy and other neurological disorders , its mechanism of action remains an enigma . the use of the kd causes major metabolic changes . the most significant of them seems to be the situation of chronic ketosis , but there are others as well , for instance , high level of polyunsaturated fatty acids ( pufas ) . these primary influences lead to secondary , in part adaptive , effects , for instance changes in mitochondrial density and gene expression . clinically , the influences of the diet are considered as anticonvulsive and neuroprotective , although neuroprotection can also lead to prevention of seizures . potential clinical implications of these mechanisms are discussed .
[ "the endotracheal tube ( ett ) should be placed at the optimal level to avoid inadvertent complication . if the ett is too deep , it increases the risk of unintended single lung ventilation . on the other hand , if the ett is too shallow , it may cause vocal cord injury by the ett balloon or accidental extubation ....	abstractendotracheal tube ( ett ) should be placed at the optimal level to avoid single lung ventilation or accidental extubation . this study was performed to estimate the mid - tracheal level by using surface anatomical landmarks in adult patients.neck computed tomography images of 329 adult patients between the ages of 16 and 79 years were reviewed . in the midline sagittal plane , the levels corresponding to the vocal cords , cricoid cartilage , suprasternal notch , manubriosternal junction , and carina were identified . the surface distances from the cricoid cartilage to the suprasternal notch ( extcc - ssn ) and that from the suprasternal notch to the manubriosternal junction ( extssn - msj ) were measured . the relationship between mid - tracheal level and the surface distances was analyzed using bland altman plot.the difference between the extcc - ssn and the mid - tracheal level was 6.6 ( 12.5 ) mm , and the difference between the extssn - msj and the mid - tracheal level was 19.2 ( 6.1 ) mm . the difference between the extcc - ssn and the mid - tracheal level was smaller in females compared with males [ 1.7 ( 11.7 ) mm vs 12.8 ( 10.7 ) mm ; p < 0.001].the mid - tracheal level , which is helpful in planning the insertion depth of an ett , can be predicted by the surface distance between the cricoid cartilage and suprasternal notch in adults , especially in females .
[ "embryos generated through assisted reproductive technologies ( art ) are deemed surplus when , for some reason , they are not used for reproductive purposes ( svendsen and koch 2008 ; haimes and taylor 2011 ) ; instead , they are then disposed of or , where this is allowed by a country s art regulation , may be do...	this paper is based on linked qualitative studies of the donation of human embryos to stem cell research carried out in the united kingdom , switzerland , and china . all three studies used semi - structured interview protocols to allow an in - depth examination of donors and non - donors rationales for their donation decisions , with the aim of gaining information on contextual and other factors that play a role in donor decisions and identifying how these relate to factors that are more usually included in evaluations made by theoretical ethics . our findings have implications for one factor that has previously been suggested as being of ethical concern : the role of gratitude . our empirical work shows no evidence that interpersonal gratitude is an important factor , but it does support the existence of a solidarity - based desire to give something back to medical research . thus , we use empirical data to expand and refine the conceptual basis of bioethically theorizing the ivf stem cell interface .
[ "thyroid cancer is the most common endocrine neoplasia which accounts for about 1% of human cancers . mtc originates from calcitonin - producing cells ( c - cells ) of the thyroid gland and accounts for 35% of thyroid cancers . mtc is relatively slow - growing tumor but , if metastasized or relapsed , it becomes ve...	medullary thyroid carcinoma ( mtc ) , which originates from thyroid parafollicular c cells , accounts for 3 to 5% of thyroid malignancies . mtc occurs either sporadically or in an inherited autosomal dominant manner . hereditary mtc occurs as a familial mtc or as a part of multiple endocrine neoplasia ( men ) type 2a and b syndromes . a strong genotype - phenotype correlation has been observed between hereditary mtc and germ - line gain of function mutations of the ret proto - oncogene . most cases of pediatric mtc are hereditary whereas sporadic mtc is rare in children and is usually diagnosed in adults . therefore , mtc in children is most often diagnosed in the course of a familial genetic investigation . the standard treatment of mtc mainly requires surgery involving total thyroidectomy and central neck node dissection before extrathyroidal extension occurs . to prevent mtc development in hereditary syndromes , prophylactic thyroidectomy is performed in presymptomatic patients . an appropriate age at which the surgery should take place is determined based upon the data from genotyping , serum calcitonin measurements , and ultrasonography . for the treatment of advanced mtc cases , the broad spectrum receptor tyrosine kinase inhibitors vandetanib and cabozantinib , which also inhibit ret , are used although they are not always effective .
[ "neurosurgery is characterized by the delicate balance between surgical success and potential for devastating side effects . thanks to multiple technological improvements , the morbidity of neurosurgical interventions has substantially decreased over the last decades , allowing for the resection of previously inope...	current neuronavigation systems can not adapt to changing intraoperative conditions over time . to overcome this limitation , we present an experimental end - to - end system capable of updating 3d preoperative images in the presence of brain shift and successive resections . the heart of our system is a nonrigid registration technique using a biomechanical model , driven by the deformations of key surfaces tracked in successive intraoperative images . the biomechanical model is deformed using fem or xfem , depending on the type of deformation under consideration , namely , brain shift or resection . we describe the operation of our system on two patient cases , each comprising five intraoperative mr images , and we demonstrate that our approach significantly improves the alignment of nonrigidly registered images .
[ "the contribution to human health of the specific fatty acid ( fa ) composition of the diet has received considerable attention in the literature . fatty acids are key nutrients that affect early growth and development as well as the prevention of chronic disease in later life.1 among the fas , omega-3 polyunsatura...	omega-3 polyunsaturated fatty acids ( n-3 pufas ) , particularly eicosapentanoic acid ( epa ) and docosahexanoic acid ( dha ) , has been acknowledged as essential very long - chain fatty acids contributing to either achieving optimal health or protection against diseases , and even longevity . recent high impact studies dealing with epa and dha have sparked a renewed interest in using n-3 pufas for cancer prevention and cancer treatment , for which n-3 pufas may exert their anticancer actions by influencing multiple targets implicated in various stages of cancer development , including cell proliferation , cell survival , angiogenesis , inflammation , and metastasis against various cancers . however , gastrointestinal cancers develop implicated with the close connection between inflammation and cancer and n-3 pufas especially imposed excellent actions of antiinflammation and antioxidation as well as their restorative actions . in detail , these beneficial lipids can restore or modify inflammation - associated lipid distorsion and alteration of lipid rafts . although the chemopreventive effect of n-3 pufas has been studied in various experimental models , our understanding regarding the underlying mechanisms of n-3 pufas against gi cancer is still limited . in this review article , we described the in - detailed perspective and underlying mechanism of n-3 pufas application for gi cancers and added in vivo efficacy of n-3 pufas with fat-1 transgenic mice experience . we suggest that future work should consider the n-6/n-3 fa ratio , combination treatment of other nutritions and alteration of lipid rafts to be a key element in experimental design and analysis .
[ "sexual development in males is a multistep process , implying a delicate network of molecular events that directs the bipotential gonad to differentiate into testis ( sex determination ) and consequent differentiation of internal and external genitalia in the presence of testicular hormones ( sex differentiation )...	background and objectives:46 xy disorders of sexual development ( dsd ) cover a wide spectrum of phenotypes ranging from unambiguous female genitalia to ambiguous male genitalia with hypospadias or dysgenetic gonads . management of these patients depends on the cause of dsd , degree of feminization , age at presentation , and gender orientation . the aim of this study was to evaluate the presentation and management of patients with 46xy dsd at our center.patients and methods : all new and old patients of 46xy dsd attending the endocrine opd in a period of 16 months were included in this study . clinical , cytogenetic , hormonal , and radiological evaluation were done to identify the cause of dsd.results:among 19 patients , eight were diagnosed with disorders of gonadal development ( one with complete gonadal dysgenesis , four with partial gonadal dysgenesis , two with congenital bilateral anorchia , and one with ovotesticular dsd ) and eight with disorders of androgen synthesis and action ( one with complete androgen insensitivity syndrome [ ais ] , three with partial ais and four with 5 reductase deficiency ) . in three patients , a definitive diagnosis could not be made.conclusions:management of patients with dsd depends on etiology , gender assignment , gender orientation , hormonal treatment , genital surgery , and consequent psychosocial implications . due to the overlapping clinical and biochemical parameters in different subsets of dsd , only a preliminary etiological diagnosis can be made in some cases . genetic studies with long - term follow - up are required for an accurate diagnosis .
[ "urinary tract infection ( uti ) is a frequent cause of morbidity both in the community and in the hospital setting . the causative pathogen can vary greatly geographically , and so it is prudent to identify those with resistant strains and have current data on the appropriate empirical therapy within a region . th...	abstracturinary tract infections are one of the most common infectious diseases diagnosed in the community and in the hospital setting . their treatment is complicated by drug - resistant pathogens and the colonization by microbes of indwelling urinary catheters . this study assessed the occurrence and antimicrobial susceptibility of methicillin - resistant staphylococcus aureus ( mrsa ) uropathogens isolated for 5 consecutive years at university hospital waterford between 2010 and 2014 . we created 4 clinically relevant subdivisions , based on urine source : hospital inpatients , patients from the emergency department , patients referred from their general practitioner , and nursing home patients . we performed a retrospective review from the hospital 's electronic microbiological system and calculated resistance rates for each of the standard antimicrobial agents . during the 5-year study period , we studied 151 urine isolates obtained from 128 patients who had an mrsa cultured in their urine sample . there was 100% resistance of all mrsa isolates to flucloxacillin and coamoxiclav . ninety - eight percent of isolates were resistant to ciprofloxacin . the resistance rate for trimethoprim was 7.4% and there was only 2.7% resistance for nitrofurantoin . for a clinical subset of patients , we also demonstrated 100% sensitivity for samples tested against teicoplanin and vancomycin . urinary mrsa is an infrequently studied phenomenon , but with the rising trend of hospital superbugs nationally , its management is of critical importance . suitable agents to address this within our population include nitrofurantoin in the well patient requiring urinary mrsa eradication or vancomycin / teicoplanin in the unwell patient requiring intravenous therapy . in all groups , fluoroquinolones should be avoided due to significant resistance rates .
[ "acquired angioedema ( aae ) , an acquired deficiency of c1esterase inhibitor , is a medically treatable condition which can cause severe abdominal pain mimicking an acute surgical abdomen . this disorder is strongly associated with chronic lymphocytic leukemia ( cll ) and other indolent lymphoplasmacytic disorders...	introductionacquired angioedema ( aae ) , an acquired deficiency of c1esterase inhibitor , is a medically treatable condition which can cause severe abdominal pain mimicking an acute surgical abdomen . this disorder is strongly associated with chronic lymphocytic leukemia ( cll ) and other indolent lymphoplasmacytic disorders.discussionwe describe a patient with known cll who developed incapacitating , recurrent severe abdominal pains , culminating in partial bowel resection . signs , symptoms , laboratory and pathologic findings demonstrated aae.conclusionwider appreciation of the possibility of aae , particularly in patients with lymphoproliferative disorders , could lead to preventive therapy and spare unnecessary surgery . this is more important now that more effective medical therapies are available .
[ "", "", "distal clavicle fractures associated with partial and complete coracoclavicular ligament disruption are potentially unstable , and non - operative treatment of these fractures is associated with a high non - union rate.[13 ] partial ligament disruptions ( conoid or trapezoid ) retain some inherent stab...	purpose : distal clavicle fracture associated with complete coracoclavicular ligament disruption represents an unstable injury , and osteosynthesis is recommended . this study was performed ( 1 ) to retrospectively analyse the clinico - radiological outcomes of two internal fixation techniques , and ( 2 ) to identify and analyse radiographic fracture patterns of fracture that are associated with this injury.materials and methods : a total of 15 patients underwent osteosynthesis with either ( 1 ) acromioclavicular joint - spanning implants ( group 1 , hook plate device , n = 10 ) or ( 2 ) joint - sparing implants ( group 2 , distal radius plate , n = 5 ) ; these were reviewed at a mean period of 26.1 months ( 12 to 40 months ) . clinical outcomes were measured using constant score ( cs ) , simple shoulder test ( sst ) , and walch acj score ( ws ) . radiographs and ultrasonography were used to assess the glenohumeral and acromioclavicular joints , and the subacromial space . preoperative radiographs were analyzed for assessment of fracture lines to identify radiographic patterns . statistical analysis of the data was performed to determine any significant differences between the two groups.results:the overall clinical outcome was satisfactory ( cs 80.8 , sst 11.3 , ws 17.6 ) and a high union rate ( 93.3% ) was observed . radiographic complications ( acromioclavicular degeneration and subluxation , hook migration , abnormal ossification ) did not negatively influence the final clinical outcomes . four distinct radiographic fracture patterns were observed . a statistically significant difference ( p < 0.05 ) was observed in the reoperation rates between the two groups.conclusions:internal fixation of this fracture pattern is associated with a high union rate and favorable clinical outcomes with both techniques . a combination of distal radius plate and ligament reconstruction device resulted in stable fixation and significantly lower reoperation rates , and should be used when fracture geometry permits ( types 1 and 2).design : retrospective review of a consecutive clinical case series.setting:level 1 academic trauma service , public hospital .
[ "a 68-year - old woman visited the clinic with the chief complaints of pain , swelling , and a warm sensation in her left thigh for over 2 days prior to her visit . the patient also complained about a warm sensation during the nighttime but body temperature was normal when measured in the clinic . she had undergone...	a 68-year - old woman who suffered from polycythemia vera presented at our clinic with the chief complaints of pain , swelling , and a warm sensation in her left thigh . she had undergone a left bipolar hemiarthroplasty following a hip fracture 24 days prior to this presentation . her erythrocyte sedimentation rate and c - reactive protein ( crp ) levels were elevated . in addition , a postoperative infection was suspected in the 3-phase bone scan ; therefore , she received intravenous antibiotic therapy . this approach proved to be ineffective and she was subsequently diagnosed with a deep vein thrombosis via color doppler ultrasonography . it is interesting to note that a deep vein thrombosis can present with symptoms similar to those of a postoperative infection . furthermore , an elevated crp level is frequently observed in patients suffering from polycythemia vera . therefore , the two conditions , which require completely different treatments , can be confused . we report on this case with a review of the relevant literature .
[ "brachial plexus surgery using the da vinci surgical robot is a new procedure . to evaluate the advantages and the restrictions of the technique , a cadaveric study of supraclavicular and axillary approaches was conducted . we found that the axillary approach was useful and advantageous for lower roots , particular...	brachial plexus surgery using the da vinci surgical robot is a new procedure . although the supraclavicular approach is a well known described and used procedure for robotic surgery , axillary approach was unknown for brachial plexus surgery . a cadaveric study was planned to evaluate the robotic axillary approach for brachial plexus surgery . our results showed that robotic surgery is a very useful method and should be used routinely for brachial plexus surgery and particularly for thoracic outlet syndrome . however , we emphasize that new instruments should be designed and further studies are needed to evaluate in vivo results .
[ "older people have particular spiritual needs that are distinct from those of others , particularly in times of ill health and death and dying . it has been reported that spirituality has a positive effect on health outcomes and welfare of the elderly . nowadays , aging phenomenon and relevant problems with its com...	background : spirituality is recognized as a personally important matter to the elderly , and there are evidences of its impact on their health . the aim of this study was to explore the concept of spirituality from the perspectives of iranian healthy elderly individuals.materials and methods : a conventional qualitative content analysis of carried out with 21 healthy elderly people from both male and female genders were chosen using a purposive sampling method in tehran in 2010 - 2011 . data collection was done through semi structured interviews . a qualitative content analysis was used to analyze the participants experiences and perceptions on spirituality , using a central question what characterizes the spirituality in the iranian healthy elderly people?results : the following categories emerged from the data analysis : ( 1 ) spiritual health , with four sub categories including saying prayer as a calming factor ; beneficence as a way to god ; loss of psychological and spiritual support ; faith as a way to happiness ; ( 2 ) spiritual beliefs , with three sub categories including seeking help from god in difficulties ; god 's power over life and death ; doing good deeds is the god 's will ; and ( 3 ) religious practice with three sub categories including saying prayer ; reading quran ; and going to mosque , religious ceremonies and pilgrimage.conclusions:in this study was found that spirituality was a fundamental element in elderly individuals lives that help them to adapt with daily living conditions .
[ "according to the national regulations regarding diagnostic criteria of brain death ( bd ) , instrumental confirmatory tests should be used in certain clinical situations , such as intoxications , infratentorial processes , extensive facial damage , children younger than 2 years of age , or any case in which clini...	introductionstasis filling , defined as delayed , weak , and persistent opacification of proximal segments of the cerebral arteries , is frequently found in brain dead patients . this phenomenon causes a major problem in the development of reliable computed tomographic angiography ( cta ) protocol in the diagnosis of brain death ( bd ) . the aim of our study was to characterize stasis filling in the diagnosis of bd . to achieve this , we performed a dynamic evaluation of contrast enhancement of the cerebral and extracranial arteries in patients with bd and controls.methodsstudy population included 30 bd patients , who showed stasis filling in computed tomographic perfusion ( ctp ) series . thirty patients , after clipping of an intracranial aneurysm , constituted the control group . the study protocol consisted of cta , ctp , and angiography . time density curves ( tdcs ) of cerebral and extracranial arteries were generated using 40-s series of ctp.resultscerebral tdcs in bd patients represented flat curves in contrast to tdcs in controls , which formed steep and narrow gaussian curves . we found longer time to peak enhancement in bd patients than in controls ( 32 vs. 21 s ; p < 0.0001 ) . in bd patients , peak enhancement in the cerebral arteries occurred with a median delay of 14.5 s to peak in extracranial arteries , while no delay was noted in controls ( p < 0.0001 ) . cerebral arteries in bd patients showed lower peak enhancement than controls ( 34.5 vs. 81.5 hu ; p < 0.0001 ) . in all bd patients , ctp revealed zero values of cerebral blood flow and volume . angiography showed stasis filling in 14 ( 46.7 % ) and non - filling in 16 ( 53.3 % ) cases.conclusiona confrontation of stasis filling with ctp results showed that stasis filling is not consistent with preserved cerebral perfusion , thus does not preclude diagnosis of bd .
[ "gastric cancer is the second most frequent neoplasm of the alimentary tract after the large intestine . 5,103 people in poland were affected by it in 2008 . the case - to - death ratio of around 1 indicates unfavourable prognosis as to recovery from this disease [ 1 , 2 ] . this poor result is determined by the fa...	the typical symptoms of advanced cancer of the stomach are well known in clinical practice . the presented case concerns a patient with symptoms of left - sided renal colic , caused by a malignant tumour involving the ureter , which was diagnosed with a ct scan . the multifocal process , involving the stomach , two parts of the colon , the left ovary and the side of the pelvis , was confirmed only during surgery.the resection or partial resection of the above - mentioned organs involved by the malignant process and reconstruction of the alimentary tract as well as the ureter were performed at time of this operation . the patient 's recovery was without any complications . the histopathological findings support the diagnosis of this malignant process as disseminated stomach cancer.in the available literature only two cases of stomach cancer metastasis to the ureter have been described . in both cited examples resection of the ureter with nephrectomy was performed . the review of the literature supports the value of stomach palliative resection in prolonging life and improving quality of life .
[ "eosinophilic gastritis is an extremely rare disease that is characterized by eosinophilic infiltration of the various layers of the gastrointestinal tract in the absence of any definite causes of eosinophilia . patients with eosinophilic gastritis have diverse symptoms , including abdominal pain , emesis , abdomin...	eosinophilic gastroenteritis is very rare disorder that is characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of any definite causes of eosinophilia . it is associated with various clinical gastrointestinal manifestations , and depends on the involved layer and site . we report a case of eosinophilic gastritis presenting with severe necrosis . the symptoms disappeared immediately after beginning steroid treatment , and the eosinophil count decreased to the reference range . the patient showed eosinophilic gastritis characterized by necrotic change such as necrotizing gastritis . it is a unique presentation of eosinophilic gastritis . to the best of our knowledge , no case of eosinophilic gastritis characterized by necrotic change such as necrotizing gastritis has been previously reported in korea .
[ "the skin is the largest organ of the body and protects the organism against external physical , chemical , and biological insults such as wounding , uvb radiation , and microorganisms . this major barrier resides in the upper layers of the epidermis ( for review see segre , 2006 ) . the epidermis is the upper part...	caspase-14 is a unique member of the evolutionarily conserved family of cysteinyl aspartate specific proteinases , which are mainly involved in inflammation and apoptosis . however , recent evidence also implicates these proteases in proliferation and differentiation . although most caspases are ubiquitously expressed , caspase-14 expression is confined mainly to cornifying epithelia , such as the skin . moreover , caspase-14 activation correlates with cornification , indicating that it plays a role in terminal keratinocyte differentiation . the determination of in vitro conditions for caspase-14 activity paved the way to identifying its substrates . the recent development of caspase-14deficient mice underscored its importance in the correct degradation of ( pro)filaggrin and in the formation of the epidermal barrier that protects against dehydration and uvb radiation . here , we review the current knowledge on caspase-14 in skin homeostasis and disease .
[ "gossypiboma ( retained surgical sponge ) describes a mass of cotton or sponge that is left behind in the body cavity during a surgical operation . these foreign bodies can often mimic tumors or abscesses when detected clinically or with radiation . in fact , surgical sponges without opaque markers are the leading ...	gossypiboma is a term used to describe a foreign mass within the body that is composed of a cotton matrix . gossypiboma can cause infection or abscess formation from an early stage , or it can remain clinically silent for many years . gossypiboma can be diagnosed using several methods including abdominal x - ray films , us of the abdomen , contrast - enhanced computed tomography of the abdomen , and during surgery . however , the variable appearance of gossypiboma can lead to diagnostic misinterpretations . here , we report a successful diagnosis of gossypiboma using a novel method , that is , endoscopic ultrasound - fine - needle aspiration .
[ "to demonstrate the usefulness of enhanced depth imaging optical coherence tomography ( edi - oct ) in investigating choroidal lesions inaccessible to ultrasound sonography .", "in a 60-year - old woman with an asymptomatic choroidal nevus , normal oct was used to observe the macula and edi - oct to image the cho...	purposeto demonstrate the usefulness of enhanced depth imaging optical coherence tomography ( edi - oct ) in investigating choroidal lesions inaccessible to ultrasound sonography.methodsin a 60-year - old woman with an asymptomatic choroidal nevus , normal oct was used to observe the macula and edi - oct to image the choroidal nevus that was inaccessible to ultrasound . the exact location of the lesion in the choroid and the dimensions of the nevus were measured.resultsthe lesion was located in the superior macula , and the nevus was homogeneous in its reflectivity . we observed a thickened choroid delineated by the shadow cone behind it , measuring 1,376 325 m in the larger vertical cut and 1,220 325 m in the larger horizontal cut in an image with a 1:1 pixel mapping and automatic zoom . the macular profile and thickness were both normal.conclusionsedi-oct appears to be an excellent technique for measuring choroidal nevi and all choroidal lesions accessible to oct imaging by depicting their exact location in the choroid , their dimensions , and their demarcation from the surrounding healthy tissue , thus allowing for a more efficient and accurate follow - up .
[ "kelch - like ech - associated protein 1 ( keap1)-nuclear factor e2-related factor 2 ( nrf2 ) is a major cellular pathway that protect normal cells against oxidative and xenobiotic damage.1 nrf2 is an essential transcription factor for antioxidant and detoxification genes and is crucial for the chemopreventive effe...	nuclear factor e2-related factor 2 ( nrf2 ) is a transcription factor that upregulates expression of a battery of genes to combat oxidative and electrophilic stress . modification of kelch - like ech - associated protein 1 ( keap1 ) by reactive oxygen species stabilizes nrf2 by escaping from degradation . nrf2 then binds to antioxidant response elements ( ares ) on the promoter region of various genes . activation of the keap1-nrf2-are pathway plays critical roles in the chemopreventive effect of various phytochemicals . however , nrf2 can protect cancer cells from oxidative stress and promote cell proliferation . moreover , recent studies reveal that activation of the nrf2 pathway is critical for resistance to chemotherapeutic agents . the aim of this review is to provide a molecular basis for the use of nrf2 inhibitors in overcoming chemoresistance .
[ "a 3-year - old male , known to have isolated speech delay , presented to the emergency department with severe body aches and inability to walk . few days prior to his presentation , the child started to have flu - like symptoms in the form of rhinorrhea and low - grade fever . this was followed by irritableness , ...	rhabdomyolysis is an acute life - threatening condition that can occur in childhood secondary to many causes . the authors report the case of a 3-year - old male child who presented with acute rhabdomyolysis . the peak plasma creatine kinase level was extremely high . the 2 main causes of rhabdomyolysis in childhood are viral myositis and trauma , which can sometimes lead to acute renal failure . the highest creatine kinase levels reported in the literature so far was a 6-digit level in 2014 case report . in this study , the authors report the case of a 7-digit creatine kinase level in a child secondary to viral myositis who did not require renal dialysis .
[ "the study was approved by the institutional ethics committee , and informed consent was obtained from all patients in accordance with the tenets of the declaration of helsinki . the donors were selected based on these inclusion criteria : myopic spherical refractive error ranging from 0.5 d to 10.00 d with no asti...	purpose : to describe the technique of cryopreservation of corneal lenticules extracted after small incision refractive lenticule extraction ( relex smile ) and initial results of femtosecond laser intrastromal lenticular implantation for hyperopia.methods:lenticules were collected from patients undergoing relex smile for the correction of myopia and subjected to a tissue processing technique and cryopreservation . these lenticules were subsequently used to treat 8 hyperopic eyes and 1 aphakic eye . a femtosecond laser was used to create a pocket into each patient 's cornea , followed by implantation of a cryopreserved lenticule . the patients were monitored through follow - up examinations for a mean 155.4 days ( 38310 days).results : the mean interval from storage of lenticules to removal from liquid nitrogen was 96 days ( range , 19178 days ) . mean spherical equivalent of hyperopic eyes treated was + 4.50 1.1 diopter ( d ) . mean keratometry and pachymetry changed from preoperative 43.9 d and 531.6 m to 47.4 d and 605.2 m , respectively , postoperatively . mean residual spherical equivalent for hyperopic eyes was + 0.6 d and + 4.1 d for the aphakic eye . none of the eyes showed evidence of rejection or loss of best - corrected visual acuity at the end of the follow - up period.conclusions:the cryopreservation technique seems to be a safe method of long - term storage of refractive lenticules extracted after relex smile for use in allogeneic human subjects . it may potentially be a safe and effective alternative to excimer laser ablation for hyperopia because of the low risks of regression , haze , flap - related complications , postoperative dry eye , and higher - order aberrations.clinical trial registration url : http://www.clinicaltrials.gov . unique identifier : ctri/2014/01/004331 .
[ "sepsis is the major cause of death in the intensive care unit . despite improvement of antibiotics treatment and supportive techniques , the mortality of septic shock increases to approximately 60% . , it not only helps doctors to make an early diagnosis of sepsis , but also predicts outcomes . there have been som...	objective . to investigate the prognostic significance of serum soluble triggering receptor expressed on myeloid cells-1 ( strem-1 ) , procalcitonin ( pct ) , n - terminal probrain natriuretic peptide ( nt - pro - bnp ) , c - reactive protein ( crp ) , cytokines , and clinical severity scores in patients with sepsis . methods . a total of 102 patients with sepsis were divided into survival group ( n = 60 ) and nonsurvival group ( n = 42 ) based on 28-day mortality . serum levels of biomarkers and cytokines were measured on days 1 , 3 , and 5 after admission to an icu , meanwhile the acute physiology and chronic health evaluation ii ( apache ii ) and sequential organ failure assessment ( sofa ) scores were calculated . results . serum strem-1 , pct , and il-6 levels of patients in the nonsurvival group were significantly higher than those in the survival group on day 1 ( p < 0.01 ) . the area under a roc curve for the prediction of 28 day mortality was 0.792 for pct , 0.856 for strem-1 , 0.953 for sofa score , and 0.923 for apache ii score . multivariate logistic analysis showed that serum baseline strem-1 pct levels and sofa score were the independent predictors of 28-day mortality . serum pct , strem-1 , and il-6 levels showed a decrease trend over time in the survival group ( p < 0.05 ) . serum nt - pro - bnp levels showed the predictive utility from days 3 and 5 ( p < 0.05 ) . conclusion . in summary , elevated serum strem-1 and pct levels provide superior prognostic accuracy to other biomarkers . combination of serum strem-1 and pct levels and sofa score can offer the best powerful prognostic utility for sepsis mortality .
[ "nine male competitive cyclists participated in this study . their mean sd age , height , and body mass were 33.3 7.5 yr , 184 4 cm , and 77.3 7.0 kg , respectively . they had a maximal oxygen consumption ( vo2max ) of 4.8 0.2 lmin ( oxycon pro ; viasys healthcare , germany ) with a peak power output of 418 1...	abstractpurposethis study aimed to determine the effects of heat acclimatization on performance and pacing during outdoor cycling time trials ( tt , 43.4 km ) in the heat.methodsnine cyclists performed three tt in hot ambient conditions ( tth , approximately 37c ) on the first ( tth-1 ) , sixth ( tth-2 ) , and 14th ( tth-3 ) days of training in the heat . data were compared with the average of two tt in cool condition ( approximately 8c ) performed before and after heat acclimatization ( ttc).resultstth-1 ( 77 6 min ) was slower ( p = 0.001 ) than tth-2 ( 69 5 min ) , and both were slower ( p < 0.01 ) than ttc and tth-3 ( 66 3 and 66 4 min , respectively ) , without differences between ttc and tth-3 ( p > 0.05 ) . the cyclists initiated the first 20% of all tt at a similar power output , irrespective of climate and acclimatization status ; however , during tth-1 , they subsequently had a marked decrease in power output , which was partly attenuated after 6 d of acclimatization and was further reduced after 14 d. hr was higher during the first 20% of tth-1 than that in the other tt ( p < 0.05 ) , but there were no differences between conditions from 30% onward . final rectal temperature was similar in all tth ( 40.2c 0.4c , p = 1.000 ) and higher than that in ttc ( 38.5c 0.6c , p < 0.001).conclusionsafter 2 wk of acclimatization , trained cyclists are capable of completing a prolonged tt in a similar time in the heat compared with cool conditions , whereas in the unacclimatized state , they experienced a marked decrease in power output during the tth .
[ "worksites in glass and metal works , foundries , rolling mills , in the vicinity of hardening furnaces , rotary kilns in the cement industry , high - temperature laboratory furnaces , as well as firefighting , are associated , in addition to common mechanical hazards ( e.g. , due to splashes of molten metals and s...	the paper analyses the selected optical parameters of protective optic filters used for protection of the eyes against hazardous radiation within the visible ( vis ) and near infrared ( nir ) spectrum range . the indexes characterizing transmission and reflection of optic radiation incident on the filter are compared . as it follows from the completed analysis , the newly developed interference filters provide more effective blocking of infrared radiation in comparison with the currently used protective filters .
[ "this retrospective observational study was conducted using electronic medical records from the south central veterans affairs health care network ( visn 16 ) , one of the largest of the 23 visns in the veterans health administration ( vha ) . the vha is a national integrated health care system providing a set of c...	objectivethis study compared the clinical and economic benefits associated with dual - goal achievement , glycated hemoglobin ( hba1c ) < 7% ( 53 mmol / mol ) and ldl cholesterol ( ldl - c ) < 100 mg / dl , with achievement of only the ldl - c goal or only the hba1c goal in veterans with type 2 diabetes mellitus ( t2dm).research design and methodsthis retrospective cohort analysis evaluated electronic medical records ( veterans integrated service network 16 ) in adult t2 dm patients with two or more measurements of ldl - c and hba1c between 1 january 2004 and 30 june 2010 ( n = 75,646 ) . cox proportional hazards models were used to compare microvascular and cardiovascular outcomes by goal achievement status ; generalized linear regression models were used to assess diabetes - related resource utilization ( hospitalization days and number of outpatient visits ) and medical service costs.resultsrelative to achievement of only the ldl - c goal , dual - goal achievement was associated with lower risk of microvascular complications ( adjusted hazard ratio [ ahr ] 0.79 ) , acute coronary syndrome ( 0.88 ) , percutaneous coronary intervention ( 0.78 ) , and coronary artery bypass graft ( cabg ) ( 0.74 ) ; it was also associated with fewer hospitalization days ( adjusted incidence rate ratio [ airr ] 0.93 ) and outpatient visits ( 0.88 ) , as well as lower diabetes - related annual medical costs ( $130.89 ) . compared with achievement of only the hba1c goal , dual - goal achievement was associated with lower risk of the composite cardiovascular - related end point ( ahr 0.87 ) and cabg ( ahr 0.62 ) , as well as fewer outpatient visits ( airr 0.98).conclusionsachieving both hba1c and ldl - c goals in diabetes care is associated with additional clinical and economic benefits , as compared with the achievement of either goal alone .
[ "endotracheal intubation is one of the most important skills for anesthesiologists in securing the airway during general anesthesia and resuscitation . failure to secure the airway can cause anesthesia - related life - threatening morbidity and mortality . however , the difficult laryngoscopy and tracheal intubatio...	backgroundthe aim of this study was to determine if ultrasound ( us ) measurements of anterior neck soft tissue thickness at hyoid bone ( dshb ) , thyrohyoid membrane ( dsem ) , and anterior commissure ( dsac ) levels can be used to predict difficult laryngoscopy.material/methodswe included 203 patients age 2065 years scheduled to undergo general anesthesia in this prospective observational study . correlation analysis and receiver operating characteristic curve ( roc ) analysis were used to determine the roles of screening tests [ interincisor gap ( iig ) , thyromental distance ( tmd ) , modified mallampati score ( mms ) ] and us measurements ( dshb , dsem , dsac ) in predicting difficult laryngoscopy.resultsthere were 28 out of 203 patients categorized as difficult laryngoscopy . dshb , dsem , dsac , and mms were greater in the difficult laryngoscopy group ( p<0.0001 ) . there was a strong positive correlation between dsem and dshb ( r=0.74 ) ; moderate positive correlations between dsem and dsac ( r=0.60 ) , dshb and dsac ( r=0.69 ) ; small positive correlations between mms and dshb ( r=0.32 ) , mms and dsem ( r=0.27 ) , mms and dsac ( r=0.32 ) , all p values 0.0001 ; very small positive correlation between tmd and iig ( r=0.18 , p=0.0089 ) ; small negative correlation between iig and mms ( r=0.27 , p=0.0001 ) ; and very small negative correlations between mms and tmd ( r=0.20 , p=0.004 ) , iig and dsac ( r=0.18 , p=0.011 ) , iig and dshb ( r=0.15 , p=0.034 ) . the areas under the roc curve ( aucs ) of mms , dshb , dsem , and dsac were significantly larger compared with the reference line ( p<0.0001).conclusionsanterior neck soft tissue thicknesses measured by us at hyoid bone , thyrohyoid membrane , and anterior commissure levels are independent predictors of difficult laryngoscopy . combinations of those screening tests or risk factors with us measurements might increase the ability to predict difficult laryngoscopy .
[ "", "w celu oceny wpywu perikardiotomii tylnej na wystpowanie wysiku osierdziowego , tamponady oraz migotania przedsionkw przeprowadzono prospektywne badanie kliniczne z randomizacj .", "badana grupa skadaa si z 96 pacjentw ( 77 mczyzn i 19 kobiet ) w wieku rednio 58,1 9,8 roku . pacjenci zostali losowo przydz...	introductionpericardial effusion and atrial fibrillation occur commonly after coronary artery surgery.aim of the studya prospective randomized clinical trial was conducted to evaluate the effects of posterior pericardiotomy on the occurrence of pericardial effusion , tamponade , and atrial fibrillation.material and methodsthe study group consisted of 96 patients ( 77 male and 19 female ) at a mean age of 58.1 9.8 years . the patients were randomly assigned to one of three study groups : patients undergoing posterior pericardiotomy ( group i , n = 30 ) , controls ( group ii , n = 33 ) , and patients with additional posterior pericardial drainage tubes ( 28 mm ) who did not undergo posterior pericardiotomy ( group iii , n = 33).resultspostoperative hospitalization ( p = 0.03 ; 11.56 10.64 ) and reoperation due to tamponade ( p = 0.019 ; 12.1% ) were significantly higher in group ii . extensive pericardial effusions were detected in one patient on the first postoperative day ( group ii , n = 1 ) , in one patient on the fifth postoperative day ( group iii , n = 1 ) , and in one patient on the 30th day after the operation ( group iii , n = 1 ) . pericardial effusion exhibited regression in group i on postoperative day 30 ( p = 0.028 ) . a higher rate of postoperative atrial fibrillation was noted in group i , but no significant differences were found between the groups with regard to postoperative atrial fibrillation.conclusionspatients who did not undergo posterior pericardiotomy or did not receive posterior chest tubes exhibited residual pericardial effusion , required longer hospitalization , and had to be reoperated due to tamponade . both posterior pericardiotomy and the use of posterior tubes are effective in the early postoperative period .
[ "cancer places a huge burden on society and has been identified as the leading cause of death in both more and less economically developed countries . projections based on the globocan 2012 estimates predict a substantive increase to 19.3 million new cancer cases per year by 2025 , due to growth and ageing of the g...	cisplatin is an effective drug used in the treatment of many cancers , yet its ototoxic potential places cancer patients , exposed to this drug , at risk of hearing loss , thus negatively impacting further on a patient 's quality of life . it is paramount for health care practitioners managing such patients to be aware of cisplatin 's ototoxic properties and the clinical signs to identify patients at risk of developing hearing loss . english peer - reviewed articles from january 1975 to july 2015 were assessed from pubmed , science direct , and ebscohost . seventy - nine articles and two books were identified for this review , using mesh terms and keywords such as ototoxicity , cisplatin , hearing loss , and ototoxicity monitoring . this review provides an up - to - date overview of cisplatin - associated ototoxicity , namely , its clinical features , incidence rates , and molecular and cellular mechanisms and risk factors , to health care practitioners managing the patient with cancer , and highlights the need for a team - based approach to complement an audiological monitoring programme to mitigate any further loss in the quality of life of affected patients , as there is currently no otoprotective agent recommended routinely for the prevention of cisplatin - associated ototoxicity . it also sets the platform for effective dialogue towards policy formulation and strengthening of health systems in developing countries .
[ "the synthetic modification \n of proteins enables the construction \n of biomolecular hybrids that can be used to study protein function , deliver potent therapeutics to cellular targets , and build new materials . the synthesis of these constructs requires a suite of chemoselective \n bioconjugation reactions tha...	the synthetic modification of proteins plays an important role in chemical biology and biomaterials science . these fields provide a constant need for chemical tools that can introduce new functionality in specific locations on protein surfaces . in this work , an oxidative strategy is demonstrated for the efficient modification of n - terminal residues on peptides and n - terminal proline residues on proteins . the strategy uses o - aminophenols or o - catechols that are oxidized to active coupling species in situ using potassium ferricyanide . peptide screening results have revealed that many n - terminal amino acids can participate in this reaction , and that proline residues are particularly reactive . when applied to protein substrates , the reaction shows a stronger requirement for the proline group . key advantages of the reaction include its fast second - order kinetics and ability to achieve site - selective modification in a single step using low concentrations of reagent . although free cysteines are also modified by the coupling reaction , they can be protected through disulfide formation and then liberated after n - terminal coupling is complete . this allows access to doubly functionalized bioconjugates that can be difficult to access using other methods .
[ "\n alcohol withdrawal syndrome ( aws ) is characterized by varied symptoms that range from mild to severe intensity depending on several factors including the quantity , frequency and duration of alcohol intake , and the number of prior withdrawal episodes , as well as individual differences in the vulnerability [...	objective . to identify the underlying factor structure of alcohol withdrawal syndrome , as measured with ciwa - ar . methods . exploratory factor analysis was conducted on the items of ciwa - ar . on 201 alcohol - dependent male patients seeking treatment for alcohol withdrawal at 36 hours of abstinence . results . a three - factor solution was obtained that accounted for 68.74% of total variance . first factor had loading from four items ( 34.34% variance ) , second factor also had four items ( 24.25% variance ) , and the third had two items ( 10.04% variance ) . conclusions . factor analysis reveals the existence of multidimensionality of alcohol withdrawal as measured with ciwa - ar and we found three factors that can be named as delirious , autonomic and nonspecific factors .
[ "twenty - two workers were followed up from 15th april to 30th april 2008 during working hours , from approximately 6 am to 3 pm , for a total of 160 working hours . this included only workers who had worked more than 50% of each day 's working period and had worked for at least 10 days of the follow - up period . ...	backgroundheat illness is a major cause of preventable morbidity worldwide . workers exposed to intense heat can become unable to activate compensation mechanisms , putting their health at risk . heat stress also has a direct impact on production by causing poor task performance and it increases the possibility of work - related morbidity and injuries . during the sugarcane harvest period , workers are exposed to excessive sunlight and heat from approximately 6 am to 3 pm . a first assessment of heat stress during the 2006/2007 harvesting season served to redesign the existing rehydration measures . in this project , sugarcane workers were provided with more rehydration solutions and water during their work schedule.objectiveto assess heat stress preventive measures in order to improve existing rehydration strategies as a means of increasing productivity.methodsa small group of 22 workers were followed up for 15 days during working hours , from 6 am to 3 pm . selection criteria were defined : to have worked more than 50% of the day 's working schedule and to have worked for at least 10 days of the follow - up period . a simple data recollection sheet was used . information regarding the amount of liquid intake was registered . production output data was also registered . temperature measurements were recorded by using a portable temperature monitoring device ( easylog , model el - usb-2).resultsthe average temperature measurements were above the nicaraguan ministry of labour thresholds . seven workers drank 78 l of liquid , improving their production . output production increased significantly ( p=0.005 ) among those best hydrated , from 5.5 to 8 tons of cut sugarcane per worker per day.conclusionsproductivity improved with the new rehydration measures . awareness among workers concerning heat stress prevention was increased .
[ "choroid plexus papilloma ( cpp ) is a rare benign tumor accounting for 0.5% of all intracranial tumors that is more common in childhood , consisting of 1.5 to 6.4% of pediatric intracranial tumors.1 \n 2 the majority of cpps occur during the first 2 years of life , with 12.5 to 20% ( 10 to 12% ) reported in infant...	choroid plexus papilloma is a rare benign tumor accounting for 0.5% of all intracranial tumors . the majority of choroid plexus papillomas occur during the first 2 years of life in the ventricular system . moreover , dense calcification of the tumor is uncommon . we report an adult case of densely calcified , atypical choroid plexus papilloma that originated from the cerebellopontine angle without connection to the forth ventricle . because the case involves a rare combination of four features adult , dense calcification , atypical form , and cerebellopontine angle each characteristic associated with the choroid plexus papilloma was discussed . the finding of calcification at the cerebellopontine angle in an adult should suggest the possible presence of choroid plexus papilloma .
[ "multipath signals occur in numerous microwave and rf applications when an unwanted portion of the original transmission propagates along any alternate path and ultimately couples to the receiver distorting the amplitude and phase of the desired signal [ 14 ] . if the amplitude of the multipath signal is sufficient...	microwave imaging techniques are prone to signal corruption from unwanted multipath signals . near - field systems are especially vulnerable because signals can scatter and reflect from structural objects within or on the boundary of the imaging zone . these issues are further exacerbated when surface waves are generated with the potential of propagating along the transmitting and receiving antenna feed lines and other low - loss paths . in this paper , we analyze the contributions of multi - path signals arising from surface wave effects . specifically , experiments were conducted with a near - field microwave imaging array positioned at variable heights from the floor of a coupling fluid tank . antenna arrays with different feed line lengths in the fluid were also evaluated . the results show that surface waves corrupt the received signals over the longest transmission distances across the measurement array . however , the surface wave effects can be eliminated provided the feed line lengths are sufficiently long independently of the distance of the transmitting / receiving antenna tips from the imaging tank floor . theoretical predictions confirm the experimental observations .
[ "jaw cysts are usually painless , but they can increase in size as they absorb neighboring structures . enucleation generally induces bone regeneration within a cystic lesion less than 3 cm in diameter and eliminates the lesion ; however , it is difficult to postoperatively predict lesion recurrence and bone regene...	objectivesthe purpose of this study is to evaluate the treatment efficacy of enucleation after decompression.materials and methodsa total of 17 patients with cystic lesion of the jaw were treated with decompression followed by enucleation . pre- and postdecompression panoramic radiographs were analyzed.resultsthe mean percentage of reduction after decompression was 64% . the reaction was graded as good ( > 80% ) in five patients ( 29.4% ) , moderate ( 50%-80% ) in nine patients ( 52.9% ) , and poor ( < 50% ) in three patients ( 17.6% ) . the reduction rate of larger cystic lesions was faster than that of smaller lesions . however , the reduction rate was not affected by age . the duration of follow - up ranged from one to eight years . there were no complications , and one case recurred.conclusiondecompression is an effective method for the initial treatment of jaw cysts .
[ "for the first time , the presented data suggest that a variant in the retn gene plays a significant role in acne pathogenesis . we also demonstrate an excess transmission of mutant allele g at retn-420 from 130 trio families using tdt analysis . therefore , we suggest that inherited variation in retn at -420 appea...	resistin ( retn ) , recently found to be relevant to inflammation and inflammatory disorders . we , therefore , aimed to investigate the potential role of retn gene polymorphism in pathogenesis of acne vulgaris with familial history . we investigated the retn-420c / g polymorphism in 180 patients with acne vulgaris and 180 healthy individuals in a case - control association analysis . in this study , we also investigated the heritability of the retn susceptible allele from 140 trio families with acne affected offspring . the genotyping was performed by polymerase chain reaction and direct dna sequencing . the retn-420c / g polymorphism was significantly associated with acne in patients compared with healthy controls ( p=0.014 ) . the minor allele g at -420 was more prevalent in cases vs. controls ( p=0.002 ) . the retn-420c / g polymorphism was significantly associated with severity of acne vulgaris in patients ( p=0.0097 ) . the results of a transmission disequilibrium test revealed a significant association between the retn-420c / g polymorphism and acne vulgaris ( p<0.001 ) . for the first time in the literature , to our knowledge , we demonstrate a significant association of the retn-420c / g functional polymorphism with familial acne vulgaris .
[ "many studies over the past 15 years have focused on discovering solvents that help promote efficient cc bond formation under benign reaction conditions . new solvents in dielsalder(2 ) and barbier reactions have been sought to help streamline the one - pot transformations further , reducing synthetic steps and org...	indium - promoted coupling reactions between propargyl aldehydes ( 1 ) and -chloropropargylphenyl sulfide are reported . although water has been shown to accelerate indium metal promoted reactions , the reverse pattern was observed in this series . use of n - methylformamide ( nmf ) , which has not previously been a solvent known for use in indium - promoted reactions , afforded an acceleration of these barbier - style reactions compared to water . indium - promoted reactions in this study also showed excellent regiocontrol and good stereocontrol , allowing for easy entry into the formation of epoxydiyne and enediyne skeletal structures . this paper also describes use of the barbier coupled product ( 2 ) as a new , and easy , entry into the formation of enediyne and epoxydiyne skeletal structures .
[ "sepsis is the systemic inflammation caused by infection with bacteria , viruses , fungi , parasites , or toxic products , and has become one of the leading causes of mortality in children . in developed countries , the mortality rate of pediatric sepsis is about 210% and is as high as 50% in developing countries ....	backgroundpediatric sepsis has high morbidity in children , may lead to acute kidney injury ( aki ) , and further aggravate the disease . baicalin is a kind of flavonoid in scutellaria baicalensis georgi and has been reported to protect against several diseases , but its roles in septic aki remain unclear . this study aimed to uncover the effects of baicalin in aki during pediatric sepsis.material/methodsblood urea nitrogen ( bun ) and serum creatinine ( cr ) levels were detected in 50 pediatric patients , who underwent basic therapy with or without baicalin adjunctive therapy . mouse sepsis models were constructed by cecal ligation and puncture ( clp ) and treated with baicalin intragastrically , after which bun and cr examination , tunel apoptosis assay , and expression analyses of bax and bcl2 were performed.resultsbaicalin adjunctive therapy significantly decreased bun and cr levels in pediatric sepsis patients ( p<0.05 ) . clp led to elevated bun and cr levels in the mouse model ( p<0.01 ) , indicating kidney injury accompanied by sepsis . baicalin decreased bun and cr levels ( p<0.05 ) , and reduced the apoptotic cell percent in the renal tissue ( p<0.05 ) of the clp model . it inhibited bax and promoted bcl2 in the renal tissue , which was consistent with cell apoptosis changes.conclusionsbaicalin is capable of suppressing renal cell apoptosis and protecting against aki in pediatric sepsis . this study provides a potential adjunctive therapy for treating aki in pediatric sepsis , and further research is necessary to reveal its deeper mechanisms .
[ " the main cause of treatment failure and death in cancer patients is metastasis the formation of secondary tumors in organs distant from the original neoplastic cell tissue . adjuvant therapy of proven efficacy is not currently available for cancer patients ; therefore , the search for new targets of therapeut...	the receptor for advanced glycation end - products ( rages ) is associated with the malignancy of cancer . a recent study has suggested that glyceraldehyde - derived ages ( glycer - ages ) enhanced the malignancy of melanoma cells , but glucose - derived ages did not . however , the effects of glycer - ages on other cancer cells remain poorly understood , and the molecular mechanisms behind the above - mentioned effect have not been clarified . the present paper aimed to examine the effect of glycer - ages on cultured lung cancer a549 cells . rage was expressed in a549 cells . glycer - ages significantly attenuated cell proliferation . furthermore , glycer - ages enhanced the migration capacity of the cells by activating rac1 via ros and also increased their invasion capacity . we demonstrated that glycer - ages enhanced the migration and invasion of a549 cells rather than their proliferation . these results suggest that glycer - ages play a critical role in the malignancy of cancer rather than its proliferation and are potential targets for therapeutic intervention .
[ "osseointegrated implants are a practical alternative to traditional prosthodontics ; however , designing an implant - supported prosthesis with function and esthetics is a challenge . malaligned implants often complicate the clinical laboratory procedures employed for fabrication of superstructures . due to improp...	aim : demand from implant patients for quality and efficient treatment is increasing . fortunately dental implant treatment is evolving with patients expectations.materials and methods : the study comprised of 45 patients for whom 89 implants were placed at different sites . efficacy of the stents is evaluated in determining the position and diameter of the implants.conclusion:this study shows the extreme accuracy of this surgical stents in implant installation in terms of position and diameter .
[ "type 1 diabetes ( t1d ) is characterized by autoimmune destruction of pancreatic -cells , primarily mediated by t lymphocytes , resulting in insulin deficiency and lifelong exogenous insulin dependence ( 1 ) . latent autoimmune diabetes in adults ( lada ) is a subtype of autoimmune diabetes , but the progression o...	objectiveb lymphocytes play an important role in the immunopathogenesis of autoimmune diabetes . we hypothesized that the altered b - cell subset phenotype is associated with autoimmune diabetes.research design and methodspatients with type 1 diabetes ( t1d ) ( n = 81 ) , latent autoimmune diabetes in adults ( lada ) ( n = 82 ) , or type 2 diabetes ( t2d ) ( n = 95 ) and healthy control subjects ( n = 218 ) with normal glucose tolerance ( ngt ) were recruited . we determined the percentage of circulating b - lymphocyte subsets , including cd19+cd23cd21 + ( marginal zone b [ mzb ] ) , cd19+cd23+cd21 ( follicular b [ fob ] ) , and cd19+cd5+cd1dhi ( interleukin-10producing regulatory b [ b10 ] ) cells by flow cytometry.resultspatients with t1d or lada had increased percentages of mzb cells and decreased percentages of fob cells compared with healthy control subjects with ngt and patients with t2d . moreover , patients with t1d showed the lowest frequency of b10 cells compared with patients with lada or t2d , whereas healthy control subjects expressed the highest frequency of b10 cells . of note , the frequency of mzb cells was negatively associated and the frequency of fob cells was positively associated with fasting c - peptide ( fcp ) . the frequency of b10 cells was positively correlated with fcp and negatively correlated with hemoglobin a1c.conclusionsthe data show that patients with t1d or lada express an altered frequency of b - cell subsets , which is associated with islet function and glycemia . these findings suggest that b lymphocytes may be involved in loss of self - tolerance and -cell destruction and could be used as a biomarker and potential target for immunological intervention .
[ "human papillomavirus ( hpv ) , a virus from the papillomavirus family , is capable of infecting humans . about 200 different strains of hpv identified , based on dna homology , have been found to be etiologically linked to cervical , vaginal , vulvar , penile , anal , oral , and plantar infectious lesions and canc...	human papillomavirus ( hpv ) infection is the leading cause of cancer mortality among women worldwide . the molecular understanding of hpv proteins has significant connotation for understanding their intrusion in the host and designing novel protein vaccines and anti - viral agents , etc . genomic , proteomic , structural , and disease - related information on hpv is available on the web ; yet , with trivial annotations and more so , it is not well customized for data analysis , host - pathogen interaction , strain - disease association , drug designing , and sequence analysis , etc . we attempted to design an online reserve with comprehensive information on hpv for the end users desiring the same . the human papillomavirus proteome database ( hpvpdb ) domiciles proteomic and genomic information on 150 hpv strains sequenced to date . simultaneous easy expandability and retrieval of the strain - specific data , with a provision for sequence analysis and exploration potential of predicted structures , and easy access for curation and annotation through a range of search options at one platform are a few of its important features . affluent information in this reserve could be of help for researchers involved in structural virology , cancer research , drug discovery , and vaccine design .
[ "according to numerous estimations , 15% to 29% of patients with cataract have 1.5 diopters ( d ) of refractive astigmatism.1,2 cataract surgeons usually prefer to treat cataract and correct refractive ( spherical and astigmatic ) disorders at the time of the surgery . corneal incision ( astigmatic keratotomy ) and...	purpose : to present clinical results of toric intraocular lens ( iol ) implantation for preexisting astigmatism correction and determine the time of any postoperative rotation.patients and methods : twenty - nine eyes of 19 patients underwent uncomplicated phacoemulsification and were implanted with an acrysof toric iol . uncorrected visual acuity , residual astigmatism , and postoperative rotation of the iol were estimated one and six months after the operation.results:uncorrected visual acuity was 0.5 in 26 of 29 eyes ( 89.7% ) and 0.8 in 19 of 29 patients ( 65.5% ) . the mean toric iol axis rotation was 2.2 1.5 ( range 0.67.8 ) one month postoperation and 2.7 1.5 ( range 0.98.4 ) six months postoperation.conclusion:implantation of one - piece hydrophobic acrylic toric iols appears to have acceptable stability , which encourages visual outcome and emerges as an attractive alternative for correction of refractive astigmatism .
[ "song is a complex , learned motor skill that involves the precise coordination of vocal and respiratory musculature in order to produce highly stereotyped renditions of a memorized song model . two pathways contributed to this behavior are identified in the songbird forebrain : the motor pathway that is required t...	the song of zebra finch is stable in life after it was learned successfully . vocal plasticity is thought to be a motor exploration that can support continuous learning and optimization of performance . the activity of ra , an important pre - motor nucleus in songbird 's brain , influences the song directly . this variability in adult birdsong is associated with the activity of nmda receptors in lman - ra synapses , but the detailed mechanism is unclear . the control of gain refers to modulation of a neuron 's responsiveness to input and is critically important for normal sensory , cognitive , and motor functions . here , we observed the change of gain in ra projection neurons after exogenous nmda was applied to activate nmda receptors using the whole - cell current clamp recording . we found that nmda substantially increased the slope ( gain ) of the firing rate - current relationship in ra projection neurons . the ampa receptor - dependent excitability played a crucial role in the modulation of gain by nmda . these results suggested that nmda receptors may regulate the dynamics of ra projection neurons by input - output gain .
[ "first described by veterinarians , pythiosis is a serious life- and limb - threatening infection endemic to thailand , but rarely seen in the western hemisphere . known to infect immunocompetent horses , dogs , and other large animals,2 , 3 \n pythium infection was first reported in humans in 1989 in association w...	introductionpythiosis is a serious life- and limb - threatening infection endemic to thailand , but rarely seen in the western hemisphere . here , we present a unique case of vascular pythiosis initially managed with limb - sparing vascular bypass grafts complicated by a pseudoaneurysm in our repair.presentation of casethe patient is a 17 year - old jamaican male with severe aplastic anemia . he sustained a minor injury to his left leg while fishing in jamaica , which evolved to become an exquisitely tender inguinal swelling . his physical exam and imaging were significant for arteriovenous fistula with limb ischemia . pathology obtained during surgery for an extra - anatomic vascular bypass showed extensive invasion by pythium insidiosum . he later developed a pseudoaneurysm at the site of proximal anastomosis and required urgent intervention.discussionthis patient presented with a rare , but classic case of vascular pythiosis , which was unrecognized at the time of presentation . a variety of therapeutic modalities have been used to treat this disease , including antibiotics , antifungals , and immunotherapy , but the ultimate management of vascular pythiosis is surgical source control.conclusiona high index of suspicion in susceptible patients is needed for timely diagnosis of vascular pythiosis to achieve optimal source control .
[ "", "tissue culture methods and irradiation procedure have been described in . the three dimensional tissue culture model ( 3d epioral ) and media were purchased from mattek corporation ( ashland , ma ) . the 3d epioral tissue is a co - culture organotypic model and consisted of human fibroblasts on the bottom an...	we evaluated a three - dimensional ( 3d ) human oral cell culture that consisted of two types of cells , oral keratinocytes and fibroblasts as a model of oral mucositis which is a debilitating adverse effect of chemotherapy and radiation treatment . the 3d cell culture model was irradiated with 12 or 2 gy , and total rna was collected 6 h after irradiation to compare global gene expression profiles via microarray analysis . here we provide detailed methods and analysis on these microarray data , which have been deposited in gene expression omnibus ( geo ) : gse62395 .
[ "adolescents in sub - saharan africa face high exposure to human immunodeficiency virus ( hiv ) infection . despite all efforts to prevent the disease , prevalence estimates in sub - saharan unaids ( i.e. , the joint united nations programme on hiv and aids ) priority countries range from 1.3 to 15.6 % among young...	self - report of sexual behavior among adolescents is notoriously inconsistent , yet such measures are commonly used as outcomes for human immunodeficiency virus ( hiv ) prevention intervention trials . there has been a growing interest in the use of hiv and other sexually transmitted disease biomarkers as more valid measures of intervention impact in high hiv prevalence areas , particularly in sub - saharan africa . we examine the challenges , benefits , and feasibility of including hiv and herpes simplex virus type 2 ( hsv-2 ) biomarker data , with details about different data collection and disclosure methods from two adolescent prevention trials in kenya and zimbabwe . in kenya , whole blood samples were collected using venipuncture ; adult guardians were present during biomarker procedures and test results were disclosed to participants and their guardians . in contrast , in zimbabwe , samples were collected using finger pricks for dried blood spots ( dbs ) ; guardians were not present during biomarker procedures , and results were not disclosed to participants and/or their guardians . in both countries , prevalence in the study samples was low . although the standard of care for testing for hiv and other sexually transmitted infections includes disclosure in the presence of a guardian for adolescents under age 18 , we conclude that more research about the risks and benefits of disclosure to adolescents in the context of a clinical trial is needed . notably , current serological diagnosis for hsv-2 has a low positive predictive value when prevalence is low , resulting in an unacceptable proportion of false positives and serious concerns about disclosing test results to adolescents within a trial . we also conclude that the dbs approach is more convenient and efficient than venipuncture for field research , although both approaches are feasible . manufacturer validation studies using dbs for hsv-2 , however , are needed for widespread use .
[ "stroke is rare in children , however , a common cause of neurological disease , and it is a major cause of death ranks in the top ten in pediatric period11,15 ) . documented incidence has been reported as 2.5 - 8/100000 children / year12,13 ) . medical treatment includes maintaining cerebral perfusion pressure wit...	objectivelife - threatening hemispheric stroke is associated with a high mortality and morbidity . decompressive hemicraniectomy has been regarded as an effective treatment option for refractory intracranial hypertension . here , we reported the clinical course of 5 children with decompressive craniectomy and duroplasty after non - traumatic refractory intracranial hypertension.methodsfour toddlers and one preschool - girl were included in this study ; there were 3 boys and 2 girls with a mean age of 34.6 months ( range 17 - 80 ) . decompressive craniectomy including duroplasty was performed in cases of dilatation of pupil size after intensified standard medical therapy had proven insufficient . all children had a pediatric glasgow coma scale score < 8 at pre - operation state . the mean time - point of craniectomy after stroke attack was 12 hours ( range 4 - 19).resultsduring the long - term follow - up period ( mean 47.6 months ) , no children died . one year later , when we checked their glasgow outcome scale scores , only one toddler received a score of 4 ( moderate disability ) . but the others had good recoveries although they had minor physical or mental deficits . according to the pediatric cerebral performance category scale , 4 children received a score of 2 ( mild disability).conclusiondespite our small cases , we suggest that decompressive hemicraniectomy and duroplasty is an acceptable and life - saving treatment for refractory intracranial hypertension after unilateral hemispheric stroke in toddlers and preschool children .
[ "this was a double - blind , randomized , crossover trial in accordance with the declaration of helsinki and good clinical practice . the primary objective was to assess albuminuria during different treatments compared with that with placebo ; secondary objectives were to assess effect on 24-h blood pressure , glom...	objectivewe investigated whether the antiproteinuric effect of the direct renin inhibitor aliskiren is comparable to that of irbesartan and the effect of the combination.research design and methodsthis was a double - blind , randomized , crossover trial . after a 1-month washout period , 26 patients with type 2 diabetes , hypertension , and albuminuria ( > 100 mg / day ) were randomly assigned to four 2-month treatment periods in random order with placebo , 300 mg aliskiren once daily , 300 mg irbesartan once daily , or the combination using identical doses . patients received furosemide in a stable dose throughout the study . the primary end point was a change in albuminuria . secondary measures included change in 24-h blood pressure and glomerular filtration rate ( gfr).resultsplacebo geometric mean albuminuria was 258 mg / day ( range 842,361 ) , mean sd 24-h blood pressure was 140/73 15/8 mmhg , and gfr was 89 27 ml / min per 1.73 m2 . aliskiren treatment reduced albuminuria by 48% ( 95% ci 2762 ) compared with placebo ( p < 0.001 ) , not significantly different from the 58% ( 4279 ) reduction with irbesartan treatment ( p < 0.001 vs. placebo ) . combination treatment reduced albuminuria by 71% ( 5979 ) , more than either monotherapy ( p < 0.001 and p = 0.028 ) . fractional clearances of albumin were significantly reduced ( 46 , 56 , and 67% reduction vs. placebo ) . twenty - four - hour blood pressure was reduced 3/4 mmhg by aliskiren ( ns / p = 0.009 ) , 12/5 mmhg by irbesartan ( p < 0.001/p = 0.002 ) , and 10/6 mmhg by the combination ( p = 0.001/p < 0.001 ) . gfr was significantly reduced 4.6 ( 95% ci 0.38.8 ) ml / min per 1.73 m2 by aliskiren , 8.0 ( 3.612.3 ) ml / min per 1.73 m2 by irbesartan , and 11.7 ( 7.415.9 ) ml / min per 1.73 m2 by the combination.conclusionsthe combination of aliskiren and irbesartan is more antiproteinuric in type 2 diabetic patients with albuminuria than monotherapy .
[ "nanobiomaterials are characterized by constituent \n particles and/or surface features less than 100 nm \n in at least one dimension \n . \n starting with photolithography and dry etching in the \n 1980 's to high - resolution electron beam lithography and other technologies \n in the 1990 's , nanotechnology all...	cell - surface interactions play a crucial role for biomaterial application in orthopaedics . it is evident that not only the chemical composition of solid substances influence cellular adherence , migration , proliferation and differentiation but also the surface topography of a biomaterial . the progressive application of nanostructured surfaces in medicine has gained increasing interest to improve the cytocompatibility and osteointegration of orthopaedic implants . therefore , the understanding of cell - surface interactions is of major interest for these substances . in this review , we elucidate the principle mechanisms of nano- and microscale cell - surface interactions in vitro for different cell types onto typical orthopaedic biomaterials such as titanium ( ti ) , cobalt - chrome - molybdenum ( cocrmo ) alloys , stainless steel ( ss ) , as well as synthetic polymers ( uhmwpe , xlpe , peek , plla ) . in addition , effects of nano- and microscaled particles and their significance in orthopaedics were reviewed . the significance for the cytocompatibility of nanobiomaterials is discussed critically .
[ "six a17 bac and one fosmid library were used to create mt3.5 ( table s1 ) . most were processed by sanger paired - end sequencing of 3 - 6 kb shotgun libraries . sequences were downloaded in february / march 2009 with scaffolding performed by aligning all bac and fosmid ends against contigs and then anchored and o...	legumes ( fabaceae or leguminosae ) are unique among cultivated plants for their ability to carry out endosymbiotic nitrogen fixation with rhizobial bacteria , a process that takes place in a specialized structure known as the nodule . legumes belong to one of the two main groups of eurosids , the fabidae , which includes most species capable of endosymbiotic nitrogen fixation 1 . legumes comprise several evolutionary lineages derived from a common ancestor 60 million years ago ( mya ) . papilionoids are the largest clade , dating nearly to the origin of legumes and containing most cultivated species 2 . medicago truncatula ( mt ) is a long - established model for the study of legume biology . here we describe the draft sequence of the mt euchromatin based on a recently completed bac - assembly supplemented with illumina - shotgun sequence , together capturing ~94% of all mt genes . a whole - genome duplication ( wgd ) approximately 58 mya played a major role in shaping the mt genome and thereby contributed to the evolution of endosymbiotic nitrogen fixation . subsequent to the wgd , the mt genome experienced higher levels of rearrangement than two other sequenced legumes , glycine max ( gm ) and lotus japonicus ( lj ) . mt is a close relative of alfalfa ( m. sativa ) , a widely cultivated crop with limited genomics tools and complex autotetraploid genetics . as such , the mt genome sequence provides significant opportunities to expand alfalfa s genomic toolbox .
[ "surgical treatment of avascular necrosis ( avn ) of head of femur include core decompression , osteotomies , nonvascularized bone grafting , free vascularized fibular grafts , hip resurfacing , bipolar hip arthroplasty ( bha ) and total hip arthroplasty ( tha).123 tha is indicated in the young individual in avn wi...	background : bipolar hip arthroplasty ( bha ) is one of the options for treatment of avascular necrosis ( avn ) of the femoral head . acetabular erosion and groin pain are the most allowing for gross motion between the common complications . we propose that these complications are secondary to improper acetabular preparation allowing for motion between the bha head and the acetabulum.materials and methods : the current study retrospectively evaluated patientsrecords from case files and also called them for clinical and radiological followup . 96 hips with avn of the femoral head treated with bha were included in the study . all patients were males with a mean age of 42 years ( range 30 - 59 years ) . in all cases , the acetabulum was gently reamed till it became uniformly concentric to achieve tight fitting trial cup . clinical followup using harris hip score ( hhs ) and radiological study for cup migration were done at followup.results:the mean followup was 7.52 years ( range 4 - 16 years ) . the hhs significantly improved from a preoperative value of 39.3 ( range , 54 - 30 ) to a postoperative value of 89.12 ( range 74 - 96 ) . according to hhs grades , the final outcome was excellent in 52 hips , good in 28 and fair in 16 hips . hip and groin pain was reported in four hips ( 5% ) , but did not limit activity . subsidence ( less than 5 mm ) of the femoral component was seen in 8 cases . subgroup analysis showed patients with ficat stage 3 having better range of motion , but similar hhs as compared to ficat stage 4 patients.conclusion:bipolar hip arthroplasty ( bha ) using tight fitting cup and acetabular reaming in avn hip has a low incidence of groin pain , acetabular erosion and revision in midterm followup . good outcome and mid term survival can be achieved irrespective of the ficat stage .
[ "the success of valproic acid ( vpa , 2-propylpentanoic acid ) , a short branched chain fatty acid , for the therapy of absence seizures , partial seizures , tonic - clonic seizures , bipolar disorder , schizoaffective disorder , social phobias , neuropathic pain and for the prophylaxis and treatment of migraine he...	valproic acid ( vpa ) has successfully been used in the therapy of a number of conditions including absence seizures , partial seizures , tonic - clonic seizures , bipolar disorder , schizoaffective disorder , social phobias , neuropathic pain and migraine headaches . there is a high rise in number of cases of toxicity due to overdose of vpa . hyperammonemia , a common side - effect of vpa , is caused by several proposed etiologies , reported as having uncertain correlation with vpa dose or concentration . we present here a case of a 25-year - old female patient with a past history of psychiatric complaints , presented with elevated serum vpa levels associated with elevated venous ammonia levels subsequent to vpa overdose . later in the presence of sub - therapeutic serum vpa levels her venous ammonia levels remained raised and slowly down - trending . vpa levels and ammonia levels were found to be normal after 14 days . patient was treated with levocarnitine . her liver enzymes were never elevated . different decay kinetics of venous ammonia in presence of high and low concentrations of vpa indicates that vpa can cause symptomatic hyperammonemia via more than one concurrent etiological mechanism . in this patient , the mechanisms causing hyperammonia secondary to vpa use were not related to hepatic damage or carnitine deficiency .
[ "intramammary infection ( mastitis ) is the most common reason for the use of antimicrobials in dairy cows . antimicrobials have been used to treat mastitis for more than fifty years , but consensus about the most efficient , safe , and economical treatment is still lacking . the concept of evidence - based medicin...	treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account . in acute mastitis , where bacteriological diagnosis is not available , treatment should be initiated based on herd data and personal experience . rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial . treating subclinical mastitis with antimicrobials during lactation is seldom economical , because of high treatment costs and generally poor efficacy . all mastitis treatment should be evidence - based , i.e. , the efficacy of each product and treatment length should be demonstrated by scientific studies . use of on - farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials .
[ "approximately 40 million people are infected with the human immunodeficiency virus ( hiv ) worldwide ( unaids 2006 ) . infections by this lentivirus from the family retroviridae are characterized by a long asymptomatic period after host immune defenses control the initial infection . during this subsequent chronic...	abstractmany pathogens of humans are blood borne , including hiv , malaria , hepatitis b and c , west nile virus , dengue , and other viral hemorrhagic fevers . although several of these pathogens are transmitted by blood - feeding arthropods , hiv is not . a number of properties of hiv and its life cycle have been identified as proximate explanations for the absence of arthropod transmission , but little consideration has been given to why hiv has not evolved this form of transmission . we consider the empirical evidence for arthropod transmission , and suggest that mechanical transmission has not evolved in hiv because such strains would induce a faster onset of aids during infection , which would thereby limit their ability to spread . on the other hand , it is not as clear why biological transmission has not occurred . available data suggests that a lack of appropriate genetic variation in hiv is one explanation , but it is also possible that a conflict between natural selection occurring within and between infected individuals has prevented its evolution instead . we discuss the potential significance of these ideas , and argue that taking such an evolutionary perspective broadens our understanding of infectious diseases and the potential consequences of public health interventions .
[ "in the normal kidney , immunohistochemical expression of contractile protein alpha - smooth muscle actin ( asma ) is limited to the vascular smooth muscle cells . in pathological conditions , the expression of asma the first experimental publication on this subject , by johnson et al , involved a series of clinica...	summarybackgroundin a healthy kidney , contractile protein alpha - smooth muscle actin ( asma ) is immunohistochemically strongly expressed only in the blood vessels , while in pathological conditions it can be visualized in glomerular mesangial cells and interstitial myofibroblasts . the aim of this study was to explore the possible correlation between expression of asma in glomerulonephritis ( gn ) and indicators of renal function.material/methodswe analyzed expression of asma in percutaneous renal biopsy of 142 adult and pediatric patients with gn and its correlation with blood pressure , serum creatinine , creatinine clearance and 24-hour urine protein at the time of biopsy . immunoexpression of asma was analyzed quantitatively using computer - assisted morphometric analysis . relative surface of asma expression in all glomeruli and interstitium was calculated for each patient.resultsin adults and children , greater expression of asma in interstitium was associated with higher serum creatinine and reduced creatinine clearance . conversely , greater asma expression in glomeruli was associated with normal or decreased serum creatinine in adults and increased creatinine clearance in children . in children , correlation was found between high blood pressure and asma expression in interstitium.conclusionswe confirmed that interstitial expression of asma is associated with reduced renal function at time of biopsy . the connection of asma expression in glomeruli with lower serum creatinine and normal or increased creatinine clearance suggests a favorable role of this phenotypic change in glomerular filtration rate ; further investigation is needed .
[ "chondroblastoma accounts for < 1% of all primary bone tumors . usually occurring in young adolescents , however , unusual sites of presentation such as patella , talocalcaneal , and temporomandibular joint has been reported . since last decade , fine needle aspiration cytology ( fnac ) has evolved as a simple , sa...	chondroblastoma is a rare , giant cell - rich , benign neoplasm of bone . since the past few decades fine needle aspiration cytology ( fnac ) has gained momentum in preoperative diagnosis of bone lesions . at cytology , other giant cell - rich tumors and tumorlike lesions such as aneurysmal bone cyst ( abc ) , giant cell tumor , and chondromyxoid fibroma fall under the differential diagnosis of chondroblastoma . due to the difference in the treatment protocol and prognosis , preoperative diagnosis is mandatory . we describe the cytomorphology in two cases of chondroblastoma diagnosed at fnac and confirmed by histopathology . at cytology , the presence of giant cells , chondroid matrix , mononuclear cells with nuclear indentation , and grooving along with glassy , vacuolated cytoplasm are characteristic of chondroblastoma . in addition to this , the presence of chicken wire calcification is a useful clue to the accurate diagnosis of chondroblastoma at fnac .
[ "suicide is a grave public health issue with a global mortality rate of 16 per 100,000 individuals.1 suicide is one of the top three leading causes of death , particularly among individuals aged 1544 years , which is a productive age group.1 suicide is a complex event that is influenced by biological , cultural , p...	backgroundsuicide is a grave public health issue that is responsible for a high mortality rate among individuals aged 1544 years . attitudes toward suicide among medical staff members have been associated with appropriate therapeutic responses to suicidal individuals . the aim of this study was to examine the effects of parental rearing on attitudes toward suicide among japanese medical college students.methodswe examined the association between parental bonding and attitudes toward suicide in 160 medical college students in japan . the parental bonding instrument was used to assess the attitudes and behaviors of parents . the attitudes toward suicide were evaluated using the japanese version of the attitudes toward suicide questionnaire.resultsthe mean age of the subjects was 25.24.0 years old . the majority of the participants in our study agreed that anyone could commit suicide ( 88.8% ) and that suicide is preventable ( 86.3% ) . after adjusting for age and sex , multivariate regression analysis revealed that maternal care approached a statistically significant association with the right to suicide attitude . under the same conditions , maternal care was shown to be significantly associated with the common occurrence attitude . no other significant relationships were observed between parental bonding and attitudes toward suicide.conclusionthis study suggests that a higher level of maternal care ensures that children think that suicide occurs less commonly . the promotion of best practices for suicide prevention among medical students is needed . child rearing support might be associated with suicide prevention .
[ "copd is characterized by persistent airway obstruction , usually of a progressive nature and associated with an enhanced chronic inflammatory response in airways to noxious particles or gases.1 copd is associated with increased mortality and reduced life expectancy.2 of the 3.8 million mortalities caused by chroni...	backgroundlow adherence to global initiative for chronic obstructive lung disease ( gold ) guideline recommendations has been reported worldwide . there has been no study on the adherence to gold guidelines for copd treatment in turkey.objectivesto investigate the rates of adherence to gold 2010 guidelines for copd treatment among pulmonologists.designa multi - center , cross - sectional , observational study was carried out in eleven pulmonary outpatient clinics across turkey . adherence to gold was evaluated through hospital records . demographic and clinical data were recorded.resultsstudy included 719 patients ( mean age : 62.99.7 years ; males 85.4% ) of whom 16 was classified as gold stage i , 238 as ii , 346 as iii , and 119 as iv , and only 59.5% received appropriate treatment . rates of guideline adherence varied across gold stages ( i , 6.3% ; ii , 14.7% ; iii , 84.4% ; and iv , 84% ) . causes of inappropriate therapies were overtreatment ( stage i , 100% and stage ii , 91.1% ) , undertreatment ( stage iii , 3.3% and stage iv , 10.9% ) and lack of treatment ( stage ii , 3.8% ; stage iii , 2.3% ; and stage iv , 5.9% ) . the most preferred regimen ( 43.4% ) was long - acting 2-agonist - inhaled corticosteroid - long - acting muscarinic antagonist . overall , 614 patients ( 89% ) received treatment containing inhaled corticosteroid.conclusionpulmonologists in turkey have low rates of adherence to gold guidelines in copd treatment . inappropriateness of therapies was due to overtreatment in early stages and excessive use of inhaled corticosteroid ( ics ) in all disease stages .
[ "amphotericin b ( amb ) , an amphoteric polyene macrolide , has been considered one of the main options of antifungal therapy for serious and life - threatening mycotic infections for over 50 years despite the introduction of newer antifungal medications such as the azoles ( e.g. , voriconazole ) and echinocandins ...	backgroundnephrotoxicity is the most clinically significant adverse reaction of amphotericin b. different aspects of amphotericin b ( amb ) nephrotoxicity have not been studied well in our population.objectivesthe purpose of this study was to assess the frequency , time onset , and possible associated factors of amb nephrotoxicity in hospitalized patients in hematology - oncology wards in the southwest of iran.patients and methodsa cross - sectional , observational study was performed over a period of 9 months at 2 hematology - oncology and 1 hematopoietic stem cell transplantation wards at namazi hospital . patients aged 15 years or older with no documented history of acute kidney injury or chronic kidney disease who were scheduled to receive formulations of amb intravenously for at least 1 week were included . the required demographic and clinical data of the patients were recorded . urine urea , creatinine , sodium , potassium , and magnesium levels were measured at days 0 , 3 , 5 , 7 , 10 , and 14 of the amb treatment . amb nephrotoxicity based on serum creatinine increase , renal potassium wasting , hypokalemia , and hypomagnesemia were determined.resultsamong the 40 patients recruited for the study , 11 ( 27.5% ) patients developed amb nephrotoxicity with a mean standard deviation onset of 6.73 2.36 days . in 5 patients , amb nephrotoxicity resolved spontaneously without any intervention . according to the multivariate logistic regression model , none of the studied demographic , clinical , and paraclinical variables were significantly associated with amb nephrotoxicity . the duration of hospitalization ( p = 0.541 ) and the mortality rate ( p = 0.723 ) were comparable between the patients with and without amb nephrotoxicity . hypokalemia and renal potassium wasting were identified in 45% and 27.5% of the patients during amb treatment , respectively.conclusionsnearly one - third ( 27.5% ) of our cohort developed nephrotoxicity within the first week of amb treatment . hypokalemia and renal potassium wasting were more notable , affecting about one - half and one - third of the amb recipients , respectively .
[ "o - glycans have been found to play an important role in protein stability and tertiary structure , stabilize protein conformation , modulate the activity of enzymes ( e.g. by reversible attachment of o - linked glcnac to cytoplasmic and nuclear proteins ) and signaling molecules , are essential for a number of re...	the glycosylation abilities of snails deserve attention , because snail species serve as intermediate hosts in the developmental cycles of some human and cattle parasites . in analogy to many other host - pathogen relations , the glycosylation of snail proteins may likewise contribute to these host - parasite interactions . here we present an overview on the o - glycan structures of 8 different snails ( land and water snails , with or without shell ) : arion lusitanicus , achatina fulica , biomphalaria glabrata , cepaea hortensis , clea helena , helix pomatia , limax maximus and planorbarius corneus . the o - glycans were released from the purified snail proteins by -elimination . further analysis was carried out by liquid chromatography coupled to electrospray ionization mass spectrometry and for the main structures by gas chromatography / mass spectrometry . snail o - glycans are built from the four monosaccharide constituents : n - acetylgalactosamine , galactose , mannose and fucose . an additional modification is a methylation of the hexoses . the common trisaccharide core structure was determined in arion lusitanicus to be n - acetylgalactosamine linked to the protein elongated by two 4-o - methylated galactose residues . further elongations by methylated and unmethylated galactose and mannose residues and/or fucose are present . the typical snail o - glycan structures are different to those so far described . similar to snail n - glycan structures they display methylated hexose residues .

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