New identification tags used statewide will be able to track first responders by scanning ID badges to organize where first responders should go
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Τρίτη 5 Απριλίου 2016
New ID system to help track SD first responders
Perceptions of medical students regarding dimensions of environmental wellness
2016-04-05T17-31-03Z
Source: Journal of the Pakistan Medical Association
Shahjahan Katpar, Rakhshaan Khan, Rabia Siddiqui, Mehwish Hussain, Rehana Rehman.
Objective: To explore the status of awareness on environmental wellness in medical students of Karachi. Methods: The cross-sectional questionnaire-based survey was carried out at Bahria University Medical & Dental College, Karachi, from January 2009 to July 2013, and comprised randomly selected medical students. The response options were; never, sometimes, mostly and always (numbered 0-4) and these were analyzed in terms of frequency, proportion and percentages by Predictive analysis software version18. Results: Out of 800 questionnaires distributed, 736(92%) were received fully completed. There were 210(28.5%) male and 526(71.5%) female respondents, with a male-to-female ratio of 1:2.5. Female medical students were more serious in taking care of their environment tasks (p
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MHPE programs in Pakistan: concerns for quality
2016-04-05T17-31-03Z
Source: Journal of the Pakistan Medical Association
Syed Moyn Aly, Muhammad Shahid Shamim.
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In vitro effects of nicotine on the non-small-cell lung cancer line A549
2016-04-05T17-31-03Z
Source: Journal of the Pakistan Medical Association
Tao Gao, Xue-Liang Zhou, Sheng Liu, Chang-Xiu Rao, Wen Shi, Ji-Chun Liu.
Objective: To investigate in vitro effects of nicotine on the non-small-cell lung cancer line A549. Methods: The case-control study was conducted at the First Affiliated Hospital of Nanchang University from 1st January to 30th June, 2014 and comprised A549 cells which were treated with a series of concentrations of nicotine (0.01 µM, 0.1 µM, 1 µM and 10 µM) for 24 hours. Control cells were incubated under the same conditions without the addition of nicotine. Cell growth was detected by monotetrazolium salt [3-(4, 5-dimethyl-2-thiazolyl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] assay. Cell apoptosis was detected by Haematoxylin and Eosin staining, immunofluorescence analysis of Filamentous actin and electron microscope observation. Results: Nicotine had no significant effect on A549 cell growth at the dose of 0.01µM (p>0.05), but had significant growth inhibitory effects at the doses of 0.1µM, 1µM and 10µM (p
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Physical activity and sedentary lifestyle towards teenagers’ overweight/obesity status
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Madhavi Bhargava, Pracheth R.
We read the article titled, physical activity and sedentary lifestyle towards teenagers overweight/obesity status with interest.1 The authors have done a commendable job in highlighting the role of physical activity in the teenagers towards increasing overweight and obesity. Their effort is admirable. The study provides good insights into present day problems of increased technology dependence and reducing outdoor physical activity like walking and cycling. However, the following issues need to be addressed not just in the article, but also for wider dissemination and understanding.
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The Gastric Mucosa from Patients Infected with CagA+ or VacA+ Helicobacter pylori Has a Lower Level of Dual Oxidase-2 Expression than Uninfected or Infected with CagA−/VacA− H. pylori
Abstract
Background
Helicobacter pylori (H. pylori) is a well-recognized gastroduodenal pathogen and class I carcinogen. Dual oxidase-2 (DUOX2), a member of NADPH oxidase family, has several critical physiological functions, including thyroid hormone biosynthesis and host mucosal defense.
Aim
To investigate the effect of H. pylori infection on DUOX2 gene expression in human stomach.
Materials and Methods
The biopsies were obtained from patients who underwent endoscopic diagnosis. The patient serum was assayed for two virulence factors of H. pylori, CagA IgG and VacA. The inflammation in gastric mucosa was analyzed with histology. Real-time quantitative PCR was used to detect the expression of three members of NADPH oxidase, NOX1, NOX2, and DUOX2, as well as lactoperoxidase (LPO) in the gastric mucosa. NOX2, DUOX2, and myeloperoxidase (MPO) protein levels were quantified by Western blots or immunohistochemistry.
Results
The H. pylori-infected gastric mucosa had more severe inflammation than uninfected samples. However, the expression of DUOX2 mRNA and protein was lower in gastric mucosa of patients with H. pylori infection compared to the uninfected. Among the H. pylori-infected patients, those having CagA IgG or VacA in the serum had lower DUOX2 expression levels than those infected with H. pylori without either virulence factor. The NOX2 and MPO levels were higher in those patients infected with H. pylori irrespective of the virulence factors than those uninfected patients. NOX1 and LPO mRNA were undetectable in the gastric mucosa.
Conclusion
CagA+ or VacA+ H. pylori in the stomach of patients may suppress DUOX2 expression to promote its own survival. Increased NOX2 could not eliminate H. pylori infection.
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Coverage of birth registration in municipal corporation area of Ahmedabad, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Kamlesh G. Jain, Haresh R. Chandwani, Bala D. V., Kartik N. Trivedi.
Background: It is a recognized child right to acquire a name and a nationality, and birth registration may be necessary to allow access to services. Birth registration is not only a matter of human rights but it also serves as an important instrument for planning about health, education and overall development. This study examines level of registration of birth in the Municipal Corporation area of Ahmedabad and to study the perception of people about birth registration system. Methods: Observational descriptive study was carried out in urban area of Ahmedabad Municipal Corporation which consists of six zones. One ward from each zone was chosen randomly for the study. The sample size was determined as per the total births registered in that particular year, which came out to be 940. The required sample size was stratified according to different zones depending on the births occurring in that particular zone. To know the perception of people about birth registration, house to house visit was carried out in the defined area. Only those parents whose children were ≤3 years were interviewed. Data collected was analyzed using Epi-Info software. Results: Out of 940 children, 889 (94.57%) were registered and mean age of child was 1.906±092 years. Number of registrations increased with the educational status of the parents and birth order. Only 838 (94.3%) had applied for the registration of their child within stipulated time (
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Epidemiology of goiter in Elfigaiga, River Nile state, Sudan
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Ali Ibrahim Elamin, Mohammed Eltahir Mahmoud.
Background: Iodine deficiency continues to be a significant public health problem in many areas all over the world, more than 1.5 billion people worldwide are estimated to be at risk of iodine deficiency, of these more than 650 million have goiter. Methods: A total coverage of the whole population had been carried out to measure the prevalence of goiter, only 556 inhabitants were examined using cross-sectional study and house to house survey. Questionnaire and observation were used as a tool for data gathering, which had been carried out by a well-trained and expert professionals, water samples from houses (goitrous and nongoitrous families) was examined in the laboratory for determination of iodine deficiency in drinking water and for determination of calcium salts and flourides as goitrogens in drinking water. Results: The study showed that goiter prevalence in the study area was (11.9%), the clinical assessment was done for both sexes at different age group, and it was found that goiter was more frequent among females (85%) furthermore it is mainly distributed within the age group 31-40 years (30%). Water samples from goitrous and non-goitrous families were investigated to detect iodine concentration in drinking water, and it was found not deficient of iodine (0.12 mg/l) and (0.18) respectively. Conclusions: This study was carried out during the period (May-December 2010) to study the epidemiology of goiter, a cross-sectional design was used to achieve the stated objectives, the study is consist of seven chapters and 140 pages, and contain both theoretical and practical parts. Then all the field work and clinical assessment was done by professional personnel. On the other side there was some constrains that a rise during the study, as financial problems and some missed cases. Then by the end of the study there were some recommendations to be fulfilled.
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Aeroallergens sensitization pattern at Taif city: Saudi
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Moufag Mohammed Saeed Tayeb.
Background: Taif city is an agricultural area with high altitude. Sensitization to aeroallergens (AA) in Taif city is not identified. Methods: This study is a retrospective evaluation of a specific IgE (sIgE) blood results to AA of 149 patients. The study group was chosen from all age groups referred to AL BORG laboratory complaining of allergic diseases with expected sensitization to AA in Taif city, starting from January up to December in the year 2013. Results: The commonest AA distributions in Taif city were to indoor AA followed by pollens. The indoor AA is dermatophagoides pteronyssinus 26%, dermatophagoides farina 25%, american cockroach 22% and cat epithelia/hair 21% respectively. While, the pollens are dessert palm pollens 18%, timothy grass 18%, rye grass 17%, bermuda grass 15%, ambrosia 15%, acacia 15%. Conclusions: Indoor followed by pollen AAs are the commonest sensitization pattern at Taif city. This pattern is compatible with worldwide literature except for high percentage of desert palm pollens which is an amazing result that needs a further evaluation
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Prevalence and factors influencing anaemia among pregnant women in rural Mysuru, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Anup Gopinath, N. C. Ashok, Praveen Kulkarni, Renuka Manjunath.
Background: Anaemia in pregnancy is one of the major causes of maternal morbidity and mortality in India and the world. Determining the status and factors influencing anaemia among pregnant women in rural areas is essential to treat as well as prevent the same. The objective was to estimate the prevalence of anaemia among pregnant women of rural areas of Mysuru, India and to determine the factors influencing anaemia among the study participants. Methods: A cross-sectional study was conducted in the villages under PHCs of Hadinaru and Suttur of Nanjangud Taluk, Mysuru district, India for a period of 18 months. A total of 300 pregnant women residing in these villages, and consenting to participate were included in the study. A structured proforma was used to collect sociodemographic details. Haemoglobin was estimated using Sahlis haemoglobinometer and type of anaemia was determined by peripheral blood smear. The data was entered using Epi Data v3.1 software, and analyzed using R statistical Software v3.0.2. Results: The prevalence of anaemia was 51%, majority had mild anaemia (37%). 79% of the study participants were aged 20-29 years, 85% studied upto High school, 83% belonged to lower Socioeconomic class and 66% lived in joint families. The important factors influencing anaemia were poor nutrition (49%), low socioeconomic status (39%) and open defecation (51%). Conclusions: More than half of the pregnant women were anaemic. Also, majority of the anaemic women had mild anaemia, which showed the positive impact of MCH services. The factors influencing anaemia which have been identified in this study need to be addressed to reduce the burden of anaemia among pregnant women in our country.
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A community based case control study on risk factors for treatment interruptions in people with tuberculosis in Kollam district, Kerala, southern India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Shameer K. M., Manjunath K., Sam D. Marconi, Krishnaveni V., Rakesh P. S., Jasmin H. Prasad.
Background: Treatment adherence to anti-TB treatment is a critical determinant of treatment outcomes, prognosis and further emergence of drug resistance. The objective of the study was to identify the risk factors for treatment interruptions among the newly diagnosed patients with tuberculosis registered for treatment under Revised National Tuberculosis Control Program in Kollam District, Kerala, southern India. Methods: A community based case control study was undertaken with cases being patients registered for TB treatment under category I in two randomly selected TB Units of Kollam districts with treatment interruption as defined by missing at least three consecutive doses of anti TB medicines. Controls were those who successfully completed the anti-tuberculosis treatment regimen. Interview was conducted with a structured questionnaire. Univariate and multivariate analysis was done and odds ratios with 95% confidence interval for the risk factors for treatment interruption were calculated. Results: A total of 47 cases and 94 controls were interviewed. In the final logistic regression model, hazardous alcohol use (Adjusted OR 16.67, 95% CI 3.22-61.42) and adverse drug reactions (Adjusted OR 2.46, 95% CI 1.07-6.14) were found as statistically significant risk factors for treatment interruption. Conclusions: Hazardous use of alcohol and adverse effects to drugs are identified as the potential risk factors for treatment interruptions among the people with TB initiated on Category 1 DOTS regimen in Kollam district, Kerala, India. Alcohol use disorder and hazardous drinking among TB patients is a matter of concern that needs to be translated to an effective intervention program.
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Is the Ambu aScope 3 Slim single-use fiberscope equally efficient compared with a conventional bronchoscope for management of the difficult airway?
| Related Articles |
Is the Ambu aScope 3 Slim single-use fiberscope equally efficient compared with a conventional bronchoscope for management of the difficult airway?
J Clin Anesth. 2016 May;30:68-73
Authors: Fukada T, Tsuchiya Y, Iwakiri H, Ozaki M
Abstract
STUDY OBJECTIVE: The study objective was to evaluate whether the single-use fiberoptic bronchoscope (FOB), Ambu aScope 3 Slim, was equally efficient compared with the conventional reusable FOB, Olympus LF-GP, for nasal fiberoptic intubation in a manikin.
DESIGN: A randomized crossed-over study.
SETTING: The postanesthesia care unit of Tokyo Women's Medical University Hospital.
SUBJECTS: Twenty anesthesiologists who have experienced >50 one-lung ventilation thoracic surgery procedures were invited to participate in this study.
INTERVENTIONS: A 6.5-mm internal diameter cuffed endotracheal tube (ET) was inserted into the manikin under Ambu aScope 3 Slim (group A) or Olympus LF-GP (group C) guidance.
MEASUREMENTS: The following time parameters from the beginning of FOB insertion through a nostril were compared between groups: until vocal cord visualization (T1); visualization of the carina (T2); and proper ET placement, as confirmed by the distance of the ET tip to carina (T3).
MAIN RESULTS: Mean (SD) T1 in group A and group C were 20 seconds (17 seconds) and 14 seconds (12 seconds), respectively (P= .1050). Mean (SD) T2 in group A and group C were 40 seconds (29 seconds) and 25 seconds (15 seconds), respectively (P= .0287). Mean (SD) T3 in group A and group C were 70 seconds (33 seconds) and 50 seconds (22 seconds), respectively (P= .0098). One case in group A had failed intubation
CONCLUSIONS: The Ambu aScope 3 Slim required more time to intubate than the conventional reusable FOB. It requires more rigidity, similar to the conventional FOB for management of the difficult airway.
PMID: 27041269 [PubMed - in process]
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Study on cutaneous manifestation among type II diabetes mellitus in rural Pondicherry, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Kandaswamy, Kanagarajan P., Suganthi K., Lokeshmaran A..
Background: Diabetes has emerged as a major public health care problem in India. According to Diabetes atlas published by the International Diabetes Federation (IDF), there was on 2007 an estimated 40.9 million people with diabetes in India and this number is predicted to rise to almost 69.9 million people by 2025. The skin is affected by both the acute metabolic derangements and the chronic degenerative complications of diabetes. Cutaneous signs of diabetes mellitus are extremely valuable to the clinician as some of them can alert the physician to the diagnosis of diabetes and also reflect the status of glycemic control and lipid metabolism. The objective was to study the cutaneous manifestations in patient with type II diabetes mellitus. Method: The present cross sectional study was conducted at field based area of Mahatma Gandhi Medical College and Research Institute, Puducherry, India from January 2013 to June 2013. Data collection was done using pretested proforma and information regarding age, sex, duration of diabetes, treatment, blood glucose (Fasting, Post prandial), urine examination, specific investigations and skin lesions were taken. A complete physical and dermatological examinations of the patients was done. Statistical analysis was done. Results: Among the total number of 166 patients studied, there were 44 (26.50%) women and 122 (73.49%) men; the male: female ratio was 3:1, of the total diabetic patients, majority 85 (51.2%) had
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Awareness about breast cancer among women attending obstetrics and gynaecology department in a tertiary care hospital of Jharkhand, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Mithilesh Kumar, Vivek Kashyap.
Background: Most of the patients of breast cancer seek medical advice when the disease is fairly advanced. Lack of awareness about the risk factors and symptoms of the disease is the main cause of late detection of this cancer- at a stage that they can no more be cured. The objective was to determine the awareness about breast cancer among women attending obstetrics and gynaecology department of Rajendra Institute of Medical Sciences (RIMS), Ranchi. Methods: It was a descriptive, cross sectional hospital based study conducted in Obstetrics and Gynaecology department of RIMS, Ranchi between January to March 2015 among women aged more than 15. A total of 162 women selected by consecutive sampling were interviewed using a pretested semi-structured questionnaire after taking informed consent. Data entry was done in MS excel and analyzed in SPSS software. Frequency distribution was done and chi square test was used to find the association between awareness of breast cancer with different socio-demographic profile. Results: Mean age of the participants was 30.15±10.54. Out of total 162 participants, 123 (75.9%) had heard about breast cancer. 72 (58.5%) of the participants had knowledge of breast cancer from friends and neighborhood. 46.4% of the participants were aware of at least one of the symptoms of breast cancer. 66 (53.6%) of the participants thought family history was the cause for breast cancer. 17 (13.8%) of the participants were aware of breast self-examination and 4 participants had ever done it. Awareness of breast cancer was significantly associated with education, ethnicity, and residence of the participants. Conclusion: there was low level of awareness about breast cancer in the study population. There is a need for programs for increasing awareness regarding breast cancer for correct knowledge and its early detection.
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Effect of interleukin 6 –174G>C gene polymorphism on opioid requirements after total hip replacement
Abstract
Objective
In recent years, increasing attention has been paid to the contribution of genetic factors to variability in patient pain threshold and the efficacy of pain management. One of the genes implicated in pain pathology and treatment response is interleukin 6 (IL6). The aim of the present study was to evaluate the association between IL6 (rs1800795: –174G>C) and opioid requirements in patients after total hip replacement (THR).
Methods
A total of 196 patients eligible for the study (126 women, 70 men) were subjected to THR. The THR procedure was performed using spinal anaesthesia after implementing routine peri-operative monitoring. After the procedure each patient was individually observed, and the patient-specific chart of dynamic changes in pain perception was recorded, using the five-level Verbal Rating Scale (VRS). The multimodal analgesic treatment after THR was defined by the operating surgeons after considering indications and contraindications to the use of different groups of drugs (opioid and non-opioid analgesics). Postoperative pain was controlled by the patient-controlled analgesia method and VRS during the day-time, as well as night-time nurse-controlled analgesia. All medication adjustments were recorded in the individual patient files. In the case of moderate pain intensity (VRS-assessed), a patient was administered the non-opioid analgesic drug, and for high intensity pain the opioid. The analysis of pain relief therapy included information on the drugs applied, mode of dosing (single or multiple), daily dose, route of administration, and drug refusal due to the absence of pain recorded each study day, i.e. on the day of surgery and recovery in the postoperative room (day 0), and then daily from day 1 to day 6. Polymorphism rs1800795:G>C in the promoter region of the IL6 gene (–174G>C) was determined using the PCR–RFLP method.
Results
The patients carrying at least one IL6 –174G allele (GG homozygote and GC heterozygote) were administered opioids significantly more often on days 0 (p = 0.0029), 3 (p = 0.019) and 4 (p = 0.031) after surgery compared with CC homozygous patients. Those patients also required a significantly higher opioid dose on days 3 (p = 0.029) and 4 (p = 0.030). Multivariate analysis demonstrated that the presence of the –174G allele was an independent factor predisposing patients to the administration of opioids during the first 24 h [p = 0.001, odds ratio (OR) 7.1, 95 % confidence interval (CI) 2.17–22.7], on day 3 (p = 0.01, OR 2.79, 95 % CI 1.25–6.26) and day 4 (p = 0.01, OR = 2.61, 95 % CI 1.17–5.79).
Conclusion
The presence of the G allele IL6 gene (–174G>C) polymorphism was found to be an independent factor predisposing to a higher dose and more frequent administration of opioids in the first days after total hip replacement.
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Lifestyle habits and diseases amongst rural geriatrics population
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Singh Jai Prakash, Gupta Shyam Bihari, Singh Atul Kumar.
Background: Modern science through improved sanitation, vaccination, and antibiotics, and medical attention has eliminated the threat of death from most infectious diseases. Death from lifestyle diseases like heart diseases and cancers are now the primary causes of death. Everybody naturally has to die of something, but lifestyle diseases take people before their time. Aim & Objective of the study was to find out association of risk factors (BMI and occupation) with lifestyle related diseases among the rural elderly. Methods: This cross-sectional study was conducted during January 2015 to April 2015 in a rural (Bhojipura block) areas of district Bareilly, Uttar Pradesh. 121 elderly persons of age 60 years and above were selected by systematic random sampling method and interviewed on a predesigned pretested questionnaire by house to house visits in the study area. Data was analysed by percentage and Chi squire tests. Results: Mixed dietary habit (27.8%), alcohol (9.3%) and smoking addictions (31.5%) were more common in men while tobacco chewing (16.4%) and sedentary habit (71.6%) was more common in women. Prevalence of hypertension, diabetes and chronic liver diseases were more common in both obese/obesity and working group in comparison to non-obese/obesity and non- working group. Here association of diabetes and chronic liver diseases with occupation & body mass index (BMI) was found statistically significant (0.05). Conclusions: Present study observed higher prevalence of hypertension, diabetes and chronic liver diseases among working group as compared to non- working group. Present study also shows higher BMI increases risk factors for lifestyle diseases.
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A cross-sectional study among community on knowledge, attitude and practice about blood donation in Udaipur city of Rajasthan, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Jyoti Jain, Mukul Dixit.
Background: This study has been carried out to find out the knowledge, attitude and practice about blood donation in community of Udaipur city. Methods: This study was conducted in Udaipur city of Rajasthan on the community regarding to know about knowledge, attitude and practice about blood donation. For this sample of 755 respondents were taken during the period of 1st December 2015- 15th January 2016 on the basis of statistical method of sample size determination. Results: Majority of respondents were having awareness and knowledge about blood donation. Practice of donation was found to be more in males are more as compared to females. Females prefer more to donate blood for their relatives and family than others as compared to males. Frequency of donation blood was found to be more in male than female donors. Conclusions: The community has become more aware of the facts about blood donation. More and more people have started donating blood. Thus provision of adequate privacy, awareness communication materials and advertisements to address the fear factor may strengthen the recruitment and retention of voluntary blood donors to donate blood on regular basis to achieve 100% of blood donation.
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Personal activity tracker used to identify heart arrhythmia
Emergency physicians used information from a patient's Fitbit to determine when his heart arrhythmia started
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Socially induced serotonergic fluctuations in the male auditory midbrain correlate with female behavior during courtship
Cues from social partners trigger the activation of socially responsive neuromodulatory systems, priming brain regions including sensory systems to process these cues appropriately. The fidelity with which neuromodulators reflect the qualities of ongoing social interactions in sensory regions is unclear. We addressed this issue by using voltammetry to monitor serotonergic fluctuations in an auditory midbrain nucleus, the inferior colliculus (IC), of male mice (Mus musculus) paired with females, and by concurrently measuring behaviors of both social partners. Serotonergic activity strongly increased in male mice as they courted females, relative to serotonergic activity in the same males during trials with no social partners. Across individual males, average changes in serotonergic activity were negatively correlated with behaviors exhibited by female partners, including broadband squeaks, which relate to rejection of males. In contrast, serotonergic activity did not correlate with male behaviors, including ultrasonic vocalizations. These findings suggest that during courtship, the level of serotonergic activity in the IC of males reflects the valence of the social interaction from the perspective of the male (i.e., whether the female rejects the male or not). As a result, our findings are consistent with the hypothesis that neuromodulatory effects on neural responses in the IC may reflect the reception, rather than the production, of vocal signals.
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Health problems among the aged: a community based study from urban Aligarh, Uttar Pradesh, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Mohd Maroof, Anees Ahmad, Najam Khalique, M. Athar Ansari.
Background: Old age is associated with decline in physical, physiological & cognitive function affecting the quality of life of the elderly population. The robust increase in proportion of elderly has resulted in demographic burden in a developing country like India. To cope up with this burden appropriate & timely intervention is required based on the situational analysis of the health problems faced by the aged population. The objective was to study the prevalence of health problems among elderly population and to find out the relationship of health problems with gender. Methods: This community based observational cross- sectional study was done among 225 individuals aged 60 years & above residing at field practice area of Urban Health Training Centre, JN Medical College, AMU, Aligarh. The data was obtained through pretested & predesigned questionnaire by selecting individuals using systematic random sampling with PPS. Data was entered & analysed by SPSS 20. Test of proportions & Chi square test were applied. P value
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Tactile texture signals in primate primary somatosensory cortex and their relation to subjective roughness intensity
This study investigated the hypothesis that a simple intensive code, based on mean firing rate, could explain the cortical representation of subjective roughness intensity and its invariance with scanning speed. We examined the sensitivity of neurons in the cutaneous, finger representation of primary somatosensory cortex (S1) to a wide range of textures [1 mm high, raised-dot surfaces; spatial periods (SPs), 1.5–8.5 mm], scanned under the digit tips at different speeds (40–115 mm/s). Since subjective roughness estimates show a monotonic increase over this range and are independent of speed, we predicted that the mean firing rate of a subgroup of S1 neurons would share these properties. Single-unit recordings were made in four alert macaques (areas 3b, 1 and 2). Cells whose discharge rate showed a monotonic increase with SP, independent of speed, were particularly concentrated in area 3b. Area 2 was characterized by a high proportion of cells sensitive to speed, with or without texture sensitivity. Area 1 had intermediate properties. We suggest that area 3b and most likely area 1 play a key role in signaling roughness intensity, and that a mean rate code, signaled by both slowly and rapidly adapting neurons, is present at the level of area 3b. Finally, the substantial proportion of neurons that showed a monotonic change in discharge limited to a small range of SPs (often independent of response saturation) could play a role in discriminating smaller changes in SP.
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Sensory-driven and spontaneous gamma oscillations engage distinct cortical circuitry
Gamma oscillations are a robust component of sensory responses but are also part of the background spontaneous activity of the brain. To determine whether the properties of gamma oscillations in cortex are specific to their mechanism of generation, we compared in mouse visual cortex in vivo the laminar geometry and single-neuron rhythmicity of oscillations produced during sensory representation with those occurring spontaneously in the absence of stimulation. In mouse visual cortex under anesthesia (isoflurane and xylazine), visual stimulation triggered oscillations mainly between 20 and 50 Hz, which, because of their similar functional significance to gamma oscillations in higher mammals, we define here as gamma range. Sensory representation in visual cortex specifically increased gamma oscillation amplitude in the supragranular (L2/3) and granular (L4) layers and strongly entrained putative excitatory and inhibitory neurons in infragranular layers, while spontaneous gamma oscillations were distributed evenly through the cortical depth and primarily entrained putative inhibitory neurons in the infragranular (L5/6) cortical layers. The difference in laminar distribution of gamma oscillations during the two different conditions may result from differences in the source of excitatory input to the cortex. In addition, modulation of superficial gamma oscillation amplitude did not result in a corresponding change in deep-layer oscillations, suggesting that superficial and deep layers of cortex may utilize independent but related networks for gamma generation. These results demonstrate that stimulus-driven gamma oscillations engage cortical circuitry in a manner distinct from spontaneous oscillations and suggest multiple networks for the generation of gamma oscillations in cortex.
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A study on perception and practice of menstruation among school going adolescent girls in district Ambala Haryana, India
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Tanoja Bachloo, Randhir Kumar, Anmol Goyal, Parmal Singh, Sachin Singh Yadav, Anu Bhardwaj, Anshu Mittal.
Background: Adolescence is a highly dynamic period characterized by rapid growth and development. Adolescent girls have limited knowledge about menstruation and its hygiene, this study will be carried out among the school going adolescents in rural and urban area of Ambala district with the following aims and objectives, Status of knowledge of school going adolescent girls about menstruation and their practice during menstruation. Method: A cross-sectional study was conducted in Ambala district Haryana, sample were taken by multi-stage random sampling during June to December 2015. A total 400 adolescents were taken from class 9th to 12th from four Secondary schools two from urban and two from rural school. Data were collected by interview method with the help of a pre-tested predesigned semi structures questionnaire. Results: Mean age of adolescent girls was 15.26±1.61 years. 95% of adolescents attained menarche at the time of interview; Mean age of menarche in the study subjects was 12.21±1.70 year. 51.2% girls had negative reactions to menarche like scared, upset/guilt discomfort etc. Common problem reported by adolescents girls were abdominal pain 77.6%, approx. 9.7% adolescent girls did not practice any restriction during menstruation. Most common restriction were restricted from physical activities and visit religious place, mother was the main sources of knowledge regarding menstruation. Majority of girls had not heard about menstruation at the time of menarche (55.7%) while 65.3% were afraid after first menstruation. Conclusion: Low level of knowledge about menstruation, poor menstrual hygiene was found in our study. There is a different type of misconception, myths, restriction and lack of menstruation related knowledge. Education regarding menstruation reproductive health with more focus on menstrual hygiene should be made a part of school curriculum.
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Paramedic @ Nellis AFB - Loyal Source Government Services
Emergency Department trained Paramedics (EMT-P) to support treatment in a hospital emergency department (ED), ambulance emergency response, in-flight emergency response, non-in-flight emergency response, transfer and transport services for active duty military personnel, their dependents, retirees, their dependents and other eligible beneficiaries, in accordance with the terms and conditions of this ...
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KV1 channels identified in rodent myelinated axons, linked to Cx29 in innermost myelin: support for electrically active myelin in mammalian saltatory conduction
Saltatory conduction in mammalian myelinated axons was thought to be well understood before recent discoveries revealed unexpected subcellular distributions and molecular identities of the K+-conductance pathways that provide for rapid axonal repolarization. In this study, we visualize, identify, localize, quantify, and ultrastructurally characterize axonal KV1.1/KV1.2 channels in sciatic nerves of rodents. With the use of light microscopic immunocytochemistry and freeze-fracture replica immunogold labeling electron microscopy, KV1.1/KV1.2 channels are localized to three anatomically and compositionally distinct domains in the internodal axolemmas of large myelinated axons, where they form densely packed "rosettes" of 9-nm intramembrane particles. These axolemmal KV1.1/KV1.2 rosettes are precisely aligned with and ultrastructurally coupled to connexin29 (Cx29) channels, also in matching rosettes, in the surrounding juxtaparanodal myelin collars and along the inner mesaxon. As >98% of transmembrane proteins large enough to represent ion channels in these specialized domains, ~500,000 KV1.1/KV1.2 channels define the paired juxtaparanodal regions as exclusive membrane domains for the voltage-gated K+ conductance that underlies rapid axonal repolarization in mammals. The 1:1 molecular linkage of KV1 channels to Cx29 channels in the apposed juxtaparanodal collars, plus their linkage to an additional 250,000–400,000 Cx29 channels along each inner mesaxon in every large-diameter myelinated axon examined, supports previously proposed K+ conductance directly from juxtaparanodal axoplasm into juxtaparanodal myeloplasm in mammalian axons. With neither Cx29 protein nor myelin rosettes detectable in frog myelinated axons, these data showing axon-to-myelin linkage by abundant KV1/Cx29 channels in rodent axons support renewed consideration of an electrically active role for myelin in increasing both saltatory conduction velocity and maximum propagation frequency in mammalian myelinated axons.
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Accidental awareness during anesthesia in children
Summary
This educational review explores the current understanding of accidental awareness during general anesthesia (AAGA) in children. Estimates of incidence in children vary between 1 in 135 (determined by direct questioning) and 1 in 51 500 (determined from spontaneous reporting). The lessons from the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland show that the characteristics of spontaneous reports of AAGA are extremely variable and relate to the type of procedure and anesthetic technique rather than age group: approximately 50% of experiences were distressing; most lasted less than 5 min; neuromuscular blockade (NMB) combined with pain caused the most distress; most cases (approximately 70%) occur at induction or emergence. The value of depth of anesthesia monitoring in preventing AAGA is uncertain but is probably useful in patients having total intravenous anesthesia and NMB. Reports of AAGA by children should be received sympathetically and a generic protocol for managing distressed patients is presented.
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Socio-demographic determinants influencing antenatal care seeking behaviour among women in Bangladesh: an application of factor analysis
2016-04-05T10-32-58Z
Source: International Journal of Community Medicine and Public Health
Mosrat Jahan, Esrat Jahan.
Background: Pregnancy-related complications are one of the leading causes of death among women in the reproductive ages in developing countries. Antenatal care is an essential component for reducing maternal and infant morbidity and mortality. The study had been made an attempt to investigate the socio-demographic determinants of antenatal care seeking behavior among women in Bangladesh. Methods: Present study used secondary data from Bangladesh Demographic and Health Survey (BDHS-2011) with married women aged between 15-49 years. Results were obtained by adopting data reduction procedure and multinomial logistic regression model. Results: Factor analysis procedure had been used to determine two factors: (F1) current status of age & reproductive experience - consisted of the variables respondents age, partners age, marital duration, and number of living children; and (F2) initial status of marital age & birth - consisted of the variables age at marriage and age at 1st birth. These two factors were used in the subsequent analysis instead of the six demographic variables. The logistic regression analysis indicated region, type of place of residence, education, wealth index, Mass media exposure and two extracted factors had significant influence on antenatal care seeking behavior in Bangladesh. Conclusions: This study suggests that cultural issues, demographic and socioeconomic status are important determinants of Antenatal care seeking behaviour. Appropriate programs for strengthening female education and women empowerment should be to improve the health of mothers and children in the country.
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Paramedic @ Nellis AFB - Loyal Source Government Services
Emergency Department trained Paramedics (EMT-P) to support treatment in a hospital emergency department (ED), ambulance emergency response, in-flight emergency response, non-in-flight emergency response, transfer and transport services for active duty military personnel, their dependents, retirees, their dependents and other eligible beneficiaries, in accordance with the terms and conditions of this ...
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Selection of head and whisker coordination strategies during goal-oriented active touch
In the rodent whisker system, a key model for neural processing and behavioral choices during active sensing, whisker motion is increasingly recognized as only part of a broader motor repertoire employed by rodents during active touch. In particular, recent studies suggest whisker and head motions are tightly coordinated. However, conditions governing the selection and temporal organization of such coordinated sensing strategies remain poorly understood. We videographically reconstructed head and whisker motions of freely moving mice searching for a randomly located rewarded aperture, focusing on trials in which animals appeared to rapidly "correct" their trajectory under tactile guidance. Mice orienting after unilateral contact repositioned their whiskers similarly to previously reported head-turning asymmetry. However, whisker repositioning preceded head turn onsets and was not bilaterally symmetric. Moreover, mice selectively employed a strategy we term contact maintenance, with whisking modulated to counteract head motion and facilitate repeated contacts on subsequent whisks. Significantly, contact maintenance was not observed following initial contact with an aperture boundary, when the mouse needed to make a large corrective head motion to the front of the aperture, but only following contact by the same whisker field with the opposite aperture boundary, when the mouse needed to precisely align its head with the reward spout. Together these results suggest that mice can select from a diverse range of sensing strategies incorporating both knowledge of the task and whisk-by-whisk sensory information and, moreover, suggest the existence of high level control (not solely reflexive) of sensing motions coordinated between multiple body parts.
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Temporal accuracy of human cortico-cortical interactions
The precision in space and time of interactions among multiple cortical sites was evaluated by examining repeating precise spatiotemporal patterns of instances in which cortical currents showed brief amplitude undulations. The amplitudes of the cortical current dipoles were estimated by applying a variant of synthetic aperture magnetometry to magnetoencephalographic (MEG) recordings of subjects tapping to metric auditory rhythms of drum beats. Brief amplitude undulations were detected in the currents by template matching at a rate of 2–3 per second. Their timing was treated as point processes, and precise spatiotemporal patterns were searched for. By randomly teetering these point processes within a time window W, we estimated the accuracy of the timing of these brief amplitude undulations and compared the results with those obtained by applying the same analysis to traces composed of random numbers. The results demonstrated that the timing accuracy of patterns was better than 3 ms. Successful classification of two different cognitive processes based on these patterns suggests that at least some of the repeating patterns are specific to a cognitive process.
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When is compensation for lumbar spinal stenosis a clinical sagittal plane deformity?
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A case of liver cirrhosis with bleeding from stomal varices successfully treated using balloon-occluded retrograde transvenous obliteration
Abstract
A 66-year-old male patient with liver cirrhosis because of alcohol intake underwent a Hartmann's procedure for rectal cancer. Four months later, bleeding from the sigmoid stoma occurred and persisted for 2 months. A colonoscopic examination revealed bleeding from stomal varices. Three-dimensional computed tomography (CT) imaging demonstrated the inferior mesenteric vein and left superficial epigastric vein as the feeding and drainage vessels, respectively. Balloon-occluded retrograde transvenous obliteration (B-RTO) through the left epigastric vein was performed using a microballoon catheter inserted from the right femoral vein according to the Seldinger method. A CT examination performed 2 days after the B-RTO procedure revealed that the blood flow had disappeared, with thrombosis formation in both the stomal varices and the feeding vein. No recurrent bleeding from the stoma occurred. B-RTO using a microballoon catheter is useful as a therapeutic procedure for stomal varices to prevent bleeding, since the procedure can be performed with minimal invasion using the Seldinger method.
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Seroprevalence of coeliac disease in at-risk subjects at the main tertiary hospital, southwest of Saudi Arabia
Publication date: Available online 5 April 2016
Source:Arab Journal of Gastroenterology
Author(s): Ahmed M. Al-Hakami
Background and study aimsCoeliac disease (CD) is a gluten-induced autoimmune inflammation of small bowel villi, leading to atrophy and malabsorption. The current study aims to assess the prevalence of CD in high-risk subjects in the Aseer region, southwest of Saudi Arabia and to investigate the associated presentations.Patients and methodsThis is a retrospective case-finding study of the laboratory records for a 3-year period (2009–2012) at the main tertiary hospital (Aseer Central Hospital). Serum anti-tissue transglutaminase (atTG) and endomysial antibody (EmA) levels were determined along with small intestinal histopathological examination.ResultsThe proportion of cases that tested positive for at least one coeliac antibody marker was 18.4% (58/315). Forty cases underwent endoscopic examination during the analysis, among which 22 were confirmed to have CD. The individual antibody positivity for atTG and EmA was 17.5% and 15.6%, respectively. The most common clinical condition (47%) associated with these markers was type 1 diabetes mellitus (T1DM). Interestingly, gastrointestinal presentations constituted only 11.5%.ConclusionsThe rate of CD among hospital requests, including non-gastrointestinal symptomatic patients, at the Aseer main tertiary hospital seems to be high. Determining the prevalence of CD and also investigating the high-risk group commonly affected by CD warrant more screening studies.
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De novo mutations in CSNK2A1 are associated with neurodevelopmental abnormalities and dysmorphic features
Abstract
Whole exome sequencing (WES) can be used to efficiently identify de novo genetic variants associated with genetically heterogeneous conditions including intellectual disabilities. We have performed WES for 4102 (1847 female; 2255 male) intellectual disability/developmental delay cases and we report five patients with a neurodevelopmental disorder associated with developmental delay, intellectual disability, behavioral problems, hypotonia, speech problems, microcephaly, pachygyria and dysmorphic features in whom we have identified de novo missense and canonical splice site mutations in CSNK2A1, the gene encoding CK2α, the catalytic subunit of protein kinase CK2, a ubiquitous serine/threonine kinase composed of two regulatory (β) and two catalytic (α and/or α′) subunits. Somatic mutations in CSNK2A1 have been implicated in various cancers; however, this is the first study to describe a human condition associated with germline mutations in any of the CK2 subunits.
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Impact on ambient dose rate in metropolitan Tokyo from the Fukushima Daiichi Nuclear Power Plant accident
Source:Journal of Environmental Radioactivity, Volumes 158–159
Author(s): Kazumasa Inoue, Hiroshi Tsuruoka, Tan Van Le, Moeko Arai, Kyoko Saito, Masahiro Fukushi
A car-borne survey was made in metropolitan Tokyo, Japan, in December 2014 to estimate external dose. This survey was conducted for all municipalities of Tokyo and the results were compared with measurements done in 2003. The ambient dose rate measured in the whole area of Tokyo in December 2014 was 60 nGy h−1 (23–142 nGy h−1), which was 24% higher than the rate in 2003. Higher dose rates (>70 nGy h−1) were observed on the eastern and western ends of Tokyo; furthermore, the contribution ratio from artificial radionuclides (134Cs and 137Cs) to ambient dose rate in eastern Tokyo was twice as high as that of western Tokyo. Based on the measured ambient dose rate, the effective dose rate after the accident was estimated to be 0.45 μSv h−1 in Tokyo. This value was 22% higher than the value before the accident as of December 2014.
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Prevalence of mutations within major hydrophilic region of hepatitis B virus and their correlation with genotypes among chronically infected patients in Egypt
Publication date: Available online 4 April 2016
Source:Arab Journal of Gastroenterology
Author(s): Walaa M. Abu Zeid, Dalia I. Ramadan, Mohamed A. Shemis
Background and study aimsMutations within the major hydrophilic region (MHR) of the hepatitis B surface antigen (HBsAg) have been reported in relation to viral persistence by evasion from vaccine and immunotherapy, severity of liver disease and lack of detection by commercial kits. The aim of this study was to elucidate the circulation of hepatitis B virus (HBV) genotypes, subgenotypes and serotypes in Egypt, with recognition of the pattern and prevalence of MHR mutations possibly occurring during the course of the disease.Patients and methodsEighty-eight samples from patients with chronic HBV infection were included in the study. The surface protein-encoding gene (S gene) in the HBV genome was subjected to amplification and partial sequencing.ResultsBased on phylogenetic analysis, only genotype D was found circulating among patients. The majority of isolates belonged to subgenotype D3 (86.3%), followed by D7 (8%), then D5 (3.4%) and lastly D1 (2.3%). Two subtypes were identified: ayw2 (97%) and ayw3 (2%). The 'w' sub-determinant was not defined in one isolate (1%). A significant proportion of patients (13/88, 14.8%) exhibited mutations in the MHR, 10 of whom harboured mutations in the 'a' determinant region and three outside. The first loop comprised four patients with three mutations (P127S, P127T and Y134F). The second loop contained six patients, all with one mutation, S143L, which was most frequently encountered in this study (6.8%).ConclusionsWe conclude that genotype D, subgenotype D3 and HBsAg subtype ayw2 are the most common types circulating in Egypt, which account for 100%, 86.3% and 97% of the population, respectively, with a moderate degree of MHR mutations.
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Wandering spleen in the pelvic region in an adult man with symptoms of acute abdomen
Publication date: Available online 4 April 2016
Source:Arab Journal of Gastroenterology
Author(s): Nahed A. Makhlouf, Khairy H. Morsy, Samir Ammar, Radwan A. Mohammed, Hazem A. Yousef, Mohamed G. Mostafa
Wandering or ectopic spleen is a condition characterised by migration of spleen in the abdomen or pelvis. This anomaly is rare, with a reported incidence of <0.2%. It occurs mostly in women between 20 and 40years of age. Clinical diagnosis is difficult because of lack of precise signs, symptoms, and nonspecific laboratory data. Diagnosis of a wandering spleen highly depends on the results of imaging studies such as abdominal ultrasound and abdominopelvic computed tomography (CT) scanning. Treatment includes surgery with the choice between splenopexy in a noninfarcted spleen and splenectomy when infarction has occurred. We report a rare case of wandering spleen in a 27-year-old man with infarction due to torsion of its pedicle, which was diagnosed by CT and treated by splenectomy. Conclusion: Despite the rarity of wandering spleen, the possibility of torsion of its long pedicle with acute splenic infarction should be considered in the differential diagnosis of acute abdomen.
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Interaction between STAT3 gene polymorphisms and smoking on Crohn’s disease susceptibility: a case-control study in a Chinese Han population
Inflammation Research
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A phase 3, open-label study of daclatasvir plus asunaprevir in Asian patients with chronic hepatitis C virus genotype 1b infection who are ineligible for or intolerant to interferon alfa therapies with or without ribavirin
Journal of Gastroenterology and Hepatology
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Clinical outcomes and prevalence of cancer in patients with possible groove pancreatitis
Journal of Gastroenterology and Hepatology
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Statin use and the risk of colorectal adenoma: a meta-analysis
Journal of Gastroenterology and Hepatology
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CT-colonography vs. colonoscopy for detection of high-risk sessile serrated polyps
The American Journal of Gastroenterology
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Consumption of fruit and vegetables reduces risk of pancreatic cancer: Evidence from epidemiological studies
European Journal of Cancer Prevention
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The surgical management of necrotising enterocolitis (NEC)
Early Human Development
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Epidemiology and outcomes of hepatitis C infection in elderly US Veterans
Journal of Viral Hepatitis
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A randomized phase II study of the clinical effects of ultrasonically activated coagulating shears (Harmonic scalpel) in open gastrectomy for gastric cancer
Surgery Today
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National trends in nonoperative management of rectal adenocarcinoma
Journal of Clinical Oncology
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Comparative effectiveness and safety of anti-tumor necrosis factor agents in biologic-naïve patients with Crohn’s disease
Clinical Gastroenterology and Hepatology
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The efficacy and particular side effects of therapy peginterferon alpha-2a acute hepatitis C hemodialysed patients
International Journal of Infectious Diseases
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Norovirus infection and acquired immunity in 8 countries: Results from the MAL-ED study
Clinical Infectious Diseases
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Relamorelin reduces vomiting frequency and severity and accelerates gastric emptying in adults with diabetic gastroparesis
Gastroenterology
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Efficacy of percutaneous interventions in patients with hepatic echinococcosis
International Journal of Infectious Diseases
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Follow-up in childhood functional constipation: a randomized, controlled clinical trial
Journal of Pediatric Gastroenterology and Nutrition
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Enteroscopy and radiology for the management of celiac disease complications: Time for a pragmatic roadmap
Digestive and Liver Diseases
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Simultaneous esophagectomy and off-pump coronary artery bypass grafting: a practicable approach with good survival
Diseases of the Esophagus
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Hypertension in Intensive Care Unit Patients.
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
İlhan - Kurultak, Reyhan - Calayoğlu.
Arterial hypertension, also has higher incidence in normal population, is a common problem in intensive care unit. However the data regarding HT are particularly about the outpatients, who have variety of cardiovascular risks and it had remained limited in ICU patients. The ignoring of HT involuntary by health professionals who fight with the more complicated life threatening problems, the existence of different medical conditions of patients and variety of each individual needs can lead this situation. Despite of these difficulties, it is expected that the clinician should be successful to do correct action completely in management of HT like a lot of the other medical conditions. In this review, the evaluation and treatment of HT in ICU is examined in light of recent data.
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A Rare Cause of Seizure; Lipoid Proteinozis (Urbach Wiethe disease): A Case Report
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
Nursel Yurttutan, Nagihan Bilal, Betul Kizildag, Tugba Paksoy Dogruluk, Uygar Utku, Mehmet Akif Sarica.
Lipoid Proteinozis (LP) known as Urbach-Wiethe disease is a rare autosomal recessive inherited genodermatozis. Patients usually present with hoarseness and skin-mucosa abnormalities. Lipoid Proteinozis involves the central nervous system (CNS) rarely. The essential imaging finding in LP is appearance of atypical intracranial calcifications, mostly occurring in the medial temporal lobes. Herein we report a rare case presenting with seizure accompanied computed tomography (CT), magnetic resonance imaging (MRI) findings and also with pathological confirmation.
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Meigs’ Syndrome with Elevated Serum CA125: Case Report
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
Esin Kasap, Mine Genç, Berrin Korkut, Neslin Sahin, Sibel Demir.
An elevated serum CA125 level in association with a pelvic mass,pleural effusion,and massive ascites usually signifies a dismal prognosis in a postmenopausal woman.However, surgery and histopathological examination are required for the correct diagnosis and treatment,since an elevated CA125 level can be falsely positive for ovarian malignancy.We present a case of Meigs syndrome due to left ovarian fibroma with elevated CA125 level in a postmenopausal woman.
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Bilateral abducens nerve and right facial nerve palsy occuring after head trauma
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
İsmail Boyraz, Bünyamin Koç, Hakan Sarman, Mansur Kürşad Erkuran.
Lesions of the nervus abducens, the 6th cranial nerve tend to be rare, usually occur suddenly following head injuries. A 43-year-old male patient presented with a history of fall from a height due to an occupational accident on the date of 11.01.2014. Cranial tomography demonstrated bilateral epidural hematoma. The epidural hematoma was drained during the operation. After the surgery, eye examination showed no vision loss, except limited bilateral lateral gaze. When the patient was unable to walk due to diplopia, he was advised to close one eye. On the right side, there were findings suggesting central facial paralysis. There may be multiple cranial nerve damage following head injury. Therefore, all cranial nerves should be thoroughly examined.
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Rational Drug Use And Parkinson Disease
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
Filiz Özyiğit, Sibel Canbaz Kabay, Özlem Arık.
Aim: Parkinsons disease (PD) is a neurodegenerative disease characterized by increased activity of GABA in basal ganglia and the loss of dopamine in nigrostriatum, associated with rigidity, resting tremor, gait with accelerating steps, and fixed inexpressive face.(1) Current treatments mostly aim to have the symptoms under control. The treatment of the disease can be done accurately when it is integrated with especially patient compliance and all sub-disciplines of pharmacology like drug interactions, pharmacovigilance and pharmacoeconomy. It is aimed in this study to analyse the age when the disease was determined, comorbid diseases, drug use and adverse effects in patients who were diagnosed Parkinson disease and whose treatment already started and to research the Vitamin B12, TSH, Triglyceride, Folic Acid levels that are related with the disease in the literature. Method: The study was conducted on 111 patients who had applied to Kütahya Dumlupınar University Medical Faculty Evliya Çelebi Education & Research Hospital between 2006 and 2013 and were diagnosed Parkinson disease. The following data of the patients- age, gender, drugs having been used, treatments related with the comorbid diseases, adverse effects, B12 vitamin values in the files of 44 patients, their Triglyceride levels, TSH and Folic acid levels- were reviewed retrospectively from their follow-up files. Findings: The participants of the study were 111 subjects diagnosed Parkinson disease and 47 of them (42,3%) were female while 64 (57,7%) were male. The age range during which the disease was seen frequently was (65-74) and the age average was 64 (25-86). 107 (96,3%) of the 111 subjects were started with antiparkinson treatment. In terms of the comorbid diseases to Parkinson, no comorbid diseases were determined in 78 (70,2%) of the 111patients while depression was seen in 8 (%24,4) subjects, hypothyroidis was seen in 13 (39,4%) subjects, DM was seen in 7 (21,2%) subjects, hyperlipidaemia was seen in 2 (6,2%) subjects. 40 (36%) of the patients didnt use any additional drugs, but additional drug use was determined in 71 (63%) patients. In terms of the data of the 44 patients, whose laboratory data could be obtained, it was found that that on average B12 value was 412.53 and TSH value was1.48 while Folate value was 9.35 and TG value was 131.56. In these 44 patients, B12 value of 32 (73%) patients, TSH value of 24 (55%) patients, Folate value of 30 (68%) patients were low, whereas TG value of 23 (47%) was low. Discussion & Conclusion: Rational drug use is extremely crucial in the treatment of Parkinson disease. One of the most important factors in the treatment success is compliance with the treatment. A careful follow up of folate, B12, TSH, Triglyceride levels related to the disease in the literature in patients diagnosed Parkinson disease and taking the required precautions will provide synergistic contribution to the treatment success.
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The Evaluation Of Histopathological Diagnosis In Hysterectomy Materials
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
Çiğdem Kunt İşgüder, Hatice Yılmaz Doğru, Asker Zeki Özsoy, Bülent Çakmak, İlhan Bahri Delibaş, Akgül Arıcı, Fazlı Demirtürk.
Aim: The aim of this study is to assess the preoperative clinic indications and postoperative histopathological diagnosis of hysterectomies with benign indications. Materilas and Methods: Clinical features and reports of postoperative histopathological diagnosis of 170 patients, whose underwent hysterectomy with benign indications in Gaziosmanpasa University Medical Faculty Department of Obstetrics and Gynecology, were retrospectively evaluated. Results: The mean age of the patients was 50.48±7.50 (min:38, max:74). Leiomyoma with 77 case (%45.3) was the most hysterectomy indicated disease. Thereafter, dysfunctional uterine bleeding in 50 (%29.49), and endometrial hyperplasia 22 (%12.9) were detected. The other clinical indications were uterine prolapse in 17 patients (%10), chronic pelvic pain in 2 (%1.2) and adenomyosis in 2 (%1.2). The results of histopathological reports belong to hysterectomy materials indicated that leiomyoma was the most common pathological finding with 87 cases (%51.2), subsequently adenomyosis in 35 cases (% 20.5) and endometrial hyperplasia in 31 (18.3) was detected. Endometrial polyp was found in 10 cases (%5.9) and atrophic endometrium in 7 cases (%4.1). Combined pathology was defined in 44 hysteterctomy materials. Leiomyoma and endometrial hyperplasia were detected as the most common combination with a ratio of %50. In addition, chronic cervicitis was seen in %64.7 of cervical examinations of hysterectomy materials. Conclusion: Adenomyosis should be kept in mind while planning the diagnosis and treatment of patients whose admitted with compliants of menometrorrhagia, seconder dysmenorrhea and chronic pelvic pain in 4th and 5th decade. Endometrial sampling caused by the co-existence of leiomyoma and endometrial hyperplasia must be necessary in hysterectomy planned cases for leiomyoma those already have menometrorrhagia.
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Off-Pump Coronary Artery Surgery in Diabetic Elderly and Octogenerian Groups :Perioperative Outcome and Clinical Results
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
Suleyman Surer, Ilker Ince, Ali Bulut, Uğursay Kızıltepe.
Abstract Objective: Increased risk for perioperative morbidity and mortality after beating heart coronary artery bypass grafting(CABG) in diabetic octogenarians (Group II) and elderly (Group I) can be in question. We aimed to compare the risk factors and the results of off-pump CABG between diabetic elderly and octogenarian groups . Methods: This study retrospectively enrolled 37 diabetic patients with an age equal to or greater than 65 years who underwent isolated OPCAB at our department . Twenty-five patients were between 65 and 75 years of age while 12 patients had an age equal to or greater than 76 years. Each study group was assessed for preoperative properties, operative characteristics, and postoperative outcomes. Results: Elderly patients had a significantly higher mean number of arterial anastomoses (p=0.045), body mass index (BMI) (P=0.001), number of smoking subjects (p=0.027), and number of subjects using ACE inhibitors (P=0.027) compared to the octogenarians. Octogenarians had a significantly greater mean number of venous grafts (1.5±0.61 vs 2.25±0.75, p= 0.008). Conclusions: People of advanced age have been increasingly operated with CABG operation as persons 80 years old or older live longer than previously expected. Off-pump CABG was a beneficial surgical coronary revascularization method for both elderly and octogenarian patients.
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Impact of Adenotonsillectomy and Adenoidectomy on Mean Platelet Volume (MPV) Levels
2016-04-05T00-57-04Z
Source: Journal of Contemporary Medicine
Serhan Derin, Murat Şahan, Hatice Topal, Yaşar Topal.
Objective: Adenotonsillar hypertrophy (ATH) leads to many disorders, especially cardiopulmonary diseases. Previous studies have reported the increase in pulmonary hypertension incidence in patients with ATH, as well as a decrease after adenotonsillectomy. Mean platelet volume (MPV) is becoming a prognostic indicator for pulmonary hypertension in recent studies, as it is in most cardiac diseases. It is known that larger platelets have increased proinflammatory and vasomotor activity, and prothrombotic potential. The purpose of this study to investigate whether of MPV levels changes after adenotonsillectomy and adenoidectomy. Methods: In this study, MPV values in patients with ATH were evaluated, and the impact of surgical treatment on MPV levels was analyzed. Thirty-five patients had adenotonsillectomy, while the remaining 30 patients had adenoidectomy. The preoperative and postoperative third month hemogram results were compared. Results: The mean age of the children was 6.51 ± 2.75 (2-16) years. The decrease in MPV levels after the operation was statistically significant (Preoperative 9,75±0,95; Postoperative 8,14±1,25). p
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Humanin prevents brain mitochondrial dysfunction in a cardiac I/R injury model
Myocardial ischemia-reperfusion (I/R) injury causes interferences in systemic circulation and damages not only the heart but also several vital organs including the brain. Nevertheless, limited information is available regarding the effect of cardiac I/R injury on the brain including the blood brain barrier (BBB) breakdown, brain oxidative stress and mitochondrial function. Recently, a novel peptide called humanin has been shown to exert potent neuroprotective effects. However, the effect of humanin on the brain under cardiac I/R injury has not yet been investigated. Forty-two male Wistar rats were divided into two groups; an I/R group which were subjected to a 30-minute left anterior descending coronary artery occlusion, followed by 120-minute reperfusion (I/R group: n = 36), and a sham group (n = 6). The I/R group was divided into six subgroups. Each subgroup was intravenously given either vehicle or humanin analog (84 μg/kg/day) at three different time points: pre-ischemia, during-ischemia and at the onset of reperfusion. At the end of the experimental protocol, animals were sacrificed, and the brains were removed for determination of mitochondrial function, oxidative stress and western blot analyses. I/R injury condition caused BBB breakdown, increased brain oxidative stress and mitochondrial dysfunction. Only pre-ischemic humanin treatment attenuated brain mitochondrial dysfunction, but it did not prevent BBB breakdown nor brain oxidative stress. Humanin treatment during ischemia and at the reperfusion period provided no neuroprotection. These findings indicate that humanin exerted neuroprotection during cardiac I/R injury via improved brain mitochondrial function.
This article is protected by copyright. All rights reserved
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Lessons from the laboratory; integrated regulation of cerebral blood flow during hypoxia
Exposure to acute or chronic hypoxaemia in otherwise healthy humans results in compensatory increases in cerebral blood flow (CBF) at rest and during exercise referred to as hypoxic cerebral vasodilatation. These elevations in CBF offset the reduction in arterial oxygen content (CaO2) and maintain cerebral O2 delivery (CDO2) conforming to the conservation of mass principle. In this review, we discuss the fundamental principles that contribute to the defence of CDO2 and the corresponding implications for metabolism. We critically address to what extent the increase in CBF reflects an adaptive or indeed maladaptive physiological response. The molecular mechanisms of CBF regulation in hypoxia are also briefly discussed and future directions proposed.
This article is protected by copyright. All rights reserved
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Experiences of working from a freestanding position as a case manager when supporting clients in the Swedish welfare system.
The Swedish state uses a case management function known as Personligt Ombud (PO). The role as PO differs from the traditional professional roles. It has a freestanding position in the welfare system. The aim of this study was to investigate POs' experiences of working from a freestanding position when supporting clients. Telephone interviews were conducted with 22 POs across Sweden. The interviews were recorded, transcribed, and analyzed by latent qualitative content analysis. The findings were reflected in three categories - freedom-promoted flexibility, surfing through a complex welfare system, and working for legitimacy. POs developed a holistic view to both the client as well as to the welfare system. POs experienced solely representing the client, which is a positive feature because part of the POs' role is advocating for the clients rights. The PO service differs from the PO service from other existing case management models and may need to develop strategies for decision-making and support in their own role. For example, they may use group supervision teams or 'reflective teams'. The freestanding position may also entail problems in terms of lack of legitimacy. It is important for POs to develop good platforms with the surrounding actors among others things to improve the co-ordination process. It could be interesting if the PO model would be tested in other countries that have a fragmented welfare system. The PO model may also be useful to other 'target groups' who are in need of co-ordinated rehabilitation services. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
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A rare variant in COL11A1 is strongly associated with adult height in Chinese Han population
Source:Journal of Genetics and Genomics
Author(s): Changbing Shen, Xiaodong Zheng, Jing Gao, Caihong Zhu, Randy Ko, Xianfa Tang, Chao Yang, Jinfa Dou, Yan Lin, Yuyan Cheng, Lu Liu, Shuangjun Xu, Gang Chen, Xianbo Zuo, Xianyong Yin, Liangdan Sun, Yong Cui, Sen Yang, Xuejun Zhang, Fusheng Zhou
Human height is a highly heritable trait in which multiple genes are involved. Recent genome-wide association studies have identified that COL11A1 is an important susceptibility gene for human height. To determine whether the variants of COL11A1 associate with adult and children height, we analyzed splicing and coding single-nucleotide variants across COL11A1 through exome-targeted sequencing and follow-up validation in a total 20,426 Chinese Han samples. A total of 105 variants were identified by exome-targeted sequencing, of which 30 SNPs were located in coding region. The strongest association signal between and height was P_value of 4.8 x 10-7. Chr1_103380393 also showed nominal significance in the validation stage (P = 1.21 x 10-6). Combined analysis of 16,738 samples strengthened the original associations of chr1_103380393 with adult height (Pcombined = 3.1 x 10-8), with an increased height of 0.292se per G allele (95% CI: 0.19-0.40). There was no evidences (P = 0.843) showing that chr1_103380393 altered child height in 3,688 child samples. Only the group of 12-15 years showed slight significance with P-value of 0.0258. This study firstly shows that genetic variants of COL11A1 contribute to adult height in Chinese Han population but not to children height, which expand our knowledge of the genetic factors underlying height variation and the biological regulation of human height.
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