2016-12-14T06-04-54Z
Source: National Journal of Integrated Research in Medicine
Soham Patel*, Mayur Parmar**, Aumkar Trivedi***, Jalark Patel****, Jigar Joshi*****, Mayuri Chavda******.
Background and Aim: Hypertension is one of the medical conditions that are of great importance in the management of dental patients. It may present as an emergency during dental treatment or necessitate a change in patients management. Present study was performed with an aim to determine the prevalence of undiagnosed hypertension and how well controlled diagnosed hypertensive patients presenting at a dental out-patient clinic in Goenka research institute of Dental Science, India. Methodology: A cross sectional survey of patients presenting at the Goenka research institute of Dental Science, Piplaj Gandhinagar India between July and October 2015 was undertaken. Consenting patients above 15 years of age had their blood pressure assessed with the aid of a digital sphygmomanometer. The relationship between blood pressure and body mass index, family history of hypertension as well as socioeconomic status were assessed. Statistical significance was set at p
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Τετάρτη 14 Δεκεμβρίου 2016
Prevalence Of Undiagnosed Hypertension Amongst Patients Attending Goenka Research Institute Of Dental Science, Piplaj Gandhinagar, India- A Cross Sectional Study
A study to determine the knowledge and level of awareness of medical undergraduates about herbal medicines and herb-drug interactions
2016-12-14T04-23-56Z
Source: International Journal of Basic & Clinical Pharmacology
Jaspreet K. Boparai, Amandeep Singh, Ashwani K. Gupta, Prithpal S. Matreja, P. M. L. Khanna, Vipan Gupta, Rakesh K. Gautam.
Background: The increasing usage of herbal medicines worldwide has increased the probability of co-administration of herbal and allopathic medicines. This may lead to serious safety concerns, including herb-drug interactions (HDIs). Many HDIs may be overlooked due to poor doctor-patient communication about herbal drug usage probably because of lack of knowledge of herbal medicines and HDIs among physicians. The study was thus planned to identify the knowledge and awareness of medical students regarding the use of herbal medicines and about HDIs, to help improve the teaching skills and curriculum development for medical students. Methods: 286 medical students of 2nd, 3rd and 4th year MBBS course completed the study. All the participants were asked to fill a self-administered questionnaire consisting of 15 questions which included both open-ended and close-ended questions related to age, sex, knowledge, awareness and usage of herbal medicines and about herb-drug interactions. Data was analyzed and expressed as counts and percentages. Results: Majority (95.45%) of the students were aware of the fact that herbs can be used as medicines. They were most familiar with the herbs tulsi, neem, turmeric, aloe, ashwagandha and ginger. 46.85% consider herbal medicines to be risk free, and majority (55.6%) were not aware of the fact that herbs can cause herb-drug interactions. Media and elderly family members were their most common sources of information regarding herbal medicines. Majority (75.17%) would prefer allopathic medicines over herbal medicines. Only 23.07% always informed the physician about their usage of herbal medicines, although most (84.96%) felt that history regarding use of herbal medicines should be taken. Majority were not aware of the regulatory status of herbal medicines. Conclusions: Lack of knowledge and awareness of medical students about herbal medicines and herb-drug interactions was seen in the study. There is a need to inform the students of allopathic system of medicine about the adverse outcomes of herbal medicines and the knowledge about herb-drug interactions should be a part of the medical curriculum.
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WHO core prescribing indicators in patients with allergic contact dermatitis in a coastal town of South India
2016-12-14T04-23-57Z
Source: International Journal of Basic & Clinical Pharmacology
Divyashanthi C. M., Bhanu P. Kolasani, Pandiamunian Jayabal, Prasanand Sasidharan, Barathane Datchanamurthy.
Background: Prescribing pattern analysis utilizing WHO core drug prescribing indicators can be helpful for the assessing the beneficial and adverse impacts of the prescribed drugs. Even though many drugs are commonly used in treatment of Allergic contact dermatitis (ACD) they are least studied in terms of prescribing patterns. Hence the present study was planned to analyze the prescribing pattern and study the WHO core prescribing indicators in patients with ACD in our institute. Methods: A prospective observational study was carried out with prescriptions of 81 outpatients who attended the dermatology OPD with the diagnosis of ACD over a period of six months. Details such as basic demographics, specific drugs prescribed with their dose and dosage forms were recorded and WHO core prescription indicators analysed. Results: Overall, corticosteroids both topical and systemic were the most commonly prescribed drugs (45.54%) followed by antihistamines (30.69%) and antimicrobials (13.86%). The most commonly prescribed topical corticosteroid was desonide (58.82%), systemic corticosteroid was prednisolone (47.61%), antihistamine was cetirizine (54, 83%) and antimicrobials were cephalosporins (42.86%). Average drugs per prescription for patients of ACD were 6.8. Percentage of drugs prescribed by generic name was 22.77%. Percentage of encounters with antibiotic prescribed was 13.86% whereas injection prescribed was 9.90%. Percentage of drugs prescribed from National list of essential medicines (NLEM) was 53.57%. Conclusions: Corticosteroids remain the mainstay of treatment in ACD. The percentage of encounters with an injection and the use of systemic steroids were low and were according to the guidelines. But drugs prescribed by generic name and those prescribed from NELM were found to be satisfactory but can further be improved.
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Prescribing pattern and WHO core prescribing indicators in post-operative patients of Gynaecology department of a Tertiary Care Teaching Hospital
2016-12-14T04-23-57Z
Source: International Journal of Basic & Clinical Pharmacology
Bhanu P. Kolasani, Prasanand Sasidharan, Divyashanthi C. M., Annabelle Rajaseharan, Pandiamunian Jayabal.
Background: Prescription pattern analysis is an essential tool to provide an insight regarding the existing drug usage and to ensure rational drug therapy. Even though drugs used for gynecological disorders are one of the commonly used, they are least studied in terms of prescribing patterns. Hence the present study was planned to analyze the prescribing pattern and WHO core prescribing indicators among post-operative patients of Gynaecology department in our institute. Methods: A prospective observational study was conducted in 76 post-operative patients of Gynaecology department for a period of six months. Each prescription was analyzed for demographic data, total number and various categories of drugs prescribed, the percentage of individual drugs prescribed in each category, the dosage forms and the percentage of drugs prescribed by generic name, and from essential drug list were also analyzed. Results: A total of 990 medications were prescribed among which anti-microbial agents (32.52%) were the most commonly prescribed category followed by analgesics (19.60%) and Intravenous fluids (13.53%). Metronidazole (27.02%) was the most commonly prescribed antimicrobial, Diclofenac (68.04%) was the commonly prescribed analgesics and Ringer lactate (38.81%) was the commonly prescribed Intravenous fluid. Most commonly prescribed antiulcer drug was ranitidine (75.0%), antiemetic was Ondansetron (76.39%). Majority of drugs (72.54%) were prescribed by generic name. Average number of drugs per prescription was 13.03. Percentages of encounters with antibiotics were 32.52%. The percentage of drugs prescribed from the National List of Essential Medicines (NLEM) was 82.16%. Injection (57.78%) was the most common drug formulation. Conclusions: Antimicrobial agents and analgesics were the most commonly prescribed drugs. Prescription by generic name was high, usage of antibiotics and injections were also high and Poly-pharmacy was common, especially among antimicrobial agents. Prescribing according to the national essential list of medicines was high, which indicates rational prescription.
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Potential anti-seizure activity of atorvastatin in rat models of seizure
2016-12-14T04-23-57Z
Source: International Journal of Basic & Clinical Pharmacology
Ashwini P. Singh, Radhika M. S..
Background: Atorvastatin belongs to the class of Hypolipidemic statins. Increasing evidence indicates that statins are neuroprotective in several conditions, including stroke, cerebral ischemia and traumatic brain injury. However, only scanty and controversial reports are available on anticonvulsant action of statins. The present study therefore aims at exploring the influence of atorvastatin on seizures as compared to standard anticonvulsants phenytoin and sodium valproate in Wistar rats. Methods: Rats were divided into 8 groups (n=6), each treated intraperitoneally (i.p) with atorvastatin, phenytoin or sodium valproate in their therapeutic equivalent doses. Their effects were evaluated on seizures induced by maximum electroshock seizure (MES) and pentylenetetrazole (PTZ). Hind limb extension (HLE) in MES model, number of seizures, duration of seizure, number of myoclonic jerks and time for onset as well as recovery from seizures in PTZ model were monitored. Statistical analysis was done using Kruskal-Wallis ANOVA and Mann-Whitney U test for significance. Results: Atorvastatin failed to protect rats against HLE in MES seizure model. However, atorvastatin significantly prolonged seizure onset time (p
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Anatomical principles of intraperitoneal drain placement
2016-12-14T04-04-05Z
Source: International Journal of Research in Medical Sciences
Ketan Vagholkar, Shrikant Suryawanshi, Suvarna Vagholkar.
Drain placement after abdominal surgery continues to be a standard practice. However in recent years there has been reluctance amongst surgeons to drain the peritoneal cavity liberally thereby leading to a multitude of septic complications. A brief review of the physical dynamics of intraperitoneal spaces is presented with a view to improve the practice of optimum drain placement.
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Role of chest ultrasonography in the prognostic evaluation of patients with community acquired pneumonia: a prospective study
2016-12-14T04-04-05Z
Source: International Journal of Research in Medical Sciences
Kizhakkepeedika Davis Rennis, Muhammed Anaz, Easwaramangalath Venugopal Krishnakumar, Vadakkan Thomas, Ambooken Poulose Robert.
Background: Chest ultrasonography (USG) has shown a growing interest during the last few years in the diagnosis of pneumothorax, pneumonia, or pulmonary contusions. This study was aimed to assess the ability of bedside chest USG in the prognosis of community-acquired pneumonia (CAP) patients and to compare USG with pneumonia severity index (PSI) score and conventional chest radiograph (CXR). Methods: This prospective study was done in patients who get admitted with history and examination findings suggestive of community-acquired pneumonia were included in the study, PSI scoring and CXR were evaluated at the time of presentation. Chest physician performed the thoracic USG. PSI scoring, CXR and USG were repeated on third day and at the time of final outcome. Diagnosis at hospital discharge was taken as the reference standard. Results: Total 100 patients (57±17 years) were included in the study. Correlation between USG, CXR and PSI score were analysed using Spearman's correlation (r). A significant (p = 0.001) correlation between USG and PSI score was found on day 1 (r=0.35), on day 3 (r=0.43) and on the final day (r=0.25). Similarly a significant correlation (p=0.001) was also found between USG and CXR (on day1(r=0.81), on day 3 (r=0.81) and on final day (r=0.74). Conclusions: The chest-ultrasound as a bedside real time, reliable, rapid and non-invasive technique is useful in the prognostic evaluation of pneumonia patients.
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Metallo-Β-Lactamase Producing Clinical Isolates Of Acinetobacter Baumannii And Pseudomonas Aeruginosa In A Teaching Hospital Of Rural Gujarat-India.
2016-12-14T04-03-11Z
Source: National Journal of Integrated Research in Medicine
Yagnesh Pandya*, Suman Singh**, Dhara Badodariya***, Nimisha Shethwala****.
Background: Production of metallo-β-lactamase, an enzyme that hydrolyze a variety of β-lactams including carbapenems leaving little therapeutic option is increasing. To manage patients effectively, it is important to know the local prevalence of MBLs in the hospital. Present study was undertaken to determine prevalence of metallo-β-lactamase production along with the clinical profile of Acinetobacter baumannii and Pseudomonas aeruginosa. Methods: Prospective cross sectional study was carried out during December-2010 to November-2011. Relevant demographic and clinical details were collected. Acinetobacter baumannii and Pseudomonas aeruginosa were subjected to antimicrobial susceptibility testing by Kirby-bauer disc diffusion method and mini API system, (bioMerieux-France). Imipenem/meropenem resistant isolates were tested for metallo-β-lactamase production by imipenem-EDTA combined disc test. Results: 81 strains of Acinetobacter baumannii and 28 strains of Pseudomonas aeruginosa were isolated. Most common specimens from which Acinetobacter baumanni and Pseudomonas aeruginosa isolated were from respiratory tract i.e. 47(58%) and 12(42.9%) respectively. Majority of the strains of Acinetobacter baumannii 44 (54.3%) and Pseudomonas aeruginosa 17 (60.7%) were isolated from non critical areas. Both organisms showed high prevalence of multidrug resistance with MBLs production of 29.6% in Acinetobacter baumannii and 42.9% in Pseudomonas aeruginosa. Conclusion: Metallo-β-lactamase-mediated carbapenem resistance is a significant threat in hospitalized patients. It should be addressed with rapid detection and stringent infection control measures. [Yagnesh P NJIRM 2016; 7(6): 29-33]
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Learning and Teaching in Microbiology: Students’ Perception
2016-12-14T04-03-11Z
Source: National Journal of Integrated Research in Medicine
Shazia Chavan*, Sarala Menon**, Ashwini Ronghe***, Abhay Chowdhary****.
Aims and objectives: The aim of the study was to evaluate the students perception regarding the existing teaching system in Microbiology in our college. We also attempted to implement the changes suggested by the students after analyzing the feedback. Feedback was taken again after the changes were made. Materials and methods: A structured validated questionnaire on teaching methodology was distributed among one hundred and ninety two second year MBBS students at the end of second term. The changes suggested were implemented and a questionnaire was given at the end of third term. The data was collected and analysed using simple statistical methods. Results: Sixty nine percent (69%) of students felt that the changes suggested in the second term were implemented in third term. Students were taught using tutorials and seminars and seventy six percent (75.9%) students said they benefitted from them. Students found revision practicals were conducted systematically. Conclusion: Feedback should be an ongoing process to know about students perspectives. The feedback from the students facilitated a change in teaching methodology by the faculty. It is evident from the feedback that the students were satisfied with the changes adopted in our department. They found the department student-friendly &approachable after the feedback. [Shazia C NJIRM 2016; 7(6): 25-28]
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Prevalence Of Undiagnosed Hypertension Amongst Patients Attending Goenka Research Institute Of Dental Science, Piplaj Gandhinagar, India- A Cross Sectional Study
2016-12-14T04-03-11Z
Source: National Journal of Integrated Research in Medicine
Soham Patel*, Mayur Parmar**, Jalark Patel***, Aum Trivedi****.
Background and Aim: Hypertension is one of the medical conditions that are of great importance in the management of dental patients. It may present as an emergency during dental treatment or necessitate a change in patients management. Present study was performed with an aim to determine the prevalence of undiagnosed hypertension and how well controlled diagnosed hypertensive patients presenting at a dental out-patient clinic in Goenka research institute of Dental Science, India. Methodology: A cross sectional survey of patients presenting at the Goenka research institute of Dental Science, Piplaj Gandhinagar India between July and October 2015 was undertaken. Consenting patients above 15 years of age had their blood pressure assessed with the aid of a digital sphygmomanometer. The relationship between blood pressure and body mass index, family history of hypertension as well as socioeconomic status were assessed. Statistical significance was set at p
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Prediction Of Outcome In Critically Ill Or Emergency Surgical Patients: Comparision Of Ph, Base Deficit/Excess And Anion Gap
2016-12-14T04-03-11Z
Source: National Journal of Integrated Research in Medicine
Shekhar Chaudhary*, Suresh Singh**, Deepak Malviya***.
Introduction: Abnormal arterial acid-base balance is among the best predictors of mortality in critically ill patient and early detector of serious conditions. The present study was undertaken to predict the outcome of critically ill patients and to compare various parameters for pH, base deficit/excess, anion gap correlate the prediction of mortality and morbidity of outcome. Method: The present study was conducted among 38 patients of age group 20-69 years of either sex, admitted in emergency and intensive Care unit at Nehru Hospital, BRD Medical College, Gorakhpur. Patients in both groups (19 each) were observed for hemodynamic parameters and biochemical parameters for maximum 3 days. Predicted mortality by LODS at the time of admission and actual mortality on day 3 were also noted. Results: Correlation between predicted mortality by LODS and actual mortality in medically ill patients shows high correlation for pH and moderate correlation for HCO3- and low correlation for anion gap and base excess/deficit. In emergency surgical patients high correlation was observed for pH, HCO3- and base excess/deficit while moderate correlation for anion gap. Conclusion: Measuring the pH, anion gap and base deficit at the time of admission, can predict the mortality rate which is comparable to other scoring systems. Early correction of acid-base alteration is recommended to reduce mortality rate. [Shekhar C NJIRM 2016; 7(6): 13-19]
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A Cross- Sectional Observational Study On The Prevalence Of Mechanical Low Back Pain In Physiotherapy Students
2016-12-14T04-03-11Z
Source: National Journal of Integrated Research in Medicine
Patil Vishakha S*, Master Mahaziver F**, Naik Rajashree V***.
Background & Objectives: Ergonomics is an integral part of rehabilitation. However, few therapists implement it themselves, hence suffering from various musculoskeletal disorders the most common being low back pain. Taking a community of physiotherapy students, the prevalence of mechanical low back pain was investigated to illuminate the possible risk factors faced by the students in question. The aim of the study was to investigate the prevalence of mechanical low back pain and disability in physiotherapy students. Methods: The study was conducted in the physiotherapy department of a tertiary health care centre in Mumbai. A self-constructed, semi-structured proformawas handed over to the students, who were made to fill out the Modified Oswestry Low Back Pain and Disability Questionnaire. Pain Intensity was recorded on the Visual Analogue Scale. The data was compared and analysed. Results: 352 per1000 students suffered from mechanical low back pain. Majority suffered from mild disability. Standing was the most affected activity. Interpretation & Conclusion: Physiotherapy students should bemade aware of the potential causes of mechanical low back pain, which could stem from the practice of this occupation. Primary prevention will lead to a better state of health for the students and future therapists, enhancing patient rehabilitation. [Patil V NJIRM 2016; 7(6):9-12]
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Cross Cultural Adaptation, Reliability and Validity of Gujarati Version of Fear Avoidance Belief Questionnaire in Chronic Low Back Pain
2016-12-14T04-03-11Z
Source: National Journal of Integrated Research in Medicine
Dibyendunarayan D Bid*, Neela C Soni**, Priyanshu V Rathod***, A. Thangamani Ramalingam****, Rakesh Kumar Sinha*****.
Background: The Fear-Avoidance Beliefs Questionnaire (FABQ) is useful for measuring fear avoidance beliefs in patients with low back pain (LBP); however, no psychometrically validated Gujarati version is available. Study Design: Cultural translation and psychometric testing. Objective: To translate and test the psychometric properties of Gujarati versions of the FABQ. Summary of Background Data: Although commonly used, no previous reports exist on the translation process or the testing of the psychometric properties of the Guajarati version of the FABQ to be used in India. Methods: Translation and cross-cultural adaptation of the original English versions of the FABQ was performed according to published guidelines. A panel of 20 healthcare professionals completed the content validity form. Test-retest reliability for the FABQ-G was examined in 30 CLBP patients. Patients completed the questionnaire twice with an interval of 48 hours. Results: The Content validity and Face validity was found to be excellent. FABQ-G exhibited excellent internal consistency shown by a Cronbachs α value of 0.843 and subscales FABQ-G-W and FABQ-G-PA also showed good internal consistencies (α=0.652 and 0.654 respectively). The test-retest reliability was excellent in chronic low back pain (CLBP) patients (ICC=0.915) and (ICC=0.864 & 0.818 for the FABQ-W and FABQ-PA, respectively). Pain intensity score had high correlation with FABQ-W (r=0.819; p
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An evaluation of the indications, complications and results of patients with percutaneous endoscopic gastrostomy
2016-12-14T01-48-32Z
Source: Medicine Science | International Medical Journal
Oguzhan Yildirim, Yuksel Seckin, Yilmaz Bilgic, Melih Karıncaoglu, Murat Aladag.
Aim of this study is to evaluate the indications, complications and results of patients undergoing percutaneus endoscopic gastrostomy. In our study, we evaluated the outpatients or hospitalized patients applying to Turgut Özal Medical Center between April 2008-November 2010. 247 patients who would be unable to perform oral feeding for at least 4 weeks and underwent for PEG procedure were evaluated retrospectively. PEG procedure was performed 296 times on 247 cases. The most common indication for PEG has been neurological diseases (39.2%), other indications follow up in order with respiratory failure (10.5%), multiple trauma (10.1%), hypoxic encephalopahty (8.6%) and the other diseases (6.5%). Complications associated with PEG were wound infection (5.6%), tube blockage (3.2%), tube fracture (2.4%), tube leakage (2.4%), breakage (2.4%), and buried bumper syndrom (3.2%). Overall minor complication rate was %13,7, and overall major complication rate (buried bumpersyndrome) was 3.2%. The most common complication was wound infection. During follow-up, 102 patients died of primary disease. 30 days (early) and 1 year mortality rates were 14.3% and 39.5%. Overall mortality rate was 41,3% and mean survival was 17.34 ± 0.7 months. PEG tube was removed in 10 cases because of a adequate oral intake. The mean duration of a PEG tube stay was 16 ± 1.2 months. PEG is a procedure requiring no general anesthesia with low morbidity and mortality rates. It is also an effective, safe method which can be performed at the bedside. It should be one of methods prefered for patients who need long-term enteral nutrition.
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Impact of proximal vascular ligation on survival of patients with colon cancer
Annals of Surgical Oncology
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Post-treatment resistance analysis of hepatitis C virus from phase 2 and 3 clinical trials of ledipasvir/ sofosbuvir
Journal of Hepatology
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The effect of obesity on treatment outcomes for low back pain
Chiropractic & Manual Therapies
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Hepatitis C infection and the risk of non-liver-related morbidity and mortality in HIV-positive persons in the Swiss HIV Cohort Study
Clinical Infectious Diseases
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The role of conventional ultrasonography in the evaluation of antrum wall thickness in obese patients
Obesity Surgery
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Perceived stress as a risk factor for peptic ulcers: A register-based cohort study
BMC Gastroenterology
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The role of capsule endoscopy in the diagnosis and treatment of obscure gastrointestinal bleeding in older individuals
European Journal of Gastroenterology & Hepatology
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Acute liver injury induced by levetiracetam and temozolomide co-treatment
Digestive and Liver Diseases
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Randomized controlled study of the safety and efficacy of nitrous oxide-sedated endoscopic ultrasound-guided fine needle aspiration for digestive tract diseases
World Journal of Gastroenterology
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Treatment-emergent depression and anxiety between peginterferon alpha-2a versus alpha-2b plus ribavirin for chronic hepatitis C
BMC Psychiatry
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Totally laparoscopic total gastrectomy using the overlap method; Early outcomes of 50 consecutive cases
Surgical Endoscopy
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Risk factors for development of pulmonary hypertension in infants with bronchopulmonary dysplasia: systematic review and meta-analysis
Paediatric Respiratory Reviews
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Evolution after anti-TNF discontinuation in patients with inflammatory bowel disease: A multicenter long-term follow-up study
The American Journal of Gastroenterology
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Water exchange method significantly improves adenoma detection rate: A multicenter, randomized controlled trial
The American Journal of Gastroenterology
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Targeted therapies provide treatment options for poorly differentiated pancreatic neuroendocrine carcinomas
Oncology
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Infliximab induced tuberculosis in patients with UC: Experience from a country with high prevalence of tuberculosis-India
Journal of Gastroenterology and Hepatology
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Utility of double endoscopic intraluminal operation for esophageal cancer
Surgical Endoscopy
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Sex differences in the association of obesity and colorectal cancer risk
Cancer Causes and Control
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Systematic review and meta-analysis of robotic versus open pancreaticoduodenectomy
Surgical Endoscopy
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Clinical, histological, and molecular risk factors for cancer recurrence in patients with stage II colon cancer
European Journal of Gastroenterology & Hepatology
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Parasympathetic withdrawal increases heart rate after two weeks at 3,454 m altitude
Chronic hypoxia increases resting heart rate (HR), but the underlying mechanism remains incompletely understood. We investigated the relative contributions of the sympathetic and parasympathetic nervous systems, along with potential non-autonomic mechanisms, by individual and combined pharmacological inhibition of muscarinic and/or β-adrenergic receptors. In seven healthy lowlanders, resting HR was determined at sea level (SL) and after 15–18 days of exposure to 3,454 m high altitude (HA) without drug intervention (CONT) as well as after intravenous administration of either propranolol (PROP), glycopyrrolate (GLYC), or PROP and GLYC in combination (PROP+GLYC). Circulating norepinephrine concentration increased from 0.9 ± 0.4 nmol−1 at SL to 2.7 ± 1.5 nmol−1 at HA (P = 0.03). The effect of HA on HR depended on the type of autonomic inhibition (P = 0.006). Specifically, HR was increased at HA from 64 ± 10 to 74 ± 12 beats min−1 during CONT (P = 0.007) and from 52 ± 4 to 59 ± 5 beats min−1 during PROP (P < 0.001). In contrast, HR was similar between SL and HA during GLYC (110 ± 7 and 112 ± 5 beats min−1, P = 0.28) and PROP+GLYC (83 ± 5 and 85 ± 5 beats min−1, P = 0.25). Our results identify a reduction in cardiac parasympathetic activity as the primary mechanism underlying the elevated HR associated with two weeks of exposure to hypoxia. Unexpectedly, the sympathoactivation at HA that was evidenced by increased circulating norepinephrine concentration had little effect on HR, potentially reflecting down-regulation of cardiac β-adrenergic receptor function in chronic hypoxia. These effects of chronic hypoxia on autonomic control of the heart may concern not only HA dwellers, but also patients with disorders that are associated with hypoxemia.
This article is protected by copyright. All rights reserved
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North American Spine Society Presidential Address
Wow! It's hard to believe I am standing here in front of you all at the podium as the outgoing NASS President. Truly, this is, and has been, beyond my wildest dreams. Looking back, I'm not really sure how I got here! For sure, I feel like I've just gotten by, fooling you all into thinking that I know what I'm doing. Regardless, thank you for letting me represent you. That's as much as I'd ever hoped to do this past year—to represent you, the NASS members. I had no hidden agenda or secret to-do list.
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A response to a commentary by Dr. Daniel J. Cher
We appreciate the interest of Dr. Cher, an industry employee, in our paper as it is important for manufacturers to fully investigate the safety and efficacy of their products. However, we believe that our results were misinterpreted.
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The optimal treatment for symptomatic neurogenic claudication or radiculopathy in the presence of mild degenerative scoliosis remains unclear
Degenerative lumbar scoliosis is a relatively common spinal disorder that typically affects patients older than 50 years old. As the population ages, the number of patients with this disease process will inevitably increase. The vast majority of patients have minor deformities (<30° coronal Cobb angles) and are relatively asymptomatic. A subset of patients develop axial back pain with or without neurologic symptoms (neurogenic claudication or radiculopathy). Patients typically develop radicular symptoms on the concave side of their apical or low lumbar fractional curves.
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