Avalance

KEY CLINICAL MASSAGE: A 23-year-old rancher was admitted with the diagnosis of brucellosis. In evaluations, a massive vegetation in the aortic valve was seen. A combination of antibiotic therapy and cardiac surgery were performed, it seems this approach reduces mortality and complications. ABSTRACT: Brucellosis (also known as "undulant fever," "Mediterranean fever," or "Malta fever") is a zoonotic infection transmitted to humans from infected animals (cattle, sheep, goats, camels, pigs, or other animals) by ingestion of food products (such as unpasteurized dairy products) or by contact with tissue or fluids...

INTRODUCTION: Our objective was to investigate the trajectories of anxiety, depression, emotional and social functioning in women with newly diagnosed vulvar cancer from the time of diagnosis to 12 months after treatment. A further aim was to identify risk factors for high levels of anxiety. MATERIAL AND METHODS: PROVE (PROspective Vulvar Cancer Evaluation) is a nationwide longitudinal cohort study investigating quality of life in women with newly diagnosed vulvar cancer by the following validated patient-reported outcome measures at diagnosis, and 3 and 12 months after treatment: The Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Vulvar module VU34...

INTRODUCTION: The aimed of this psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale in type 2 diabetes. METHODS: This psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale among 1028 type 2 diabetes in Mashhad city, Iran, 2022. Cluster sampling method was used for selection the participants. The validity and reliability of diabetes distress scale designed and evaluated by Polonsky was assessed in this study...

OBJETIVO: Estudio dirigido a identificar las posibles diferencias de sexo en la presentación y diagnóstico del Trastorno Del Espectro Autista (TEA). El TEA es un desorden del neurodesarrollo, con el cual uno de cada 44 niños/as es diagnosticado en Estados Unidos. Se estima que los niños presentan una probabilidad mayor de ser diagnosticados que las niñas. SELECCIÓN DE DATA: Se realizó una revisión sistemática para conocer las barreras en el diagnóstico temprano del TEA en féminas de 2 a 17 años...

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse birth outcomes; however, to date, the available studies on such relations, with the exception of birth weight, has not been systematically synthesized. We conducted a systematic review and meta-analysis of the available observational studies on the association of maternal exposure to PAHs and their metabolites during pregnancy with indicators of fetal growth and gestational age at delivery. We searched Web of Science, PubMed and Scopus systematically for all relevant published papers in English until 13 January 2023...

The Soil Moisture Ocean Salinity (SMOS) was the first mission providing L-band multi-angular brightness temperature (TB) at the global scale. However, radio frequency interferences (RFI) and aliasing effects degrade, when present SMOS TBs, and thus affect the retrieval of land parameters. To alleviate this, a refined SMOS multi-angular TB dataset was generated based on a two-step regression approach. This approach smooths the TBs and reconstructs data at the incidence angle with large TB uncertainties. Compared with Centre Aval de Traitement des Données SMOS (CATDS) TB product, this dataset shows a better relationship with the Soil Moisture Active Passive (SMAP) TB and enhanced correlation with in-situ measured soil moisture...

BACKGROUND: Focused ultrasound (FUS) shows promise for enhancing drug delivery to the brain by temporarily opening the blood-brain barrier (BBB), and it is increasingly used in the clinical setting to treat brain tumours. It remains however unclear whether FUS is being introduced in an ethically and methodologically sound manner. The IDEAL-D framework for the introduction of surgical innovations and the SYRCLE and ROBINS-I tools for assessing the risk of bias in animal studies and non-randomized trials, respectively, provide a comprehensive evaluation for this...

The care transitions concept emerged in medical literature more than 40 years ago, with an exponential rise in publications dedicated to its exploration since that time. It is generally accepted that older patients are particularly vulnerable during care transitions because of complex medical comorbidity, frailty, cognitive dysfunction, and the fragmented nature of health care. A care transition is defined as the movement of patients from one health care setting to another as their care needs change during acute or chronic illness...

Avalglucosidase alfa (AVAL) was approved in the United States (2021) for patients with late-onset Pompe disease (LOPD), aged ≥ 1 year. In the present study, pharmacokinetic (PK) simulations were conducted to propose alternative dosing regimens for pediatric LOPD patients based on a bodyweight cut-off. Population PK (PopPK) analysis was performed using nonlinear mixed effect modeling approach on pooled data from three clinical trials with LOPD patients, and a phase 2 study (NCT03019406) with infantile-onset Pompe disease (IOPD: 1-12 years) patients...

Extracorporeal membrane oxygenation (ECMO) has been used in highly selected COVID-19 patients with severe respiratory failure. Scarce data exist on long-term outcomes of these patients. We performed a single-center prospective evaluation of consecutive COVID-19 ECMO patients successfully discharged from the intensive care unit between February 2020 and January 2022. Physical, cognitive and psychological outcome was assessed at 3, 6, and 12 months by in-person evaluation. All the 34 discharged patients (median age 49 years old) were alive at one year, and 25 of them were evaluated at the follow-up clinic...

The term pseudoascitis is used in patients who give the false impression of ascites, with abdominal distension but without peritoneal free fluid. The case of a 66-year-old woman, hypertensive and hypothyroid with occasional alcohol consumption, who consults due to progressive abdominal distension of 6 months of evolution and diffuse percussion dullness is presented, in whom a paracentesis is performed with the wrong endorsement of examination ultrasound that reports abundant intrabdominal free fluid (Fig. 1), later finding in the CT scan of the abdomen and pelvis an expansive process of cystic appearance of 295mm x 208mm x 250mm...

This study used friction stir-back extrusion to fabricate the AZ91 + 3 wt% bioactive glass gradient composite wire. The microstructure, mechanical properties, and corrosion resistance of a material in a simulated body fluid were investigated. Three 2-mm diameter holes with varying hole patterns were drilled in the cross-section of the AZ91 rod to apply 3 wt % bioactive glass to the AZ91 matrix. The results demonstrated that the hole pattern strongly influenced the material's flow in the extruded wire's cross-section...

BACKGROUND AND AIM: Ultrasound-guided radiofrequency ablation (RFA) is a minimally invasive therapy for thyroid nodules (TNs). Understanding the determinants of RFA efficacy can improve treatment and prognosis. This study aims to investigate the relationship between ultrasound parameters of benign TNs and the efficacy of RFA. METHODS: A pretest-posttest interventional study was conducted in 2021 on 250 randomly sampled patients with benign TNs, receiving RFA. For this purpose, the volume reduction (VR) and the VR ratio (VRR) of the nodules were measured at the 1-, 3-, 6-, and 12-month follow-up periods after the RFA completion...

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome in the upper extremities. Acupuncture is often used as a treatment method in CTS and numerous studies consider it effective. However, no study has yet compared the efficacy of physical therapy including bone and neural mobilization, exercise and electrotherapy with and without acupuncture in CTS patients. PURPOSE: comparing the effect of physiotherapy plus acupuncture with physiotherapy alone on pain, disability and grip strength in CTS patients...

This study had two overriding goals, (1) examine the stability of rapid automatized naming (RAN) in predicting reading achievement while taking into account two other frequently studied constructs, phonological awareness and fluid intelligence (Gf) and (2) examine the predictive power of RAN measured at age 4 on reading ability. The stable pattern of RAN development found in a previously reported growth model was challenged by relating phonological awareness and Gf to the model. Children (N = 364) were followed from age 4 to age 10...

OBJECTIVES: Understanding the concepts and structures of health promotion in the faculty from the perspective of its members. STUDY DESIGN: Qualitative study. SETTINGS: Faculties of Medical Sciences University. PARTICIPANTS: A sample of four main groups in the faculty (students, faculty members, staff and managers) were purposively sampled for demographic characteristics and their views on the concepts of health promotion...

Colorectal cancer (CRC) is the third most common cancer and the leading cause of gastrointestinal cancer death. 90% of people diagnosed with colorectal cancer are over the age of 50; nevertheless, the illness is more aggressive among those detected at a younger age. Chemotherapy-based treatment has several adverse effects on both normal and malignant cells. The primary signaling pathways implicated in the advancement of CRC include hedgehog (Hh), janus kinase and signal transducer and activator of transcription (JAK/STAT), Wingless-related integration site (Wnt)/β-catenin, transforming growth factor-β (TNF-β), epidermal growth factor receptor (EGFR)/Mitogen-activated protein kinases (MAPK), phosphoinositide 3-kinase (PI3K), nuclear factor kappa B (NF-κB), and Notch...

A 53-year-old male patient with history of repaired hernia, who is admitted for 5 days of progressive dyspnea with diagnosis of abdominal sepsis, a computed tomography angiography was made, revealing pulmonary embolism in bilateral main pulmonary artery, and cardiac thrombectomy was performed.

The central nucleus of the amygdala (CeA) is involved in the expression of fear and anxiety disorders. Anatomically, it is divided into medial (CeM), lateral (CeL), and capsular (CeC) divisions. The CeA is densely innervated by dopaminergic projections that originate in the ventral periaqueductal gray/dorsal raphe (vPAG/DR) and the ventral tegmental area (VTA). However, whether dopamine (DA) exerts a homogenous control over the CeA or differentially regulates the various CeA subdivisions is still unknown. Here, we performed a neuroanatomical analysis of the mouse CeA and found that DAergic innervations from the PAG/DR and VTA constitute distinct, non-overlapping, pathways differing also in the relative expression of the dopamine transporter...

CONTEXT: Allopathic, osteopathic, and naturopathic medical education all prepare students to practice medicine yet diverge in certain respects. Despite the significant changes that have occurred in the education of each discipline, a more recent comparison and analysis of these three pathways hasn't been published. OBJECTIVE: The review intended to examine the five segments of the educational process common to all three pathways: admissions, preclinical education, clinical education, graduate medical education, and continuing medical education...