Mohamed S M Khalil, Adele T Timbs, Shirley J Henderson, Anna Schuh, John M Old
Hb J-Meerut [ HBA2 : c.362C>A (or HBA1 )] is a rare, stable, nonpathogenic α-globin gene variant that peaks in the area between the P3 and A0 windows on high performance liquid chromatography (HPLC). Few cases from different ethnic origins have been published but the majority were Asian Indians. Coinheritance with other hemoglobin (Hb) variants are rarer and can change the Hb J-Meerut phenotype making a diagnostic dilemma. In this study, we have reported 15 cases of Hb J-Meerut, discovered during a wide spectrum study of α-globin chain variants in the UK...
September 14, 2020: Hemoglobin
Emily B Ambinder, Kelly S Myers, Lisa A Mullen, Philip Di Carlo, Mary Philip, Roberto Fragomeni, Derek Nguyen, Eniola Oluyemi
It is a clinical dilemma when a finding reported as suspicious on a breast MRI is not visualized at the time of a scheduled MRI-guided breast biopsy. We retrospectively reviewed all canceled MRI-guided biopsies at our institution between 6/1/2009 and 9/20/2019 and found a cancellation rate of 6.9% (72/1051). In one case, a mastectomy was performed after the canceled biopsy revealing a focus of DCIS in the same quadrant as the original finding (malignancy rate 2.1%). Our results support the current practice of 6-month follow-up MRI recommendation after a canceled MRI-guided biopsy for lesion nonvisualization...
September 13, 2020: Breast Journal
Melissa Bain
Veterinarians perform surgery for a number of reasons, from treating a problem to preventing future problems. There is an inextricable link between the physical and psychological aspects of an animal's health, and surgery is often a conduit to bridge that gap. Some surgical procedures can affect an animal's behavior, such as castration, and some pose an ethical dilemma, such as ear cropping and declawing. Ameliorating pain, decreasing stressful experiences for the animal, and identifying and treating concurrent problem behaviors are hallmarks of improving animal welfare...
2020: Frontiers in Veterinary Science
Hassan Kesserwani
The etiology of chronic progressive myelopathy can be a challenging diagnostic dilemma, especially in the absence of a structural lesion of the neural axis or a conspicuous inflammatory process. The differential diagnosis can be pleomorphic. However, the emergence of signs of adrenal dysfunction, lack of a structural lesion of the spinal cord and the emergence of cerebral demyelination should raise the suspicion of X-linked adrenoleukodystrophy (ALD). The biochemical signature of elevated serum very long chain fatty acids and a pathogenic mutation of the ATP-binding cassette subfamily D1 (ABCD1) gene is pathognomic...
August 9, 2020: Curēus
Matthew G K Benesch, Angela S D Bussey
Postsurgical pyoderma gangrenosum is a very rare form of cutaneous ulceration that is poorly recognized outside of dermatology and in some circumstances has been mistaken for necrotizing fasciitis. Here, we present a rare case of sigmoid diverticulitis with left ureter obstruction that perforated and quickly progressed into necrotizing fasciitis of the left buttock and leg via retroperitoneal spread in an immunocompetent patient. Nearly a year after intense surgical therapy, the patient rapidly developed ulcerating lesions over the left hip which presented a diagnostic dilemma...
September 2020: Journal of Surgical Case Reports
Linhong Chen, Xiaocang Xu
Background: How to cope with the rapid growth of LTC (long-term care) needs for the old people without activities of daily living (ADL), which is also a serious hazard caused by public health emergencies such as COVID-2019 and SARS (2003), has become an urgent task in China, Germany, Japan, and other aging countries. As a response, the LTCI (long-term care insurance) system has been executed among European countries and piloted in 15 cities of China in 2016. Subsequently, the influence and dilemma of LTCI system have become a hot academic topic in the past 20 years...
2020: Journal of Multidisciplinary Healthcare
Katarzyna Wiśniewska, Katarzyna Pawlak-Buś, Piotr Leszczyński
Primary Sjögren's syndrome (pSS) is a chronic, autoimmune disease predominantly involving exocrine glands. Lymphadenopathy is one of the possible symptoms of pSS. It may also suggest development of non-Hodgkin lymphoma (NHL), the most severe complication of pSS, or be a symptom of less common diseases, such as Kikuchi-Fujimoto disease (KFD), presented in this paper. Kikuchi-Fujimoto disease is an extremely rare, benign and self-limiting disorder, characterized by regional lymphadenopathy. This paper presents a case of previously unreported association of pSS, KFD and renal cancer in a patient with recurrent cervical lymphadenopathy, as well as a discussion on the coexistence of these diseases based on available literature searching for PubMed, Scopus and Google Scholar databases, particularly in this subject...
2020: Reumatologia
Mária Babinčáková, Paweł Bernard
The COVID-19 lockout situation affected people all over the world. Despite all of the disadvantages, this situation offered new experiences and perspectives and pushed education advances forward as never before. Something that seemed to be unreal became a worldwide reality within a few days. Instructors of all subjects at all educational levels moved to a virtual environment instantly. Higher education institutions, universities, and colleges seemed to be fairly prepared for this situation. Unfortunately, primary and secondary schools, especially in eastern and central Europe, never considered distance education as a valuable alternative before, so they did not have software, hardware, and staff prepared for such a situation...
September 8, 2020: Journal of Chemical Education
Burkhard Dasch, Philipp Lenz, Peter K Zahn
BACKGROUND: Cardiopulmonary resuscitation (CPR) is a medical emergency intervention aimed at ending a life-threatening cardiovascular arrest as quickly as possible. However, the medical ethics of starting CPR in patients who have incurable and terminal disease is a matter of controversy. This ethical dilemma affects cancer patients in particular, as they are often suffering from advanced disease in a palliative situation. Few data are as yet available concerning the prevalence of CPR in patients with terminal cancer...
September 8, 2020: Annals of Palliative Medicine
Mukhesh Thangavel, Raghavan Sivaram, Waqar Jan, Ahmed Tariq, Saseendar Shanmugasundaram
INTRODUCTION: Synovial chondromatosis (SC) is a relatively common benign condition of the synovial joint characterized by the formation of cartilaginous nodules in synovium. However, extra articular osteochondromatosis is rare and only few have been reported around the ankle joint. We have reported such a presentation and have reviewed the literature extensively. PRESENTATION OF CASE: We present a 26 year old male patient with a painless swelling over the lateral aspect of his left ankle...
August 31, 2020: International Journal of Surgery Case Reports
Avraham Travers, Azim Jalali, Stephen Begbie, Christine Semira, Suzanne Kosmider, Sumitra Ananda, Rachel Wong, Margaret Lee, Jeremy Shapiro, Matthew Burge, Desmond Yip, Javier Torres, Brigette Ma, Louise Nott, Andrew Dean, Jeanne Tie, Adnan Khattak, Stephanie Lim, Hui-Li Wong, Peter Gibbs
BACKGROUND: The management of metastatic colorectal cancer patients with a poor performance status (PS) continues to be a clinical dilemma, with the potential activity and safety of treating this population remaining poorly understood. Few of these patients are enrolled onto clinical trials, and poor PS is often multifactorial. PATIENTS AND METHODS: We analyzed the Treatment of Recurrent and Advanced Colorectal Cancer registry to describe treatment practices and outcomes in poor (Eastern Cooperative Oncology Group [ECOG] PS 2) and very poor PS (ECOG PS > 2) patients to explore the relationship between age, tumor burden, comorbidities, and PS, and to evaluate the benefit of systemic therapy...
August 12, 2020: Clinical Colorectal Cancer
Pedro Pereira, Pedro Costa-Moreira, Guilherme Macedo
Besides the adverse effects associated with endoscopic retrograde cholangiopancreatography (ERCP), indirect visualization of the biliopancreatic system through fluoroscopy has limited its diagnostic and therapeutic efficacy. Direct visualization through cholangiopancreatoscopy may overcome this limitation and allow the resolution of many dilemmas related to the diagnostic and therapeutic drawbacks of ERCP. Herein, we discuss the current indications of single-operator cholangioscopy (SOC) concerning the diagnostic interventions within the biliopancreatic system...
September 9, 2020: Journal of Gastrointestinal and Liver Diseases: JGLD
Y L Ho, M Fauzi, K Sothee, A Basheer
INTRODUCTION: Hyperhidrosis is a disorder of excessive and uncontrollable sweating beyond the body's physiological needs. It can be categorised into primary or secondary hyperhidrosis based on its aetiology. Detailed history review including onset of symptoms, laterality of disease and family history are crucial which may suggest primary hyperhidrosis. Secondary causes such as neurological diseases, endocrine disorders, haematological malignancies, neuroendocrine tumours and drugs should be adequately examined and investigated prior to deciding on further management...
September 2020: Medical Journal of Malaysia
Clayton Fordahl
This article follows recent calls to turn social theory away from its fixations on intellectual history and toward the mechanics and craft of creating social theories in the research process. The subject of this article is a dilemma common to theorizing in social science: dysnomia, or the phenomenon in which some object is poorly named. Specifically, this article focuses on how social scientists distinguish original concepts from their equivalents in everyday speech. Three tactics for dealing with dysnomia are named-academic arcana, classification and sociologism-and considered in order to ascertain the strengths and weaknesses of each...
September 11, 2020: British Journal of Sociology
Jörg Reichrath
How to deal with the powerful rays of the sun represents a fundamental question of environmental medicine, affecting skin cancer prevention campaigns and many other aspects of public health. However, when preparing recommendations for sunlight exposure, physicians, scientists, and other health authorities are in a dilemma, because solar radiation exerts both positive and negative effects on human health. While positive effects are at least in part mediated via the UV(Ultraviolet)-B-induced cutaneous synthesis of vitamin D, negative effects include the UV-mediated photocarcinogenesis of skin cancer...
2020: Advances in Experimental Medicine and Biology
Celso M de Melo, Kazunori Terada
The iterated prisoner's dilemma has been used to study human cooperation for decades. The recent discovery of extortion and generous strategies renewed interest on the role of strategy in shaping behavior in this dilemma. But what if players could perceive each other's emotional expressions? Despite increasing evidence that emotion signals influence decision making, the effects of emotion in this dilemma have been mostly neglected. Here we show that emotion expressions moderate the effect of generous strategies, increasing or reducing cooperation according to the intention communicated by the signal; in contrast, expressions by extortionists had no effect on participants' behavior, revealing a limitation of highly competitive strategies...
September 11, 2020: Scientific Reports
Luchuo Engelbert Bain, Seda Muftugil-Yalcin, Mary Amoakoh-Coleman, Marjolein B M Zweekhorst, Renaud Becquet, Tjard de Cock Buning
BACKGROUND: Worldwide, over half of the adolescent pregnancies recorded are unintended. The decision to continue the pregnancy to term or to opt for an abortion is a constant dilemma that is directly or indirectly influenced by stakeholders and also by the wider social environment. This study aimed at understanding the perceived decision-making preferences and determinants of early adolescent pregnancy in the Jamestown area of Accra in Ghana. METHODS: A vignette-based qualitative study design was used...
September 11, 2020: Reproductive Health
Maite A A M van Gerwen, Joachim Nieuwland, Hein A van Lith, Franck L B Meijboom
When non-human animals are labeled as 'pests', their moral status and welfare seem relatively unimportant. In a multi-stakeholder project, we develop an assessment frame for a more responsible rodent management that includes animal welfare. An online survey among 129 Dutch pest controllers was carried out in order to find out more about pest controllers' attitudes about animal welfare. Respondents indicate to consider animal welfare in their job. They see differences in the welfare impact of different rodent control methods...
September 9, 2020: Animals: An Open Access Journal From MDPI
José Orlando de Melo Junior, Márcia Aparecida Lodi Campos Melo, Luiz Antônio da Silva Lavradas, Plínio Gabriel Ferreira Lopes, Ingra Ianne Luiz Ornelas, Paula Lacerda de Barros, Paulo José da Mata Pereira, Paulo Niemeyer Filho
OBJECTIVE: Venous thromboembolism (VTE) is particularly prevalent in neurosurgical patients. A major dilemma arises when a patient needs to be treated with therapeutic anticoagulation during the early days after brain surgery due to the concern of intracranial hemorrhage (ICH). There is still a lack of studies regarding the optimal time to start therapeutic anticoagulation and risk assessment of ICH in this setting. This study aims to assess the risk of ICH for patients with venous thromboembolism treated with therapeutic anticoagulation started within the first 30 days after intracranial neurosurgical procedure...
September 1, 2020: Clinical Neurology and Neurosurgery
Yuma Yamada, Yusuke Sato, Takashi Nakamura, Hideyoshi Harashima
Due to the rapid changes that have occurred in the field of drug discovery and the recent developments in the early 21st century, the role of drug delivery systems (DDS) has become increasingly more important. For the past 20 years, our laboratory has been developing gene delivery systems based on lipid-based delivery systems. One of our efforts has been directed toward developing a multifunctional envelope-type nano device (MEND) by modifying the particle surface with octaarginine, which resulted in a remarkably enhanced cellular uptake and improved intracellular trafficking of plasmid DNA (pDNA)...
September 8, 2020: Journal of Controlled Release: Official Journal of the Controlled Release Society
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