Ewa Więsik-Szewczyk, Anna Felis-Giemza, Mirosław Dziuk, Karina Jahnz-Różyk
A 32-year-old-man, with a history of chronic urticaria from the age of 27, diagnosed with an adult-onset Still's disease and received a low dose of glucocorticoids, methotrexate and tocilizumab. Despite the long-term combined treatments, he suffered from chronic urticaria, low-grade fever and bone pain. He was found to have high inflammatory markers, hypogammaglobulinemia, monoclonal IgM - kappa light chain in serum and increased radiotracer uptake in the whole bone scintigraphy. No pathological variants for monogenic autoinflammatory diseases were present in the genome exome sequencing...
2020: International Journal of General Medicine
Chandrasekaran Ananthanarayanan, Sabarinath Menon, Baiju Dharan, Thomas Mathew, Vijay Thomas Cherian, Thomas Koshy
Myxomas are the most common primary intra-cardiac tumors in adults. Myxoma occurring in a preschooler is very rare, and cardiac surgery in acute stroke is a challenging decision. We present a rare case of acute cardio-embolic stroke in a 3-year-old child due to left atrial myxoma which was successfully treated.
July 2020: Indian Journal of Thoracic and Cardiovascular Surgery
Nori L Bradley, Naisan Garraway
PURPOSE OF REVIEW: The aim of this study was to describe important features of clinical examination for the surgical abdomen, relevant investigations, and acute management of common surgical problems in the critically ill. RECENT FINDINGS: Lactate remains a relatively nonspecific marker of gut ischemia. Dual energy computed tomography (DECT) scan can improve diagnosis of bowel ischemia. Further evidence supports intravenous contrast during CT scan in critically ill patients with acute kidney injury...
October 16, 2020: Current Opinion in Critical Care
Yael Keshet, Ariela Popper-Giveon
The growing number of terror attacks worldwide draws attention to the difficulties that healthcare practitioners experience when they treat terrorists or suspected terrorists. Research literature on the challenges faced by healthcare practitioners treating terrorists in conflict areas is limited. In-depth interviews were conducted during 2016-2017 with 50 Jewish and Arab healthcare practitioners (managers, physicians, and nurses) employed in 11 public hospitals in Israel, who treat Palestinian terrorists and security prisoners, in the context of a prolonged and violent national conflict...
October 1, 2020: Violence and Victims
Elizabeth Mayne
No abstract text is available yet for this article.
October 15, 2020: Journal of Clinical Pathology
P Alcaide-Leon, J Cluceru, J M Lupo, T J Yu, T L Luks, T Tihan, N A Bush, J E Villanueva-Meyer
BACKGROUND AND PURPOSE: Differentiating between treatment-related lesions and tumor progression remains one of the greatest dilemmas in neuro-oncology. Diffusion MR imaging characteristics may provide useful information to help make this distinction. The aim of the study was to assess the diagnostic accuracy of the centrally reduced diffusion sign for differentiation of treatment-related lesions and true tumor progression in patients with suspected glioma recurrence. MATERIALS AND METHODS: The images of 231 patients who underwent an operation for suspected glioma recurrence were reviewed...
October 15, 2020: AJNR. American Journal of Neuroradiology
Faouzia Tanveer, Ali Talha Khalil, Muhammad Ali, Zabta Khan Shinwari
COVID-19 which started in Wuhan, China and swiftly expanded geographically worldwide, including to Low to Middle Income Countries (LMICs). This in turn raised numerous ethical concerns in preparedness, knowledge sharing, intellectual property rights, environmental health together with the serious constraints regarding readiness of health care systems in LMICs to respond to this enormous public health crisis. From the restrictions on public freedom and burgeoning socio-economic impacts to the rationing of scarce medical resources, the spread of COVID-19 is an extraordinary ethical dilemma for resource constrained nations with less developed health and research systems...
October 15, 2020: International Journal for Equity in Health
S Kristina Kalkan, Sofija Forkapić, B Slobodan Marković, B Milivoj Gavrilov, Kristina Bikit-Schroeder, Dušan Mrđa, G Milica Radaković, Radislav Tošić
There is a dilemma whether the Chernobyl accident is the main source of this anthropogenic radionuclide in the region of Vojvodina, Northern Province of Serbia. The difference compared to the other dominant source of radiocaesium in the environment, the nuclear weapon tests, is lying in the local character of contamination due to accidents, which implies it's highly dependent on meteorological parameters, such as precipitation and wind in the area at that time. According to published data, the average value of surface contamination by radiocaesium on the territory of the former Yugoslavia after the Chernobyl accident was several times higher than the estimated contamination by nuclear testing (1945-1963)...
October 5, 2020: Chemosphere
Yajing Liu, Shaoshuai Mao, Shisheng Huang, Yongqin Li, Yuxin Chen, Minghui Di, Xinxin Huang, Junjun Lv, Xinxin Wang, Jianyang Ge, Shengxi Shen, Xiaoming Zhang, Dahai Liu, Xingxu Huang, Tian Chi
Programmable A > I RNA editing is a valuable tool for basic research and medicine. A variety of editors have been created, but a genetically encoded editor that is both precise and efficient has not been described to date. The trade-off between precision and efficiency is exemplified in the state of the art editor REPAIR, which comprises the ADAR2 deaminase domain fused to dCas13b. REPAIR is highly efficient, but also causes significant off-target effects. Mutations that weaken the deaminase domain can minimize the undesirable effects, but this comes at the expense of on-target editing efficiency...
October 15, 2020: EMBO Journal
Rubina Mulchandani, Tanica Lyngdoh, Ashish Kumar Kakkar
INTRODUCTION: The coronavirus pandemic has affected more than 20 million people so far. Elevated cytokines and suppressed immune responses have been hypothesized to set off a cytokine-storm, contributing to ARDS, multiple-organ failure and in the most severe cases, death. We aimed to quantify the differences in the circulating levels of major inflammatory and immunological markers between severe and non-severe COVID-19 patients. METHODS: Relevant studies were identified from PubMed, Embase, Web of Science, SCOPUS and pre-print servers...
October 14, 2020: European Journal of Clinical Investigation
Elfriede Ruttmann, Hannes Abfalterer, Julian Wagner, Michael Grimm, Ludwig Müller, Katie Bates, Hanno Ulmer, Nikolaos Bonaros
OBJECTIVES: A treatment dilemma arises when surgery is indicated in patients with infective endocarditis (IE) complicated by stroke. Neurologists recommend surgery to be postponed for at least 1 month. This study aims to investigate the neurological complication rate and neurological recovery potential in patients with IE-related stroke. METHODS: A total of 440 consecutive patients with left-sided IE undergoing surgery were investigated. During follow-up, neurological recovery was assessed using the modified Rankin scale and the Barthel index...
October 15, 2020: European Journal of Cardio-thoracic Surgery
Nikoleta E Glynatsi, Vincent A Knight
Memory-one strategies are a set of Iterated Prisoner's Dilemma strategies that have been praised for their mathematical tractability and performance against single opponents. This manuscript investigates best response memory-one strategies with a theory of mind for their opponents. The results add to the literature that has shown that extortionate play is not always optimal by showing that optimal play is often not extortionate. They also provide evidence that memory-one strategies suffer from their limited memory in multi agent interactions and can be out performed by optimised strategies with longer memory...
October 14, 2020: Scientific Reports
Anjali A Satoskar, John P Shapiro, Mikayla Jones, Cherri Bott, Samir V Parikh, Sergey V Brodsky, Lianbo Yu, Haikady N Nagaraja, Daniel W Wilkey, Michael L Merchant, Jon B Klein, Tibor Nadasdy, Brad H Rovin
Staphylococcus infection-associated glomerulonephritis (SAGN) and primary IgA nephropathy (IgAN) are separate disease entities requiring different treatment approaches. However, overlapping histologic features may cause a diagnostic dilemma. An exploratory proteomic study to identify potential distinguishing biomarkers was performed on formalin fixed paraffin embedded kidney biopsy tissue, using mass spectrometry (HPLC-MS/MS) (n = 27) and immunohistochemistry (IHC) (n = 64), on four main diagnostic groups-SAGN, primary IgAN, acute tubular necrosis (ATN) and normal kidney (baseline transplant biopsies)...
October 14, 2020: Scientific Reports
Åshild Gjellestad, Trine Oksholm, Frøydis Bruvik
BACKGROUND: The use of forced treatment and care of home-dwelling persons with dementia is a universally important topic. These patients are completely dependent on care from others to continue living at home. AIM: This study aimed to gain insights into formal decisions related to the forced treatment and care of home-dwelling persons with dementia. DESIGN AND SAMPLE: This is a cross-sectional study, based on formal decisions of forced treatment and care of home-dwelling persons with dementia in Norway between 1 January 2015 and 31 December 2016...
October 15, 2020: Nursing Ethics
Elizabeth V Asztalos, Kellie E Murphy, Stephen G Matthews
OBJECTIVE:  A single course of synthetic antenatal corticosteroids is standard care for women considered to be at risk for preterm birth before 34 weeks of gestation. While the intended target is the fetal lung, the fetal brain contains remarkably high levels of glucocorticoid receptors in structures critical in the regulation of behavior and endocrine function. Negative programming signals may occur which can lead to permanent maladaptive changes and predispose the infant/child to an increased risk in physical, mental, and developmental disorders...
October 14, 2020: American Journal of Perinatology
Mahesh Sultania, Dillip K Muduly, Vigneshwaran Balasubiramaniyan, Mohammed Imaduddin, R Ephraim, Itisha Chaudhary, Abhitesh Singh, Anshul Jain, Lalchhandami Colney, Sachin Ambre, K R Dipin, Madhabananda Kar
BACKGROUND: The COVID-19 pandemic has caused a global health emergency and affected the resources in both the public and private health sectors significantly. The present study aims to assess the impact of the pandemic on the services by the department in the first 3 months since the first COVID case in the region. METHODS: The study period was from 16 March to 15 June 2020. We queried the database for data on site of the tumor, diagnosis, stage, tumor board decisions and planning, surgical procedures, adjuvant treatment, and follow-up details...
October 2020: Journal of Surgical Oncology
Athanasios Roumeliotis, Stefanos Roumeliotis, Konstantinos Leivaditis, Marios Salmas, Theodoros Eleftheriadis, Vassilios Liakopoulos
The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilemma of choosing the superior modality between APD and Continuous Ambulatory Peritoneal Dialysis (CAPD) has not yet been resolved. When it comes to fast transporters and assisted PD, APD is certainly considered the most suitable Peritoneal Dialysis (PD) modality...
October 13, 2020: International Urology and Nephrology
Tim E Darsaut, Jean Raymond
BACKGROUND: Pragmatic care trials have been designed to provide optimal neurovascular care in the presence of uncertainty. The feasibility, benefits, and drawbacks of using this novel approach remain unknown. METHODS: We report the progress of 9 randomized trials integrated into routine practice to guide the endovascular or surgical treatment of intracranial aneurysms, arteriovenous malformations, and acute stroke. We review the criticisms and commentaries we have received and discuss the corresponding ethical and scientific concepts that need to be revised to practice outcome-based neurovascular care...
October 10, 2020: Neuro-Chirurgie
Brigitte Eisenwort, Carolin Schmid, Maksim Tilis, Dmitrij Tsoy, Gabriela Diendorfer-Radner, Anika Sedlaczek, Claudia Klier
BACKGROUND: Due to demographic changes over the last few decades, the number of multilingual children has grown rapidly. Many of them face problems in learning their second language. Similarities between linguistic manifestations of stages of second language acquisition and an impairment of language acquisition cause a diagnostic dilemma. The Vienna Model of language assessment in multilingual children will be presented. METHODS: A key feature of our procedure is the integration of medical students as native speakers in diagnosing acquisition of the first language...
October 13, 2020: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
Jens Søndergaard, John Sahl Andersen
No abstract text is available yet for this article.
October 12, 2020: Ugeskrift for Laeger
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