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Manas Kumar Kundu, Suprakas Hazra, Dipak Pal, Malavika Bhattacharya
Noncommunicable diseases (NCDs) have become a major public health problem in India accounting for 62% of the total burden of foregone DALYs and 53% of total deaths. Out-of-pocket expenditure associated with the acute and long-term effects of NCDs is high resulting in catastrophic health expenditure for the households. A large national survey in India found that spending on NCDs accounted for 5.17% of household expenditure. According to a macroeconomic analysis, it is estimated that each 10% increase in NCDs is associated with a 0...
October 2018: Indian Journal of Public Health
Randy S Tashjian, Ryan R Williams, Harry V Vinters, William H Yong
An autopsy is a specialized surgical procedure consisting of external and internal examination of a deceased individual for the purposes of documenting abnormalities and determining or confirming medical diagnoses that may have contributed to their death. One of the benefits of an autopsy is the opportunity to collect and store biospecimens for the purposes of biobanking. This chapter outlines the procedures necessary to procure, store, and utilize biospecimens obtained during an autopsy. With the emergence of molecular diagnostics, this chapter also discusses factors that influence the integrity of autopsy biospecimens prior to procurement...
2019: Methods in Molecular Biology
Piyush Mishra, Veena Ammanathan, Ravi Manjithaya
Growing amount of evidence in the last two decades highlight that macroautophagy (generally referred to as autophagy) is not only indispensable for survival in yeast but also equally important to maintain cellular quality control in higher eukaryotes as well. Importantly, dysfunctional autophagy has been explicitly shown to be involved in various physiological and pathological conditions such as cell death, cancer, neurodegenerative, and other diseases. Therefore, modulation and regulation of the autophagy pathway has emerged as an alternative strategy for the treatment of various disease conditions in the recent years...
2018: Frontiers in Cell and Developmental Biology
Jiri Polivka, Jiri Polivka, Vladimir Rohan
The model of centralized stroke care in the Czech Republic was created in 2010-2012 by Ministry of Health (MH) in cooperation with professional organization-Cerebrovascular Section of the Czech Neurological Society (CSCNS). It defines priorities of stroke care, stroke centers, triage of suspected stroke patients, stroke care quality indicators, their monitoring, and reporting. Thirteen complex cerebrovascular centers (CCC) provide sophisticated stroke care, including intravenous thrombolysis (IVT), mechanical thrombectomy (MTE), as well as other endovascular (stenting, coiling) and neurosurgical procedures...
December 2018: EPMA Journal
Beata Morawiec, Brygida Przywara-Chowaniec, Piotr Muzyk, Mariusz Opara, Lam Ho, Lui Chun Tat, Olivier Muller, Ewa Nowalany-Kozielska, Damian Kawecki
Background: Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms. The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain. Methods: This cohort study included patients with chest pain with onset maximum of 6 h before admission and no persistent ST-segment elevation on electrocardiogram...
2018: Disease Markers
Stefania Oliva, Rossella Troia, Mattia D'Agostino, Mario Boccadoro, Francesca Gay
In the biology of multiple myeloma (MM), immune dysregulation has emerged as a critical component for novel therapeutic strategies. This dysfunction is due to a reduced antigen presentation, a reduced effector cell ability and a loss of reactive T cells against myeloma, together with a bone marrow microenvironment that favors immune escape. The Programmed Death-1 (PD-1) pathway is associated with the regulation of T cell activation and with the apoptotic pathways of effector memory T cells. Specifically, the binding with PD-1 ligand (PD-L1) on the surface of tumor plasma cells down-regulates T cell-proliferation, thus contributing to the immune escape of tumor cells...
2018: Frontiers in Immunology
Kazuhiro Togasaki, Yasutaka Sukawa, Takanori Kanai, Hiromasa Takaishi
Standard treatment options for patients with advanced gastric cancer (GC) offer limited efficacy and are associated with some toxicity, which necessitates the development of more effective therapies for improving the treatment outcomes for this disease. Immunotherapy involving immune checkpoint inhibitors (ICIs) which inhibit the programmed death 1 (PD-1)/programmed death ligand 1 interaction has emerged as a new treatment option. Nivolumab, a human IgG4 monoclonal antibody inhibitor of PD-1, has demonstrated promising clinical activity and induced durable responses in patients with advanced GC...
2018: OncoTargets and Therapy
Mohsen Kalantari, Mohammad Hossein Motazedian, Qasem Asgari, Zahra Soltani, Aboozar Soltani, Kourosh Azizi
Phlebotominae sand flies are involved in human diseases, such as leishmaniasis, and cause a considerable number of deaths every year. Besides, some of them have been identified as allergen sources or the potential mechanical vectors related to nosocomial infections. The present study aimed to assess the monthly activity, fauna, and detection of protozoan agents in phlebotomine sand flies using polymerase chain reaction (PCR) in re-emerging zoonotic cutaneous leishmaniasis foci of Shiraz and Kharameh in Fars province, southern Iran during 2016-2017...
December 2018: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
Andre Kramer, Norman Urban, Stephanie Döll, Thomas Hartwig, Maryam Yahiaoui-Doktor, Ralph Burkhardt, Sirak Petros, André Gries, Michael Bernhard
BACKGROUND: Management of critically ill non-trauma patients in the resuscitation room of an emergency department (ED) is very challenging, and it is difficult to identify patients with a higher risk of death. Previous studies have shown that lactate indices can predict survival for selected diseases and syndromes. OBJECTIVE: As reported for other patient populations, we set out to determine whether admission lactate or lactate dynamics (LD) within 24 h can predict 30-day mortality in unselected critically ill non-traumatic patients...
December 8, 2018: Journal of Emergency Medicine
Cindy L J Weinstein, Nicholas Ryan, Tulin Shekar, Davis Gates, Stephen J Lane, Ioana Agache, Robert A Nathan
BACKGROUND: The safety of long-acting beta agonists added to inhaled corticosteroids for the treatment of persistent asthma has been controversial. OBJECTIVE: To determine whether administering formoterol in combination with mometasone furoate increases the risk of serious asthma outcomes compared to mometasone furoate alone. METHODS: We conducted a 26-week, randomized, double-blind trial in adolescent and adult patients (≥12 years) with persistent asthma in 35 countries with the primary objective of evaluating whether mometasone furoate-formoterol increases the risk of serious asthma outcomes (adjudicated hospitalization, intubation, or death) compared to mometasone furoate alone...
December 8, 2018: Journal of Allergy and Clinical Immunology
Rasoul Abdollahzadeh, Abdolreza Daraei, Yaser Mansoori, Masoumeh Sepahvand, Mahsa M Amoli, Javad Tavakkoly-Bazzaz
Breast cancer (BC) is the most frequently occurring malignancy in women worldwide. Despite the substantial advancement in understanding the molecular mechanisms and management of BC, it remains the leading cause of cancer death in women. One of the main reasons for this obstacle is that we have not been able to find the Achilles heel for the BC as a highly heterogeneous disease. Accumulating evidence has revealed that noncoding RNAs (ncRNAs), play key roles in the development of BC; however, the involving of complex regulatory interactions between the different varieties of ncRNAs in the development of this cancer has been poorly understood...
December 10, 2018: Journal of Cellular Physiology
Peng Yue, Zhiyong Zhu, Yongli Wang, Yimin Xu, Jia Li, Karen V Lamb, Yahong Xu, Ying Wu
AIMS: To explore the motivation of family members of patients at high risk for sudden cardiac death for undertaking cardiopulmonary resuscitation (CPR) training. BACKGROUND: Home cardiac arrests are associated with poor outcomes because few family members learn CPR. Little is known about factors that motivate family members to participate in CPR training. DESIGN: We used grounded theory to establish a theoretical framework to explore the motivational factors for learning CPR among family members...
December 10, 2018: Journal of Advanced Nursing
C-Q Miao, Q Lu, P Liu, L Bai, H Qu, A-Q Ma
OBJECTIVE: Nardilysin (N-arginine dibasic convertase, NRDC) is a kind of metalloendopeptidase associated with several inflammatory diseases. NRDC is reported to be eligible for early detection of acute coronary syndrome. However, the availability and effectiveness of NRDC in predicting the prognosis of patients with ST-elevation myocardial infarction has never been investigated. PATIENTS AND METHODS: From January 2010 to January 2012, the prospective observational cohort study enrolled a total of 396 STEMI patients, who were sampled with blood within 24 hours after admission...
November 2018: European Review for Medical and Pharmacological Sciences
Fengying Xu, Zongmei Wen, Xueying Shi, Jie Fan
Lung diseases are common and significant causes of illness and death around the world. Inflammasomes have emerged as an important regulator of lung diseases. The important role of IL-1 beta and IL-18 in the inflammatory response of many lung diseases has been elucidated. The cleavage to turn IL-1 beta and IL-18 from their precursors into the active forms is tightly regulated by inflammasomes. In this chapter, we structurally review current evidence of inflammasome-related components in the pathogenesis of acute and chronic lung diseases, focusing on the "inflammasome-caspase-1-IL-1 beta/IL-18" axis...
2018: Experientia. Supplementum
Guiqin Peng, Zongwei Tang, Yongjia Xiang, Wanyi Chen
Reactive oxygen species (ROS) have been widely accepted as critical molecules playing regulatory roles in various biological processes, including proliferation, differentiation and apoptotic/ferroptotic/necrotic cell death. Emerging evidence suggests that ROS may be involved in the induction of epithelial‑to‑mesenchymal transition (EMT), which has been reported to promote cancer stem‑like cell (CSC) generation. Recent data indicate that altered accumulation of ROS is associated with CSC generation, EMT and hypoxia exposure, but the underlying mechanisms are poorly understood...
December 6, 2018: Oncology Reports
Daisy J M Ermers, Karin J H van Bussel, Marieke Perry, Yvonne Engels, Henk J Schers
Background: Advance care planning (ACP) is a crucial element of palliative care. It improves the quality of end-of-life care and reduces aggressive and needless life-prolonging medical interventions. However, little is known about its application in daily practice. This study aims to examine the application of ACP for patients with cancer in general practice. Methods: We performed a retrospective cohort study in 11 general practices in the Netherlands. Electronic patient records (EPRs) of deceased patients with colorectal or lung cancer were analysed...
December 10, 2018: Family Practice
Claudia Teodora Judea-Pusta, Gabriela Muţiu, Andrei Vasile Paşcalău, Camelia Liana Buhaş, Adina Nicoleta Ciursaş, Carmen Delia Nistor-Cseppento, Alina Bodea, Adrian Sorin Judea, Răzvan Marius Vicaş, Luciana Dobjanschi, Ovidiu Laurean Pop
Ethylene glycol is a toxic alcohol that is mainly introduced into an organism through the digestive pathway. Its priority toxic metabolites are glycolic acid and oxalic acid. We present the case of a young person, of the male persuasion, without any personal pathological history, found unconscious and presenting signs of violence. The patient is emergency hospitalized presenting coma, convulsive syndrome, severe metabolic acidosis and a positive result for alcoholism. Anamnestic data is extremely poor. The results of the clinical and paraclinical examinations suggest a possible poisoning with toxic alcohols...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Jill Crosby, Dagmawi Werku, Tigist Zewdu, Grace Wanjiku, Jessica Schmidt
Introduction: The term acute abdomen refers to a clinical syndrome of sudden onset, severe abdominal pain. The differential diagnosis for this presentation is broad, but most cases require emergent medical or surgical management. Especially in cases of ischaemic bowel, time to diagnosis can mean the difference between survival and death. As a result, mortality remains high in resource-limited settings. Case report: We describe the case of a 28-year-old male who presented to an urban Ethiopian emergency centre with three days of vomiting, bloody diarrhoea, and abdominal pain...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Babawale Taslim Bello, Olalekan Ezekiel Ojo, Olapeju Funke Oguntunde, Adedotun Ademola Adegboye
Introduction: Late presentation, usually to the emergency centre (EC), is frequently reported among patients with chronic kidney disease (CKD) in resource-limited settings, and is known to be associated with poor outcomes. This study aims to describe the pattern of EC presentation of adults with CKD in Southwest Nigeria. Methods: This was a prospective observational study of 158 consecutively presenting CKD patients at the EC of two tertiary hospitals in Southwest Nigeria...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Giovanna Leoni, Oliver Soehnlein
Cardiovascular diseases, including myocardial infarction and its complications such as heart failure, are the leading cause of death worldwide. To date, basic and translational research becomes necessary to unravel the mechanisms of cardiac repair post-myocardial infarction. The local inflammatory tissue response after acute myocardial infarction determines the subsequent healing process. The diversity of leukocytes such as neutrophils, macrophages and lymphocytes contribute to the clearance of dead cells while activating reparative pathways necessary for myocardial healing...
2018: Frontiers in Pharmacology
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