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Clinical disease

Nalini Bansal, Vivek Vij, Mukul Rastogi, Manav Wadhawan, Ajay Kumar
Echinococcus multilocularis (EM) is the most virulent species of the genus Echinococcus. It causes a highly lethal helminthic disease in humans. The disease may present as hepatic mass mimicking a malignant neoplasm. Due to the vascular and neural invasion, protean clinical manifestations including Budd-Chiari syndrome (BCS) may be the clinical presentation of this condition. We herein report three cases of Echinococcus multilocularis; the first case presenting as multiple hepatic space-occupying lesions, second as liver mass infiltrating the nerve bundles, and the third as a hepatic mass infiltrating the large vessels including inferior vena cava and right hepatic vein presenting as BCS...
August 18, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Stephen Tsaur, Lacey Gleason, Yuli Kim
Quality indicators for adult congenital heart disease (ACHD) were recently published due to a lack of consensus regarding delivery of care to adults with congenital heart disease (CHD). The objective of this study was to examine adherence to quality indicators for the care of patients with tetralogy of Fallot. Adults with tetralogy of Fallot seen in outpatient cardiology clinics at a tertiary care facility between July 2014 and June 2015 were included, and electronic medical records for each visit were reviewed...
August 18, 2018: Pediatric Cardiology
Nathaniel W Taggart, Brent M Gordon, Gareth J Morgan, Bryan H Goldstein
The complex nature of congenital heart disease (CHD) has hindered the establishment of management standards for peri-catheterization anticoagulation. We sought to describe anticoagulation practice variability among providers performing cardiac catheterization in children and adults with CHD. A web-based survey ( ) was distributed to pediatric and congenital interventional cardiologists. Respondents were queried on their training, practice setting, years in practice, and case volume...
August 18, 2018: Pediatric Cardiology
Dan Yang, Hongyu Kuang, Yuanlin Zhou, Chunqiong Cai, Tiewei Lu
Long-term oral warfarin is recommended in pediatric Kawasaki disease patients with large coronary artery aneurysms; however, heterogeneity is considerable. This study aimed to determine variables affecting warfarin dosage in Kawasaki disease. The enrolled individuals (194 children) were divided into four groups: (1) Cases with severe coronary artery lesions (CAL) of IV to V degrees or thrombogenesis treated with oral warfarin were assigned to Group A; (2) Group B, CAL of I degrees; (3) Group C, CAL of II and III degrees cases with small or medium-sized CAL not treated with warfarin; (4) Group D, normal children without Kawasaki disease...
August 18, 2018: Pediatric Cardiology
Jiaoyang Liu, Guoyan Tang, He Huang, Huan Li, Peng Zhang, Lihua Xu
BACKGROUND: Nasopharyngeal carcinoma (NPC) is notable for its high incidence rates in select geographic and ethnic populations, especially among Chinese and Malay populations in Southeastern Asia. However, relevant biomarkers for the development and prognosis of NPC are not yet clear; therefore, discovering novel biomarkers will facilitate prediction of prognosis and development of targeted therapeutic tactics. This study aims to quest the potential prognostic value of NUAK1 (a downstream member of Akt) in NPC...
August 18, 2018: European Archives of Oto-rhino-laryngology
Adrian Caceres, Maria Luisa Avila, Marco Luis Herrera
INTRODUCTION: Invasive mycosis of the central nervous system represent a diverse group of diseases that have gradually emerged as not only opportunistic infections in patients with immune susceptibility due to congenital and acquired deficiency, immunomodulation, solid organ and stem cell transplantation, hematological malignancies, and chronic steroid use but also in selected risk populations such as low weight preterm infants, patients with shunted hydrocephalus and external ventricular drainages, skull base surgery, and head injury...
August 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jacob H Rand, Douglas J Taatjes
The antiphospholipid syndrome (APS) is an autoimmune thrombophilic disorder that was described as a diagnostic entity over 30 years ago. And yet the pathogenic mechanisms that are responsible for its clinical manifestations remain to be definitively established. The syndrome is defined by (1) the concurrence of vascular thrombosis and/or pregnancy complications together with (2) positivity for immunoassays and coagulation tests that were derived from clinical observations of two anomalous laboratory test results-specifically, false positivity for syphilis infection in uninfected individuals and the finding of inhibitors of blood coagulation in patients who lacked any bleeding tendencies...
August 18, 2018: Histochemistry and Cell Biology
Anthony Yao, Craig Aboltins, Alan A McNab, Cesar Salinas-La Rosa, Justin Denholm, Jwu Jin Khong
PURPOSE: Orbital tuberculosis (TB) is a rare extra-pulmonary manifestation of tuberculosis and its clinical diagnosis poses unique challenges, with potential for destructive complications as well as social and public health implications. The aim of this study is to report our experience of patients presenting with orbital TB and to identify common aspects. METHODS: A systematic search for mandatory notifications of orbital tuberculosis between January 01, 1994 and December 12, 2016 was undertaken in the Victorian Tuberculosis database...
August 18, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Tanya Sapundzhieva, Rositsa Karalilova, Anastas Batalov
To assess the role of musculoskeletal ultrasound as a predictor for the achievement of DAS28 remission in patients with rheumatoid arthritis (RA). One hundred and forty-one patients underwent physical and ultrasound examination at five visits (at baseline and after 1, 3, 6 and 12 months). Patients were divided into two groups according to the type of treatment, which involved synthetic (sDMARDs) and biologic (bDMARDs) disease-modifying antirheumatic drugs. Ultrasound assessment of the wrist, second and third metacarpophalangeal, second and third proximal interphalangeal joint, second and fifth metatarsophalangeal joint (the German US7 score) was performed on gray scale (GS) and on power Doppler ultrasound (PDUS)...
August 18, 2018: Rheumatology International
A Nor Azizah, S P Thong, L C Hung
Kawasaki disease (KD) is an acute systemic vasculitis usually affecting children <5 years old. We report a 44-dayold baby who had persistent fever despite being on antibiotics for presumed sepsis. Erythema of Bacillus Calmette-Guerin (BCG) scar and thrombocytosis were noted on day-2 of illness. Diagnosis of incomplete KD was made on the 10th day of illness. Her fever resolved with intravenous immunoglobulin, but echocardiogram revealed coronary artery aneurysm. High index of suspicion is required to diagnose KD in infants ≤3 months since it is rare and commonly presents with incomplete clinical features...
August 2018: Medical Journal of Malaysia
A R Ruhaila, H C Chong
OBJECTIVE: To determine the prevalence, correlates and independent predictors of self-reported depression, anxiety and stress in Rheumatoid arthritis (RA) patients in Hospital Melaka. METHODS: This was a cross-sectional survey using convenient sampling of 192 RA patients who attended the Rheumatology Clinic outpatient appointment, Hospital Melaka from June 2013 to December 2013. Depression, Anxiety and Stress Scale (DASS21) questionnaire was used to evaluate symptoms of depression, anxiety and stress...
August 2018: Medical Journal of Malaysia
Yixiu Zhao, Xin Zhang, Jing Luan, Buchang Zhao, Na An, Na Sun, Xinhui Wang, Tao Zhao, Yanhong Sun, Zidong Donna Fu, Yan Zhang, Yan Zhang
BACKGROUND/AIMS: Shenxian-shengmai (SXSM) oral liquid, a Chinese patent compound medicine, has been used to treat sinus bradyarrhythmias induced by mild sick sinus syndrome in clinical practice. Myocardial ischemia, in particular in serious or right coronary-related heart diseases, can cause bradyarrhythmias and cardiac dysfunction. Moreover, reperfusion of ischemic myocardium is associated with additional myocardial damage known as myocardial ischemia-reperfusion (I/R) injury. This study was designed to evaluate the effects of SXSM on bradyarrhythmias and cardiac dysfunction induced by myocardial I/R injury, and to explore the underlying mechanisms...
August 17, 2018: Cellular Physiology and Biochemistry
Paula Müller, Heiko Lemcke, Robert David
A large number of clinical trials have shown stem cell therapy to be a promising therapeutic approach for the treatment of cardiovascular diseases. Since the first transplantation into human patients, several stem cell types have been applied in this field, including bone marrow derived stem cells, cardiac progenitors as well as embryonic stem cells and their derivatives. However, results obtained from clinical studies are inconsistent and stem cell-based improvement of heart performance and cardiac remodeling was found to be quite limited...
August 17, 2018: Cellular Physiology and Biochemistry
Aaron M Wolfson, Michael Fong, Luanda Grazette, Joseph E Rahman, David M Shavelle
Heart failure (HF) has a large societal and economic burden and is expected to increase in magnitude and complexity over the ensuing years. A number of telemonitoring strategies exploring remote monitoring and management of clinical signs and symptoms of congestion in HF have had equivocal results. Early studies of remote haemodynamic monitoring showed promise, but issues with device integrity and implantation-associated adverse events hindered progress. Nonetheless, these early studies established that haemodynamic congestion precedes clinical congestion by several weeks and that remote monitoring of intracardiac pressures may be a viable and practical management strategy...
August 18, 2018: Heart: Official Journal of the British Cardiac Society
Junlong Li, Medha Sasane, Jie Zhang, Jing Zhao, Marie Louise Ricculli, Zhiwen Yao, Suman Redhu, James Signorovitch
OBJECTIVE: Longer time to progression (TTP) is associated with prolonged post-progression survival (PPS) in anaplastic lymphoma kinase+non-small cell lung cancer (NSCLC). This study evaluated whether TTP is associated with PPS among previously treated patients with metastatic v-Raf murine sarcoma viral oncogene homolog B V600E NSCLC receiving dabrafenib as monotherapy or in combination with trametinib. DESIGN: Secondary analysis of phase II clinical trial data. SETTING: Patients who experienced disease progression treated with dabrafenib monotherapy or in combination with trametinib as second line or later in an open-label, non-randomised, phase II study...
August 17, 2018: BMJ Open
Danika Tremain, Megan Freund, Paula Wye, Jenny Bowman, Luke Wolfenden, Adrian Dunlop, Kate Bartlem, Christophe Lecathelinais, John Wiggers
OBJECTIVES: To evaluate the potential effectiveness of a practice change intervention in increasing preventive care provision in community-based substance use treatment services. In addition, client and clinician acceptability of care were examined. DESIGN: A pre-post trial conducted from May 2012 to May 2014. SETTING: Public community-based substance use treatment services (n=15) in one health district in New South Wales (NSW), Australia...
August 17, 2018: BMJ Open
Nisha I Parikh, Kristopher Kapphahn, Haley Hedlin, Jeffrey E Olgin, Matthew A Allison, Jared W Magnani, Kelli R Ryckman, Molly E Waring, Marco Valentin Perez, Barbara V Howard
OBJECTIVES: Pregnancy, menses and menopause are related to fluctuations in endogenous sex hormones in women, which cumulatively may alter cardiac electrical conduction. Therefore, we sought to study the association between number of pregnancies and reproductive period duration (RD, time from menarche to menopause) with ECG intervals in the Women's Health Initiative Clinical Trials. DESIGN: Secondary analysis of multicentre clinical trial. SETTING: USA...
August 17, 2018: BMJ Open
Drushca Lalloo, Evangelia Demou, Julia Smedley, Ira Madan, Kaveh Asanati, Ewan Beaton Macdonald
OBJECTIVES: Studies identifying national occupational health (OH) research priorities have been conducted in several countries to establish where OH research should be focused and where funding should be targeted. However, the UK findings are now over 20 years old, and OH practice is continuously evolving. The aim of this study was to identify current research priorities for UK occupational physicians (OPs) and occupational health researchers (OHRs). METHODS: Current research priorities in OH were identified using a modified Delphi technique...
August 18, 2018: Occupational and Environmental Medicine
N C Gareis, E Angeli, E Huber, N R Salvetti, F M Rodríguez, H H Ortega, G J Hein, F Rey
High-producing dairy cows frequently suffer metabolic alterations that cause different diseases, which could decrease the reproductive efficiency of the herd. Among these reproductive disorders, cystic ovarian disease (COD) has been related to alterations in metabolites and hormonal factors such as insulin, adiponectin and leptin. The aim of this study was to determine the protein expression of adiponectin and some of its downstream targets in ovarian follicles of control cows and cows with clinical diagnosis of COD...
August 7, 2018: Theriogenology
Amélie Bernier-Jean, William Beaubien-Souligny, Thierry Ducruet, Anatolie Duca, Martin Albert, Valéry Lavergne, Josée Bouchard
PURPOSE: Recent studies suggest that acute kidney injury (AKI) can affect distant organ function and increase non-renal complications. We determined whether AKI is associated with an increased risk of incident infections. MATERIAL AND METHODS: We conducted a one-year single-center retrospective cohort study, excluding patients readmitted to the ICU or for <24 h, on chronic dialysis, and kidney transplant recipients. The primary outcome was the development of incident infections analyzed by multivariate time-dependent Cox models...
August 8, 2018: Journal of Critical Care
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