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Patrick Dorn, Michael A Kuhn, Barbara A Schweizer, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Xiphodynia is a rare condition with hardly any data published regarding xiphoidectomy as a valid treatment option for intractable disease. It is necessary to bear this syndrome in mind after having filtered out other differential diagnoses. METHODS: Between 2003 and 2015, 11 patients underwent xiphoidectomy for intractable xiphodynia at our institution. Patients' charts were reviewed including preoperative workup, operative technique, and results. Every patient had routine follow-ups, 4 weeks after the procedure and 1 year after surgery...
May 16, 2018: World Journal of Surgery
Nurcan Buduneli, David A Scott
Cigarette smoking presents oral health professionals with a clinical and research conundrum: reduced periodontal vascular responsiveness to the oral biofilm accompanied by increased susceptibility to destructive periodontal diseases. This presents a significant problem, hampering diagnosis and complicating treatment planning. The aim of this review is to summarize contemporary hypotheses that help explain mechanistically the phenomenon of a suppressed bleeding response to dysbiotic plaque in the periodontia of smokers...
May 16, 2018: Molecular Oral Microbiology
Estelle C Nijssen, Patty J Nelemans, Roger J Rennenberg, Vincent van Ommen, Joachim E Wildberger
OBJECTIVES: Recently, safety guidelines for the use of intravascular iodinated contrast material have been updated, and the recommended threshold for giving prophylaxis to prevent contrast-induced nephropathy (CIN) has been reduced to estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m. Data on this population in the context of CIN, especially evidence for efficacy of the recommendation of prophylactic intravenous hydration, are lacking. The aim of the current study was to test implicit assumptions underlying the guideline update: (1) patients with eGFR <30 mL/min/1...
May 14, 2018: Investigative Radiology
Pierre Foëx, John W Sear
No abstract text is available yet for this article.
June 2018: Anesthesia and Analgesia
Jagmeet P Singh, Jeanne E Poole, Paul Kolm
No abstract text is available yet for this article.
September 2017: JACC. Clinical Electrophysiology
Ratan V Bhat, Ulf Andersson, Shalini Andersson, Laurent Knerr, Udo Bauer, Anna Sundgren Andersson
Spanning over three decades of extensive drug discovery research, the efforts to develop a potent and selective GSK3 inhibitor as a therapeutic for the treatment of type 2 diabetes, Alzheimer's disease (AD), bipolar disorders and cancer have been futile. Since its initial discovery in 1980 and subsequent decades of research, one cannot underscore the importance of the target and the promise of a game changing disease modifier. Several pharmaceutical companies, biotech companies, and academic institutions raged in a quest to unravel the biology and discover potent and selective GSK3 inhibitors, some of which went through clinical trials...
May 11, 2018: Journal of Alzheimer's Disease: JAD
Nicholas V C Ralston, Laura J Raymond
BACKGROUND: Methylmercury (CH3 Hg+ ) toxicity is characterized by challenging conundrums: 1) "selenium (Se)-protective" effects, 2) undefined biochemical mechanism/s of toxicity, 3) brain-specific oxidative damage, 4) fetal vulnerability, and 5) its latency effect. The "protective effects of Se" against CH3 Hg+ toxicity were first recognized >50 years ago, but awareness of Se's vital functions in the brain has transformed understanding of CH3 Hg+ biochemical mechanisms...
May 9, 2018: Biochimica et Biophysica Acta
Meike J Wittmann, Tadashi Fukami
Inhibitory priority effects, in which early-arriving species exclude competing species from local communities, are thought to enhance regional species diversity via community divergence. Theory suggests, however, that these same priority effects make it difficult for species to coexist in the region unless individuals are continuously supplied from an external species pool, often an unrealistic assumption. Here we develop an eco-evolutionary hypothesis to solve this conundrum. We build a metacommunity model in which local priority effects occur between two species via interspecific interference...
June 2018: American Naturalist
Anja Bosy-Westphal, Wiebke Braun, Corinna Geisler, Kristina Norman, Manfred J Müller
It seems reasonable that overweight and obesity should be defined based on body composition rather than indirect indices like BMI or waist circumference. The use of conventional parameters like fat mass or visceral fat is however of similar and limited value for disease risk prediction at the population level and does not contribute much beyond the use of simple BMI or waist circumference. This conundrum may be partly explained by using complex phenotypes (e.g., Metabolic Syndrome or whole body insulin resistance) rather than more disease-specific outcomes like liver- and muscle insulin resistance...
May 2018: European Journal of Clinical Nutrition
Sarah E Henrickson, Artemio M Jongco, Kelly F Thomsen, Elizabeth K Garabedian, Isaac P Thomsen
Chronic granulomatous disease (CGD), a primary immunodeficiency characterized by a deficient neutrophil oxidative burst and the inadequate killing of microbes, is well known to cause a significantly increased risk of invasive infection. However, infectious complications are not the sole manifestations of CGD; substantial additional morbidity is driven by noninfectious complications also. These complications can include, for example, a wide range of inflammatory diseases that affect the gastrointestinal tract, lung, skin, and genitourinary tract and overt autoimmune disease...
May 9, 2018: Journal of the Pediatric Infectious Diseases Society
Akshay M Khatri, George Jolly, Arun Kumar
No abstract text is available yet for this article.
May 1, 2018: American Journal of Therapeutics
Nancy Devlin, John Brazier, A Simon Pickard, Elly Stolk
The article 3L, 5L, What the L? A NICE Conundrum Written by Nancy Devlin, John Brazier, A. Simon Pickard, Elly Stolk was originally published electronically on the publisher's internet portal (currently Springer Link) on (26th February, 2018) without open access.
May 10, 2018: PharmacoEconomics
Marilyn M Schapira
No abstract text is available yet for this article.
May 7, 2018: Journal of General Internal Medicine
David J Dries
No abstract text is available yet for this article.
May 2018: Air Medical Journal
Huy Bui, Van Hoi Pham, Van Dai Pham, Thi Hong Cam Hoang, Thanh Binh Pham, Thuy Chi Do, Quang Minh Ngo, Thuy Van Nguyen
A vast majority of the organic solvents used in industry and laboratories are volatile, hazardous and toxic organic compounds, they are considered as a potent problem for human health and a cause of environmental pollution. Although analytical laboratory methods can determine extremely low solvent concentration, the sensing method with low cost and high sensitivity remains a conundrum. This paper presents and compares three methods (volatile organic compound (VOC), liquid drop and saturated vapour pressure) for determination of organic solvents in liquid environment by using photonic sensor based on nano-porous silicon (pSi) microcavity structures...
May 7, 2018: Environmental Technology
Nathan K Gamble, Michal Pruski
Disorders of sexual differentiation lead to what is often referred to as an intersex state. This state has medical, as well as some legal, recognition. Nevertheless, the question remains whether intersex persons occupy a state in between maleness and femaleness or whether they are truly men or women. To answer this question, another important conundrum needs to be first solved: what defines sex? The answer seems rather simple to most people, yet when morphology does not coincide with haplotypes, and genetics might not correlate with physiology the issue becomes more complex...
May 7, 2018: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
Marye J Gleva, Melissa Robinson, Jeanne Poole
PURPOSE OF REVIEW: In the current era of implantable cardioverter-defibrillator procedures, the decision of whether or not to perform defibrillation threshold testing at the time of implantation is now less of a clinical conundrum. In this paper, we summarize this current practice, beginning with the physiology of defibrillation, followed by a review of the salient data, and discussion of specific situations where defibrillation threshold testing remains a clinical consideration. RECENT FINDINGS: Two prospective randomized trials demonstrated no mortality difference and no overall complication rate difference between patients who underwent defibrillation testing at implant compared with patients who underwent no defibrillation testing...
May 5, 2018: Current Cardiology Reports
S R Howard
The genetic control of pubertal timing has been a field of active investigation for the last decade, but remains a fascinating and mysterious conundrum. Self-limited delayed puberty (DP), also known as constitutional delay of growth and puberty, represents the extreme end of normal pubertal timing, and is the commonest cause of DP in both boys and girls. Familial self-limited DP has a clear genetic basis. It is a highly heritable condition, which often segregates in an autosomal dominant pattern (with or without complete penetrance) in the majority of families...
May 3, 2018: Molecular and Cellular Endocrinology
Robert McMillen
Dr John Thorp presents the clinical conundrum of working in an establishment where his views on abortion, based on his interpretation of Hippocratic and Catholic ethical codes, were not in kilter with those of his department. Others interpret Hippocratic and Christian ethics differently. As Thorp concedes, the oath was not uncontested even in Hippocrates' day, with most Greek thinkers commending abortion, at least prior to viability (US Supreme Court. Roe v. Wade, 410 U.S. 113 1973 Section VI). Perhaps Hippocrates was against inducing abortion, in 500 BC, because of the harm it would do the mother?...
May 4, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Gautam R Shroff, Rachel Stoecker, Allyson Hart
Management of atrial fibrillation (AF) in patients with advanced chronic kidney disease (CKD) poses a complex conundrum because of higher risks for both thromboembolic and bleeding complications compared to the general population. This makes it particularly important for clinicians to carefully weigh the risks versus benefits of anticoagulation therapy to determine the individualized net clinical benefit for every patient. During the past few years, 4 non-vitamin K-dependent oral anticoagulant (NOAC) agents have supplemented warfarin in the therapeutic armamentarium for the prevention of systemic thromboembolism in nonvalvular AF...
May 2, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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