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https://www.readbyqxmd.com/read/28546325/reciprocal-interaction-of-24-hour-blood-pressure-variability-and-systolic-blood-pressure-on-outcome-in-stroke-thrombolysis
#1
Lars Kellert, Christian Hametner, Niaz Ahmed, Geraldine Rauch, Mary J MacLeod, Francesco Perini, Kennedy R Lees, Peter A Ringleb
BACKGROUND AND PURPOSE: Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. METHODS: From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed...
May 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28545928/sitosterolemia-a-multifaceted-metabolic-disorder-with-important-clinical-consequences
#2
Eleftheria Tzavella, Eleftheria Hatzimichael, Christina Kostara, Eleni Bairaktari, Moses Elisaf, Vasilis Tsimihodimos
Sitosterolemia is a metabolic disorder characterized by increased intestinal absorption and tissue accumulation of phytosterols. Although sitosterolemia is considered a rare disease, its prevalence may be significantly higher than initially thought. Indeed, accumulating evidence suggests that patients with unexplained hematologic abnormalities or premature cardiovascular disease in the absence of classic risk factors may exhibit disordered phytosterol metabolism. In this review, we present a patient with sitosterolemia, describe the pathophysiology and the clinical picture of this disorder, and discuss the clinical value of phytosterol supplementation in patients with primary dyslipidemias...
April 30, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28545782/autoimmune-encephalopathy-for-psychiatrists-when-to-suspect-autoimmunity-and-what-to-do-next
#3
REVIEW
Mark Oldham
OBJECTIVE: To provide a critical review of autoimmune encephalopathy-broadly defined as neuropsychiatric features directly related to an autoimmune process-relevant for psychiatric practice. METHODS: We consulted rheumatology textbooks to define the scope of autoimmune conditions and identified recent reviews of rheumatic conditions, autoimmune vasculitis, and autoimmune encephalitis. We integrated these with primary reports to provide a clinically relevant overview of autoimmune encephalopathy...
May 2017: Psychosomatics
https://www.readbyqxmd.com/read/28545580/early-response-in-cognitive-behavior-therapy-for-syndromes-of-medically-unexplained-symptoms
#4
Maria Kleinstäuber, Michael J Lambert, Wolfgang Hiller
BACKGROUND: Early dramatic treatment response suggests a subset of patients who respond to treatment before most of it has been offered. These early responders tend to be over represented among those who are well at termination and at follow-up. Early response patterns in psychotherapy have been investigated only for a few of mental disorders so far. The main aim of the current study was to examine early response after five therapy-preparing sessions of a cognitive behavior therapy (CBT) for syndromes of medically unexplained symptoms (MUS)...
May 25, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28545410/combined-proximal-tubulopathy-crystal-storing-histiocytosis-and-cast-nephropathy-in-a-patient-with-light-chain-multiple-myeloma
#5
Chung-Kuan Wu, An-Hang Yang, Hung-Chih Lai, Bing-Shi Lin
BACKGROUND: The diagnosis of myeloma, a plasma dyscrasia, often results from the workup of unexplained renal disease. Persistent renal failure in myeloma is commonly caused by tubular nephropathy due to circulating immunoglobulins and free light chains. Myeloma cast nephropathy is characterized by crystalline precipitates of monoclonal light chains within distal tubules. Immunoglobulin crystallization rarely occurs intracellularly, within proximal tubular cells (light chain proximal tubulopathy) and interstitial histiocytes (crystal-storing histiocytosis)...
May 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28545069/behavioral-alterations-are-associated-with-vitamin-b12-deficiency-in-the-transcobalamin-receptor-cd320-ko-mouse
#6
Kaveri Arora, Jeffrey M Sequeira, Alejandro I Hernández, Juan M Alarcon, Edward V Quadros
Vitamin B12 (cobalamin) deficiency is prevalent worldwide and causes megaloblastic anemia and neurologic deficits. While the anemia can be treated, the neurologic deficits can become refractive to treatment as the disease progresses. Therefore, timely intervention is critical for a favorable outcome. Moreover, the metabolic basis for the neuro-pathologic changes and the role of cobalamin deficiency in the pathology still remains unexplained. Using a transcobalamin receptor / CD320 knockout mouse that lacks the receptor for cellular uptake of transcobalamin bound cobalamin, we aimed to determine whether cobalamin deficiency in the central nervous system produced functional neurologic deficits in the mouse that would parallel those observed in humans...
2017: PloS One
https://www.readbyqxmd.com/read/28543854/endocardial-fibroelastosis-is-secondary-to-hemodynamic-alterations-in-the-chick-embryonic-model-of-hypoplastic-left-heart-syndrome
#7
Zivorad Pesevski, Alena Kvasilova, Tereza Stopkova, Ondrej Nanka, Eliska Drobna Krejci, Christine Buffinton, Radka Kockova, Adam Eckhardt, David Sedmera
BACKGROUND: Endocardial fibroelastosis (EFE) is a diffuse thickening of the ventricular endocardium, causing myocardial dysfunction and presenting as unexplained heart failure in infants and children. One of the postulated causes is persistent and increased wall tension in the ventricles. RESULTS: To examine whether reduced ventricular pressure in a chick model of hypoplastic left heart syndrome induced by left atrial ligation (LAL) at ED4 is associated with EFE at later stages, myocardial fibrosis was evaluated by histology and immunoconfocal microscopy and mass spectrometry (MS) at ED12...
May 20, 2017: Developmental Dynamics: An Official Publication of the American Association of Anatomists
https://www.readbyqxmd.com/read/28543790/are-heart-rate-monitors-valuable-tools-for-diagnosing-arrhythmias-in-endurance-athletes
#8
Robert Gajda, Elżbieta Katarzyna Biernacka, Wojciech Drygas
Millions of physically active individuals worldwide use heart rate monitors (HRMs) to control their exercise intensity. In many cases, the HRM indicates an unusually high heart rate (HR) or even arrhythmias during training. Unfortunately, studies assessing the reliability of these devices to help control HR disturbances during exercise do not exist. We examined 142 regularly training endurance runners and cyclists, aged 18-51, with unexplained HR abnormalities indicated by various HRMs to assess the utility of HRMs in diagnosing exertion-induced arrhythmias...
May 19, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28543710/presentation-diagnosis-and-management-of-popliteal-artery-entrapment-syndrome-11-years-of-experience-with-61-legs
#9
Luc Corneloup, Claude Labanère, Laurent Chevalier, Jérémie Jaussaud, Aude Mignot, Laurent Gencel, Olivier Corneloup, Dominique Midy
BACKGROUND: Popliteal Artery Entrapment Syndrome (PAES) is still underdiagnosed yet it may significantly interfere with lifestyle, especially among young sportspeople, with symptoms like intermittent claudication. While case reports and small case series are sometimes published, studies with larger populations are quite rare. METHODS: This study summarizes our experience with PAES on 61 limbs (35 patients) over a period of 11 years, describing the demographics, the disease and the diagnostic and therapeutic methods used with PAES patients...
May 19, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28541745/graphical-data-display-for-clinical-cardiopulmonary-exercise-testing
#10
Daniel Dumitrescu, Stephan Rosenkranz
Cardiopulmonary exercise testing is a well-known, valuable tool in the clinical evaluation of patients with different causes of exercise limitation, and unexplained dyspnea. A wealth of data is generated by each individual test. This may be challenging with regard to a comprehensive and reliable interpretation of an exercise study in a timely manner. An optimized graphical display of exercise data may substantially help to improve the efficacy and reliability of the interpretation process. However, there are limited and heterogeneous recommendations on standardized graphical display in current exercise testing guidelines...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28541648/expert-consensus-survey-on-medication-adherence-in-psychiatric-patients-and-use-of-a-digital-medicine-system
#11
Ainslie Hatch, John P Docherty, Daniel Carpenter, Ruth Ross, Peter J Weiden
BACKGROUND: There is an unmet need to objectively assess adherence problems that are a common cause of unexplained or unexpected suboptimal outcome. A digital medicine system (DMS) has been developed to address this need in patients with serious mental illness. OBJECTIVE: To conduct a quantitative expert consensus survey to (1) assess relative importance of causes of suboptimal outcomes, (2) examine modalities used to assess adherence, (3) provide guidance on when and how to use the DMS in clinical practice once available, and (4) suggest interventions for specific reasons for nonadherence...
May 23, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28541008/protein-losing-enteropathy-as-a-complication-of-the-ketogenic-diet
#12
Won Kee Ahn, Soyoung Park, Heung Dong Kim
The ketogenic diet is an effective treatment for the patients with intractable epilepsy, however, the diet therapy can sometimes be discontinued by complications. Protein-losing enteropathy is a rarely reported serious complication of the ketogenic diet. We present a 16-month-old Down syndrome baby with protein-losing enteropathy during the ketogenic diet as a treatment for West syndrome. He suffered from diarrhea, general edema and hypoalbuminemia which were not controlled by conservative care for over 1 month...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28540566/-osteosynthesis-associated-infections-epidemiology-definition-and-diagnosis
#13
REVIEW
N Renz, S Feihl, C E Dlaska, M A Schütz, A Trampuz
Osteosynthesis-associated infections occur in 1-5% after closed and in up to 30% after open fractures. There are three different descriptions of implant-associated infections after fracture fixation, which are crucial for the selection of the adequate treatment strategy; temporal appearance from the index surgery (early versus late), pathogenesis of the infection (exogenous, hematogenous and contiguous from an adjacent focus), duration of infection symptoms (acute versus chronic). Diagnosis of osteosynthesis-associated infection is challenging, as chronic low-grade infections often present only with unspecific and subtle clinical symptoms...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28540052/a-unique-case-of-massive-gastrointestinal-bleeding
#14
Akihiko Kida, Koichiro Matsuda, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
OBJECTIVES: Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation. METHODS/RESULTS: We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28539306/sarcomere-mechanics-in-striated-muscles-from-molecules-to-sarcomeres-to-cells
#15
Dilson E Rassier
Muscle contraction is commonly associated with the cross-bridge and sliding filament theories, which have received strong support from experiments conducted over the years in different laboratories. However, there are studies that cannot be readily explained by the theories, showing (i) a plateau of the force-length relation extended beyond optimal filament overlap, and forces produced at long sarcomere lengths that are higher than those predicted by the sliding filament theory, (ii) passive forces at long sarcomere lengths that can be modulated by activation and Ca(2+), which changes the force-length relation, and (iii) an unexplained high force produced during and after stretch of activated muscle fibers...
May 24, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/28539136/anomalous-left-atrial-drainage-of-the-right-superior-caval-vein-with-partial-anomalous-pulmonary-venous-return
#16
Sherief Sulaiman, Rajesh G Nair
We present a case of anomalous direct connection of the right superior caval vein to the left atrium. The diagnosis was made in a 2-year-old child with unexplained cyanosis and apparently normal heart. Corrective surgery was performed, and the child recovered completely.
May 25, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28539036/a-case-of-tuberculous-peritonitis-presenting-as-small-bowel-obstruction
#17
Hae Koo Kim, Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Yong Jin Nam
The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28538643/immature-patients-in-a-mature-system-regional-analysis-of-florida-s-pediatric-trauma-system
#18
Christopher W Snyder, Nicole M Chandler, Cristen N Litz, Etienne E Pracht, Paul D Danielson, David J Ciesla
BACKGROUND: The state of Florida's trauma system is organized into seven regions, two of which lack designated pediatric trauma centers. Injured children residing in these regions often require transfer out of their home region for definitive care. The purpose of this study was to evaluate the effectiveness and efficiency of the current regionalization approach, focusing on variations between regions. METHODS: Using the Florida Agency for Health Care Administration database, we identified all trauma patients 15 years old or younger admitted between 2009 and 2014...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538363/the-effect-of-alpha-linolenic-acid-on-glycemic-control-in-individuals-with-type-2-diabetes-a-systematic-review-and-meta-analysis-of-randomized-controlled-clinical-trials
#19
Elena Jovanovski, Dandan Li, Hoang Vi Thanh Ho, Vladimir Djedovic, Any de Castro Ruiz Marques, Esra Shishtar, Sonia Blanco Mejia, John L Sievenpiper, Russell J de Souza, Lea Duvnjak, Vladimir Vuksan
BACKGROUND: Polyunsaturated fats (PUFAs) have been shown to reduce type 2 diabetes (T2DM) risk and improve insulin responsiveness in T2DM subjects, but whether the plant sources of omega-3 PUFA (alpha-linolenic acid [ALA]) have an effect on glycemic control requires further investigation. METHODS: The parameters of interest were glycated hemoglobin (HbA1c), fasting blood glucose (FBG), fasting blood insulin (FBI), homeostatic model assessment for insulin resistance (HOMA-IR), fructosamine, and glycated albumin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538176/tonic-lat-hdac7-signals-sustain-nur77-and-irf4-expression-to-tune-naive-cd4%C3%A2-t-cells
#20
Darienne R Myers, Tannia Lau, Evan Markegard, Hyung W Lim, Herbert Kasler, Minghua Zhu, Andrea Barczak, John P Huizar, Julie Zikherman, David J Erle, Weiguo Zhang, Eric Verdin, Jeroen P Roose
CD4(+) T cells differentiate into T helper cell subsets in feedforward manners with synergistic signals from the T cell receptor (TCR), cytokines, and lineage-specific transcription factors. Naive CD4(+) T cells avoid spontaneous engagement of feedforward mechanisms but retain a prepared state. T cells lacking the adaptor molecule LAT demonstrate impaired TCR-induced signals yet cause a spontaneous lymphoproliferative T helper 2 (TH2) cell syndrome in mice. Thus, LAT constitutes an unexplained maintenance cue...
May 23, 2017: Cell Reports
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