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Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: iron insufficiency has been proposed to play a central role in restless legs syndrome ( rls ) pathophysiology indicated primarily by the secondary causes of rls such as pure iron deficiency anemia and end stage renal disease or pregnancy which are both associated with altered iron metabolism . it has also been shown that frequent blood donors have an increased risk of rls.1 overall , it has gained wide clinical acceptance that rls is commonly occurring with iron deficiency anemia , although there have been few studies documenting this relationship.24 in addition , it has been shown that rls severity negatively correlates with serum ferritin.3,5 correcting iron status in rls patients with iron deficiency has been found to reduce rls symptoms.3,6 complete remission of rls symptoms has also been reported after intravenous substitution of iron in rls patients with and without clear anemia.710 thus pharmacological data as well as data from secondary rls support a relation between iron deficiency and rls . for evaluating the iron status of rls patients , serum and cerebrospinal fluid ( csf ) measures involved in iron metabolism,11 autopsy evaluation of brain iron status,12,13 transcranial parenchymal ultrasound,14,15 and magnetic resonance imaging ( mri ) measurements16,17 have been performed . all of these data supported the view that there is a measurable brain iron deficiency particularly in the substantia nigra in rls patients.18 t2-hypointensity is thought to represent iron deposition as iron deposits shorten t2 relaxation times on t2-weighted mris.19 using a cranial mri scan with a standard t2 * -sequence , differences of regional mean t2-values can be measured throughout the brain as a consequence of different brain iron concentrations . up to now , significant differences in brain iron concentrations were found in the substantia nigra in rls patients as compared to controls in two studies using t2 * -weighted mri.16,17 in this study we investigated regional brain iron concentrations using a standard t2 *...

using a t2 * gradient echo magnetic resonance imaging ( mri ) sequence , regional t2 signal intensity ( si ) values , a surrogate marker for t2 values , were determined in 12 regions of interest ( substantia nigra , pallidum , caudate head , thalamus , occipital white matter , and frontal white matter bilaterally ) and in two reference regions ( cerebrospinal fluid and bone ) in 12 patients suffering from moderate to severe idiopathic restless legs syndrome ( rls ; mean age 58.5 8.7 years ) for 12.1 9.1 years and in 12 healthy control subjects ( mean age 56.8 10.6 years ) . iron deposits shorten t2 relaxation times on t2-weighted mri . we used regional t2 * si to estimate regional t2-values . a t2-change ratio was calculated for each region of interest relative to the reference regions . we did not find significant differences in any of the investigated brain regions . in addition , serum measures involved in iron metabolism did not correlate with t2 si values . we could not replicate earlier findings describing reduced regional brain iron concentrations in patients with rls . our results do not support the view of substantially impaired regional brain iron in rls .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: percutaneous radiofrequency ( rf ) ablation is a minimally invasive and nonsurgical technique used to treat various solid tumors . many studies have shown that this technique is safe and effective in treating hepatic and renal tumors [ 13 ] . recent investigations of rf ablation s practicability and outcome as a successful method for extricating primary and metastatic lung tumors have been promising [ 48 ] . studies have shown that rf ablation is evolving into a suitable alternative and adjuvant method to open thoracic surgery of primary and metastatic lung cancer , which is commonly associated with high morbidity and mortality [ 9 , 10 ] . however , there are many issues concerning rf ablation that need to be addressed . these questions mainly involve patient selection , location and type of lung malignancy , accessibility of the lesion , possible risks for acute and chronic complications and management , and finally , pain management , both during and after the rf ablation . in this article , we present a case that utilized a technique to decrease the pain associated with rf ablation of a malignancy located within the subpleural lung . under ct guidance , we created an artificial pneumothorax prior to the rf ablation , which resulted in minimizing the pain usually experienced during and after the procedure . the patient s written informed consent was obtained after the risk , benefits , and alternatives of the procedure were fully explained . a waiver of informed consent was obtained from the irb for this report . a 43-year - old woman with a history of metastatic colorectal cancer to the liver , originally diagnosed in 1999 , presented with newly rising carcinoembryogenic antigen ( cea ) , and ct scan of the chest confirmed the development of three new subcentimeter nodules within both lungs . these nodules were consistent with pulmonary parenchymal metastases : one within the right middle lobe and , notably , two nodules within the anterior segment of the left upper lobe , one within the subpleural aspect...

one of the main issues with radiofrequency ( rf ) ablation of the subpleural lung malignancy is pain management during and after rf ablation . in this article , we present a case that utilized a technique to decrease the pain associated with rf ablation of a malignancy located within the subpleural lung . under ct guidance , we created an artificial pneumothorax prior to the rf ablation , which resulted in minimizing the pain usually experienced during and after the procedure . it also decreased the amount of pain medications usually used in patients undergoing rf ablation of a subpleural lung lesion .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: paratuberculosis ( map ) , is a disease affecting mainly domestic but also wild ruminants , including mouflons ( ovis musimon ; wild sheep ) [ 13 ] . in wild ruminants , paratuberculosis often manifests subclinically without overt symptoms which makes the disease more concerning from an epidemiological point of view [ 3 , 4 ] . during the subclinical as well as clinical phase of the infection , the animals spread the agent into the environment by faecal shedding , where it can act as a source of infection for other animals . , animals intended for transport across different regions or countries must undergo quarantine lasting at least 30 days with respect to major epizootic and notifiable diseases , such as bluetongue , bovine tuberculosis , brucellosis , and foot and mouth disease . paratuberculosis does not belong to the above mentioned group and the examination of imported ruminants therefore depends on the preference of the owner of the receiving farm . in addition , due to economic constraints , the belief that paratuberculosis does not represent a problem , or because of its low priority compared to other animal diseases , paratuberculosis control programmes in europe are mostly based on voluntary participation . in some countries , paratuberculosis numbers among the notifiable diseases , but there is no obligation to test animals with clinical signs . thus , animals are not examined due to concerns regarding their obligatory elimination or problems with selling animal remains ( herds with paratuberculosis status ) . animals can be negatively influenced either by physical ( hunger , thirst , injury , etc . ) or psychological / ethological stress ( handling , restraint , new environment , etc . ) . compared to domesticated , calm animals , wild species with excitable temperaments react to stressors more sensitively . while physical stress is connected with pain , psychological stress is characterised by fear which is one of the most important stressors . various stressors can detrimentally affect the...

there is no european legislation concerning paratuberculosis that requires that imported animals be kept in quarantine and commonly they are directly released into areas with other animals . in this study , detection of latent infection of paratuberculosis in healthy mouflons previously diagnosed as paratuberculosis - free , but originating from a real time quantitative pcr- ( qpcr- ) positive herd , occurred after their transport to a new farm . during a twelve - day quarantine period , all mouflons irregularly shed mycobacterium avium subsp . paratuberculosis ( map ) in faeces , and in a small number of cases also in milk . after the animals were released from quarantine , map was detected for a further two days , after which , testing was negative , except in one case . therefore , the stress connected with transport , novel environment , dietary change , or limited area with high density of animals might have contributed to the induction of paratuberculosis and the shedding of map from the animals , previously diagnosed as map - negative . according to these results , the keeping of imported animals in quarantine and their examination for map presence not only before the transport but also afterwards should be recommended . the designation of a particular area of a farm as a quarantine enclosure could help to mitigate the impact of stress caused by a confined space with a high density of animals .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the host colonization by microbiota is a gradual and complex process initiated by the exposure of newborns to the maternal vagina or skin microbiota , according to the mode of delivery , which fluctuates throughout life due to external and internal factors , including dietary habits , antibiotic treatments and host diseases . the adult human intestine contains approximately 4 10 microorganisms including viruses , fungi and 500 to 1000 bacterial species . the bacterial density increases along the gastrointestinal tract to reach 3.8 10 bacteria per gram of fecal matter in the colon , and the composition of this microbiota also varies according to spatial localization . , escherichia coli , whereas the colon is enriched in dietary fiber - consuming bacteria , such as clostridium sp . and bacteroides species . depending on the origin of their vendor , the small intestine of mice can also be colonized by segmented filamentous bacteria ( sfb ) . the gut microbiota and microbiota - derived metabolites are essential for healthy host functions , influencing the immune system , the nervous system ( the gut brain axis ) , the endocrine system and the metabolism . despite its key role within the organism , the microbiota encompasses millions of proteins and putative antigens to which the host must be tolerant . physical and chemical protective barriers , such as the mucus layer , production of antimicrobial peptides , the secretion of immunoglobulin a ( iga ) and the epithelium per se , allow microbiota sequestration within the lumen and prevent damage associated with bacterial dissemination . when the gut barrier integrity is impaired , the immune system can respond to antigens of the microbiota , inducing chronic and noxious inflammation , as well as a disequilibrium in bacterial species composition with direct consequences on the different key physiological systems influenced by the microbiota . the role of the intestinal microbiota in shaping the immune system was clearly demonstrated by the use of axenic mice...

the relationship between host organisms and their microbiota has co - evolved towards an inter - dependent network of mutualistic interactions . this interplay is particularly well studied in the gastrointestinal tract , where microbiota and host immune cells can modulate each other directly , as well as indirectly , through the production and release of chemical molecules and signals . in this review , we define the functional impact of transforming growth factor - beta ( tgf- ) on this complex interplay , especially through its modulation of the activity of local regulatory t cells ( tregs ) , type 17 helper ( th17 ) cells , innate lymphoid cells ( ilcs ) and b cells .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: insulin resistance syndromes are a heterogeneous group of disorders with variable clinical phenotypes , associated with increased blood glucose and insulin levels . hyperglycemia did not respond to age appropriate insulin dosage ; therefore , insulin dosage was increased , but did not lead to appropriate glycemic control . twenty two exons of insulin receptor gene ( insr ) , on short arm of chromosome 19 , were sequenced , but no identifiable disease causing mutation was detected . although a rare mutation within the intronic or promoter region has not been excluded in this case , further molecular studies on patients with insulin resistance syndromes associated with certain features are needed . insulin resistance syndromes are a group of disorders with variable clinical spectrum , including extreme high insulin levels , glucose intolerance , and diabetes mellitus . various endocrine and metabolic conditions syndromes associated with insulin resistant state , are leprechaunism or donohue 's syndrome ( abnormal facial appearance , early life growth retardation ) , rabson - mendenhall syndrome ( dental and nail abnormalities , skin lesions ) , werner syndrome ( features of premature aging ) , and alstrom syndrome ( childhood blindness , impaired hearing ) . abnormal facial appearance and dentition in association with insulin resistance resembles rabson - mendenhall syndrome ( rms ) ( omim # 262190 ) , an autosomal recessive disorder caused by mutation in the insulin receptor gene ( insr , omim*147670 ) . growth and developmental delay , coarse facies , prognathism , gingival hypoplasia , premature and dysplastic dentition , enlarged genitalia , acanthosis nigricans , lichenified skin , onychauxis , and hypertrichosis are some of the clinical manifestations observed in these patients . herein , we present a patient with insulin resistance syndrome with the clinical diagnosis of rms ; however , molecular analysis of the insr gene did not show any mutation . a 10-year old girl was referred to the children 's...

backgroundinsulin resistance syndromes are a heterogeneous group of disorders with variable clinical phenotypes , associated with increased blood glucose and insulin levels.case presentationherein , a 10-year old girl with abnormal face and dentition is presented . she has suffered from diabetes mellitus type i since she was 6 years old . hyperglycemia did not respond to age appropriate insulin dosage ; therefore , insulin dosage was increased , but did not lead to appropriate glycemic control . twenty two exons of insulin receptor gene ( insr ) , on short arm of chromosome 19 , were sequenced , but no identifiable disease causing mutation was detected.conclusionalthough a rare mutation within the intronic or promoter region has not been excluded in this case , further molecular studies on patients with insulin resistance syndromes associated with certain features are needed .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: low back pain ( lbp ) is an extremely prevalent and costly condition , affecting over 90% of adults in the united states at some point during their lifetime.1 the prevalence of chronic lbp in the us has increased from 3.9% in 1992 to 10.2% in 2006.2 claims associated with lbp among medicare beneficiaries increased by 131.7% from 1991 to 2002 in the us , and the associated charges to medicare during this time period increased by 387.2%.3 overall , the total cost burden associated with lbp in the us , including lost productivity and decreased wages , is estimated to range between $ 60 billion and $ 200 billion annually.4,5 the sacroiliac ( si ) joint is a common cause of chronic lbp.6 the prevalence of si joint pain has been reported to range between 15%30% of patients with chronic lbp , recognizing that not all of these patients require surgery.6,7 therefore , it is reasonable to expect that the disability burden associated with si joint pain will parallel that of lbp . a study of treatment of spinal disorders among medicare beneficiaries found that costs for epidural injections increased from $ 396.7 million in 2002 to $ 743.8 million in 2006 , an increase of 121.1%.8 total medicare costs for inpatient lumbar spinal surgery totaled more than $ 1 billion in 2003.9 determining that the si joint is the pain generator is based on three or more positive provocation tests that indicate that the si joint is the source of pain , followed by a confirmatory image - guided diagnostic injection of the si joint ; a 50% or greater reduction in pain immediately after the injection of a local anesthetic is used to confirm that the si joint is the pain generator.10,11 the traditional si joint pain treatment options have included either nonoperative care , such as physical therapy , epidural injections , si joint injections , radiofrequency ablation , and pain medications , or traditional open si joint arthrodesis surgery . less invasive , nonoperative therapies often have limited benefit , as they only address the symptoms of...

introductionthe economic burden associated with the treatment of low back pain ( lbp ) in the united states is significant . lbp caused by sacroiliac ( si ) joint disruption / degenerative sacroiliitis is most commonly treated with nonoperative care and/or open si joint surgery . new and effective minimally invasive surgery ( mis ) options may offer potential cost savings to medicare.methodsan economic model was developed to compare the costs of mis treatment to nonoperative care for the treatment of si joint disruption in the hospital inpatient setting in the us medicare population . lifetime cost savings ( 2012 us dollars ) were estimated from the published literature and claims data . costs included treatment , follow - up , diagnostic testing , and retail pharmacy pain medication . costs of si joint disruption patients managed with nonoperative care were estimated from the 20052010 medicare 5% standard analytic files using primary international classification of diseases , ninth revision , clinical modification ( icd-9-cm ) diagnosis codes 720.2 , 724.6 , 739.4 , 846.9 , or 847.3 . mis fusion hospitalization cost was based on diagnosis related group ( drg ) payments of $ 46,700 ( with major complications - drg 459 ) and $ 27,800 ( without major complications - drg 460 ) , weighted assuming 3.8% of patients have complications . mis fusion professional fee was determined from the 2012 medicare payment for current procedural terminology code 27280 , with an 82% fusion success rate and 1.8% revision rate . outcomes were discounted by 3.0% per annum.resultsthe extrapolated lifetime cost of treating medicare patients with mis fusion was $ 48,185/patient compared to $ 51,543/patient for nonoperative care , resulting in a $ 660 million savings to medicare ( 196,452 beneficiaries at $ 3,358 in savings / patient ) . including those with icd-9-cm code 721.3 ( lumbosacral spondylosis ) increased lifetime cost estimates ( up to 478,764 beneficiaries at $ 8,692 in savings / patient).conclusiontreating...

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the health benefits of the use of radiation in medical practice are nowadays widely acknowledged . nevertheless , for instance , the risks for pregnant women , more precisely for their embryo / fetus to develop structural and functional brain defects , have been described based on epidemiological studies from atomic bomb survivors . these observations are particularly relevant in the case of radiotherapy treatment or medical imaging during pregnancy , which often results in abortion , delay of maternal therapy , or preterm delivery when women were diagnosed with cancer during pregnancy . furthermore , the use of medical radiation modalities employing low doses , such as ct scans , has increased tremendously over the past decades . the advantages of this increasing use of low doses in the hospital are obvious , but a major concern exists regarding the cumulative exposure doses of repetitive tests and the inappropriate utilization of these imaging techniques [ 3 , 4 ] . in all , the benefits of current medical practice can still be improved for pregnant women and their unborn child , for which a better understanding of radiation effects , especially in the low - dose range , is imperative . the human developing brain is extremely sensitive to radiation exposure , which is especially the case when exposure occurs within a specific developmental time - window , that is , between weeks 8 and 25 of gestation . this period is characterized by specific coordinated developmental processes and corresponds to embryonic days 11 ( e11 ) to 17 in mice ( see figure 1 ) . in most cases , the mouse has been the experimental model of choice to investigate radiation - induced defects to the brain , but the high vulnerability of the fetal brain to environmental insults has been recognized in many other mammalian species , including primates and other rodents [ 68 ] . research on prenatal radiation - induced brain defects has mainly focused on the developing neocortex , of which the developmental hallmarks are depicted in figure...

ionizing radiation is omnipresent . we are continuously exposed to natural ( e.g. , radon and cosmic ) and man - made radiation sources , including those from industry but especially from the medical sector . the increasing use of medical radiation modalities , in particular those employing low - dose radiation such as ct scans , raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques . one of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother , of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors . in the following years , animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits . however , the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established . this review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: ec coupling relies on a supramolecular complex between dhpr , which is the tt voltage sensor , and the ryr1 , which is the sr ca release channel . the distinctive spatial relationship between these two proteins was revealed using freeze fracture shadowing electron microscopy . on the sr terminal cisternae side of the triad junction , large proteins named these form ordered 2d arrays , whereby ryr1s contact each other through their corners forming two or three rows along the edge of the terminal cisternae . on the tt side , groups of four particles ( tetrads ) , identified as four dhprs , correlated with the disposition of individual ryr1 particles on the sr . the tetrads of dhpr are formed by the specific interaction between each dhpr and each of the four corners of the much larger , prism - shaped homotetrameric ryr1 , and do not form in its absence . further evidence of the tight interaction between dhpr and ryr1 is the change in intra - tetrad distance when applying an effector known to change the conformation of ryr1 . the skeletal muscle dhpr is a heteropentamer formed by the 1s or cav1.1 , 2-1 , 1a , and subunits . cav1.1 , an l - type voltage - activated ca channel , acts as the voltage sensor for ec coupling . since its ca channel activity is irrelevant in the ec coupling context , much effort has been dedicated to understand how the dhpr transmits the voltage - sensing signal induced by membrane depolarization to the ryr1 . the main candidates that have emerged are the ii - iii loop of a1s and the 1a subunit : their presence is essential for ec coupling and tetrad formation . thus , it became important to see how these two entities are organized within the dhpr complex and how is their spatial relationship with respect to the ryr1 . the dhpr has been visualized within the context of the muscle tissue by freeze fracture followed by rotary shadowing as described above . in this technique , the frozen tissue is fractured through the less cohesive membrane planes , exposing the protruding regions of...

excitation contraction coupling , the rapid and massive ca2 + release under control of an action potential that triggers muscle contraction , takes places at specialized regions of the cell called triad junctions . there , a highly ordered supramolecular complex between the dihydropyridine receptor ( dhpr ) and the ryanodine receptor ( ryr1 ) mediates the quasi - instantaneous conversion from t - tubule depolarization into ca2 + release from the sarcoplasmic reticulum ( sr ) . the dhpr has several key modules required for ec coupling : the voltage sensors and ii - iii loop in the alpha1s subunit , and the beta subunit . to gain insight into their molecular organization , this review examines the most updated 3d structure of the dhpr as obtained by transmission electron microscopy and image reconstruction . although structure determination of a heteromeric membrane protein such as the dhpr is challenging , novel technical advances in protein expression and 3d labeling facilitated this task . the 3d structure of the dhpr complex consists of a main body with five irregular corners around its perimeter encompassing the transmembrane alpha 1s subunit besides the intracellular beta subunit , an extended extracellular alpha 2 subunit , and a bulky intracellular ii - iii loop . the structural definition attained at 19 resolution enabled docking of the atomic coordinates of structural homologs of the alpha1s and beta subunits . these structural features , together with their relative location with respect to the ryr1 , are discussed in the context of the functional data .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: parathyroid glands are located behind the thyroid gland that produces parathyroid hormones ( pth ) . pth has a main role in bone formation , vitamin d activation occurred in the kidney by pth that leads to intestinal absorption of calcium and phosphate re - absorption . the primary function of pth is to maintain the extracellular fluid calcium concentration , which is done by pth effect on bone and kidney directly and on the intestine through its effects on synthesis of 1 , 25 ( oh)d , indirectly . primary hyperparathyroidism ( phpt ) is a generalized disorder of calcium , phosphate , and bone metabolism due to excessive secretion of pth . secondary hyperparathyroidism ( shpt ) is caused by impaired phosphate excretion , and failure to activate vitamin d. hypocalcemia is caused by elevated levels of the fibroblast growth factor 23 ( fgf-23 ) , and reduced synthesis of calcitriol , which is the active form of vitamin d. elevated phosphate level , decreased ionized calcium level , and reduced serum calcitriol lead to continuous stimulation of the parathyroid glands that causes increased pth release . tertiary hpt is defined as long - time shpt leads to autonomous parathyroid glands that lead to hypercalcemia , pruritis and extra - skeletal calcification , bone involvement despite aggressive treatment to suppress pth . hpt leads to bone involvement that include generalized osteoporosis , multiple focal areas of demineralization of the skull , and brown tumor . the brown tumor or osteitis fibrosa cystica is a benign bone lesion that caused by hpt . pelvis , ribs , clavicle , mandible and the extremities are most commonly affected bones in brown tumor , whereas maxillary involvement is rare ( 0.1% ) . this case report was unique due to the presentation of brown tumors in the maxillofacial region . in july 2012 , a 29-year - old man was referred to internal medicine clinic , al zahra hospital , isfahan , iran with chief complaint of generalized bone pain that started seven months ago and , swelling in the cheek...

parathyroid glands produce parathyroid hormone ( pth ) . pth has a main role in bone formation . hyperparathyroidism ( hpt ) is explained as primary , secondary and tertiary types defined as overproduction of pth . the brown tumor or osteitis fibrosa cystica is a benign bone lesion that is caused by hpt . this complication has been decreased by diagnosis and successful treatment of secondary hyperparathyroidism . pelvis , ribs , clavicle , mandible and the extremities are most commonly affected bone in brown tumor , whereas maxillary involvement is rare . the present article report a 29-year - old man with chief complaints of bone pain , swelling cheeks and teeth displacement with secondary hpt . parathyroidectomy was done due to bone disorder . it is important for dentists and endocrinologists to understand maxillofacial manifestation of secondary hpt to prevent its complication .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: shigellosis is among the most common causes of bacterial diarrheal disease in both developing and developed countries . shigella consists of four serogroups including serogroup a ( s. dysenteriae ) , serogroup b ( s. flexneri ) , serogroup c ( s. boydii ) and serogroup d ( s. sonnei ) . it is one of the major causes of morbidity in children with diarrhea in iran ( 1 , 2 ) . it has been recently reportedit as the prevalent shigella serotype in iran ( 4 , 5 ) . treatment using adequate antibiotics is effective for shigellosis particularly for the children and immunosuppressed patients because it may shortens the clinical course of the disease , reduce the risk of transmission and prevent potentially lethal complications . , the conventional bacterial typing methods such as antimicrobial resistance pattern , bacteriophage typing , or serotyping have been replaced by molecular techniques such as ribotyping , pulsed - field gel electrophoresis ( pfge ) , and pcr - based methods ( 1 , 11 , 12 ) . an entero - bacterial repetitive intergenic consensus ( eric ) sequence is an imperfect palindrome of 127 bp . eric sequences have been found only in intergenic regions , apparently only within transcribed regions . pcr- mediated genomic fingerprinting based on eric sequences has been found to be useful for subtyping gram - negative enteric bacteria and differentiation of their strains ( 13 ) . the present study was conducted to determine the antimicrobial susceptibility and genetic relationship among s. sonnei strains isolated from pediatric patients in tehran , iran . the study included all s. sonnei strains isolated from pediatric patients with diarrhea who were admitted to several hospitals in tehran , iran , during 2008 - 2010 . a single specimen was obtained from each patient , and rectal swabs were collected from patients on the day of admission at the hospital . when the isolates were identified as shigella by the conventional methods ( 14 ) , these were serotyped using slide agglutination with specific antisera (...

abstractbackgroundshigella sonnei is considered as a major cause of diarrheal disease in both developing and developed countries . iran is one of the endemic areas of shigellosis . the present study was undertaken to investigate the antibiotic susceptibility and genetic relatedness of s. sonnei strains isolated from pediatric patients in tehran , iran.methodsthe study included all s. sonnei strains isolated from pediatric patients with diarrhea admitted to several hospitals in tehran , iran , during 2008 - 2010 . shigella spp . strains were recovered from patients using standard microbiological methods . s. sonnei strains were further studied by antimicrobial susceptibility testing and enterobacterial repetitive intergenic consensus ( eric ) - pcr analysis.resultseighty nine shigella isolates were isolated . s. sonnei was themost prevalent shigella species ( 60.7% ) followed by , s. flexneri ( 31.5% ) . eleven antimicrobial resistance patterns ( r1-r11 ) were identified among s. sonnei isolates . the majority of the strains were resistant to trimethoprim - sulfamethoxazole , tetracycline and streptomycin . all isolates were susceptible to ciprofloxacin , ceftizoxime and chloramphenicol . all strains were typable by eric - pcr . five eric - pcr patterns ( e1-e5 ) were found among s. sonnei isolates ; however the half of the isolates was clustered in e4 pattern.conclusionthe antibiotic resistance rates are increasing among s. sonnei strains . moreover , a predominant clone or limited clones of s. sonnei were responsible for shigellosis caused by this shigella species in pediatric patients in tehran , iran .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the efficacy of antitumor necrosis factor ( tnf- ) , infliximab , has been shown to be effective in various disease treatment including crohn s disease ( cd ) . however , there is limited information in the use of infliximab in patients on hemodialysis . although the highest incidence in cd is among younger generations , 1030 years old , older people are also affected . here we report a case of an old man on hemodialysis who developed cd and was successfully treated with infliximab . a 76-year - old man , 166 cm tall and weighing 47.1 kg , receiving hemodialysis for 6 years was referred to our division of gastroenterology , akita city hospital , akita city , japan , in the middle of november 2013 , because of diarrhea , abdominal pain , and fever for 1 week . he was diagnosed with wolff - parkinson - white syndrome in 1973 , paroxysmal atrial fibrillation in 1982 , myocardial infarction in 1993 , and immunoglobulin a ( iga ) nephropathy in 2005 . tenderness in the left lower abdomen and a marked edema in both sides of the pretibia and ankle were observed . laboratory data were as follows : an increase of c - reactive protein ( crp ) , 10.73 mg / dl ( normal range 0.19 ) ; an increase of erythrocyte sedimentation rate , 46 mm / h ; hypoalbuminemia , 2.0 g / dl ; hypocholesterolemia , 107 mg / dl ; and moderate anemia , hemoglobin 9.0 g / dl ( figure 1 ) . ultrasonography and computed tomography ( ct ) found wall thickness in continuous form in the left colon . sigmoidoscopy revealed multiple irregular - shaped ulcers in the sigmoid colon ( figure 2 ) . barium enema study exhibited collar button ulcers , longitudinal ulcers , and coarse mucosa in the left colon ( figure 3 ) . negative results were obtained in the following tests : cytomegalovirus antigenemia , stool culture , and clostridium difficile toxin . rapid efficacy of infliximab in cd and reports of safety of infliximab in patients on hemodialysis encouraged us and our patient to use infliximab rather than steroid hormone that has an adverse...

abstractthere is limited information in the use of antitumor necrosis factor , infliximab , in patients on hemodialysis . in crohn s disease ( cd ) , only 3 cases are reported.a 76-year - old man on hemodialysis for renal failure caused by immunoglobulin a nephropathy developed diarrhea and abdominal pains . a marked edema was observed in the pretibia and ankle . an increase of c - reactive protein ( crp ) and erythrocyte sedimentation rate , hypoalbuminemia , hypocholesterolemia , and moderate anemia was found . ultrasonography and computed tomography ( ct ) found wall thickness in the left colon . sigmoidoscopy revealed multiple ulcers in the sigmoid colon and noncaseating epithelioid granuloma was found in the biopsy specimen . barium enema study exhibited collar button signs and longitudinal ulcers in the left colon.a severe form of cd was diagnosed . metronidazole seemed to decrease crp but was ineffective in ameliorating diarrhea . infliximab rather than steroid hormone was chosen for the treatment . standard induction therapy with infliximab was initiated . symptoms rapidly improved then disappeared . cd activity index decreased from 747 to a remission level of 134 after 2 infusions of infliximab . scheduled maintenance infliximab therapy was administered after the induction therapy . ultrasonography and ct showed a disappearance of the wall thickness of the colon . adverse reactions were not observed.infliximab was effective and safe in a patient with cd on hemodialysis . our case has added additional literature in accordance with previous reports supporting infliximab as effective and safe in patients on hemodialysis .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study:

cyanine dyes have been shown to undergo reversible photoswitching , where the fluorophore can be switched between a fluorescent state and a dark state upon illumination at different wavelengths . the photochemical mechanism by which switching occurs has yet to be elucidated . in this study , we have determined the mechanism of photoswitching by characterizing the kinetics of dark state formation and the spectral and structural properties of the dark state . the rate of switching to the dark state depends on the concentration of the primary thiol in the solution and the solution ph in a manner quantitatively consistent with the formation of an encounter complex between the cyanine dye and ionized thiol prior to their conjugation . mass spectrometry suggests that the photoconversion product is a thiolcyanine adduct in which covalent attachment of the thiol to the polymethine bridge disrupts the original conjugated -electron system of the dye .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: gastrointestinal toxicity induced by non - steroidal anti - inflammatory drugs ( nsaids ) is one of the major causes of peptic ulcers . due to its widespread use , low - dose aspirin ( lda ) , which is used for prophylaxis of atherothrombotic diseases , plays an important role in the occurrence of peptic ulcers . in japan , previous studies have shown that upper gastrointestinal bleeding caused by lda can be decreased with acid suppressants , such as proton pump inhibitors ( ppi ) . unfortunately , these protective effects are incomplete , and new therapeutic options have not been developed [ 14 ] . many gastroduodenal mucoprotective drugs have not been evaluated in terms of efficacy for lda - related toxicity , although they are often used in clinical settings in japan . in addition , there is little clinical information and the current condition of lda - related gastrointestinal mucosal injury remains uncertain in japanese subjects [ 5 , 6 ] . we conducted this study to clarify the current condition of mucosal injury in japanese patients taking lda and to identify potential effective treatments against lda - induced mucosal injury . this study involved a retrospective review of medical records . from january 2005 through december 2006 , 5555 patients underwent upper gastrointestinal endoscopy at the department of internal medicine of teikyo university hospital ( tokyo , japan ) . among these patients , 548 had taken lda for 1 month or more and were selected for inclusion in this study . patients with malignant diseases , hemorrhage from variceal lesions , and mallory - weiss syndrome were excluded because of difficulty in performing accurate endoscopic evaluations . two well - trained examiners with more than 10 years experience retrospectively evaluated endoscopic records to determine whether gastroduodenal mucosal injury and bleeding from the lesion were present ; examiners were blinded to patient data . if the two examiners differed in opinion , another examiner evaluated the record again to make a final...

the present study was conducted to investigate the prevalence of mucosal injury in patients taking low - dose aspirin in japan and examine the effect of gastric mucoprotective drugs on aspirin - related gastroduodenal toxicity . we selected 530 patients who had taken low - dose aspirin for 1 month or more after undergoing esophagogastroduodenoscopy from 2005 through 2006 at teikyo university hospital , tokyo , japan . endoscopic records were retrospectively reviewed to determine the presence of massive bleeding and mucosal injury ( ulcer or erosion ) . the influence of clinical factors , including co - administration of gastroprotective drugs , was also examined . hemorrhage was observed in 25 patients ( 3.7% ) and mucosal injury ( 36.2% ) in 192 patients . the presence of helicobacter pylori antibody was a significant risk factor associated with mucosal injury . patients taking any gastroprotective drug showed a significantly lower rate of mucosal injury than those not taking these drugs . patients taking rebamipide concomitantly with proton pump inhibitors or histamine 2 receptor antagonists had mucosal injury less frequently than those taking acid suppressants plus other mucoprotective drugs . in conclusion , these results show the possible gastroprotective effects of rebamipide , suggesting that it may be a good choice in aspirin users with gastroduodenal toxicity that is not suppressed by acid suppressants alone .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the axillary crutch is an assistive device that supports the gait of patients with lower limb impairments . however , crutch walking has several unresolved issues , including the appropriate length of the crutch1 , crutch palsy2 , palmar pain during crutch weight bearing3 , and deviation of the axillary pad from the axilla during the crutch stance phase4 . in particular , the axillary pad often deviates from the axilla during the crutch stance phase , and this is one of the main issues for safe crutch walking . if the axillary pad is not held firmly against the chest wall , the crutch tends to be easily displaced from the axilla , possibly leading to falls . therefore , the cause of the axillary pad deviation from the axilla needs be identified to ensure user safety . we previously showed that external rotation of the crutch throughout the crutch stance phase ensured that the axillary pad was held tightly against the chest wall during single - crutch walking5 . however , this observation is thought to apply only to single - crutch walking . thus , the aim of this study was to analyze the crutch position in the horizontal plane to confirm the stability of the axillary pad during double - crutch walking . twelve healthy young subjects were enrolled in this study ( 6 males and 6 females ; mean age , 22.1 0.5 years ; mean height , 168.7 8.0 cm ; mean weight , 63.3 11.3 kg ) . this study was performed in accordance with the ethical principles of the declaration of helsinki and was approved by the ethics committee of kyushu university of nursing and social welfare . all subjects received a description of this study and provided their written , informed consent before participating in this study . before carrying out the measurements , the crutches were adjusted to the appropriate length for each subject , and adequate practice of crutch walking was done . the appropriate crutch length was determined using the standard method described by rusk and lowman6 . double -...

[ purpose ] the aim of this study was to analyze the crutch position in the horizontal plane to confirm the stability of the axillary pad during double - crutch walking . [ subjects ] twelve healthy young subjects ( 6 males and 6 females ) . [ methods ] the subjects were asked to walk in a straight line , using double crutches , for a distance of 5 m , 5 times . crutch position data were obtained using four infrared reflective markers attached to both crutches ( two markers each on both crutches ) . the crutch angles of each subject were compared across three time points during the crutch stance phase ( crutch contact , mid stance , and crutch off ) . [ results ] crutch angles of each of the two crutches were significantly different across the crutch stance phase of 11 of the 12 subjects . phasic differences were shown by 4 of the 12 subjects , and a strong correlation was observed between the left and right crutch angles of all subjects . [ conclusion ] external rotation of the crutch throughout the stance phase was very important for keeping the axillary pad in the axilla , not only for single - crutch walking , but also for double - crutch walking . in addition , symmetry of the crutch positioning is one of the most important factors for safe double - crutch walking .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: breast cancer is one of the leading causes of death in women worldwide ( 1 , 2 ) and is the second most common malignancy newly diagnosed in korean women . more than 15000 women were newly diagnosed with breast cancer in 2011 , and breast cancer was in second ( 21.5% ) place among all newly diagnosed cancers in korean women ( www.ncc.re.kr ) . moreover , the 5-year survival rate of breast cancer has increased from 83.2% to 91.3% over the last 10 years due to advances in postoperative treatment modalities and medications . the overall incidence of breast cancer in korean women has increased from 1999 to 2011 , and the prevalence of breast cancer during this period is 19.3% of all cancers in women ( 3 ) , which agrees with reports on the western population ( 1 , 4 ) . as the number of breast cancer survivors increases , patient management and surveillance after primary treatment has come under the spotlight . women who have been treated for breast cancer are at risk for second breast cancers , such as tumor recurrence in the ipsilateral breast or a newly developed cancer in the contralateral breast ( 2 , 4 , 5 ) . reported risks for locoregional tumor recurrence range from 5 - 27% , whereas the risk for development of contralateral breast cancer is 5 - 10% , with a two six - fold increased risk ( 4 , 6 , 7 , 8 , 9 , 10 ) . in addition , recent studies have demonstrated that local recurrence is an independent predictor of survival , an high relative risks for developing distant metastases or breast cancer - related deaths in patients with local recurrences have been shown when compared to patients without a recurrence ( 10 ) . considering these risks , a well - designed , evidence - based post - treatment surveillance protocol is needed to manage patients with breast cancer after their primary treatment . the surveillance program would be intended to detect second breast cancers at an early stage when curative intervention is possible . up to now , mammography has been the only evidence - based imaging modality...

women who have been treated for breast cancer are at risk for second breast cancers , such as ipsilateral recurrence or contralateral metachronous breast cancer . as the number of breast cancer survivors increases , interest in patient management and surveillance after treatment has also increased . however , post - treatment surveillance programs for patients with breast cancer have not been firmly established . in this review , we focus on the imaging modalities that have been used in post - treatment surveillance for patients with breast cancer , such as mammography , ultrasonography , magnetic resonance imaging , and positron emission tomography , the effectiveness of each modality for detecting recurrence , and how they can be applied to manage patients .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: from 1994 through 2005 , epidemiologic data on animal - related injuries and associated postexposure prophylaxis ( pep ) treatment were prospectively collected for marseille rabies treatment centre patients . only patients who had been injured in france were selected ; rabies pep for travelers who were injured abroad is detailed elsewhere ( 6 ) . of the 4,965 eligible patients , 4,367 were outpatients or inpatients ( 192488/year ) , and from 2001 through 2005 , a total of 598 were managed by teleconsultation only because their exposure risk was considered to be zero . the number of inpatients and outpatients decreased markedly from 1999 to 2001 ( figure 1 ) , which is consistent with the general decrease in the number of pep treatments in france after the elimination of terrestrial mammal rabies ( 7 ) . furthermore , prescreening of persons by telephone also contributed to this decrease . the increase observed during 20042005 is likely an effect of the international alert in relation to the cases of rabid dogs imported from morocco ; these cases were intensively reported by the french media . the proportion of animal - related injuries tended to increase in late spring / early summer ( figure 2 ) , probably as a result of increased outdoor activities in southern france , which makes contact with animals more likely . number of injured patients per year seeking care for rabies postexposure prophylaxis , marseille centre , marseille , france , 19942005 . average proportions of injured patients seeking care for rabies postexposure prophylaxis , by month , marseille centre , marseille , france , 19942005 . the overall annual incidence of injured patients seeking care for rabies pep was 16/100,000 , which is consistent with incidence recently reported in united states ( 8,9 ) ( where rabies is enzootic in bats and raccoons ) but far less than that reported in recently available studies from the canine rabies endemic countries of turkey ( 467/100,000 ) ( 10 ) and india ( 1,700/100,000 ) ( 11 ) . the overall mean...

the administration of human rabies postexposure prophylaxis near marseille ( southern france ) has changed since the eradication of terrestrial mammal rabies in 2001 . most injuries were associated with indigenous dogs ; rabies vaccine was overprescribed . we suggest that the world health organization guidelines be adapted for countries free of terrestrial mammal rabies .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: leflunomide ( lef ) is a disease - modifying antirheumatic drug for treating rheumatoid arthritis ( ra ) . its efficacy was established by double - blind , randomized controlled trials . a 5-year follow - up study demonstrated comparative safety profile as in the phase iii trial , showing no excessive pulmonary adverse event . however , lef - related interstitial lung disease ( ild ) was increasingly reported after introduction of lef in japan in 2003 , and diffuse alveolar damage ( dad ) was the principal histopathological change in autopsied cases . here an 80-year - old taiwanese woman was admitted to our hospital because of shortness of breath . her medical history was notable for remote pulmonary tuberculosis , which had been cured for 5 years and ra , which had been diagnosed for 11 years . follow - up chest radiograph taken 2 years earlier showed mild fibrocalcified lesion in right upper lung zone without obvious interstitial changes . she was a nonsmoker and her current medication included oral prednisolone ( 10 mg / day ) , cyclosporine ( 100 mg / day ) , and lef ( 20 mg / day ) . methotrexate ( mtx ) ( 7.5 mg / week ) was prescribed initially after the diagnosis of ra . due to poor disease control , she had been in her usual state of health until 2 days before admission , when progressive dyspnea on exertion developed , along with productive cough , fever , and chills . at admission , her vital signs were : temperature 37.3 c , heart rate 110 beats / min , blood pressure 147/89 mm hg , respiratory rate 28 breaths / min , and oxygen saturation 95% while breathing supplementary oxygenation at a rate of 10 l / min through a face mask . laboratory examinations showed normal leukocyte count ( 5110/l ) , elevated blood urea nitrogen ( 57 mg / dl ) , creatinine ( 1.6 mg / dl ) , aspartate aminotransferase ( 93 u / l ) , c - reactive protein level ( 11.7 mg / dl ) , and mildly increased rheumatoid factor level ( 44 iu / ml ) ( normal range , 020.1 iu / ml ) . she was intubated with ventilator...

abstractpatients with rheumatoid arthritis ( ra ) often have pulmonary involvement , and interstitial lung disease ( ild ) is the primary manifestation , in which diffuse alveolar damage ( dad ) is a rare histopathologic pattern . leflunomide ( lef ) is a frequently prescribed disease - modifying antirheumatic drug for treating ra . lef - related ild in the form of dad has been reported in patients with ra , with the duration of lef treatment before symptom onset ranging from 6 to 1204 days.we present a case of elderly woman with ra under prolonged lef treatment for > 9 years ( 3291 days ) , who had acute respiratory failure with the initial presentation of exertional dyspnea , fever , chills , and productive cough for 2 days . the histopathologic result of surgical lung biopsy was compatible with dad . she was diagnosed as having lef - related ild , based on correlated clinical history , compatible histopathologic examination and excluding possible infection after extensive survey.although the causative role of lef can not be confirmed , this case still hints that lef - related dad may occur even if lef has been prescribed for a prolonged period .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: to report a case of choroidal excavation accompanied by vogt - koyanagi - harada disease ( vkh ) . a 54-year - old japanese woman who was complaining of bilateral blurring of vision associated with headache underwent optical coherence tomography ( oct ) , fluorescein angiography , and indocyanine green angiography as well as a routine ophthalmological examination . oct of the left eye revealed the presence of a unilateral choroidal excavation under the fovea and subretinal fibrin over the site of the excavation . treatment successfully resolved vkh symptoms with gradual resolution of subretinal fibrin and fluid ; however , the choroidal excavation remained . our results suggest that choroidal excavation can be induced by choroidal inflammation caused by vkh . due to the increased availability of optical coherence tomography ( oct ) imaging , the entity of focal choroidal excavation has gained interest in recent years . it has been well - described in healthy individuals with otherwise normal eyes [ 1 , 2 , 3 , 4 ] . focal choroidal excavation has been defined as an area of choroidal excavation in the macular area detected with oct without the existence of a posterior staphyloma or scleral ectasia . we report a case of unilateral choroidal excavation in a patient with vogt - koyanagi - harada disease ( vkh ) . a 54-year - old japanese woman presented with bilateral blurring of vision associated with headache that had started 2 weeks earlier . her general family medical history and her personal medical history , including her history of ocular disease , were unremarkable . the best - corrected visual acuity on presentation was 0.6 in the right eye and 0.1 in the left eye . slit - lamp biomicroscopy showed bilateral anterior chamber cells and posterior synechiae , and fundus examination showed bilateral disc swelling with exudative retinal detachment ( fig . fluorescein angiography detected bilateral multifocal leakage with pooling of dye in the subretinal space in the late phase ( fig . 1d ) . a spectral -...

purposeto report a case of choroidal excavation accompanied by vogt - koyanagi - harada disease ( vkh).methodsa 54-year - old japanese woman who was complaining of bilateral blurring of vision associated with headache underwent optical coherence tomography ( oct ) , fluorescein angiography , and indocyanine green angiography as well as a routine ophthalmological examination.resultsfundoscopy showed papilloedema and serous retinal detachment in both eyes . fluorescein angiography detected bilateral multifocal leakage with pooling of dye in the subretinal space . indocyanine green angiography showed patches of hyperfluorescence and hypofluorescent spots bilaterally . a diagnosis of vkh was reached soon afterwards . oct of the left eye revealed the presence of a unilateral choroidal excavation under the fovea and subretinal fibrin over the site of the excavation . treatment successfully resolved vkh symptoms with gradual resolution of subretinal fibrin and fluid ; however , the choroidal excavation remained.conclusionsthis case is the first report of choroidal excavation associated with vkh . our results suggest that choroidal excavation can be induced by choroidal inflammation caused by vkh .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the metabolic syndrome ( ms ) is a complex metabolic disturbance that includes several risk factors for cardiovascular diseases , such as systemic artery hypertension , atherogenic dyslipidemia , insulin resistance ( with or without glucose intolerance ) and prothrombotic and proinflammatory tendencies . the syndrome is due to a complex interaction between genetic factors , poor dietary habits and physical inactivity . population studies reported by the national health and nutrition examination survey ( nhanes ) have shown that the ms , as defined by the international diabetes federation ( idf ) , has a prevalence of 39% among the us adult population . the estimated prevalence of ms in the brazilian population is 29.8% ( ci95 = 28 - 32% ) and prevalence increased from the youngest ( 26 - 34 y ) to the oldest ( 55 - 64 y ) group ( 15.8% and 48.3% , respectively ) . there are scientific evidences showing that some lifestyle behaviors are associated to the risk of having the ms : lack of physical activity , smoking and poor dietary habits , involving particularly excessive intake of carbohydrates and lipids . high carbohydrate ingestion has been correlated with low levels of hdl cholesterol and increased concentration of triglycerides , whereas increased intake of saturated fat associates with hyperinsulinemia . nevertheless , the precise role of dietary habits in the etiology of the ms is still poorly understood . investigations have been restricted to a few observational studies in adults , not particularly in the elderly population . the present study investigated the influence of nutritional components on the prevalence of ms in a population of elderly women , in the city of passo fundo , brazil . the aim was to contribute for the establishment of the role of dietary habits in the risk for the metabolic syndrome among the elderly . the population studied was composed of 284 elderly women , aging 60 years or over , socially active and participating of a third age group for recreational activities ( diviso de...

background : the metabolic syndrome is a complex metabolic disturbance due to an interaction between genetic factors , poor dietary habits and physical inactivity.aims:to investigate the role of dietary intake on the prevalence of the metabolic syndrome in a population of elderly , socially active women in brazil.patients and methods : a total of 284 women with mean age 69.3 6.3 years were evaluated in a cross - sectional retrospective study . the metabolic syndrome was diagnosed according to criteria of the international diabetes federation . the dietary intake was evaluated through a questionnaire for 24-hour dietary recall . the groups with or without the metabolic syndrome were compared for dietary intake and risk factors for metabolic syndrome by the multiple regression model adjusted for age , smoking , physical activity , educational level , total energy intake and fiber contents of the diet . the odds ratio for the presence of the metabolic syndrome was calculated for each nutrient by quartile for total energy intake adjusted by the residue method.results:the prevalence of metabolic syndrome was 32% in the sample . there was not found any association between dietary intake , including all macronutrients and several micronutrients , and the presence of metabolic syndrome.conclusion:no associations were observed between nutritional factors and the prevalence of the metabolic syndrome in elderly women , a result possibly due to the fact that these factors have an influence in earlier phases of life , or to a recent modification of dietary habits , which however was not able to prevent the establishment of the syndrome .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: many headache sufferers complaint that headache leads to sleep disruption in them while on the other hand , inadequate sleep leads to increased frequency , severity , and chronicity of headache . this relationship is well documented in primary headache disorders , particularly in chronic headache sufferers as compared to episodic variety . chronic daily headache ( cdh ) comprises a group of headache disorders occurring at least 15 days per month for 3 or more consecutive months . around 5% of the normal population suffers from cdh . among the many sleep disorders described in the international classification of sleep disorders , insomnia , daytime sleepiness , and obstructive sleep apnea including snoring insomnia had been suggested as an independent risk factor for chronification of headache . increased snoring incidence had been observed in chronic headache sufferers compared to episodic ones . sleep disordered breathing was found to be associated with migraine but not with tension headache . these disorders are commonly left under diagnosed and when treated helps in better control of headache . polysomnography ( psg ) is used for objectively assessing sleep macro- and micro - architecture and aids in detecting sleep disorders . the majority of the earlier studies had studied migraine population , few had studied tension - type headache , and very few both . we performed the study to evaluate subjectively and objectively sleep disorders in patients of primary cdh . a secondary subgroup analysis was performed in between chronic migraine ( cm ) and chronic tension - type headache ( ctth ) patients and polysomnographic variables among them were compared . this was a prospective , hospital - based observational study carried out at our tertiary care hospital over a span of 2 years from october 2013 to december 2015 . 83 patients of primary cdh were selected from patients attending outpatient department ( opd ) . these patients were evaluated by history , clinical examination , sleep questionnaires , and...

objective : studies related to sleep disorders and polysomnography ( psg ) among chronic daily headache patients are rare . we studied this and compared chronic migraine ( cm ) with chronic tension - type headache.methods:eighty-three patients were recruited . they were evaluated by semi - structured interview , headache , and sleep diaries along with epworth sleepiness scale score and insomnia symptom score . overnight psg was performed and data compared.results:chronic tension - type headache was more common than cm , both having female preponderance . insomnia followed by excessive daytime sleepiness was prevalent sleep disorder . sleep efficiency and stage 3 sleep were lower in cm compared to chronic tension - type . esss was significantly increased among chronic tension - type patients . no significant correlation was found among psg parameters in patients with or without sleep disorders.conclusion:insomnia being most common sleep disorder among chronic headache population . chronic tension - type headache had slightly better slow - wave sleep than cm and significantly increased daytime sleepiness .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: osteoporosis associated with hemochromatosis in men was first described by delbarre in 1960 and confirmed by pawlotsky et al . in 1979 . hemochromatosis due to excess tissue iron storage is frequently due to a homozygous mutation , cysteine to tyrosine , c282y , in the hfe gene . the prevalence of osteoporosis in hemochromatosis and the pathogenic mechanisms involved are not completely understood , for example , whether there is a relationship between the serum ferritin and bone mineral density . in men with hemochromatosis and a serum ferritin between 350 and 8410 g / l , the presence of osteoporosis was associated with a lower serum free testosterone . however , in men with the homozygous hfe mutation , the serum ferritin and the serum testosterone did not differ between those with and without osteoporosis . most osteoporotic men were not hypogonadal ( 76.9% ) . interestingly , in men heterozygous for the hfe mutation , c282y , but without iron overload , liver disease was associated with a lower bone mineral density in men of all ages and in women older than 60 years . in a three - year longitudinal study of postmenopausal women , however , in postmenopausal women a higher serum ferritin was not correlated with a lower bone mass [ 8 , 9 ] . in postmenopausal women with and without osteoporosis the serum ferritin was not significantly different between the two groups , but in another study of postmenopausal women , mean age 73 years , who had sustained a hip fracture , those who had a serum ferritin above 150 g / l had a lower bone density than those in whom the serum ferritin was less than 150 g / l . in a study that looked at transiliac biopsy samples the concentration of iron in the cortical bone was greater in osteoporotic participants than in nonosteoporotic participants ( p 0.01 ) . in a rat study , ovariectomy was associated with an increased concentration of iron in bone and the loss of bone mass and the deterioration of bone microarchitecture was ameliorated by oral treatment with an iron...

mutations in the hfe gene may be associated with increased tissue iron stores reflected in an elevated serum ferritin . with homozygous mutation c282y , the increase in serum ferritin may be associated with tissue damage in the liver , pancreas , and pituitary and with a reduced bone mineral density . with heterozygous mutation c282y , the degree of iron retention is less but information relating to how a heterozygous c282y mutation might impact bone mineral density is uncertain . the present study was undertaken to study the relationships between bone mineral density measured by dual energy x - ray absorptiometry and the serum ferritin and serum iron in postmenopausal women heterozygous for the c282y mutation . the spinal bone mineral density , l24 , was significantly less than age matched community controls ( p = 0.016 ) . there was no significant change in the femoral neck bone mineral density compared to age matched community controls . the correlation between the spinal bone mineral density , l24 , the femoral neck bone mineral density , and the serum ferritin was not significant . the serum iron correlated significantly inversely with the femoral neck bone mineral density ( p = 0.048 ) . the heterozygous c282y mutation may be associated with impairment of bone cell function in postmenopausal women when only small increases in the serum iron or serum ferritin have occurred .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: osteoarthritis of the knee is a common problem in the elderly patients with a lifetime risk of symptomatic knee osteoarthritis approaching 45% . intraarticular corticosteroid injection is a common conservative management modality in treatment of osteoarthritis of knee . bellamy et al . in 2008 showed a well - established short - term benefit with intraarticular corticosteroid injection in treatment of knee osteoarthritis with some side - effects . the incidence of septic arthritis of knee after intraarticular corticosteroid injection ranges from one in 3000 to one in 50,000 and may be higher in immunocompromised patients . the treatment of iatrogenic septic arthritis necessitates multiple joint washout and debridement , long - term antibiotic therapy and prolonged inpatient hospital stay . a higher rate of infectious complications following intraarticular injection can be expected in immunocompromised patients . we would like to report an extremely rare case of simultaneous bilateral septic arthritis of knee as a result of intraarticular corticosteroid injection to both knees in a rheumatoid arthritis patient with end stage renal disease on dialysis . to the best our knowledge , a 66-year - old male patient was admitted to hospital under the medical team for investigation of recent unexplained weight loss of approximately one stone in 6 months . patient had severe bilateral arthritis of both knees that was being treated conservatively by the rheumatologist . as a part of his conservative management , the patient received bilateral knee intraarticular corticosteroid injections . a combination of 80 mg of methylprednisolone and 8 ml of 1% lignocaine was injected into each knee under aseptic precautions . after 6 days , the patient complained of severe bilateral knee pain and was unable to weight bear . after 2 days , his both knees were aspirated revealing purulent fluid , which was sent to microbiology for culture and sensitivity . he was referred to the orthopedic service for review . on examination , he was...

osteoarthritis of knee is one of the common problems in elderly population . intraarticular corticosteroid injection is a conservative management modality in osteoarthritis of knee . septic arthritis is an infective complication of intraarticular corticosteroid injection . septic arthritis in rheumatoid arthritis patients have worse prognosis because of delay in diagnosis . a higher rate of infectious complications following intraarticular injection is expected in immunocompromised and rheumatoid patients . we would like to report an extremely rare case of simultaneous bilateral knee septic arthritis after bilateral knee intraarticular steroid injection in a rheumatoid arthritis patient . patient was treated successfully with multiple bilateral knee arthroscopic washouts and long - term intravenous antibiotics . this case report emphasizes the increased risk of infection in rheumatoid arthritis patients and a risk benefit assessment on individual basis before carrying out intraarticular steroid injection . patient should be aware of this increased risk of infection .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: derived from the foxglove plant , cardiac glycosides have been used for the treatment of heart failure for more than 200 years and are continued to be used today for patients with atrial fibrillation and heart failure . currently , cardioactive steroid toxicity has become a well - known entity that even now , continues to be an issue . according to the national poison data system , in 2013 , there were 26 deaths in the u.s . directly attributable to digoxin overdose , with many more non - fatal cases reported . bufadienolides are a group of cardioactive steroids with a chemical structure similar to digoxin . they are used in multiple traditional chinese medications and aphrodisiacs . because they are structurally similar to digoxin , they also display a similar toxicity profile . there have been multiple case reports of overdose with clinical presentations similar to digoxin toxicity , with death occurring owing to arrhythmia . currently , the only available treatment is the same digoxin - specific antibody fragments used to treat digoxin overdose . in this paper , we will discuss the clinical and electrocardiographic similarities between digoxin and bufadienolide - containing substances . a 39-year - old man presented to the emergency department with vomiting and diaphoresis after eating a half block of vital signs at the time were within normal limits ; heart rate was 65 bpm and regular , blood pressure was 157/66 mmhg , and respiratory rate was 20 breaths / min . shortly after arrival , ecg revealed sinus rhythm at 100 bpm with complete heart block ( fig . potassium was 4.6 meq / l and digoxin concentration was 1.14 ng / ml ( normal=0.50.8 ng / ml ) . 2 shows a qrs complex that is mildly wider than baseline , with 3:2 grouped beating ; this would indicate supraventricular tachycardia ( atrial or junctional with 3:2 block ) or bidirectional ventricular tachycardia ( vt ) with 3:2 exit block . ultimately , he deteriorated to ventricular fibrillation and underwent 90 min of resuscitation . treatment...

classically derived from toad venom , bufadienolides are a group of cardioactive steroids with properties similar to digoxin . some traditional chinese medications , including several aphrodisiacs , contain bufadienolides . owing to their physiologic similarities to digoxin , bufadienolides have been shown to produce a toxic profile similar to that of digoxin and there have been multiple case reports of the use of these aphrodisiacs resulting in death . this report will describe a case that illustrates the electrophysiologic similarities between bufadienolide toxicity and digoxin toxicity as well as the treatment of bufadienolide toxicity .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: our patient was an 8-month - old male child of indian origin and the first issue of a nonconsanguineous marriage . he presented to our center with the complaints of cough , cold , progressively increasing breathlessness , and refusal to feed over the past 3 days . past history was elicited that the child was a full - term baby weighing 2.4 kg . his important clinical course is summarized in table 1 . on presentation to us , he had tachycardia ( 160 beats per minute ) , tachypnea ( 64 breaths per minute ) , capillary refill time of 3 s , and blood pressure of 76/60 mmhg in the right arm supine position . the child had increased work of breathing , as evidenced by the subcostal and intercostal retractions . cardiac examination revealed a pansystolic murmur ( grade iii ) , in the third and fourth intercostal spaces . his weight , length , and head circumference were below the third percentile for his age ( weight 3.5 kg , length 61 cm , head circumference 37 cm ) . he had narrow and upslanting palpebral fissures , epicanthal folds , and prominent ears [ figure 1 ] . past clinical course of the patient hgt = hemoglucotest ; pcv = packed cell volume ; cbc = complete blood count ; tlc = total leucocyte counts ; dlc = differential leucocyte count ; anc = absolute neutrophil count ; alc = absolute lymphocyte count ; crp = c - reactive protein ; tof = tetralogy of fallot ; ps = pulmonary stenosis ; vsd = ventricular septal defect ; * dose of the iv calcium 2cc / kg / dose , tds for 3 days facial profile of the child . note the narrow and upslanting palpebral fissures , epicanthal folds , and prominent ears q1 : name some hereditary and nonhereditary conditions in which the facial dysmorphisms associated with the underlying heart disease can give a clue to the etiology of the condition . ans . : table 2 elaborates the conditions in which facial dysmorphisms associated with underlying heart disease can give a clue to the etiology of the condition . conditions in which facial dysmorphisms are associated with a heart...

our patient presented with congenital heart disease ( chd : tetralogy of fallot ) , hypocalcemia , hypoparathyroidism , and facial dysmorphisms . suspecting digeorge syndrome ( dgs ) , a fluorescence in situ hybridization ( fish ) analysis for 22q11.2 deletion was made . the child had a hemizygous deletion in the 22q11.2 region , diagnostic of dgs . unfortunately , the patient succumbed to the heart disease . dgs is the most common microdeletion syndrome , and probably underrecognized due to the varied manifestations . this case stresses the importance of a detailed physical examination and a high index of suspicion for diagnosing this genetic condition . timely diagnosis can help manage and monitor these patients better and also offer prenatal diagnosis in the next pregnancy .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: astrocytic tumors are the most common primary glial tumors of the central nervous system , and are divided according to the degree of anaplasia and presence of necrosis into low grade astrocytomas ( diffuse astrocytoma , pilocytic astrocytoma ) or high grade astrocytomas ( anaplastic astrocytoma , glioblastoma multiforme ) . glioblastoma multiforme ( gbm ) represents 50% of all gliomas and 20% of all operated intracranial solid lesions . the median age for diagnosis for all primary brain tumors is 57 years , although gbms are often diagnosed at slightly older ages . symptoms at presentation may be acute or subacute and include seizures , headaches , weakness or sensory disturbances , language dysfunction , changes in behavior or personality , or cognitive impairment . magnetic resonance imaging is the preferred method for radiologic diagnosis , as these tumors are contrast enhancing , often with central necrosis and peritumoral edema . imaging with positron emission tomography and magnetic resonance spectroscopy may allow for non - invasive grading of gliomas , but pathologic confirmation is needed in most cases [ 13 ] . the last decade has brought many advanced research discoveries such as the discovery of linolenic acid selective activity against tumor cells or the deciphering the role of cysteine protease inhibitors in brain tumor development . despite advances in therapeutic management of gbm , prognosis remains poor and the median overall survival rate is below 1 year . even in the most favorable cases ( young patients treated with radical surgery , radiotherapy and chemotherapy ) , death occurs in most cases within 2 years . several prognostic factors have been established : age , performance status , therapy ( quality of surgery , radiotherapy , chemotherapy ) , and specific tumor characteristics such as location and nature ( de novo or secondary to a low grade glioma ; methylation of the mgmt gene promoter ) [ 68 ] . at the time of tumor recurrence , the infiltrative nature of gbms may preclude...

summarybackgroundastrocytic tumors are the primary brain tumors , which often progress to glioblastoma , a highly malignant neoplasm of the central nervous system . there is much new data regarding to the formation and progression of these tumors ; however , glioblastoma remains one of the most fatal neoplasms in humans.the aim of the study was to evaluate the role of c - erbb-2 protein expression in various groups of astrocytic tumors.material/methods65 cases of astrocytic tumors were divided into 3 groups : diffuse astrocytoma ( group i ; n=17 cases ) , anaplastic astrocytoma ( group ii ; n=23 cases ) and glioblastoma ( group iii ; n=25 cases ) . c - erbb-2 protein expression was estimated semiquantitatively on immunohistochemically stained tissue sections using antibodies against c - erbb-2 protein . statistical analysis was performed in all examined groups.resultsthe c - erbb-2 protein expression was observed in 15 out of 17 cases ( 88.3% ) in group i , 22 out of 25 cases ( 88% ) cases in group ii , and in 19 out of 23 cases ( 82.6% ) in group iii . there were no statistically significant differences between the examined groups . the strongest c - erbb-2 immunoexpression was observed in low grade astrocytomas ( diffuse astrocytomas g2 ) ; in the glioblastoma group the c - erbb-2 protein expression was weak and 17.4% of cases were negative.conclusionsc-erbb-2 protooncogene alteration is an early phenomenon in glial tumor development and progression .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: surgical services in many areas of rural africa , where most of the population reside , are mostly provided by government and mission hospitals in contrast to urban areas where private hospitals play a more substantial role in fulfilling surgical needs of the involved population . furthermore for a variety of reasons , the majority of the medical workforce practice in the urban settings further compounding the provision of surgical care to the mostly needy rural populace . hence it is not unusual for the surgical wards to be frequently filled to an overflowing situation and the medical staff stretched to the limit . in many hospitals it is not uncommon to see patients share beds or be placed on extra beds placed in between regular beds , hindering movement in the wards . a complex problem of surgical ward congestion in a low resource economy certainly does not have an easy solution as there are not enough infrastructures , well - trained professionals , and supportive services to tackle the problem head on . paradoxically in many areas , the structural buildings are not the problem but the lack of professionals in combination with lack of basic supplies and appropriate working incentives . day - case surgery has been developed in many countries as an important approach in reducing inpatient admissions . ideally day - case surgery demands a dedicated ward and a dedicated day - case theater or variations of above.1 hence day - case surgery should ideally function as a system demanding initial capital investment but more importantly incorporating : surgeons , anesthesiologists , nurses , and other supporting staff dedicated to make the system function . the shortage of a trained workforce and a functioning health network system , in most of the african countries , remain hindering factors to full development of day - case procedures . hence different options or modifications are needed to help solve the problem of inpatient congestion with an option being for individual specialists to develop lists of very...

background : surgical ward congestion continues to be a problem across rural africa . day - case surgery has helped minimize this problem in most developed countries but remains underdeveloped across africa . the objective of this study was to carefully expand day - case services within the framework of already existing hospital infrastructure.materials and methods : seventy - one consecutive patients out of 149 mostly urologic patients that met the study criteria were treated and followed up on a daycase basis over a 15-month period . in the absence of a day surgery unit , these patients were prioritized and operated on urologic theater days while adequately utilizing the equipped preoperative holding area for patient recovery . patients were all nonemergent , of american society of anesthesiologists physical status ( asa - ps ) classes 1 and 11 and accepting to undergo day - case procedure among other selection criteria . the main outcome measures were to determine the percentage reduction in admission rate and encountered complications.results:forty-nine ( 69% ) of these 71 patients were treated using local anesthesia . the day - case surgery rate for the urology service was increased to 47.65% from a previous rate of 21.6% . six patients ( 8.4% ) felt that their postoperative pain was more significant than they had anticipated . postoperative nausea and vomiting occurred in two patients ( 2.8% ) . there was one case of scrotal hematoma that resolved on observation . there was no mortality.conclusions:in the absence of a dedicated day - case service , individual specialists should develop or increase safe lists of cases in their respective fields that can be done on a day - case basis in order to reduce demand for in - patient beds .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: . limitations of osteochondral grafts include limited donor site , morbidity , questionable cell viability , and fibrocartilage formation in between osteochondral plugs . cell - based strategies have explored chondrocytes and mesenchymal stem cells ( mscs ) with extensive basic science and preclinical studies . however , clinical strategies have focused on autologous chondrocyte implantation , yet the concept itself is not ideal ; it is a 2-step procedure with donor site morbidity , the quantity of harvested chondrocytes is limited , and chondrocytes dedifferentiate into fibroblasts when cultured ex vivo . because of these limitations , the focus in cartilage repair is shifting toward bone marrow mesenchymal stem cells ( bm - mscs ) and biodegradable scaffolds with or without growth factors . bm - mscs are available in larger quantities , are easier to isolate and expand , and demonstrate strong chondrogenic potential . platelet - rich preparation such as platelet - rich plasma ( prp ) and platelet - rich fibrin glue ( pr - fg ) is a novel biological scaffold that has not been widely tested by itself as an msc carrier in clinical chondrogenesis . the -secretory granules of platelets contain transforming growth factor ( tgf)-1 and insulin growth factor-1 ( igf-1 ) , which stimulate cartilage regeneration . it is expected that the biological effect of multiple growth factors on tissue regeneration is greater than that of a single growth factor . pr - fg has also been shown to provide sustained release and protection against proteolytic degradation of endogenous growth factors . because the average baseline blood platelet count in an individual is 200,000 75,000/l , a platelet concentrate count of 1,000,000/l ( 5-fold ) has been commonly described for therapeutic platelet - rich preparations . concentrations of growth factors in pr - fg are found to be in supraphysiological levels ( 5- to 27-fold , according to different processing methods ) . the concentrations of tgf-1 and igf-1 in pr - fg are in the range of...

objective : to test the hypothesis that platelet - rich fibrin glue ( pr - fg ) can be used clinically as a scaffold to deliver autologous culture - expanded bone marrow mesenchymal stem cells ( bm - mscs ) for cartilage repair and to report clinical results 1 y after implantation of mscs pr-fg.patients and methods : autologous bm - mscs were culture expanded , placed on pr - fg intraoperatively , and then transplanted into 5 full - thickness cartilage defects of femoral condyles of 5 patients and covered with an autologous periosteal flap . patients were evaluated clinically at 6 and 12 mo by the lysholm and revised hospital for special surgery knee ( rhssk ) scores and radiographically by x - rays and magnetic resonance imaging ( mri ) at the same time points . repair tissue in 2 patients was rated arthroscopically after 12 mo using the international cartilage repair society ( icrs ) arthroscopic score.study design : case series ; level of evidence 4.results:all patients symptoms improved over the follow - up period of 12 mo . average lysholm and rhssk scores for all patients showed statistically significant improvement at 6 and 12 mo postoperatively ( p < 0.05 ) . there was no statistically significant difference between the 6 and 12 mo postoperative clinical scores ( p = 0.18 ) . icrs arthroscopic scores were 8/12 and 11/12 ( nearly normal ) for the 2 patients who consented to arthroscopy . mri of 3 patients at 12 mo postoperatively revealed complete defect fill and complete surface congruity with native cartilage , whereas that of 2 patients showed incomplete congruity.conclusion:autologous bm - msc transplantation on pr - fg as a cell scaffold may be an effective approach to promote the repair of articular cartilage defects of the knee in human patients .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: in the gastrointestinal ( gi ) tract , 5-hydroxytryptamine ( serotonin , 5-ht ) is a major signaling molecule , which mediates gi functions ( motility and secretion ) , emesis , nausea and pain [ 1 , 2 ] . most of colonic 5-ht is synthesized and released from mucosal enterochromaffin ( ec ) cells ; therefore , alterations in the release of 5-ht from ec cells affect both physiological and pathophysiological colonic functions . irritable bowel syndrome ( ibs ) is a gi chronic disorder characterized by abdominal discomfort or pain associated with altered bowel habits . abnormal levels of chromogranin a ( a marker for all endocrine cells ) in the colon of ibs patients have been demonstrated , thus indicating a role of the colonic endocrine cells ( namely , 5-ht - containg ec cells or peptide yy ( pyy)-containing l cells ) , in the regulation of colonic function in ibs patients [ 4 - 6 ] . indeed , a recent human study suggests that the increased 5-ht release from colonic ec cells contributes to the development of abdominal pain in ibs patients . therefore , an improved understanding of endogenous modulator system for 5-ht release from ec cells may provide novel insights into the etiology and pharmacotherapy of functional bowel disorders such as ibs . our in vitro studies have demonstrated that isolated guinea - pig colon is a helpful in vitro - preparation for studying the mechanism modulating the release of 5-ht from ec cells [ 8 - 10 ] . experimental data from the in vitro - preparations indicate that melatonin , endogenous tachykinins ( tks ; neuropeptides such as substance p and neurokinin a ) and pyy play important roles in the modulation of the release of 5-ht from ec cells via a unique endogenous tachykinergic nk2/nk3 receptor cascade system [ 8 - 11 ] . this review focuses on the evidence establishing a potential role of the endogenous nk2/nk3 receptors cascade system controlling the release of 5-ht from ec cells , with special attention being paid to the pathophysiology of gut disorders including ibs...

5-hydroxytryptamine ( 5-ht ) released from colonic mucosal enterochromaffin ( ec ) cells is a major signaling molecule , which participates in the pathophysiological regulation of colonic functions in gut disorder including irritable bowel syndrome ( ibs ) , but the endogenous modulator system for the 5-ht release is not yet well elucidated . our in vitro studies in guinea - pig colon have indicated that the cascade pathway of neuronal tachykinergic nk3 receptors and nk2 receptors on peptide yy ( pyy)-containing endocrine l cells represents an endogenous modulator system for 5-ht release from ec cells and that melatonin , endogenous tachykinins and pyy play important roles in modulation of the release of 5-ht from ec cells via the endogenous nk2/nk3 receptor cascade system . this review aims at examining the potential role of the endogenous tachykinergic nk2/nk3 receptor cascade system controlling the release of 5-ht from ec cells , with special attention being paid to the pathophysiology of gut disorders including ibs .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: undernutrition in childhood , causing wasting , fetal growth restriction , stunting , and micronutrient deficiencies , is one of the main burdens of the health system and also affects the economic and sociocultural status of society . poverty and malnutrition play a crucial role in increasing morbidity and mortality , impairing cognitive development in children , and increasing common childhood infections . acute malnutrition is the clinical term for undernutrition , a major concern of the health sector . it is defined as a weight - for - height z - score ( whz ) < 2 ( wasting ) . acute malnutrition affects more than 50 million under - five ( u5 ) children , causing 8.0% of child deaths globally each year . acutely malnourished children are categorized into severe acute malnutrition ( sam ) and moderate acute malnutrition ( mam ) on the basis of body measurements . sam is defined as whz < 3 , affecting approximately 19 million children under the age of five worldwide annually . focusing on children with mam are defined as having whz < 2 and 3 , accounting for 11.0% of undernourished children worldwide ; these children face a higher risk of morbidity from infectious disease , which puts them at three times more risk of death than their counterparts with sufficient nutrition . the findings show that more than 400,000 child deaths can be prevented each year by adequate identification and proper management of acute malnutrition . it is caused by poor maternal nutrition before and during pregnancy , inappropriate infant feeding practices , and repeated episodes of infections . other contributing factors include lack of food ( due to lower purchasing power or destruction of crops during natural disasters and conflicts ) and lack of resources and information . the existing situation of health and nutrition in afghanistan indicates that progress towards achievement of millennium development goals ( mdg ) 2015 has been relatively slow , with an u5 mortality rate of 102 deaths per 1,000 live births . a high percentage...

abstractacute malnutrition affects more than 50 million under - five ( u5 ) children , causing 8.0% of global child deaths annually . the prevalence of acute malnutrition ( wasting ) among u5 children in afghanistan was 9.5% nationally and 3.7% in faryab province in 2013 . a cross - sectional study was conducted for 600 households in faryab to find the prevalence and causes of acute malnutrition . odds ratios ( ors ) and 95% confidence intervals ( cis ) were estimated using a logistic model . demographic results of this study showed that 54.0% of the household heads and 92.3% of the mothers had no education . three - fourths of households had a monthly income 250 usd . according to the measurement of weight for height z - score ( whz ) , 35.0% ( 210/600 ) of the children had acute malnutrition ( wasting , whz < 2 ) . in more than half of the households , water , sanitation , and hygiene ( wash ) conditions were poor . when adjusted , a significant association of acute malnutrition among u5 children was found with the education level of household heads ( or=1.49 ; 95% ci , 1.022.17 ) , age of household heads ( or=2.01 ; 95% ci , 1.213.35 ) , income ( or=1.66 ; 95% ci , 1.042.27 ) , education level of mothers ( or=2.21 ; 95% ci , 1.004.88 ) , age of children ( or=1.99 ; 95% ci , 1.322.93 ) , history of children with diarrhea in the last two weeks of data collection ( or=1.57 ; 95% ci , 1.102.27 ) , feeding frequency ( or=3.01 ; 95% ci , 1.217.46 ) , water sources ( or=1.89 ; 95% ci , 1.262.83 ) , and iodized salt ( or=0.59 ; 95% ci , 0.390.88 ) . the present study indicated that an increase in education level of parents , household income , and quality of wash would result in a significant decrease in prevalence of wasting among u5 children .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: night - guard bleaching is an effective and simple method for regaining the esthetic appearance of intrinsically discolored or stained teeth . there is concern about the adverse effect of bleaching materials on existing restorations in the oral cavity . many studies have reported that there is little evidence of bleaching agents causing significant changes in dental materials , including glass - ionomer cements , ceramics and gold . however , many in vitro studies have reported a significant increase in mercury release from dental amalgam after treatment with peroxides [ 13 ] . bleaching agents such as carbamide peroxide decompose into free radicals , which theoretically have the potential to corrode metal alloys such as dental amalgam existing in or near the teeth being whitened . mercury is contained in dental amalgam from which it can be released into the oral cavity and distributed throughout the body as a result of being inhaled or swallowed . so , ionic mercury leached out from amalgam restorations may present a risk to the dental patient [ 5 , 6 ] . treatment duration , the ph and concentration of the bleaching agent , aging and surface polishing of amalgam restorations are some of the factors that control mercury release from dental amalgam exposed to carbamide peroxide bleaching agent . therefore , it is of clinical importance to find ways to reduce mercury release from amalgam restorations following a routine procedure such as home bleaching . this study assessed the effect of surface polish of dental amalgam on the amount of mercury release after treatment with 16% carbamide peroxide bleaching gel . the null hypothesis was that polishing dental amalgam does not decrease the amount of mercury release after treatment with 16% carbamide peroxide gel . two commercially available dental amalgams were selected for this in vitro experimental study . the characteristics and chemical compositions of these materials forty - eight samples from two amalgam brands ( totally 96 samples ) [ ( oralloy magicap s ,...

objectives : this study evaluated the effect of surface polishing on mercury release from dental amalgam after treatment with 16% carbamide peroxide gel.materials and methods : ninety - six samples from two different amalgam brands were prepared in truncated cone - shaped pvc polymer molds with an external surface area of 195 mm2 . half of the specimens were polished with green and red rubber , a brush and tin oxide paste at low speed . samples were treated with 16% carbamide peroxide gel in tubes containing 3 ml of carbamide peroxide gel and 0.1 ml of distilled water for 14 and 28 hours . subsequently , carbamide peroxide gel on the sample surfaces was rinsed away with 7.0 ml of distilled water until the volume of each tube increased to 10 ml . the mercury level of each solution was measured using the vav440 mercury analyzer system . considering the surface area of each amalgam disc , mercury amounts were calculated in g / mm2 . data were analyzed using two - way anova.results:there were significant differences between the mean levels of mercury release from polished vs. unpolished amalgam surfaces after treatment with 16% carbamide peroxide . increasing the storage time from 14 to 28 hours did not result in significant changes in the amount of mercury release . there was no significant interaction effect between amalgam surface polish and storage time statistically.conclusion:polished amalgam restorations release less mercury after treatment with carbamide peroxide bleaching gel in comparison with unpolished amalgam restorations .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the genomes of higher organisms are littered with repetitive sequence elements , and evidence for how this came to be is accumulating through a combination of bench work and bioinformatics . long interspersed nuclear elements ( lines or l1s ) are retrotransposons that have generated integrated dna copies of themselves through rna intermediates . intact l1 rnas encode two proteins , orf1p and orf2p , which together associate with l1 rna and direct its nuclear importation , reverse transcription to dna , and integration at a random site within the host genome [ 1 - 3 ] . sequence analyses show a succession of l1 families in mammalian genomes , each family expanding over time before being relegated to the status of fixed dna by host - defense mechanisms and perhaps by direct competition from newer , more competent l1s . in humans , this history is traced in order through the inactive l1pa5 , l1pa4 , l1pa3b and l1pa2 families and the currently active l1pa1 family . in the mouse , the a , gf and tf families are currently active . although typically regarded as genetic baggage , martin vingron and his colleagues ( zemojtel et al . ) estimate in a recent paper in bmc genomics , that the mouse genome has approaching 5,000 intact active l1s in the diploid nucleus this is a timely reminder of both the harmful and potentially beneficial effects of l1 elements to cause functional changes in the genome . catalog examples of mouse transcripts that have incorporated portions of line sequences embedded in their genomic loci . although such incorporation into exons ' exonization ' and the related phenomenon of the co - option of transposon sequences for functional purposes ' exaptation ' have been described previously ( reviewed in ) , the new work from vingron 's team provides an update on the prevalence of l1 exonization within the mouse transcriptome . in most examples of exonization described by the authors , the l1 sequence provides a new start site of transcription ( figure 1 ) and provides exonic sequence followed...

long interspersed nuclear elements ( lines ) are among the most successful parasitic genetic sequences in higher organisms . recent work has discovered many instances of line incorporation into exons , reminding us of the hazards they pose to genes in their vicinity as well as their potential to be co - opted for the host 's purposes .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: within clinical trials ( cts ) there are three dimensions where activities , their duration , and the conditions on which these time - bound activities unfold decide the fate of the study . these are : ( 1 ) assessment of safety prediction if a potential medicinal product will have any safety concerns through the evaluation of its potential adverse effects , ( 2 ) proof of concept and large studies efficacy , ( 3 ) postmarketing surveillance , pharmacovigilance , and periodic safety update reports . the coordination of an individual ct project and the general management of the projects running simultaneously have a strategic importance to ensure timely marketing authorization of the promising candidates in the portfolio . in all phases of cts , the common management items tend to remain the same , i.e. , the scope , resources , and the timelines . the productivity of the pharmaceutical industry has decreased over time , and the costs of producing new medicines have been rising sharply . critical path analysis ( cpa ) is a method which is intended to improve drug development and reduce uncertainty and cost by applying scientific tools to the clinical development process . when activity durations are deterministically or experientially known , the cpa can be applied to manage time and resources for a given trial . the motivation for cpa and overall project management for cts come from the fact that there are many dependent and independent ( parallel ) activities involved , and also there are many uncertainties . to meet the objective of systematic planning , cpa is one of the many network techniques which have been widely used for planning , scheduling and controlling the large and complex projects . cpa formally identifies tasks which must be completed on time for the timely completion of the whole project . it also identifies which tasks can be delayed if the resource needs to be reallocated to catch up on missed or overrunning tasks . a further benefit of cpa is that it helps us to identify the minimum...

clinical research operates in a strictly regulated environment under various management models , but a distinct management model of clinical trial ( ct ) still needs exploration and research . critical path analysis ( cpa ) is a management approach can be used for monitoring , analysis , and prediction of success of its time - bound operational activities . a model ct was compiled with 78 activities , which were further merged into 35 major activities . after performing dependence analysis , the list was finalized with 25 activities which were taken in activity predecessor to create a network diagram and perform cpa considering patients , conduct , and outcome . activities were inclusive , described the trial entirely with accuracy , and were in chronological and logical sequences . this approach does not replace an understanding of or adherence to the requirements contained in all applicable regulations , guidelines or standard operating procedures governing clinical studies but ensures the proper use of operational and decisional approaches including optimal resource management . as the need to meet deadlines becomes more important and the need to produce good , stable project plans , cpa is very useful for determining activities that can lead to project delay . with this approach , project may be effectively monitored , and realistic schedules can be maintained .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: from may 2004 to may 2006 , we conducted face - to - face interviews with diabetic patients aged 18 years attending clinics affiliated with an academic medical center ( university of chicago , chicago , il ) or physician offices affiliated with a suburban hospital ( macneal hospital , berwyn , il ) . before conducting the study , we knew that patients attending the university of chicago were predominately african american , whereas patients attending macneal hospital were mainly latino and caucasian . to achieve an ethnically diverse study population , we planned for balanced recruitment from the two sites . we identified patients using electronic billing data provided by the clinics . patients were included if they had an icd-9 billing code of 250.xx in the past year and were 18 years of age . we excluded patients with type 1 diabetes , as well as those who had dementia during telephone recruitment . additional patients were excluded if they scored < 17 points on the mini - mental state examination ( 15 ) during in - person interviews . we successfully contacted 2,990 patients , 2,398 of whom were determined eligible for the study . a total of 910 patients ( 38% of eligible subjects ) scheduled interviews , and 701 patients ( 29% of eligible subjects ) completed interviews . the average age and sex distributions of subjects who completed interviews did not differ from those of other eligible subjects . for the purposes of this analysis , we focused on the 676 patients who identified themselves as non - hispanic african american , non - hispanic caucasian , or latino . to determine race / ethnicity , we separately asked patients to identify their race ( e.g. , african american , caucasian , asian , native american ) and to identify themselves as hispanic , latino , or spanish . interviews took approximately 1 h and were conducted by trained interviewers in english or spanish . the overall survey included an in - depth examination of health state utilities related to diabetes treatments and complications not...

objective to evaluate ethnic differences in medication concerns ( e.g. , side effects and costs ) that may contribute to ethnic differences in the adoption of and adherence to type 2 diabetes treatments.research design and methods we conducted face - to - face interviews from may 2004 to may 2006 with type 2 diabetic patients 18 years of age ( n = 676 ; 25% latino , 34% non - hispanic caucasian , and 41% non - hispanic african american ) attending chicago - area clinics . primary outcomes of interest were concerns regarding medications and willingness to take additional medications.resultslatinos and african americans had higher a1c levels than caucasians ( 7.69 and 7.54% vs. 7.18% , respectively ; p < 0.01 ) . latinos and african americans were more likely than caucasians to worry about drug side effects ( 66 and 49% vs. 39% , respectively ) and medication dependency ( 65 and 52% vs. 39% , respectively ; both p < 0.01 ) . ethnic minorities were also more likely to report reluctance to adding medications to their regimen ( latino 12% , african american 18% , and caucasian 7% ; p < 0.01 ) . in analyses adjusted for demographics , income , education , and diabetes duration , current report of pain / discomfort with pills ( odds ratio 2.43 [ 95% ci 1.394.27 ] ) , concern regarding disruption of daily routine ( 1.97 [ 1.143.42 ] ) , and african american ethnicity ( 2.48 [ 1.324.69 ] ) emerged as major predictors of expressed reluctance to adding medications.conclusionslatinos and african americans had significantly more concerns regarding the quality - of - life effects of diabetes - related medications than caucasians . whether these medication concerns contribute significantly to differences in treatment adoption and disparities in care deserves further exploration .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: metaiodobenzylguanidine ( mibg ) is an agent that is specifically taken up by sympathetic nervous system tissues , including neuroblastoma tumors . i - mibg plays an essential role in the diagnostic evaluation of patients with neuroblastoma . in addition , high - dose i - mibg therapy is an important part of the treatment of patients with relapsed or refractory neuroblastoma . the norepinephrine transporter ( net ; encoded by slc6a2 gene ) is thought to be the primary transporter responsible for specific active cellular uptake of mibg . several studies have demonstrated that neuroblastoma cell lines that lack net mrna expression fail to accumulate mibg [ 46 ] . net mrna levels appear to correlate in vitro with extent of mibg uptake [ 68 ] . moreover , a range of cells that do not typically accumulate mibg can be engineered to do so by transfection of the net gene [ 917 ] . additional studies in neuroblastoma and other neuroendocrine tumors have suggested that vesicular monoamine transporters ( vmats ) and organic cation transporters ( octs ) may also play a role in mediating uptake of mibg [ 1820 ] . approximately 10% of patients with neuroblastoma have tumors that do not accumulate mibg on the basis of negative diagnostic i - mibg scans . one small study utilized rt - pcr to evaluate net gene expression in 6 neuroblastoma tumors from patients with negative baseline mibg diagnostic scans . none of these tumors had detectable net mrna , while 90% of the 48 mibg - avid tumors had detectable net transcripts . the correlation between clinical mibg uptake with net protein expression and mrna expression of other putative mibg transporters has not been studied . the primary aim of the current study was to determine the association between tumor net mrna and protein expression with mibg avidity in patients with neuroblastoma . secondary aims included evaluation of the association of slc6a2 gene polymorphisms with mibg avidity , association of mrna expression for other membrane transporters with mibg avidity , as well...

purpose . 123i - metaiodobenzylguanidine ( mibg ) is used for the diagnostic evaluation of neuroblastoma . we evaluated the relationship between norepinephrine transporter ( net ) expression and clinical mibg uptake . methods . quantitative reverse transcription pcr ( n = 82 ) and immunohistochemistry ( ihc ; n = 61 ) were performed for neuroblastoma net mrna and protein expression and correlated with mibg avidity on diagnostic scans . the correlation of net expression with clinical features was also performed . results . median net mrna expression level for the 19 mibg avid patients was 12.9% ( range 1.673.7% ) versus 5.9% ( range 0.6110.0% ) for the 8 nonavid patients ( p = 0.31 ) . median percent net protein expression was 50% ( range 0100% ) in mibg avid patients compared to 10% ( range 080% ) in nonavid patients ( p = 0.027 ) . mycn amplified tumors had lower net protein expression compared to nonamplified tumors ( 10% versus 50% ; p = 0.0002 ) . conclusions . net protein expression in neuroblastoma correlates with mibg avidity . mycn amplified tumors have lower net protein expression .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: role of food acids as the main cause of erosion has been documented in numerous studies . dentin hypersensitivity is usually associated with cervical erosion and has been suggested as a direct clinical outcome of erosion . clinical pattern of erosion includes porosities in dentin surrounded by a prominent enamel margin . various studies have evaluated the role of fluoride - containing solutions and varnishes and casein , calcium and phosphate - containing compounds ( casein phosphopeptide - amorphous calcium phosphate [ cpp - acp ] ) in the prevention and reduction of erosive wear . application of ionized fluoride , i.e. , sodium fluoride , amine fluoride or stannous fluoride on tooth surfaces results in deposition of calcium fluoride ( caf2 ) on the enamel surface . under neutral conditions , caf2 deposition is facilitated by increasing the concentration of fluoride ion , longer exposure time , and lowering the ph of the solution . the fluoride ions released from caf2 can incorporate into the dental hard tissue and result in its further stability , hardness and increased abrasion resistance . when enamel and dentin are exposed to fluoride ions , the calcium and phosphate present in tooth structure form fluorapatite crystals with these ions . cpp - acp complex provides optimal concentrations of calcium and phosphate ions for enhancement of enamel remineralization . tooth mousse ( tm ) is a water - based sugar - free cream that contains cpp - acp . when applied , it maintains optimal concentrations of calcium and phosphate ions on enamel surfaces to enhance remineralization . in vitro studies have demonstrated that cpp - acp can be absorbed by the salivary pellicle and dental plaque . thus , a calcium - rich reservoir is formed that can facilitate remineralization . until date , no study has compared the efficacy of cpp - acp paste and sodium fluoride mouthwash for prevention of erosive wear . considering the popularity of sodium fluoride mouthwash among the iranian population and the recent introduction of tm...

aim : the purpose was to compare the effect of 0.2% sodium fluoride mouthwash and casein phosphopeptide - amorphous calcium phosphate paste on prevention of dentin erosion.materials and methods : buccal surfaces of 36 sound premolar teeth were ground flat and polished with abrasive discs . half the polished surfaces were covered with tape to maintain a reference surface . samples were randomly allocated into three groups . group a was pretreated with tooth mousse ( tm ) 4 times a day for 5 days . group b was pretreated with 0.2% sodium fluoride mouthwash 4 times a day for 5 days . group c was considered as the control group with no pretreatment . in the next step , the samples were exposed to coca - cola 4 times a day for 3 days . after each erosive cycle , the samples were rinsed with deionized water and stored in artificial saliva . the surface loss was determined using profilometry.results:the erosion in both groups a and b was less than the control group . the surface loss in mouthwash group was significantly lower than in the control group . erosion in tm group was more than the mouthwash group and less than the control group.conclusion:sodium fluoride mouthwash is more effective for prevention of dentin erosion .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: coarctation of the aorta is a localised stenosis of the aorta , most commonly located just distal to the origin of the left subclavian artery and closely related to the attachment of the ductus arteriosus with the aorta . frequently associated congenital defects are a bicuspid aortic valve , valvular and subvalvular aortic stenosis , mitral stenosis , ventricular septal defect and persistent ductus arteriosus . coarctation causes an increased afterload for the left ventricle , resulting in an increased systolic pressure in the left ventricle and upper part of the body . treatment of aortic coarctation can be performed surgically or percutaneously . even after successful correction hypertension often persists due to abnormal vascular physiology . uncorrected or unnoticed coarctation results in a high morbidity and mortality , mainly due to hypertension - associated problems . however , patients with isolated coarctation ( coarctation without additional congenital defects ) often remain asymptomatic for years and the defect may be unnoticed even until the fifth or sixth decade of life . although a late detected coarctation almost always includes irreversible cardiovascular damage , adequate treatment can result in a substantial improvement in both quality of life and prognosis [ 47 ] . in the present article , we describe two patients with late detected coarctation to illustrate the clinical consequences , diagnostic clues for earlier detection and current therapeutic options to achieve optimal treatment in these patients . a 40-year - old woman was referred to our hospital in 2004 because of a recently discovered difference in blood pressure between the right and left arm and a cardiac murmur . hypertension had already been diagnosed 20 years before and she was treated with an angiotensin receptor blocker . every now and then she suffered from chest pain , especially in bed at night , sporadically during exertion . she had no pregnancy wish and besides hypertension and migraine she had no further medical...

in patients with unexplained hypertension , especially in combination with a cardiac murmur , the presence of an aortic coarctation should always be ruled out given the high morbidity and mortality . however , particularly patients with an isolated coarctation often remain asymptomatic for years and the defect may be unnoticed even until the fifth or sixth decade of life . in the present article , we describe two patients with late detected coarctation to illustrate the clinical consequences , diagnostic clues for earlier detection and current therapeutic options to achieve optimal treatment . the key sign of an aortic coarctation , a difference in arterial blood pressure measured between the upper and lower extremities , should always be examined , followed by echocardiography . we conclude that even in case of a late detected severe coarctation , surgical or percutaneous repair has proven to be feasible and substantially effective , improving quality of life and lowering the risk of further hypertension - associated problems .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: onchocerciasis is a vector - borne parasitic disease caused by infection with the filarial nematode onchocerca volvulus and can result in eye or skin lesions . although adult worms can live for years under the skin in fibrous nodules that are often palpable , morbidity is caused by the body 's immune reaction to the microfilariae ( mf ) that leave the nodules and migrate through the skin and sometimes enter the eye . in 2007 , the world health organization ( who ) estimated 37 million persons were infected with onchocerciasis in 37 endemic countries ( 30 in africa , six in the americas , and one in the arabian peninsula ) . in the americas there are 13 geographically isolated endemic foci found within mexico , guatemala , colombia , venezuela , brazil , and ecuador [ 3 , 4 ] where 470,222 persons were at risk of infection in 2011 . the onchocerciasis elimination program of the americas ( oepa ) was established in 1992 in response to a resolution of the directing council of the pan american health organization ( paho ) calling for the elimination of onchocerciasis ocular morbidity in the americas by 2007 . a new resolution in 2008 by paho called for the interruption of transmission throughout the region by 2012 . a subsequent 2009 paho resolution ( cd49.r19 ) , calling for the elimination or drastic reduction of 12 neglected infectious diseases of poverty in the americas by 2015 , includes onchocerciasis as an elimination target . the oepa strategy is to support national programs in the six endemic countries to provide twice - yearly mass drug administration ( mda ) of ivermectin ( mectizan , donated by merck & co. ) to 85% of the eligible population at risk [ 6 , 9 , 10 ] . the guatemala ministry of public health ( moph ) , with the assistance of oepa , began mda with ivermectin in 1996 and has achieved 85% coverage of the eligible population at risk in twice - yearly mda rounds since 2002 . interruption of transmission was demonstrated in two of the four foci ( santa rosa in 2007 and escuintla - guatemala...

in latin america , onchocerciasis is targeted for elimination by 2012 through twice - yearly mass treatment of the eligible population with ivermectin . in guatemala , two of the four historical endemic foci have demonstrated elimination of transmission , following world health organization guidelines . using established guidelines ophthalmological , serological , and entomological evaluations were conducted in 2007 - 8 to determine the transmission status of onchocerciasis in the huehuetenango focus . the prevalence of onchocerca volvulus microfilariae in the anterior segment of the eye in 365 residents was 0% ( 95% confidence interval [ ci ] 00.8% ) , the prevalence of infection of o. volvulus in simulium ochraceum among 8252 flies collected between november 2007 and april 2008 was 0% ( 95% ci 00.02% ) , and the prevalence of antibodies to a recombinant o. volvulus antigen in 3118 school age children was 0% ( 95% ci 00.1% ) . these results showed transmission interruption ; thus , in 2009 mass treatment was halted and posttreatment surveillance began . to verify for potential recrudescence an entomological evaluation ( from december 2010 to april 2011 ) was conducted during the 2nd and 3rd year of posttreatment surveillance . a total of 4587 s. ochraceum were collected , and the prevalence of infection of o. volvulus was 0% ( 95% ci 00.04% ) . transmission of onchocerciasis in the huehuetenango focus has been eliminated .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: uterine granuloma is a rare entity and may be either focal or diffuse in nature . diffuse granulomas represent a local reaction without an obvious cause or may be associated with infection or systemic granulomatous disorders . infective conditions associated with uterine granulomas could be tuberculosis , atypical mycobacteria , endemic mycosis , cytomegalovirus infection and parasites . we report two cases of uterine granuloma , the first in which there was diffuse non - necrotizing granuloma . the second case showed diffuse granulomas with caseation in the myometrium and was positive for acid fast bacillus ( afb ) stain . a 50-year - old patient presented in august 2010 with heavy and irregular bleeding per vaginum for last 10 months . she had undergone dilatation and curettage ( d and c ) and cervical biopsy in december 2009 for menorrhagia . she had a second episode of menometrorrhagia in march 2010 followed by a repeat d and c. the endometrial curettings was reported as simple hyperplasia without atypia . her general , local examination and routine investigations were normal . a total abdominal hysterectomy with bilateral salpingo - oophorectomy was performed and the patient was discharged in satisfactory condition on eighth post - operative day . histology revealed endometrium in proliferative phase and myometrium showed multiple non - necrotizing epithelioid cell granulomas . photomicrograph showing non - caseating epithelioid cell granulomas with multinucleated giant cells present in the myometrium ( h and e , 200 ) a 40-year - old presented with pain and mass lower abdomen of five months duration with no menstrual irregularity . general physical examination was normal , local examination was suggestive of fibroid corresponding to size of 18 weeks pregnant uterus . ultrasonography revealed a large single intramural fibroid 10 9.7 cm with thin endometrium and normal ovaries . histopathological examination revealed endometrium in secretory phase , uterine tumor as leiomyoma and in addition myometrium...

uterine granulomas confined to the myometrium are uncommon . granulomas maybe infectious , non - infectious or idiopathic in origin . they may be diffuse or focal in nature . in this report , we describe two cases of granulomas of diffuse variety involving the myometrium . the first case shows non - necrotizing granuloma probably related to previous instrumentation . the second case depicts caseating granulomas along with leiomyoma of uterus .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: at 23 years of age , our patient presented with a palpable neck mass with no other underlying disease . sonographic findings revealed an enlarged isoechoic mass ( 42.52.5 cm ) with peripheral rim - like calcification in the right lobe of the thyroid . a preoperative diagnosis of papillary thyroid carcinoma was determined and a bilateral total thyroidectomy with ccnd and right internal jugular neck dissection was performed . the pathologic diagnosis determined that the mass was a diffuse sclerosing variant of papillary thyroid carcinoma confined to the right thyroid parenchyma ( fig . the tumor metastasized to several lymph nodes on the right side of the neck and the following regional lymph nodes ( 8/30 ) : level ii ( 2/6 ) , level iii ( 2/13 ) , level iv ( 3/10 ) , and perithyroidal ( 1/1 ) . approximately 30 mci of radioactive iodine ( i ) was used for postoperative adjuvant treatment . excision of the left surgical site with left modified radical neck dissection and right level ii and iii selective node dissection were performed . the tumor had again metastasized to several lymph nodes on the left side of the neck and the following regional lymph nodes ( 8/33 ) : right level ii ( 0/3 ) ; left level ii ( 1/9 ) , level iii ( 1/4 ) , and level iv ( 4/15 ) , and perithyroidal ( 2/2 ) . postoperatively , 200 mci of radioactive iodine ( i ) was administered and a daily dose of 200 g of levothyroxine was prescribed for adjuvant treatment . even though the patient continued with treatment , the tumor recurred at the left surgical site and the tumor size increased . at 31 years of age , the patient identified another newly developed , palpable small mass at the right postauricular area , which grew rapidly within a month . excision of the trachea with right modified radical neck node dissection and left level vi selective neck dissection was performed . histologic diagnosis of the pretracheal lesion determined that the lesion was an anaplastic thyroid carcinoma with a focal papillary carcinoma component , and the...

this study reports a case of anaplastic transformation from a well - differentiated thyroid carcinoma in a young patient . the first recurrent tissue contained poorly differentiated foci that revealed lower thyroglobulin , thyroid transcription factor 1 ( ttf-1 ) , and galectin-3 expression than the well - differentiated area . however there was no increased p53 or ki-67 expression in the poorly differentiated foci , nor in the well - differentiated area . the tissue subsequently relapsed and revealed only anaplastic features , complete loss of thyroglobulin , ttf-1 , and galectin-3 expression and revealed an increase in p53 and ki-67 expression . the braf v600e and braf v600v mutation were found in the initially diagnosed papillary thyroid carcinoma and the poorly differentiated foci of the recurring papillary thyroid carcinoma ; however , only the braf v600v mutation was found in the anaplastic carcinoma . these results suggest that overexpression of p53 and ki-67 contributed to the anaplastic transformation . we also found that the braf type changed during the tumor relapse .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: spontaneous intracranial hypotension ( sih ) is an increasingly recognised syndrome with the hallmark of orthostatic headache ( oh ) . pathophysiology suggests spontaneous leakage of cerebrospinal fluid ( csf ) through a spinal meningeal fistula.1 diagnosis of sih remains challenging and the criteria of the international headache society are evolving.2 3 a simple , cost - effective , non - invasive , and repeatable diagnostic tool that would aid in diagnosis , follow - up , and understanding of the pathophysiology of sih would be useful . high resolution transorbital sonography of the optic nerve sheath diameter ( onsd ) is increasingly used for the assessment of raised intracranial pressure.4 sonographic measurements showing increased onsd in patients with raised intracerebral pressure ( icp ) were confirmed using high - resolution mri.5 6 literature on ultrasound diagnostics in patients with sih is very sparse and consists only of a case study and an investigation in 10 patients on the effect of epidural blood patch on onsd and ophthalmic venous flow.79 up to now , all measurements reported in the literature were only performed with patients lying supine , and no measurements were made after change to the upright position . based on pathophysiological considerations , we hypothesised that there is a change in onsd from supine to upright position and that this change should be more pronounced in patients with acute ohs . in the current study we evaluated the diagnostic value of onsd by performing two high - resolution orbital ultrasound assessments , in supine and upright positions , in three groups : symptomatic and asymptomatic sih patients , and controls . ultrasound of the onsd is part of our routine diagnostic workup in all patients presenting with sih in our departments . we included all patients ( 18 years or older ) with confirmed sih from january 2013 to december 2014 . sih was diagnosed according to criteria of the international headache society.2 these criteria are : ( a ) any headache...

objectivespontaneous intracranial hypotension ( sih ) is most commonly caused by cerebrospinal fluid ( csf ) leakage . therefore , we hypothesised that patients with orthostatic headache ( oh ) would show decreased optic nerve sheath diameter ( onsd ) during changes from supine to upright position.methodstransorbital b - mode ultrasound was performed employing a high - frequency transducer for onsd measurements in the supine and upright positions . absolute values and changes of onsd from supine to upright were assessed . ultrasound was performed in 39 sih patients , 18 with oh and 21 without oh , and in 39 age - matched control subjects . the control group comprised 20 patients admitted for back surgery without headache or any orthostatic symptoms , and 19 healthy controls.resultsin supine position , mean onsd ( sd ) was similar in patients with ( 5.380.91 mm ) or without oh ( 5.480.89 mm ; p=0.921 ) . however , in upright position , mean onsd was different between patients with ( 4.840.99 mm ) and without oh ( 5.530.99 mm ; p=0.044 ) . furthermore , the change in onsd from supine to upright position was significantly greater in sih patients with oh ( 0.530.34 mm ) than in sih patients without oh ( 0.050.41 mm ; p0.001 ) or in control subjects ( 0.010.38 mm ; p0.001 ; area under the curve : 0.874 in receiver operating characteristics analysis).conclusionssymptomatic patients with sih showed a significant decrease of onsd , as assessed by ultrasound , when changing from the supine to the upright position . ultrasound assessment of the onsd in two positions may be a novel , non - invasive tool for the diagnosis and follow - up of sih and for elucidating the pathophysiology of sih .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: aerial parts are used in the treatment of kidney stones , hypertension , fever and cough ( http://www.forestry.gov.my/ ) . the earlier studies have shown that endophytic microorganisms isolated from medicinal plants produce the same metabolites as their hosts . therefore , there is a great potential in exploring endophytes as a source of therapeutic natural products . however , despite several traditional medicinal applications of nepenthes spp . the objective of this study was to isolate and to identify the endophytic bacteria ( eb ) from nepenthes spp . namely , nepenthes ampullaria , n. gracilis , n. macfarlanei , n. mirabilis , n. rafflesiana and n. sanguinea were collected from frim , selangor , malaysia . however , leaves and twigs from one to three individual plants of nepenthes spp . , namely , n. alba , n. albomarginata , n. gracillima and n. sanguinea were collected from the gunung jerai ( gj ) , gurun , kedah , malaysia . leaves with petioles were thoroughly washed under running tap - water and the surface - sterilization of plant material samples was carried out as reported elsewhere . the stem pieces were soaked in 70% ethanol and flamed to make their surface sterile . aseptically , the leaf and stem tissue pieces were inoculated in the petri plates containing luria - bertani ( lb ) agar medium . the plates were incubated in an incubator at 37c ( 3c ) for 18 - 20 h in the dark . the isolation , cultivation of endophytes , amplification of 16s rdna , sequencing of 16s rdna , identification of endophytes and rooted phylogenetic tree construction was carried out as reported by bhore et al . incubation of the inoculated leaf discs and stems pieces on lb agar medium enabled cultivable eb to grow , and the colonies of grown eb were visible on the margins of the leaf and stem tissues . all 96 isolates were identified based on 16s rdna sequence blast ( megablast ) hits analysis . the annotated 16s rrna gene fragment ( 16s rdna ) nucleotide sequences of all isolates have been submitted to the...

background : nepenthes species are used in traditional medicines to treat various health ailments . however , we do not know which types of endophytic bacteria ( eb ) are associated with nepenthes spp.objective:the objective of this study was to isolate and to identify eb associated with nepenthes spp.materials and methods : surface - sterilized leaf and stem tissues from nine nepenthes spp . collected from peninsular malaysia were used to isolate eb . isolates were identified using the polymerase chain reaction - amplified 16s ribosomal dna ( rdna ) sequence similarity based method.results:cultivable , 96 isolates were analyzed ; and the 16s rdna sequences analysis suggest that diverse bacterial species are associated with nepenthes spp . majority ( 55.2% ) of the isolates were from bacillus genus , and bacillus cereus was the most dominant ( 14.6% ) among isolates.conclusion:nepenthes spp . do harbor a wide array of cultivable endophytic bacteria .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: a 41-year - old male injection drug user was brought to the emergency department unresponsive , febrile and hypotensive . initial investigations revealed a white blood cell count of 19.310/l ; urinalysis , chest x - ray and abdominal computed tomography were all unremarkable . fluid resuscitation , vasopressor support and empirical antibiotic therapy with intravenous ( iv ) piperacillin / tazobactam , vancomycin and clindamycin were initiated . following resuscitation , the patient provided a vague history : he was well until the day of admission , at which time he developed a headache , severe fatigue and generalized malaise . his medical history was significant for hepatitis c and previous episodes of bacteremia related to injection drug use . blood cultures collected on admission grew b cereus ( four of four bottles ) and serratia marcescens . blood cultures were persistently positive for b cereus until day 14 of admission . on day 29 , the patient developed a small antecubital abscess that was drained and cultured b cereus . the patient received a total of six weeks of iv vancomycin and was discharged home . nine days following the admission of case 1 , a 49-year - old man with a history of daily heroin and crystal methamphetamine injection drug use presented to hospital with confusion and agitation . he was afebrile , with no obvious focus of infection on history or physical examination . his medical history was significant for recently diagnosed hiv infection and hepatitis c. initial laboratory results showed a white blood cell count of 13.110/l . blood cultures collected on admission grew b cereus and lactobacillus , and the patient was switched to iv vancomycin and ciprofloxacin . three subsequent blood cultures were positive for b cereus ; blood cultures eventually cleared on day 14 of admission . iv vancomycin was continued for a total duration of eight weeks and the patient was discharged . twenty days after case 1 was admitted to hospital , a 33-year - old man with a history of heroin and cocaine...

bacillus cereus is a bacteria commonly found in nature that is most frequently implicated as the cause of gastrointestinal illness caused by ingestion of contaminated food ; however , there are also reports of extraintestinal infections , although rare . this article describes three cases in which b cereus bacteremia occurred among injection drug users living in vancouver , british columbia , within a short period of time . pulsed - field gel electrophoresis was performed to determine whether these three isolates were related .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: a 38-year - old man came to the netherlands in january 2009 to work as a rigger in the harbor of rotterdam . since october 2008 , he had lived in kapit , sarawak , in borneo and hunted wild animals in the surrounding jungles . one week after arriving in the netherlands , he came to our hospital with a 5-day history of fever , myalgia , headache , and low back pain . his medical history was uneventful , and he had not experienced any previous malaria attacks . laboratory investigations showed a moderate anemia ( hemoglobin 7.8 mmol / l [ reference range 8.511.0 mmol / l ] ) , a normal leukocyte count ( 5.8 10/l [ reference range 4.310 10/l ] ) , thrombocytopenia ( platelet count 22 10/l [ reference range 150400 10/l ] ) , an increased level of c - reactive protein ( 158 mg / l [ reference range < 10 mg / l ] ) , and liver function abnormalities ( serum alanine aminotransferase 199 u / l [ reference range < 41 u / l ] ; aspartate aminotransferase 128 u / l [ reference range < 37 u / l ] ; lactate dehydrogenase [ ldh ] 1,059 u / l [ reference range < 450 u / l ] ; gamma - glutamyltransferase 183 u / l [ reference range < 50 u / l ] ; alkaline phosphatase 285 u / l [ reference range < 120 u / l ] ; and total bilirubin 99 mol / l [ reference range < 17 mol / l ] ) . plasma lactate level was within normal limits . in a rapid diagnostic test for malaria ( binaxnow malaria test ; binax , scarborough , me , usa ) , his blood sample was negative for p. falciparum histidine - rich protein 2 but showed a positive reaction with pan - malarial aldolase antigen , which suggested a non p . results of quantitative buffy coat analysis were positive for malaria trophozoites , schizonts , and gametocytes . a thin blood film showed parasite density of 2% infected erythrocytes ( 84,000 trophozoites/l ) , schizonts , and gametocytes with an inconclusive morphologic appearance ( figure 1 ) . a p. knowlesi infection was suspected because of his recent stay in kapit , malaysian borneo . the patient was treated orally with...

we describe a pcr - confirmed case of plasmodium knowlesi infection with a high parasitemia level and clinical signs of severe malaria in a migrant worker from malaysian borneo in the netherlands . investigations showed that commercially available rapid antigen tests for detection of human plasmodium infections can detect p. knowlesi infections in humans .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: fibroblasts are one of the most commonly used somatic cells to produce induced pluripotent stem ( ips ) cells [ 1 , 2 ] . therefore , it is essential to determine the genetic and epigenetic stability of fibroblasts in long - term culture . it has been shown that long - term in vitro culture of somatic cells increases the risk of cell senescence , chromosomal aneuploidy , as well as multiploidy karyotypes [ 3 , 4 ] . however , the potential changes in epigenetic gene regulation in long - term cultured human fibroblasts are not well investigated . dosage compensation of the x chromosome in mammalian female cells is one of classic examples of epigenetic gene regulation . it is achieved through an event referred to as x chromosome inactivation ( xci ) in which one of the two x chromosomes is silenced during development [ 57 ] . xci is initiated in the x - inactivation center of the x chromosome , within which a gene encoding x inactive - specific transcript ( xist ) is expressed solely from the inactivated x chromosome . xist gene is crucial for xci because its noncoding rna directly interacts with and coats the inactive x chromosome . after the completion of xci , the two x chromosomes in female cells are distinguished by differential transcription of the xist gene , dna methylation , and histone modifications such as histone h3 lysine 27 trimethylation ( h3k27me3 ) [ 8 , 9 ] . in this study , human dermal fibroblasts ( hdfs ) we then examined the cell - growth rate , the stability of xci in short- and long - term passages . we found that early passages of female hdfs retained a normal karyotype with the expected xci pattern while high - passage cells exhibited a higher risk of carrying more than one copy of the inactive x chromosomes due to the presence of three or four copies of x - chromosomes in one nucleus . this research project was approved and monitored by the ethical committee in the first affiliated hospital of nanjing medical university . written informed consent was obtained from all 8 female...

human primary fibroblasts are a popular type of somatic cells for the production of induced pluripotent stem ( ips ) cells . here we characterized biological properties of primary fibroblasts in terms of cell - growth rate , cytogenetic stability , and the number of inactive x chromosomes during long - term passaging . we produced eight lines of female human dermal fibroblasts ( hdfs ) and found normal karyotype and expected pattern of x chromosome inactivation ( xci ) at low passages ( passage p1 - 5 ) . however , four out of the eight hdf lines at high passage numbers ( p10 ) exhibited duplicated hallmarks of inactive x chromosome including two punctuate signals of histone h3 lysine 27 trimethylation ( h3k27me3 ) and x inactive - specific transcript ( xist ) rna signals in approximately 8.518.5% of the cells . our data suggest that the copy number of inactive x chromosomes in a subset of female hdf is increased by a two - fold . consistently , dna fluorescent in situ hybridization ( fish ) identified 3 - 4 copies of x chromosomes in one nucleus in this subset of cells with two inactive xs . we conclude that female hdf cultures exhibit a higher risk of genetic anomalies such as carrying an increased number of x chromosomes including both active and inactive x chromosomes at a high passage ( p10 ) .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: the most recent introduction to the dental ceramics family is zirconia , which in its pure form is a polymorphic material . fabrication of fixed prosthesis involves layering of metallic substructure or all ceramic core structure with an aesthetic ceramic veneering material . the underlying substructure provides the required strength and the overlying ceramic gives the required esthetics . yttrium oxide partially stabilized tetragonal zirconia polycrystal ( y - tzp ) was introduced in dentistry as a core material in the 1990s . many studies on the use of zirconia have been conducted , but some features still remain unclear . there is a lack of information on how temperature change and water treatments affect the material properties and clinical durability of veneered zirconia cores . unlike other prostheses in the body , oral prosthesis recent studies have shown an indication that water molecules have an influence on the bond between veneered and veneering material . slow surface transformation to the stable monoclinic phase occurs through environmental stresses , usually in the presence of water molecules , hot water vapor , or body fluids such as saliva [ 47 ] . studies have shown the bond between the zirconium core and the veneering ceramic to be influenced by water molecules which eventually affects the clinical durability of the restoration in function [ 8 , 9 ] . aging of zirconia may have detrimental effects on its bonding with veneering ceramics ; mechanical stresses and wetness exposure accelerate this process . presently , different companies are providing milled zirconia cores from presintered zirconia blocks and are offering long time warranty ( 15 yrs ) for their products . on observing the growing trends and future possibilities , it is very important to understand the clinical durability , limitation , and function of the veneered zirconia as a restorative material . this study was undertaken to investigate and compare the bond strengths of commercial zirconia framework materials with veneering...

a study was undertaken to evaluate the effect of artificial aging through steam and thermal treatment as influencing the shear bond strength between three different commercially available zirconia core materials , namely , upcera , ziecon , and cercon , layered with vita vm9 veneering ceramic using universal testing machine . the mode of failure between zirconia and ceramic was further analyzed as adhesive , cohesive , or mixed using stereomicroscope . x - ray diffraction and sem ( scanning electron microscope ) analysis were done to estimate the phase transformation ( m - phase fraction ) and surface grain size of zirconia particles , respectively . the purpose of this study was to simulate the clinical environment by artificial aging through steam and thermal treatment so as the clinical function and nature of the bond between zirconia and veneering material as in a clinical trial of 15 years could be evaluated .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: hodgkin s lymphoma was first described in 1832 , but the nature of the pathognomic reed - sternberg cells , on which diagnosis of the disease is based has only been cleared in the past few years . radiotherapy has been employed for treatment of localized disease from the 1940s and combination chemotherapy was presented for anatomically progressive diseases in the 1960s . there has been great improvement in the outcome in the last three decades concluing to the fact that hodgkin s lymphoma is mentioned as one of the most curable non - cutaneous malignancies . combined therapy ( chemotherapy and radiotherapy ) can lead to the cure of more than 90% of children and adolescents with hodgkin s disease , but the intensive treatment may cause early and late complications . damage of soft tissues , respiratory , cardiovascular , skeletal and endocrine systems , dental development disturbance and second cancers are considered to be late complications of such treatment . these complications may have adverse effects on the patient s quality of life after discontinuation of treatment . hypodontia ( partial anodontia ) , microdontia , altered eruption patterns and root stunting are some of the stated complications . developmental abnormalities resulting after malignant chemotherapy occur when the patient is treated prior to six years of age . diminished root surface area due to radiation exposure is the reason for early tooth loss . combined radio chemotherapy which is commonly used for the treatment of childhood neoplasia causes periodontium effects .there are just few reports of the complications of the dental system caused by radiotherapy in childhood in the literature . we report a girl who received chemotherapy and radiation of the head and neck area at five years of age and demonstrated developmental disturbances following chemoradiotherapy . this case report describes a 26-year - old girl , who at the age of 5 years , received chemotherapy and radiotherapy for hodgkin s disease in the neck region . the patient...

the improvement in survival and local control measures in children with neoplasm in the head and neck region may lead to increased iatrogenic adverse effects of treatment . the aim of this study was to report a new case of the long - term effects of chemoradiotherapy on oral health and dental development in a patient treated for hodgkin s disease at an early age . in this case report , a 26-year - old female is presented , who at the age of 5 years received chemotherapy and radiotherapy for hodgkin s disease in the neck region . the patient consulted the department of oral medicine because of dental changes and tooth loss despite adequate dental care and oral hygiene . clinical examination revealed loose teeth and inflamed gingiva of the mandible , x - ray showed premature root resorption , v - shaped and shortened roots and alveolar bone loss . after examination , the patient was referred for extracting the mandibular teeth and then wassent to the prosthetics department . therefore , in order to decrease dental treatment sequelae in patients who have had cured malignant disease , these cases should have life - long dental care and follow - up .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: internal limiting membrane ( ilm ) free autografts have been used to repair refractory macular holes instead of using conventional surgical techniques like vitrectomy and peeling off the ilm , with encouraging results according to several authors . furthermore , to treat retinal tears in retinal detachment surgery , laser therapy or cryotherapy are used with excellent results , achieving appropriate sealing of the tears and thus contributing to retinal reattachment . laser therapy is also applied for the transoperative treatment of retinotomies that are occasionally performed to drain the subretinal fluid . not having those means to achieve tear sealing poses a complication that in some hospital sites , mainly in third world countries like mexico , is not entirely uncommon . in this case report we describe the use of an ilm autograft to seal a transoperative retinotomy in a patient who underwent primary vitrectomy for rhegmatogenous retinal detachment and proliferative vitreoretinopathy . a 55-year - old female patient came for consultation with sudden loss of vision and also reporting a rapidly progressive superior altitudinal scotoma of her right eye . on examination , the patient had a visual acuity of hand motion on her right eye , and fundus examination with a goldman 3-mirror lens revealed total retinal detachment with peripheral horseshoe tears in the 1 , 2 , 7 , and 9 o'clock positions , with presence of an inferior and temporal fixed fold . vitrectomy surgery was then performed with membrane peeling under perfluorocarbon fluids , placing a # 287 exoplant with a # 240 band and silicone oil as intraocular tamponade . the tears were all treated with laser therapy . while the air - fluid exchange was being completed , a retinotomy in the raphe was inadvertently made . laser treatment of the retinotomy site was no longer possible at that moment due to malfunction of the laser device . 0.02 ml of brilliant blue g ( fluoron gmbh , ulm , germany ) were injected into the vitreous cavity to stain the ilm...

during a pars plana vitrectomy , an unplanned retinotomy in the raphe was performed in a 55-year - old female patient with rhegmatogenous retinal detachment and proliferative vitreoretinopathy . since diathermy and laser therapy were not available at that moment , it was decided to peel off a small graft of the internal limiting membrane adjacent to the retinotomy site which had been previously stained with brilliant blue g. the graft was displaced under perfluorocarbon fluids and placed inside the retinotomy . three weeks after surgery , the apparent closure of the retinotomy was observed clinically .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: laser in situ keratomileusis ( lasik ) has a high rate of improving uncorrected snellen visual acuity ( 1 ) , however it can degrade the quality of vision , resulting in reports of reduced night vision clarity , glare , and halos ( 2 ) . the contrast sensitivity test more effectively evaluates the visual quality over a range of sizes and daytime contrast levels ( 3 ) and is necessary to assess the visual performance in refractive surgery patients ( 4 ) . the increased higher order aberrations induced after lasik is one reason for the reduced contrast sensitivity ( 5 , 6 ) . the contrast sensitivity after wavefront - guided lasik using the ablation depth based on the individual higher order aberrations compared with standard lasik after surgery showed a significantly improvement ( 7 ) . the reduction in the contrast sensitivity was greater for higher amounts of myopia in standard lasik ( 8) . however , previous studies for contrast sensitivity after wavefront - guided lasik did not include high myopia patients . the aim of this study was to evaluate the contrast sensitivity , glare sensitivity and total high order aberrations after wavefront - guided lasik in both moderate and high myopia patients . the high myopia group included 25 eyes of 14 patients with -7.78~-6.17d ( table 1 ) . the uncorrected visual acuity , spherical equivalent , contrast sensitivity and glare sensitivity were measured preoperatively , and at 1 week , 1 month and 2 months postoperatively on patients undergoing wavefront - guided lasik . the ocular total higher order aberration ( hoa ) was measured at 2 months postoperatively . were performed using a hartmann - shack aberrometer ( wavescan , visx , sunnyvale , ca , u.s.a . ) and visx star s4 ( visx ) excimer laser , respectively . in all patients , the individual aberrations gained including the higher order aberrations by wavescan was programmed into the star s4 laser to create a customized treatment . a flap thickness of 130 m was created using a moria m2 microkeratome ( moria ,...

this study evaluated the visual quality after wavefront - guided laser in situ keratomileusis ( lasik ) for treating myopia . thirty - two eyes with moderate myopia ( -5.78~-2.17d ) and 25 eyes with high myopia ( -7.78~-6.17d ) were prospectively reviewed . the contrast sensitivity ( cs ) , glare and the total higher order aberrations ( hoa ) were measured before and 1 week , 1 month and 2 months after lasik . the pupil diameter was measured at day- and night - time illumination . the cs and glare at all spatial frequencies were not reduced after wavefront - guided lasik ( p<0.05 ) and the difference between the moderate and high myopia group was not significant . no significant correlation was found between the amounts of myopia and the postoperative cs ( p>0.05 ) . the area under the log contrast sensitivity function ( aulcsf ) showed no correlation with the total hoa ( r2=-0.071 , p=0.612 , between the daytime aulcsf and the total hoa with a 4 mm entrance pupil , r2=-0.176 , p=0.260 , between the nighttime aulcsf and the total hoa with a 6 mm entrance pupil ) . there was no decrease in cs and glare after wavefront - guided lasik for myopia . in conclusion , wavefront - guided lasik based on the individual ablation patterns is a good option for refractive surgery to improve the visual quality in both moderate and high myopia cases .

Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them? Study: introduction of imaging modalities , especially magnetic resonance ( mr ) , and of modern methods of neurosurgery and pharmacotherapy revolutionized diagnosis and therapy of pituitary tumors . currently , mr is the method of choice for imaging of the pituitary gland and the perisellar area . advanced mr techniques mr diffusion , mr spectroscopy and mr perfusion have been increasingly applied [ 112 ] . the proper diagnosis and management of patients with pituitary tumors are of high importance in clinical practice [ 1417 ] . mr imaging protocol of pituitary and sellar region including postoperative studies usually consists of unenhanced and enhanced t1-weighted images in coronal and sagittal planes . t2-weighted unenhanced images are also performed sometimes , but most authors have reported postoperative studies of the sellar region using only t1-weighted images [ 1820 ] . there are only a few papers concerning applications of t2-weighted sequences in imaging of the postoperative sella [ 2123 ] . nakasu et al found that t2-weighted imaging could be a reliable and sufficient method to assess the sella in patients after pituitary surgery . in the literature there is still disagreement whether t2-weighted images are useful in assessment of the sellar region after resection of pituitary tumors . the purpose of this study was to investigate the magnetic resonance features of the postoperative sella with fast spin echo ( fse ) t2-weighted imaging ( t2 ) and to evaluate the benefits of this sequence compared to the classically performed contrast - enhanced t1-weighted imaging ( t1+c ) on a 1.5 t unit . the aim of our study was also to assess whether t2 sequence could replace t1-weighted images after contrast administration . . this could be especially useful in patients with high risk of nephrogenic systemic fibrosis ( nsf ) . the study group consisted of 101 patients who underwent resection of pituitary tumors with the following diagnoses : pituitary adenoma ( 89 cases ) , pituitary abscess ( 1 case ) , rathke s...

summarybackgroundthe proper diagnosis and management of patients after surgery for pituitary tumors are of great importance in clinical practice . the purpose of this study was to investigate the magnetic resonance features of the postoperative sella with fast spin echo t2-weighted imaging and to evaluate the benefits of this sequence compared to the classically performed contrast - enhanced t1-weighted imaging at 1.5 t unit.material/methodsthe study group consisted of 101 patients who underwent resection of pituitary tumors . there were 58 women ( 57.4% ) , aged 22 to 75 ( mean age , 52.67 years ) and 43 men ( 42.6% ) , aged 21 to 79 ( mean age , 49 years ) . in all patients preoperative and multiple postoperative mr studies were performed . post - contrast t1 and pre - contrast t2 images were interpreted by 2 independent readers ( neuroradiologists).resultscontrast - enhanced t1-weighted imaging was significantly superior to t2-weighted imaging in assessment of infundibulum ( p<0.05 ) . there was no statistically significant difference for each of readers between t1- and t2-weighted images regarding to the following features : visualization of residual pituitary gland ( p=0.062 and p=0.368 ) , contours of pituitary ( p=0.959 and p=0.265 ) , optic chiasm ( p=0.294 and p=0.843 ) , and visualization of presence of residual tumor ( p=0.204 and p=0.169 ) . t2-weighted images were significantly superior to contrast - enhanced t1-weighted imaging with regard to visualization of contours of residual tumors ( p<0.05).conclusionst2-weighted images may help to discriminate tumorous from non - tumorous involvement of the postoperative sella and the sphenoid sinus . t2-weighted images are also very useful for a long time after the resection in the postoperative evaluation of the implanted muscle with fascia .