الملخص
In this review, we provide a brief synopsis of the connections between adipose tissue and metabolic health and highlight some recent developments in understanding and exploiting adipocyte biology. Adipose tissue plays critical roles in the regulation of systemic glucose and lipid metabolism and secretes bioactive molecules possessing endocrine, paracrine, and autocrine functions. Dysfunctional adipose tissue has a detrimental impact on metabolic health and is intimately involved in key aspects of metabolic diseases such as insulin resistance, lipid overload, inflammation, and organelle stress. Differences in the distribution of fat depots and adipose characteristics relate to divergent degrees of metabolic dysfunction found in metabolically healthy and unhealthy obese individuals. Thermogenic adipocytes increase energy expenditure via mitochondrial uncoupling or adenosine triphosphate-consuming futile substrate cycles, while functioning as a metabolic sink and participating in crosstalk with other metabolic organs. Manipulation of adipose tissue provides a wealth of opportunities to intervene and combat the progression of associated metabolic diseases. We discuss current treatment modalities for obesity including incretin hormone analogs and touch upon emerging strategies with therapeutic potential including exosome-based therapy, pharmacological activation of brown and beige adipocyte thermogenesis, and administration or inhibition of adipocyte-derived factors.
الملخص
Objective:To investigate the efficacy of clinical pathway teaching method in standardized training of general practitioners in gastroenterology.Methods:From 2018 to 2019, 40 residents who participated in the standardized training of general practitioners in the Department of Gastroenterology, Zhongshan Hospital Qingpu Branch, Fudan University Medical College were randomized into the experimental group and the control group. The residents of the experimental group were trained by clinical pathway teaching method, while the control group were trained by traditional methods. After 6 weeks' teaching, theoretical examination, operation skills and case analysis test were assessed and satisfaction surveys were conducted.Results:The operation skills and case analysis scores of the experimental group were significantly better than those of the control group [operation test (91.50±2.77) vs. (89.80±3.74), P<0.01; case analysis (92.10±1.98) vs. (86.40±2.87), P<0.01]. The teaching satisfaction of the experimental group was significantly higher than that of the control group, and the difference was statistically significant ( P<0.01). Conclusion:The teaching model of clinical pathway can improve the teaching quality of the residents in the department of gastroenterology, improve the satisfaction of the doctors in the training, and broaden clinical thinking, which is worthy of promotion in clinical teaching.
الملخص
OBJECTIVE@#To investigate the diagnostic value of 6 conventional physical examination tests for the diagnosis of supraspinatus tendon tears, and how well they could tell the difference between partial-and full-thickness tears.@*METHODS@#A total of 91 patients with different shoulder symptoms who received shoulder arthroscopic procedure were enrolled in the study from June 2017 to September 2020. The intraoperative findings were compared with the results of the preoperative physical examination of 6 clinical tests, including the Hug-up test, the Jobe test, the 0°abduction test, the drop arm test, the Neer test, and the Hawkins test, to determine the sensitivity, specificity, positive and negative predictive value, accuracy, positive and negative likelihood ratio of each test.@*RESULTS@#By arthroscopy, a total of 44 full-thickness tears, 34 partial-thickness tears, and 13 intact supraspinatus tendons were found in all 91 cases. The Hug-up and the Jobe tests significantly correlated with the intraoperative findings. The sensitivity of the Hug-up test, the Jobe test, the 0° abduction test, the drop arm test, the Neer test, and the Hawkins test was 0.90, 0.79, 0.64, 0.42, 0.49, 0.24 respectively;the specificity was 0.61, 0.69, 0.54, 0.38, 0.31, 0.77;the positive predictive value was 0.93, 0.94, 0.89, 0.80, 0.81, 0.86;the negative predictive value was 0.50, 0.36, 0.20, 0.10, 0.09, 0.14;the accuracy was 0.86, 0.78, 0.63, 0.42, 0.46, 0.32;the positive likelihood ratio was 2.30, 2.58, 1.39, 0.69, 0.71, 1.06;and the negative likelihood ratio was 0.16, 0.30, 0.67, 1.50, 1.65, 0.98.@*CONCLUSION@#The Jobe test and the Hug-up test are both effective at accurately diagnosing supraspinatus tendon tears, the Hug-up test detects supraspinatus tears with a high sensitivity, and similar specificity. The tests assessed in this study are not capable of distinguish between partial-and full thickness supraspinatus tendon tears.
الموضوعات
Humans , Arthroscopy , Physical Examination/methods , Rotator Cuff , Rotator Cuff Injuries/surgery , Tendonsالملخص
Objective:To clarify the risk factors for post-operative central nervous system infection (PCNSI) to provide references for prevention and treatment of PCNSI.Methods:A total of 397 patients with neurosurgery diseases, admitted to and accepted 403 surgeries in our hospital from February 1 st, 2015 to December 30 th, 2015, were chosen in our study; their clinical data were collected. The incidence of PCNSI was analyzed. Risk factors for PCNSI were analyzed by univariate analysis and multivariate Logistic regression analysis. The ajusted specific infection rate of PCNSI was calculated in 12 chief surgeons who performed≥8 operations during the study period to assess the influence of surgeons in PCNSI incidence. Results:The PCNSI incidence in these 397 patients was 9.2% (37/403). The cerebrospinal fluid (CSF) culture positive rate was 29.7% (11/37), including 6 (54.6%) with positive gram staining. Univariate analysis showed that as compared with the non-infected group (366 surgeries), patients in the PCSNI group (37 surgeries) had significantly higher National Nosocomial Infections Surveillance (NNIS) scale, significantly higher proportion of patients with preoperative stay>6 d, significantly longer operative duration, and statistically higher proportion of involvement of scrub nurses with experience in fewer than 8 procedures ( P<0.05). Multivariate Logistic regression analysis showed operative duration ( OR=1.389, 95%CI: 1.202-1.606, P=0.000) and involvement of scrub nurses with experience in fewer than 8 procedures ( OR=2.860, 95%CI: 1.276-6.412, P=0.011) were independent risk factors for PCNSI. After adjustment by NNIS scale, the ajusted specific infection rate of PCNSI in 12 chief surgeons was 20.0%, 23.0%, 17.3%, 18.2%, 13.4%, 12.5%, 6.3%, 8.0%, 5.2%, 4.0%, 0.0%, and 0.0%, respectively, enjoying obvious differences. Conclusion:Specialized infection control training should give to surgeons with high adjusted specific infection rate of PCNSI; this training, shortening operative duration, and training of neurosurgery specialist nurses will be important measures to reduce PCNSI incidence.
الملخص
Hereditary angioedema (HAE) is a rare autosomal dominant disorder caused by genetic deficiency or decreased function of C1-esterase inhibitor. It is characterized by swelling of subcutaneous and submucosal tissues of the extremities, gastrointestinal tract, and upper airways which can be life-threatening. Thus, early recognition and treatment of the disease are important. Short- and longterm prophylaxes are used to decrease the severity and frequency of attacks. Icatibant is a selective bradykinin B2-receptor antagonist, earlier treatment of acute attacks and hospital admission. The authors present a case of 47-year-old woman who was diagnosed with type II HAE, danazol as a long term. Her symptoms improved dramatically after drug treatment. The unpredictability and recurrence of HAE attacks could have a negative impact on social life and quality of life. This case shows that timely and proper treatment could improve quality of life and reduce morbidity and mortality. (
الملخص
Purpose@#The purpose of this study was to investigate the effects of head nurses’ authentic leadership, job satisfaction and organizational commitment as perceived by newly licensed nurses and to identify related factors influencing turnover intention. @*Methods@#A descriptive survey study was conducted with survey data collected between September 9 and 27, 2019 from 190 newly licensed nurses. The data was analyzed using statistical methods including descriptive statistics, frequency analysis, independent t-test, Pearson correlation coefficients, and multiple linear regression employing SPSS 24.0. @*Results@#The analysis results show that the turnover intention had positive correlations with the total work experience and work experience with a head nurse, while negative correlations were found with job satisfaction and organizational commitment. The factors affecting the dependent variable of turnover intention were analyzed as the total work experience (β=23, p=.014) and organizational commitment (β=-.68, p<.001). In addition, the explanation ability of turnover intention of newly licensed nurses was 48% (F=36.06, p<.001). @*Conclusion@#The results show that even after their preceptee period, there is a need for systematic long-term job-training programs to enhance the work adaptability and organizational commitment of newly licensed nurses.
الملخص
Background@#The concept of work-life balance (WLB) has become an important issue in workers' health and safety. This study aims to investigate the relationship between WLB and occupational injury and work-related musculoskeletal pain.Method: The study included 27,383 workers who participated in the Fifth Korean Working Conditions Survey. Participants were divided into good WLB and poor WLB groups based on their responses to the five question items which comprised two dimensions: workon-life conflict (items, 1–3) and life-on-work conflict (items 4 and 5). Occupational injury and musculoskeletal pain were also assessed using the question items. The χ 2 test and multivariate logistic regression analyses were performed to examine the relationship of WLB to occupational injury and musculoskeletal pain while considering socio-demographic and occupational characteristics and ergonomic and psychological risk factors. @*Results@#Of the 27,383 participants, 252 (0.9%) had experienced an occupational injury and 6,408 (23.4%) had musculoskeletal pain. The poor WLB group had higher injury rates for both men (1.7%) and women (0.9%) than the good WLB group (1.1% and 0.4%, respectively).Additionally, the prevalence of musculoskeletal pain was higher for both men and women in the poor WLB group (25.2% and 28.0%, respectively) than for men and women in the good WLB group (18.7% and 23.6%, respectively). In the logistic regression analysis, the adjusted odds ratio of WLB for occupational injury was 1.37 (95% confidence interval [CI]: 1.06–1.78), and that for musculoskeletal pain was 1.14 (95% CI: 1.07–1.21), showing positive associations of WLB with both occupational injury and musculoskeletal pain. @*Conclusions@#Poor WLB causes an increase in occupational injury and musculoskeletal pain.Therefore, an improvement in WLB may reduce the incidence of occupational injury and musculoskeletal pain among workers. Social and policy-related initiatives are needed to improve workers' WLB to reduce occupational injury and musculoskeletal pain.
الملخص
Background@#The concept of work-life balance (WLB) has become an important issue in workers' health and safety. This study aims to investigate the relationship between WLB and occupational injury and work-related musculoskeletal pain.Method: The study included 27,383 workers who participated in the Fifth Korean Working Conditions Survey. Participants were divided into good WLB and poor WLB groups based on their responses to the five question items which comprised two dimensions: workon-life conflict (items, 1–3) and life-on-work conflict (items 4 and 5). Occupational injury and musculoskeletal pain were also assessed using the question items. The χ 2 test and multivariate logistic regression analyses were performed to examine the relationship of WLB to occupational injury and musculoskeletal pain while considering socio-demographic and occupational characteristics and ergonomic and psychological risk factors. @*Results@#Of the 27,383 participants, 252 (0.9%) had experienced an occupational injury and 6,408 (23.4%) had musculoskeletal pain. The poor WLB group had higher injury rates for both men (1.7%) and women (0.9%) than the good WLB group (1.1% and 0.4%, respectively).Additionally, the prevalence of musculoskeletal pain was higher for both men and women in the poor WLB group (25.2% and 28.0%, respectively) than for men and women in the good WLB group (18.7% and 23.6%, respectively). In the logistic regression analysis, the adjusted odds ratio of WLB for occupational injury was 1.37 (95% confidence interval [CI]: 1.06–1.78), and that for musculoskeletal pain was 1.14 (95% CI: 1.07–1.21), showing positive associations of WLB with both occupational injury and musculoskeletal pain. @*Conclusions@#Poor WLB causes an increase in occupational injury and musculoskeletal pain.Therefore, an improvement in WLB may reduce the incidence of occupational injury and musculoskeletal pain among workers. Social and policy-related initiatives are needed to improve workers' WLB to reduce occupational injury and musculoskeletal pain.
الملخص
BACKGROUND/AIMS: Among irritants causing gastric ulcer, Helicobacter pylori (H. pylori) might be pivotal, after which eradication became essential way in either inhibiting ulcerogenesis or preventing ulcer recurrence. Since threonine is essential in either mucus synthesis or cytoprotection, we hypothesized that the dietary threonine from Corynebacterium glutamicum (C. glutamicum) can mitigate the cytotoxicity of H. pylori infection.MATERIALS AND METHODS: RGM-1 cells were challenged with 100 multiplicity of infection H. pylori for 6 hours, during which threonine alone or combination with Corynebacterium sp. was administered and compared for anti-Helicobacter, anti-inflammation, anti-oxidative, and cytoprotective actions.RESULTS: Threonine alone or combination of threonine and C. glutamicum yielded significant bacteriostatic outcomes. The increased expressions of interleukin (IL)-1β, IL-8, Cox-2, and iNOS mRNA after H. pylori infection were significantly decreased with either threonine alone or the combination of threonine and C. glutamicum. The elevated expressions of NF-kB, HIF-1a, and c-jun after H. pylori infection were all significantly decreased with the combination of threonine and broth from C. glutamicum (P < 0.05), leading to significant decreases in 2′,7′-dichlorofluorescein-diacetate (P < 0.01). Tracing further host antioxidative response, the attenuated expression of heme oxygenase-1, Nrf2, and dehydrogenase quinone-1 after H. pylori infection was significantly preserved with combination of threonine and C. glutamicum. H. pylori infection led to significant increases in apoptosis accompanied with Bcl-2 decreases and Bax increases, while the combination of threonine and C. glutamicum significantly attenuated apoptosis, in which attenuated EGF, TGF-β, and VEGF were significantly regulated, while β-catenin did not change.CONCLUSIONS: Threonine synthesized from C. glutamicum significantly alleviated the cytotoxicity of H. pylori in gastric epithelial cells.
الموضوعات
Apoptosis , Corynebacterium glutamicum , Corynebacterium , Cytoprotection , Epidermal Growth Factor , Epithelial Cells , Helicobacter pylori , Heme Oxygenase-1 , Interleukin-8 , Interleukins , Irritants , Mucus , NF-kappa B , Oxidative Stress , Oxidoreductases , Recurrence , RNA, Messenger , Stomach Ulcer , Thiram , Threonine , Ulcer , Vascular Endothelial Growth Factor Aالملخص
BACKGROUND: The objective of this study was to compare differences in lifestyle diseases, musculoskeletal pain, psychosocial stress, and self-health awareness according to gender in Korean farmers. METHODS: The study population comprised 436 farmers residing in rural areas in Korea. A self-administered questionnaire was used to survey demographic characteristics, health-related behaviors, and musculoskeletal pain. The psychosocial well-being index short form (PWI-SF) was used to survey psychosocial stress, and the 12-item short form health survey (SF-12) was used to survey self-health awareness. In addition, a clinical examination was performed for each participant, and lifestyle diseases were identified through a health checkup. RESULTS: Among lifestyle diseases, females showed a significantly higher proportion than males for metabolic syndrome (OR: 4.57 [95% CI, 1.67–12.51]). For musculoskeletal pain, females again showed significantly higher proportion than males for hand pain (OR: 16.79 [95% CI, 3.09–91.30]), and pain in at least one body part (OR: 2.34 [95% CI, 1.16–4.70]). For psychosocial stress, females showed a significantly higher proportion than males for high-risk stress (OR: 3.10 [95% CI, 1.17–8.24]). Among the items in self-health awareness, females showed significantly higher proportion than males for mental component score (MCS) (OR: 3.10 [95% CI, 1.52–6.31]) and total score (OR: 2.34 [95% CI, 1.11–4.90]). CONCLUSIONS: For all items that showed significant differences, females showed higher proportion than males, which indicates that female farmers tended to have poorer overall health than male farmers. Therefore, specialized programs will have to be developed to improve the health of female farmers.
الموضوعات
Female , Humans , Male , Farmers , Hand , Health Surveys , Korea , Life Style , Musculoskeletal Diseases , Musculoskeletal Painالملخص
Objective To perform the separation and confirmation of mixed semen stains with immunological test method, and find a more effective method for the detection of mixed semen stains. Methods The semens of three volunteers were mixed. The mixed semen stains were processed and tested with prostate-specific antigen (PSA) colloidal gold immunoassay strip method, immunomagnetic beads method and laser capture microdissection, respectively. Statistics of the results of STR were gathered and compared with those of a single semen stain. Results After PSA colloidal gold immunoassay strip method testing, the samples showed a purplish red line in the test area and the control area. The results obtained with the immunomagnetic beads method showed a more complete and effective short tandem repeat (STR) sequence. The mixed semen stains were processed with laser capture microdissection and low volume amplified. The results were summarized and superimposed to obtain a complete single typing, which matched the single semen stain typing, with a typing success rate of 84.00%. Single suspect Y-STR typing was obtained with the application of the method above in actual cases, which provided evidence basis for rapid solving of the case. Conclusion The combination of PSA colloidal gold immunoassay strip method, immunomagnetic beads method and laser capture microdissection can be used to separate and confirm the mixed semen stains.
الموضوعات
Humans , Male , Coloring Agents , DNA Fingerprinting , Forensic Medicine , Immunologic Tests , Microsatellite Repeats , Semenالملخص
PURPOSE: In recent years, there has been an increasing focus on thyroid function in pediatric obese patients, but no nationwide study evaluating the relationship between thyroid function and obesity has yet been conducted in Korea. We aimed to evaluate thyroid dysfunction in obese Korean children. METHODS: We analyzed the associations between obesity and thyroid hormone levels among 975 Korean boys and girls aged 10–18 years and who participated in the Korean National Health and Nutrition Examination Survey VI (2013–2015). RESULTS: Average serum thyrotropin (TSH) and serum free thyroxine (fT4) levels in the nonobese group were 2.7±0.1 μIU/mL and 1.3±0.0 ng/dL, respectively, and those in the overweight group were 3.1±0.2 μIU/mL and 1.2±0.0 ng/dL. Serum TSH level was significantly higher in the abdominal obesity group than in the normal group (P=0.023). fT4 level was significantly lower in both the overweight and abdominal obesity groups than in the normal group (P < 0.001, P=0.014). Serum TSH level was associated positively with abdominal obesity and levels of high-density lipoprotein cholesterol and triglyceride. Serum fT4 level was negatively correlated with abdominal obesity (P=0.014). CONCLUSIONS: Korean children with abdominal obesity showed increased TSH and decreased fT4 levels compared to normal children.
الموضوعات
Adolescent , Child , Female , Humans , Cholesterol , Korea , Lipoproteins , Nutrition Surveys , Obesity , Obesity, Abdominal , Overweight , Thyroid Gland , Thyrotropin , Thyroxine , Triglyceridesالملخص
Objective: To investigate the characteristics of magnetic resonance imaging (MRI) for primary hepatic fibrosarcoma so as to enhance the cognition for primary hepatic fibrosarcoma. Methods: The clinical documents, laboratory data and manifestations of MRI and pathology of 1 patient with primary hepatic fibrosarcoma were researched by using retrospective analysis, and the previously relevant literatures were combined to analyze and summarize MRI imaging characteristic of primary hepatic fibrosarcoma. Results: The primary hepatic fibrosarcoma has series of characteristics included of lower incidence, wider range of age, usual occurrence in male, without hepatitis history and background of liver cirrhosis, without specificity on clinical symptoms, sign and laboratory examination, and with symptoms of stomachache and glycopenia in part of patients. And the manifestations of MRI included that liver has larger phyma, and the most of boundary of phyma were clearness, and the necrosis, cystic change and bleeding could be found in inner of phyma, and there was no calcification, and hematogenous metastasis often occurred and lymphatic metastasis was rare. The enhanced scan showed that tumor wall, tumor septa and solid component have been continuously enhanced. And the pathological manifestation of primary hepatic fibrosarcoma showed that it was spindle cell sarcoma. And the results of immunohistochemistry indicated that alpha fetoprotein (AFP) was (-), and smooth muscle actin (SMA) was (+) and vimentin was (+). Conclusion: Hepatic fibrosarcoma is rare in clinical practice, but its malignancy is pretty high and its prognosis is poor. To enhance the cognition about the characteristics of MRI about primary hepatic fibrosarcoma would contribute to correctly diagnose it.
الملخص
Objective To evaluate the effect of sevoflurane on hippocampal cyclic AMP (cAMP)-protein kinase A (PKA)-cAMP response element-binding protein (CREB) signaling pathway in aged rats.Methods Sixty healthy aged male Sprague-Dawley rats,aged 18 months,weighing 600-750 g,were divided into control group (C group,n =30) and sevoflurane group (group Sev,n =30) using a random number table method.Group Sev inhaled 2% sevoflurane for 4 h.Group C inhaled the mixture of 50% air and oxygen (2 L/min) for 4 h.Morris water maze test was performed on 1-6 days before anesthesia and at 1 day after the end of anesthesia (at the corresponding time points in group C).The animals were sacrificed and hippocampi were removed at 1,3 and 7 days after anesthesia (at the corresponding time points in group C) for determination of the hippocampal cAMP content (using enzyme-linked immunosorbent assay) and expression of hippocampal CREB,phosphorylated CREB (p-CREB) and PKA (using Western blot),and the p-CREB/CREB ratio was calculated.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,the frequency of crossing the original platform was decreased,the time of staying at the original platform quadrant was shortened at 1 day after the end of anesthesia,and the expression of hippocampal cAMP and PKA was down-regulated at 1,3 and 7 days after the end of anesthesia,and the expression of CREB and p-CREB was down-regulated and p-CREB/CREB ratio was decreased at 1 day after the end of anesthesia in group Sev (P< 0.05).Conclusion The mechanism of sevoflurane-induced postoperative cognitive dysfunction may be related to inhibiting hippocampal cAMP-PKA-CREB signaling pathway in aged rats.
الملخص
BACKGROUND: This study was conducted to identify the sleep status of daytime workers who do not work in shifts. This study analyzed factors affecting sleep duration and sleep quality. METHODS: This study was conducted on 1171 daytime workers at a manufacturing workshop. We used a self-administered questionnaire to investigate demographic variables, work type, working period, musculoskeletal symptoms and the Pittsburgh Sleep Quality Index to assess sleep. Regular health checkup was conducted for the worker’s clinical examination. RESULTS: The mean sleep duration was 6.36 h and the mean score on the Pittsburgh Sleep Quality Index was 4.46. Work type and obesity were related to sleep duration. Age, obesity and musculoskeletal pain were significantly related to sleep quality. The prevalence ratio of researcher group for short sleep duration was 1.27 (95% confidence interval: 1.02–1.58). The prevalence ratio of those aged 50 years and over was 0.47 (0.25–0.91) and of those in their 40s was 0.56 (0.35–0.91) for poor sleep quality compared to those in their 20s. The prevalence ratio of the obesity group for poor sleep quality was 1.53 (1.10–2.12). The prevalence ratio of musculoskeletal pain group for poor sleep quality was 1.92 (1.29–2.84). CONCLUSIONS: Age, obesity and musculoskeletal pain were factors affecting the poor quality on sleep of daytime workers. In addition, work type related to short sleep duration.
الموضوعات
Education , Musculoskeletal Pain , Obesity , Prevalenceالملخص
PURPOSE: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. METHODS: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. RESULTS: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0–2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). CONCLUSIONS: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.
الموضوعات
Child , Humans , Abdominal Pain , Academies and Institutes , Bacteria , Diarrhea , Enterotoxins , Fever , Gastroenteritis , Incidence , Local Government , Medical Records , Prevalence , Public Health , Seasons , Seoul , Staphylococcus aureus , Staphylococcus , Vomitingالملخص
BACKGROUND: Tranexamic acid has been used to reduce bleeding after total knee arthroplasty in patients for the reason of big trauma and blood loss. Diabetes mellitus patients may have the poor ability to resist infection and heal tissue and vascular lesions. There are still no relevant literature reports about whether the application of tranexamic acid will achieve hemostasis and does not increase the risk of venous thrombosis of lower limbs.OBJECTIVE: To evaluate the efficacy and safety of tranexamic acid on perioperative blood loss in osteoarthritis or rheumatoid arthritis patients complicated with type 2 diabetes mellitus during total knee arthroplasty.METHODS: One hundred patients with the diagnosis of osteoarthritis or rheumatoid arthritis patients complicated with type 2 diabetes mellitus were selected between January 2013 and January 2015. Among all the subjects, 46 patients who received the operation before January 2014 served as the control group and 54 patients who received the operation after January 2014 were selected as the treatment group. Patients in the treatment group received 15 mg/kg tranexamic acid dissolved in 250 mL normal saline by fast intravenous infusion before the end of the operation. The patients in the control group just received 250 mL normal saline. Perioperative bleeding, blood transfusion, hemoglobin, hematocrit and coagulation index level were compared between the two groups, and deep venous thrombosis of lower limbs was observed.RESULTS AND CONCLUSION: (1) The postoperative drainage, hidden blood loss, total blood loss, transfusion volume,and transfusion rate in the treatment group were lower than that in control group (P < 0.05). (2) The levels of hemoglobin and hematokrit in the two groups were not significantly different, but decreased at 3 hours, 1 and 3 days after the surgery,and increased at 5 days postoperatively, but still lower than preoperatively. The levels of hemoglobin and hematokrit in the treatment group were significantly higher than that in the control group at different time points postoperatively (P <0.05). (3) Prothrombin time, activated partial thromboplastin time, and fibrinogen were not significantly different preoperatively, during tourniquet removal, at 3 hours, 1 and 5 days postoperatively between the two groups. D-dimer levels were not significantly different preoperatively and during tourniquet removal in both groups, but increased at 3 hours, 1 and 5 days postoperatively; moreover, D-dimer levels were significantly lower in the treatment group than in the control group (P < 0.05). D-dimer levels were not significantly different between the two groups at 5 days after surgery. (4)Deep venous thrombosis of lower limbs was not visible in double lower limb venous ultrasonography in both groups at 5 days and 1 month postoperatively. (5) To decrease the blood loss, intravenous infusion of 15 mg/kg of tranexamic acid during total knee arthroplasty before tourniquet removel is effective and safe in osteoarthritis or rheumatoid arthritis patients complicated with type 2 diabetes mellitus.
الملخص
PURPOSE: Quadriplegic children with cerebral palsy are more susceptible to osteoporosis because of various risk factors that interfere with bone metabolism. Pamidronate is effective for pediatric osteoporosis, but there are no guidelines for optimal dosage or duration of treatment in quadriplegic children with osteoporosis. We aimed to evaluate the efficacy of low-dose pamidronate treatment in these patients. METHODS: Ten quadriplegic patients on antiepileptic drugs (6 male, 4 female patients; mean age, 10.9±5.76 years), with osteoporosis and gross motor function classification system level V, were treated with pamidronate (0.5–1.0 mg/kg/day, 2 consecutive days) every 3–4 months in a single institution. The patients received oral supplements of calcium and vitamin D before and during treatment. The lumbar spine bone mineral density (BMD) z score and biochemical markers of bone metabolism were measured regularly during treatment. RESULTS: The main underlying disorder was perinatal hypoxic brain damage (40%, 4 of 10). The mean cumulative dose of pamidronate was 4.49±2.22 mg/kg/yr, and the mean treatment period was 10.8±3.32 months. The BMD z score of the lumbar spine showed a significant increase from −4.22±1.24 before treatment to −2.61±1.69 during treatment (P=0.008). Alkaline phosphatase decreased during treatmentn (P=0.037). Significant adverse drug reactions and new fractures were not reported. CONCLUSION: Low-dose pamidronate treatment for quadriplegic children with cerebral palsy increased lumbar BMD and reduced the incidence of fracture.
الموضوعات
Child , Female , Humans , Male , Alkaline Phosphatase , Anticonvulsants , Biomarkers , Bone Density , Calcium , Cerebral Palsy , Classification , Drug-Related Side Effects and Adverse Reactions , Hypoxia, Brain , Incidence , Metabolism , Osteoporosis , Quadriplegia , Risk Factors , Spine , Vitamin Dالملخص
Grover disease (also known as transient or persistent acantholytic dermatosis) is a pruritic polymorphic papulovesicular eruption that is histologically characterized by the presence of epidermal acantholysis. It primarily occurs in middle-aged individuals and manifests as scattered erythematous or brown papules as well as papulovesicles on the sun-exposed skin of the trunk. A 52-year-old man had erythematous papules and patches linearly arranged on the left thigh and leg with mild pruritus. The skin lesions were successfully treated with a topical corticosteroid. However, 2 months later, the lesions recurred. The histological examination of a punch biopsy revealed focal acantholytic clefts with dyskeratotic cells, hyperkeratosis, and the infiltration of perivascular lymphocytes and eosinophils. Taken together with the late onset and lack of family history, we diagnosed this condition as Grover disease distributed along the Blaschko line, a condition presented here for the first time.
الموضوعات
Humans , Middle Aged , Acantholysis , Biopsy , Eosinophils , Leg , Lymphocytes , Pruritus , Skin , Thighالملخص
BACKGROUND: Iron pots have long been used for cooking in several countries. Early studies have shown that the use of such iron pots can increase the iron content of food cooked in them and that this increased iron content has some effect on iron uptake. This study was designed to evaluate the iron content in rice cooked in a traditional iron pot and study the iron uptake by macrophages through heme oxygenase-1 (HO-1). METHODS: The iron pot used in this study was round-shaped and had no legs. The iron content of rice cooked in the iron pot was measured. Thereafter, the bioavailability of iron was measured using western blot analysis. RESULTS: A total of 35 samples were analyzed for iron concentrations, which were 10.94±18.08 mg/L (range: 0.18–56.53 mg/L). The biochemical activity in most of materials was 1.5–9 times that of the activity observed in the control group. CONCLUSION: The iron concentration of rice cooked in iron pots were found to be relatively high. The introduction of iron pots in routine cooking practices may be a promising way of increasing the supply of iron, especially for people with severe iron deficiency anemia. Further, increased activity of HO-1, induced by supplementation of iron from the cast iron, may help in maintaining iron homeostasis.