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Gastroesophageal reflux disease (GERD) is a frequently and commonly occurring disease in clinic. In recent decades, with the development in pathophysiology and drug researches, modern medicine has achieved remarkable progress and results in diagnosis and treatment. However, the treatments for non-erosive reflux disease, refractory gastroesophageal reflux disease, proton pump inhibitor resistance, overlap of disease symptoms, and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine (TCM) was widely used in clinical practice, which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine (CACM) and undertaken by the Spleen and Stomach Disease Branch of CACM, "the 12th Youth Salon of Clinical Predominance Disease Series (GERD)" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions, improvement and maintenance of symptoms, response to overlapping disease symptoms, reduction and withdrawal of acid suppressors, and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths, combing the difficulties of modern medical diagnosis and treatment, which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.
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Introduction: The reasons for tooth loss have been well defined for several centuries. However, systematic analysis of the causes of tooth loss in the first years of the present century would shed light on the current manifestation of this phenomenon. Objective: Determine the main causes of tooth mortality in the last 20 years. Methods: A systematic review was conducted using the Boolean search engines in PubMed, Web of Science, Scopus and SciELO bibliographic search platforms. The search was based on the following MeSH terms: cause, motive, mortality, extraction, dental extraction, loss, and combinations thereof. The articles included were in English or Spanish. Calibration was performed by the authors to evaluate the articles to be selected. Results: A total 593 articles were retrieved: 16 from Web of Science, 39 from Scopus, 531 from Pubmed and 1 from SciELO, of which 26 were included in the study. A predominance was found of articles published in English (80.8 percent). The main causes of tooth mortality dealt with were dental caries (92.30 percent) and periodontal disease (50.0 percent). Conclusions: The evidence obtained in the last 20 years is insufficient to determine the main reasons for dental extraction by continent. There is little availability of articles about areas from the most densely populated and developed countries in each continent. The articles included showed a predominance of dental caries and periodontal disease as the main reasons for dental extraction(AU)
Introducción: Las razones de la pérdida dentaria han sido bien definidas desde hace varios siglos. Sin embargo, sistematizar sobre las causas en los primeros años del presente siglo aportaría una visión de cómo se manifiestan en la actualidad. Objetivo: Determinar las principales causas de mortalidad dental en los últimos 20 años. Métodos: Se realizó una revisión sistemática utilizando los motores de búsqueda booleanos en la plataforma de búsqueda bibliográfica de PubMed, Web of Science, Scopus y SciELO. Las palabras clave utilizadas para la búsqueda fueron MesH: causa, motivo, mortalidad, extracción, extracción dental, pérdida y una combinación entre ellas. Se incluyeron artículos en español e inglés. Se realizó una calibración entre los autores para la evaluación de los artículos a seleccionar. Resultados: Como resultado de la búsqueda se obtuvieron 593 artículos, de los cuales 16 fueron de Web of Science, 39 de Scopus, 531 de Pubmed y 1 de SciELO. Los artículos incluidos en el estudio fueron 26. Predominaron las investigaciones publicadas en inglés (80,8 por ciento), que destacó entre los motivos de mortalidad dental estudiados, se encontró un predominio de caries dental (92,30 por ciento) y enfermedad periodontal (50,0 por ciento). Conclusiones: La evidencia obtenida en los últimos 20 años para determinar las principales razones de extracción dentaria por continentes es insuficiente y se observa la poca presencia de artículos en poblaciones de países con mayor desarrollado y número de habitantes de cada continente. Los artículos incluidos mostraron un predominio de la caries dental y la enfermedad periodontal como los principales motivos de extracción dentaria(AU)
الموضوعات
Humans , Periodontal Diseases/mortality , Tooth Extraction , Dental Caries , Review Literature as Topic , Developed Countries , Databases, Bibliographic , Search Engineالملخص
Resumen El Staphylococcus aureus es uno de los principales microorganismos causantes de mastitis subclínica en las vacas lecheras. Determinar la prevalencia del S. aureus se hace necesario en vacas de hatos lecheros grandes y pequeños ubicados en la región norte, centro y sur del departamento del Valle del Cauca, Colombia. Se utilizó la metodología del National Mastitis Council recolectando 1070 muestras de leche de 273 vacas en 17 hatos mediante un muestreo polietápico, durante el periódo 2015 - 2016. Se realizó cultivo con todas las muestras recolectadas independientemente del resultado de la prueba de California mastitis test. Se utilizó el análisis bayesiano de los datos para obtener estimaciones más precisas. La prevalencia bayesiana del patógeno S. aureus en vacas lecheras en el Valle del Cauca fue de 31,94% y se tiene un 95% de probabilidad de que el intervalo (30,03 - 37,62%) contenga el valor de dicha prevalencia. La región Norte, Centro y Sur evidenciaron prevalencias de 33%, 34% y 24% respectivamente. En cuanto al tamaño del hato se evidenció que las vacas de los hatos pequeños presentan mayor prevalencia con 47% que las vacas de los hatos grandes 17% a la presencia del patógeno. La alta prevalencia encontrada en las vacas genera un alto impacto en la salud pública debido a una posible contaminación zoonótica por este patógeno.
Abstract Staphylococcus aureus is one of the main microorganisms responsible of subclinical mastitis in dairy cows. To determine the bayesian prevalence of S. aureus of cows in large and small dairy farms located in the northern, central and southern region of the Valle del Cauca province in Colombia. We Followed the National Mastitis Council methodology, 1070 milk samples from 273 cows in 17 dairy farms by means of a multi-stage sampling, were collected during the period 2015-2016. Cultivation was carried out with all the samples. Bayesian inference was used. The prevalence of the pathogen S. aureus in dairy cows in Valle del Cauca is 31,94% and there is a 95% probability that the interval (30,03 - 37,62%). The North, Central and South regions showed prevalence values of 33%, 34% and 24% respectively. Small dairy farms have prevalence, 47%, large dairy farms 17%. The high prevalence found in the cows studied generates a high impact on public health due to possible zoonotic contamination by this pathogen.
Resumo O Staphylococcus aureus é um dos principais microrganismos causadores de mastite subclínica em vacas leiteiras. Determinar a prevalência de S. aureus em vacas de leite em pequenas e grandes rebanhos leiteiros localizados região no norte, centro e sul do estado do Valle del Cauca, Colômbia. A metodologia do Conselho Nacional de Mastite 1070 foi utilizado para coletar amostras de leite de 273 vacas em 17 rebanhos através de amostragem de vários estágios durante o período 2015 - 2016. O cultivo foi realizado com todas as amostras coletadas, independentemente do resultado do teste de mastite Califórnia. O análise Bayesiana dos dados foi utilizada para obter estimativas mais precisas. Bayesian prevalência de agentes patogénicos S. aureus em vacas leiteiras no Valle foi 31,94% e tem uma probabilidade de 95% com um intervalo 30,03% - 37,62%. As regiões Norte, Central e Sul apresentaram prevalências de 33%, 34% e 24%, respectivamente. Em relação ao tamanho do rebanho, ficou evidente que as vacas dos pequenos rebanhos apresentam maior prevalência do patogeno com 47% comparado com 17% nas vacas dos grandes rebanhos. A alta prevalência encontrada nas vacas estudadas gera alto impacto na saúde pública, agravado pelo fato de metade do leite consumido na Colômbia ser cru.
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Resumen Se determinaron las condiciones más favorables para la síntesis de hidróxido de níquel (II) por precipitación química a partir de la disolución lixiviada del sulfuro de níquel de la tecnología Caron. La disolución lixiviada de fuerza iónica igual a 4,6 mol-L-1 fue tratada con hidróxidos de amonio y sodio. Se calcularon las propiedades termodinámicas como entalpía, entropía y energía libre y se construyeron diagramas de zona de predominancia. Se demostró la conveniencia de realizar el proceso a 303 K, pH entre 11 y13 y concentración de amoníaco de 0,5 a 1,0 mol•L-1. En estas condiciones fueron obtenidas altas eficiencias de precipitación de los cationes metálicos de la disolución inicial. El sólido precipitado se caracterizó mediante espectrometría de absorción atómica y difracción de rayos X. Se obtuvo un beta-hidróxido de níquel (II) con la siguiente composición química: 58,5 ≤ Ni ≤ 59,1%, 1,7 ≤ Co ≤ 2,1%, 0,5 ≤ Fe ≤ 0,6%, Cu, Zn, Mn y Mg ≤ 0,2%.
Abstract The most favorable conditions for the synthesis of nickel (II) hydroxide were determined by chemical precipitation, from the leached solution of nickel sulfide from the Caron technology. The leached solution with an ionic strength equal to 4.6 mol-L-1 was treated with ammonium and sodium hydroxides. Thermodynamic properties such as enthalpy, entropy, and free energy were calculated and predominance zone diagrams were constructed. The convenience of performing the process at 303 K, pH between 11 and 13, and ammonia concentration of 0.5 to 1.0 mol•L-1 was demonstrated. Under these conditions, high precipitation efficiencies of the metal cations from the initial solution were obtained. The precipitated solid was characterized by atomic absorption spectrometry and X-ray diffraction. Nickel (II) beta-hydroxide with the following chemical composition was obtained: 58.5 ≤ Ni ≤ 59.1%, 1.7 ≤ Co ≤ 2.1%, 0.5 ≤ Fe ≤ 0.6%, Cu, Zn, Mn and Mg ≤ 0.2%.
Resumo As condições mais favoráveis para a síntese do hidróxido de níquel (II) foram determinadas por precipitação química, a partir da solução lixiviada de sulfeto de níquel da tecnologia Caron. A solução lixiviada de força iônica igual a 4,6 mol-L-1, foi tratada com hidróxidos de amônio e sódio. Foram calculadas propriedades termodinâmicas, como entalpia, entropia e energia livre, e diagramas de zonas de predominância foram construídos. Foi demonstrada a conveniência de realizar o processo a 303 K, pH entre 11 e 13 e concentração de amônia de 0,5 a 1,0 mol•L-1. Nessas condições, foram obtidas altas eficiências de precipitação dos cátions metálicos da solução inicial. O sólido precipitado foi caracterizado por espectrometria de absorção atômica e difração de raios-x. Foi obtido beta-hidróxido de níquel (II) com a seguinte composição química: 58,5 ≤ Ni ≤ 59,1%, 1,7 ≤ Co ≤ 2,1%, 0,5 ≤ Fe ≤ 0,6%, Cu , Zn, Mn e Mg ≤ 0,2%.
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Background:The objective of the study was to determine the pattern of disparities among paediatric hospital admissions according to gender.Methods:This retrospective observational study was done at pediatric ward of Al-Tibri Medical College and Hospital Karachi from June 2018 to May 2019. Pediatric patients below 12 years of age admitted to the pediatric ward of the hospital were included while patients who were admitted for less than 24 hours, refused for consent by parent/guardian, surgical or ICU pediatric patients were excluded. SPSS was used for data analysis. Quantitative data included age, gender, diagnosis and seasonal variation, expressed as frequency in percentages and chi-square test was applied to test for significance.Results:Among 734 pediatric hospital admissions, 423 (58%) were males and 311 (42%) females. Highest percentages of pediatric admission in both genders were infants afterwhich second most patients were from the 1-4 years group in both genders (p=0.01). 215 patients of acute gastroenteritis were male while 142 females. Among patients admitted with respiratory disease, 56 were males while 48 were females. 52 male patients were admitted with viral fever while 34 patients admitted were females (p=0.01).Conclusions:Our study reported a significant difference among gender variances in pediatric hospital admissions. Overall, not only males were predominant in admission to pediatric wards, they were also found to be predominant in disease categorization. Further studies set to determine the reasons behind such gender differences would help in determining plans accordingly to improve outcome of diseases
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Background: Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response. Aim: The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient. Materials and Methods: The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology. Results: Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern. Conclusion: The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.
الموضوعات
Capillaries/pathology , Carcinoma, Squamous Cell/immunology , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/secondary , Endothelial Cells/pathology , Endothelium, Vascular/pathology , Forecasting , Germinal Center/pathology , Histiocytosis, Sinus/pathology , Humans , Hyperplasia , Lymph Nodes/immunology , Lymph Nodes/pathology , Lymphatic Metastasis/immunology , Lymphatic Metastasis/pathology , Lymphocytes/pathology , Macrophages/pathology , Mouth Neoplasms/immunology , Mouth Neoplasms/pathology , Neck Dissection/methods , Prognosis , Risk Factorsالملخص
PURPOSE: To study the relationship between the distribution of the ocular surface temperature and the nasal predominance in pterygium. METHODS: In order to identify the distribution of the ocular surface, the surface temperature was measured at four points on the eyelids and on the bulbar conjunctiva with a non-contact thermometer. The ocular surface temperature in the pterygium patient group was compared with that in a normal control group. The temperature difference at each point on the ocular surface was also examined. RESULTS: In both of the patient and the normal groups, the surface temperature on the eyelid was at its lowest on the temporal lower eyelid, and highest on the nasal upper eyelid. On the bulbar conjunctiva, the surface temperature of the nasal conjunctiva was at its lowest, and at its highest on the upper conjunctiva. The most distinctive temperature difference between the patient and control groups was shown on the nasal and temporal bulbar conjunctivas, and statistically significant (p<0.05). CONCLUSIONS: Considering the temperature distribution over the ocular surface, we propose that an intrinsic factor that causes the nasal predominance of pterygium could be the comparatively low local temperature of the nasal bulbar conjunctiva.
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Humans , Conjunctiva , Eyelids , Intrinsic Factor , Pterygium , Thermometersالملخص
Congenital myopathies are clinical and genetic heterogeneous disorders characterized by skeletal muscle weakness and specific structural changes in muscle fiber. Congenital myopathy with fiber type disproportion (CFTD) is an established disorder of congenital myopathy. CFTD is characterized by non-progressive childhood neuromuscular disorders with a relatively good prognosis and type 1 fiber predominance and smallness. Congenital myopathy with type 1 fiber predominance (CMT1P) is also a distinct entity of congenital myopathy characterized by non-progressive childhood neuromuscular disorders and type 1 fiber predominance without smallness. Little is known about CMT1P. Clinical characteristics, including dysmorphic features such as hip dislocation, kyphoscoliosis, contracture, and high arch palate, were analyzed along with laboratory and muscle pathologies in six patients with CMT1P and three patients with CFTD. The clinical manifestations of CFTD and CMT1P were similar. However, the frequency of dysmorphic features is less in CMT1P than in CFTD. Long term observational studies of CMT1P are needed to determine if it will change to another form of congenital myopathy or if CMT1P is a distinct clinical entity.
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Male , Infant , Humans , Female , Child, Preschool , Child , Adult , Myopathies, Structural, Congenital/diagnosis , Muscular Diseases/pathology , Muscles/pathology , Biopsyالملخص
Severe bradycardia and asystole are uncommon complications during epidural anesthesia but can be life threatening if not properly managed. There are several risk factors including baseline bradycardia, first degree AV block, preoperative beta-blocker, male gender, high sensory block level, and American Society of Anesthesiologists (ASA) physical status class 1. A 48-year-old, ASA class 1, male patient was admitted for the repair of a ventral hernia under epidural anesthesia. Approximately 60 minutes after the epidural anesthesia, heart rate decreased markedly to 10/min without loss of consciousness and a decrease in saturation. The heart rate returned to 90/min after administering atropine. We concluded that severe bradycardia was induced by vagal activation as a result of the low venous return and high sympathetic blockade (T4 sympathetic level).
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Humans , Male , Middle Aged , Anesthesia, Epidural , Atrioventricular Block , Atropine , Bradycardia , Heart Arrest , Heart Rate , Hernia, Ventral , Risk Factors , Unconsciousnessالملخص
Type 2 fiber predominance or a decrease of the type 1/type 2 ratio was rarely reported as the only abnormal pathologic finding in patients suffering from muscle cramp and myalgia. Here, we describe the clinicopathologic findings of three cases of type 2 fiber predominance, presented with muscle cramp and myalgia in otherwise healthy patients. All of them were young men (18, 19 and 22 years). Light microscopic and neurologic examinations, and laboratory data showed mere nonspecific findings that were not concordant with their subjective symptoms. However, enzyme histochemistry performed on muscle biopsy revealed an increased fraction of type 2 fibers; 73%, 80%, and 75%, in each case. The pathogenesis of this entity remains unclear, but the recognition of this unusual clinicopathologic entity is important for both pathologists and neurologists so they can avoid misdiagnoses or unnecessarily tiresome studies. We emphasize that type 2 fiber predominance should be included in the underlying causes of unexplained muscle cramps and exertional myalgia, especially among young adults, although it remains unclear whether the fiber type predominance is a separate entity or a part of other underlying neurologic or systemic disorders.
الموضوعات
Humans , Male , Young Adult , Biopsy , Diagnostic Errors , Muscle Cramp , Myalgia , Neurologic Examinationالملخص
[ Objective ] To investigate the decisive factor of syndrome differentiation of systemic lupus erythematosus (SLE) , so as to provide its experimental evidence. [Methods] Serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in SLE patients with yin deficiency of the liver and kidney (group B) and with excessive toxic heat (group C) were detected by enzyme-linked immunosorbent assay (ELISA) . Serum levels of sICAM-1 and sVCAM-1 in SLE patients were compared with those in healthy volunteers (group A). Relationship of serum C-reaction protein (CRP), complement 3 ( C3) and complement 4 (C4) with sICAM-1 and sVCAM-1 as well as relationship between sICAM-1 and sVCAM-1 in SLE patients were observed. [ Results ] Serum levels of sICAM-1 and sVCAM-1 in groups B and C were higher than those of group A ( P
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To find out the clustering of HBV carriers within a family, 50 HBsAg carriers were studied. The distribution of HBsAg was found to be high (33%) among the offspring of HBsAg negative father and positive mother when compared to positive father and negative mother (16%) or where both the parents were HBsAg negative (31%0. The frequency of HBV DNA was also found to be high among the offspring of HBV DNA negative father and HBV DNA positive mother (25%). Male infection leading to a clustering of HBsAg carrier families.
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The authors reviewed angiographic findings of 96 cases of ruptured anterior communicating artery aneurysms that were operated at the Department of Neurosurgery of Hanyang University Hospital from Jan. 1986 to June 1990. The results were summarized as follows ; 1) Asymmetricity of caliber of A1 was observed in 71.9%(69/96) and which was 3 times more frequent than that of reported incidence of control group(2~23%). 2) The incidence of predominance of left A1 was 54.2%(53/96) and that of right A1 was 17.7%(17/96). Among them, predominant A1 was operated as afferent artery of aneurysm in 94.2%(65/69). 3) Of 69 cases in which a unilateral A1 showed predominance, the direction of aneurysm was opposite to the side of predominant A1 in 66.7%(46/69) and ipsilateral to the predominant A1 in only 2.9%(2/69). 4) Above findings suggest that it is desirable to approach the anterior communicating artery aneurysm via the side of predominant A1 when the direction of aneurysm is uncertain on cerebral angiogram.