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Background: Haiti, like many low-income countries in crisis, has limited resources for etiologic diagnosis of vaginal discharge. As such, we sought to characterize variability in diagnoses of women presenting with vaginal discharge syndrome, with the goal to improve standardization of syndromic management. Materials and Methods: Participants aged 18 years and older endorsing vaginitis, or dysuria were recruited at Jerusalem Clinic over two, one-week periods in April 2018 and July 2019. We calculated Spearman rank correlations among history, exam findings, and diagnoses based on clinical presentation, to understand presentation groupings and their management. Results: Among 98 women, median age was 33.5 years, and most frequent symptoms were: vaginal discharge (97%), vaginal itch (73%), and/or suprapubic pain (68%). Most common physical exam findings were vaginal discharge (86%), suprapubic/lower quadrant tenderness (29%), cervical motion tenderness (24%), and cervical erythema (20%). Most symptoms and physical exam findings were weakly correlated with each other. Nearly one-third (31%) were diagnosed with normal physiologic vaginal discharge or no diagnosis, followed by Bacterial vaginosis (31%), vulvovaginal candidiasis (15%), cervicitis/PID (13%), and STI (7%). No reported symptoms strongly differentiated diagnostic categories. Diagnoses varied considerably by exam findings. Conclusions: The weak correlations between symptoms, exam findings, and diagnoses could represent variability in assessment. In the absence of reliable and accessible laboratory testing, the importance of standardizing syndromic management becomes increasingly relevant. Results from our study support the utility of speculum examination and more standardized documentation of physical exam findings. Next steps include the development of local algorithms to promote standardization of treatment of vaginal discharge syndrome.
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Chronic intestinal pseudo-obstruction(CIPO)is an intestinal motility dysfunction caused by intestinal myopathies or neuropathies or mesenchymopathies.The clinical manifestation is almost the same with mechanical intestinal obstruction,but in the absence of any obstruction in the gastrointestinal tract.According to etiology,it can be divided into primary and secondary.While according to gastrointestinal neuromuscular disorders,it can be categorized as myopathy,neuropathy and mesenchymopathy,which have different pathogenesis.The disease with the clinical manifestation,imaging examination or histopathology was diagnosed,but mechanical intestinal obstruction must be excluded.Presently,the therapies of CIPO mainly are stimulating the motility of intestine and ensuring the necessary nutrition of the children.The review is mainly focused on the research progress of the pathogenesis,clinical manifestation,diagnosis,therapy of pediatric CIPO in recent years.
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BACKGROUND: Micro-nano-sized modification of the material surface provides an effective way to enhance the endothelialization of cardiovascular implants. Shear stress plays an important role in the endothelialization of cardiovascular implants.OBJECTIVE: To review the effects of flow shear stress on endothelial cell cytoskeleton alignment, migration, adhesion and apoptosis on the micropatterned substrates.METHODS: The author performed a retrieval of PubMed and CNKI databases from 2002 to 2017 to search literatures about the effects of shear stress on endothelial cells on the micropatterned substrates. The keywords were micrometer topology, micropattern, flow shear stress, endothelial cells in English and Chinese, respectively.RESULTS AND CONCLUSION: The shear stress parallel to the long axis of the micropattern which is applied to the endothelial cells on micropatterned substrates promotes endothelial cell microfilaments alignment along the long axis direction of micropattern, strengthens endothelial cell migration along the flow direction, increases the level of FAK phosphorylation, enhances endothelial cell adhesion, and improves endothelial cell activity. However, there are some controversies on the effects of parallel shear stress on the microtubule arrangement of endothelial cells on micropatterned substrates. Some studies have reported that parallel shear stress promotes endothelial cell microtubules alignment along the long axis of micropatterns. But others have found that parallel shear stress has no effect on endothelial cell microtubule arrangement. There are different conclusions about the effects of shear stress perpendicular to the long axis of the micropattern on endothelial cells on the micropatterned substrates. Some literatures have found vertical shear stress destroys the structure of endothelial cell microfilaments and microtubules,weakens the degree of microfilaments and microtubules arranged along the long axis of micropatterns, and attenuates endothelial cell adhesion and cell activity. But some have found vertical shear stress does not destroy the structure and alignment of endothelial cell microfilaments and microtubules, and still can promote endothelial cell migration along the flow direction. The magnitude of shear force affects endothelial cell migration, and the number of endothelial cells on the micropatterned substrates migrating along the flow direction increases with the increasing intensity of shear stress.
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Objective:To explore the characteristics of attention during visual search tasks in adults with attention-deficit/hyperactivity disorder (ADHD).Methods:Totally 45 adult patients with ADHD who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV) and 44 healthy controls matched with age,gender and IQ were selected.The reaction time and accuracy rate of two groups were compared under visual search tasks of low and high visual working memory load.Results:The reaction time was longer in patients with ADHD than in the healthy controls in both low-load task [(823 ± 144) ms vs.(754 ± 123) ms,P ＜ 0.01] and highload task [(912 ± 163) ms vs.(851 ± 162) ms,P ＜ 0.01].Compared with the performance in low load task,the search reaction time was longer in high load task [ADHD group:(823 ± 144) ms vs.(912 ± 163) ms,P ＜ 0.01;control group:(754 ± 123) ms vs.(851 ± 162) ms,P ＜0.01] and the accuracy rate was lower during high load task than low load task[ADHD group:(95.9 ±4.3)％ vs.(91.2 ± 14.29)％;control group:(95.8 ± 4.2)％ vs.(94.4 ±4.9) ％,P ＜ 0.01] in both ADHD and control groups.Conclusion:The results suggest impairment in top-down attentional control in ADHD adults.When the visual working memory load is increasing,ADHD patients allocate more working memory resources on storing the target representation and less resources on visual attention,so the search efficiency may be influenced.
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Objective To study the expression and significance of Ezrin in triple negative breast cancer tissues .Methods We selected 102 cases ,including 24 ones of triple negative breast cancer ,58 ones of non‐triple negative breast cancer ,and 20 of benign breast disease .The expression of Ezrin in all the specimens was detected by SP immunohistochemistry .We observed whether there was any difference between the positive expression rates of Ezrin in the three groups . We also analyzed the correlation between Ezrin expression and clinicopathologic parameters of triple negative breast cancer .Results The positive expression rate of Ezrin in groups of triple negative breast cancer , non‐triple negative breast cancer , and benign breast disease was 15 .00% ,48 .28% and 75 .00% ,respectively . The difference between the three groups differed significantly ( P 0 .05 ) . Conclusion Ezrin is highly expressed in triple negative breast cancer tissues ;therefore , it can be used as an important indicator of poor prognosis of triple negative breast cancer .