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Utilization of Hands Treatments Right after Distal Distance Bone fracture: A nationwide Perspective.
51 months) (p = 0.040). Conclusion Around 54% of patients with MS survived two or more years following gastrostomy. Younger patients had better survival. The most frequent cause of death was respiratory infection. © The Author(s) 2020.in English, French Contexte Les complications infectieuses nécessitant un traitement néphrotoxique sont fréquentes chez les patients atteints de fibrose kystique (FK), ce qui exige une surveillance de leur fonction rénale. Quoique des études chez l’adulte suggèrent qu’en raison de la réduction de la masse musculaire, la mesure du DFGe basée sur la cystatine C (Cys-C) serait la méthode à privilégier, les patients pédiatriques demeurent sous-étudiés. Objectif Déterminer la meilleure formule de calcul pour estimer le DFG chez les enfants atteints de FK. Méthodologie Au total, 17 patients atteints de FK et traités avec des antibiotiques néphrotoxiques ont été recrutés à l’hôpital pour enfants du London Health Sciences Centre de London (Ontario, Canada). Le DFG mesuré par 99Tc DTPA (mDFG) a été mesuré en quatre points à partir de 120 minutes avec un modèle à deux compartiments, en appliquant la correction de Brøchner-Mortenson. Les taux de créatinine, d’urée et de CysC ont été mesurés simultanément. Le DFGe a été stées n’a bien fonctionné dans notre cohorte d’enfants atteints de FK avec une constitution physique préservée, possiblement en raison d’une inflammation provoquant une élévation du taux de Cys-C. Compte tenu de ces résultats, nous ne pouvons déterminer laquelle parmi ces formules de DFGe est la meilleure.Introduction Idiopathic hypereosinophilic syndrome is defined as persistently elevated peripheral blood absolute eosinophil count of more than 1.5 × 109/L for at least six months with no obvious secondary cause. Case Presentation We report the case of a 26-year-old gentleman of Malay ethnicity who presented to the medical department with a three-week history of abdominal distension associated with dyspepsia and epigastric pain. Physical examination revealed ascites. The complete blood count portrayed peripheral leucocytosis with eosinophilia of 8.84 × 109/L. Parasitic serology was negative. Paracentesis analysis showed exudative ascites with an absolute eosinophil count of 8 × 109/L. He was referred to the haematology department. He was noticed to have bilateral tonsillitis and pruritic skin rash at the legs. There were no palpable lymph nodes or organomegaly. A peripheral blood film showed 44% eosinophils with no excess blasts. Clonal eosinophilic fusion studies did not detect FIP1L1-PDGFRA mutation. JAK2 V617F and BCR-ABL1 mutations were undetected. Serum B12 and tryptase levels were normal. A whole-body computed tomography imaging showed bowel wall thickening at the duodenum, jejunum, ileum, rectosigmoid and splenic flexure. Sections of fragments taken from the endoscopy showed features of eosinophilic gastritis and colitis on histology. Bone marrow biopsy depicted marked eosinophilia. He was started on oral imatinib mesylate 200 mg daily and oral prednisolone 0.5 mg/kg daily which was tapered based on response. He achieved complete remission and is now asymptomatic. Conclusion The diagnosis of hypereosinophilic syndrome should be considered in a patient with unexplained ascites. Secondary sinister causes such as malignancy should always be excluded. © The Author(s) 2020.Aim Although pulse pressure variation is a good predictor of fluid responsiveness, its measurement is invasive. Therefore, a technically simple, non-invasive method is needed for evaluating circulatory status to prevent fluid loading and optimize hemodynamic status. We focused in the pulse-wave transit time (PWTT) defined as the time interval between electrocardiogram R wave to plethysmograph upstroke, which has been recently introduced to non-invasively assess cardiovascular response. In the present study, we evaluated the efficacy of pulse-wave transit time (PWTT) with ventilator-induced variation (PWTTV) in predicting fluid responsiveness. Methods We evaluated six domestic pigs weighing 46.0 ± 3.5 kg. After anesthesia induction, electrocardiogram, femoral arterial blood pressure, plethysmograph on the tail, and carotid artery blood flow were monitored and hemorrhage was induced by withdrawing 20 mL/kg blood over 20 min; 5 mL/kg blood volume was then autotransfused over 10 min. Then PWTTV and pulse pressure variation were measured at tidal volumes of 6 and 12 mL/kg. Results Area under the receiver operating curve values for the prediction of a >10% change in carotid artery blood flow were 0.979 for pulse pressure variation and 0.993 for PWTTV at a tidal volume of 6 mL/kg and 0.979 and 0.979, respectively, at a tidal volume of 12 mL/kg (all P 10% changes in carotid artery blood flow induced by autotransfusion. © 2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.Background Our pilot study has demonstrated improvements in health outcomes through participation in a new sport, light volleyball (LVB), among older adults. In response to the promising results of the LVB pilot study and the priority of allocating resources to the prevention of age-related fitness degradation by the Hong Kong (HKG) government, the present study aims to investigate the effectiveness of a LVB intervention on physical and psychological health attributes among older adults at a larger scale in HKG. Methods/design This study will apply both quantitative and qualitative methods with a large sample (approximately 315 participants). We will adopt a randomized controlled trial (RCT) design to further evaluate the effectiveness of a LVB intervention on health outcomes against a comparison group, Tai Chi (TC), and a control group (C). Older adults will be eligible to join the intervention if they are (a) aged 65 years and above; (b) living in the community independently; (c) absent of diagnosed cognitive impairment; (d) not regular participants in a structured PA program for two years preceding the study; and (e) able to achieve a passing score on the Timed-up-and-go test (TUG) and Abbreviated Mental Test (AMT).About 315 participants will be randomly assigned into 3 groups in 111 ratio. LVB group participants will receive 16-week LVB program; TC group will utilize a simplified 24-form Yang Style TC, and C group participants will be instructed to maintain their normal daily activity and join regular non-exercise social gatherings. Measurements will be collected before and after the intervention, and 6 months and 12 months after completion of the intervention. Discussion This intervention, if effective, will enhance older adult's physical and psychological health, and provide the data and evidence to support policymaking in relation to future PA promotion for older adults. Trial registration number ChiCTR1900026657. © The Author(s). 2020.Objectives Bacterial components are used to improve immune responses in patients with respiratory infections. Pharmacological formulations of bacterial components include a mixture of bacterial antigens, some of which are complete inactivated bacteria, that is, named bacterial suspensions; while others are fragments of bacteria, which are presented as bacterial lysates. Although bacterial lysates have been broadly used as immune-stimulators, the biological support for the therapeutic effectiveness of bacterial suspension has not yet been studied. Thus, the aim of our study was to investigate the immunological activity induced by bacterial suspension. Methods This work was an exploratory translational study. Peripheral blood mononuclear cells were obtained from healthy donors and cultured in time-dose dependent assays with a commercial bacterial suspension. Flow cytometry was used for phenotypic analysis and for determining soluble cytokines in culture supernatants. Results We observed that bacterial suspension activates B cells in a dose-dependent manner. Peripheral blood mononuclear cells were able to secrete IL-6 and IL-10 after 24 h of bacterial suspension stimulation. TLR2 expression was observed mainly on CD19+ CD38Lo B cells after 72 h of culture; remarkably, most of the TLR2+ CD19+ cells were also IL-10+. click here Conclusion Our findings suggest that bacterial suspension induces the activation of B cell subsets as well as the secretion of IL-6 and IL-10. Expression of TLR2 on CD19+ cells could act as an activation loop of IL-10+ B regulatory cells. The clinical implications of these findings are discussed at the end of this article. © The Author(s) 2020.Introduction Viral hepatitis is a serious blood-borne and sexually transmitted systemic communicable disease affecting the liver. Commonly, it is caused by hepatitis B and C viruses. HIV infection has been one of the largest public health challenges that can also be transmitted vertically. Objective To determine seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic at Atat Hospital, Southern Ethiopia. Methods Hospital-based cross-sectional study was conducted among 222 pregnant women from May to July, 2017. A structured questionnaire was used to collect socio-demographic characteristics and predicators of hepatitis B, C and HIV infections through face-to-face interview. Venous blood sample of 5 mL was collected from study participants, and serum was tested for HBsAg, anti-HCV and anti-HIV using rapid test kits and further confirmed by enzyme-linked immunosorbent assay. Logistic regression analysis was used to identify predictors of hre all uncommon infections in this population, with hepatitis B virus the most common. All hepatitis C virus positive pregnant women were co-infected with HIV. Significant association was found between hepatitis B virus infection and predictors. Therefore, continuous screening of pregnant women for hepatitis B and C infections should be performed. © The Author(s) 2020.Objectives Blindness is one of the most widespread final pathways of diabetic retinopathy and its associated diabetic macular edema. The general practitioners are the first to encounter these diabetic patients. Fundoscopy is now considered as an ideal way for the diagnosis of patients with diabetic retinopathy. Therefore, this study was undertaken to know the ability and skills of general practitioners for the diagnosis and management of patients with diabetic retinopathy and diabetic macular edema. Methods This study was conducted in all major cities in Qassim province of Saudi Arabia during January to May 2017. A validated questionnaire was used to assess the general practitioners' knowledge and practice for the management of diabetic retinopathy and diabetic macular edema. Questions related to referrals, diagnosis, and treatment options to diabetic retinopathy and diabetic macular edema were asked to the general practitioners. Results Of 96 general practitioners, 76 returned the questionnaire with a responre needed that highlight the acquisition of their skills in fundoscopy. © The Author(s) 2020.Objective This population-based retrospective cohort study investigates long-term results of femoral thrombendarterectomy combined with simultaneous endovascular intervention of the iliac or femoropopliteal vessels, or both, with focus on freedom from recurrent intervention, limb salvage and survival. Methods All patients undergoing femoral thrombendarterectomy and simultaneous endovascular intervention between 1999 and 2013 were included. Stratification was according to clinical symptoms, intermittent claudication or critical ischemia, with subgroups for rest pain and ulcer/gangrene, and for type of endovascular intervention, iliac, femoropopliteal or both. We assessed technical success, 30-day complications, freedom from recurrent intervention, survival and amputation free survival in all patients. Limb salvage was assessed in patients with critical ischemia. Results We identified 151 operations in 143 patients with a total of 164 limbs treated. A total of 13 patients had bilateral and 8 patients had subsequent contralateral operations.
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