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A great autopsy research study of lymphocytic hypophysitis induced by nivolumab treatment for esophageal cancerous melanoma.
Moreover, we present an explanatory model of pain, which is not only novel in its application to SCD pain but also captures the multidimensional nature of the SCD pain experience and supports the need for such a multimodal approach. This model also highlights opportunities for new investigative and therapeutic targets - both pharmacological and non-pharmacological.

Multimodal pain regimens that are less dependent on opioids are urgently needed to improve acute pain outcomes for individuals with SCD. selleck chemical The proposed explanatory model for SCD pain offers novel opportunities to improve acute pain management for SCD patients.
Multimodal pain regimens that are less dependent on opioids are urgently needed to improve acute pain outcomes for individuals with SCD. The proposed explanatory model for SCD pain offers novel opportunities to improve acute pain management for SCD patients.
To identify latent classes of acute stroke patients with distinct experiences with the symptom clusters of depression, anxiety, fatigue, sleep disturbance, and pain symptoms and assess, if the selected variables determine a symptom-cluster experience in acute stroke patients.

A sample of 690 participants were collected from July 2020 to December 2020 in a cross-sectional descriptive study. Latent class analysis was conducted to distinguish different clusters of acute stroke participants who experienced five patient-reported symptoms. Furthermore, multinomial logistic regression was selected to verify the influencing indicators of each subgroup, with selected socio-demographic variables, clinical characteristics, self-efficacy, and perceived social support as independent variables and the different latent classes as the dependent variable.

Three latent classes, named "all high symptom," "high psychological disorder," and "all low symptom," were identified, accounting for 9.6%, 26.3%, and 64.1% of symptomthat can be used in predicting symptom-cluster experiences following a stroke. Also, the ability to characterize subgroups of patients with distinct symptom experiences helps identify high-risk patients. Focusing on symptom clusters in clinical practice can inspire us to create effective targeted interventions for subgroups of stroke patients suffering from the same symptom cluster.[This corrects the article DOI 10.1093/geroni/igab046.].
Antibodies against thyroid peroxidase (anti-TPO) serve as clinical markers of thyroid autoimmune diseases (TAIDs). By trying to elucidate the causes of heterogeneity in autoantibody levels among patients with different TAIDs it becomes possible to clarify the pathophysiology of GD and HT.

To investigate the heterogeneity of epitopes recognized by anti-TPO in patients with Hashimoto's thyroiditis (HT), Graves' disease (GD) and overlap-syndrome.

We carried out a cross-sectional study on 398 patients with GD, HT and overlap syndrome and analyzed the specificity of epitopes and binding constants of TPO with monoclonal antibodies (MAbs). Ten MAbs to TPO were used, of which five were reactive with native TPO and the rest were reactive with denaturated TPO.

The autoantibodies in blood serum of HT patients inhibited the binding of MAb63 more significantly than those in serum of GD patients 59.62 % versus 54.02 %, respectively (p=0.001). The anti-TPOs in serum of GD patients inhibited the binding of MAb77 more significantly than those in serum of HT patients 54.36 % versus 51.13 %, respectively (p=0.047). The binding of MAb45 was more inhibited in serum of patients with anti-TPO concentration over 1000IU/ml (58.36 %). The blood serum of patients with overlap-syndrome showed less significant inhibition of MAb63 binding than that of patients with no overlap-syndrome 52.47 % versus 58.81 %, respectively (p=0.043).

Mapping the epitopes to TPO with the help of MAbs may improve the differential diagnosis between different thyroid autoimmunities.
Mapping the epitopes to TPO with the help of MAbs may improve the differential diagnosis between different thyroid autoimmunities.
To examine influences on screening of Latinx adults with type 2 diabetes for cognitive problems by identifying patient-, clinician-, and clinic-level factors.

This was a mixed methods study consisting of semi-structured interviews with Latinx adults with type 2 diabetes (
=30; mean age=68; 57% Mexican American) and surveys and interviews with health care providers (
=15) in Central Texas. Data were examined with thematic analysis (interviews) and descriptive statistics (surveys and inventories).

For the interviewed patients, screening was important, but inability to work related to a possible diagnosis of dementia was a concern. Both providers and patients agreed that other health issues (e.g., hyperglycemia) took precedence over cognitive screening. Providers (96.7%) were expected to screen patients but lacked clinic support and time; they relied on patients for initial prompts. Only one clinic required staff education on cognitive screening, with an emphasis on potential cultural differences in test results and adequate resources related to dementia for Latinx adults.

Clinics serving Latinx adults have a responsibility to deliver appropriate care. Leadership should consider innovative practices such as the creation, with patients, of educational materials for screening-a need highlighted by most participants.
Clinics serving Latinx adults have a responsibility to deliver appropriate care. Leadership should consider innovative practices such as the creation, with patients, of educational materials for screening-a need highlighted by most participants.
Vagal nerve stimulation (VNS) can be indicated in patients with drug-resistant epilepsy, who are not eligible for resective epilepsy surgery. In VNS therapy, the responder rate (i.e., percentage of subjects experiencing ≥50% seizure reduction) is ~50%. At the moment, there is no widely-accepted possibility to predict VNS efficacy in a particular patient based on pre-implantation data, which can lead to unnecessary surgery and improper allocation of financial resources. The principal aim of PRediction of vagal nerve stimulation EfficaCy In drug-reSistant Epilepsy (PRECISE) study is to verify the predictability of VNS efficacy by analysis of pre-implantation routine electroencephalogram (EEG).

PRECISE is designed as a prospective multicentric study in which patients indicated to VNS therapy will be recruited. Patients will be classified as predicted responders vs. predicted non-responders using pre-implantation EEG analyses. After the first and second year of the study, the real-life outcome (responder vs. non-responder) will be determined. The real-life outcome and predicted outcome will be compared in terms of accuracy, specificity, and sensitivity. In the meantime, the patients will be managed according to the best clinical practice to obtain the best therapeutic response. The primary endpoint will be the accuracy of the statistical model for prediction of response to VNS therapy in terms of responders and non-responders. The secondary endpoint will be the quantification of differences in EEG power spectra (Relative Mean Power, %) between real-life responders and real-life non-responders to VNS therapy in drug-resistant epilepsy and the sensitivity and specificity of the model.

PRECISE relies on the results of our previous work, through which we developed a statistical classifier for VNS response (responders vs. non-responders) based on differences in EEG power spectra dynamics (Pre-X-Stim).

www.ClinicalTrials.gov, identifier NCT04935567.
www.ClinicalTrials.gov, identifier NCT04935567.
Identification of sex- and age-related differences in the presentation of atypical symptoms at stroke onset may reduce prehospital delay and improve stroke treatment if acknowledged at first contact.

To explore sex- and age-related differences in patient-reported typical and atypical symptoms of a stroke.

We used data from a cross-sectional survey at two non-comprehensive stroke units in the Capital Region of Denmark. Patient-reported symptoms, stroke knowledge, and behavioral response were analyzed by the Chi-square test or a Fisher's exact test separated by sex. Multivariable logistic regression adjusted for covariates were used to explore sex- and age-related differences according to each patient-reported typical or atypical symptoms.

In total, 479 patients with acute stroke were included (median age 74 years [25th to 75th percentile 64-80], and 40.1% were women). Female sex was associated with higher odds of presenting with atypical symptoms, such as loss of consciousness (OR 2.12 [95% CI 1.08-4.18]) and nausea/vomiting (OR 2.33 [95% CI 1.24-4.37]), and lower odds of presenting with lower extremity paresis (OR 0.59 [95% CI 0.39-0.89). With each year of age, the odds decreased of presenting with sensory changes (OR 0.95 [95% CI 0.94-0.97]) and upper extremity paresis (OR 0.98 [95% CI 0.96-0.99]), whereas odds of presenting with dysphagia (OR 1.06 [95% CI 1.02-1.11]) increased.

Patients of female sex and younger age reported on admission more frequently atypical stroke symptoms. Attention should be drawn to this possible atypical first presentation to facilitate correct identification and early stroke revascularization treatment to improve the outcome for both sexes.
Patients of female sex and younger age reported on admission more frequently atypical stroke symptoms. Attention should be drawn to this possible atypical first presentation to facilitate correct identification and early stroke revascularization treatment to improve the outcome for both sexes.Traumatic brain injury (TBI) is a major global health issue, with outcomes spanning from intracranial bleeding, debilitating sequelae, and invalidity with consequences for individuals, families, and healthcare systems. Early diagnosis of TBI by testing peripheral fluids such as blood or saliva has been the focus of many research efforts, leading to FDA approval for a bench-top assay for blood GFAP and UCH-L1 and a plasma point-of-care test for GFAP. The biomarker S100B has been included in clinical guidelines for mTBI (mTBI) in Europe. Despite these successes, several unresolved issues have been recognized, including the robustness of prior data, the presence of biomarkers in tissues beyond the central nervous system, and the time course of biomarkers in peripheral body fluids. In this review article, we present some of these issues and provide a viewpoint derived from an analysis of existing literature. We focus on two astrocytic proteins, S100B and GFAP, the most commonly employed biomarkers used in mTBI. We also offer recommendations that may translate into a broader acceptance of these clinical tools.
Intraventricular hemorrhage (IVH) is a common complication in preterm infants and is related to neurodevelopmental outcomes. Infants with severe IVH are at higher risk of adverse neurological outcomes and death, but the effect of low-grade IVH remains controversial. The purpose of this study was to evaluate the impact of different degrees of IVH on mortality and neurodevelopmental outcomes in very preterm infants.

Preterm infants with a gestational age of <30 weeks admitted to neonatal intensive care units were included. Cerebral ultrasound was examined repeatedly until discharge or death. All infants were followed up to 18-24 months of corrected age. The impact of different grades of IVH on death and neurodevelopmental disability was assessed by multiple logistic regression.

A total of 1,079 preterm infants were included, and 380 (35.2%) infants had grade I-II IVH, 74 (6.9%) infants had grade III-IV IVH, and 625 (57.9%) infants did not have IVH. The mortality in the non-IVH, I-II IVH, and III-IV IVH groups was 20.
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