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Past the gene: epigenetic along with cis-regulatory goals provide fresh mating potential for the near future.
Purpose We investigate the effect that variation in the anatomy of the greater trochanter (GT), in particular the medial overhang, can have on femoral stem alignment in total hip arthroplasty (THA). Methods Pre- and post-operative anteroposterior pelvic radiographs of 576 consecutive patients undergoing THA were retrospectively analysed. Medial overhang of the GT relative to the lateral femur diaphysis was measured. The femoral morphology was classified according to Dorr classification. The alignment of the femoral stem axes on post-operative radiographs was recorded. Results Following exclusions, 500 THAs performed by six surgeons all using the same cemented polish tapered stems were analysed 320 THAs were performed via the posterior-lateral approach and 180 via the direct-lateral approach. Mean stem varus was 0.53° (range -7 to 7°). Mean medial overhang was 21 mm (range 8-43 mm). An overhang of 30 mm of overhang). Conclusions Scrutiny of pre-operative radiographs to determine high-risk patients is important, and we propose a classification system of GT anatomy to aid assessment.Nonbacterial thromboembolic endocarditis (NBTE), or marantic endocarditis, is a rare complication associated with advanced cancer. Enoxaparin or unfractionated heparin is considered the standard treatment for NBTE. In this case report, we describe a 59-year-old female with metastatic pancreatic cancer who presented with embolic stroke and was found to have new NBTE of the mitral valve while she was receiving the therapeutic dose of enoxaparin. Of note, her recent echocardiogram one week ago was negative for mitral valve vegetations. Apoptosis inhibitor Our case emphasized that for patients with advanced cancer presenting with stroke, the diagnosis of NBTE should be entertained even for those on systemic anticoagulation.Coronary artery disease (CAD) is a significant contributor to mortality in America. A common risk factor of CAD is hyperlipidemia. Treatment guidelines of hyperlipidemia are well established. Statins are the cornerstone of treating hyperlipidemia. New medications such as proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9 inhibitors) have also illustrated significant results in treating hyperlipidemia. While multiple studies exemplify the disparities in statin and PCSK9 inhibitors utilization to reduce CAD mortality and risk factors, there are no systematic reviews to validate these disparities. We conducted a search on PubMed, including Medline and PubMed Central, and Google Scholar. For this analysis, we selected articles published between 2000 and 2020 and those that fit the inclusion and exclusion criteria. Based on the type of study, we performed appropriate quality assessments and deleted studies with a score of less than seven or with a high risk of biases. The search strategy resulted in 322 studies. After inclusion and exclusion criteria were applied, we included 20 articles in the analysis of this review. This systematic review demonstrates that non-white races and women were less likely to receive the correct, clinically indicated, therapy for hyperlipidemia. A multi-faceted approach is required to solve this inequality in healthcare.Tumor-associated macrophages (TAMs) have recently emerged as potentially crucial therapeutic targets for cancer. Thus, the development of macrophage-mediated phagocytosis assays is vital for preclinical drug screening of different tumor cells. This assay can be used to evaluate the effect of anti-cancer therapy, such as immunotherapy, radiotherapy, and chemotherapy, on different tumor cells. Here, we describe the in-vitro phagocytosis assay in detail. As an example of immunotherapy treatment, we used a monoclonal antibody to block an anti-phagocytic signal (CD47) to evaluate the assay using human brain tumor cells and monocyte-derived macrophages. We also demonstrated that this assay can be used to evaluate the effect of different irradiation doses on the phagocytosis of brain tumor cells. This functional assay is fast, accurate, and highly reproducible. Furthermore, the results successfully demonstrate that anti-CD47 antibodies and irradiation can enhance the macrophage-mediated phagocytosis of brain tumors.Pancreatic cancer patients experience debilitating pain, which makes pain management an integral part of the treatment plan. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-guided CPN) is an alternative palliative therapy for patients with pain due to pancreatic cancer. We report a patient who developed paralytic ileus after undergoing EUS-guided CPN. A 77-year-old male patient presented with nausea, vomiting, and abdominal pain of one-day duration. He was diagnosed with stage IV pancreatic adenocarcinoma three weeks prior to presentation for which he underwent EUS-guided CPN. He had a 30-pack-year smoking history and quit 31 years ago. He reported moderate alcohol use and denied illicit drug use. In the emergency department, vital signs demonstrated normal blood pressure, heart rate, respiratory rate, and temperature. Abdominal exam was significant for minimal epigastric tenderness without guarding or rebound. Complete blood count (CBC), basic metabolic panel (BMP), and liver function tests were ucapture the occurrence of the rare side effects of EUS-guided CPN.This case report presents the case of a 28-year-old man who developed scurvy during the coronavirus disease 2019 (COVID-19) pandemic. Scurvy is a disease resulting from a nutritional deficiency of vitamin C (ascorbic acid). It is a rare condition, whose signs and symptoms can vary from patient to patient. The treatment is vitamin C supplementation, which is often followed by a swift recovery. To our knowledge, this is the first reported case of scurvy during the COVID-19 pandemic. This article highlights a rare acquired bleeding disorder, which may manifest more commonly during a pandemic due to food scarcity or stay-at-home mandates in those already at risk.In this technical report, we describe a method for teaching the Neonatal Resuscitation Program (NRP) courses while also maintaining social distancing during the COVID-19 pandemic a method we call 'Socially Distanced NRP.' The unique aspects of Socially Distanced NRP courses include small class sizes, keeping one group of students and their instructors together throughout the course, and creating socially distanced stations where students complete the performance skills, integrated skills, and simulation and debriefing parts of the NRP course. The four socially distanced stations include airway, chest compressions, umbilical venous catheter placement, and team leader. Feedback from 79 NRP students showed no difference in overall course rating between Socially Distanced NRP and standard NRP courses. No cases of COVID-19 transmission were identified in the Socially Distanced NRP courses. We believe that Socially Distanced NRP is a safe and effective way to provide mandatory NRP training during the COVID-19 pandemic.
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