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Multistate lively control RCS trademark for the steady adjustment absorber/reflector change programs.
Craniotomy and surgical evacuation of significant (≥1cm in maximum diameter) EDH and/or SDH was carried out in 26 patients. External ventricular drain was inserted in two patients with significant IVH. Thirty-eight patients had good overall outcome, eight patients showed poor outcome. None of the reviewed patients developed clinical deterioration and/or progression of the intracranial bleeding on follow-up brain CT scans. Conclusion Enoxaparin is a safe prophylaxis against venous thromboembolism in patients with traumatic closed intracranial bleeding. © 2020 Jamous.Myeloid-derived suppressor cells (MDSCs) are heterogeneous groups of pathologically activated myeloid cells with potent immunosuppressive function. Due to their role in negatively regulating the immune system, MDSCs have been strongly correlated with disease progression during HIV. However, findings vary considerably between studies. The dominant phenotype of MDSC subsets during HIV is not well ascertained. Moreover, there is no clear understanding on the clinical significance of MDSCs during HIV infection. The existing evidences showed the double-sided roles of MDSCs in HIV. On the one hand, MDSCs are linked to deleterious effects during HIV infection as they inhibit proliferation of protective T cell response. On the other hand, the immunosuppressive abilities of MDSCs were shown to be beneficial in curbing the damaging effects of persistent immune activation associated with chronic HIV infection. Therefore, this review aimed to describe the differences in the existing literatures pertaining to the phenotype, frequency and roles of MDSCs during HIV infection. © 2020 Ademe.Background The purpose of this study is to evaluate the safety and efficacy of oral melatonin administered with thoracic epidural analgesia in patients with multiple bilateral fractured ribs. Patients and Methods A prospective, double-blind randomized control study was carried out on 80 patients of either sex, American Society of Anesthesiologists (ASA) Grade I and II, aged above 18 years, presenting with multiple bilateral fractured ribs. They were randomly divided into two groups, 40 patients each. Placebo group patients received oral placebo tablets and melatonin group (TEA and melatonin) patients received oral melatonin tablets (5 mg), about 1 hour before epidural infusion of local anesthetics and then every 12 hours till the cessation of bupivacaine infusion. Results Melatonin administration was associated with a significant decrease in total morphine analgesia consumption, from 31.8 ± 1.41 mg in the TE group to 13.03 ± 0.85 mg in the melatonin group (P less then 0.001), with a significant decrease (P less then 0.001) in the mean infusion rate of bupivacaine required for controlling the pain, from 0.17 ± 0.014 mL/kg/hour in the TE group to 0.12 ± 0.001 mL/kg/hour in the melatonin group. The duration of bupivacaine infusion in the melatonin group was also significantly shorter than in the TE group (96.48 ± 1.87 and 100.05 ± 3.39 hours, resp., P less then 0.001). Conclusion We conclude that premedication of patients with 5 mg melatonin is associated with significant prolongation of thoracic epidural analgesic effects compared to placebo. Registration This clinical study was registered at Pan African Clinical Trial Registry with no. "PACTR 201711002741378" on 02-11-2017. © 2020 Abdelrahman et al.Type 2 diabetes mellitus (T2DM) is associated with an increased risk of disordered eating behaviors including binge eating disorder (BED). Comorbid BED in patients with T2DM has been associated with adverse clinical outcomes such as higher body mass index (BMI) and depressive symptoms. Identifying and addressing this disorder in patients with T2DM is a significant challenge for health-care providers. The purpose of this narrative review is to discuss current perspectives on BED in the context of T2DM with implications for screening and management of these highly comorbid conditions. BED continues to be underrecognized and underdiagnosed. However, there are established tools that providers can use to screen for BED such as the SCOFF Questionnaire and Questionnaire on Eating and Weight Patterns-5. There are several effective treatments for BED including cognitive behavioral therapy, interpersonal therapy, and lisdexamfetamine dimesylate. However, few studies have examined the effects of these treatments in patients with co-morbid T2DM and BED. © 2020 Chevinsky et al.Introduction The aim of this study was to assess the effects of Rubus anatolicus on glucose metabolism in HepG2, CRI-D2 and C2C12 cell lines. Materials and Methods R. anatolicus was collected in Golestan province, Iran. Three different cell lines HepG2 (human liver cell), CRI-D2 (mice pancreatic cell) and C2C12 (rat myoblast) were used for cell culture experiments. Cell viability was measured using MTT assay. Cells were treated with various concentrations of the extract (6.25-400 μg/mL) and then the extracellular glucose level and intracellular glycogen content were measured using colorimetric methods. The insulin level of the culture medium was measured using the ELISA method. Results Our findings showed that R. anatolicus extract enhances glucose uptake and consumption by all three cell lines. The R. anatolicus extract exposure also elevated cellular glycogen content in HepG2 and C2C12 cells (for 200 and 100 μg/mL) significantly. We found a significant increase in glucose uptake and consequently higher stimulation of insulin secretion in CRI-D2 cell pancreatic cells treated with R. anatolicus extract. Conclusion The R. anatolicus appears to activate glucose uptake and cellular glycogen synthesis probably by activating the glycogenesis or inhibition of glycogenolysis pathways. The extract enhances insulin secretion in the pancreatic cells by increased glucose uptake. © 2020 Safarzad et al.Introduction This systematic scoping review aims to assess the frequency and severity of clinical manifestations of pregnant women with brucellosis. Methods Three literature databases, PubMed, Web of Science and China National Knowledge Infrastructure (CNKI), and two search engines (Google and Yahoo) were adopted to identify the relevant articles that published until 31 December 2019. Two investigators independently screened the publications and extracted the data; the case reports and case series which described at least two symptoms or clinical manifestations of pregnant women with brucellosis were included. Results A total of 27 articles describing the information of 521 pregnant women with brucellosis were included. Serum agglutination test was the most common laboratory test in the diagnosis of brucellosis. A total of 36 clinical manifestations were extracted from the included articles, and the most common clinical manifestations were fever (400, 76.8%), joint pain/swelling/arthralgia (389, 74.7%), sweats (382, 73.3%), fatigue/asthenia/weakness (262, 50.3%) and back pain (189, 36.3%). Among the 32 included individual cases that with available obstetric outcome information, 10 (31.3%) suffered preterm delivery, 12 (37.5%) had an abortion and 3 (9.8%) had intrauterine fetal death. Conclusion Brucellosis is popular and threatening for pregnant women. Regarding the localized body system complications, osteoarticular system was mostly involved, the obstetrics outcomes were severe among pregnant women with brucellosis. The detailed clinical and epidemiological characteristics in this scoping review may add a better and more complete understanding of the disease for both physicians and policy-makers, and provide evidence for timely diagnosis, adequate therapy and better prevention. Necrostatin 1S mouse © 2020 Liu et al.Background Citrobacter freundii is the most common class of pathogens in the genus Citrobacter and is an important pathogen associated with certain underlying diseases or immune dysfunction. The aim of this study was to elucidate the resistance mechanism of clinically derived carbapenem-resistant C. freundii isolate and to characterize the genetic environment and delivery pattern of the IncN1 plasmid carrying the bla IMP-4 gene from C. freundii isolate. Materials and Methods We identified a clinical isolate of C. freundii L91 carrying bla IMP-4 and performed phylogenetic analysis by whole-genome sequencing. The complete genomic sequence of L91 was obtained using the Illumina HiSeq 4000-PE150 and PacBio RS II platforms. link2 Antimicrobial susceptibility testing was determined by the VITEK 2 system. Plasmid characteristics were presented by S1-pulsed-field gel electrophoresis (PFGE), Southern blotting and conjugation experiments. Results S1-PFGE, Southern blot and conjugation assay confirmed the presence of bla IMP-4 genes on a conjugative plasmid in this isolate. C. freundii L91 and transconjugant L91-E. coli 600 strains both showed resistance to carbapenems. In silico analysis further showed that pIMP-4-L91 is an IncN1 plasmid with a length of 51,042 bp. Furthermore, bla IMP-4 gene was found encoded in the bla IMP-4-qacG2-aacA4-catB3 cassette array within a class 1 integron. A conserved structure sequence (ΔISKpn27-bla IMP-4-ΔISSen2-hp-hp-IS6100) was found in the upstream and downstream of the bla IMP-4. Conclusion We performed a comprehensive phylogenetic analysis of carbapenemase-resistant C. freundii and elucidated the resistance mechanism of clinically derived C. freundii L91. Not only that, we also found that the bla IMP-4 gene is located on the IncN1 plasmid and has a horizontal transfer function and a certain ability to spread. To lower the risk of the dissemination of such C. freundii isolates in clinical settings, more surveillance is needed in the future. © 2020 Chi et al.Introduction Klebsiella pneumoniae is a pathogen commonly found in community-onset bacteremia. It causes an invasive syndrome that is frequently presented by metastatic infections and abscesses elsewhere and that is necessary for surgical or drainage intervention. To achieve a scoring algorithm to identify patients with community-onset K. pneumoniae bacteremia (CoKPB) who are at risk for abscess occurrences, a retrospective cohort study consisting of adults with CoKPB was conducted. link3 Methods A 6-year cohort study consisting of adults having community-onset monomicrobial K. pneumoniae bacteremia was conducted. In addition to clinical variables collected from medical records, the hypermucoviscosity (HMV)-related gene (rmpA and magA) and an HMV phenotype were integrated into the proposed scoring algorithm. Results Of the 258 eligible adults, only 79 (30.6%) had abscesses related to bacteremia. Besides the presence of magA (ie, capsular serotype K1) and the HMV-phenotype, five clinical predictors were significantly associated with abscesses in a multivariate analysis male gender, comorbidities with diabetes mellitus or neurological disorders, recent chemotherapy, and high c-reactive protein levels. Together, these predictors were used to calculate the CoKPB abscess score. Based on the scoring algorithm, a cut-off value of +2 yielded the high sensitivity (93.7%) and the acceptable specificity (50.8%); the area under the ROC curve was 0.83. Conclusion A simple scoring algorithm that has substantial sensitivity and satisfactory specificity was proposed and the importance of the HMV phenotype or capsular K1 serotype was emphasized. The proposed predictive model needs external validation, but this scoring algorithm might be convenient and useful for clinicians. © 2020 Hong et al.
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