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Effectiveness regarding dermoscopy from the look at repair examination tendencies.
PURPOSE Superoxide dismutase (SOD) is an enzyme that ensures detoxification against oxidative stress in extracellular components. We aimed to evaluate the impact of SOD3G362A polymorphism (rs 2536512) on the impairment of seminal SOD activity and its risk for idiopathic male infertility in Algeria, as well as to investigate the association between sperm DNA integrity, standard semen parameters, and seminal SOD activity. METHODS In this case-control study, we included 111 infertile men with idiopathic infertility and 104 fertile controls from Algeria. Semen analyzing was done according to the World Health Organization manual. Seminal SOD activity was measured using a commercially colorimetric method (Randox Laboratories Ltd., UK). DNA fragmentation was evaluated using the Halosperm kit (Halotech DNA S.L, Spain) and SOD3G362A genotyping was assessed by polymerase chain reaction-restriction length fragment polymorphism (PCR-RFLP). RESULTS Seminal SOD activity was significantly lower in the infertile group than in the control group (85.87±40.11 vs 154.24±48.456U/mL, p0.05) and SOD3G362A (OR=0.826, 95%CI 0.439-1.55, p=0.554). For GA vs GG and (OR=0.639, 95% CI 0.305-1.340, p=0.235) for AA vs GG. CONCLUSIONS Seminal SOD evaluation can be a beneficial indicator for sperm quality and risk for idiopathic male infertility in Algeria, while sperm DNA integrity, as well as SOD3G362A genotypes, are not. AIMS To evaluate the performance of FINDRISC and ModAsian FINDRISC for the screening of undiagnosed diabetes and dysglycaemia in primary care. To compare the performance of FINDRISC with the recommendations of the American Diabetes Association (ADA) and US Preventive Services Task Force (USPSTF) guidelines. METHODS This cross-sectional study was carried out on 293 patients without a prior history of diabetes at a primary care clinic in Malaysia. Questions on body mass index and waist circumference were modified based on the Asian standard in ModAsian FINDRISC. Haemoglobin A1c of ≥6.5% (48 mmol/mol) was used to diagnose diabetes. Areas under the receiver operating curve (ROC-AUC) for FINDRISC and ModAsian FINDRISC were analyzed. RESULTS The prevalence of undiagnosed diabetes was 7.5% and prediabetes was 32.8%. The ROC-AUC of FINDRISC was 0.76 (undiagnosed diabetes) and 0.79 (dysglycaemia). There was no statistical difference between FINDRISC and ModAsian FINDRISC. The recommended optimal FINDRISC cut-off point for undiagnosed diabetes was ≥11 (Sensitivity 86.4%, Specificity 48.7%). FINDRISC ≥11 point has higher sensitivity compared to USPSTF criteria (72.7%) and higher specificity compared to the ADA (9.6%). VcMMAE research buy CONCLUSIONS FINDRISC is a useful diabetes screening tool to identify those at risk of diabetes in primary care in Malaysia. Synthetic glucocorticoids are widely prescribed for the treatment of numerous inflammatory and autoimmune diseases and they can also affect the way the adrenal gland produces endogenous glucocorticoids. Indeed, patients undergoing synthetic glucocorticoid treatment can develop adrenal insufficiency, a condition characterised by reduced responsiveness of the adrenal to ACTH stimulation or stressors (e.g. surgical or inflammatory stress). To better elucidate the long-term effect of synthetic glucocorticoids treatment and withdrawal on adrenal function, we have investigated the long-term effects of prolonged treatment with methylprednisolone on HPA axis dynamics and on the adrenal steroidogenic pathway, both in basal conditions and in response to an inflammatory stress (lipopolysaccharide, LPS). We have found that 5-days treatment with methylprednisolone suppresses basal ACTH and corticosterone secretion, as well as corticosterone secretion in response to a high dose of ACTH, and down-regulates key genes in the adrenal steroidogenic pathway, including StAR, MRAP, CYP11a1 and CYP11b1. These effects were paralleled by changes in the adrenal expression of transcription factors regulating steroidogenic gene expression, as well as changes in the expression of adrenal clock genes. Importantly, 5 days after withdrawal of the treatment, ACTH levels are restored, yet basal levels of corticosterone, as well as most of the key steroidogenic genes and their regulators, remain down regulated. We also show that, although 5-days treatment with methylprednisolone reduces the corticosterone response to LPS, an increase in intra-adrenal pro-inflammatory cytokine gene expression was observed. Our data suggests that the steroidogenic pathway is directly affected by synthetic glucocorticoid treatment in the long-term, presumably via a mechanism involving activation of the glucocorticoid receptor. Furthermore, our data suggests a pro-inflammatory effect of synthetic glucocorticoids treatment in the adrenal gland. BACKGROUND Frailty and cognitive impairment are well-known risk factors of delirium after cardiac surgery. Frailty is closely associated with cognitive impairment. This study aimed to examine how frailty and cognitive impairment affect the incidence of delirium after cardiac surgery in older patients. METHODS In total, 89 patients (aged ≥65 years) who underwent cardiac surgery between April 2016 and December 2017 were included (74.9 ± 5.5 years, male 64.1%). They were divided according to the combination of frailty and mild cognitive impairment (MCI) Group 1, non-frailty and non-MCI; Group 2, non-frailty and MCI; Group 3, frailty and non-MCI; and Group 4, frailty and MCI. Frailty was defined as a score of at least 3 points according to the Japanese version of the Cardiovascular Health Study criteria, and MCI was defined as a Montreal Cognitive Assessment score less than 26. Delirium was evaluated using the Intensive Care Delirium Screening Checklist, and a score of 4 or higher indicated delirium. Multivariate logistic regression analysis was performed to examine the influence of the combination of frailty and MCI on delirium after cardiac surgery. RESULTS In total, 31 patients (34.8%) showed postoperative delirium. Multivariate analysis-adjusted baseline characteristics (reference, Group 1) showed that only Group 4 had a risk of delirium after cardiac surgery (odds ratio, 7.494; 95% confidence interval 1.539-36.494). CONCLUSION Preoperative coexistence of frailty and MCI poses the greatest risk of delirium after cardiac surgery. Therefore, attention should be paid to both physical and cognitive function prior to surgery. Further studies are warranted to investigate the optimal intervention for high-risk patients.
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