Notes

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Diabetes mellitus with autosomal dominant inheritance, such as maturity-onset diabetes of the young (MODY), is a genetic form of diabetes mellitus. MODY is a type of monogenic diabetes mellitus in which multiple genetic variants may cause an alteration to the functioning of beta cells. The three most known forms of MODY are caused by modifications to the
,
, and
genes. However, other MODY variants can cause multiple alterations in the embryonic development of the endoderm. This is the case in patients presenting with MODY5, who have a mutation of the hepatic nuclear factor 1B (
gene.

We present the clinical case of a 15 year-old patient with a family history of diabetes mellitus and a classical MODY type 5 (MODY5) phenotype involving the pancreas and kidney, with a novel, unreported mutation in the
gene.

MODY5 is characterised by a mutation in the
gene, which plays an important role in the development and function of multiple organs. It should be suspected in patients with unusual diabetes and multisystem involvement unrelated to diabetes.

Liver failure is usually associated with the inflammation and oxidation of hepatocytes. Due to their unique properties, graphene and graphene-based nanostructures such as magnetic graphene oxide (MGO) are useful in biomedicine and engineering. In this study, synthesized MGO was used to improve the liver failure induced by carbon tetrachloride (CCl
). The hepatoprotective effects of intraperitoneal injection of MGO on the rat model of CCl
-induced acute liver failure were investigated.

In order to provide a rat model of acute liver failure, male rats were intraperitoneally injected with 2 ml/kg body weight CCl
. In the experimental groups, rats received 2 ml/kg CCl
and 300 mg/kg MGO body weight simultaneously. Four days after injection, symptoms of acute liver failure appeared. The control, sham, CCl
, and CCl
 + MGO groups were compared and analyzed both histologically and biochemically.

The results indicated that the MGO injection reduced all CCl
-induced liver failure such as necrosis, fibrosis, inflammation, aspartate transaminase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) in the experimental groups of the rat model of acute liver failure.

The hepatoprotective effects of MGO might be due to histopathological suppression and inflammation inhibition in the liver.
The hepatoprotective effects of MGO might be due to histopathological suppression and inflammation inhibition in the liver.Smartphone-based retinal photography is a promising method for increasing accessibility of retinal screening in the primary care and community settings. Recent work has focused on validating its use in detection of diabetic retinopathy. However, retinal imaging can be technically challenging and additional work is needed to improve ease of retinal imaging in the primary care setting. We therefore performed usability testing of a smartphone-based retinal camera, RetinaScope, among medical assistants in primary care who had never performed retinal imaging. A total of 24 medical assistants performed first-time imaging in a total of five rounds of testing, and iterative improvements to the device were made between test rounds based on the results. The time to acquire a single ~50 degree image of the posterior pole of a model eye decreased from 283 ± 60 seconds to 34 ± 17 seconds (p less then 0.01) for first-time users. The time to acquire 5 overlapping images of the retina decreased from 325 ± 60 seconds to 118 ± 26 seconds (p = 0.02) for first-time users. Testing in the human eye demonstrated that a single wide-view retinal image could be captured in 65 ± 7 seconds and 5 overlapping images in 229 ± 114 seconds. Users reported high Systems Usability Scores of 86 ± 13 throughout the rounds, reflecting a high level of comfort in first-time operation of the device. see more Our study demonstrates that smartphone-based retinal photography has the potential to be quickly adopted among medical assistants in the primary care setting.
Comorbidity is of significant concern in multiple sclerosis (MS). Few population-based studies have reported conditions occurring in MS after diagnosis, especially in contemporary cohorts.

To explore incident comorbidity, mortality and hospitalizations in MS, stratified by age and sex.

In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years) and 61,828 matched MS-free individuals were identified between 1 January 2008 and 31 December 2016, using national registers. Incidence rates (IRs) and incidence rate ratios (IRRs) with 95% CI were calculated for each outcome.

IRs of cardiovascular disease (CVD) were higher among MS patients than MS-free individuals, (major adverse CVD IRR 1.42; 95% CI 1.12-1.82; hemorrhagic/ischemic stroke 1.46; 1.05-2.02; transient ischemic attack 1.65; 1.09-2.50; heart failure 1.55; 1.15-2.10); venous thromboembolism 1.42; 1.14-1.77). MS patients also had higher risks of several non-CVDs such as autoimmune conditions (IRR 3.83; 3.01-4.87), bowel dysfunction (2.16; 1.86-2.50), depression (2.38; 2.11-2.68), and fractures (1.32; 1.19-1.47), as well as being hospitalized and to suffer from CVD-related deaths ((1.91; 1.00-3.65), particularly in females (3.57; 1.58-8.06)).

MS-patients experience a notable comorbidity burden which emphasizes the need for integrated disease management in order to improve patient care and long-term outcomes of MS.
MS-patients experience a notable comorbidity burden which emphasizes the need for integrated disease management in order to improve patient care and long-term outcomes of MS.
Adherence to multiple sclerosis (MS) disease-modifying drugs (DMDs) is essential for realization of their optimal effectiveness and benefits.

To evaluate the usefulness and validity of a smartphone-based e-diary as a tool for adherence assessment as well as its effectiveness as a promoter of adherence to DMDs.

An MS tailored e-diary (MyMS&Me) reminded patients to take their DMDs on time. DMD intake was self-recorded in the e-diary by the participants. Three methods of adherence evaluation were compared e-diary derived, retrospective self-reported, and the medication possession rate (MPR). The proportion of patients with poor adherence to DMDs (defined as MPR <80%) among e-diary users was compared with a control group without intervention.

Sixty-two patients downloaded the e-diary (Female 41 (66%), Expanded Disability Status Scale 3.2 ± 2.2) and 55 controls were enrolled. The median difference between e-diary-derived adherence and the MPR was -3% (95% limits of agreement -53% to 12%). The median difference between retrospective self-reported adherence and the MPR was 0.
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