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Low-Grade Chondrosarcoma of the Posterior Cricoid Dish.
Objective The relationship between serum uric acid (SUA) and the risk of ischemic stroke (IS) has been fully elucidated in previous studies. Therefore, we further investigated the relationship between SUA levels and the risk of IS. Patients and methods 2195 patients at the Beijing Hospital, between February 2012 and May 2018, were enrolled in our hospital-based cross-sectional study. The patients were divided into an IS group and a (non-IS) control group, based on their medical records. SUA level was measured using the enzymatic uricase method. Univariate and multivariable logistic regression models were used for the analysis. Results A total of 300 patients with IS [176 men; age (mean ± SD) 71.38 ± 10.66 years] and 1895 control patients [1060 men; age (mean ± SD) 66.12 ± 12.04 years] were enrolled in this study. IS patients had higher concentrations of SUA, compared with control group patients [6.11 ± 1.92 vs. 5.77 ± 1.62 (mg/dL)]; P = 0.004). We observed a J-shaped association between SUA levels and the risk of IS. Both the univariate and multivariate logistic regression analyses found a significantly elevated risk of IS in the bottom and upper SUA levels both in quartiles and deciles, compared with the intermediate SUA levels. Conclusion These results indicate a J-shaped, independent association between SUA levels and the risk of IS in high-risk individuals.Diarrhoea is a common, widespread and frustrating reality for sheep enterprises in most sheep producing regions globally and of particular concern in Australia as the major risk factor for breech flystrike. Parasitic disease has long been recognised as an important factor in diarrhoea in sheep, particularly the gastrointestinal nematodes (Trichostrongylus and Teladorsagia species). This review focuses on the role of parasitic infections in causing diarrhoea in sheep, with emphasis on the epidemiology of diarrhoea outbreaks related to worms and opportunities to manage the risk of diarrhoea outbreaks in sheep related to parasitic infections. Parasitic nematodes damage the gastrointestinal tract via a complex relationship between direct impacts from worms, such as physical changes to the gut mucosa, and indirect effects largely associated with the host response. Diarrhoea associated with large worm burdens is most efficiently managed through integrated parasite management programs. Despite some limitations, measuring faecal worm egg counts remains a mainstay for assessing the contribution of worms to outbreaks of diarrhoea in sheep. Larval hypersensitivity scouring is emerging as a significant cause of worm-related diarrhoea in sheep without large adult worm burdens in some geographic locations. The syndrome describes a heightened inflammatory response to the ingestion of trichostrongylid infective larvae seen in the gut of sheep with diarrhoea, and is most effectively addressed through selecting sheep for low breech soiling ('dag scores'), as worm resistant sheep may show an increased propensity for diarrhoea, even with low rates of larval challenge. Importantly, dag should be considered as a separate trait to WEC in breeding indexes. Outbreaks of diarrhoea in young sheep are often multifactorial, and co-infections with nematodes and other infectious agents associated with diarrhoea are common. This presents challenges for the field investigation of diarrhoea in grazing sheep.Purpose To evaluate the effective doses received by donors and recipients, identify effective dose contributions, and make risk assessments. Materials and methods It was a retrospective study. 100 Donors and 100 recipients were enrolled with an operative day from March 2016 to August 2017. The dose was analyzed for all radiation-related examinations over a period of 2 years, 1 year before and 1 year after the LDLT procedure. The effective doses of plain X-rays, CT, fluoroscopy, and nuclear medicine per patient were simulated by a Monte Carlo software, evaluated by the dose-length product conversion factors, evaluated by the dose-area product conversion factors, and evaluated by the activity conversion factors, respectively. The risks of radiation-induced cancer were assessed on the basis of the ICRP risk model. Results The median effective doses were 71 (range 30-186) mSv for donors and 147 (32-423) mSv for recipients. see more The radiation examinations were mainly performed in the last three months of preoperative period to first month of postoperative period for recipients and donors. The HCC recipients received a higher effective dose, 195 (64-423) mSv, than those with other indications. The median radiation-induced cancer risk was 0.38 % in male and 0.48 % in female donors and was 0.50 % in male and 0.58 % in female recipients. Conclusion Donors and recipients received a large effective dose, mainly from the CT scans. To reduce effective doses should be included in future challenges in some living donor liver transplants centers that often use CT examinations.Purpose To investigate the interobserver agreement of different thyroid imaging report and data system (TI-RADS) and ultrasound (US) features. Methods Two researchers independently searched PubMed, Embase and the Web of Science for relevant studies published between October 1972 and December 2018. Studies investigating interobserver agreement between different radiologists were included. The Guidelines for Reporting Reliability and Agreement Studies (GRRAS) and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) score tools were applied to assess the quality of the studies. The data for the inter-agreements of TI-RADS categories and ultrasound features were extracted, and combined with STATA 12.0 (StataCorp, College Station, TX) was used. Results Seven studies including 927 patients were eligible for this meta-analysis. There was a moderate variability in the TI-RADS categories among radiologists (0.54; 95% CI 0.49-0.58). Regarding the US features, the reliability of composition (0.61; 95% CI 0.55-0.66) and calcification (0.71; 95% CI 0.65-0.77) was good, the reliability of echogenicity (0.58; 95% CI 0.51-0.64), shape (0.53; 95% CI 0.45-0.62), margin (0.40; 95% CI 0.32-0.48) and echogenic foci (0.43; 95% CI 0.32-0.54) was moderate. Subgroup analyses showed that experience/training, the number of observers and the number of patients were the main factors influencing the variability. Conclusions The interobserver agreement for the TI-RADS categories was moderate. There remains potential for improvement, especially in terms of the echogenicity, shape, margin and echogenic foci, the precision of the description and the targeted training needed.
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