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Doctor-patient relationship: Data through Bangladesh.
Healthcare workers have substantial concerns about the effectiveness of the personal protective equipment. Staff desired a refresher training with individual feedback of their abilities to don and doff effectively and assurance that if they donned and doffed correctly their equipment was effective. A nontoxic fluorescent solution, only visible under ultraviolet light, was utilized during the training. This solution was sprayed on and given as a nebulized treatment to a high-fidelity simulator during the scenario. It allowed educators and learners to easily visualize any contamination. This innovative training method demonstrated that following the PPE training improves workplace safety and decreases the risk of transmission. This article is protected by copyright. All rights reserved.BACKGROUND Autologous stem cell transplantation is an established treatment option for patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL). STUDY DESIGN AND METHODS In this prospective multicenter study, 147 patients with MM were compared with 136 patients with NHL regarding the mobilization and apheresis of blood CD34+ cells, cellular composition of infused blood grafts, posttransplant recovery, and outcome. RESULTS Multiple myeloma patients mobilized CD34+ cells more effectively (6.3 × 106 /kg vs. 3.9 × 106 /kg, p = 0.001). The proportion of poor mobilizers (peak blood CD34+ cell count 100 days) nonrelapse mortality (NRM; 6% vs. 0%, p = 0.003). CONCLUSIONS Non-Hodgkin's lymphoma and MM patients differ in terms of mobilization of CD34+ cells, graft cellular composition, and posttransplant recovery. Thus, the optimal graft characteristics may also be different. © 2020 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.Proliferative Vasculopathy and Hydranencephaly-Hydrocephaly syndrome (PVHH, OMIM 225790), also known as Fowler syndrome, is a rare autosomal recessive disorder of brain angiogenesis. PVHH has long been considered to be prenatally lethal. We evaluated the phenotypes of the first three siblings with survival into adulthood, performed a systematic review of the Fowler syndrome literature and delineated genotype-phenotype correlations using a scoring system to rate the severity of the disease. Thirty articles were included, describing 69 individual patients. To date, including our clinical reports, 72 patients have been described with Fowler syndrome. Only 6/72 (8%) survived beyond birth. Although our three patients carry the same mutations (c.327 T > A - p.Asn109Lys and c.887C > T - p.Ser296Leu) in FLVCR2, only two of them presented with the same cerebral features, ventriculomegaly and cerebral calcifications, as affected fetuses. The third sibling has a surprisingly milder clinical and radiological phenotype, suggesting intrafamilial variability. Although no clear phenotype-genotype correlation exists, some variants appear to be associated with a less severe phenotype compatible with life. As such, it is important to consider Fowler syndrome in patients with gross ventriculomegaly, cortical malformations and/or cerebral calcifications on brain imaging. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Although tetracycline has been used to treat cutaneous sarcoidosis, the mechanism of action for this treatment remains unclear. This study evaluated the efficacy of minocycline treatment on cutaneous sarcoidosis and the relationship between its efficacy and the presence of Propionibacterium acnes in skin sarcoid lesions. METHODS We retrospectively reviewed results in 13 patients with cutaneous sarcoidosis treated with minocycline at Saitama Medical Center between 2010 and 2017. To demonstrate the presence of P. acnes in the skin lesions, skin biopsy specimens from 11 of the 13 patients were evaluated with immunohistochemistry using a specific monoclonal antibody against P. acnes (PAB antibody). RESULTS Of the 13 patients treated with minocycline, six patients (46%) achieved a complete response (CR) and seven (54%) had a partial response (PR). The skin lesions regressed in 1.5-5 months (average, 3.2 months) after treatment with minocycline. No relapse had occurred during the minocycline therapy. Elevated serum angiotensin-converting enzyme levels were observed in five of the patients, and the levels reduced after treatment with minocycline. Selleck ONO-7475 P. acnes, identified as round bodies that reacted with PAB antibody, were observed in the skin sarcoid granulomas in all patients tested. The number of PAB-positive round bodies was significantly higher in the skin lesions of patients who had CR than in those who had PR. CONCLUSIONS These results suggest the effectiveness of minocycline for the treatment of cutaneous sarcoidosis and an association of P. acnes with the efficacy of minocycline therapy for cutaneous sarcoidosis. © 2020 the International Society of Dermatology.The goal of the present article is to investigate whether positive and negative affects mediate or moderate the impact of self-esteem on life satisfaction among Chinese rural-to-urban migrants. Participants contained 712 rural-to-urban migrants recruited from four construction sites in China, who were evaluated with Rosenberg Self-Esteem Scale, Positive and Negative Affect Scale, and Satisfaction with Life Scale. Correlation analysis indicated self-esteem positively predicted life satisfaction. In addition, we demonstrated the mediating effects of positive affect and negative affect partially in the links from self-esteem to life satisfaction, but failed to reveal the moderating effects. These findings suggested that affect balance intervention program may benefit the life satisfaction in Chinese rural-to-urban migrants. © 2020 Wiley Periodicals, Inc.Angiotensin converting enzyme-2 (ACE2) is the receptor for the coronavirus SARS-CoV-2, which causes COVID-19. We propose the following hypothesis Imbalance in the action of ACE1- and ACE2-derived peptides, thereby enhancing Angiotensin-II (ANG II) signaling, a primary driver of COVID-19 pathobiology. ACE1/ACE2 imbalance occurs due to the binding of SARS-CoV-2 to ACE2, reducing ACE2-mediated conversion of ANG II to ANG peptides that counteract pathophysiological effects of ACE1-generated ANGII. This hypothesis suggests several approaches to treat COVID-19 by restoring ACE1/ACE2 balance 1) ANG II receptor blockers (ARBs); 2) ACE1 inhibitors (ACEIs); 3) Agonists of receptors activated by ACE2-derived peptides [e.g., ANG (1-7), which activates MAS1]; 4) Recombinant human ACE2 or ACE2 peptides as decoys for the virus. Reducing ACE1/ACE2 imbalance is predicted to blunt COVID-19-associated morbidity and mortality, especially in vulnerable patients. Importantly, approved ARBs and ACEIs can be rapidly repurposed to test their efficacy in treating COVID-19.
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