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Propofol ameliorates kidney ischemia/reperfusion injuries by simply enhancing macrophage M2 polarization via PPARγ/STAT3 signaling.
OBJECTIVE Fetal fractional limb volume has been proposed as a useful measure for quantifying fetal soft tissue development. The aim of this study was to investigate the growth of fractional arm volume (AVol) and fractional thigh volume (TVol) of fetuses with maternal gestational diabetes (GDM) compared with that of fetuses with normal glucose tolerance (NGT). We hypothesized fetal fractional limb volume would be larger in GDM group than in NGT group in late gestation. DESIGN Exploratory observational study SETTING Saitama Municipal Hospital SAMPLE A total of 165 (125 NGT and 40 GDM) singleton Japanese pregnant women METHODS AVol and TVol were assessed between 20 and 37 weeks gestation as cylindrical limb volumes based on 50% of the fetal humeral or femoral diaphysis length. Women were diagnosed as GDM based on the criteria of the Japan Society of Obstetrics and Gynecology. MAIN OUTCOME MEASURES AVol and TVol were compared between women with NGT and those with GDM at each gestational age period (2-week intervals from 20 weeks to 37 weeks gestation). RESULTS Overall, 287 ultrasound scans were performed (NGT group, 205 scans; GDM group, 82 scans). There was no significant difference of AVol between the groups before 32 weeks gestation. AVol was significantly larger in the GDM group than in the NGT after 32 weeks gestation (p less then 0.05). TVol was not statistically different between the groups across gestation. CONCLUSIONS Detection of variations in fetal AVol may provide greater insight into understanding the origins of altered fetal body proportion in GDM. This article is protected by copyright. All rights reserved.BACKGROUND Impairments in several markers of the cardiovascular system have been described in impaired glucose tolerance (IGT) and diabetes, but the relative importance of those are not known. We aimed to investigate which cardiovascular markers that were most closely linked to an impaired glucose control. METHOD In a population-based study of individuals all aged 50 years, the Prospective study of Obesity, Energy and Metabolism (POEM), 502 subjects were thoroughly investigated regarding endothelial function, arterial compliance, heart rate variability, arterial blood flow and atherosclerosis, performance at an exercise test with gas exchange (VO2 and VCO2 ), left ventricular structure and function, lung function and multiple measurements of blood pressure. Based on an oral glucose tolerance test (OGTT), the participants were grouped into; normal, IGT and diabetes. RESULTS Of all hemodynamic and structural variables analyzed, an impaired glucose control was most closely related to resting heart rate (based on Chi2 -value at ANOVA). Heart rate was followed by maximal workload, VO2 -recovery 5 min following exercise, reflectance index at pulse wave analysis, manual systolic blood pressure, ambulatory pulse and pulse pressure, echogenicity of carotid intima-media complex at ultrasound, and pulse wave velocity (p less then 0.0005 for all variables). All of these variables still showed p less then 0.05 vs an impaired glucose control following adjustment for BMI. CONCLUSION Of multiple measured cardiovascular markers, resting heart rate was most closely related to an impaired glucose control. Also exercise capacity and the recovery in VO2 following exercise were amongst the top-ranked cardiovascular impairments linked to an impaired glucose control. This article is protected by copyright. All rights reserved.Inflammatory myopathies (IM) [1] and myasthenia gravis (MG) [2] are autoimmune disorders presenting with muscle weakness. Their coexistence is infrequent, and the myasthenia-myositis clinical spectrum has emerged as a novel concept [3]. A 66-year-old woman with postoperative hypothyroidism presented with acute onset muscle pain in limbs starting two weeks earlier. This article is protected by copyright. All rights reserved.BACKGROUND Distal hereditary motor neuropathies(dHMN) are a clinically and genetically heterogeneous group of disorders. The purpose of this study was to identify the genetic distribution of dHMN in a large cohort of Chinese patients and provide insight into the underlying common pathophysiology of dHMN. METHODS Multi-gene panel testing or whole-exome sequencing was performed in 70 index patients with clinically diagnosed dHMN between January 2007 and December 2018. We recorded the clinical features, CMT neuropathy scores (CMTNS) and electrophysiological data at diagnosis. RESULTS We identified 24 causative mutations in 70 index patients with dHMN (34.3%). Mutation in the HSPB1 gene was the most common cause of dHMN. Some CMT genes (MPZ, SH3TC2, GDAP1) were found to be related to dHMN with minor sensory involvement. Patients with a dHMN-plus phenotype (distal motor neuropathy and additional neurological deficits) carried variants in genes related to hereditary spastic paraplegia, amyotrophic lateral sclerosis and spinal muscular atrophy (FUS, KIF5A, KIF1B, ZFYVE26, DNAJB2). CONCLUSIONS Comprehensive genetic testing of dHMN patients allows for identification of the pathogenic mutation in one third of cases. Pure motor neuropathies and motor neuropathies with minor sensory involvement share many genes with CMT. Causes for dHMN-plus phenotypes overlap with motor neuron disease. This article is protected by copyright. All rights reserved.COVID-19 presents many pressing challenges to the global dermatological community and our patients with ongoing skin needs, which must be considered by every dermatology provider. Many of these are logistical and administrative, distinct from physical manifestations, and could be summarized by the acronym COVID (Consultations, Operations, Videoconferencing, Immunosuppressive medications, Drug and equipment shortages). While the pandemic may represent a threat to many parts of our existence, dermatologists can help the patients we care for by considering noncutaneous implications of COVID-19 upon our practice. © 2020 Wiley Periodicals, Inc.We studied luteinizing hormone (LH) pulsatility and episodic progesterone release of the corpus luteum (CL) on Day 11 and Day 21 in inseminated gilts and aimed to establish a relationship between these two hormones. Blood was collected at 15-minute intervals for 12 hours on Days 11, 16, and 21 from a vena cava caudalis catheter. At euthanasia eight gilts were pregnant and six gilts were not pregnant. GW9662 purchase Progesterone parameters (basal, mean, pulse frequency, and pulse amplitude) did not differ between pregnant and non-pregnant gilts on Day 11, LH pulse frequency and amplitude tended to differ (p = 0.07 and p = 0.079). In pregnant gilts basal and mean progesterone, progesterone pulse amplitude and frequency declined significantly from Day 11 to Day 21 (p less then 0.05). A significant decline was also seen in the LH pulse amplitude from Day 11 to Day 21 (p less then 0.05). None of the LH pulses was followed by a progesterone pulse within 1 hour on Day 21. On Day 11 and Day 21 appeared a synchronicity in the LH pulse pattern, as there were two or three LH pulses in 12 hours and these LH pulses appeared in the same time window. We conclude that on Day 11 and Day 21 of pregnancy in gilts progesterone pulses do not follow an LH pulse within one hour. Further we demonstrated that the successful or not successful formation of a CL of pregnancy is independent of progesterone release on Day 11 after insemination. We confirmed the decline of progesterone from Day 11 to Day 21 in the vena cava caudalis and could demonstrate that this decline is partly due to lower progesterone pulse amplitude and frequency and that the decline occurs simultaneously with a decline in LH pulse amplitude. This article is protected by copyright. All rights reserved.Jackson et al (2020) have recently described the extraordinary times we face as a result of the Covid-19 pandemic. As we write, the number of cases and the associated mortality continues to rise. In the United Kingdom (UK) a number of 'Nightingale Hospitals' have been constructed within large arenas. Clinical staff who have recently left National Health Service (NHS) are being asked to return to practice to support the rapidly escalating numbers of patients, and nursing students from year two of their degree programme onwards are being asked to opt-in to an extended placement working to further bolster the numbers of care staff available. This article is protected by copyright. All rights reserved.Fine needle aspiration cytology (FNAC) is a widely accepted safe, simple and rapid diagnostic procedure used in the examination of neoplastic and non-neoplastic lesions of various locations. Since its introduction FNAC has developed into an effective diagnostic tool practiced in a large majority of medical centers evaluating and treating oncologic patients. The role of FNAC has been limited in the examination of primary soft tissue lesions, however, as many physicians working in this area recommended against using FNAC. An increasing use of minimally invasive diagnostic procedures in the last decade has resulted in a better acceptance of FNAC as a first-line approach or as a complementary tool to core needle biopsy (CNB) in the diagnosis of musculoskeletal lesions. This review discusses the role and value of FNAC in the evaluation and treatment of soft tissue tumors based on the experience gathered over the course of 48 years at the Sarcoma Center in Lund, Sweden. FNAC reports most often provide diagnostic information allowing the initiation of treatment or, when definitive diagnosis cannot be rendered from a cytologic examination, guiding the continued diagnostic investigation. The main advantages of soft tissue FNAC are good sensitivity and specificity, a low morbidity, speed of diagnosis and low cost/benefit ratio. The most important disadvantages stem from limited experience in cytologic diagnosis of soft tissue tumors and a lack of standardized and uniform reporting system for soft tissue FNAC. This article is protected by copyright. All rights reserved.BACKGROUND In children with pectus excavatum, the posteriorly depressed sternum compresses and displaces the heart. However, the currently recommended compression site and depth for cardiopulmonary resuscitation have not been studied in this population. AIM This retrospective study investigated the location of the center of ventricles with the largest cross-sectional area to determine the optimal site and depth for chest compressions in pediatric pectus excavatum patients. METHODS Chest computed tomography images of 94 pediatric pectus excavatum patients before and after correction surgery were compared with normal patients. The caudal displacement of the ventricles was calculated by dividing the length of sternum by the length from the suprasternal notch to the transverse level of the largest cross-sectional area of the ventricles. The proportional leftward deviation of the center of the ventricles from the midline versus transverse diameter of the thorax was calculated. The remaining internal thickness was placement and leftward deviation of the ventricles compared with the normal population despite correction surgery and the currently recommended compression site and depth might injure intrathoracic structures without effective cardiac compression during cardiopulmonary resuscitation. This article is protected by copyright. All rights reserved.
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