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Drooling standing weighing scales within Parkinson's condition: A systematic assessment.
The distribution of Crimean-Congo hemorrhagic fever (CCHF), a tickborne arboviral disease, is not well known in West Africa. We report 2 recent human cases of CCHF with infectious syndrome and severe bleeding in Mauritania. CCHF was diagnosed by ELISA and real time reverse transcription PCR. No secondary CCHF cases were found.We isolated Brucella melitensis biovar 3 from the spleen of an Asian badger (Meles leucurus) in Nilka County, northwestern China. Our investigation showed that this isolate had a common multilocus variable-number tandem-repeat analysis 16 genotype, similar to bacterial isolates from local aborted sheep fetuses.OBJECTIVE To analyze the effect of intra- and interfractional motion during breast intensity modulated radiation therapy (IMRT) by calculating dose distribution based on four-dimensional computed tomography (4DCT). METHODS 20 patients diagnosed with left breast cancer were enrolled. Three-dimensional CT (3DCT) along with 10 phases of 4DCT were collected for each patient, with target volumes independently delineated on both 3DCT and all phases of 4DCT. IMRT plans were generated based on 3DCT (43.2 Gy in 16 fractions). The plan parameters for each segment were split into phases based on time duration estimates for each respiratory phase, with phase-specific dose distributions calculated and summated (4D-calculated dose). The procedure is repeated for 16 fractionations by randomly allocating starting phase using random-number generation to simulate interfractional discrepancy caused by different starting phase. Comparisons of plan quality between the original and 4D-calculated doses were analyzed. RESULTS There was a significant distortion in 4D-calculated dose induced by respiratory motion in terms of conformity and homogeneity index compared to those of the original 3D plan. Mean doses of the heart and the ipsilateral lung were significantly higher in the 4D-calculated doses compared to those of the original 3D plan (0.34 Gy, p = 0.010 and 0.59 Gy, p less then 0.001), respectively). The mean internal mammary lymph node (IMN) dose was significantly greater in the 4D-calculated plan, compared to the original 3D plan (1.42 Gy, p less then 0.001). CONCLUSIONS IMN doses should be optimized during the dose-calculation for the free-breathing left breast IMRT. ADVANCES IN KNOWLEDGE The interplay effect between respiratory motion and multileaf collimator modulation caused discrepancies in dose distribution, particularly in IMN.Introduction Several reports suggest a possible association between polymorphisms in the cytochrome P450 2C9 (CYP2C9) gene and the risk for non-steroidal anti-inflammatory drug (NSAID)-related adverse gastrointestinal events, including gastrointestinal bleeding. Because findings were controversial, a systematic review and a meta-analysis of eligible studies on this putative association was conducted.Areas covered The authors have revised the relationship between CYP2C9 polymorphisms and the risk of developing NSAID-related gastrointestinal bleeding, as well as other adverse gastrointestinal events, and performed meta-analyzes. The bias effect and potential sources of heterogeneity between studies was analyzed.Expert opinion Individuals classified as poor metabolizers after CYP2C9 genotyping (activity scores equal to 0 or 0.5) have an increased risk of developing NSAID-related gastrointestinal adverse events with an odds ratio (OR) = 1.86, (p = 0.004) and the OR for subjects with gastrointestinal bleeding is = 1.90, (p = 0.003). Gene-dose effect for variant CYP2C9 alleles (p = 0.005 for all gastrointestinal adverse events, and p = 0.0001 for bleeding patients) was observed. Also, there is an allele-specific effect in the association CYP2C9*2 is a poor risk predictor, whereas CYP2C9*3 is a highly significant predictor of gastrointestinal adverse events (p = 0.006) and gastrointestinal bleeding (p = 0.0007).Introduction Glial cells are closely associated with neurons located throughout the nervous system and regulate neuronal activity and function through various mechanisms including the secretion of proteins and other signaling molecules. Glia-secreted proteins play crucial roles in modulating neuronal function in physiological and pathological conditions. Aberrant activation of glial cells leading to neuroinflammation is a common phenomenon observed in various neurological disorders. Aberrantly activated glial cells secrete proteins in disease-specific manner and can be exploited as a repository for novel biomarker discovery.Areas covered In this review, we describe the recent advances in proteomic techniques, highlighting the need for their application to the secretomic field. Studies regarding the secretome profile of glial cells published within the last 5 years are discussed in detail. The use of glia-based biomarkers in various neuroinflammatory and neurodegenerative diseases is also discussed.Expert opinion Precise diagnosis and timely treatment of neurological disorders remains a challenge and glia-focused research to identify specific biomarkers appears to be a promising approach to combat these disorders. Recent technological advancement in proteomic research would open new frontiers for more rigorous analysis of glial secretome variations over time and the discovery/development of novel biomarkers for neurological disorders.RATIONALE Metabolic syndrome (MetS), the clinical clustering of hypertension, dyslipidemia, insulin resistance and abdominal obesity, has been associated with a prothrombotic and hypofibrinolytic state, although data linking MetS with venous thromboembolism (VTE) remains limited. OBJECTIVE The aim of this study was to measure the prevalence of MetS in patients with pulmonary embolism (PE) across a large population and to examine its impact on VTE recurrence. selleck chemicals llc METHODS This was a retrospective, population-based analysis utilizing de-identified information from a large statewide database, the Indiana Network for Patient Care (INPC). All patients with an ICD-defined diagnosis of PE from 2004 to 2017 were included. We measured the frequency with which patients with PE carried a comorbid diagnosis of each MetS component. Multiple logistic regression analysis was performed with VTE recurrence as the dependent variable to test the independent effect of MetS diagnosis, with a statistical model utilizing a directed acyclic graph (DAG) to account for potential confounders and mediators.