We present the case of a 13-year-old female diagnosed with juvenile systemic sclerosis, diffuse cutaneous subtype, along with active disseminated tuberculosis. This co-occurrence poses unique diagnostic and therapeutic challenges, particularly given the risk of tuberculosis exacerbation due to immunosuppressive therapy required for systemic sclerosis. The patient had signs/symptoms like progressive skin tightening and Raynaud's phenomenon; the diagnosis was confirmed by the presence of anti-Scl-70 antibodies.
View Article and Find Full Text PDFBackground: Accurately identifying cognitive changes in Mexican American (MA) adults using the Mini-Mental State Examination (MMSE) requires knowledge of population-based norms for the MMSE, a scale which has widespread use in research settings.
Objective: To describe the distribution of MMSE scores in a large cohort of MA adults, assess the impact of MMSE requirements on their clinical trial eligibility, and explore which factors are most strongly associated with their MMSE scores.
Methods: Visits between 2004-2021 in the Cameron County Hispanic Cohort were analyzed.
Collusion occurs when multiple malicious participants of a distributed protocol work together to sabotage or spy on honest participants. decentralized protocols often rely on a subset of participants called workers for critical operations. Collusion between workers can be particularly harmful to the security of the protocol.
View Article and Find Full Text PDFBackground: Prior studies have found a reduced risk of dementia of any etiology following influenza vaccination in selected populations, including veterans and patients with serious chronic health conditions. However, the effect of influenza vaccination on Alzheimer's disease (AD) risk in a general cohort of older US adults has not been characterized.
Objective: To compare the risk of incident AD between patients with and without prior influenza vaccination in a large US claims database.
Bangladesh is a maritime country with an area of 118000 km which supports a large number of commercially important species. Currently seaweeds are considered as important component of blue economy development in Bangladesh and farming is practiced at small scale level ( spp, , sp. are cultured).
View Article and Find Full Text PDFThere is growing evidence for neuronal hyperexcitability in Alzheimer's disease. Hyperexcitability is associated with an increase in epileptiform activity and the disruption of inhibitory activity of interneurons. Interneurons fire at a high rate and are frequently associated with high-frequency oscillations in the gamma frequency band (30-150 Hz).
View Article and Find Full Text PDFIntroduction: This study aimed to determine if thromboelastography (TEG) is associated with reduced blood product use and surgical reintervention following cardiopulmonary bypass (CPB) compared to traditional coagulation tests.
Methods: A retrospective review was conducted of 698 patients who underwent CPB at a tertiary-care, community-based, university-affiliated hospital from February 16, 2014 to February 16, 2015 (Period I) and from May 16, 2015 to May 16, 2016 (Period II). Traditional coagulation tests guided transfusion during Period I and TEG guided transfusion during Period II.
Several common and debilitating neurodegenerative disorders are characterized by the intracellular accumulation of neurofibrillary tangles (NFTs), which are composed of hyperphosphorylated tau protein. In Alzheimer's disease (AD), NFTs are accompanied by extracellular amyloid-beta (Aβ), but primary tauopathy disorders are marked by the accumulation of tau protein alone, including forms of frontotemporal dementia (FTD), corticobasal degeneration (CBD), and progressive supranuclear palsy (PSP), among others. F-THK5351 has been reported to bind pathological tau as well as associated reactive astrogliosis.
View Article and Find Full Text PDFCognitive impairment after concussion has been widely reported, but there is no reliable imaging biomarker that predicts the severity of cognitive decline post-concussion. This study tests the hypothesis that patients with a history of concussion and persistent cognitive impairment have fractional anisotropy (FA) and mean diffusivity (MD) values from diffusion tensor imaging (DTI) that are specifically associated with poor performance on the Montreal Cognitive Assessment (MoCA). Fifty-three subjects (19 females) with concussions and persistent cognitive symptoms had MR imaging and the MoCA.
View Article and Find Full Text PDFBackground: Previous research found that infants who were exposed to high levels of arsenic in utero had an increased risk of infectious disease in the first year of life. This prospective study examined the association between arsenic exposures during gestation, and respiratory, diarrheal, and febrile morbidity in children 4-5 years of age.
Methods: A cohort of pregnant women was recruited in 2008-2011 in Bangladesh.
Purpose: Allogeneic hematopoietic stem cell transplantation (AHCT) outcomes depend on disease and patient characteristics. We previously developed a novel prognostic model, hematopoietic cell transplant composite-risk (HCT-CR) by incorporating the refined disease risk index (DRI-R) and hematopoietic cell transplant-comorbidity/age index (HCT-CI/Age) to predict post-transplant survival in patients with acute myeloid leukemia and myelodysplastic syndrome. Here we aimed to validate and prove the generalizability of the HCT-CR model in an independent cohort of patients with hematologic malignancies receiving AHCT.
View Article and Find Full Text PDFTheories of semantic memory based on neuropsychological findings have posited a distinction between stored semantic representations and the mechanisms used to access and manipulate them (e.g., Lambon Ralph, Jefferies, Patterson, & Rogers, 2017; Warrington & Cipolotti, 1996).
View Article and Find Full Text PDFThe gain/amplification CKS1B gene at chromosome region 1q21 (1q+) is one of the most common genetic aberrations in multiple myeloma (MM). Amplification of CKS1B is frequently associated with the deletion of the CDKN2C gene at chromosome region 1p32 (1p-), which is also associated with inferior outcomes. In this retrospective study, we evaluated the outcomes of patients with 1q+ and/or 1p- after high-dose therapy and autologous hematopoietic cell transplantation (auto-HCT).
View Article and Find Full Text PDFMolecular data and minimal residual disease (MRD) have been shown to influence outcomes in acute myeloid leukemia (AML) patients undergoing allogeneic hematopoietic cell transplantation (AHCT). Here we developed and validated a novel AML-specific disease risk group (AML-DRG) and revised our previously developed hematopoietic cell transplant-composite risk (HCT-CR) model by incorporating molecular data and MRD status to predict outcomes of patients with AML. The study included 1414 consecutively treated adult AML patients who received a first AHCT.
View Article and Find Full Text PDFCurrent biomarkers used in research and in clinical practice in Alzheimer's Disease (AD) are the analysis of cerebral spinal fluid (CSF) to detect levels of Aβ42 and phosphorylated-tau, amyloid and FDG-PET, and MRI volumetry. Some of these procedures are still invasive for patients or expensive. Electroencephalography (EEG) and Magnetoencephalography (MEG) are two non-invasive techniques able to detect the early synaptic dysfunction and track the course of the disease.
View Article and Find Full Text PDFHepatic arterial infusion pumps are increasingly utilized as an option for liver directed therapy in the treatment of metastatic colorectal carcinoma. After skeletonization of the hepatic artery through the ligation of extra-hepatic branches, these pumps are implanted surgically with their tip placed in the common hepatic artery. Subsequently, a nuclear medicine pump study is performed to ensure homogeneous perfusion of the liver and detect any extrahepatic perfusion.
View Article and Find Full Text PDFBackground And Purpose: Ventricular enlargement in elderly raises a challenging differential diagnosis to physicians. While Alzheimer's disease is the most common form of dementia, idiopathic normal pressure hydrocephalus (iNPH) constitutes a potentially reversible syndrome. iNPH has a unique pathophysiology pertaining to cerebrospinal fluid (CSF) dynamics and periventricular white matter.
View Article and Find Full Text PDFArsenic crosses the placenta, possibly increasing the risk of adverse reproductive outcomes. We aimed to examine the association between maternal arsenic exposure and fetal/neonatal survival using data from a prospective cohort study of 1,616 maternal-infant pairs recruited at a gestational age of ≤16 weeks in Bangladesh (2008-2011). Arsenic concentration in maternal drinking water was measured at enrollment.
View Article and Find Full Text PDFUnlabelled: Continuous quality improvement is a component of professionalism. Maintenance of Certification (MOC) is a mechanism in the USA for physicians to keep current with medical knowledge and contribute to practice improvement. Little is known about primary care physicians' perceptions of the practice improvement (Part IV) components of MOC.
View Article and Find Full Text PDFIntroduction: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management.
Presentation Of Case: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts.
Bronchoscopy programs implementing the experiential learning model address different learning styles. Problem-based learning improves knowledge retention, critical decision making, and communication. These modalities are preferred by learners and contribute to their engagement, in turn leading to durable learning.
View Article and Find Full Text PDFBackground: Arsenic has antimicrobial properties at high doses yet few studies have examined its effect on gut microbiota. This warrants investigation since arsenic exposure increases the risk of many diseases in which gut microbiota have been shown to play a role. We examined the association between arsenic exposure from drinking water and the composition of intestinal microbiota in children exposed to low and high arsenic levels during prenatal development and early life.
View Article and Find Full Text PDFObjective: As the utility of Child-Pugh (C-P) class is limited by the subjectivity of ascites and encephalopathy, we evaluated a previously established objective method, the albumin-bilirubin (ALBI) grade, as a prognosticator for yttrium-90 radioembolization (RE) treatment for patients with hepatocellular carcinoma (HCC).
Materials And Methods: A total of 117 patients who received RE for HCC from 2 academic centers were reviewed and stratified by ALBI grade, C-P class, and Barcelona Clinic Liver Cancer stage. The overall survival (OS) according to these 3 criteria was evaluated by Kaplan-Meier survival analysis.
Hypertension is the leading cause of cardiovascular disease in the United States and worldwide. It also provides a useful model for team-based chronic disease management. This article describes the M.
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