Patient's barrier to initiate insulin therapy for type 2 D.M.

Background: Diabetes Mellitus is a health challenging of the century, more than 300 million people lives with diabetes, and it is one of the biggest global health concerns, awing to its complications. Good glycemic control is the cornerstone to decrease risk of type 2 diabetes complications. Even though, many people still have poor glycemic control which can be partly attributed to late insulin initiation, that can be challenging and forced by numbers of barriers.

Does preoperative silodosin administration facilitate ureteral dilatation during flexible ureterorenoscopy? A randomized clinical trial.

Purpose: To assess whether preoperative administration of silodosin can facilitate the placement of ureteral access sheath (UAS) prior to flexible ureteroscopy (F-URS) and reduce the occurrence of ureteric injury in challenging cases.

Methods: This prospective randomized clinical trial was carried out on 147 patients diagnosed with upper ureteric stone or stone kidney, non-stented. The patients were randomly divided into two equal groups.

Toll-Like Receptor-4 Antagonist Enhances the Repair of Ultraviolet Radiation-Induced DNA Damage and Augments Anti-Tumor Immune Responses in Mice.

Ultraviolet (UV) irradiation of the skin is related to the development of skin cancer. UVB also causes DNA damage in the form of cyclobutane pyrimidine dimers (CPDs), which can result in stable mutations. Toll-like receptor 4 (TLR4), a component of innate immunity, plays a key role in cancer.

Variation of Contrast Values for Myocardial Perfusion Imaging in Single-photon Emission Computed Tomography/Computed Tomography Hybrid Systems with Different Correction Methods.

Objectives: Single-photon emission computed tomography/computed tomography (SPECT/CT) hybrid systems have the advantage of performing various scans using the same imaging setting. Absorption and scattering of the gamma rays by the patient's body significantly affect images obtained from scintigraphy, especially in myocardial perfusion imaging. An important parameter for image quality in SPECT is image contrast which is defined as the difference in density between regions of the image corresponding to different levels of radioactive uptake in the patient.

Sitagliptin-induced Pancreatitis: Chronic Use Would Not Spare You the Complication.

Medication-induced pancreatitis is an overlooked cause of acute pancreatitis. We present an 81-year-old male patient with acute sharp epigastric pain radiating to his back, who was found to have lipase of more than 30,000 U/L. The patient denied current alcohol use.

EPR detection and characterisation of a paramagnetic Mo(iii) dihydride intermediate involved in electrocatalytic hydrogen evolution.

EPR spectroscopy and theoretical data show that the slow heterogeneous electron-transfer kinetics associated with the reduction of an 18-electron Mo(IV) acetato dihydride are a consequence of an η(2)-η(1) rearrangement of the carboxylate ligand which gives a unique paramagnetic 17-electron Mo(III) dihydride.

Substantiation of 25 kGy radiation sterilization dose for banked air dried amniotic membrane and evaluation of personnel skill in influencing finished product bioburden.

Preparation of amniotic membrane (AM) by air drying method followed by radiation sterilization is simple and valuable approach; sterility and quality of the final AM product are depending on the quality management system at the tissue bank. Validation and substantiation of radiation sterilization dose (RSD) for tissue allografts is an essential step for the development and validation of the standard operating procedures (SOP). Application of SOP is perfectly relying on trained staff.

Solar fuels: photoelectrosynthesis of CO from CO2 at p-type Si using Fe porphyrin electrocatalysts.

Photoelectrocatalytic conversion of CO2 to CO can be driven at a boron-doped, hydrogen terminated, p-type silicon electrode using a meso-tetraphenylporphyrin Fe(III) chloride in the presence of CF3CH2OH as a proton source and 0.1 M [NBu4][BF4]/MeCN/5% DMF (v/v) as the electrolyte. Under illumination with polychromatic light, the photoelectrocatalysis operates with a photovoltage of about 650 mV positive of that for the dark reaction.

Ferracyclic carbamoyl complexes related to the active site of [Fe]-hydrogenase.

The active site of the [Fe]-hydrogenase features an iron(II) centre bearing cis carbonyl groups and a chelating pyridine-acyl ligand. Reproducing these unusual features in synthetic models is an intriguing challenge, which will allow both better understanding of the enzymatic system and more fundamental insight into the coordination modes of iron. By using the carbamoyl group as a surrogate for acyl, we have been able to synthesize a range of ferracyclic complexes.

Incidental hyperdensities within the reticuloendothelial system.

This is a case report of a 79-year-old woman who was found to have numerous hyperdense nodular lesions in the upper abdomen, which were incidentally discovered during routine follow-up of a lung nodule. These hyperdense lesions included a lace-like reticular distribution within the liver, multiple extremely dense lymph nodes, and a shrunken hyperdense spleen. We discuss differential considerations for such a constellation of findings and explain why we believe the findings in this case are consistent with prior thorium dioxide exposure.

Towards alternatives to anodic water oxidation: basket-handle thiolate Fe(III) porphyrins for electrocatalytic hydrocarbon oxidation.

Selective electrocatalytic oxidation of hydrocarbons to alcohols, epoxides or other (higher value) oxygenates should in principal present a useful complementary anodic half-cell reaction to cathodic generation of fuels from water or CO(2) viz. an alternative to oxygen evolution. A series of new basket-handle thiolate Fe(III) porphyrins have been synthesised and shown to mediate anodic oxidation of hydrocarbons, specifically adamantane hydroxylation and cyclooctene epoxidation.

Solar fuels: visible-light-driven generation of dihydrogen at p-type silicon electrocatalysed by molybdenum hydrides.

We show that a robust molybdenum hydride system can sustain photoelectrocatalysis of a hydrogen evolution reaction at boron-doped, hydrogen-terminated, p-type silicon. The photovoltage for the system is about 600-650 mV and the current densities, which can be sustained at the photocathode in non-catalytic and catalytic regimes, are similar to those at a photoinert vitreous carbon electrode. The kinetics of electrocatalysed hydrogen evolution at the photocathode are also very similar to those measured at vitreous carbon-evidently visible light does not significantly perturb the catalytic mechanism.

Early assessment of the efficacy of digital infrared thermal imaging in pediatric extremity trauma.

Young children or those with intellectual disability with trauma to an extremity often undergo radiographs of the whole limb. The objective of the study was to assess the efficacy of digital infrared thermal images (DITI) in pediatric extremity trauma. We hypothesized fractures to be associated with local hyperthermia, detectable with DITI, which could direct focused radiographs.

Treating and downstaging hepatocellular carcinoma in the caudate lobe with yttrium-90 radioembolization.

Purpose: This study was designed to determine the technical feasibility, safety, efficacy, and potential to downstage patients to within transplantation criteria when treating patients with hepatocellular carcinoma (HCC) of the caudate lobe using Y90 radioembolization.

Methods: During a 4-year period, 8 of 291 patients treated with radioembolization for unresectable HCC had disease involving the caudate lobe. All patients were followed for treatment-related clinical/biochemical toxicities, serum tumor marker response, and treatment response.

Paramagnetic bridging hydrides of relevance to catalytic hydrogen evolution at metallosulfur centers.

Paramagnetic hydrides are likely intermediates in hydrogen-evolving enzymic and molecular systems. Herein we report the first spectroscopic characterization of well-defined paramagnetic bridging hydrides. Time-resolved FTIR spectroelectrochemical experiments on a subsecond time scale revealed that single-electron transfer to the μ-hydride di-iron dithiolate complex 1 generates a 37-electron valence-delocalized species with no gross structural reorganization of the coordination sphere.

Protonation of [FeFe]-hydrogenase sub-site analogues: revealing mechanism using FTIR stopped-flow techniques.

The formation of transient metal hydride(s) at the metallo-sulfur active sites of [FeFe]-hydrogenase is implicated in both hydrogen evolution and uptake reactions. Stopped-flow spectroscopic techniques can provide insight into the reactivity patterns of model {2Fe2S} sub-sites towards protons, and this information contributes to understanding the nature of the biological systems. In this study we have focussed on the influence of the nature of the bridging dithiolate ligand in influencing the kinetics and activation energy parameters for protonation in synthetic sub-sites including Fe2{micro-[S(CH2)(n)S]}(CO)4(PMe3)2 [n = 2, ethane-1,2-dithiolate (edt) or n = 3, propane-1,3-dithiolate (pdt)], Fe2[(micro-SCH2)2NH](CO)4(PMe3)2 and (NEt4)2{Fe2[(micro-SCH2)2NH](CO)4(CN)2}.

Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma.

Background & Aims: Chemoembolization is one of several standards of care treatment for hepatocellular carcinoma (HCC). Radioembolization with Yttrium-90 microspheres is a novel, transarterial approach to radiation therapy. We performed a comparative effectiveness analysis of these therapies in patients with HCC.

Artificial hydrogenases: assembly of an H-cluster analogue within a functionalised poly(pyrrole) matrix.

We show that a redox active {Fe(4)S(4)}(2+)-cubane assembly covalently bound within a cysteinyl-alkylammonium functionalised polypyrrole can be modified with a diiron dithiolate carbonyl unit to give an artificial hydrogenase H-cluster framework confined within the polymer matrix.

Safety of yttrium-90 microsphere radioembolization in patients with biliary obstruction.

Purpose: There are few data on radioembolization in the setting of biliary obstruction. The present study was performed to assess the safety of yttrium-90 ((90)Y) radioembolization in the setting of tumor-related biliary obstruction and total bilirubin levels of 2 mg/dL or lower.

Materials And Methods: Twelve patients with liver tumors underwent 19 treatment sessions with (90)Y to the obstructed liver lobe or segment.

Chemoembolization for hepatocellular carcinoma: comprehensive imaging and survival analysis in a 172-patient cohort.

Purpose: To determine comprehensive imaging and long-term survival outcome following chemoembolization for hepatocellular carcinoma (HCC).

Materials And Methods: One hundred seventy-two patients with HCC treated with chemoembolization were studied retrospectively in an institutional review board approved protocol; this study was HIPAA compliant. Baseline laboratory and imaging characteristics were obtained.

Agreement between competing imaging measures of response of hepatocellular carcinoma to yttrium-90 radioembolization.

Purpose: There are currently at least six major competing criteria used to determine response to yttrium-90 and other liver-directed therapies, including: (i) Response Evaluation Criteria in Solid Tumors (RECIST); (ii) World Health Organization (WHO), (iii) volumetric, (iv) two-dimensional (2D) European Association for the Study of the Liver (EASL), and (v) three-dimensional (3D) EASL criteria; and (vi) functional diffusion-weighted (DW) magnetic resonance (MR) imaging. This study evaluated agreement among these competing tumor response classification schemes based on quantitative measurements of tumor size, necrosis, and changes in water mobility.

Materials And Methods: In this retrospective study, 20 patients with hepatocellular carcinoma (HCC) underwent (90)Y radioembolization.

Direct hepatic artery puncture for transarterial therapy in liver cancer.

In the treatment of liver malignancies, therapies such as bland embolization, chemoembolization and radioembolization require access to the hepatic artery by means of conventional transfemoral or brachial catheterization. Challenging vascular anatomy can impede selective access to tumoral vessels, preventing the safe and effective delivery of embolic material. Direct percutaneous hepatic arterial puncture under ultrasonographic guidance may be an alternative method to obtain intrahepatic arterial access for the purposes of hepatic arteriography and delivery of therapeutic agents.