Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis.

Objective: To verify the safety and effectiveness of traditional Chinese red yeast rice-extract (RYR) for reduction of LDL cholesterol.

Methods: Systematic literature review and meta-analysis. Medline and EMBASE were searched until November 2014.

MetDFBA: incorporating time-resolved metabolomics measurements into dynamic flux balance analysis.

Understanding cellular adaptation to environmental changes is one of the major challenges in systems biology. To understand how cellular systems react towards perturbations of their steady state, the metabolic dynamics have to be described. Dynamic properties can be studied with kinetic models but development of such models is hampered by limited in vivo information, especially kinetic parameters.

Febrile neutropenia: significance of elaborated screening for respiratory viruses, and the comparison of different sampling methods, in neutropenic patients with hematological malignancies.

Background: During febrile neutropenia in only 30 to 60 percent an infectious agent is identified. This diagnostic gap could hypothetically be reduced with the broad implementation of molecular detection techniques like PCR, which has revolutionized the detection of infectious diseases during the last two decades.

Findings: We performed a longitudinal prospective study (N = 81) of neutropenic patients to assess the role of respiratory viruses in neutropenic fever and to determine the clinical relevance of blind screening for these viruses.

Field testing in Suriname of two blood pressure-measuring devices for low-resource and middle-resource countries, according to a WHO protocol.

Introduction: High blood pressure (BP) is known to be the greatest modifiable risk factor of cardiovascular diseases, of which 80% occur in low-resource and middle-resource settings. Yet, BP measurement in these countries remains extremely poor. In 2005, a WHO committee invited manufacturers to produce devices especially for use in low-resource settings.

Involvement of stress in the pathogenesis of autoimmune thyroid disease: a prospective study.

Background: An association between stress and autoimmune thyroid disease (AITD) (especially Graves' hyperthyroidism) has been reported, but all studies so far on this topic have been retrospective.

Objective: To evaluate prospectively the relationship between stress and (i) de novo occurrence of thyroid antibodies and (ii) development of overt autoimmune hyper-/hypothyroidism.

Study Design: Two nested case-control studies in a prospective cohort of 790 euthyroid women who were 1st or 2nd degree relatives of AITD patients.

Obsessions in normality and psychopathology.

Background: This study examines the presence of obsessions in the general population and in various psychiatric disorders. Second, the impact of obsessions is studied in terms of general functioning and quality of life in the general population.

Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a large representative sample of the Dutch population (n = 7,076).

Co-occurrence of obsessive-compulsive disorder and substance use disorder in the general population.

Aim: Very little is known about the relationship between obsessive-compulsive disorder (OCD) and substance use disorder (SUD). The aim of this study is to compare the co-occurrence of OCD with SUD to the co-occurrence of SUD with other psychiatric disorders in a representative community sample.

Design: In order to examine the association of SUD and OCD, logistic regression analyses were used generating odds ratios and 95% confidence intervals for life-time prevalence and 12-month prevalence.

Frequent detection of respiratory viruses without symptoms: toward defining clinically relevant cutoff values.

Highly sensitive techniques, such as PCR, have greatly improved the detection of respiratory viruses. However, the sensitivity of PCR tests also complicates clinical interpretation, as the presence of small amounts of viral targets may not necessarily have clinical relevance. We performed a prospective case-control study in asymptomatic and symptomatic young children.

Isolated fractures of the teardrop of the acetabulum.

Introduction: Fractures of the teardrop are very rare. We would like to present two patients with a fracture of the teardrop. The teardrop is a radiological entity, also known as the U figure.

Quantitation of respiratory viruses in relation to clinical course in children with acute respiratory tract infections.

Quantitation of respiratory viruses by PCR could potentially aid in clinical interpretation of PCR results. We conducted a study in children admitted with acute respiratory tract infections to study correlations between the clinical course of illness and semiquantitative detection of 14 respiratory viruses. Clinical improvement was associated with reduction of viral quantity after 3 days of hospitalization.

Creatinine clearance is independently associated with one year mortality in a primary PCI cohort with cardiogenic shock.

Background: Acute ST-segment elevation myocardial infarction (STEMI) complicated with cardiogenic shock (CS) has still the highest in hospital mortality. Patients with STEMI and increasing creatinine levels within 24 h after admission have a poor prognosis. Data about STEMI complicated with CS and kidney function are sparse.

Detection of aberrant transcription of major histocompatibility complex class II antigen presentation genes in chronic lymphocytic leukaemia identifies HLA-DOA mRNA as a prognostic factor for survival.

In human B cells, effective major histocompatibility complex (MHC) class II-antigen presentation depends not only on MHC class II, but also on the invariant chain (CD74 or Ii), HLA-DM (DM) and HLA-DO (DO), the chaperones regulating the antigen loading process of MHC class II molecules. We analysed immediate ex vivo expression of HLA-DR (DR), CD74, DM and DO in B cell chronic lymphocytic leukaemia (B-CLL). Real-time reverse transcription polymerase chain reaction demonstrated a highly significant upregulation of DRA, CD74, DMB, DOA and DOB mRNA in purified malignant cells compared to B cells from healthy donors.

What to do with the other ear after cochlear implantation.

Unilateral cochlear implantation has become a widely accepted surgical intervention for both deaf children and adults. It is a reliable and effective method to rehabilitate profound deafness. Recently the benefits of the use of a contralateral hearing aid (bimodal stimulation) with a cochlear implant became clear.

Nonunion of the femoral neck: possibilities and limitations of the various treatment modalities.

Nowadays in cases of nonunions of the femoral neck, the surgeon is tempted to perform prosthetic replacement of the hip, more so if there is also evidence of avascular necrosis of the head of femur. This provides rapid pain relief and allows early mobilization. However, long-term results of hip arthroplasties, especially in younger people and in the presence of osteopenia, are not always as expected; and a less radical approach is worth considering.

Ototoxicity in a randomized phase III trial of intra-arterial compared with intravenous cisplatin chemoradiation in patients with locally advanced head and neck cancer.

Purpose: Cisplatin concomitantly administered with radiotherapy is increasingly used in locally advanced head and neck squamous cell carcinoma. We aimed to compare the incidence of hearing loss between patients treated with intra-arterial high-dose cisplatin chemoradiation with sodium thiosulfate (CRT-IA) and intravenous high-dose cisplatin chemoradiation without sodium thiosulfate (CRT-IV).

Patients And Methods: We conducted a prospective analysis of hearing thresholds at low and (ultra-) high frequencies obtained before, during, and after treatment in 158 patients.

Risk factors of ototoxicity after cisplatin-based chemo-irradiation in patients with locally advanced head-and-neck cancer: a multivariate analysis.

Purpose: Cisplatin chemo-irradiation is increasingly used in locally advanced squamous cell carcinoma of the head and neck. The objective of this study is to determine risk factors of ototoxicity due to intra-arterial high-dose cisplatin chemoradiation.

Methods And Materials: A prospective analysis of hearing thresholds at low and (ultra) high frequencies obtained before, during, and after treatment in 146 patients.

Role of viruses in Kenyan children presenting with acute encephalopathy in a malaria-endemic area.

In malaria-endemic areas, it is difficult to differentiate between cerebral malaria (CM), bacterial meningitis, and viral encephalitis. We examined the cerebrospinal fluid of 49 children who fulfilled the World Health Organization's (WHO) definition of CM and in 47 encephalopathic children, without malaria, looking for viruses with polymerase chain reaction. In the children with CM, four (9%) had evidence of Herpes simplex virus 1 in the cerebrospinal fluid, whereas in the encephalopathy group without malaria, six (12%) were positive.

Total hip replacement using hemi-circumferential interposition acetabuloplasty for acetabular deficiency in post-Perthes deformities: technique and long-term results.

We describe a technique of hemi-circumferential interposition grafting that allows placement of the cup in the anatomical position of the original acetabulum in the rare cases of post-Perthes or Perthes-like deformities of the femoral head combined with a steep and shallow acetabulum. This technique was performed on 10 hips (9 patients, with an average age of 56 years). One revision was performed for septic loosening after 2.

Audiometric patterns in ototoxicity of intra-arterial Cisplatin chemoradiation in patients with locally advanced head and neck cancer.

This study describes audiometric patterns of ototoxicity in a consecutive series of patients uniformly treated with intra-arterial high-dose cisplatin chemoirradiation for advanced cancer of the head and neck. Air conduction thresholds were measured from 0.125 to 16 kHz and bone conduction thresholds were measured from 0.

Risk factors for mortality due to shigellosis: a case-control study among severely-malnourished children in Bangladesh.

To determine the risk factors for death of severely-malnourished Bangladeshi children with shigellosis, a case-control study was conducted at the Clinical Research and Service Centre of ICDDR,B: Centre for Health and Population Research in Dhaka, Bangladesh. One hundred severely-malnourished children (weight-for-age <60% of median of the National Center for Health Statistics), with a positive stool culture for Shigella dysenteriae type 1 or S. flexneri, who died during hospitalization, were compared with another 100 similar children (weight-for-age <60% and with S.

Bleeding diathesis in Noonan syndrome.

An 18-year-old girl with Noonan syndrome was operated on for prominent ears. Subcutaneous haematomas developed on both sides, and coagulation tests reported a bleeding diathesis. This is seldom mentioned in descriptions of the syndrome, but it has been shown that one-third of all patients with the syndrome have defects in haemostasis.

B-cell antigen receptor-induced apoptosis: looking for clues.

Triggering of the B cell antigen receptor (BCR) can initiate divergent responses ranging from activation and cell division to apoptosis, depending on the differentiation stage and additional signals the cell receives. Despite considerable progress in unraveling general apoptosis pathways, the route from the BCR to apoptosis execution is still quite obscure, and there is no consensus yet concerning the mechanism or the players involved. Here, we will summarize current developments in this field and will attempt to pinpoint key questions and perspectives for future research.

Acetabular reduction osteotomy using surgical dislocation of the hip joint for treatment of a malunited acetabular fracture.

Introduction: Acetabular fractures remain a challenge for the orthopedic and trauma surgeon, with frequently poor outcome in terms of pain and lack of motion and high rate of posttraumatic arthritis especially in badly reconstructed fractures where the anatomy was not restored. Surgical treatment of malunited acetabular fractures is often necessary, although it can be very complex.

Case Presentation: We report a young woman who sustained both column fracture with central dislocation of the femoral head in which the posterior wall fragment was initially not fixed anatomically.

Apoptosis via the B cell antigen receptor requires Bax translocation and involves mitochondrial depolarization, cytochrome C release, and caspase-9 activation.

Various routes to apoptosis can be active during B cell development. In a model system of mature B cells, differences in caspase-3 processing have suggested that antigen receptor (BCR)-mediated apoptosis may involve a zVAD-insensitive initiator protease(s). In search of the events leading to caspase-3 activation, we now establish that both CD95- and BCR-mediated apoptosis depend on Bax activation and cytochrome C (cytC) release.