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Concurrent HBV was found in 28.57% of the NAFLD patients. Patients with concurrent HBV had lower platelet counts, longer prothrombin time/INR and higher fibrosis stage than those without CHB. Conclusion Advanced fibrosis in patients with NAFLD was common in the biopsy series, and was related to aging, hypertension, diabetes mellitus and concurrent HBV infection.Patients with nontuberculous mycobacterial lung disease (NTM-LD) often have significant exercise intolerance and poorer health-related quality of life (HRQL). The goals of treatment for NTM-LD should include reducing the severity of symptoms, improving HRQL, and reducing acute exacerbations. Nonpharmacological treatment, including pulmonary rehabilitation program and optimal nutritional strategy, should be one part of treatment for NTM-LD. A pulmonary rehabilitation (PR) program can comprise education, airway clearance techniques instruction, exercise training program, and inspiratory muscle training (IMT). Airway clearance techniques can improve the volume of sputum expectorated, cough symptom, breathlessness, and HRQL. Exercise training can improve exercise capacity and HRQL, and reduce acute exacerbations and dyspnea. Clinical benefits of IMT remain controversial but high-intensity IMT has been shown to be effective in increasing respiratory muscle strength with concurrent improvement of HRQL and exercise capacity. Body weight and muscle mass loss are common in patients with NTM-LD. An adequate protein and caloric diet combined with antioxidant nutrients might be the most appropriate dietary strategy. Comprehensive treatment for NTM-LD should include the combination of both pharmacological and nonpharmacological treatments. The management programs should be tailored to the individual's condition.Background/purpose Intentional replantation was a conventional treatment option in surgical endodontics but usually be seen as a last resort. [https://www.selleckchem.com/products/Abitrexate.html selleck] Therefore, the purpose of this study was to evaluate the long-term treatment outcome of intentional replantation in Taiwanese population, including the survival rates and the related prognostic factors. Methods Subjects included 215 teeth from 199 patients who had received intentional replantation in a Taiwan medical center. Patients at age under 20 years and those follow-up periods less than 6 months were excluded. The replanted teeth were followed up for a period of 6 months-120 months. Post-treatment assessments, including tooth survival and functional status, were evaluated using both clinical and radiographic examinations. Results Kaplan-Meier survival analysis revealed the overall tooth survival rate at 4 years was 82.8%. In bivariate analysis, both root-end filling material and enamel matrix derivative (EMD) applications were found to be significant (P less then 0.05). The multivariate analysis revealed that age and the presence of a sinus tract or abscess might be the predictors of treatment outcome in intentional replantation. Conclusion Intentional replantation, operated with improved modern technique, is a reliable and viable treatment with a high long-term survival rate (82.8%). If replanted teeth are diagnosed as acute or chronic apical abscess at the pre-operative examination, the risk of failure is measured 2.7 times higher than those diagnosed with other conditions. Application of EMD on the root surface of a replanted tooth may promote the formation and regeneration of periodontal apparatus, therefore increasing the functioning rate and improving the treatment outcome.Background This nationwide study aimed to compare the medical burdens of pyogenic spondylitis (PS) and tuberculous spondylitis (TS) between 2007 and 2016 in Korea. Methods We used a national database managed by the National Health Insurance Service (NHIS) with data from the years 2007 and 2016. A total of 9655 newly diagnosed patients with PS or TS were correspondingly enrolled in the PS or TS group. Chi square test analyses were used to compare the PS and TS groups. Results The overall incidence of infectious spondylitis during the study period was 9655 persons. The PS and TS groups consisted of 7305 and 2350 cases, respectively. Individual medical costs in the PS group (USD 10,049 ± 94 vs. USD 16,672 ± 17,729, P less then 0.001) and the TS group (USD 4882 ± 6869 vs. USD 8531 ± 10,709, P less then 0.001) both increased. The total medical cost for the PS group increased significantly between 2007 and 2016 in Korea (USD 24,428,560 vs. USD 81,044,196, P less then 0.001). In contrast, the total medical cost for the TS group decreased between 2007 and 2016 in Korea (USD 8,573,038 vs. USD 4,879,520, P less then 0.001). Conclusion This nationwide study shows that the total medical cost of PS has increased and that the total medical cost of TS has decreased between 2007 and 2016 in Korea.Background The natural food supplements curcumin and genistein, and the drug ivacaftor were found effective as CFTR potentiators in the organoids of individuals carrying a S1251N gating mutation, possibly in a synergistic fashion. Based on these in vitro findings, we evaluated the clinical efficacy of a treatment with curcumin, genistein and ivacaftor, in different combinations. Methods In three multi-center trials people with CF carrying the S1251N mutation were treated for 8 weeks with curcumin+genistein, ivacaftor and ivacaftor+genistein. We evaluated change in lung function, sweat chloride concentration, CFQ-r, BMI and fecal elastase to determine the clinical effect. We evaluated the pharmacokinetic properties of the compounds by evaluating the concentration in plasma collected after treatment and the effect of the same plasma on the intestinal organoids. Results A clear clinical effect of treatment with ivacaftor was observed, evidenced by a significant improvement in clinical parameters. In contrast we observed no clear clinical effect of curcumin and/or genistein, except for a small but significant reduction in sweat chloride and airway resistance. Plasma concentrations of the food supplements were low, as was the response of the organoids to this plasma. Conclusions We observed a clear clinical effect of treatment with ivacaftor, which is in line with the high responsiveness of the intestinal organoids to this drug. No clear clinical effect was observed of the treatment with curcumin and/or genistein, the low plasma concentration of these compounds emphasizes that pharmacokinetic properties of a compound have to be considered when in vitro experiments are performed.Introduction The activity of an Endocrinology and Nutrition (E&amp;N) department consists of inpatient care both by those attached to the department and through consultations with specialists from other departments. The inpatient care activity of all the E&amp;N departments of a public health system has not been studied in Spain. Material and methods This was a retrospective study of hospital ward activity during 2018 of the E&amp;N departments of the Castilla-La Mancha Public Health Service. It was undertaken in order to ascertain the characteristics of the patients attended to, both by those in charge of the E&amp;N departments and through interconsultation with other departments, as well as the case-mix of the pathology of these patients. All patients admitted to E&amp;N and a 10% sample of those treated through interconsultation were analysed. Results 261 admissions were recorded for Castilla-La Mancha Public Health Service E&amp;N departments. 82.8% were urgent and 53.7% were due to type 1 diabetes mellitus. A total of 5955 patients were seen on an interconsultation basis, 591 of whom were analysed. The most frequent reason for interconsultation was diabetes mellitus/hyperglucemia (28.8%), requiring 6.1±6.7 days per patient. However, interconsultations for artificial nutrition required more days of attendance per patient and accounted for a higher percentage of the total number of days of interconsultation (60.4%). Conclusions The inpatient care activity of the E&amp;N departments of Castilla-La Mancha Public Health Service mainly consists of attending to patients with chronic pathologies of high hospital prevalence such as diabetes mellitus/hyperglucemia and, especially, clinical nutrition.Emerging literature suggests that diet plays an important modulatory role in inflammatory bowel disease (IBD) through the management of inflammation and oxidative stress. The aim of this narrative review is to evaluate the evidence collected up till now regarding optimum diet therapy for IBD and to design a food pyramid for these patients. The pyramid shows that carbohydrates should be consumed every day (3 portions), together with tolerated fruits and vegetables (5 portions), yogurt (125ml), and extra virgin olive oil; weekly, fish (4 portions), white meat (3 portions), eggs (3 portions), pureed legumes (2 portions), seasoned cheeses (2 portions), and red or processed meats (once a week). At the top of the pyramid, there are two pennants the red one means that subjects with IBD need some personalized supplementation and the black one means that there are some foods that are banned. The food pyramid makes it easier for patients to decide what they should eat.The updated RCN Competence Framework for orthopaedic and trauma practitioners was published in 2019 following completion of a 2 year project undertaken by a working group of representatives from England, Northern Ireland, Scotland and Wales. Expert musculoskeletal practitioners, including an allied health professional and working across the lifespan in varying domains of orthopaedic and trauma practice, collaborated to produce a working document applicable to trauma and orthopaedic (T&amp;O) practitioners from all NHS (UK) pay bands. The 2019 document builds on the original and subsequent versions (2005 and 2012), importing new evidence and reformatting it so that it is contemporary and easily cross referenced with the NMC Code (2018). The restructure includes an example of a learning contract demonstrating how the framework can be applied in practice, whether for self-learning, or in conjunction with the revalidation process. This paper reflects on and describes the process undertaken by the working group in the development and restructuring of the 2019 framework, including its evaluation to date and planned in the future.Background The critical shoulder angle (CSA) has been shown to be correlated with shoulder disease states. The biomechanical hypothesis to explain this correlation is that the CSA changes the shear and compressive forces on the shoulder. The objective of this study is to test this hypothesis by use of a validated computational shoulder model. Specifically, this study assesses the impact on glenohumeral biomechanics of modifying the CSA. Methods An inverse dynamics 3-dimensional musculoskeletal model of the shoulder was used to quantify muscle forces and glenohumeral joint forces. The CSA was changed by altering the attachment point of the middle deltoid into a normal CSA (33°), a reduced CSA of 28°, and an increased CSA of 38°. Subject-specific kinematics of slow and fast speed abduction in the scapular plane and slow and fast forward flexion measured by a 3-dimensional motion capture system were used to quantify joint reaction shear and compressive forces. Results Increasing the CSA results in increased superior-inferior forces (shearing forces; integrated over the range of motion; P less then .