Yangmorin1431
South Asians are a high-risk ethnic group for cardiovascular disease despite having lower levels of conventional cardiovascular risk factors such as obesity and smoking. Ethnic differences in pulse wave reflections, arterial stiffness, and subclinical atherosclerosis as measured using augmentation index (AIX), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) may reflect some of this excess risk.
We conducted a cross-sectional analysis of pooled data from three community-based sources in Atlanta, Georgia, USA. Data on 530 South Asians collected from local health fairs was compared with data on 507 White and 192 African Americans from the Emory Predictive Health Initiative and 351 White and 382 African Americans from the Morehouse and Emory Team up to Eliminate Health Disparities Study.
Linear regression models adjusted for age, sex, smoking, MAP, fasting glucose, TC, HDL-C, creatinine, and body mass index were used to assess the relationship between ethnicity and vascular function measures. In fully adjusted models, South Asians had higher heart rate corrected AIX as compared with Whites and African Americans (by 5.47%, p<0.01 and 3.50%, p<0.01; respectively), but lower PWV (by 0.51m/s, p<0.01 and 0.72m/s, p<0.01; respectively) and lower CIMT (by 0.02mm p=0.03 and 0.04mm p<0.01; respectively).
Systemic pulse wave reflections, independent of other risk factors, are higher in South Asians as compared with Whites and African Americans. Future research is needed to determine whether higher AIX explains the increased cardiovascular risk among South Asians.
Systemic pulse wave reflections, independent of other risk factors, are higher in South Asians as compared with Whites and African Americans. Future research is needed to determine whether higher AIX explains the increased cardiovascular risk among South Asians.
Amyloid beta (Aβ) deposition was identified to precede tau pathology and neurodegeneration in familial Alzheimer's disease (AD). But the divergence between sporadic and familial AD limits the extension of these findings to sporadic AD.
Longitudinal changes of biomarkers among different stages were assessed using linear mixed-effects models. The slopes of the models were used to estimate rates of change to calculate the biomarker trajectories in sporadic AD.
Cerebrospinal fluid (CSF) Aβ was estimated to decline 45.2 years (abnormal 27.8 years) before dementia, and Aβ deposition seemed to increase 31.7 years (abnormal 26.7 years) before dementia. It was estimated to take 29.0 years (CSF t-tau), 12.2 years (memory), 11.6 years (hippocampus), 9.3 years (hypometabolism), and 6.1 years (cognition) to move from normal to dementia.
The trajectory in sporadic AD is led by Aβ accumulation, followed by CSF t-tau increase, memory deficits, brain atrophy, hypometabolism, and cognitive decline.
The trajectory in sporadic AD is led by Aβ accumulation, followed by CSF t-tau increase, memory deficits, brain atrophy, hypometabolism, and cognitive decline.
Research has shown increased health-care resource use (HRU) among patients with Alzheimer's disease and related disorders (ADRD) well before diagnosis, but the degree to which HRU is correlated with disease severity at the time of initial assessment is not well documented.
Retrospective analysis of linked medical records and claims data for three cohorts mild ADRD (first [index] Mini-Mental State Examination [MMSE] ≥20), moderate/severe ADRD (index MMSE<20), controls without cognitive impairment. HRU during the pre-index year was compared using multivariate regressions.
ADRD cohorts had significantly (
<.01) higher HRU than controls. Compared to mild ADRD patients, moderate/severe ADRD patients had higher rates of hospitalizations (relative risk [RR] 1.57), emergency department visits (RR 1.36), potentially avoidable hospitalizations (RR 1.72), and accidental falls (RR 1.58).
HRU before initial assessment increases with disease severity at the time of assessment, highlighting the need for timely evaluation and improved management in the earliest stages of ADRD.
HRU before initial assessment increases with disease severity at the time of assessment, highlighting the need for timely evaluation and improved management in the earliest stages of ADRD.
Altered metabolism may occur years before clinical manifestations of Alzheimer's disease (AD). We used untargeted metabolomics on the cerebrospinal fluid of patients with mild cognitive impairment (MCI) to uncover metabolomic derangements.
CSF from 92 normal controls and 93 MCI underwent untargeted metabolomics using high-resolution mass spectrometry with liquid chromatography. Partial least squares discriminant analysis was used followed by metabolite annotation and pathway enrichment analysis (PES). Significant features were correlated with disease phenotypes.
We identified 294 features differentially expressed between the two groups and 94 were annotated. PES showed that sugar regulation (N-glycan,
= .0007; sialic acid,
= .0014; aminosugars,
= .0042; galactose,
= .0054), methionine regulation (
= .0081), and tyrosine metabolism (
= .019) pathways were differentially activated and significant features within these pathways correlated with multiple disease phenotypes.
There is a metabolic signature characterized by impairments in sugars, methionine, and tyrosine regulation in MCI. Targeting these pathways may offer new therapeutic approaches to AD.
There is a metabolic signature characterized by impairments in sugars, methionine, and tyrosine regulation in MCI. Targeting these pathways may offer new therapeutic approaches to AD.
Weight loss is associated with higher mortality and progression of cognitive decline, but its associations with magnetic resonance imaging (MRI) changes related to Alzheimer's disease (AD) are unknown.
We included 412 patients from the NUDAD project, comprising 129 with AD dementia, 107 with mild cognitive impairment (MCI), and 176 controls. Associations between nutritional status and MRI measures were analyzed using linear regression, adjusted for age, sex, education, cognitive functioning, and cardiovascular risk factors.
Lower body mass index (BMI), fat mass (FM), and fat free mass index were associated with higher medial temporal atrophy (MTA) scores. Lower BMI, FM, and waist circumference were associated with more microbleeds. Stratification by diagnosis showed that the observed associations with microbleeds were only significant in MCI.
Lower indicators of nutritional status were associated with more MTA and microbleeds, with largest effect sizes in MCI.
Lower indicators of nutritional status were associated with more MTA and microbleeds, with largest effect sizes in MCI.Isolated distal radioulnar joint (DRUJ) dislocation is a rare injury. Reports of isolated DRUJ luxations, volar or dorsal, are often case reports and rarely a series of cases. Bafilomycin A1 manufacturer We present a case of an isolated acute dorsal dislocation of the distal radioulnar joint in a 25-year-old man. The patient underwent closed reduction and a transcutaneous radioulnar pinning was done followed by cast immobilization in neutral rotation during 6 weeks. After six months follow -up, the functional result was satisfactory, patient experienced no pain and had no restrictions in work or sports-related activities.Peritrochanteric fractures are the most common fragility fractures for which patient are admitted in hospital and often require surgical interventions. With increasing life expectancy and early age of presentation, revision surgeries are increasing due to re-trauma, implant failure, infections etc. Here we present the case of a 65 years female, with inter trochanteric fracture femur right side with ipsilateral malunited proximal femur fracture, which was managed with customised proximal femoral nail. This case exemplifies the need for novel techniques and implants in our armamentarium to deal with such unusual fractures in elderly population.Treatment with an Ilizarov ring external fixator is less invasive of soft tissues than is open reduction and internal fixation (ORIF) surgery. Operative treatment of fractures with an Ilizarov ring external fixator after elbow ankylosis has not been reported. We describe our experience with this surgical treatment (i.e., placement of an Ilizarov external ring fixator) for a fracture that occurred after elbow ankylosis. A 63-year-old Japanese woman fell from standing height onto her left elbow. A transverse fracture was observed at the ankylosed site and the patient underwent surgery 8 days after the injury. The surgery was performed in the prone position under general anesthesia. Four months postoperatively, the fracture showed bone union and the fixator was removed. At the 1-year follow-up, she had no pain and no nerve palsy, can could perform the same activities as before the injury. Thus, treatment with an Ilizarov ring external fixator for a fracture around the elbow joint is a minimally invasive procedure that affords firm fixation and achieves fracture-site compression. Osteosynthesis of fractures after elbow ankylosis treated with an Ilizarov external ring fixator has not been reported previously. This technique was less invasive to the soft tissues and was considered to be a good surgical treatment to achieve osteosynthesis of fractures after elbow ankylosis.Concomitant ipsilateral femoral neck and shaft fractures are uncommon high-energy injuries characteristically occurring in young adults. Between 75 and 100% of these injuries occur in association with polytrauma to other organ systems. Associated femoral neck fractures are typically undisplaced, occurring in 2-9% of all femoral shaft fractures. These injuries present both technical and infrastructural challenges particularly in a low resource environment. Several methods of treatment have been used to successfully treat these fractures but there exists no consensus about the optimal management strategy. The "rendezvous" technique using dual implants in an overlapping fashion has been proposed as one method to treat these fractures. We present three cases of ipsilateral hip and femoral shaft fractures which were satisfactorily treated using this technique. The "rendezvous" technique is a simple method, with a good clinical outcome and a low complication rate that can be used to treat ipsilateral femoral neck and shaft fractures.Cardiac tamponade is a recognised sequelae of non-penetrating and penetrating chest trauma. Delayed cardiac tamponade has been described following blunt chest trauma. We present a 29 year-old gentleman who had initially presented to peripheral district general hospital following direct blunt chest wall trauma. His initial trauma CT demonstrated a small mediastinal haematoma and large left haemopneumothorax and disruption/dislocation of the costal cartilage. He initially underwent a thoracoscopic procedure uneventfully. He then had worsening chest radiograph appearances with enlarging cardiac contours. Transthoracic echocardiography confirmed cardiac tamponade. He underwent creation of a pericardial window and excision of the protruding fourth costal cartilage.
Most recurrences of early stage cervical cancer occur in the pelvis or lymphatic system. Distant metastases occur in a minority of patients. Large abdominal wall recurrence presenting as cellulitis and intra-abdominal mass is unusual and presents diagnostic as well as treatment challenges.
A 46-year-old woman with a history of stage 1B1 poorly differentiated squamous cell carcinoma of the cervix 2years earlier presented with infraumbilical abdominal wall erythema, tenderness and warmth to the touch. She had a subcutaneous mass in that area with associated abdominopelvic pain. Imaging showed a 9.5×11cm lobulated mass in the anterior lower abdominal wall, encompassing the width of the lower rectus muscles also invading the small bowel and the bladder. Superimposed cellulitis led to the symptoms with which she presented. She was treated with intravenous antibiotics, and biopsy of the mass revealed squamous cell carcinoma consistent with her prior cervical cancer. She was treated with neoadjuvant chemotherapy followed by surgical debulking with negative margins and adjuvant chemotherapy.
