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Copyright © 2020 Eisaku Oho et al.Heat stroke is a serious medical condition that can cause multiple organ dysfunction, including central nervous system damage. The complications of heat stroke occur because of hypoperfusion, an inflammatory response, and thrombosis, resulting in variable imaging findings. This report describes a rare case of rapidly progressive heat stroke with rhabdomyolysis and acute kidney injury in a 53-year-old woman with atypical brain computed tomography and magnetic resonance imaging findings involving the bilateral cerebral cortex and deep gray matter but excluding the cerebellum. She had an increased diffusion-weighted imaging signal and a reduced apparent diffusion coefficient within the bilateral basal ganglia and cerebral cortex, which have not been reported previously. These findings indicate that cytotoxic edema is a potential mechanism of brain damage in individuals with heat stroke. © 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.Background We report the first case of a missense variant in the APC gene that interrupts splicing by creating a new cryptic acceptor site. The variant, c.289G>A, p.(Gly97Arg), is located in exon 3, and qualitative and semi-quantitative RNA splicing analysis reveal that the variant results in skipping of the last 70 nucleotides of the exon, which leads to the introduction of a frameshift and a premature stop codon. Case presentation The variant was detected in two, apparently unrelated, Danish families with an accumulation of colorectal cancers, colonic adenomas and other cancers. The families both have an attenuated familial adenomatous polyposis phenotype, which is consistent with the association of pathogenic variants in the 5' end of the gene.One variant-carrier also had Caroli Disease and a Caroli Disease associated hepatic mucinous cystadenocarcinoma. This is the first description of a person with both Caroli Disease and a pathogenic APC variant, and although the APC variant is not known to be connected to the development of the hepatic malformations in Caroli Disease, it remains unclear whether the variant could have contributed to the carcinogenesis of the liver tumour. Conclusions Based on functional and co-segregation data we classify the APC c.289G>A, p.(Gly97Arg) variant as pathogenic (class 5). Our findings emphasize the importance of a functional evaluation of missense variants although located far from the exon-intron boundaries. © The Author(s) 2020.Introduction The World Health Organization has declared the coronavirus disease (COVID-19) as a pandemic on 11 March 2020, after the number of confirmed cases outside China increased 13-fold. As the epicentre of the initial outbreak, China has been updating the National COVID-19 Diagnostic and Treatment Guideline with up-to-date information about the disease. To facilitate the implementation of integrative Chinese-Western Medicine in COVID-19 management, Traditional Chinese medicine (TCM) has been recommended in recent editions of the national guideline. Methods The national guideline summarised the opinions and frontline experience of medical experts across the country to provide by far the best management for COVID-19. We extracted the case definition and clinical classifications of COVID-19 in China along with relevant TCM treatments cited in the seventh edition of the guideline, with an intend to disseminate practical information to TCM practitioners and researchers around the world. Results We presented the most recent case definition, clinical classifications, and relevant TCM treatments of COVID-19 in accordance to recommendations of the Chinese guideline. TCM treatments are stratified into two groups based on patients' disease status. Four types of Chinese patent medicines are recommended for suspected COVID-19 cases. Several herbal formulae are recommended for confirmed COVID-19 cases according to their clinical classification and TCM pattern diagnoses. click here Two herbal formulae are also recommended for rehabilitation of recovering cases. Conclusion To control the waves of COVID-19 outbreak, countries must ensure the adherence of their citizens to local public health measures. Medical professionals should diagnose and treat patients according to up-to-date guidelines. Future evaluation of the outcomes of implementing TCM recommendations will strengthen the evidence base for COVID-19 management for the sake of public health and the internationalisation of TCM. © 2020 Elsevier GmbH. All rights reserved.In professional partnerships not only the premises of the practice, the practice furnishings and the nonmedical personnel are jointly utilized by two or more physicians, but medical personnel can also be jointly employed. As a rule, all income and expenditures are run jointly through the practice. Outwardly, the professional partnership forms a legal unit that is also reflected in the mutual liability of the partners. For the protection of this unit, the professional partnership is allowed to participate in the replacement of the licensing of a retiring partner through the successor, if the licensing is replaced within the professional partnership. Within the framework of the partnership contract, overall great care and in many aspects caution is also warranted. Additionally, the individual situation of the partnership and the individual partners must always be essentially taken into consideration. Even the local treatment situation has an important influence with respect to the requirements planning, particularly on regulation of retirement of a partner. In view of the complexity of the material, the partial aspects of the structure of a contract shown in this article and the appropriate regulatory options can only represent a small excerpt. In view of the legal overlaps from corporate law, laws concerning the medical profession and if necessary licensing laws, a lawyer with the appropriate experience and expertise should be commissioned with the construct of a medical partnership contract. © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020.Since December 2019, a disease caused by a novel strain of coronavirus (COVID-19) had infected many people and the cumulative confirmed cases have reached almost 180,000 as of 17, March 2020. The COVID-19 outbreak was believed to have emerged from a seafood market in Wuhan, a metropolis city of more than 11 million population in Hubei province, China. We introduced a statistical disease transmission model using case symptom onset data to estimate the transmissibility of the early-phase outbreak in China, and provided sensitivity analyses with various assumptions of disease natural history of the COVID-19. We fitted the transmission model to several publicly available sources of the outbreak data until 11, February 2020, and estimated lock down intervention efficacy of Wuhan city. The estimated R 0 was between 2.7 and 4.2 from plausible distribution assumptions of the incubation period and relative infectivity over the infectious period. 95% confidence interval of R 0 were also reported. Potential issues such as data quality concerns and comparison of different modelling approaches were discussed.