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A 54-year old female patient with the genetic disease of arterial calcification due to deficiency of CD73 was studied under the Undiagnosed Disease Program of the National Institutes of Health. She presented with symptoms of claudication in her 40s and later developed arthritic symptoms, ectopic calcification in her left hand and severe arterial calcifications of the lower extremities. Since little was known about the composition of the calcifications in arterial calcification due to deficiency of CD73, we investigated their chemical identity and microscopic morphology in this patient with imaging and x-ray diffraction analysis. We found that, microscopically, the bulk calcifications consisted of fragments of either solid or porous internal structure. Both periarticular and arterial calcifications were primarily hydroxyapatite crystals of the same crystalline anisotropy, but different crystalline grain sizes. This was consistent with the presence of hydroxyapatite crystals along with birefringent calcium pyrophosphate dihydrate crystals in the synovial fluid of the patients by polarized light microscopy. The result suggests that tissue calcification in both locations follow a similar biochemical mechanism caused by an increase in extracellular tissue-nonspecific alkaline phosphatase activity.Epithelial-mesenchymal transition (EMT) is a critical process that occurs during the embryonic development, wound healing, organ fibrosis and the onset of malignancy. Emerging evidence suggests that the EMT is involved in the invasion and metastasis of cancers. The inflammatory reaction antecedent to fibrosis in the onset of oral submucous fibrosis (OSF) and the role of EMT in its malignant transformation indicates a hitherto unexplored involvement of EMT. This review focuses on the role of EMT markers which are regulators of the EMT mediated complex network of molecular mechanisms involved in the pathogenesis of OSF and OSCC. Further the gene enrichment analysis and pathway analysis supports the association of the upregulated and downregulated genes in various EMT regulating pathways.

Contrast-induced acute kidney injury (CI-AKI) is a common cause of hospital-acquired AKI and a serious complication of percutaneous coronary intervention.

The aim of the present study was to assess whether remote ischemic preconditioning (RIPC) reduces the incidence of CI-AKI.

We conducted a prospective, randomized, sham-controlled clinical study. The study included 101 patients admitted to the Intensive Cardiac Therapy Clinic of Medical University of Lodz for elective percutaneous coronary intervention. The participants were randomly assigned in a 11 ratio to either a control group (n = 51) or an RIPC group (n = 50). In the latter, RIPC was achieved before percutaneous coronary intervention by 4 cycles of 5-minute inflation of a cuff on the left upper arm to 200 mm Hg followed by 5-minute deflation. In the control group, a deflated cuff was placed on the left arm for 40 minutes. Serum creatinine concentration was measured to check for the presence of CI-AKI within 48 to 72 hours of percutaneous coronary intervention. Serum neutrophil gelatinase-associated lipocalin level was also measured within 3 hours.

CI-AKI occurred in 2 patients from the RIPC group (4%) and 3 patients from the control group (5.9%), but the difference was not significant (

 = 0.98). The patients who developed CI-AKI also demonstrated increased serum neutrophil gelatinase-associated lipocalin concentrations (the area under the receiver operator characteristic curve = 0.97; 95% CI, 0.938-1.00;

< 0.00) and the optimal cutoff point value was 118.9 ng/mL.

The use of RIPC before elective percutaneous coronary intervention was not found to prevent CI-AKI. ClinicalTrials.gov identifier NCT03761368. (

. 2020; 81XXX-XXX).

The use of RIPC before elective percutaneous coronary intervention was not found to prevent CI-AKI. ClinicalTrials.gov identifier NCT03761368. (Curr Ther Res Clin Exp. 2020; 81XXX-XXX).

Apple peels contain phlorizin, which can reduce plasma glucose levels in a manner similar to that of inhibitors for sodium-glucose cotransporters.

In this study, we examined the influence of a peeled apple, a sodium-glucose cotransporter-2 inhibitor (ipragliflozin) in combination with a peeled apple, and an unpeeled apple on interstitial glucose in a healthy individual across 3 experiments.

For Experiments 1, 2, and 3, the healthy volunteer consumed 327 g peeled Sun Fuji apple, took 50 mg ipragliflozin, and then consumed 327 g peeled Sun Fuji apple, or consumed 370 g unpeeled Sun Fuji apple (peel weight was 43 g), respectively. In each condition, the apple was eaten within a 15-minute period and interstitial glucose levels were measured every 15 minutes for 11.5 hours using FreeStyle Libre (Abbott Laboratories, Abbott Park, Illinois).

Results showed that neither consumption of the unpeeled apple nor ipragliflozin were able to suppress the rapid or transient increases in postprandial glucose; however, the 2 were found to comparably suppress interstitial glucose during the late phase.

On the whole, these findings demonstrate that eating unpeeled apples may be beneficial for plasma glucose management, but ipragliflozin is a superior option because the apple peel's function did not last as long as ipragliflozin. (

. 2020; 81XXX-XXX).

On the whole, these findings demonstrate that eating unpeeled apples may be beneficial for plasma glucose management, but ipragliflozin is a superior option because the apple peel's function did not last as long as ipragliflozin. (Curr Ther Res Clin Exp. 2020; 81XXX-XXX).The virtual issue will only include the main essay.The recent pandemic (COVID-19) has seen a sweeping and surging use of products intended to clean and disinfect, such as air sprays, hand sanitizers, and surface cleaners, many of which contain fragrance. However, exposure to fragranced cleaning products has been associated with adverse effects on human health. Products can emit a range of volatile chemicals, including some classified as hazardous, but relatively few ingredients are disclosed to the public. Thus, relatively little is known about the specific emissions from these products. This study investigates the volatile organic compounds (VOCs) emitted from "pandemic products" that are being used frequently and extensively in society. In addition, among these emissions, this study identifies potentially hazardous compounds, compares so-called green and regular versions of products, and examines whether ingredients are disclosed to the public. Using gas chromatography/mass spectrometry, 26 commonly used pandemic products, including 13 regular and 13 so-called green versions, were analyzed for their volatile emissions. Product types included hand sanitizers, air disinfectants, multipurpose cleaners, and handwashing soap. All products were fragranced. The analyses found the products collectively emitted 399 VOCs with 127 VOCs classified as potentially hazardous. All products emitted potentially hazardous compounds. Comparing regular products and green products, no significant difference was found in the emissions of the most prevalent compounds. Further, among the 399 compounds emitted, only 4% of all VOCs and 11% of potentially hazardous VOCs were disclosed on any product label or safety data sheet. This study reveals that pandemic products can generate volatile emissions that could pose risks to health, that could be unrecognized, and that could be reduced, such as by using fragrance-free versions of products.

Knee hyperextension in stance is a difficult condition to treat in children with spastic diplegic cerebral palsy (CP). In children with passive knee hyperextension, the presence of contracture or spasticity of the calf leads to knee hyperextension in stance phase. We hypothesize surgical treatment of the contracture of the calf will lead to less knee hyperextension.

We performed a retrospective review of children who were evaluated in our movement laboratory over 23 years with a diagnosis of CP Gross Motor Function Classification System I, II or III. We selected children who had passive knee hyperextension on exam and who underwent calf lengthening surgery. Children were divided into two groups early recurvatum (ER) (n = 20) and late recurvatum (LR) (n = 14).

There was no difference in the preoperative passive knee extension among the groups or the surgeries performed. For children who had passive knee hyperextension, calf lengthening improved static dorsiflexion with knee flexion on clinical exam by 9.3° in the ER group, 9.6° in the LR group as well as dorsiflexion with knee extension on clinical exam by 9.5° in the ER group and 6.4° in the LR group. The kinematic data showed that the ER group improved their knee hyperextension by 11° (p < 0.001), whereas the LR group did not significantly change their stance phase knee position.

Children with passive knee hyperextension who have a calf contracture and walk in knee hyperextension in the first half of stance phase may improve after calf lengthening.Level of Evidence III.

Children with passive knee hyperextension who have a calf contracture and walk in knee hyperextension in the first half of stance phase may improve after calf lengthening.Level of Evidence III.

In the 1980s the first results of an early multilevel contracture release (MLCR) in patients suffering from progressive Duchenne muscular dystrophy (DMD) showed a positive effect on ambulation. Despite the demonstrated positive effects of prolongation of walking this treatment is not part of current guidelines. The aim of our study was to evaluate the effect of MLCR as well as its combination with glucocorticoid (GC) treatment on ambulation.

Data of all boys (n = 86) with DMD treated in our outpatient department were analyzed regarding the treatment and loss of independent ambulation. In all, 23 were treated with GC only, ten were operated on, 21 received GC and underwent MLCR and 32 received neither of the two treatments.

The analysis of the loss of independent ambulation in our cohort showed a comparable extension of the ambulatory period between the GC-treated and MLCR-treated boys (p = 0.008 and p = 0.005, respectively). Furthermore, an additive effect of both therapies was found; patients with DMD who had both treatments were able to walk two years longer than those with only one of the two treatment options (p<0.001).

Standard GC treatment and early MLCR in lower limbs have an independent positive effect on prolongation of ambulation in patients with DMD. see more In our cohort, the combination of both therapies is significantly more effective than each therapy alone. We suggest both should be offered to all DMD patients eligible.Level of evidence III.

Standard GC treatment and early MLCR in lower limbs have an independent positive effect on prolongation of ambulation in patients with DMD. In our cohort, the combination of both therapies is significantly more effective than each therapy alone. We suggest both should be offered to all DMD patients eligible.Level of evidence III.

Scoliosis, chest wall deformities and pulmonary involvement are common features of Marfan syndrome (MFS). We aimed to assess the impact of spinal and chest wall deformities on pulmonary function in paediatric MFS patients with a surgically managed spinal deformity.

In this multicentre retrospective study, spirometry, lung volumes and radiographic imaging were performed on 26 MFS patients between the ages of seven and 18 years who were undergoing planned spinal fusion surgery for spinal deformity. A correlation analysis assessed the relationship between radiographic measurements of spinal and chest wall deformities and predicted total lung capacity (TLC), forced vital capacity (FVC) and the ratio between forced expiratory volume in one second and FVC (FEV1/FVC).

In total, 18 patients (70%) had impaired pulmonary function. Thoracic kyphosis (mean 19.3°; -32° to 54°) had a strong positive correlation with FEV1/FVC (r = 0.65; p < 0.001). Significant decrease in FEV1/FVC below 80% occurred at kyphosis under 15° (p = 0.