Billeandersen3461

Deficiency of ASM (acid sphingomyelinase) causes the lysosomal storage Niemann-Pick disease (NPD). Patients with NPD type B may develop progressive interstitial lung disease with frequent respiratory infections. Although several investigations using the ASM-deficient (ASMKO) mouse NPD model revealed inflammation and foamy macrophages, there is little insight into the pathogenesis of NPD-associated lung disease. Using ASMKO mice, we report that ASM deficiency is associated with a complex inflammatory phenotype characterized by marked accumulation of monocyte-derived CD11b+ macrophages and expansion of airspace/alveolar CD11c+ CD11b- macrophages, both with increased size, granularity, and foaminess. Both the alternative and classical pathways were activated, with decreased in situ phagocytosis of opsonized (Fc-coated) targets, preserved clearance of apoptotic cells (efferocytosis), secretion of Th2 cytokines, increased CD11c+/CD11b+ cells, and more than a twofold increase in lung and plasma proinflammatory cytokines. Macrophages, neutrophils, eosinophils, and noninflammatory lung cells of ASMKO lungs also exhibited marked accumulation of chitinase-like protein Ym1/2, which formed large eosinophilic polygonal Charcot-Leyden-like crystals. In addition to providing insight into novel features of lung inflammation that may be associated with NPD, our report provides a novel connection between ASM and the development of crystal-associated lung inflammation with alterations in macrophage biology.Objectives The purpose of this study was to explore how demographic, relationship, mental health, and life stressors are associated with suicide among older male farmers and to determine if these differ by age.Methods We conducted exploratory analyses with Centers for Disease Control (CDC) National Violent Death Reporting System (NVDRS) 2003-2017 dataset. We identified individuals who completed suicide while working in agriculture (N = 2,106). We explored descriptive statistics for farmers who completed suicide and compared these by age using chi-square tests.Results The majority of the sample was male, non-Hispanic, and White. Marital status differed significantly by age, with older farmers more likely to be married or widowed. Having a mental health issue was not statistically significant by age; however, depression was most prevalent among those 65+. Older farmers who completed suicide were also significantly more likely to report physical health problems.Conclusions Results illustrate the vulnerability of individuals contemplating suicide and emphasize the need to consider the phenomenon from a holistic perspective that accounts for individuals nested within community.Clinical implications We recommend health providers consider a systems approach to suicide prevention as our results indicate individual, familial, and societal factors contributing to the incidence of suicide completion among older farmers.Social media, and in particularly Twitter, can be a resource of enormous value to retrieve information about the opinion of general populaton to vaccines. The increasing popularity of this social media has allowed to use its content to have a clear picture of their users on this topic. In this paper, we perform a study about vaccine-related messages published in Spanish during 2015-2018. More specifically, the paper has focused on two specific diseases influenza and measles (and MMR as its vaccine). By also including an analysis about the sentiment expressed on the published tweets, we have been able to identify the type of messages that are published on Twitter with respect these two pathologies and their vaccines. Results showed that in contrary on popular opinions, most of the messages published are non-negative. On the other hand, the analysis showed that some messages attracted a huge attention and provoked peaks in the number of published tweets, explaining some changes in the observed trends.Objectives Practices of social inclusion are important for maintaining the relationships of persons with dementia and are associated with positive clinical outcomes. The objective of this study was to explore the in-action practices of social inclusion in the activity center of a community-based organization.Methods This study applies an ethnographic approach - including participant observation, informal and semi-structured interviews - with persons with dementia (n = 31) and organization staff members (n = 9) to explore the in-action practices of social inclusion.Results Seven in-action practices of inclusion were identified ensuring time for individual relationships, building schedules centered around flexibility, empowering decision-making, normalizing dementia-related behaviors, involving family members, soliciting and integrating persons with dementia's feedback, and supporting persons with dementia to practice social inclusion.Conclusions Care providers of individuals with dementia can effectively facilitate active connections with them by continually soliciting and incorporating their feedback, and by supporting persons with dementia to practice inclusion and care for others.Clinical Implications Community-based organizations can be effective at supporting the active connection of individuals with dementia with others and should be promoted for individuals with mild to moderate dementia.

To discuss the prevention and treatment of lymph or chyle leak following neck dissection in patients with thyroid carcinoma.

A total of 1724 patients with thyroid carcinoma received neck dissection in the Sun Yat-sen University Cancer Center between November 2009 and October 2014. The incidence and management of leak were analyzed.

A total of 92 (5.34%) patients developed leak, 28 (1.62%) developed lymph leak, 59 (3.42%) developed chyle leak, and 5 (.29%) developed chylothorax. Medical management to stop postoperative lymph or chyle leak included pressure dressing, reoperation, fasting, or low-fat diet therapy.

Lymph or chyle leak may occur in thyroid carcinoma patients who underwent neck dissection. Clinicians should alert to leak when there were IV + VI region lymph node metastasis and should become aware of chylothorax after pressure dressing. buy Eliglustat A careful identification and ligation of lymphatic duct may be an effective way to avoid lymph or chyle leak.

Lymph or chyle leak may occur in thyroid carcinoma patients who underwent neck dissection.