Francishines2430

Older age and Caucasian race were identified as significant risk factors for malignancy, while never smoker was a protective factor. Metformin use in this solid organ transplant cohort was not found to significantly reduce malignancy risk compared to use of other anti-diabetic agents. This article is protected by copyright. All rights reserved.AIM To identify children with complex medical needs by examining their patterns of hospital care. METHODS We conducted a retrospective population-based study on 18 577 patients aged 6 to 12 years from the Haukeland University Hospital register over a 3-year period (from 2013 to 2015). Data were structured to examine the temporal patterns and sequences of referrals, care episodes and diagnoses, including across medical specialties. RESULTS Over a third of patients had repeated referrals, and 14.9% of all had three or more. Furthermore, 9.3% of patients were referred to both somatic and mental health care services. Patients with such combined referrals had a higher number of referrals as well as a higher number of different diagnoses. A-674563 concentration Overall, there was a high frequency of non-specific diagnoses, and 34.8% of patients still had a non-specific main diagnosis at the end of their hospital contact. CONCLUSION This study demonstrates an increased risk for complex care pathways in children with multiple referrals. Interdisciplinary patterns of referrals were relatively common, particularly for patients in mental health care. These findings highlight the importance of developing interdisciplinary-based approaches for patients with complex complaints. This article is protected by copyright. All rights reserved.U.S. children are exposed to lead through lead-based paint, lead-contaminated dust in older homes and through contaminated water, air, soil, or consumer and imported products1,2 . Approximately 24 million housing units have one or more lead-based paint hazards, including 3.6 million homes with children aged ≤6 years1 . Epidemiologic studies have reported positive associations between lead and elevated immunoglobulin E (IgE) in children3-5 ; IgE is often associated with allergic asthma6 . This article is protected by copyright. All rights reserved.Juvenile idiopathic arthritis (JIA) is a chronic disease. During its "high disease activity (HDA)" stage, JIA can cause severe pain, and thus could seriously affect patients' physical and psychological health. Early detection of the HDA stage of JIA can reduce the damage of the disease by treating it at an early stage and alleviating the painful experience of the patients. So far, no effective cure of JIA has been found, and one major goal of disease management is to improve patients' quality of life. To this end, patients' health-related quality of life (HRQOL) scores are routinely collected over time from JIA patients. In this paper, we demonstrate that a new statistical methodology called dynamic screening system (DySS) is effective for early detection of the HDA stage of JIA. By this approach, a patient's HRQOL scores are monitored sequentially, and a signal is given by DySS once the longitudinal pattern of the scores is found to be significantly different from the pattern of patients with low disease activity. Dimension reduction of the observed HRQOL scores and the corresponding impact on the performance of DySS are also discussed. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.OBJECTIVE A network meta-analysis (NMA) of randomized clinical trials (RCTs) was performed aiming to compare the treatment outcome of dry needling, acupuncture, or wet needling using different substances in managing myofascial pain of the masticatory muscles (TMD-M). METHOD An electronic search was undertaken to identify RCTs published until September 2019, comparing dry needling, acupuncture, or wet needling using local anaesthesia (LA), botulinum toxin-A (BTX-A), granisetron, platelet-rich plasma (PRP) or passive placebo versus real active placebo in patients with TMD-M. RCTs meeting the inclusion criteria were stratified according to the follow-up time; immediate post-treatment to 3 weeks, and one to 6 months post-treatment. Outcome variables were post-treatment pain intensity, increased mouth opening (MMO) and pressure threshold pain (PPT). The quality of evidence was rated according to Cochrane's tool for assessing risk of bias. Mean difference (MD) was used to analyzed via frequentist NMA using STATA sosuggests that LA, BTX-A, granisetron and PRP hold some promise as injection therapies, but no definite conclusions can be drawn due to the low-quality of evidence of the included studies. This NMA did not provide enough support for any of the needling therapies for TMD-M. This article is protected by copyright. All rights reserved.AIMS Using 3 different perpetrators the impact of voriconazole, cobicistat and rifampicin (single dose), we evaluated the suitability of a microdose cocktail of factor Xa inhibitors (FXaI; rivaroxaban, apixaban and edoxaban; 100 μg in total) to study drug-drug interactions. METHODS Three cohorts of 6 healthy volunteers received 2 treatments with microdoses of rivaroxaban, apixaban and edoxaban alone and with coadministration of 1 of the perpetrators. Plasma and urine concentrations of microdosed apixaban, edoxaban and rivaroxaban were quantified using a validated ultra-performance liquid chromatography-tandem mass spectrometry with a lower limit of quantification of 2.5 pg/mL. RESULTS Voriconazole caused only a minor interaction with apixaban and rivaroxaban, none with edoxaban. Cobicistat significantly increased exposure of all 3 FXaI with area under the plasma concentration-time curve ratios of 1.67 (apixaban), 1.74 (edoxaban) and 2.0 (rivaroxaban). A single dose of rifampicin decreased the volume of distribution and elimination half-life of all 3 FXaI. CONCLUSIONS The microdosed FXaI cocktail approach is able to generate drug interaction data and can help elucidating the mechanism involved in the clearance of the different victim drugs. This is a safe approach to concurrently study drug-drug interactions with a drug class. (EudraCT 2016-003024-23). © 2020 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.BACKGROUND An increasing number of publications on social media has paralleled the growth of social media use in the past decade. Our study examined the trends in these publications relating to the fields of dermatology, pathology, and dermatopathology. METHODS PubMed was searched for relevant literature from 2009 to present, using the following key terms "social media", "dermatology", "dermatopathology", and "pathology." Topics of articles, years of publication, countries of origin, and contributing journals were compiled and analyzed. RESULTS A total of 99 publications were retrieved during the period between 2009 and November 2019. Top publication years included 2019 (n = 21), 2018 (n = 24), 2017 (n = 20), and 2016 (n = 13). The most common topic areas noted were related to dissemination of information (n = 17; 17.2%), knowledge exchange for physicians (n = 16; 16.2%), and social networking (n = 15; 15.2%). CONCLUSION The number of published articles on social media in these specialties has increased since 2009, signifying the widespread use of social media for professional networking, knowledge exchange, real-time communication with patients and colleagues, and patient care. Social media in the areas of dermatology, dermatopathology and pathology has undergone social construction during the past decade due to changes in technology and ideologies surrounding the use of social media within medicine. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Objective methods for distinguishing melanoma in situ (MIS) from photodamaged skin (PS) are needed to guide treatment in patients with melanocytic proliferations. Melanocyte density (MD) could serve as an objective histologic criterion in difficult cases. Calculating MD via manual cell counts (MCC) with IHC stained slides has been previously published. However, the clinical application of this method is questionable, as quantification of MD via MCC on difficult cases is time consuming, especially in high volume practices. METHODS ImageJ is an image processing software that uses scanned slide images to determine cell count. In this study, we compared MCC to ImageJ calculated MD in MITF-IHC stained MIS biopsies and control PS acquired from the same patients. RESULTS We found a statistically significant difference in MD between PS and MIS as measured by both MCC and ImageJ software (P  less then  0.01). Additionally, no statistically significant difference was found when comparing MD measurements recorded by ImageJ vs those determined by the MCC method. CONCLUSION MD as determined by ImageJ strongly correlates with the MD calculated by MCC. We propose the use of ImageJ as a time efficient, objective and reproducible tool to assess MD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Interaction of pretilachlor with photosystem (PS)-II of the cyanobacterium Desmonostoc muscorum PUPCCC 405.10 has been studied in this paper. Pretilachlor negatively affected growth, chlorophyll a (Chl a), photosynthesis, and carbon dissimilation in a dose-dependent manner. Effects were also observed in PSs, especially PS-II (an 11-35% decrease), as well as the whole photosynthetic electron transport activity. The fluorescence emission spectrum of Chl a revealed a dose-dependent effect of pretilachlor on both the antenna and the core complex of PSs, with more severe effect on the former. Data of O-J-I-P fluorescence transient of Chl a revealed that pretilachlor interfered with electron flow between QA and QB sites of PS-II. It was further observed that pretilachlor decreased maximum fluorescence, variable and relative variable fluorescence, maximum quantum yield, quantum yield of electron transport, the rate of trapped exciton movement, quantum yield of electron transfer, and performance index of primary photochemistry; however, there was a progressive increase in the net rate of PS-II closure, quantum yield of energy dissipation, and effective antenna size per active reaction center. A decrease in photosynthetic activity leads to a decrease in carbon dissimilation, as evidenced by low activity of glucose-6-phosphate dehydrogenase and pyruvate kinase. Thus, pretilachlor, which is otherwise known to kill weeds by interfering with cell division, affected the growth of the cyanobacteria by interacting with PS-II. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.OBJECTIVES/HYPOTHESIS The objectives of this study were to evaluate laryngeal inflammation and mucosal integrity in a murine model of reflux disease and to assess the protective effects of topical agents including alginate, hyaluronic acid, and cashew gum. STUDY DESIGN Animal study. METHODS A surgical murine model of reflux disease was evaluated at 3 or 7 days postsurgery, and laryngeal samples were collected to measure inflammation (wet weight and myeloperoxidase [MPO]) and mucosal integrity (transepithelial resistance [TER] and mucosal permeability to fluorescein). Additional groups of animals were administered one of several topical agents (alginate, hyaluronic acid, or cashew gum) daily, and laryngeal inflammation and mucosal integrity were evaluated at 3 days postsurgery. RESULTS At 3 days, and not 7 days postsurgery, we observed increased laryngeal wet weight and MPO, decreased laryngeal TER, and increased laryngeal mucosa permeability. Alginate partially decreased laryngeal inflammation (wet weight and not MPO) and dramatically improved laryngeal mucosal integrity.