Mathishenry8692

This represents the second case of autosomal recessive congenital ichthyosis (ARCI) in the setting of PWS and UPD15. There needs to be a high index of suspicion of this genetic mechanism when there is unexpected phenotype or evolution of the clinical course in a patient with PWS.The gut is one of the main endocrine organs in our body, producing hormones acknowledged to play determinant roles in controlling appetite, energy balance and glucose homeostasis. One of the targets of such hormones is the adipose tissue, a major energetic reservoir, which governs overall metabolism through the secretion of adipokines. Disturbances either in nutrient and metabolic sensing and consequent miscommunication between these organs constitute a key driver to the metabolic complications clustered in metabolic syndrome. Thus, it is essential to understand how the disruption of this crosstalk might trigger adipose tissue dysfunction, a strong characteristic of obesity and insulin resistance. The beneficial effects of metabolic surgery in the amelioration of glucose homeostasis and body weight reduction allowed to understand the potential of gut signals modulation as a treatment for metabolic syndrome-related obesity and type 2 diabetes. In this review, we cover the effects of gut hormones in the modulation of adipose tissue metabolic and endocrine functions, as well as their impact in tissue plasticity. Furthermore, we discuss how the modulation of gut secretome, either through surgical procedures or pharmacological approaches, might improve adipose tissue function in obesity and metabolic syndrome.

Primary choledocholithiasis (PC) is a common disease in biliary surgery. The treatment is always challenging due to its high recurrence. A systemic review is undertaken to determine the risk factors for recurrence and provide with the individualized management strategy.

Electronic databases PubMed (Medline), Embase and Cochrane Central Register of Controlled Studies were searched for relevant articles on risk factors for PC recurrence. Its therapeutic intervention was also collected and analysed.

A total of 36 articles were eligible for inclusion. The recurrent risk factors include abnormalities of biliary anatomy (peripapillary diverticulum), dynamics (choledochal dilation, sharp angulation and stone number), metabolism (advanced age and hypothyroidism) and bacterial infection (Enterobacter and Helicobacter pylori). These factors eventually induce cholestasis and stone formation. At present, there is no guideline and expertise consensus for PC management. The treatment mainly consists of stone retrieval approaches and internal drainage surgeries. The former are minimally invasive methods endoscopic sphincterotomy (EST), papillary balloon dilation (EPBD) and laparoscopic common bile duct exploration (LCBDE). The latter include choledochoduodenostomy (CDS) and choledochojejunostomy (CJS) with Roux-en-Y reconstruction. By far, the internal drainage surgeries have significantly lower recurrence than stone retrieval approaches.

Abnormal biliary anatomy, dynamics, metabolism and bacterial infection are the risk factors for PC. Both EST/EPBD and LCBDE can be performed as initial treatment. For recurrent PC, CDS is more suitable to the elderly, while Roux-en-Y CJS reserves for young patients or those in good conditions.

Abnormal biliary anatomy, dynamics, metabolism and bacterial infection are the risk factors for PC. Both EST/EPBD and LCBDE can be performed as initial treatment. For recurrent PC, CDS is more suitable to the elderly, while Roux-en-Y CJS reserves for young patients or those in good conditions.

This study was conducted to determine the effect of professional values of nurses on their attitudes towards caregiving roles.

This is a cross-sectional, correlational and descriptive study. The data were collected from 319 nurses working at different units in a public hospital between January and May 2019. The data collection tool included a 10-question participant information form, the nursing professional values scale and the attitude scale for nurses in caregiving roles. The variables were analysed using the multiple linear regression.

The nurses had professional values and attitudes towards caregiving roles at high levels. Significant differences were found in the overall scales and their subscales especially due to nurses loving their profession (P < 0.05). Attitudes of the nurses towards caregiving roles were predicted by human dignity (β = 0.52, P < 0.01), action (β = 0.34, P < 0.01) and autonomy (β = -0.29, P < 0.01). Human dignity, action and autonomy accounted for 30% of the variance in their attitudes towards caregiving roles (∆R

= 0.30).

Scores obtained by the nurses loving their profession from the nursing professional values scale and the attitude scale for nurses in caregiving roles were higher. In addition, nurses' caregiving roles were explained with professional values.

Scores obtained by the nurses loving their profession from the nursing professional values scale and the attitude scale for nurses in caregiving roles were higher. In addition, nurses' caregiving roles were explained with professional values.

To investigate the adult outcomes of children with juvenile-onset recurrent respiratory papillomatosis via long-term follow-up.

Retrospective study.

Beijing Tongren Hospital.

The study includes 121 patients with recurrent respiratory papillomatosis.

We followed up respiratory papillomatosis patients aged least 14years and analysed their clinical features based on recurrence-free time.

In total, 112 (92.6%) patients underwent three or more operations. The age at initial operation was 4.3±2.9years; 47.9% (58/121) experienced recurrence and underwent surgical treatment after age 14. At follow-up, 5% (6/121) had died, 41.3% (50/121) had been recurrence-free for 5years or more (cured group), and 53.7% (65/121) had recurrence in the past 5years (recurrent group). The age at the last operation was 9.2±4.6years in the cured group. GSK1059615 PI3K inhibitor The overall operation frequency was higher in the recurrence group than in the cured group (17.8±11.9 vs 8.7±6.5). Additionally, the human papillomavirus (HPV) infection and tracheal dissemination rates were higher in the recurrence group than in the cured group (90.