Steelelau1513
Familial hypercholesterolemia (FH) is a rare autosomal gene deficiency disease with increased low-density lipoprotein cholesterol, xanthoma, and premature coronary heart disease. Calcified aortic valve disease (CAVD) is prevalent in FH patients, resulting in adverse events and heavy health care burden. Aortic valve calcification is currently considered an active biological process, which shares several common risk factors with atherosclerosis, including aging, hypertension, dyslipidemia, and so on. Unfortunately, the pathogenesis and therapy of CAVD in FH are still controversial. There is no pharmacological intervention recommended to delay the development of CAVD in FH, and the only effective treatment for severe CAVD is aortic valve replacement. In this review, we summarize the detailed description of the pathophysiology, molecular mechanism, risk factors, and treatment of CAVD in FH patients.Antiarrhythmic drugs remain the mainstay therapy for patients with atrial fibrillation (AF). A major disadvantage of the currently available anti-AF agents is the risk of induction of ventricular proarrhythmias. Aiming to reduce this risk, several atrial-specific or -selective ion channel block approaches have been introduced for AF suppression, but only the atrial-selective inhibition of the sodium channel has been demonstrated to be valid in both experimental and clinical studies. this website Among the other pharmacological anti-AF approaches, "upstream therapy" has been prominent but largely disappointing, and pulmonary delivery of anti-AF drugs seems to be promising. Major contradictions exist in the literature about the electrophysiological mechanisms of AF (ie, reentry or focal?) and the mechanisms by which anti-AF drugs terminate AF, making the search for novel anti-AF approaches largely empirical. Drug-induced termination of AF may or may not be associated with prolongation of the atrial effective refractory period. Anti-AF drug research has been largely based on the "suppress reentry" ideology; however, results of the AF mapping studies increasingly indicate that nonreentrant mechanism(s) plays an important role in the maintenance of AF. Also, the analysis of anti-AF drug-induced electrophysiological alterations during AF, conducted in the current study, leans toward the focal source as the prime mechanism of AF maintenance. More effort should be placed on the investigation of pharmacological suppression of the focal mechanisms.
The synovial fluid test for alpha defensin has been reported to have an excellent performance in diagnosing periprosthetic joint infection (PJI). The purpose of this study was to evaluate the performance of the lateral flow test for synovial fluid alpha defensin by using the methods of a formal diagnostic accuracy study and to compare its performance with that of the laboratory-based alpha defensin test for PJI.
We conducted a diagnostic accuracy study of the index lateral flow immunoassay for synovial fluid alpha defensin relative to the reference 2013 Musculoskeletal Infection Society (MSIS) multicriteria definition of PJI. The study included a prospective multicenter cohort of outpatients with a failed hip or knee arthroplasty and a supplemental control cohort of fresh synovial fluid specimens submitted by physicians for diagnostic PJI testing.
Among 57 patients with PJI and 248 patients without PJI in the overall prospective patient cohort, the sensitivity and specificity of the alpha defensin laterults of this study demonstrate the solid diagnostic performance of the alpha defensin test and have resulted in the U.S. Food and Drug Administration (FDA) authorization of the lateral-flow test with an intended use as an aid in the clinical diagnosis of PJI.
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Patient acceptable symptom state (PASS) thresholds for the EuroQol-5 Dimension-3 Level (EQ-5D-3L) questionnaire have been established for patients being evaluated 1 year following total hip arthroplasty (THA) but with varying derivation cohorts and methods. The aim of this study was to (1) generate an EQ-5D PASS threshold 1 year following THA on the basis of an international patient cohort, (2) validate preexisting and newly generated PASS thresholds 1 year following THA using the institutional registry of an academic care center, and (3) assess whether THA PASS thresholds vary by patient age and sex.
The derivation cohort for the THA PASS threshold consisted of 774 patients (after exclusions) who were enrolled in an international, multicenter study from 2007 to 2012 and who completed the EQ-5D and a numerical rating scale (NRS) for satisfaction 1 year postoperatively. With the NRS dichotomized at 2.5 as the anchor, a PASS cutoff for the EQ-5D was generated using the 80% specificity method. The Youden metrstand the level of health-related quality of life associated with patient satisfaction following THA.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Coronavirus disease 2019 (COVID-19) is spreading worldwide, with its outlook not looking optimistic. Simultaneously, the epidemic is currently under control in many areas. The resumption of work and production in areas that have achieved control of outbreaks is a problem. Considering the extremely transmissible nature of COVID-19, and the presence of asymptomatic infected people, avoiding nosocomial infection and protecting medical staff and patients during the post-epidemic period remain difficult problems that need to be solved. At present, few articles have examined relevant experiences in the field of sports medicine. Wuhan, the People's Republic of China, was the original epicenter of COVID-19, with physicians as the initial frontline workers. Wuhan is now gradually returning to a more normal state after a series of urgent, strict, and effective measures were utilized to combat the epidemic. During this time, we collected first-hand experiences of sports medicine work resumption in the initial 2-month period, including preparations before resuming work, outpatient management methods, online outpatient services, inpatient ward management, principles for determination of the examination results, and preparations for operations.
