RESUMEN
Most ingested foreign bodies pass through the gastrointestinal tract spontaneously, but a small number of cases lead to complications and necessitate surgical intervention. We present a rare case of an ingested fork handle that perforated silently through the colon and fistulated through the abdominal wall. This case highlights the importance of balancing the risks and benefits of surgical intervention and the multidisciplinary approach to complex situations.
Asunto(s)
Pared Abdominal , Enfermedades del Colon , Cuerpos Extraños , Perforación Intestinal , Humanos , Pared Abdominal/cirugía , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Cuerpos Extraños/complicaciones , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Enfermedades del Colon/diagnóstico por imagen , Enfermedades del Colon/etiología , Enfermedades del Colon/cirugíaRESUMEN
Objective: By use of Meta analysis to compare efficacy, safety and compliance of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) on allergic rhinitis (AR). Methods: Cochrane Library, Pubmed, Embase, CNKI Database, Wan Fang and Chinese Sci-tech Journal Database (from established time to May of 2018) were searched for trials about the AR treated by SCIT and SLIT. The relevant literatures were screened, and the randomized controlled studies were chosen. Nasal symptom scores, visual analogue scale (VAS) scores, adverse reactions and compliance were used as the outcome indicators, and the methodological quality of the literatures was evaluated strictly. The extracted data were analyzed by RevMan 5.3 and Stata 14 software. Results: A total of 20 randomized controlled studies were included, the overall quality of which was relatively high. No publication bias was found. There was no significant difference in nasal symptom scores, VAS scores and compliance between SCIT and SLIT (SMD value was 0.03, 0.14, respectively, RR=1.12; 95%CI value was -0.17-0.23, -0.03-0.31, 0.92-1.35, respectively, all P>0.05); SLIT group resulted in lower overall incidence of adverse reactions than that of SCIT group (RR=1.79, 95%CI: 1.42-2.26, P<0.05). Conclusion: Both SCIT and SLIT have similar eppecacy and compliance for treatment of AR, while adverse reactions are more frequently observed in SCIT.
Asunto(s)
Cooperación del Paciente , Rinitis Alérgica , Inmunoterapia Sublingual , Administración Sublingual , Alérgenos , Desensibilización Inmunológica , Humanos , Inyecciones Subcutáneas , Proyectos de Investigación , Rinitis Alérgica/inmunología , Rinitis Alérgica/terapia , Inmunoterapia Sublingual/efectos adversos , Inmunoterapia Sublingual/métodosRESUMEN
Stroke is one of the leading causes of death and disability worldwide. There are two major types of stroke: cerebral ischemia caused by obstruction of blood vessels in the brain and haemorrhagic stroke that is triggered by the disruption of blood vessels. Thrombolytic therapy involving recombinant tissue plasminogen activator (rtPA) has been shown to be beneficial only when used within 4.5 hours of onset of acute ischemic stroke. rtPA treatment beyond this time window has been found to be unsuitable and usually resulting in haemorrhagic transformation. Stroke is a multifactorial disease that forms a possible end state for majority of patients suffering from diabetes, atherosclerosis and hypertension which are known risk factors. Although the biochemistry of stroke and related diseases is quite well understood, the knowledge on the molecular mechanisms underlying these diseases is still at its infancy. microRNAs that form a unique class of endogenous riboregulators of gene function, offer tremendous potential in unraveling the mechanisms underlying stroke pathogenesis. microRNA expression also reflects the response of individuals to drugs and therapy. Several microRNAs and their target genes, known to be involved in endothelial dysfunction, dysregulation of neurovascular integrity, edema formation, pro-apoptosis, inflammation and extra-cellular matrix remodeling contribute to the critical processes in the pathogenesis of stroke. In this review, we will also be discussing the role of microRNAs as possible diagnostic and prognostic biomarkers as well as potential therapeutic targets in stroke pathogenesis.
Asunto(s)
MicroARNs/metabolismo , Accidente Cerebrovascular/fisiopatología , Animales , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/terapia , Hemorragia Cerebral/fisiopatología , Hemorragia Cerebral/terapia , Humanos , MicroARNs/uso terapéutico , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapiaRESUMEN
AIMS/HYPOTHESIS: Increased retinol-binding protein 4 (RBP4) has been reported in association with insulin resistance and type 2 diabetes. We aimed to investigate the association of serum RBP4 with impaired glucose regulation and microalbuminuria in Chinese adults aged 40 years or older. METHODS: Serum RBP4 was measured in 763 individuals with normal glucose regulation, 508 with impaired glucose regulation and 524 newly diagnosed diabetic patients. Serum RBP4 was measured using ELISA and urine albumin/creatinine ratio was used to determine the urinary albumin excretion. RESULTS: Serum RBP4 concentrations were significantly higher in participants with isolated impaired fasting glucose, isolated impaired glucose tolerance, combined impaired fasting glucose/impaired glucose tolerance and diabetes than in those with normal glucose regulation, whereas serum RBP4 levels were not different in the four groups with dysregulation of glucose metabolism. RBP4 was associated with a higher risk for impaired glucose regulation (OR 1.011 for each 1 microg/ml increase in RBP4, 95% CI 1.000-1.022, p = 0.04) after adjustment for sex, age, BMI, current smoking and alcohol intake, family history of diabetes, insulin resistance, triacylglycerol, total cholesterol, and HDL- and LDL-cholesterol; the corresponding OR of combined impaired glucose regulation and type 2 diabetes was 1.022 (95% CI 1.009-1.035, p = 0.0009). RBP4 was associated with the risk of microalbuminuria (OR 1.023, 95% CI 1.004-1.042, p = 0.01) after adjustment for sex, age, smoking habit and alcohol intake, BMI, waist/hip ratio, homeostasis model assessment of insulin resistance, GFR, triacylglycerol, total cholesterol, and HDL- and LDL-cholesterol. CONCLUSIONS/INTERPRETATION: Serum RBP4 level is closely associated with impaired glucose regulation and is an independent risk factor for microalbuminuria.
Asunto(s)
Albuminuria/sangre , Diabetes Mellitus Tipo 2/sangre , Intolerancia a la Glucosa/sangre , Proteínas Plasmáticas de Unión al Retinol/metabolismo , Adulto , Anciano , Albuminuria/epidemiología , Presión Sanguínea , China , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Masculino , Persona de Mediana Edad , Triglicéridos/sangre , Relación Cintura-CaderaRESUMEN
A group of 30 subjects, each fit with a single disposable or non-disposable soft contact lens, was further randomized to a daily wear or extended wear schedule to determine the effect of lens wear on the normal conjunctival flora. Cultures of the subjects' inferior cul-de-sacs were taken at baseline before any lens wear and after one week of lens wear. Additionally, each subjects' lens was removed in a sterile manner and cultured at the end of the one week wear period. In all subjects, the fellow eye was used as a control. There were no statistically significant differences with respect to bacterial culture results between experimental and control eyes. Also, there were no significant differences between the pre- and post-lens wear groups. And no significant differences were found when the larger groups were broken down into different wear schedules and lens types and compared. The results of this study suggest that the ocular flora is not markedly changed after one week of contact lens wear. Also raised is the question of whether an altered ocular flora is an etiologic factor in the development of infectious keratitis in contact lens wearers.