Objective:Endoscopic ultrasound (EUS)-guided drainage is a widely used treatment modality for pancreatic pseudocysts (PPC). However, data on the clinical outcome and complication rates are conflicting. Our study aims to evaluate the rates of technical success, treatment success and complications of EUS-guided PPC drainage in a medium-term follow-up of 45 weeks.Materials and Methods:A retrospective review was conducted for 55 patients with symptomatic PPC from December 2005 to August 2010 drained by EUS. Medium-term follow-up data were obtained by searching their medical history or by telephonic interview.Results:A total of 61 procedures were performed. The symptoms that indicated drainage were abdominal pain (n = 43), vomiting (n = 7) and jaundice (n = 5). The procedure was technically successful in 57 of the 61 procedures (93%). The immediate complication rate was 5%. At a mean follow-up of 45 weeks, the treatment success was 75%. The medium term complications appeared in 25% of cases, which included three cases each of stent clogging, stent migration, infection and six cases of recurrence. There was no mortality.Conclusion:EUS-guided drainage is an effective treatment for PPC with a successful outcome in most of patients. Most of the complications require minimal invasive surgical treatment or repeated EUS-guided drainage procedures.
Circulating parathyrin (PTH or parthormon) is increased in primary hyperparathyroidism (PHP) in association with high total/ionic calcium (T/I Ca) and others mineral metabolism anomalies. This is a clinical cross-sectional and case-control study analyzing these changes after PHP surgical correction in menopausal women. Baseline parameters were: mean age at diagnosis (59.63�9.6 years), TCa of 10.9�0.7 mg/dL, PTH of 138.02�59.36 pg/mL. Longitudinal data showed: final TCa p[0.00001, ICa p[0.00001, phosphorus p[0.0001, magnesium p=0.9, 24-h urinary calcium p=0.4, 25-hydroxycholecalciferol p=0.01, PTH p[0.00001. High circulating parathyrin values due to PHP normalized after surgery in addition to statistical significant changes of TCa, ICa, P, lumbar Bone Mineral Density provided by Dual-Energy X-Ray Absorptiometry; Mg and 24-h Ca might not be a marker of general mineral metabolism improvement.
Suicide is one of the leading causes of death globally for all ages, and as such presents a very serious problem for clinicians worldwide. However, the underlying neurobiological pathology remains to a large extent unknown. In order to address this gap, we have carried out a genome-wide investigation of the gene expression in the amygdala, hippocampus, prefrontal cortex and thalamus in post-mortem brain samples obtained from 20 suicide completers and 7 control subjects. By KEGG enrichment analysis indicated we identified novel clusters of downregulated pathways involved in antigen neutralization and autoimmune thyroid disease (amygdala, thalamus), decreased axonal plasticity in the hippocampus. Two upregulated pathways were involved in neuronal death in the hippocampus and olfactory transduction in the thalamus and the prefrontal cortex. Autoimmune thyroid disease pathway was downregulated only in females. Metabolic pathways involved in Notch signaling amino acid metabolism and unsaturated lipid synthesis were thalamus-specific. Suicide-associated changes in the expression of several genes and pseudogenes that point to various functional mechanisms possibly implicated in the pathology of suicide. Two genes (SNORA13 and RNU4-2) involved in RNA processing were common to all brain regions analyzed. Most of the identified gene expression changes were related to region-specific dysregulated manifestation of genetic and epigenetic mechanisms underlying neurodevelopmental disorders (SNORD114-10, SUSd1), motivation, addiction and motor disorders (CHRNA6), long-term depression (RAB3B), stress response, major depression and schizophrenia (GFAP), signal transduction at the neurovascular unit (NEXN) and inhibitory neurotransmission in spatial learning, neural plasticity (CALB2; CLIC6, ENPP1). Some of the differentially expressed genes were brain specific non-coding RNAs involved in the regulation of translation (SNORA13). One, (PARM1) is a potential oncogene and prognostic biomarker for colorectal cancer with no known function in the brain. Disturbed gene expression involved in antigen neutralization, autoimmunity, neural plasticity, stress response, signal transduction at the neurovascular unit, dysregulated nuclear RNA processing and translation and epigenetic imprinting signatures is associated with suicide and point to regulatory non-coding RNAs as potential targets of new drugs development.
Obesity is has become a major problem worldwide. Since 1975, the prevalence of obesity nearly trippled, and nowadays we are facing an obesity epidemic. Obesity is a major risk factor for many diseases such as cardiovascular ones (mainly heart disease and stroke) -being the leading cause of death worldwide, musculoskeletal disorders or type 2 diabetes mellitus (DM).
Rheumatoid arthritis (RA) is the most widespread inflammatory rheumatic disease with about 10% of all rheumatic diseases and a global prevalence of about 1%. Through its features - joint proliferation, articular panic, articular cartilage degradation and bone erosion � RA has a destructive and disabling character and a major socio-economic impact. Osteoporosis is a bone system disease characterized by loss of bone mass and alteration of bone architecture, with consequences on bone fragility correlated with an increased fracture risk. With a major socio-economic impact, the World Health Organization (WHO) has declared osteoporosis as a public health problem, third on cardiovascular and oncological.
Heart failure is a disease characterized by cardiac remodeling or progressive dilation of left ventricle and a consequent reduction in contraction. Ventricular remodeling has been shown to be a negative prognostic factor alone, and therefore the most beneficial drugs are those that prevent or reduce left ventricular dilation. The pharmacological therapy of heart failure, although maximal, has proven to be not fully effective. The aim of our research was to evaluate resynchronization therapy in a lot of patients, monitoring their cardiac performance before and after cardiac resynchronization therapy.
The prevalance of depression and anxiety is higher at the patients diagnosticated with viral liver disease. The corelation between stress and chronic liver disease is a natural, implicit one, but still insufficiently studied. The study has the objective of finding out the clinical and also biochemical correlations between stress and chronic viral diseases. Our research was realised on a group of 78 patients with chronic viral liver disease, who underwent an evaluation of the stress level, both from a subjective point of view and based on concrete methods like questionnaires. The patients were asked to espress their state more or less affected by stress, and, subsequently, they were subjected to a questionnaire that was analyzed, followed by establishing the necessary correlations. Our patients were also evaluated by cardiologicaly, psychologicaly and psyhiatricaly examinations. After the first evaluation we had these results :38 patients (49.19%) consider that they have an average stress level, 18 patients (22.58%) have a high stress level. Only 22 patients (28.22%) declared stress was at a low level. We divided the pacients in two groups, function of Qt (questionare total score) results and we observed that a number of 38 patients ( 49.19%) registered �Qt 20 and 40 patients (50.81%) had Qt � 20, 63 patients (50.81%).We found a strong correlation between the patients� subjective evaluation of the stress level and the objective evaluation of stress level according to the used questionnaire, which confirms the objectivity of our study. We found a direct corelation, with a morphological, biochemical and functional support between stress and the arrhythmia risk in the evolution of chronic liver disease. We consider very important a complex examination psychiatricaly, psychologicaly and cardiological of the pacients diagnosticated with viral liver disease in order to help them and to prevent arrhythmic events, depression, anxiety and other mood disorders.
The prevalance of QT prolongation in chronic viral liver disease is high and the risk of complications is increased. We wanted to study the QT interval prolongation at the patients diagnosed with chronic hepatic disease and also to evaluate some of clinical and biochemical variables. We studied a cohort with 126 patients diagnosed with chronic viral hepatic diseases hospitalised to Cardiology Department, to the County Hospital of Craiova, between Octomber 2016 and January 2018. We aimed to determine the occurrence of QT interval prolongation in a large series of patients with chronic hepatic disease of viral etiology. We wanted to evaluated the QT prolongation to clinical and biochemical variables. The QT interval was measured by a standard 12-lead ECG for each patient, with prolongation defined as 460 ms. Multiple clinical and biochemical variables were evaluated including sex, age, areas (rural/urban) the frequency of arrhythmic events (PACs, PVCs, Atrial fibrillation, Bradycardia, Tachycardia), NT proBNP, Hb,uric acid, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST) , cholesterol, triglyceride, etc. The group of patients was composed by 43 woman and 83 men. From 43 women, representing 65.06% (461.56 �42.03) and from 83 men, means 66.67% (461.14 � 45.10) presented interval QT prolongation. Studing the distribution of hepatic etiologies we can see that 34 patients had hepatitis B, 35 patients hepatitis C, 5 patients B and C dual virus infection and 52 patients with chronic liver disease of etiology other than viral. We registered close results about QT interval prolongation on group, sex and origine group of patients. The value of QT interval to our patients was higher compared to other values recorder in other studies, at the patients with chronic hepatic disease, despide the fact we chose a higher value of QT prolongation. The highest value of QT interval was in the group of age between 60 and 69, even if in other studies we notice a prolonged QT interval at patients over 70 years old. The biological and biochemical profile of chronic hepatic disease of the subjects included in our study showed no statistical difference between male and female patients.We found a higher incidence of arrhythmic events, at patients with chronic hepatic disease of viral etiology, especially to premature atrial contraction and atrial fibrillation.We found a couple of correlation between QT interval prolongation and the evolution of chronic hepatic disease of viral etiology. It is very important to develop a strong and complex strategies to prevent and to treat the arrhythmic event presented at the patients diagnosticated with hepatic disease, because of the higher risk of developing life-threatening arrhythmias, includen sudden cardiac death.
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