Gastrointestinal stromal tumor of the vermiform appendix mimicking Meckel’s diverticulum: Case report with literature review

IntroductionGastrointestinal stromal tumors (GISTs) of the appendix are extremely rare. To date, only 15 cases have been reported in the English literature. Here, we present a new case of an appendiceal GIST with appendicitis.Presentation of caseA 68-year-old man who complained of right lower abdominal tenderness underwent surgery for a cystic mass mimicking Meckel’s diverticulum. Laparoscopy revealed a mass protruding from the proximal appendix with distal appendicitis. Complete resection with adequate margins was performed. Histology showed a spindle cell GIST without mitotic activity as well as a strong expression of CD117 and CD34.ConclusionPrimary appendiceal GIST occur at a very low rate and their symptoms are nonspecific. Accordingly, rare tumors of appendix including GISTs should be considered in the differential diagnosis of atypical symptoms or image findings.     

温岭市某医院临床患者营养分析与管理对策

目的:分析温岭市某医院临床患者营养状况,探讨营养管理的对策。方法:对5个不同临床科室300例患者进行营养状况调查。结果:所有患者BMI平均值为(22.67±4.27)kg/m2,各科患者BMI值之间差异有统计学意义(<0.05),其中普通外科轻体重率最高,内分泌科超重和肥胖率最高(<0.05)。所有患者营养不良率、贫血率及存在营养风险率分别为23.33%、21.33%及48.00%。各科营养不良率、贫血率及存在营养风险率之间差异均有统计学意义(<0.01)。结论:营养科应有针对性的为不同科室患者提供良好的营养支持,提高治疗效果和患者的生活质量。     

Sleep quality and its relationship with quality of life among high-risk pregnant women (gestational diabetes and hypertension)

Background: Sleep is one of the most basic human requirements. This research aims at determining the status of sleep quality and its relationship with quality of life among high-risk pregnant women in Tabriz, Iran, in 2015.

Materials and methods: This research was a sectional study done on 364 qualified women in 28–36 weeks of pregnancy suffering from mild preeclampsia and gestational diabetes. The sampling was done as convenience. Personal–social–midwifery questionnaire, Pittsburg sleep quality, and quality of life in pregnancy (QOL-ORAV) were used for gathering data. Multivariate linear regression model was used for determining the relationship between sleep quality and its subsets with quality of life and controlling confounders.

Findings: In the current study, the prevalence of sleep disturbance was 96.4%. Mean (SD) of the total score of sleep quality was 10.1 (4.1) and the total score of quality of life was 61.7 (17.3). According to Pearson’s correlation test, there was statistically significant relationship between quality of life and sleep quality and all its subsets except sleep duration and use of sleep medication (p?Discussion: The findings of current research show that sleep quality is low among high-risk pregnant women and quality of life is medium. So, it is necessary that required training is given by health cares for improving sleep quality and quality of life to mothers.     

Integrative study of cell damage and cancer risk in gas station attendants

Gas station attendants are potentially exposed to carcinogenic substances. This study aimed to evaluate chronic occupational exposed gas station attendant’s according to genetic parameters and its relationship with cancer predisposition. Forty gas station attendants were recruited and paired with 40 control subjects. Thousand cells from each subject were analyzed counting the number of pyknotic (PYC), karyolitic (KYL), karyorrhetic (KHC), condensed chromatin (CC), binucleated (BN), basal cells (BC), Nuclear buds (Nbud), and differentiated cells (DIFF). More 2.000 differentiated cells were analyzed counting micronucleated (MNi) and nuclear buds (NBud). We observed a statistical increase in BC and decrease in DIFF (p < 0.05). PYC, CC, KYL, MN, NBud were statistically increased (p < 0.05). All in all, our data showed elevated DNA damage, chromosomal instability, and cell cycle disturbing in our group of gas station attendants. It is a clear risk for their health in future and could be classified as a cancer predisposition.     

临床教师职业倦怠的相关影响因素分析

目的探讨职业倦怠的主要影响因素及与教学质量的相关性。方法对97名参与临床教学的医护人员进行调查,分析职业倦怠现状、影响因素,及职业倦怠与教学质量的相关性。结果97名临床教师中,存在轻度倦怠41例(42.27%),中度倦怠23例(23.71%),重度倦怠9例(9.28%),合计共有73名临床教师存在职业倦怠(75.26%)。女性情感耗竭维度得分高于男性(P<0.05)。不同职称者情感耗竭、人格解体和成就感降低3个维度得分均差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:婚姻状况和职称为职业倦怠的风险因素(P<0.05)。轻度倦怠与重度倦怠者社会支持利用度得分差异有统计学意义(P<0.01)。Spearman等级相关分析结果显示:职业倦怠程度与教学质量评议分数无相关性(P>0.05),职称与教学质量评议分数有正相关关系(P<0.05)。结论临床教师职业倦怠强度与职称、婚姻状况有关。临床教师职称与教学质量正相关。     

Sex-specific Associations of Sex Hormone Binding Globulin with CKD and Kidney Function: A Univariable and Multivariable Mendelian Randomization Study in the UK Biobank

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Clearing hepatitis C virus with direct antiviral agents reduces cardiovascular events in patients with prediabetes. Commentary to Sasso and colleagues

Liver health is a key determinant of cardiovascular risk (CVR). Hepatic fibrosis is the shared common result of chronic hepatitis, irrespective of aetiology. Fibrosis profoundly distorts liver tissue architecture and perturbs hepatic physiology, dictates the course of chronic liver disease and is increasingly recognized as a CVR factor. The relative weights of pre-diabetes and hepatic fibrosis as risk factors for major adverse cardiac events (MACE) in patients with HCV remain an open issue. Sasso and Colleagues answered this research question by treating approximately half of 770 HCV positive pre-diabetic patients with direct antiviral agents (DAAs), while the rest served as historical controls. Data have shown that achieving HCV clearance with DAAs was associated with a 60% reduced risk of MACE, thereby implying that this antiviral strategy is recommended in HCV positive pre-diabetic patients, regardless of the severity of liver disease and concurrent CVR factors. This study paves the way for additional studies addressing the molecular patho-mechanisms and changes in the clinical spectrum involved in cardio-metabolic protection following HCV eradication in patients with pre-diabetes.     

Effects of dance interventions on cardiovascular risk with ageing: Systematic review and meta-analysis

BackgroundExercising, including dancing, has been recommended to improve cardiovascular health of older people. Herein, we conducted a systematic review and meta-analysis verifying the effects of dance interventions on cardiovascular risk (CVR) in the elderly, comparing dancers to non-exercise controls and other types of exercise, in randomised (RCTs) and non-randomised control trials (nRCTs). Primary/Secondary outcomes: peak oxygen consumption (VO₂peak)/anthropometric measurements (body weight, BMI), and lipid profile.MethodsData Sources: MEDLINE, Cochrane Wiley, Clinical Trials.gov, PEDRO and LILACS databases. Study Selection: RCTs and nRCTs comparing elderly before and after dance interventions with non-exercising controls and/or practitioners of other types of exercise. Two independent reviewers extracted data and assessed the quality of included studies.ResultsA total of 937 articles were retrieved, 64 full texts were assessed for eligibility, and 7 articles met the inclusion criteria. Pooled mean differences between intervention and control were calculated by random-effects model. VO₂peak improved in favour of dancers (3.4 mL kg⁻¹ min⁻¹, 95%CI: 1.08, 5.78, I2 = 71%), compared to non-exercise controls. No differences were found between dance and other exercises. Body weight and BMI were not altered by dance interventions.ConclusionsDance interventions may increase VO₂peak compared to non-exercising controls. Results also indicate it is as effective as other types of exercise in improving aerobic capacity of the elderly. Dancing might be a potential exercise intervention for improving cardiorespiratory fitness and consequent CVR associated with ageing. Proper reporting on adverse events is needed to base the benefits of dancing for the older on both efficacy and safety of the interventions.