Is there any relation between ischemic cerebrovascular disease and extracranial internal carotid stenosis?

Ｉｓｔｈｅｒｅａｎｙｒｅｌａｔｉｏｎｂｅｔｗｅｅｎｉｓｃｈｅｍｉｃｃｅｒｅｂｒｏｖａｓｃｕｌａｒｄｉｓｅａｓｅａｎｄｅｘｔｒａｃｒａｎｉａｌｉｎｔｅｒｎａｌｃａｒｏｔｉｄｓｔｅｎｏｓｉｓ？ＷａｎｇＹｕｑｉ王玉琦，ＧｕｏＤａｑｉａｏ郭大乔ａｎｄＦｕＷｅ...     

Early and late outcomes in patients with severe extracranial internal carotid stenosis undergoing carotid endarterectomy

Ｃａｒｏｔｉｄｅｎｄａｒｔｅｒｅｃｔｏｍｙ (ＣＥＡ )ｈａｓｂｅｅｎｓｈｏｗｎｔｏｂｅｓｕｐｅｒｉｏｒｔｏｍｅｄｉｃａｌｔｒｅａｔｍｅｎｔｉｎｐａｔｉｅｎｔｓｗｉｔｈｓｙｍｐｔｏｍａｔｉｃｏｒａｓｙｍｐｔｏｍａｔｉｃｈｉｇｈ ｇｒａｄｅｃａｒｏｔｉｄｓｔｅｎｏｓｉｓ ＡｌｔｈｏｕｇｈＣＥＡｒｅｍａｉｎｓｔｈｅｍｏｓｔｃｏｍｍｏｎｌｙｐｅｒｆｏｒｍｅｄｏｐｅｒａｔｉｏｎｆｏｒｐｅｒｉｐｈｅｒａｌａｒｔｅｒｉａｌｄｉｓｅａｓｅｓｉｎｔｈｅＷｅｓｔ,ｉｔｉｓｎｏｔａｓｐｏｐｕｌａｒｉｎＣｈｉｎａ Ｔｈｉｓｐ…     

Hashimoto thyroiditis and obstructive sleep apnea syndrome: is there any relation between them?

Hashimoto thyroiditis (HT), which is an autoimmune disease of thyroid gland, has been declared to present with concomitant several systemic diseases. In this study, the coexistence of the Hashimoto disease with the sleep apnea syndrome has been examined. Seven female patients (33-66 year of age) with Hashimoto thyroiditis were evaluated for sleep apnea syndrome. The diagnosis of Hashimoto disease was based on the high titers of anti-thyroid antibodies and histological findings. None of the patients had any complaints of sleep disturbances. Seven healthy subjects with similar age and sex characteristics were taken as the control group. All the patients and the control subjects were undertaken a full polysomnography (PSG). Five patients with HT showed the characteristics of obstructive sleep apnea syndrome (one severe, one moderate and three mild OSAS), whereas no sleep breathing disturbance was found in the control group. These findings suggest that sleep related breathing problems may develop in the patients with autoimmune thyroiditis even if they are euthyroid.     

Is there a link between work-related stress and colorectal cancer?

The South Australian Workers Compensation Tribunal has found that stress contributed to a man's colorectal cancer. The medical evidence for this is very limited, and the case highlights the difference between scientific and legal proof.     

Is trapping a safe method to treat complex internal carotid aneurysms?

Complex intemal carotid artery （ICA） aneurysms include intracavemous, paraclinoid large/giant, dissecting andblood-blister aneurysms. Proximal parent artery occlusion （PAO） and trapping are long-practiced safe and effective option for these complex aneurysms.1 Trapping refers to both proximal and distal occlusion of parent artery including aneurysms, which is considered more reliable than proximal PAO due to without reverse flow. We hereby describe a rare case of subarachnoid hemorrhage （SAH） after trapping ICA to treat complex ICA aneurysms. The report was approved by the Ethics Committee of our institute and written informed consent was obtained from the patient.     

Is there an ethical difference between preimplantation genetic diagnosis and abortion?

When a person at risk of having a child with a genetic illness or disease wishes to have an unaffected child, this can involve difficult choices. If the pregnancy is established by sexual intercourse, the fetus can be tested early in pregnancy, and if affected a decision can be made to abort in the hope that a future pregnancy with an unaffected fetus ensures. Alternatively, preimplantation genetic diagnosis (PGD) can be used after in vitro fertilisation (IVF) to select and implant an unaffected embryo that hopefully will proceed to term and produce a healthy baby. We are aware that many individuals at risk regard the latter as ethically more acceptable than the former, and examine whether there is an ethical difference between these options. We conclude that PGD and implantation of an unaffected embryo is a more acceptable choice ethically than prenatal diagnosis (PND) followed by abortion for the following reasons: Choice after PGD is seen as ethically neutral because a positive result ("a healthy pregnancy") balances a negative result ("the destruction of the affected embryo") simultaneously (assuming the pregnancy proceeds to full term and a healthy baby is born). While there is usually the intention to establish a healthy pregnancy after an abortion, this is not simultaneous; A woman sees abortion as a personal physical violation of her integrity, and as the pregnancy proceeds she increasingly identifies with and gives ethical status to the embryo/fetus as it develops in utero and not in the laboratory; Many people see aborting a fetus as "killing", whereas in the case of PGD the spare embryos are "allowed to die". We argue that this difference of opinion gives further weight to our conclusion, but note that this has been addressed and debated at length by others.     

See-saw pattern in ventilator graphic: Is there any story behind?

The importance of ventilator graphics cannot be over emphasized that provide the useful information about airway, ventilation, compliance and lung mechanics. Some bizarre forms of graphics are usually overlooked in view of artifacts, but sometimes these tracings may in fact predict some relevant information.     

Is there a potential link between vitamin D and pulmonary morbidities in preterm infants?

Background

There hasn't been conclusive proof about the association between vitamin D and pulmonary morbidities of prematurity.

Clinical and laboratory observations on polysaccharide sulphate (PSS) in 282 cases of ischemic cerebrovascular disease.

Polysaccharide sulphate (PSS) is a new heparinoid drug. The therapeutic effect and laboratory findings in the treatment of 282 cases with ischemic cerebrovascular disease by PSS were analysed in this study. In treating patients with acute cerebral infarction, the effective rate (93.2%) and highly effective rate (62.9%) were both significantly higher in comparison with controls. Excellent results were also obtained in treating patients with cerebral infarction at late and sequela stage and patients with transient ischemic attack. Laboratory observations and animal experiments showed that PSS has anticoagulative and vasodilatory effects. It can also reduce blood viscosity and serum lipids. So PSS is an effective drug for the prevention and treatment of ischemic cerebrovascular diseases.

     

Third trimester preterm and term premature rupture of membranes: Is there any difference in maternal characteristics and pregnancy outcomes?

Background

The clinical significance and management of preterm premature rupture of membranes (PPROM) remains a topic of a controversy. Although PROM is associated with a low rate of complications, PPROM may lead to significant neonatal and maternal morbidity.