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R. Sinert S. Zehtabchi S. Desai P. Peacock B. T. Altura B. M. Altura 《Scandinavian journal of clinical and laboratory investigation》2013,73(3):317-326
Objective. Prior studies have been equivocal about whether or not serum levels of the divalent ions calcium and magnesium are altered during different types of seizures. Magnesium is a potential modulator of seizure activity because of its ability to antagonize the excitatory calcium influx through the N‐methyl‐D‐aspartate (NMDA) receptor. We hypothesize that serum ionized levels of calcium (Ca2+) and magnesium (Mg2+) would be altered significantly during certain types of seizures. Material and methods. A convenience sample of seizure patients presenting to an emergency department (ED) were enrolled in this prospective study. Novel ion‐selective electrodes were used to measure Ca2+ and Mg2+. Data were reported as mean values±standard deviations. Group comparisons were analyzed by ANOVA with post‐hoc testing using the Bonferroni, or the Fisher exact test, where appropriate, α = 0.05 (two‐tailed). Results. Forty‐nine patients with seizure and 32 healthy racially matched controls were included in the study. Seizure patients had a significantly (p<0.001) lower mean Mg2+, but not total serum Mg and a significantly (p<0.001) higher Ca2+/Mg2+ ratio than that in controls. Conclusions. We were able to show significantly lower Mg2+ and higher ionized Ca2+/Mg2+ ratios in seizure patients compared with a racially matched control group. 相似文献
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Context Sunitinib malate is an oral tyrosine kinase inhibitor used in the treatment of renal cell carcinoma (RCC) and gastrointestinal stromal tumours. Hypothyroidism has been observed in patients treated with sunitinib, but the mechanism whereby sunitinib induces hypothyroidism is unknown. Objective To describe a series of six patients who developed thyrotoxicosis while on sunitinib for metastatic RCC. Setting The study was conducted at Austin Health, a tertiary teaching hospital in Melbourne, Australia. Results Two patients developed severe thyrotoxicosis within 10 weeks after commencing sunitinib. In contrast, in the four patients who presented with later onset (16–30 weeks) thyrotoxicosis, the thyrotoxicosis was relatively mild, self‐limiting and rapidly progressed to hypothyroidism. These patients experienced recurrent episodes of thyrotoxicosis in temporal relation to their cyclical sunitinib treatment. One patient had cytological evidence of lymphocytic thyroiditis. Conclusions These findings suggest that sunitinib‐induced hypothyroidism may be a consequence of preceding thyroiditis with associated transient thyrotoxicosis. As predictive factors are currently unknown, we suggest regular monitoring of thyroid function in all patients commenced on sunitinib. Clinicians treating patients with sunitinib or other similar kinase inhibitors should to be alerted to thyroid dysfunction as a potential toxicity of these agents. 相似文献
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Nicholas J. Clark Vishal S. Desai Joshua D. Dines Mark E. Morrey Christopher L. Camp 《Current reviews in musculoskeletal medicine》2018,11(1):48-54
Purpose of Review
This review aims to describe the nonreconstructive options for treating ulnar collateral ligament (UCL) injuries ranging from nonoperative measures, including physical therapy and biologic injections, to ligament repair with and without augmentation.Recent Findings
Nonoperative options for UCL injuries include guided physical therapy and biologic augmentation with platelet-rich plasma (PRP). In some patients, repair of the UCL has shown promising return to sport rates by using modern suture and suture anchor techniques. Proximal avulsion injuries have shown the best results after repair. Currently, there is growing interest in augmentation of UCL repair with an internal brace.Summary
The treatment of UCL injuries involves complex decision making. UCL reconstruction remains the gold standard for attritional injuries and complete tears, which occur commonly in professional athletes. However, nonreconstructive options have shown promising results for simple avulsion or partial thickness UCL injuries. Future research comparing reconstructive versus nonreconstructive options is necessary.67.
S.K. Kiran Achhelal Pasi Satish Kumar Gudadappa S. Kasabi Prabhakara Gujjarappa Aakash Shrivastava Sanjay Mehendale L.S. Chauhan Kayla F. Laserson Manoj Murhekar 《Emerging infectious diseases》2015,21(1):146-149
We investigated a Kyasanur Forest disease outbreak in Karnataka, India during December 2013–April 2014. Surveillance and retrospective study indicated low vaccine coverage, low vaccine effectiveness, and spread of disease to areas beyond those selected for vaccination and to age groups not targeted for vaccination. To control disease, vaccination strategies need to be reviewed. 相似文献
68.
Lietman SA Goldfarb J Desai N Levine MA 《The Journal of clinical endocrinology and metabolism》2008,93(3):901-904
CONTEXT: Preimplantation genetic diagnosis (PGD) enables the selection of embryos without mutations for implantation and has not been described to our knowledge for mutations in GNAS. Phocomelia in a patient with Albright hereditary osteodystrophy (AHO) has also not been previously described. OBJECTIVE: The aim of this study was to identify a GNAS mutation in a patient with a severe form of AHO and pseudohypoparathyroidism type 1a with phocomelia and to perform PGD on embryos derived by in vitro fertilization to deliver an unaffected infant. DESIGN: A proband and his family are described clinically, the GNAS gene was sequenced to identify a novel mutation in the proband, and PGD was performed on embryos. SETTING: The setting was in a tertiary-care hospital. PATIENTS: The patients were from a single family in which the proband has a severe form of AHO. INTERVENTIONS: Interventions were PGD and in vitro fertilization. MAIN OUTCOME MEASURES: The main outcome measures were the clinical phenotypes and GNAS gene sequences of the proband, embryos, and family members. RESULTS: After PGD, three genotypically normal embryos were transferred back to the mother. Pregnancy ensued, and a healthy male infant was delivered at 36.5 wk gestation. The GNAS genes in the baby were confirmed as wild-type, and the infant is free of any signs of AHO. CONCLUSIONS: We describe herein a proband with AHO and severe skeletal deformities (including phocomelia) related to a novel GNAS mutation and the delivery of a male infant with homozygous normal GNAS genotype after PGD. 相似文献
69.
Andrea M. Siegel PhD Kelly D. Stone Glenn Cruse Monica G. Lawrence Ana Olivera Mi-yeon Jung John S. Barber Alexandra F. Freeman Steven M. Holland Michelle O'Brien Nina Jones Laura B. Wisch Heidi H. Kong Avanti Desai Orly FarberAlasdair M. Gilfillan PhD Juan Rivera Joshua D. Milner 《The Journal of allergy and clinical immunology》2013
70.
Emergency Radiology - Mastoid air cell fluid is a commonly seen, but often dismissed finding. Given the location of the mastoid portion of the temporal bone and its location adjacent to vital... 相似文献