Echocardiography detection of fetal ventricular aneurysm: A report of three cases

From March 2007 to September 2009, we have screened with echocardiography a total of 6,502 pregnant women for fetal heart disease. We found three cases of fetal ventricular aneurysm. The relatively large size of the aneurysm in these three cases was clearly visible under standard four‐chamber view. Two were right ventricular aneurysms arisen from the ventricular free wall, and both showed characteristics of true aneurysm with a thin wall and a large communication with the ventricular chamber. Color Doppler showed passive movement of aneurysm during right ventricle contraction. The third case was a large left ventricular aneurysm outpouching from a small opening of the left ventricular wall close to the apical region. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :257–261, 2015     

Prevalence of comorbidities and associated factors in acromegaly patients in the Turkish population

Background/aim The presence of comorbidities in patients with acromegaly causes an increase in morbidity and/or mortality and a decrease in quality of life. In this study, we aimed to investigate the demographic, clinical and laboratory features, prevalence of acromegaly-related comorbidities, and factors associated with these comorbidities in patients with acromegaly.Materials and methods In the study, 96 patients who were followed up with the diagnosis of acromegaly were included. Clinical, laboratory and imaging features, and accompanying comorbidities of the patients were recorded from the patient files.Results Of the patients included in the study, 63 (65.6%) were female and 33 (34.4%) were male. The mean age of diagnosis was 42.61± 12.08, and the mean follow-up period was 9.97 ± 7.26 years. Median insulin-like growth factor 1 level was 238.16 ng/mL (30.5–820), median growth hormone level was 2.05 ug/L (0.1–29.4). A total of 60 (62.5%) of the patients were in the well-controlled group, and 36 (37.5%) had active disease at the time of inclusion. Diabetes mellitus (DM) was detected in 30 (31.3%) patients, prediabetes in 19 (28.8%) patients, hypertriglyceridemia in 38 (42.2%) patients, hypertension (HT) in 41 (42.7%) patients, cardiovascular disease in 5 (5.2%) patients, malignancy in 9 (9.4%) patients, obstructive sleep apnea syndrome in 8 (8.3%) patients, carpal tunnel syndrome in 11 (11.5%) patients, arthropathy in 5 (5.2%) patients, hearing loss in 7 (7.3%) patients, thyroid nodule in 56 (67.5%) patients, thyroid cancer in 4 (4.2%) patients, colonic polyp in 19 (38.8%) patients.Conclusion In this study, we revealed that the most common comorbidities in acromegaly patients in the Turkish population are thyroid nodules, low high-density lipoprotein (HDL cholesterol (HDL-C) level, hypertriglyceridemia, HT, colonic polyps, DM, and prediabetes, and female sex and age at diagnosis are the most important factors associated with comorbidities.     

益气活血中药肾区离子导入治疗难治慢性肾功能衰竭的临床研究

目的:探讨益气活血中药肾区离子导入治疗难治慢性肾功能衰竭的临床疗效。方法:将62例难治慢性肾功能衰竭患者随机分为治疗组和对照组,对照组予以常规治疗,治疗组在此基础上应用益气活血中药肾区离子导入治疗,比较分析两组的临床疗效。结果:治疗组总有效率为90.3%,对照组总有效率为77.4%,治疗组优于对照组(P0.05);治疗组中医症状积分、Hb、24h upq及ALB以及肾功能指标改善情况均优于对照组(P0.05)。结论:肾区离子导入益气活血中药治疗难治慢性肾功能衰竭疗效显著,不良反应较少。     

人工种植红景天不同药用部位中红景天苷的含量测定

目的：测定人工种植红景天不同药用部位花瓣、茎、根的含量。方法：取各1 g样品经过60%的乙醇溶解,超声波清洗器清洗50 min,过滤,旋蒸,加2 mL的甲醇,用微孔滤膜（0.45 μm）过滤,采用CAPCELL PAK C₁₈柱（2.0 mm× 150 mm,i.d.,3 μm）,柱温 30 ℃,波长278 nm;样品温度10 ℃,进样体积10 μL。流动相为甲醇-1%乙酸溶液 45：55,流速为1 mL·min^-1进行定量分析。结果：有效部位中的红景天苷含量从高到低依次为花瓣（35.00mg）、根（18.89mg）、茎（1.59 mg）。结论：建立了红景天中红景天苷含量的高效液相色谱方法,可适用于不同药材中红景天苷含量的测定。     

Mutation detection rate and spectrum in familial hypercholesterolaemia patients in the UK pilot cascade project

Taylor A, Wang D, Patel K, Whittall R, Wood G, Farrer M, Neely RDG, Fairgrieve S, Nair D, Barbir M, Jones JL, Egan S, Everdale R, Lolin Y, Hughes E, Cooper JA, Hadfield SG, Norbury G, Humphries SE. Mutation detection rate and spectrum in familial hypercholesterolaemia patients in the UK pilot cascade project. Cascade testing using DNA‐mutation information is now recommended in the UK for patients with familial hypercholesterolaemia (FH). We compared the detection rate and mutation spectrum in FH patients with a clinical diagnosis of definite (DFH) and possible (PFH) FH. Six hundred and thirty‐five probands from six UK centres were tested for 18 low‐density lipoprotein receptor gene (LDLR) mutations, APOB p.Arg3527Gln and PCSK9 p.Asp374Tyr using a commercial amplification refractory mutation system (ARMS) kit. Samples with no mutation detected were screened in all exons by single strand conformation polymorphism analysis (SSCP)/denaturing high performance liquid chromatography electrophoresis (dHPLC)/direct‐sequencing, followed by multiplex ligation‐dependent probe amplification (MLPA) to detect deletions and duplications in LDLR.The detection rate was significantly higher in the 190 DFH patients compared to the 394 PFH patients (56.3% and 28.4%, p > 0.00001). Fifty‐one patients had inadequate information to determine PFH/DFH status, and in this group the detection rate was similar to the PFH group (25.5%, p = 0.63 vs PFH). Overall, 232 patients had detected mutations (107 different; 6.9% not previously reported). The ARMS kit detected 100 (44%) and the MLPA kit 11 (4.7%). Twenty‐eight (12%) of the patients had the APOB p.Arg3527Gln and four (1.7%) had the PCSK9 p.Asp374Tyr mutation. Of the 296 relatives tested from 100 families, a mutation was identified in 56.1%. In 31 patients of Indian/Asian origin 10 mutations (two previously unreported) were identified. The utility of the ARMS kit was confirmed, but sequencing is still required in a comprehensive diagnostic service for FH. Even in subjects with a low clinical suspicion of FH, and in those of Indian origin, mutation testing has an acceptable detection rate.     

Group treatments for sensitive health care problems: a randomised controlled trial of group versus individual physiotherapy sessions for female urinary incontinence

Background  

The aim was to compare effectiveness of group versus individual sessions of physiotherapy in terms of symptoms, quality of life, and costs, and to investigate the effect of patient preference on uptake and outcome of treatment.