Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 6 Articles
Acupoint therapy is one of the therapeutic means in Traditional Chinese Medicine (TCM) concerning acupoints and meridians,\nincluding manual acupuncture, electroacupuncture,moxibustion, external application, acupoint injection, and catgut embedding.\nIn the treatment of diabetes and its common chronic complications, acupoint therapy has proved to have specific curative effect and\nnotable advantages. Single or combined with western medicine, it has superior efficacy and less side effects than western medicine\nalone. Studying its mechanism can provide experimental basis for clinical treatment. Relevant researches in the recent 5 years\nmainly focused on the mechanism of electroacupuncture, point injection, catgut embedding, etc. in the treatment of diabetes and\ncommon diabetic complications such as neuropathy, nephropathy, and hepatopathy. The possible theories involve the regulation\nof nerve conduction, signal pathways, hormone level, protein expression, oxidative stress level, structure restoration, etc.The most\nstudied acupoints are Zusanli (ST36), Shenshu (BL23), Sanyinjiao (SP6), Yishu (EX-B3), and Zhongwan (CV12). However, most\nof the studies have been based on diabetes model rats rather than clinical trials. Moreover, the mechanism of acupoint therapy\ntreating other chronic complications like diabetic retinopathy and that of other effective methods like pressing ear with beans,\nauricular points plaster therapy, and external application remain unclear. Therefore, this aspect still awaits further research....
Objective: The aim of this study was to develop a simple predictor model to\ndiagnose malignancy by using ultrasound features of thyroid nodules and the\nassociation with cytopathological diagnosis obtained by fine needle aspiration.\nMaterials and Methods: The likelihood of malignancy from ultrasound\nfeatures was assessed in thyroid nodules obtained by fine-needle aspiration\nbiopsy (FNAB) according to cytopathological findings reported using Bethesda\nSystem. A score was developed depending on the presence of each ultrasound\nfeature evaluated. Results: 429 nodules were assessed, 103 (24%)\nwere malignant. The following ultrasound features were associated with malignancy,\naccording to the logistic regression analysis and were assigned a\nscore of 0, +1, +2 depending on the presence or absence of each one: hypoechogenicity,\nsolid appearance, irregular margins, microcalcifications, absence\nof a halo, diameter of greater than or equal to 10 mm and intranodular vascular flow. The area under\nthe curve of the proposed model was 0.900, demonstrating its predictive\ncapacity. 4 risk categories were stablished based on the score obtained. Malignant\nnodules scored higher than the benign nodules (7.24 Â} 1.87 vs. 3.74\nÂ} 1.83). Conclusions: The proposed predictive model demonstrated to be\nuseful and easy to apply when stratifying thyroid nodule risk of malignancy\nusing presented US features and applying the proposed risk categories\nto increase the accuracy at selecting nodules that need to be studied with\nFNA....
Introduction: In 85% of patients, the cause of Primary Hyperparathyroidism\n(PHPT) is an adenoma. Parathyroid adenoma localization is usually simple.\n96% of localizations prior to surgery are achieved with ultrasound and scintigraphy\ncombination. Difficulties can appear. If the gland is not located in a\ncervical position and has no uptake in scintigraphy but there is high suspition\nof an adenoma causing the PHPT, some extra tests should be considered.\nCase Report: We present a case of giant cystic mediastinal adenoma, a quite\nrare condition, which was diagnosed as a thyroid colloid cyst by ultrasound,\nand was not localized by scintigraphy. We report the CT scan and the magnetic\nresonance imaging (MRI) images that show the tumour. It was surgically\nresected by a cervical approach. After the excision, the patient recovered\nnormal levels of Calcium and Parathormone (PTH). Conclusion: We review\nliterature about cystic and mediastinal adenomas and diagnostic methods\nwhen the standard ones do not give an accurate localization diagnosis....
Background: Cognitive impairment is commonly observed in patients with Hashimoto thyroiditis (HT). Low levels\nof vitamin D have been correlated with cognitive impairment in non-HT population. We examined the association\nof vitamin D levels with cognitive impairment in patients with HT.\nMethods: We recruited 194 patients with HT and 200 healthy volunteers. Levels of serum 25-hydroxyvitamin D\n(25(OH)D) were measured using a competitive protein-binding assay. Cognitive funtion was assessed using\nMontreal Cognitive Assessment score (MoCA). Subjects with a MoCA scores < 26 are considered as having mild\ncognitive impairment (MCI). Multivariate analysis was performed using logistic regression models.\nResults: Fifty-five HT patients (28.4%) were diagnosed as having MCI. Patients with MCI had significantly lower\n25(OH)D levels when compared with patients without MCI (33.9...............
Background: Diabetes is a risk factor for cognitive impairment, but whether there is also a link between pre-diabetes\nand cognitive dysfunction is not yet fully established. The aim of this observational study was to investigate associations\nbetween pre-diabetes/diabetes and cognitive test results, and also between glucose levels measured during the Oral\nGlucose Tolerance Test (OGTT) and cognitive outcomes.\nMethods: During 2007--2012, in all 2994 people (mean age 72 years), residing in Malmo, Sweden, underwent a clinical\nexamination including the OGTT, cardiovascular measurements including carotid-femoral pulse wave velocity (c-f PWV)\nand two cognitive tests, the Mini Mental State Examination (MMSE), measuring global cognitive function, and A Quick\nTest of Cognitive Speed (AQT), measuring processing speed and executive functioning. Regression analyses were\nperformed to investigate associations between: (a) categories of normal or impaired glucose metabolism, and (b)\nOGTT measurements, respectively, as exposure variables and cognitive test results as outcomes. Adjustments were made\nfor demographics, lifestyle factors and cardiovascular risk factors.\nResults: Participants with pre-diabetes and diabetes scored slightly worse cognitive test results compared to the control\ngroup. Results of participants with a long disease duration of diabetes since the baseline examination 13 years earlier\nwere poorer (mean AQT test time 17.8 s slower than controls, p < 0.001). Linear associations were found between fasting\nand 2-h glucose and cognitive outcomes in the whole population, but also in a sub-analysis including only individuals\nwithout diabetes (for 2-h glucose and MMSE results: B = - 2.961, p = 0.005). Associations were stronger for older or less\nphysically active individuals. When adjusting for cardiovascular risk factors, most correlations were non-significant.\nConclusions: Pre-diabetes and diabetes are associated with minor deficits in global cognitive function, processing speed\nand executive functioning. Long-standing diabetes is associated with bigger deficits. There appears to be a continuous\ninverse correlation between glucose levels and cognitive test results, also for people without diabetes. Associations are\nstronger in older and less physically active individuals. Cardiovascular factors are important mediating factors in the\npathway between diabetes and cognitive dysfunction....
Background. Chronic spontaneous urticaria (CSU) is autoimmune in nature and associated with thyroid autoimmunity (TA), but\nevidence on autoimmunity in relation to CSU progression and prognosis is limited.We evaluated whether TA and autoimmunity\nin CSU are correlated with disease severity, therapeutic response, and time to remission and establish an association between\nCSU characteristics linked to thyroid autoantibody. Methods. Medical records of patients diagnosed with urticaria attending\noutpatient dermatology clinic at a university-based hospital from 2013 to 2017 were retrospectively reviewed. Data on the clinical\ncharacteristics, laboratory investigations particularly thyroid antibody titers, autologous serum skin test (ASST) and autologous\nplasma skin test (APST) results and their link to disease severity, treatments, and time to remission of CSU patientswere analyzed.\nResults. Of 1,096 patients with urticaria, 60.2% had CSU. Three-hundred patients fulfilled the inclusion criteria for CSU with\ncomplete thyroid antibody testing. Positive TA was significantly associated with female gender and age > 35 years (p = 0.008).\nAntithyroid peroxidase (anti-TPO)-positive patients suffered from CSU longer than 12 and 18 months compared to anti-TPOnegative\npatients (100.0% vs. 82.6%, p = 0.042, and 100.0% vs. 75.9% p = 0.020, respectively). The presence of urticarial attacks > 4\ndays/week was significantly seen in ASST and APST-positive patients compared to those without (84.6% vs. 61.3%, p = 0.011, and\n85.3% vs. 61.8%, p = 0.006, respectively). Positive APST patients were more difficult to treat than those with negative results (61.2%\nvs. 37.8%, p = 0.017). Conclusions. Antithyroid peroxidase is a predictor of time to remission, while autologous skin testing is linked\nto disease severity (ASST and APST) and therapeutic response (APST) in CSU patients....
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