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Houston Kring posted an update 6 days, 9 hours ago
Despite improvements in dialysis treatment, mortality rates remain high, especially among older hemodialysis patients. Quality of life (QOL) among hemodialysis patients is strongly associated with higher risk of death. This study aimed to describe the health-related QOL and its change in older maintenance hemodialysis patients and to demonstrate characteristics associated with health-related QOL.
Data on 892 maintenance hemodialysis patients aged 60 years or older who were surveyed using the Kidney Disease Quality of Life Short Form at baseline and 2 years after study enrollment in phases 4 (2009-2011) and 5 (2012-2014) of the Japanese Dialysis Outcomes and Practice Patterns Study were analyzed. We categorized participants into 3 age groups (60-69, 70-79, and ≥80 years) and described baseline physical component summary (PCS) and mental component summary (MCS) scores, as well as their distribution of changes after 2 years across each category.
Hemodialysis patients aged 70-79 years and ≥80 years had lower PCS scores than those aged 60-69 years (median 70-79 years = 43.1; interquartile range [IQR], 35.2-49.4; ≥80 years = 38.8; IQR, 31.6-43.8; 60-69 years = 45.4; IQR, 37.5-51.4; p < 0.001). In contrast, MCS scores did not significantly differ by age category (70-79 years = 45.6; IQR, 38.4-53.7; ≥80 years = 45.4; IQR, 36.9-55.1; 60-69 years = 46.8; IQR, 39.5-55.7; p = 0.1). As dialysis vintage lengthened, the PCS score significantly became lower, whereas no association was found with change in the MCS score. The MCS score declined over time in older patients, especially among those aged 80 years and older after 2 years’ follow-up.
Physical QOL became worse as dialysis vintage lengthened. In contrast, mental QOL declined over time within a relatively short period among older maintenance hemodialysis patients.
Physical QOL became worse as dialysis vintage lengthened. In contrast, mental QOL declined over time within a relatively short period among older maintenance hemodialysis patients.
Histiocytoses are rare diseases affecting mainly children and can occur in any organ of the body. They are divided into Langerhans type and non-Langerhans type. Langerhans cell histiocytosis (LCH) mainly affects skin, bones, and lymph nodes but can also affect the hematopoietic system. Bone lesions can be critical when they involve skull base, orbit, or vertebrae and can cause permanent neurological sequelae or death. Histopathological diagnosis and molecular markers are the mainstay for accurate diagnosis. Sixty percent of LCH cases show mutation in the BRAF oncogene. They are treated with multimodality treatment which includes surgery, chemotherapy, and BRAF inhibitor therapy. Owing to the rarity of the disease and paucity of cases, the understanding and standardization of treatment is still evolving.
A 14-year-old boy presented with backache, and his imaging showed erosion of first sacral vertebral body with soft tissue component impinging and compressing the spinal canal. Histopathology and molecular ent permanent neurological deficits. Newer therapies in the form of BRAF inhibitors are on the way, but the efficacy and benefit need to be tested.The molecular and chemical properties of neuronal nitric oxide synthase (nNOS) have made it a key mediator in many physiological functions and signaling transduction. this website The NOS monomer is inactive, but the dimer form is active. There are three forms of NOS, which are neuronal (nNOS), inducible (iNOS), and endothelial (eNOS) nitric oxide synthase. nNOS regulates nitric oxide (NO) synthesis which is the mechanism used mostly by neurons to produce NO. nNOS expression and activation is regulated by some important signaling proteins, such as cyclic adenosine monophosphate (cAMP) response element-binding protein (CREB), calmodulin (CaM), heat shock protein 90 (HSP90)/HSP70. nNOS-derived NO has been implicated in modulating many physiological functions, such as synaptic plasticity, learning, memory, neurogenesis, etc. In this review, we have summarized recent studies that have characterized structural features, subcellular localization, and factors that regulate nNOS function. Finally, we have discussed the role of nNOS in the developing brain under a wide range of physiological conditions, especially long-term potentiation and depression.An issue of the novel coronavirus infection spreading is currently in the first place among others in the list of the international medical community. Due to lack of information, conflicting research findings, multicomponent effect of the virus on the body host, as well as various consequences that the virus triggers in the body, now every medical specialty does study the viral attack pathogenesis. Recent months showed that vascular complications are the most severe in the Coronavirus Disease 2019 (COVID-19) and are the main cause of death in the patients. The mechanisms of vascular complications are complex and affect both the hemostatic system and immune responses, “inflammatory storm”, disorders of the renin-angiotensin-aldosterone system, endotheliopathy, etc. Due to the leading role of vascular complications in the viral infection pathogenesis, several groups of patients are at extra risk, including pregnant women, patients with a burdened obstetric history, with hereditary thrombophilia and antiphospholipid syndrome, and patients after in vitro fertilization (IVF). In this category of pregnant women, use of low-molecular-weight heparins (LMWH) is particularly important for both prevention of vascular and obstetric complications, and for pathogenetic therapy of COVID-19.Background Preeclampsia (PE) is a multisystem disease and is still among the leading causes of maternal and neonatal morbidity and mortality. Inadequate trophoblast invasion plays a key role in the PE pathogenesis. The proliferation, migration, and invasion of extravillous trophoblasts (EVTs) is primarily controlled by the decidua-derived transforming growth factor beta (TGF-β) and decorin. In this study, we aimed to investigate the clinical utility of serum decorin levels measured in the 11th to 14th gestational weeks to predict preeclampsia during the following weeks of gestation. Materials and Methods A total of 600 pregnant women, whose age and gestational age ranged from 18 to 40 years and 11 to 14 weeks, were included. Venous blood samples were obtained and stored at -80 °C. Subsequently, the patients who developed preeclampsia and healthy controls with a similar body mass index were identified and their first-trimester blood samples were analyzed for serum decorin levels. Results The mean serum decorin level was 8.