简介:AbstractObjective:Scoping review of published literature to establish clinical characteristics and audiologic outcomes in patients diagnosed with Susac’s Syndrome(SS) who have undergone cochlear implantation (CI).Data sources:All published studies of CI in SS and contribution of two of our own patients who have not been reported previously.Methods:A comprehensive search of MEDLINE (via PubMed) was carried out in March 2020 using the following keywords and related entry terms: Susac’s Syndrome, Cochlear Implantation. Results: Our search identified a total of five case reports of CI in SS. With the addition of our two patients reported here, we analyzed characteristics and outcomes in seven patients. Mean age at implantation was 30 years old (range 19-46), with six women and one man implanted. Mean time from onset of hearing loss to implantation was 17 months (range three months to four years). Best reported postoperative speech understanding was reported via different metrics, with six of seven patients achieving open set speech scores of 90% or better, and one subject performing at 68%. Vestibular symptoms were present preoperatively in four of seven patients (57%), with vestibular testing reported in two patients, and showing vestibulopathy in one patient. No complications were reported following cochlear implantation.Conclusion:Cochlear implantation is a viable option for hearing rehabilitation in patients with SS, with levels of attainment of open set speech comparable to other populations of CI candidates.
简介:Symptomatichepato-diaphragmaticinterpositionofabowellooporChilaiditi'ssyndromeisapeculiaranatomicalconditionmostoftenfoundbychance.Itsdescribedsymptomsrangefromintermittent,mildabdominalpainanddyspepsiatoacuteintestinalobstruction.Wereportacaseofhepato-diaphragmaticmigrationofthehepaticflexureofthecolonassociatedtoanunusual,heretoforeunreported,angina-likepainexclusivelyevokedbytheleftlateraldecubitus.Tomaximizethechanceofobservinganatomicalchangesindifferentpostures,computedtomographyofthechestandabdomenwasperformedafterairinsufflationintothecolon.Whilefrankherniationintothechestwasexcluded,thescanshowedthatthehepaticflexure-withtheinterpositionofthediaphragm-cameincontactwiththerightsideoftheheartintheleftlateral,butnotinthesupine,decubitus.Thisfindingwasreproducedbyechocardiographywhichalsoshowedvirtuallyunalteredhemodynamicsafterthechangeofposture.ECG,leftandrightventricularglobalandregionalfunctionaswellascardiacinjurymarkersalsoremainedunchangedduringthemaneuver,indicatingthatthepainevokedbythelatterwasunlikelyduetomyocardialischemia.ThiscasesuggeststhatChilaiditi'ssyndromeshouldbeincludedamongthepossible,althoughrare,causesofunexplainedangina-likesymptoms.
简介:Reiter'ssyndromeisasecondarydiseaseofurethrainfection.Itconsistsofurethritis,nonsuppurativearthritis,conjunctivitisandcutaneousmucosalesions.YoungmalesaremorelikelytogetReiter'ssyndromethanfemales.Thusfar,therearenoreportsofwomeninChinawithReiter'sSyndrome.ThisreportdocumentstwofemaleswithReiter'sSyndrome.
简介:AIM:Todeterminetheclinicalfeatures,diagnosisandtreatmentoftheprimarySjogrensyndrome(SS)relatedopticneuritis.METHODS:Theclinicaldataof8patients(12eyes)withprimarySSrelatedopticneuritiswereanalyzedretrospectively.RESULTS:Eightof128consecutivepatientswithopticneuritisresultedfromvariedcausesfulfilledthediagnosticcriteriafortheprimarySS.Theypresentedinitiallywiththesignsandsymptomsofnon-specificopticneuritis,and5patientspresentingwithoutdrynessshowedachronicinflammationofsubmandibularglandorparotidgland,andlymphocyteinfiltrationwasdemonstratedbylabialglandbiopsyin2patients.Therewereserumpositivetitersforanti-SjogrensyndromeA(SSA)in7patientsandanti-SjogrensyndromeB(SSB)in8patients.Anti-aquaporin-4(AQP4)antibodywasnegativeinallthe8patients.Bothglucocorticoidsandimmunosuppressiveagentwereadministered,andvisualacuityelevatedin8eyes(66.7%),3patients(37.5%)recurredinthefollow-up.CONCLUSION:PrimarySSrelatedopticneuritisislesscommonandeasilymisdiagnosed.Theconventionaltherapiesforopticneuritiscouldnotcontroltherecurrence.
简介:无
简介:无
简介:Tourette'ssyndromeistreatedbybehavioralorpharmacologicaltherapy.However,patientswithmalignantTourette'ssyndromealsoexhibitlife-threateningsymptoms,whichareunresponsivetoconservativetreatmentsorneurosurgicalprocedures,suchasdeepbrainstimulation.Inrecentyears,mesenchymalstemcells(MSCs)haveshowntherapeuticpotentialinmanyneurologicaldiseases.Therefore,thepresentstudyproposedtouseMSCtransplantationasanoveltherapyforTourette'ssyndrome.StereotypicbehaviorsinTourette'ssyndromeratsdecreasedsignificantlyat21daysafterhumanMSCstransplantationintothestriatum.ImmunohistochemistryanalysesrevealedsurvivaloftransplantedhumanMSCsanddifferentiationintoneuronsandastrocytesintheratbrain.ResultssuggestthatintrastriataltransplantationofhumanMSCscouldprovidetherapeuticpotentialforTourette'ssyndrome.
简介:客观:与严重煽动性的反应症候群(先生)在创伤的病人调查甲状腺荷尔蒙的引申。方法:有严重先生的五十个创伤的病人被注册并且根据他们是否介绍了multiorgandysfunction症候群(MODS)把组划分了成二。甲状腺荷尔蒙大小被拿,包括totaltriiodothyronine(TT3),全部的甲状腺素(TT4),免费triiodothyronine(FT3),免费甲状腺素(FT4)和甲状腺刺激荷尔蒙(TSH)。尖锐生理学和长期的健康评估Ⅱ(APACHEⅡ)20根据临床的数据被计算。恢复或恶化的结果被记录,以及从到时间甲状腺荷尔蒙的先生的发作的时间的长度被测量。结果:Euthyroid病了的症候群(S字)在45cases.TT3水平被介绍否定地与APACHEH分数被相关(r=-0.330,P<0。05),并且TT3/TT4value否定地与先生的持续时间被相关(r=-0.316,P<0.05)。没有MODS,在MODS病人的TT3,TT4和FT3levels是比那些显著地低的(P<0.05)。没有MODS,给低TT4或FT4的MODS病人比那些经常铺平更多(P<0.05)。与在正常TSH组的病人相比,有有的减少的TSH的病人降低T3,T4,恢复率和更高的APACHEⅡ分数,MODS发生,但是二个组之间没有差别(P>0.05).Conclusions:有严重先生的损伤病人有高可能性得到S字,它更经常并且严重地发生在MODS病人。它在甲状腺轴上显示出先生的影响。Withthe坚持和先生的恶化,有甲状腺荷尔蒙的进步减小。
简介:少年polyposis症候群是多重不同少年息肉在胃肠的道和colorectal癌症的增加的风险描绘的稀罕正染色体的主导的症候群。colorectal癌症的累积一生风险是39%,相对风险是34。少年息肉把特殊组织学被有煽动性的房间和膀胱地扩大的腺的薄板propria排队了由的许多edematous描绘了对有反应变化的圆柱的上皮立方形。临床上,少年polyposis症候群被5的存在或更多的少年息肉在colorectum,在整个胃肠的道的少年息肉或少年息肉的任何数字和少年polyposis的积极家庭历史定义。在大约与少年polyposis症候群诊断的病人的50%-60%,在SMAD4或BMPR1A基因的一个germline变化被发现。两基因在表明小径的BMP/TGF-beta起一个作用。在少年polyposis的癌症可以通过反常stromal环境导致邻近的上皮并且最后的肿瘤的转变的所谓的landscaper机制发展,这被建议了侵略的癌。这稀罕混乱的识别关于治疗为病人和他们的家庭是重要的,后续并且屏蔽在风险个人。与少年息肉的诊断面对的每位临床医生应该因此考虑少年polyposis症候群的可能性。另外,少年polyposis症候群提供一个独特模型一般来说学习colorectal癌症致病并且在癌症的分子的基因基础给卓见。这评论讨论少年polyposis症候群的临床的表明,遗传,致病和管理。
简介:无
简介:Gutmicrobiotaexertsasignificantroleinthepathogenesisofthemetabolicsyndrome,asconfirmedbystudiesconductedbothonhumansandanimalmodels.Gutmicrobialcompositionandfunctionsarestronglyinfluencedbydiet.Thiscomplexintestinal'superorganism'seemstoaffecthostmetabolicbalancemodulatingenergyabsorption,gutmotility,appetite,glucoseandlipidmetabolism,aswellashepaticfattystorage.Animpairmentofthefinebalancebetweengutmicrobesandhost’simmunesystemcouldculminateintheintestinaltranslocationofbacterialfragmentsandthedevelopmentof'metabolicendotoxemia',leadingtosystemicinflammationandinsulinresistance.Dietinducedweight-lossandbariatricsurgerypromotesignificantchangesofgutmicrobialcomposition,thatseemtoaffectthesuccess,ortheinefficacy,oftreatmentstrategies.Manipulationofgutmicrobiotathroughtheadministrationofprebioticsorprobioticscouldreduceintestinallowgradeinflammationandimprovegutbarrierintegrity,thus,amelioratingmetabolicbalanceandpromotingweightloss.However,furtherevidenceisneededtobetterunderstandtheirclinicalimpactandtherapeuticuse.
简介:AbstractMetabolic syndrome (MetS) describes a set of risk factors that can eventually lead to the occurrence of cardiovascular and cerebrovascular disease. A detailed understanding of the MetS mechanism will be helpful in developing effective prevention strategies and appropriate intervention tools. In this article, we discuss the relationship between the clinical symptoms of MetS and differences in the gut microbial community compared with healthy individuals, characterized by the proliferation of potentially harmful bacteria and the inhibition of beneficial ones. Interactions between gut microbiota and host metabolism have been shown to be mediated by a number of factors, including inflammation caused by gut barrier defects, short-chain fatty acids metabolism, and bile acid metabolism. However, although we can clearly establish a causal relationship between gut microbial profiles and MetS in animal experiments, the relationship between them is still controversial in humans. Therefore, we need more clinical studies to augment our understanding of how we can manipulate the gut microbiota and address the role of the gut microbiota in the prevention and treatment of MetS.
简介:AbstractAntiphospholipid syndrome (APS) is a thromboinflammatory disease with a variety of clinical phenotypes. Primary thrombosis prophylaxis should take an individualized risk stratification approach. Moderate-intensity vitamin K antagonist such as warfarin remains the primary strategy for secondary thrombosis prophylaxis among APS patients, especially for patients with predominantly venous disease. For now, direct oral anti-coagulants should be avoided in most APS patients, especially those with history of arterial manifestations. Obstetric APS management should be tailored based on an individual patient’s antiphospholipid antibody profile, and obstetric and thrombotic history. Pharmacological agents beyond anticoagulants may be considered for the management of microthrombotic and nonthrombotic manifestations of APS, although more data are needed. A relatively recent discovery in the area of APS pathogenesis is the implication of neutrophil extracellular traps in thrombin generation and initiation of inflammatory cascades. APS is a complex thromboinflammatory disease with a broad clinical spectrum. Personalized therapy according to an individual’s unique thrombosis and obstetric risk should be advocated.