Background and Aims: This study aims at determining the demographic profile and extra-intestinal manifestations of Ulcerative Colitis in the Nepalese patients treated in a tertiary referral centre. Methods : The study was conducted between February 1, 2014 and January 31, 2015 at the Department of Gastroenterology Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The clinical and epidemiologic data from patients diagnosed to have Ulcerative Colitis were obtained and analysed. Results : During the study period, 60 patients were identified as having ulcerative colitis. Mean age at diagnosis was 34.6 years. The mean duration of illness at diagnosis was 3.7 years. Extra-intestinal manifestations (EIM) were seen in 16.6% of the patients. Sacroilitis was the most common EIM seen in11.6% followed by peripheral arthritis in 6.6% of the patients. Episcleritis, Primary Sclerosing Cholangitis and Erythema Nodosum were seen only in 1.6% each. At the time of presentation, 38.3% (n=23) had proctosigmoiditis , 50% (n=30) left sided colitis and pancolitis was seen in 11.7% (n=7).53.3% patients had mild disease, 38.3% and 8.3 % presented with moderate to severe disease respectively. Conclusion : Peak age of onset for UC in the study was third and fourth decade which was similar to the various studies from Asia and West. Musculoskeletal manifestation was the most common extra- intestinal manifestation of UC in Nepalese population. As Nepal is perhaps the most diverse country in terms of ethnicity, cultural variation, socio-economic status and health care facilities, a comprehensive nationwide data bank involving ethnicity and geographical variation is needed for a better definition of the disease characteristics. Journal of Advances in Internal Medicine 2015;04(01):1-5.
Chapter 4 The Molecular Genetics of Lung Cancer David S. Shames, David S. ShamesSearch for more papers by this authorMitsuo Sato, Mitsuo SatoSearch for more papers by this authorJohn D. Minna, John D. MinnaSearch for more papers by this author David S. Shames, David S. ShamesSearch for more papers by this authorMitsuo Sato, Mitsuo SatoSearch for more papers by this authorJohn D. Minna, John D. MinnaSearch for more papers by this author Book Editor(s):Jack A. Roth MD, F.A.C.S., Jack A. Roth MD, F.A.C.S. Professor and Bud Johnson Clinical Distinguished Chair, Department of Thoracic and Cardiovascular Surgery, Professor of Molecular and Cellular Oncology, Director, W.M. Keck Center for Innovative Cancer Therapies, Chief, Section of Thoracic Molecular Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USASearch for more papers by this authorJames D. Cox MD, James D. Cox MD Professor and Head, Division of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USASearch for more papers by this authorWaun Ki Hong MD, D.M.Sc. (Hon.), Waun Ki Hong MD, D.M.Sc. (Hon.) American Cancer Society Professor, Samsung Distinguished University Chair in Cancer Medicine, Professor and Head, Division of Cancer Medicine Professor, Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USASearch for more papers by this author First published: 01 January 2008 https://doi.org/10.1002/9780470696330.ch4Citations: 3 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Summary This chapter contains section titled: A brief History of Cancer Genetics Overview of Lung Cancer Etiology, Incidence, and Treatment Molecular Genetics of Lung Cancer Preneoplasia and the Early Detection of Lung Cancer Epigenetic Basis of Lung Cancer—DNA Methylation and Tumor Suppressor Gene Inactivation Tumor Suppressor Genes Oncogenes and the Pathways They Regulate Receptor Tyrosine Kinases RAS/RAF/MEK/ERK Pathway References Citing Literature Lung Cancer, Third Edition RelatedInformation
Cardiovascular disease is a major source of morbidity and mortality for patients with chronic kidney disease (CKD). Peripheral arterial disease (PAD) is a strong predictor of coronary artery disease and a risk factor for mortality in the general population. This is of particular interest to nephrologists because the risk for PAD is increased in CKD. Often, PAD is overlooked as a source of morbidity and as a cardiovascular risk factor in this population. This review serves as an overview of the epidemiology, screening, diagnosis, and treatment of PAD with an emphasis on CKD.
Compelling evidence from meta-analysis of a number of clinical studies on a large aggregate of patients has established an increased level of triglycerides as an independent risk factor for atherosclerotic heart disease. The finding of triglyceride-rich lipoproteins in human atheromata has provided substantial pathophysiologic evidence for a direct role in atherogenesis. Hypertriglyceridemia is commonly embedded in the context of a metabolic syndrome that includes central obesity, insulin resistance, low levels of HDL cholesterol, and often hypertension. Hypertriglyceridemia also appears to underlie the phenomenon of small dense LDL in most instances. Therapeutic interventions must be directed at underlying obesity, insulin resistance, and diabetes when present, as well as addressing metabolic determinants of dyslipidemia per se. Diet, exercise, weight loss, and avoidance of alcohol are the cornerstones of treatment. The choice of medication should be based on the lipoprotein phenotype. Niacin, fibric acid derivatives, and omega-3 fatty acids are most useful in treating severe hypertriglyceridemia. HMG-CoA reductase inhibitors are useful in some phenotypes with moderately increased triglyceride levels. Evidence from a number of clinical trials indicates that mitigation of risk of coronary heart disease, and possibly stroke, can be effected by reducing levels of plasma triglycerides.
Dilated cardiomyopathy is a disease of diverse causes. Untreated, this condition will likely progress to advanced heart failure, sudden death, or both. There have been a number of significant advances in the understanding of the mechanisms involved in the pathogenesis of this disease. Treatments that counteract ventricular remodeling with neurohumoral blockade have substantially improved the outcome for many patients. Although cardiac transplantation is of benefit to patients with advanced disease, the growing donor heart shortage limits this option. New treatments are clearly needed, and many are being actively investigated. As the genetic and cellular derangements that result in dilated cardiomyopathy are better understood, new therapeutic targets will be identified in the quest to restore normal cardiac structure and function.
With our better understanding of Lyme disease, we now know it is not the "great imitator" of disease it once was thought to be. Limited, identifiable syndromes can be related to Lyme disease. Most of the disease's manifestations resolve without treatment. Treatment with standard antibiotics is very effective at preventing the development of long-term sequelae. The Lyme disease vaccine is safe and effective at preventing transmission of Lyme disease. Future improvements in the care of patients with Lyme disease should focus on identifying the etiology and most effective therapies for patients with posttreatment chronic Lyme disease syndrome, determining the safety and efficacy of vaccination in children, and developing second generation vaccines with improved efficacy and dosing schedules, possibly through the addition of antigens expressed in the human host.
