Implantable cardioverter defibrillator (ICD) is an innovative biomedical device designed to detect and terminate malignant ventricular arrhythmias (VAs) with convincing evidence of substantial life-saving properties. Its prophylactic use for sudden cardiac death (SCD) in patients resuscitated from cardiac arrest or at risk for malignant VAs has revolutionized the face of clinical care for many cardiac diseases with a shift from antiarrhythmic drugs. Progressive improvements in ICD device has expanded the prophylactic use of ICD to include pre-emptive therapy in a large population of patients with significantly depressed left ventricular systolic function. This expansion increased the incidence of inappropriate shocks potentially affecting treatment efficacy. Moreover, inadequate attention paid to the patient’s psychosocial concerns and cost-effectiveness of therapy has affected treatment outcomes as well as quality of life. The knowledge of these complications and challenges is critical for appropriate selection of patients who will benefit from the therapy as well as improve treatment outcomes. The purpose of this literature review and pooled analysis is to summarize the current knowledge base of clinical indications, treatment outcomes, psychosocial concerns and healthcare costs for ICD patients and to identify gaps in ICD literature that would be appropriate targets for future research. *Correspondence to: Aref Albakri, St-Marien hospital Bonn Venusberg, Department of Internal Medicine, Bonn, Germany, E-mail: arefalbakri@yahoo.com
Background and objectives: Stroke in tuberculous meningitis (TBM) has been reported in approximately 13-57% of patients with TBM. There are several mechanisms postulated for stroke in tuberculous meningitis including the role of various cytokines, chemokines and vascular endothelial growth factor (VEGF). VEGF is a potent regulator of endothelial permeability.There is a paucity of data regarding comparison of VEGF levels in patients of TBM with and without stroke. The aim of the study was to compare Serum VEGF in patients of tuberculous meningitis with and without Stroke and correlate it with various clinical, biochemical and radiological features. Methods: We compared 40 patients of probable or definite TBM with 40 age and sex matched patients of TBM with stroke.The two groups were compared for duration of illness, BMRC staging, various clinical parameters, CSF parameters (cytology, glucose and protein), MRI Brain scan features and serum VEGF levels. Results: The serum VEGF levels were significantly higher in TBM patients with stroke as compared to patients without stroke. The mean serum VEGF levels were 499.338 ± 230.320 pg/ml in patients of TBM without stroke and 1218.372 ± 570.114 pg/ml in patients of TBM with stroke. On multivariate analysis, out of the significantly different variables between patients of TBM without stroke and with stroke(i.e. duration of illness at presentation, hemiparesis, GCS score, Stage 3 BMRC, CSF protein concentration, CSF sugar, CSF lymphocyte count, presence of hydrocephalus on MRI Brain scan and serum VEGF) only GCS score and serum VEGF levels were significant. Interpretation and conclusion: The stroke in tuberculous meningitis was correlated to higher serum VEGF levels, lower GCS score. We conclude that features such as presentation in stage 3 BMRC, poor GCS at presentation, increased duration of illness at presentation, hydrocephalus on MRI and high serum VEGF levels may predict the occurrence of stroke in TBM. *Correspondence to: Rajat Jhamb MD (Medicine), FACP, FICP, FIACM, Professor, Department Of Medicine, University college of Medical Science & GTB Hospital, Delhi, India 110095, Tel: +91-9625900556; E-mail: rajatjhamb@ yahoo.com
Background: Synovial joint erosions are generally considered the result of an inflammatory process, permitting identification of the underlying form of arthritis.However, they are sometimes perceived in isolation, in the absence of any disorder known to produce erosions.In addition to the character of the erosions, a tool helpful in characterizing known forms of inflammatory arthritis is their gender and age distribution as a population phenomenon. Methods:Hands and feet of individuals in the Hamann-Todd human skeletal collection were macroscopically examined to identify individuals with isolated (single or two) appendicular articular or peri-articular cortical disruptions in absence of axial skeletal erosions, fusion, syndesmophytes or calcium pyrophosphate deposition disease-related calcific deposits.Gender and age were additionally recorded for individuals identified with rheumatoid arthritis, spondyloarthropathy and calcium pyrophosphate deposition disease.Results: Isolated articular and periarticular cortical disruption was recognized in 61 (4 women, 57 men) among 1620 individuals, independent of race.Discussion: Epidemiologic analysis revealed a pattern of isolated erosions that could not be attributed to the diseases that today are recognized to commonly cause bone erosion.If not associated with other skeletal manifestations of inflammatory/crystalline arthritis or clinical evidence of synovitis, they likely are not clinically significant.
This study sought to examine female undergraduates sports participation and adequate education, perceived implications of reproductive health problems/male dominance: University Sports administration experience.Sports has grown from its earlier humble beginnings of being a mere entertainment and recreational passtime, to becoming a prominent, business both in the social, political and economic circles of all nations of the world.Hence the researcher tried to verify perceived implications of the reproductive health problems of the girl-child and persistent male dominance in University sports vis a vis female undergraduates participation in sports and their education.Consequently, the specific objective of this study was to verify if the reproductive health problems of the girl-child, poorly funded and maintained sports facilities of the universities and perceived male dominance over the girls in virtually all sports determine female undergraduates participation in university sports and their education generally.To guide this study 3 research questions were formulated, with 3 corresponding hypotheses that were tested at 0.05 level of significance.The descriptive survey research design was considered appropriate, while the instrument for data collection was a self-structured questionnaire designed after the Likert type by the researcher.Total of 380 female undergraduates of three universities in Anambra State of Nigeria.Nnamdi Azikiwe University, Awka, Odumegwu Ojukwu University Uli, and Madonna University Elele Port Harcourt (Federal, State-and Privately-owned universities) constituted the population of the study, out of which a total of 263 respondents were sampled.The descriptive statistics of mean, frequency counts and standard deviation (SD) were used to describe the data, while inferential statistics of Chi-square (X 2 ) was used to test the 3 null hypotheses at 0.05 level of significance.Based on the data collected and analyzed, revealed that reproductive health problems (X 2 =84.18, df=3, P>0.05), poor funding/maintenance of sports for faculties (X 2 =75.412, df=3, P>0.05) male undergraduates dominance in all sports (X 2 =128.68 df. 3, P>0.05) were seen to be determinants of female undergraduates participation and education generally in universities.It was therefore recommended that stiffer measures must be taken and applied to preserve the few sports facilities built around the female hostels, to be strictly used by the female undergraduates, at their convenience.Universities need to further improve on their reproductive health service delivery, to adequately cater for the needs of the female undergraduates who presently seem to be on their own, in terms of solutions to their numerous reproductive health problems that tend to interfere with their sports participation and academic pursuits in the university.Highly qualified Nurses should be employed to serve as Matrons attached to all female hostels in the universities to assist the female undergraduates cope with their reproductive health problems at beck and call.
Culture methods Feeder based cultureStandard human pluripotent stem cells (hPSCs) cultures have supportive cells such as inactivated mouse embryonic fibroblast (MEF) feeder cells that aid cell growth, secrete several important growth factors into the medium, which help maintain pluripotency and prevent differentiation [1].Feeder based cultures are suitable for routine maintenance of hPSCs colonies, and MEFs are the most frequently used feeder cells, particularly because they support the robust growth of all types of embryonic stem cells as colonies [2].However, since MEFs have complex and undefined heterogeneity, a variety of human cell types such as human fibroblasts, tubal, foreskin, and bone marrowderived stromal cells can be used as feeder cells instead of MEF [2].Feeder based cultures are suitable for routine hPSCs maintenance, genetic engineering and single cell cloning, but are not used for clinical applications.
Recently, the dramatic changes in the epidemiology of Clostridium difficile infection (CDI) as well as increases in both incidence and severity of disease in many countries have made it a global public health problem.This increasing severity and incidence could be partially because of frequent antibiotic use and the emergence of a hypervirulent strain of Clostridium difficile.Antibiotics such as metronidazole and vancomycin could be considered as frontline treatment for CDI.But recurrent CDI occurs in ∼ 25 percent of cases and causes morbidity, mortality and healthcare costs.Due to antibiotic treatment failure in this population, novel treatment options are required.Recently, anti-toxin antibodies are developed as new therapeutic approach to the treatment of CDI.Bezlotoxumab, the first therapeutic monoclonal antibody, which is approved for the prevention of CDI recurrence.The aim of this manuscript is to provide the latest information about CDI treatment, with a particular focus on antibiotics and therapeutic antibodies that are utilized in CDI treatment.
La maladiel Qu'est-ce que la drépanocytose ?La drépanocytose est une maladie génétique de l'hémoglobine, une substance contenue dans les globules rouges, qui sert à transporter l'oxygène à travers le corps.La maladie se manifeste par une anémie (se traduisant par une fatigabilité, des vertiges, des essouffle-ments…), une sensibilité aux infections, et des crises douloureuses causées par une mauvaise circulation sanguine et par le manque d'oxygénation des tissus (surtout les os).Les manifestations sont très variables d'une personne à l'autre et, pour une même personne, d'un moment à l'autre.La Drépanocytose Encyclopédie Orphanet Grand Public Maladies Rares Info Services 01 56 53 81 36 www.orpha.net/data/patho/Pub/fr/Drepanocytose-FRfrPub125v01.pdf| Mars 2011 aux Antilles, une sur 280.l A quoi est-elle due ?La drépanocytose est due à une anomalie de l'hémoglobine.L'hémoglobine est le constituant principal du globule rouge et assure le transport d'oxygène dans le sang pour le distribuer à tous les organes.L'hémoglobine est constituée de quatre «briques» appelées chaînes, assemblées entre elles.L'hémoglobine A, majoritaire chez l'adulte, est ainsi constituée de deux chaînes dites alpha (ou a) et de deux chaînes dites bêta (ou b).En cas de drépanocytose, les chaînes b sont anormales.L'hémoglobine formée à partir des chaînes b anormales et des chaînes a normales est une hémoglobine qui « s'agglomère » dans les globules rouges (cette hémoglobine anormale est appelée hémoglobine S, abréviation pour le mot anglais « sickle » qui signifie faucille). La Drépanocytose Encyclopédie Orphanet Grand PublicMaladies Rares Info Services 01 56 53 81 36 www.orpha.net/data/patho/Pub/fr/Drepanocytose-FRfrPub125v01.pdf| Mars 2011En plus d'être déformés, les globules rouges falciformes sont plus fragiles et plus rigides que des globules rouges normaux contenant l'hémoglobine A. Ils circulent mal dans les vaisseaux, ce qui les empêche de jouer pleinement leur rôle de transporteur d'oxygène.La fabrication de la chaîne b de l'hémoglobine dépend de deux gènes, les gènes « bêtaglobine » (b-globine) localisés sur le chromosome 11.l Quelles en sont les manifestations ?La sévérité de la drépanocytose est très variable selon les personnes et au cours du temps pour une même personne.Certaines des informations ci-dessous peuvent paraître inquiétantes mais elles ne s'appliquent pas à tous les cas.Les manifestations peuvent apparaître dès l'âge de trois mois (il n'y en a aucune avant cet âge ni pendant la grossesse).Les trois principales manifestations sont : l'anémie, les crises douloureuses, qui peuvent toucher différents organes, et une moindre résistance à certaines infections.Les crises douloureuses sont plus fréquentes et plus graves durant la petite enfance.A l'âge adulte, d'autres complications peuvent apparaître.
Background: Lumpy Skin Disease Virus (LSDV), capripoxvirus, family poxviridae, was recently (2018-2019-till present) exhibiting its characteristic zoonosis [animal to human].Moreover, the person-to-person direct transmission [infectious disease] were recorded. Materials and Methods:Whole blood and tissue samples from skin nodules were collected from infected persons (showing characteristic pox nodules).LSDV was isolated on BHK-21 cell culture, and pathogen free embryonated chicken eggs (CAM).Diagnosis were confirmed by conventional Polymerase Chain Reaction and partial sequencing using the primers target gene ORF103 and Negative staining, direct electron microscopic examination.Results: LSDVh was successfully isolated from blood and skin nodules collected from infected persons.Confirmed diagnosis was achieved by the conventional PCR and sequencing procedures.The isolates were genetically characterized as Lumpy skin disease virus isolate Evros/GR/15 by partial sequence with 99 % identity.Meanwhile, LSDV virions and herpes virus particles were visualized by electron microscopic investigations (NS-DEM).The majority of LSD virions were nonenveloped showing Mulberry forms and some capsular form, and the enveloped forms.Herpes virus virions were also detected in large number, the enveloped and the non-enveloped.The apparent pathogenesis on infected human are comparatively similar to LSD in cattle however the progress of illness and stages of the disease depends on level of health care interventions.Unless the nature of human biology is greatly different from that of cattle. Conclusions:Lumpy skin disease virus is capable of infecting humans with direct transmission without the need for insects vector; that most probably by inhalation and certainly by the direct contacts with infected materials, infected persons [man to man], and as laboratory acquired infection.LSDVh causes skin nodules and may lead to death in cases of generalized infections and if involving the internal organs.However, it is obvious that Herpes virus gives hands and helping poxviruses during their pathogenesis in the infected subjects.
Since 2002 clowns, who are one of the primary exponents of therapeutic humor, have been working with seniors in aged and dementia care.In addition to the general benefits of therapeutic humour, initial research conducted in Canada, as part of Fools For Health's Down Memory Lane project (supported in part by a grant from The Ontario Trillium Foundation), suggests that clowns may help seniors with dementia connect to their immediate surroundings, recognize family members, remember the past, improve cognitive functioning, and communication skills.This research also suggests that clowns working in aged and dementia care may help increase the quality of life for seniors, their families, and for the healthcare staff who work with them.This article describes the work of clowns with seniors with particular emphasis on Fools For Health's Down Memory Lane project, which involved work with seniors with dementia.It also looks at some recent developments in the field of clowning with seniors and provides a brief overview of the practice and 'successes' of this work.
This correspondence concerns our publication: de Almeida AF, De Gaspari E. Pathog Dis.2018 Feb 1;76(1) with results obtained using mouse model that analyzed the passage of IgG antibodies with high avidity through the placenta described for the first time for Neisseria meningitidis B. Below, we explain the importance of results obtained by calling attention to check vaccines for protection in this age group with a high number of cases, including São Paulo, Brazil.Thus, further studies on the use of maternal immunization and vaccines for protection against this disease are needed.I would like to show the importance of translational research as in different diseases, especially in studies of vaccines to N.meningitidis as existing studies to Bordetella pertussis described in literature.
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among adults.It exhibits heterogeneity in its clinical course.Its cytogenetic findings play significant role in predicting treatment response and prognosis.The study was aimed to evaluate the frequencies of deletions 13q14.3,11q22.3,trisomy 12, 17p13.1 and their role in disease progression with FISH technique.Results revealed the higher prevalence of del 13q14.3followed by del 11q22.3,trisomy-12 and del 17p13.1.The higher frequencies of del 13q14.3 could be primary event in inducing CLL and other deletions could be drivers for CLL progression.
Objective: To identify the potential of cross-species transmissions of genome repeat elements as immune functional units IFUs and their ability to cause diseases in the new host. Results:The identified principle of innate immunity Pii defined the core functionality of major non-coding repeat elements, for example Endogenous Retroviruses ERVs and transposons, as sequence-based anti-virus registries.An entire ERV encompasses one immune functional unit IFU.In modern immune systems, immune responses appear to be rerouted from IFUs into immune cells.IFUs and immune cells collaborate together to enable immunity against sequence-homolog viruses, immune cells function as readers/controllers of IFUs.The host's immune system controls endogenization of IFUs.Similar immune cells can identify transmitted IFUs from related immune systems as their 'own' IFU and consequently endogenize them. Conclusion:When 'foreign' IFUs are transmitted to new hosts by vectors such as parasites, the new hosts' immune cells endogenize them as their own IFUs into germline cells, causing new diseases in future generations when they are demethylated during ageing.
Depression being a psychological disorder is known to cause morbidity and mortality of the concerned individual globally.According to an estimate from the World Health Organisation (WHO), about 57 million people equivalent to about 18% of the global population are suffering from depression in India.There are several known factors responsible for inducing depression in humans such as abusing drugs and alcohol, overwork, poor diet, using excess caffeine or sugar, lack of exercise, poor sleep, sexual abuse, genetic disorders, sadness, physical health issue, brain chemistry imbalance, lack of confidence, rejection/loneliness, loss of loved one etc.According to an epidemiological data, 30~40% of occurrences of depressive disorder involve genetic factors.Consequently, environmental factors also play significant role in development of depression.Studies have shown that cognitive therapy is as efficacious as antidepressant medications in treating depression which is believed to reduce the risk of relapse even after its discontinuation.Cognitive therapy and antidepressant medication probably engage some similar neural mechanisms, as well as mechanisms that are distinctive to each.Extensive research is therefore needed to delineate the population suffering from a specific kind of factor inducing depression which may help develop adequate therapy to treat the patients quickly and effectively.
