The American journal of the medical sciences
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Proteomic fingerprint technology combining magnetic beads with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to profile and compare the serum proteins from 45 patients with gallbladder cancer and 50 healthy blood donors. The proteomic patterns were identified; the tree model of biomarkers was constructed and evaluated using the Biomarker Patterns Software. The model tree was constructed based on the 3 biomarkers (5913 Da, 6181 Da and 13,752 Da), which generated excellent separation between the gallbladder cancer and control groups. ⋯ The blind test data showed a sensitivity of 80% and a specificity of 90%. Taken together, our studies suggested that biomarkers for gallbladder cancer could be discovered in serum by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry combined with the use of magnetic beads. The pattern of combined markers would provide a powerful and reliable diagnostic method for gallbladder cancer with high sensitivity and specificity.
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Radiological evidence of presence of air or gas within the stomach wall is termed "gastric pneumatosis" and is considered an ominous sign. However, the etiological associations range from benign self-limiting causes to life-threatening emergencies. The authors report the case of gastric pneumatosis in a 34-year-old man who presented to the emergency department with severe abdominal pain after multiple episodes of vomiting. The authors also review the clinical associations of this uncommon condition and discuss risk stratification and management strategies.
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Overweight, obesity, pre-diabetes and diabetes have become epidemic in most of Western society. An estimated 25.8 million United States adults have diabetes and some 79 million have prediabetes and are thus at high risk for future development of diabetes. Appropriate treatment of the ABCs of diabetes [A1C, blood pressure and cholesterol (dyslipidemia)] can reduce the risk for the development and progression of diabetic complications. ⋯ Multiple studies have demonstrated that intensive glycemic control will reduce the risk for diabetes microvascular and neuropathic disease, but none showed decreased macrovascular disease events during the initial phase of the trials, although benefit was seen in long-term follow-up of the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association goals for glycemia informed by these studies indicate the importance of individualizing targets for patients based on factors including the duration of diabetes, presence of acute and chronic complications and life expectancy. Writing groups convened by these organizations have also developed treatment algorithms to help clinicians appropriately use both lifestyle and pharmacotherapy interventions to safely achieve glycemic targets.
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The value of measuring procalcitonin (PCT) in patients with community-acquired pneumonia (CAP) is unclear. The aim of this study was to determine the value of PCT as a marker for microbial etiology and a predictor of outcome in CAP patients. ⋯ High PCT levels indicate that pneumococcal pneumonia and PCT levels depend on the severity of pneumonia. PCT measurements may provide important diagnostic and prognostic information for patients with CAP.
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Gender divergence on the impact of multiple cardiovascular risk factors on the femoral artery intima-media thickness (IMT) has not been studied in a biracial (black-white) community-based asymptomatic young adults. ⋯ Although men versus women had thicker IMT, the observed increasing trend of femoral IMT with increasing number of risk factors in asymptomatic young women suggests that women may be relatively more susceptible to the burden of multiple risk factors.