BMC research notes
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Case Reports
Post-streptococcal glomerulonephritis leading to posterior reversible encephalopathy syndrome: a case report.
Posterior reversible encephalopathy syndrome is a clinical radiographic syndrome of heterogeneous etiologies. Developing hypertensive encephalopathy following post-streptococcal glomerulonephritis is a known but uncommon manifestation and developing posterior reversible encephalopathy syndrome in such a situation is very rare. We report a case with contrast-enhanced computed tomography and magnetic resonance imaging findings of posterior reversible encephalopathy syndrome in the background of acute post-streptococcal glomerulonephritis. ⋯ Post-streptococcal glomerulonephritis is an important cause of acute nephritic syndrome especially in children. This case report illustrates a rare association of posterior reversible encephalopathy syndrome in a patient with post-streptococcal glomerulonephritis.
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Giant cell tumor of bone is an osteolytic, usually benign, tumor characterized by the infiltration of osteoclast-like giant cells. The receptor activator of nuclear factor kappa-B ligand pathway has been shown to play a key role in the pathogenesis of giant cell tumor. Treatment for refractory, recurrent, or metastatic giant cell tumor remains challenging. A monoclonal antibody to receptor activator of nuclear factor kappa-B ligand, denosumab, offers promise in these patients. Tartrate-resistant acid phosphatase 5b, a bone resorption marker, is secreted from osteoclasts and this marker is reported to be high in patients with giant cell tumor of bone. We investigated the effects of denosumab and the usefulness of a tartrate-resistant acid phosphatase 5b as a monitoring marker in the management of a refractory giant cell tumor of bone. ⋯ This case suggests that denosumab therapy might be an option for treating refractory giant cell tumor of bone, and that tartrate-resistant acid phosphatase 5b might be an early marker with which to monitor the efficacy of denosumab therapy for refractory giant cell tumor.
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Nosocomial and ventilator-associated pneumonia (VAP) are causes of significant morbidity and mortality in hospitalized patients. We analyzed a) the incidence and the outcome of pneumonias caused by different pathogens in the intensive care unit (ICU) of a medium-sized twenty-four bed community hospital and b) the incidence of complications of such pneumonias requiring surgical intervention such as thoracotomy and decortication. ⋯ Nosocomial pneumonias, in particular the ones that were caused by gram negative drug resistant organisms and their ensuing complications which required thoracotomy and decortication, were the cause of significant morbidity in our intensive care unit. Preventative and more intensive and novel infection control interventions in reducing the incidence of nosocomial pneumonias are strongly emphasized.
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Comparative Study
Analysis of a sample of type 2 diabetic patients with obesity or overweight and at cardiovascular risk: a cross sectional study in Spain.
The multifactorial control of diabetes relies on interventions that provide patients with the best knowledge and resources available. The objective of this research was to analyze the clinical characteristics of a sample of people with type 2 diabetes at high cardiovascular risk, and establish possible links between disease control, family history and lifestyle, to improve the quality of interventions. Family history, lifestyle habits, blood pressure, anthropometric data and laboratory tests were analyzed in this descriptive and comparative cross-sectional study. ⋯ This sample of patients with type 2 diabetes and at high cardiovascular risk, had acceptable metabolic control, facilitated by drug therapy. Family history of diabetes was associated with earlier disease onset and worse disease progression. Patients who were not following a tailored diet had worse HbA1c values compared with those who were. Individuals who practiced moderate physical activity in line with international recommendations for weight maintenance had the best BMI values, but the high prevalence of comorbidities could adversely affect exercise habits. Appropriate use of medication, dietary advice, and tailored physiotherapy physical activity suitable for people with comorbidities should be included in multifactorial treatment strategies for these patients, particularly in the presence of a family history of diabetes.
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The nucleus accumbens (NAc) has a well established role in reward processing. Yet, there is growing evidence showing that NAc function, and its connections to other parts of the brain, is also critically involved in the emergence of chronic back pain (CBP). Pain patients are known to perform abnormally in reward-related tasks, which suggests an intriguing link between pain, NAc connectivity, and reward behavior. In the present study, we compared performance on a gambling task (indicating willingness to risk losing money) between healthy pain-free controls (CON) and individuals with CBP. We then measured modular connectivity of each participants' NAc with resting state functional MRI to investigate how connectivity accounts for reward behavior in the presence and absence of pain. ⋯ Our results support previous findings that chronic back pain is accompanied by altered connectivity of the NAc. This lends itself to riskier behavior in these patients, a finding which establishes a potential cognitive consequence or co-morbidity of long-term pain and provides a behavioral link to growing research showing that chronic pain is related to abnormal changes in the dopaminergic system.