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Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS; the most common phenotype of corticobasal degeneration) are tauopathies with a relentless course, usually starting in the mid-60s and leading to death after an average of 7 years. There is as yet no specific or disease-modifying treatment. Clinical deficits in PSP are numerous, involve the entire neuraxis, and present as several discrete phenotypes. They center on rigidity, bradykinesia, postural instability, gait freezing, supranuclear ocular motor impairment, dysarthria, dysphagia, incontinence, sleep disorders, frontal cognitive dysfunction, and a variety of behavioral changes. CBS presents with prominent and usually asymmetric dystonia, apraxia, myoclonus, pyramidal signs, and cortical sensory loss. The symptoms and deficits of PSP and CBS are amenable to a variety of treatment strategies but most physicians, including many neurologists, are reluctant to care for patients with these conditions because of unfamiliarity with their multiplicity of interacting symptoms and deficits. CurePSP, the organization devoted to support, research, and education for PSP and CBS, created its CurePSP Centers of Care network in North America in 2017 to improve patient access to clinical expertise and develop collaborations. The directors of the 25 centers have created this consensus document outlining best practices in the management of PSP and CBS. They formed a writing committee for each of 12 sub-topics. A 4-member Steering Committee collated and edited the contributions. The result was returned to the entire cohort of authors for further comments, which were considered for incorporation by the Steering Committee. The authors hope that this publication will serve as a convenient guide for all clinicians caring for patients with PSP and CBS and that it will improve care for patients with these devastating but manageable disorders.

Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS; the most common phenotype of corticobasal degeneration) are tauopathies with a relentless course, usually starting in the mid-60s and leading to death after an average of 7 years. There is as yet no specific or disease-modifying treatment. Clinical deficits in PSP are numerous, involve the entire neuraxis, and present as several discrete phenotypes. They center on rigidity, bradykinesia, postural instability, gait freezing, supranuclear ocular motor impairment, dysarthria, dysphagia, incontinence, sleep disorders, frontal cognitive dysfunction, and a variety of behavioral changes. CBS presents with prominent and usually asymmetric dystonia, apraxia, myoclonus, pyramidal signs, and cortical sensory loss. The symptoms and deficits of PSP and CBS are amenable to a variety of treatment strategies but most physicians, including many neurologists, are reluctant to care for patients with these conditions because of unfamiliarity with their multiplicity of interacting symptoms and deficits. CurePSP, the organization devoted to support, research, and education for PSP and CBS, created its CurePSP Centers of Care network in North America in 2017 to improve patient access to clinical expertise and develop collaborations. The directors of the 25 centers have created this consensus document outlining best practices in the management of PSP and CBS. They formed a writing committee for each of 12 sub-topics. A 4-member Steering Committee collated and edited the contributions. The result was returned to the entire cohort of authors for further comments, which were considered for incorporation by the Steering Committee. The authors hope that this publication will serve as a convenient guide for all clinicians caring for patients with PSP and CBS and that it will improve care for patients with these devastating but manageable disorders.

Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS; the most common phenotype of corticobasal degeneration) are tauopathies with a relentless course, usually starting in the mid-60s and leading to death after an average of 7 years. There is as yet no specific or disease-modifying treatment. Clinical deficits in PSP are numerous, involve the entire neuraxis, and present as several discrete phenotypes. They center on rigidity, bradykinesia, postural instability, gait freezing, supranuclear ocular motor impairment, dysarthria, dysphagia, incontinence, sleep disorders, frontal cognitive dysfunction, and a variety of behavioral changes. CBS presents with prominent and usually asymmetric dystonia, apraxia, myoclonus, pyramidal signs, and cortical sensory loss. The symptoms and deficits of PSP and CBS are amenable to a variety of treatment strategies but most physicians, including many neurologists, are reluctant to care for patients with these conditions because of unfamiliarity with their multiplicity of interacting symptoms and deficits. CurePSP, the organization devoted to support, research, and education for PSP and CBS, created its CurePSP Centers of Care network in North America in 2017 to improve patient access to clinical expertise and develop collaborations. The directors of the 25 centers have created this consensus document outlining best practices in the management of PSP and CBS. They formed a writing committee for each of 12 sub-topics. A 4-member Steering Committee collated and edited the contributions. The result was returned to the entire cohort of authors for further comments, which were considered for incorporation by the Steering Committee. The authors hope that this publication will serve as a convenient guide for all clinicians caring for patients with PSP and CBS and that it will improve care for patients with these devastating but manageable disorders.

BACKGROUND CONTEXT: Patients with adult spinal deformity suffer from disease related disability as measured by the Oswestry Disability Index (ODI) for which surgery can result in significant improvements. PURPOSE: The purpose of this study was to show the change in overall and individual components of the ODI in patients aged 60 years or older following multi-level spinal deformity surgery. STUDY DESIGN: Prospective, multicenter, multi-continental, observational longitudinal cohort study PATIENT SAMPLE: Patients ≥60 years undergoing primary spinal fusion surgery of ≥5 levels for coronal, sagittal or combined deformity. OUTCOME MEASURES: Oswestry Disability Index (ODI) METHODS: : Patients completed the ODI pre-operatively for baseline, then at 10 weeks, 12 months and 24 months post-operatively. ODI scores were grouped into deciles, and change was calculated with numerical score and improvement or worsening was further categorized from baseline as substantial (≥20%), marginal (≥10–<20%) or no change (within 10%). RESULTS: Two-hundred nineteen patients met inclusion criteria for the study. The median number of spinal levels fused was 9 [Q1=5.0, Q3=12.0]. Two-year mean (95% CI) ODI improvement was 19.3% (16.7%; 21.9%; p<.001) for all age groups, with mean scores improved from a baseline of 46.3% (44.1%; 48.4%) to 41.1% (38.5%; 43.6%) at 10 weeks (p<.001), 28.1% (25.6%; 30.6%) at 12 months (p<.001), and 27.0% (24.4%; 29.5%) at 24 months (p<.001). At 2 years, 45.5% of patients showed 20% or greater improvement in ODI, 23.7% improved between 10% and 20%, 26.3% reported no change (defined as±10% from baseline), 4.5% of patients reported a worsening between 10% to 20%, and none reported worsening greater than 20%. 59.0% of patients were severely disabled (ODI >40%) pre-operatively, which decreased to 20.2% at 2 years. Significant improvement was observed across all 10 ODI items at 12 and 24 months. The largest improvements were seen in pain, walking, sta

Background: Long-QT syndrome (LQTS) is primarily an electrical disorder characterized by a prolonged myocardial action potential. The delay in cardiac repolarization leads to electromechanical (EM) abnormalities, which adds a diagnostic value for LQTS. Prolonged left ventricular (LV) contraction was identified as a potential risk for arrhythmia. The aim of this meta-analysis was to assess the best predictor of all EM parameters for cardiac events (CEs) in LQTS patients. Methods: We systematically searched all electronic databases up to March 2020, to select studies that assessed the relationship between echocardiographic indices—contraction duration (CD), mechanical dispersion (MD), QRS onset to peak systolic strain (QAoC), and the EM window (EMW); and electrical indices— corrected QT interval (QTC), QTC dispersion, RR interval in relation to CEs in LQTS. This meta-analysis included a total of 1041 patients and 373 controls recruited from 12 studies. Results: The meta-analysis showed that LQTS patients had electrical and mechanical abnormalities as compared to controls—QTC, WMD 72.8; QTC dispersion, WMD 31.7; RR interval, WMD 91.5; CD, WMD 49.2; MD, WMD 15.9; QAoC, WMD 27.8; and EMW, WMD −62.4. These mechanical abnormalities were more profound in symptomatic compared to asymptomatic patients in whom disturbances were already manifest, compared to controls. A CD ≥430 ms had a summary sensitivity (SS) of 71%, specificity of 84%, and diagnostic odds ratio (DOR) >19.5 in predicting CEs. EMW and QTC had a lower accuracy. Conclusions: LQTS is associated with pronounced EM abnormalities, particularly prolonged LV myocardial CD, which is profound in symptomatic patients. These findings highlight the significant role of EM indices like CD in managing LQTS patients.

Background: Long-QT syndrome (LQTS) is primarily an electrical disorder characterized by a prolonged myocardial action potential. The delay in cardiac repolarization leads to electromechanical (EM) abnormalities, which adds a diagnostic value for LQTS. Prolonged left ventricular (LV) contraction was identified as a potential risk for arrhythmia. The aim of this meta-analysis was to assess the best predictor of all EM parameters for cardiac events (CEs) in LQTS patients. Methods: We systematically searched all electronic databases up to March 2020, to select studies that assessed the relationship between echocardiographic indices—contraction duration (CD), mechanical dispersion (MD), QRS onset to peak systolic strain (QAoC), and the EM window (EMW); and electrical indices— corrected QT interval (QTC), QTC dispersion, RR interval in relation to CEs in LQTS. This meta-analysis included a total of 1041 patients and 373 controls recruited from 12 studies. Results: The meta-analysis showed that LQTS patients had electrical and mechanical abnormalities as compared to controls—QTC, WMD 72.8; QTC dispersion, WMD 31.7; RR interval, WMD 91.5; CD, WMD 49.2; MD, WMD 15.9; QAoC, WMD 27.8; and EMW, WMD −62.4. These mechanical abnormalities were more profound in symptomatic compared to asymptomatic patients in whom disturbances were already manifest, compared to controls. A CD ≥430 ms had a summary sensitivity (SS) of 71%, specificity of 84%, and diagnostic odds ratio (DOR) >19.5 in predicting CEs. EMW and QTC had a lower accuracy. Conclusions: LQTS is associated with pronounced EM abnormalities, particularly prolonged LV myocardial CD, which is profound in symptomatic patients. These findings highlight the significant role of EM indices like CD in managing LQTS patients.

Background: Long-QT syndrome (LQTS) is primarily an electrical disorder characterized by a prolonged myocardial action potential. The delay in cardiac repolarization leads to electromechanical (EM) abnormalities, which adds a diagnostic value for LQTS. Prolonged left ventricular (LV) contraction was identified as a potential risk for arrhythmia. The aim of this meta-analysis was to assess the best predictor of all EM parameters for cardiac events (CEs) in LQTS patients. Methods: We systematically searched all electronic databases up to March 2020, to select studies that assessed the relationship between echocardiographic indices—contraction duration (CD), mechanical dispersion (MD), QRS onset to peak systolic strain (QAoC), and the EM window (EMW); and electrical indices— corrected QT interval (QTC), QTC dispersion, RR interval in relation to CEs in LQTS. This meta-analysis included a total of 1041 patients and 373 controls recruited from 12 studies. Results: The meta-analysis showed that LQTS patients had electrical and mechanical abnormalities as compared to controls—QTC, WMD 72.8; QTC dispersion, WMD 31.7; RR interval, WMD 91.5; CD, WMD 49.2; MD, WMD 15.9; QAoC, WMD 27.8; and EMW, WMD −62.4. These mechanical abnormalities were more profound in symptomatic compared to asymptomatic patients in whom disturbances were already manifest, compared to controls. A CD ≥430 ms had a summary sensitivity (SS) of 71%, specificity of 84%, and diagnostic odds ratio (DOR) >19.5 in predicting CEs. EMW and QTC had a lower accuracy. Conclusions: LQTS is associated with pronounced EM abnormalities, particularly prolonged LV myocardial CD, which is profound in symptomatic patients. These findings highlight the significant role of EM indices like CD in managing LQTS patients.

Background: Long-QT syndrome (LQTS) is primarily an electrical disorder characterized by a prolonged myocardial action potential. The delay in cardiac repolarization leads to electromechanical (EM) abnormalities, which adds a diagnostic value for LQTS. Prolonged left ventricular (LV) contraction was identified as a potential risk for arrhythmia. The aim of this meta-analysis was to assess the best predictor of all EM parameters for cardiac events (CEs) in LQTS patients. Methods: We systematically searched all electronic databases up to March 2020, to select studies that assessed the relationship between echocardiographic indices—contraction duration (CD), mechanical dispersion (MD), QRS onset to peak systolic strain (QAoC), and the EM window (EMW); and electrical indices— corrected QT interval (QTC), QTC dispersion, RR interval in relation to CEs in LQTS. This meta-analysis included a total of 1041 patients and 373 controls recruited from 12 studies. Results: The meta-analysis showed that LQTS patients had electrical and mechanical abnormalities as compared to controls—QTC, WMD 72.8; QTC dispersion, WMD 31.7; RR interval, WMD 91.5; CD, WMD 49.2; MD, WMD 15.9; QAoC, WMD 27.8; and EMW, WMD −62.4. These mechanical abnormalities were more profound in symptomatic compared to asymptomatic patients in whom disturbances were already manifest, compared to controls. A CD ≥430 ms had a summary sensitivity (SS) of 71%, specificity of 84%, and diagnostic odds ratio (DOR) >19.5 in predicting CEs. EMW and QTC had a lower accuracy. Conclusions: LQTS is associated with pronounced EM abnormalities, particularly prolonged LV myocardial CD, which is profound in symptomatic patients. These findings highlight the significant role of EM indices like CD in managing LQTS patients.

Background: Long-QT syndrome (LQTS) is primarily an electrical disorder characterized by a prolonged myocardial action potential. The delay in cardiac repolarization leads to electromechanical (EM) abnormalities, which adds a diagnostic value for LQTS. Prolonged left ventricular (LV) contraction was identified as a potential risk for arrhythmia. The aim of this meta-analysis was to assess the best predictor of all EM parameters for cardiac events (CEs) in LQTS patients. Methods: We systematically searched all electronic databases up to March 2020, to select studies that assessed the relationship between echocardiographic indices—contraction duration (CD), mechanical dispersion (MD), QRS onset to peak systolic strain (QAoC), and the EM window (EMW); and electrical indices— corrected QT interval (QTC), QTC dispersion, RR interval in relation to CEs in LQTS. This meta-analysis included a total of 1041 patients and 373 controls recruited from 12 studies. Results: The meta-analysis showed that LQTS patients had electrical and mechanical abnormalities as compared to controls—QTC, WMD 72.8; QTC dispersion, WMD 31.7; RR interval, WMD 91.5; CD, WMD 49.2; MD, WMD 15.9; QAoC, WMD 27.8; and EMW, WMD −62.4. These mechanical abnormalities were more profound in symptomatic compared to asymptomatic patients in whom disturbances were already manifest, compared to controls. A CD ≥430 ms had a summary sensitivity (SS) of 71%, specificity of 84%, and diagnostic odds ratio (DOR) >19.5 in predicting CEs. EMW and QTC had a lower accuracy. Conclusions: LQTS is associated with pronounced EM abnormalities, particularly prolonged LV myocardial CD, which is profound in symptomatic patients. These findings highlight the significant role of EM indices like CD in managing LQTS patients.

Objective: To compare the outcomes of two emergency treatment procedures to alleviate pain from localised symptomatic apical periodontitis: complete chemo‐mechanical disinfection (CMD) of the root canal system, or removal of necrotic tissue from the pulp chamber (RNT), that is without instrumentation of the root canals. Methods: Fifty‐seven consecutive patients from the emergency clinic at Malmö University met the inclusion criteria: spontaneous pain and/or pain on percussion and palpation, non‐bleeding pulp in the canal orifice, pain ≥4 on a Numeric Rating Scale and ≥18 years of age. The diagnosis was symptomatic apical periodontitis, in the absence of swelling and/or fever. Pre‐operative pain levels and intake of analgesics were registered. The patients were randomised to one of the two treatment groups. Three to five days post‐operatively, the patients were contacted by telephone and asked to grade their current pain level and report any post‐operative intake of analgesics and antibiotics. Results: Of the patients treated with CMD of the root canal system, 26/30 (87%) reported satisfactory pain relief, compared with 22/27 (81%) of those treated by RNT. There was no mean difference in pain relief between the two groups (P = 0.879). Post‐operatively, 37% in each group reported using analgesics and one in each group reported using antibiotics. Conclusion: Three to five days after treatment, a majority (>80%) in both groups reported adequate pain relief, in some cases in combination with analgesics. Removal of necrotic and infected tissue from the pulp chamber might therefore be a cost‐effective emergency treatment alternative to complete chemo‐mechanical disinfection.

Objective: To compare the outcomes of two emergency treatment procedures to alleviate pain from localised symptomatic apical periodontitis: complete chemo‐mechanical disinfection (CMD) of the root canal system, or removal of necrotic tissue from the pulp chamber (RNT), that is without instrumentation of the root canals. Methods: Fifty‐seven consecutive patients from the emergency clinic at Malmö University met the inclusion criteria: spontaneous pain and/or pain on percussion and palpation, non‐bleeding pulp in the canal orifice, pain ≥4 on a Numeric Rating Scale and ≥18 years of age. The diagnosis was symptomatic apical periodontitis, in the absence of swelling and/or fever. Pre‐operative pain levels and intake of analgesics were registered. The patients were randomised to one of the two treatment groups. Three to five days post‐operatively, the patients were contacted by telephone and asked to grade their current pain level and report any post‐operative intake of analgesics and antibiotics. Results: Of the patients treated with CMD of the root canal system, 26/30 (87%) reported satisfactory pain relief, compared with 22/27 (81%) of those treated by RNT. There was no mean difference in pain relief between the two groups (P = 0.879). Post‐operatively, 37% in each group reported using analgesics and one in each group reported using antibiotics. Conclusion: Three to five days after treatment, a majority (>80%) in both groups reported adequate pain relief, in some cases in combination with analgesics. Removal of necrotic and infected tissue from the pulp chamber might therefore be a cost‐effective emergency treatment alternative to complete chemo‐mechanical disinfection.

Background : In children kidney stones are a standout amongst the majority widely recognized persistent kidney disease in kids. The most widely recognized indication of urolithiasis is stomach ache, in adult plainly particular as colicky ache, in babies and kids. Radiographic assessment of a patient through flank ache analyzes the reason for the ache. Ultrasonography (US) can recognize 90% of stones present in the kidney. Objective:  To evaluate the ultrasonography determination of renal stones with flank pain among children. Place And Duration: The duration of stud was from 01 March to 01 September 2019 at Children Hospital Lahore, Pakistan. Method And Meterial : A cross sectional observational study was included 140 patient’s coming for abdominal and KUB ultrasonography to radiology department of Children Hospital, Lahore. The patients were chosen through convenient sampling technique. All the examined patients including men and women among kids of age ranging from 1 to 16 years. Results: Overall 140 patients are included in this research. Out of 140 patients men were 92(65.7%) and women were 48(34.3%) in this study population. In 140 patients, 47(33.6%) were identified with kidney stones and 93(66.4%) were recognized without kidney stones. Out of 140 individuals 76(54.3%) patients contained ache and in 48(34.3%) pain is radiating the remaining 16(11.4%) had no pain. Conclusion: Ultrasonography is extremely helpful in the evaluation of nephrolithiasis with flank ache amongst children.

Aim: The long-term value of coronary artery calcium (CAC) scanning has not been studied extensively in symptomatic patients, but was evaluated by us in 644 consecutive patients referred for stable chest pain. Methods: We excluded patients with a history of cardiovascular disease and with a CAC score of zero. CAC scanning was done with a 16-row MDCT scanner. Endpoints were: (a) overall mortality, (b) mortality or non-fatal myocardial infarction and (c) the composite of mortality, myocardial infarction or coronary revascularisation. Revascularisations within 1 year following CAC scanning were not considered. Results: The mean age of the 320 women and 324 men was 63 years. Follow-up was over 8 years. There were 58 mortalities, while 22 patients suffered non-fatal myocardial infarction and 24 underwent coronary revascularisation, providing 104 combined endpoints. Cumulative 8‑year survival was 95% with CAC score <100, 90% in patients with CAC score >100 and <400, and 82% with CAC score ≥400 Agatston units. Risk of mortality with a CAC score >100 and ≥400 units was 2.6 [95% confidence interval (CI) 1.23–5.54], and 4.6 (95% CI 2.1–9.47) respectively. After correction for clinical risk factors, CAC score remained independently associated with increased risk of cardiac events. Conclusions: Risk increased with increasing CAC score. Patients with CAC >100 or ≥400 Agatston units were at increased risk of major adverse cardiac events and are eligible for preventive measures. CAC scanning provided incremental prognostic information to guide the choice of diagnostic and therapeutic options in many subjects evaluated for chest pain.

A large proportion of the world population harbors herpes simplex virus 1 (HSV-1), a major cause of infectious corneal blindness. HSV-specific CD8+ T cells protect from herpesvirus infection and disease. However, the genomic, phenotypic, and functional characteristics of CD8+ T cells associated with the protection seen in asymptomatic (ASYMP) individuals, who, despite being infected, never experienced any recurrent herpetic disease, remains to be fully elucidated. In this investigation, we compared the phenotype, function, and level of expression of a comprehensive panel of 579 immune genes of memory CD8+ T cells, sharing the same HSV-1 epitope specificities, and freshly isolated peripheral blood from well-characterized cohorts of protected ASYMP and nonprotected symptomatic (SYMP) individuals, with a history of numerous episodes of recurrent herpetic disease, using the high-throughput digital NanoString nCounter system and flow cytometry. Interestingly, our results demonstrated that memory CD8+ T cells from ASYMP individuals expressed a unique set of genes involved in expansion and survival, type I interferon (IFN-I), and JAK/STAT pathways. Frequent multifunctional HSV-specific effector memory CD62Llow CD44high CD8+ TEM cells were detected in ASYMP individuals compared to more of monofunctional central memory CD62Lhigh CD44high CD8+ TCM cells in SYMP individuals. Shedding light on the genotype, phenotype, and function of antiviral CD8+ T cells from "naturally protected" ASYMP individuals will help design future T-cell-based ocular herpes immunotherapeutic vaccines.IMPORTANCE A staggering number of the world population harbors herpes simplex virus 1 (HSV-1) potentially leading to blinding recurrent herpetic disease. While the majority are asymptomatic (ASYMP) individuals who never experienced any recurrent herpetic disease, symptomatic (SYMP) individuals have a history of numerous episodes of recurrent ocular herpetic disease. This study elucidates the phenotype, th

Background : In children kidney stones are a standout amongst the majority widely recognized persistent kidney disease in kids. The most widely recognized indication of urolithiasis is stomach ache, in adult plainly particular as colicky ache, in babies and kids. Radiographic assessment of a patient through flank ache analyzes the reason for the ache. Ultrasonography (US) can recognize 90% of stones present in the kidney. Objective:  To evaluate the ultrasonography determination of renal stones with flank pain among children. Place And Duration: The duration of stud was from 01 March to 01 September 2019 at Children Hospital Lahore, Pakistan. Method And Meterial : A cross sectional observational study was included 140 patient’s coming for abdominal and KUB ultrasonography to radiology department of Children Hospital, Lahore. The patients were chosen through convenient sampling technique. All the examined patients including men and women among kids of age ranging from 1 to 16 years. Results: Overall 140 patients are included in this research. Out of 140 patients men were 92(65.7%) and women were 48(34.3%) in this study population. In 140 patients, 47(33.6%) were identified with kidney stones and 93(66.4%) were recognized without kidney stones. Out of 140 individuals 76(54.3%) patients contained ache and in 48(34.3%) pain is radiating the remaining 16(11.4%) had no pain. Conclusion: Ultrasonography is extremely helpful in the evaluation of nephrolithiasis with flank ache amongst children.

A large proportion of the world population harbors herpes simplex virus 1 (HSV-1), a major cause of infectious corneal blindness. HSV-specific CD8+ T cells protect from herpesvirus infection and disease. However, the genomic, phenotypic, and functional characteristics of CD8+ T cells associated with the protection seen in asymptomatic (ASYMP) individuals, who, despite being infected, never experienced any recurrent herpetic disease, remains to be fully elucidated. In this investigation, we compared the phenotype, function, and level of expression of a comprehensive panel of 579 immune genes of memory CD8+ T cells, sharing the same HSV-1 epitope specificities, and freshly isolated peripheral blood from well-characterized cohorts of protected ASYMP and nonprotected symptomatic (SYMP) individuals, with a history of numerous episodes of recurrent herpetic disease, using the high-throughput digital NanoString nCounter system and flow cytometry. Interestingly, our results demonstrated that memory CD8+ T cells from ASYMP individuals expressed a unique set of genes involved in expansion and survival, type I interferon (IFN-I), and JAK/STAT pathways. Frequent multifunctional HSV-specific effector memory CD62Llow CD44high CD8+ TEM cells were detected in ASYMP individuals compared to more of monofunctional central memory CD62Lhigh CD44high CD8+ TCM cells in SYMP individuals. Shedding light on the genotype, phenotype, and function of antiviral CD8+ T cells from naturally protected ASYMP individuals will help design future T-cell-based ocular herpes immunotherapeutic vaccines.IMPORTANCE A staggering number of the world population harbors herpes simplex virus 1 (HSV-1) potentially leading to blinding recurrent herpetic disease. While the majority are asymptomatic (ASYMP) individuals who never experienced any recurrent herpetic disease, symptomatic (SYMP) individuals have a history of numerous episodes of recurrent ocular herpetic disease. This study elucidates the phenotype, the

Intraosseous disc herniation –or Schmörl nodes (SN)– are a herniation or prolapse of the nucleus pulposus of the intervertebral disc through the vertebral plate and into the adjacent vertebral body. They are usually associated with vertebral deformities, such as Scheuermann’s disease, or rheumatic diseases, such as ankylopoietic spondylitis. In general, they are spontaneous and asymptomatic findings, and there are only a few reported cases of symptomatic nodes. The etiology is supposedly related to a weakened spinal plate due to trauma or repeated stress. When the node is acute or recent, it can be difficult to differentiate a benign degeneration from a malignant infiltration or infection. In this paper, we discuss the unusual case of a painful Schmörl node in a man with no relevant history and a masked metastatic lumbar spinal tumor originated from pancreatic cancer. We performeda literature review., Las hernias discales intraesponjosas vertebrales o nódulos de Schmörl consisten en una herniación o una extrusión del núcleo pulposo del disco intervertebral a través del platillo vertebral hacia el cuerpo adyacente. Suelen asociarse a deformidades vertebrales, como la enfermedad de Scheuermann, o a enfermedades reumáticas, como la espondilitis anquilopoyética. En general, son hallazgos casuales y cuadros asintomáticos; son pocos los casos publicados de nódulos sintomáticos. Su aparición estaría relacionada con un platillo vertebral debilitado por traumatismo o estrés repetido. Cuando el nódulo es agudo o reciente, puede ser difícil diferenciar la degeneración benigna de una infiltración maligna o una infección. Presentamos un caso inusual de un nódulo de Schmörl doloroso en un hombre sin antecedentes de relevancia, que enmascaró una lesión metastásica de carcinoma pancreático a nivel lumbar. Se realiza una revisión bibliográfica. ABSTRACTIntraosseous disc herniation –or Schmörl nodes (SN)– are a herniation or prolapse of the nucleus pulposus of the intervertebral disc through the vertebral plate and into the adjacent vertebral body. They are usually associated with vertebral deformities, suchas Scheuermann’s disease, or rheumatic diseases, such as ankylopoietic spondylitis. In general, they are spontaneous and asymptomatic findings, and there are only a few reported cases of symptomatic nodes. The etiology is supposedly related to a weakened spinal plate due to trauma or repeated stress. When the node is acute or recent, it can be difficult to differentiate a benign degeneration from a malignant infiltration or infection. In this paper, we discuss the unusual case of a painful Schmörl node in a man with no relevant history and a masked metastatic lumbar spinal tumor originated from pancreatic cancer. We performed a literature review.

Background : In children kidney stones are a standout amongst the majority widely recognized persistent kidney disease in kids. The most widely recognized indication of urolithiasis is stomach ache, in adult plainly particular as colicky ache, in babies and kids. Radiographic assessment of a patient through flank ache analyzes the reason for the ache. Ultrasonography (US) can recognize 90% of stones present in the kidney. Objective:  To evaluate the ultrasonography determination of renal stones with flank pain among children. Place And Duration: The duration of stud was from 01 March to 01 September 2019 at Children Hospital Lahore, Pakistan. Method And Meterial : A cross sectional observational study was included 140 patient’s coming for abdominal and KUB ultrasonography to radiology department of Children Hospital, Lahore. The patients were chosen through convenient sampling technique. All the examined patients including men and women among kids of age ranging from 1 to 16 years. Results: Overall 140 patients are included in this research. Out of 140 patients men were 92(65.7%) and women were 48(34.3%) in this study population. In 140 patients, 47(33.6%) were identified with kidney stones and 93(66.4%) were recognized without kidney stones. Out of 140 individuals 76(54.3%) patients contained ache and in 48(34.3%) pain is radiating the remaining 16(11.4%) had no pain. Conclusion: Ultrasonography is extremely helpful in the evaluation of nephrolithiasis with flank ache amongst children.

Background : In children kidney stones are a standout amongst the majority widely recognized persistent kidney disease in kids. The most widely recognized indication of urolithiasis is stomach ache, in adult plainly particular as colicky ache, in babies and kids. Radiographic assessment of a patient through flank ache analyzes the reason for the ache. Ultrasonography (US) can recognize 90% of stones present in the kidney. Objective:  To evaluate the ultrasonography determination of renal stones with flank pain among children. Place And Duration: The duration of stud was from 01 March to 01 September 2019 at Children Hospital Lahore, Pakistan. Method And Meterial : A cross sectional observational study was included 140 patient’s coming for abdominal and KUB ultrasonography to radiology department of Children Hospital, Lahore. The patients were chosen through convenient sampling technique. All the examined patients including men and women among kids of age ranging from 1 to 16 years. Results: Overall 140 patients are included in this research. Out of 140 patients men were 92(65.7%) and women were 48(34.3%) in this study population. In 140 patients, 47(33.6%) were identified with kidney stones and 93(66.4%) were recognized without kidney stones. Out of 140 individuals 76(54.3%) patients contained ache and in 48(34.3%) pain is radiating the remaining 16(11.4%) had no pain. Conclusion: Ultrasonography is extremely helpful in the evaluation of nephrolithiasis with flank ache amongst children.

BACKGROUND: The relationship between conscientiousness, mental health and mental illness has been an issue for the last two decades. AIMS: By using a dual model of mental health, the present study examined a non-linear relationship between conscientiousness and healthy or non-healthy symptoms in two different cultures. METHOD: Participants in this study were 296 Iranian and 310 Swedish university students (18-24 years of age). We used two different conscientiousness scales; the 12-item conscientiousness subscale of the NEO/FFI as an imported (etic) scale, and a 10-item Iranian conscientiousness scale as an indigenous (emic) and culture-dependent scale. RESULTS: In both conscientiousness scales, multivariate analysis of variance showed that conscientiousness differentiated among four mental health groups (languishing, troubled, symptomatic and flourishing), although languishing and troubled individuals were less conscientious than flourishing and symptomatic individuals. Furthermore, the non-healthy symptomatic individuals were more conscientiousness than flourishing individuals. The results showed no significant differences between the two cultures in terms of the four mental health categories. CONCLUSIONS: It was concluded that the relationship between conscientiousness and mental health/mental illness is more a non-linear relationship than a linear one.

Background : In children kidney stones are a standout amongst the majority widely recognized persistent kidney disease in kids. The most widely recognized indication of urolithiasis is stomach ache, in adult plainly particular as colicky ache, in babies and kids. Radiographic assessment of a patient through flank ache analyzes the reason for the ache. Ultrasonography (US) can recognize 90% of stones present in the kidney. Objective:  To evaluate the ultrasonography determination of renal stones with flank pain among children. Place And Duration: The duration of stud was from 01 March to 01 September 2019 at Children Hospital Lahore, Pakistan. Method And Meterial : A cross sectional observational study was included 140 patient’s coming for abdominal and KUB ultrasonography to radiology department of Children Hospital, Lahore. The patients were chosen through convenient sampling technique. All the examined patients including men and women among kids of age ranging from 1 to 16 years. Results: Overall 140 patients are included in this research. Out of 140 patients men were 92(65.7%) and women were 48(34.3%) in this study population. In 140 patients, 47(33.6%) were identified with kidney stones and 93(66.4%) were recognized without kidney stones. Out of 140 individuals 76(54.3%) patients contained ache and in 48(34.3%) pain is radiating the remaining 16(11.4%) had no pain. Conclusion: Ultrasonography is extremely helpful in the evaluation of nephrolithiasis with flank ache amongst children.

While explaining the trajectory of a work of art generally takes away from the viewers experience, some verbal accompaniment is expected. The meaning of the work and intentions of the artist must be translated into the viewer’s first processing language, which would (given this) appear to be language [~]. Whether or not these things are so [ ], I make no attempts at disciplining myself away from performing what might be a (sort of) idea ethnography. Could tracing the stages of one idea (from germination to reception) shed light on how we make sense of the world? How we orchestrate the narratives of our social lives? How we come to prefer/cling to/make copiously accessible a particular emotion? The following is a fragmentary selection of texts taken from notebooks, papers, and press-releases. As the above may reveal certain obsessions, so might the below. And while these texts explore medium specific obsessions, I hope to make clear (however indirectly) that the fuel of this self-destructive burn is that of an obsession with somatic intensities of transformation.

While explaining the trajectory of a work of art generally takes away from the viewers experience, some verbal accompaniment is expected. The meaning of the work and intentions of the artist must be translated into the viewer’s first processing language, which would (given this) appear to be language [~]. Whether or not these things are so [ ], I make no attempts at disciplining myself away from performing what might be a (sort of) idea ethnography. Could tracing the stages of one idea (from germination to reception) shed light on how we make sense of the world? How we orchestrate the narratives of our social lives? How we come to prefer/cling to/make copiously accessible a particular emotion? The following is a fragmentary selection of texts taken from notebooks, papers, and press-releases. As the above may reveal certain obsessions, so might the below. And while these texts explore medium specific obsessions, I hope to make clear (however indirectly) that the fuel of this self-destructive burn is that of an obsession with somatic intensities of transformation.

The Glossina pallidipes salivary gland hypertrophy virus (GpSGHV) infects tsetse flies predominantly asymptomatically and occasionally symptomatically. Symptomatic infections are characterized by overt salivary gland hypertrophy (SGH) in mass reared tsetse flies, which causes reproductive dysfunctions and colony collapse, thus hindering tsetse control via sterile insect technique (SIT). Asymptomatic infections have no apparent cost to the fly's fitness. Here, small RNAs were sequenced and profiles in asymptomatically and symptomatically infected G. pallidipes flies determined. Thirty-eight host-encoded microRNAs (miRNAs) were present in both the asymptomatic and symptomatic fly profiles, while nine host miRNAs were expressed specifically in asymptomatic flies versus 10 in symptomatic flies. Of the shared 38 miRNAs, 15 were differentially expressed when comparing asymptomatic with symptomatic flies. The most up-regulated host miRNAs in symptomatic flies was predicted to target immune-related mRNAs of the host. Six GpSGHV-encoded miRNAs were identified, of which five of them were only in symptomatic flies. These virus-encoded miRNAs may not only target host immune genes but may also participate in viral immune evasion. This evidence of differential host miRNA profile in Glossina in symptomatic flies advances our understanding of the GpSGHV-Glossina interactions and provides potential new avenues, for instance by utilization of particular miRNA inhibitors or mimics to better manage GpSGHV infections in tsetse mass-rearing facilities, a prerequisite for successful SIT implementation.

Recent years have witnessed increasing popularity and promotion of biological influences (e.g., genetics) in eating disorder (ED) development. Although research suggests biological models of EDs reduce blame-oriented stigma in the general public, their effect on symptomatic individuals' attitudes toward themselves, treatment, and their prognosis has not been studied. Additionally, little is known about how other credible forms of conceptualizing ED development (e.g., cognitive-behavioral) affect individuals with disordered eating. Accordingly, the present study assessed the effects of three different forms of psychoeducation about ED development (biology-only, malleability of biology, cognitive-behavioral) among a sample high in ED symptoms. Participants (N = 216) viewed an audiovisual presentation describing ED development from one of the three perspectives before completing measures of self-blame for symptoms, prognostic expectations, self-efficacy in recovering, and attitudes toward a description of cognitive-behavioral therapy. There were no significant differences between conditions in self-blame. Relative to biology-only, the psychoeducational messages emphasizing malleable biology and cognitive-behavioral factors produced more prognostic optimism and self-efficacy in recovering. Perceived credibility of cognitive-behavioral therapy and expectations for its efficacy were highest in the cognitive-behavioral psychoeducation condition. Implications for efforts to educate the public and treatment-seeking individuals about the nature of EDs are discussed.

Generation and maintenance of high quantity and quality memory CD8(+) T cells determine the level of protection from viral, bacterial, and parasitic re-infections, and hence constitutes a primary goal for T cell epitope-based human vaccines and immunotherapeutics. Phenotypically and functionally characterizing memory CD8(+) T cells that provide protection against herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) infections, which cause blinding ocular herpes, genital herpes, and oro-facial herpes, is critical for better vaccine design. We have recently categorized 2 new major sub-populations of memory symptomatic and asymptomatic CD8(+) T cells based on their phenotype, protective vs. pathogenic function, and anatomical locations. In this report we are discussing a new direction in developing T cell-based human herpes vaccines and immunotherapeutics based on the emerging new concept of symptomatic and asymptomatic memory CD8(+) T cells.

Background A perforation in the nasal septum can cause symptoms such as bleeding, obstruction, crusts and pain, and can be a challenge to treat. Surgery is the treatment of choice, but disease, size of the perforation, or the patient’s wish may contradict surgery. A custom-made silicone obturator is a successful treatment option, but little is known how this treatment affects the microbial flora. The purposes of this thesis were (i) to investigate the microbial flora around symptomatic nasal septal perforations before treatment, (ii) during and after a 12-month treatment period with a custom-made obturator, (iii) to compare the microbial flora around symptomatic perforations with the flora from the same area of the septum in healthy individuals, (iv) to investigate the microbial colonization of the silicone obturator, and (v) also to investigate the water sorption, solubility and if the wettability of silicones are affected by water. The hypotheses were (i) that the bacterial flora around symptomatic perforations would not differ from that found in healthy individuals, apart from a possible presence of Helicobacter pylori; (ii) the bacterial flora would change in composition during the course of treatment and that microorganisms and proteins could be seen on the surface of the silicone obturators; (iii) a material that has adsorbed water would also show an increase in wettability and the surface free energy of the material. Methods Twenty-seven patients and 101 healthy individuals volunteered. Swabs were made around the rim of the perforation, or on the septum in the locus Kisselbachi area in the healthy individuals. Bacteria and fungi were isolated and identified with standard laboratory techniques. A biopsy of the granulated tissue at the perforation was taken and cultivated for Helicobacter pylori. Swabs were also taken three, six and twelve months after inserting the obturator. The obturator was analysed after being used twelve months in the nose. Seven silico

Background A perforation in the nasal septum can cause symptoms such as bleeding, obstruction, crusts and pain, and can be a challenge to treat. Surgery is the treatment of choice, but disease, size of the perforation, or the patient’s wish may contradict surgery. A custom-made silicone obturator is a successful treatment option, but little is known how this treatment affects the microbial flora. The purposes of this thesis were (i) to investigate the microbial flora around symptomatic nasal septal perforations before treatment, (ii) during and after a 12-month treatment period with a custom-made obturator, (iii) to compare the microbial flora around symptomatic perforations with the flora from the same area of the septum in healthy individuals, (iv) to investigate the microbial colonization of the silicone obturator, and (v) also to investigate the water sorption, solubility and if the wettability of silicones are affected by water. The hypotheses were (i) that the bacterial flora around symptomatic perforations would not differ from that found in healthy individuals, apart from a possible presence of Helicobacter pylori; (ii) the bacterial flora would change in composition during the course of treatment and that microorganisms and proteins could be seen on the surface of the silicone obturators; (iii) a material that has adsorbed water would also show an increase in wettability and the surface free energy of the material. Methods Twenty-seven patients and 101 healthy individuals volunteered. Swabs were made around the rim of the perforation, or on the septum in the locus Kisselbachi area in the healthy individuals. Bacteria and fungi were isolated and identified with standard laboratory techniques. A biopsy of the granulated tissue at the perforation was taken and cultivated for Helicobacter pylori. Swabs were also taken three, six and twelve months after inserting the obturator. The obturator was analysed after being used twelve months in the nose. Seven silico

The differences between Escherichia coli strains associated with symptomatic and asymptomatic urinary tract infections (UTIs) remain to be properly determined. Here we examined the prevalence of plasmid types and bacteriocins, as well as genetic relatedness, in a defined collection of E. coli strains that cause UTIs. Comparative analysis identified a subgroup of strains with a high number of virulence genes (VGs) and microcins M/H47. We also identified associations between microcin genes, VGs, and specific plasmid types.

The differences between Escherichia coli strains associated with symptomatic and asymptomatic urinary tract infections (UTIs) remain to be properly determined. Here we examined the prevalence of plasmid types and bacteriocins, as well as genetic relatedness, in a defined collection of E. coli strains that cause UTIs. Comparative analysis identified a subgroup of strains with a high number of virulence genes (VGs) and microcins M/H47. We also identified associations between microcin genes, VGs, and specific plasmid types.

Background A perforation in the nasal septum can cause symptoms such as bleeding, obstruction, crusts and pain, and can be a challenge to treat. Surgery is the treatment of choice, but disease, size of the perforation, or the patient’s wish may contradict surgery. A custom-made silicone obturator is a successful treatment option, but little is known how this treatment affects the microbial flora. The purposes of this thesis were (i) to investigate the microbial flora around symptomatic nasal septal perforations before treatment, (ii) during and after a 12-month treatment period with a custom-made obturator, (iii) to compare the microbial flora around symptomatic perforations with the flora from the same area of the septum in healthy individuals, (iv) to investigate the microbial colonization of the silicone obturator, and (v) also to investigate the water sorption, solubility and if the wettability of silicones are affected by water. The hypotheses were (i) that the bacterial flora around symptomatic perforations would not differ from that found in healthy individuals, apart from a possible presence of Helicobacter pylori; (ii) the bacterial flora would change in composition during the course of treatment and that microorganisms and proteins could be seen on the surface of the silicone obturators; (iii) a material that has adsorbed water would also show an increase in wettability and the surface free energy of the material. Methods Twenty-seven patients and 101 healthy individuals volunteered. Swabs were made around the rim of the perforation, or on the septum in the locus Kisselbachi area in the healthy individuals. Bacteria and fungi were isolated and identified with standard laboratory techniques. A biopsy of the granulated tissue at the perforation was taken and cultivated for Helicobacter pylori. Swabs were also taken three, six and twelve months after inserting the obturator. The obturator was analysed after being used twelve months in the nose. Seven silico

The differences between Escherichia coli strains associated with symptomatic and asymptomatic urinary tract infections (UTIs) remain to be properly determined. Here we examined the prevalence of plasmid types and bacteriocins, as well as genetic relatedness, in a defined collection of E. coli strains that cause UTIs. Comparative analysis identified a subgroup of strains with a high number of virulence genes (VGs) and microcins M/H47. We also identified associations between microcin genes, VGs, and specific plasmid types.

Background A perforation in the nasal septum can cause symptoms such as bleeding, obstruction, crusts and pain, and can be a challenge to treat. Surgery is the treatment of choice, but disease, size of the perforation, or the patient’s wish may contradict surgery. A custom-made silicone obturator is a successful treatment option, but little is known how this treatment affects the microbial flora. The purposes of this thesis were (i) to investigate the microbial flora around symptomatic nasal septal perforations before treatment, (ii) during and after a 12-month treatment period with a custom-made obturator, (iii) to compare the microbial flora around symptomatic perforations with the flora from the same area of the septum in healthy individuals, (iv) to investigate the microbial colonization of the silicone obturator, and (v) also to investigate the water sorption, solubility and if the wettability of silicones are affected by water. The hypotheses were (i) that the bacterial flora around symptomatic perforations would not differ from that found in healthy individuals, apart from a possible presence of Helicobacter pylori; (ii) the bacterial flora would change in composition during the course of treatment and that microorganisms and proteins could be seen on the surface of the silicone obturators; (iii) a material that has adsorbed water would also show an increase in wettability and the surface free energy of the material. Methods Twenty-seven patients and 101 healthy individuals volunteered. Swabs were made around the rim of the perforation, or on the septum in the locus Kisselbachi area in the healthy individuals. Bacteria and fungi were isolated and identified with standard laboratory techniques. A biopsy of the granulated tissue at the perforation was taken and cultivated for Helicobacter pylori. Swabs were also taken three, six and twelve months after inserting the obturator. The obturator was analysed after being used twelve months in the nose. Seven silico

胃がんは,その発見経緯から,無症状の時期に検診や外来でのスクリーニング検査で発見される無症状胃がん(asymptomatic gastric cancer:AGC)と症状を経緯にして発見される有症状胃がん(symptomatic gastric cancer:SGC)の2つに分類される.胃がん死亡を減少させるための診断戦略を考える際,両者の臨床病理学的特徴や予後を分析することは重要である.従来,外科切除例を対象として,両者を検討した報告はみれるが,胃がん全体を対象とした報告はみられない.そこで,今回,外科切除例以外も含め,全ての胃がんを対象にし,両者の臨床病理学的特徴と予後について検討した.対象は1997年1月から1999年12月まで,厚生連長岡中央綜合病院病歴室に登録された胃がん562例である.胃がん発見時の症状の有無は診療録の記載に拠って判定した.臨床病理学的特徴は,切除胃の病理学的所見,術中肉眼所見,胃内視鏡及び生検所見,胃X線所見,CT所見,超音波所見などに拠って判定した.生存率は治療のための入院日を起算日とし,これより5年経過後の生存の有無,死亡の場合はその年月日及び原病死か否かを追跡調査し算出した.AGCとSGCの頻度はそれぞれ,239例,323例であった.AGCは,SGCに比べ,男性の割合,早期がん率,検診発見率,内視鏡的切除率,手術例での治癒切除率,肉眼型が0型の割合,組織学的に分化型の割合,stageIの割合が有意に高かった.一方,SGCは,腫瘍の広範な進展のため化学療法や支持療法のみになった割合,肉眼型が2,3,4型の割合,腫瘍が胃全体を占める割合,stageII,III,IVの割合が有意に高かった.全死因を含む5年生存率は,AGC83.3%,SGC41.2%であり,AGCで有意に高かった.進行度別の5年生存率は,早期がんではAGC90.1%,SGC83.7%であり有意差はみられなかったが,進行がんではそれぞれ,38.7%,22.7%でありAGCで有意に高かった.SGCはAGCに比べ臨床病理学的に進行したものが多く,また,対象全体の40.0%を占めていたSGC進行がんの5年生存率が22.7%と低いことを考えると,胃がん死亡を減少させるためには,無症状のうちに検診またはスクリーニング検査を行い,胃がんを発見することが重要と考えられた., Gastric cancer can be classified into two categories based on the absence or presence of symptoms at diagnosis. Differences in clinicopathological features and prognoses between asymptomatic gastric cancer (ACG) and symptomatic gastric cancer (SGC) can be used to inform diagnosis strategies and ultimately improve survival rates. All cases of gastric cancer (239 AGC, 323 SGC) diagnosed in our hospital between 1997 and 1999 were used in this study. ACG patients showed significantly higher frequency of males, cases of early cancer, cases found by a mass screening program, cases treated by endoscopic resection, cases treated by curative operation, cases of type 0 macroscopic finding, cases of histologically - differentiated type, and stage I cases. By contrast, SGC patients showed significantly higher numbers of cases treated by chemotherapy alone or best support care, cases of type 2, 3, and 4 macroscopic findings, cases occupying the whole stomach, and cases of stage II , III , N . Statistically significant differences were also found for the 5 - year survival rate (83.3 % in AGC, 41.2 % in SGC), the incidence of early cancer (90.1 % in AGC, 83.7 % in SGC) , and for advanced cancer (38.7 % in AGC, 22.7 % in SGC). The higher incidence of advanced cases in SGC than in AGC (40.0 % vs. 13.0 %), coupled with the low 5 - year survival rate of advanced SGC (22.7 %), provides strong evidence of the importance of diagnosing gastric cancer during its asymptomatic period.

After three decades of relentless erudition, one might expect David Harvey's writings to peter out inexiguous fragments and glosses. Yet The New Imperialism possesses the almost athletic rational energy of his best books (like The Limits to Capital). Written with characteristic self-assurance, its five chapters confirm the massive intellectual consistency of a figure who first turned to Marxism with great elan in the early 1970s. Though a conjunctural analysis, the book is grounded in Harvey's long-standing anatomisation of 'the molecular processes of capital accumulation in time and space'.2 When wedded to a theory of how national states seek to secure their various interests on a world stage, this understanding of capitalism's inveterate tensions defines the field of possibility and constraint within which contingent decisions have created our current geo-economic and geopolitical realities. Since this field is inescapable - short of capitalism's dissolution - then, for Harvey, it is also the necessary reference-point for figuring out how to go forward from here to create a saner, more just future. Quite how clairvoyant Harvey's prognostications are remains to be seen. But his diagnostic judgements about why our global political economy has taken an 'imperial (re)turn' will likely remain of interest even after events have moved on. For it is precisely their grounding in a conception of those necessary processes that undergird non-necessary happenings that will, perhaps, prevent The New Imperialism from dating in a way other books on the same topic undoubtedly will.