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Purpose The illness-death model (IDM) is a comprehensive approach to evaluate the relationship between relapse and death. This study aimed to illustrate the value of the IDM for identifying risk factors and evaluating predictive probabilities for relapse and death in patients with non–small cell lung cancer (NSCLC) in comparison with the disease-free survival (DFS) model.Materials and Methods We retrospectively analyzed 612 NSCLC patients who underwent a curative operation. Using the IDM, the risk factors and predictive probabilities for relapse, death without relapse, and death after relapse were simultaneously evaluated and compared to those obtained from a DFS model.Results The IDM provided more detailed risk factors according to the patient’s disease course, including relapse, death without relapse, and death after relapse, in patients with resected lung cancer. In the IDM, history of malignancy (other than lung cancer) was related to relapse and smoking history was associated with death without relapse; both were indistinguishable in the DFS model. In addition, the IDM was able to evaluate the predictive probability and risk factors for death after relapse; this information could not be obtained from the DFS model.Conclusion Compared to the DFS model, we found that the IDM provides more comprehensive information on transitions between states and disease stages and provides deeper insights with respect to understanding the disease process among lung cancer patients.

Idiopathic macular telangiectasia type 2 (MacTel 2) is a slow and progressive bilateral condition that affects middle-aged and elderly individuals. Vision loss is generally mild and occurs over the course of many years. The development of sub-retinal neovascularisation (SRNV) can occur late in the disease process, and lead to more dramatic vision loss. A report is presented of 2cases of MacTel 2 in which optical coherence tomography angiography (OCTA) was essential for the diagnosis of secondary SRNV. The commercially available OCTA Cirrus AngioPlex 5000 platform (Zeiss, Jena, Germany) was used. Subretinal neovascularization was detectable in both cases in OCTA at the level of the deep capillary plexus and the avascular layer. OCTA also allowed us to monitor disease progression and monitor response to anti-VEGF therapy.

BACKGROUND: Unapparent saccades in video head impulse test (vHIT) are usually present in Meniere’s disease (MD) patients but tend to be ignored by the clinician. The result of vHIT is constantly questioned in MD patients due to a lack of uniform metrics. A more effective indicator is needed for indicating MD’s pathological progress. OBJECTIVES: To get a comprehensive understanding of the nature and usability of saccades in different MD stages. METHODS: 118 patients diagnosed with unilateral MD were recruited in this study. Patient history, audiological examination, caloric test, vHIT were performed. We proposed ‘raw saccades’ to represent all showed wave peaks behind the head peak and named saccades by their appearance sequence: 1st saccade, 2nd saccade and 3rd saccade. An exploratory saccade analysis was executed to investigate the effectiveness of saccade attributes in identifying MD stages. RESULTS: MD patients have greater detectable 1st saccade than PR score as well as 2nd saccade. The time and velocity of the 1st saccade show high interaural variability (p = 0.028, p = 0.000 respectively). No statistical difference concerning the vHIT gain, PR score and 2nd saccade among stages could be recognized on both affected and contralateral sides. Multiple comparisons show the affected 1st saccade velocity and affected 1st saccade absolute velocity have stage-difference. At late stages (3&4), the affected 1st saccade is manifested as a speed increase, and this measure shows a relatively high correlation with MD stages compared to other vestibular indicators. CONCLUSION: The 1st saccade velocity on the affected side could indicate the MD disease process and severity.

Dermatologists often diagnose or rule out early melanoma by evaluating the follow-up dermoscopic images of skin lesions. However, existing algorithms for early melanoma diagnosis are developed using single time-point images of lesions. Ignoring the temporal, morphological changes of lesions can lead to misdiagnosis in borderline cases. In this study, we propose a framework for automated early melanoma diagnosis using sequential dermoscopic images. To this end, we construct our method in three steps. First, we align sequential dermoscopic images of skin lesions using estimated Euclidean transformations, extract the lesion growth region by computing image differences among the consecutive images, and then propose a spatio-temporal network to capture the dermoscopic changes from aligned lesion images and the corresponding difference images. Finally, we develop an early diagnosis module to compute probability scores of malignancy for lesion images over time. We collected 179 serial dermoscopic imaging data from 122 patients to verify our method. Extensive experiments show that the proposed model outperforms other commonly used sequence models. We also compared the diagnostic results of our model with those of seven experienced dermatologists and five registrars. Our model achieved higher diagnostic accuracy than clinicians (63.69% vs. 54.33%, respectively) and provided an earlier diagnosis of melanoma (60.7% vs. 32.7% of melanoma correctly diagnosed on the first follow-up images). These results demonstrate that our model can be used to identify melanocytic lesions that are at high-risk of malignant transformation earlier in the disease process and thereby redefine what is possible in the early detection of melanoma.

Work-related diseases of the musculoskeletal and the peripheral nervous system are classified as overload cumulative microtrauma diseases, resulting from chronic overload and/or damage of specific neuromusculoskeletal structures. Occupational activities which predispose to them are characterised by monotypy (repetition of movements during a significant part of the working shift). Authors described 4 cases of women with musculoskeletal and peripheral nervous system disorders qualified as occupational background just in the 2nd instance of medical certification. Detailed analysis of occupational exposure and medical interview with individual diagnostic approach allowed to determine the occupational etiology of diseases, regardless of non-occupational risk factors in some cases, even if the workstation was not common. Difficulties in estimating the probability of disease process induction on the background of occupational exposure are caused by frequent coexistence of non-occupational risk factors. The 2-tier system of certification provides an independent evaluation of medical history and occupational exposure. Med Pr. 2022;73(1).

Acute coronary syndrome (ACS) remains one of the leading causes of death in the United States. With its heightened prevalence, considerable variabilities in the disease process exist across ethnicities, sex, and age. This creates substantial disparities in the recognition and management of ACS, which consequently contributes to poor outcomes. It is of utmost importance that nurse practitioners remain vigilant, cognizant, and maintain a high index of suspicion to accurately identify ACS presentations and thus efficaciously intervene to successfully manage the disease process.

Necrotizing soft tissue infections of the upper extremity threaten life and limb. Their presentation is often difficult to recognize and multiple factors contribute to the varied presentation, speed of spread, and morbidity of the disease process. The only treatment to be definitively shown to improve outcomes is prompt surgical treatment. It should be expected to perform multiple debridements as well as reconstructive procedures once the infection and necrosis has been arrested. The use of a multidisciplinary team is mandatory to optimize care for these patients. Despite advances in knowledge and treatment, these infections still have high mortality and morbidity.

Background: Phenylketonuria is an autosomal recessive disorder characterized by accumulation of phenylalanine in blood and body fluids that is caused by defective Phe hydroxylase activity. Aim of the present study is to assess lifestyle for children with phenylketonuria. Design: A descriptive design was used in this study. Setting: conducted at genetic counseling clinic in basic health care unit at El Fayoum affiliated to Ministry of Health (MOH). Sample: A purposive sample included all children with Phenylketonuria composed of 79 children accompanied by their mothers. Tools: structural interviewing questionnaire to assess demographic characteristics, and medical history, and lifestyle assessment Questionnaire for children with PKU to identify current strengths of child’s health, and risk factors. Results: (74.7%) of families were discovered the disease by Ministry of Health screening programs. (92.4%) of children were made regular follow up. (78.5%) of children had follow up visits once monthly. 89.9% of children were not Taking breast feeding 62% of mothers had inadequate knowledge about the relation between breast feeding and the disease process. Conclusion: There is a statistically significant correlation between compliance with the prescribed diet and growth problems. There is no statistically significant correlation between compliance with the prescribed diet and sleep problems. Recommendations: The current study recommended Periodic assessment of Children affected commitment to prescribed diet. Increase mother knowledge about the importance of prescribed diet for children with Phenylketonuria

espanolIntroduccion: La relacion terapeutica es considerada una condicion necesaria para la efectividad de los cuidados de enfermeria, y el instrumento terapeutico basico para la practica diaria de la Enfermeria de Salud Mental. La actual cultura del cuidado, y la concepcion del usuario como protagonista del proceso salud/enfermedad, evidencian la importancia de la perspectiva del usuario en el desarrollo de la relacion terapeutica enfermera-paciente. Objetivos: Identificar los aspectos fundamentales para establecer y afianzar una relacion terapeutica con los profesionales de enfermeria desde la perspectiva de las personas usuarias del servicio salud mental comunitario. EnglishIntroduction: The therapeutic relationship is considered a necessary condition for the effectiveness of nursing care, and the basic therapeutic instrument for the daily practice of Mental Health Nursing. The current culture of care, and the conception of the user as the protagonist of health/disease process, demonstrate the importance of the user's perspective in the development of the nurse-patient therapeutic relationship. Objectives: Identify the fundamental aspects to establish and strengthen a therapeutic relationship with nurse from the perspective of users of the community mental health service.

Introduction: End stage renal disease (ESRD) has accompanying oral pathologies that emerge from the disease process or from the impact of hemodialysis or both. Inevitably, untreated oral lesions may aggravate clinical presentation and prognosis of renal disease. The aim of our study was to investigate the clinical patterns of white lesions in the oral cavity in the patients having end-stage renal disease, and to study the factors associated with the appearance of these lesions. Methods: A cross-sectional, descriptive and observational study was designed to determine prevalence of oral white lesions among patients with ESRD attending the nephrology hemodialysis department for more than six months at Qalyub Hospital in Qalyub, Al Qalyubia Governorate, Egypt. A total of 114 adult participants of both genders from 30 up to 60 years were included in the study. A salivary pH and salivary flow rate were estimated. Results: Oral white lesions were found among 33 patients out of 114 with a prevalence of 28.9 % in the studied sample of ESRD patients. The most common oral white lesions were oral candidiasis (11.4%), Lichen planus or lichenoid reaction lesions (10.5%) and oral keratotic lesions (6.1%), while the least oral white lesions were Leukoplakia (2.6%) and uremic stomatitis (2.6%). Conclusion: An association between the prevalence of oral candidiasis and the following (salivary pH, salivary flow rate) was found. Also an association between uremic stomatitis and the higher blood urea and higher serum creatinine level was found in our studied sample of the patients with ESRD.

Continued rise in incidence and prevalence of diabetes globally warrants an effective strategy for its prevention and control. Prevention of diabetes seems more logical to attempt seeing its health care burden, long dormancy, systemic affliction and poor general awareness. Pre-diabetes is the intermediate state of erratic glucose metabolism without overt features of diabetes. This state seems to be a crossroad having a possibility to either convert into clinical diabetes, remain dormant or return to normal glucose control depending upon the efforts made. Unfortunately, due to the paucity of apparent clinical symptoms, this state embedded with reversal possibility, remains unexplored. Ayurveda account of prameha purvarupa (subclinical features of diabetes) may be proposed as the foundation upon which clinic-based pre-diabetes identification and subsequent prevention may be explored. Knowing the symptoms for their reliable proximity with upcoming diabetes may turn to be sensible sensitizers prompting the people to abort the disease process in an effective and timely manner. Considering diabetes from its purvarupa to complications as disease continuum and exploring the opportunities to intervene in order to prevent, or manage the disease on the basis of shada kriyaa kaala therefore, has a huge translational potential warrants an urgent exploration.

The aim of this study is to reveal the opinions of individuals with COVID-19 the disease before they become infected, the disease processes and the positive developments after the disease has been overcome. This study, in which the qualitative research method was used, was carried out in a phenomenological design. The working group established for the sampling method, consisted of 14 individuals living in Turkey's seven geographical regions. In addition to the personal information form, a five-item semi-structured interview form including openended questions was prepared to collect the data. Content analysis method was used to analyze the data. As a result of the analyzes, there were three upper themes, nine themes and 30 sub-themes belonging to these themes. The results of the research showed that before the COVID-19 caught, the mental reactions were positive and negative, and emotional negative reactions were given. At the beginning of the disease process, it was observed that negative reactions were manifested, but positive reactions were shown with the acceptance of the situation. However, it was understood that positive growth was achieved after the end of the disease process. The research findings were discussed depending on the literature and suggestions were made. (English) [ABSTRACT FROM AUTHOR] Bu calismada amac, COVID-19 hastaligina yakalanmis bireylerin enfekte olmadan onceki hastaliga iliskin yaklasimlarini, hastalik sureclerini ve hastaligin atlatilmasindan sonraki olumlu yondeki gelisimlerini ortaya koymaktir. Nitel arastirma yonteminin kullanildigi bu calisma fenomenolojik desende gerceklestirilmistir. Calisma grubu amacli ornekleme yontemiyle belirlenmis, Turkiye’nin yedi cografi bolgesinde yasayan 14 bireyden olusmustur. Verilerin elde edilmesinde kisisel bilgi formunun yaninda acik uclu sorularin yer aldigi bes maddelik yari yapilandirilmis gorusme formu hazirlanmistir. Verilerin cozumlenmesinde icerik analizi yonteminden yararlanilmistir. Gerceklestirilen analizler sonucunda uc ust tema, dokuz tema ve bu temalara ait 30 alt tema yer almistir. Arastirma sonuclari, COVID-19’a yakalanmadan once dusunsel tepkilerin olumlu ve olumsuz yonde oldugu, duygusal anlamda ise olumsuz tepkilerin verildigi anlasilmistir. Hastalik surecinin baslarinda ise, olumsuz tepkilerin ortaya kondugu ancak durumun kabul edilmesiyle birlikte olumlu yondeki tepkilerin gosterildigi gorulmustur. Bununla birlikte hastalik surecinin sonlanmasinin ardindan da olumlu yonde buyumenin saglandigi anlasilmistir. Arastirma bulgulari alanyazina bagli olarak tartisilmis ve onerilerde bulunulmustur. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Electronic Journal of Social Sciences is the property of Electronic Journal of Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aims to reveal how women diagnosed with breast cancer experience the disease process in the psychosocial context. The participants of the phenomenological designed study consisted of 10 women diagnosed with breast cancer. The findings that were obtained through semi-structured interviews centered around the themes of responses to the disease, coping strategies, sources of social support, and existential reflections. With regards to the responses to the disease, the participants’ responses when diagnosed with breast cancer were under the sub-themes of shock, emptiness, mental breakdown, inability to accept the diagnosis, despair, seeking social support, anxiety, and self-blame; and after the diagnosis, they were under the sub-themes of acceptance, anxiety, sadness, and helplessness. The coping strategies used by the women included the sub-themes of coping through spirituality, social support, obtaining information, exercise, and nutrition. The social support sources of women fell under the sub-themes of spouse support, friend support, support of other family members, and physician support. In terms of existential reflections, the women were found to have experienced the sub-themes of maturing, re-interpreting life, and facing death.

Huntington disease (HD) is a single-gene autosomal dominant inherited neurodegenerative disease caused by a polyglutamine expansion of the protein huntingtin (HTT). Huntingtin-associated protein 1 (HAP1) is the first protein identified as an interacting partner of huntingtin, which is directly associated with HD. HAP1 is mainly expressed in the nervous system and is also found in the endocrine system and digestive system, and then involves in the occurrence of the related endocrine diseases, digestive system diseases, and cancer. Understanding the function of HAP1 could help elucidate the pathogenesis that HTT plays in the disease process. Therefore, this article attempts to summarize the latest research progress of the role of HAP1 and its application for diseases in recent years, aiming to clarify the functions of HAP1 and its interacting proteins, and provide new research ideas and new therapeutic targets for the treatment of cancer and related diseases.

BACKGROUND Appropriate use criteria (AUC) enhance application of cardiovascular imaging techniques but have been applied in limited settings, primarily in common cardiovascular disease processes. There are several complex systemic diseases with cardiovascular implications and special populations with unique cardiovascular considerations that could benefit from appropriateness analysis. Moreover, the high medical complexity of these topics indicate they would benefit from high-yield expert consensus recommendations of the available imaging options. The ASNC Imaging Indications (ASNC-I2) Series will provide a concise overview of relevant disease processes and their multimodality evaluation and will provide consensus clinical indications, diagnostic criteria, and clinical algorithms with representative clinical cases. METHODS For each ASNC-I2 document, a diverse writing group and rating panel will be composed of experts from societies pertinent to the topic, including relevant imaging societies and clinical societies that manage the disease under evaluation. The rating panel will follow robust modified Delphi methodology and commonly-accepted appropriateness methods to create consensus diagnostic criteria, clinical algorithms, and clinical indications that they will then rate with level of agreement recorded. The clinical and imaging experts will provide concise, high-yield clinical summaries of the disease process, the non-imaging evaluation, and multimodality imaging. Relevant cases will be provided highlighting application of the diagnostic criteria and clinical algorithms. CONCLUSION The ASNC Imaging Indications (ASNC-I2) Series will complement the diverse portfolio of documents from ASNC. It will use a multisocietal approach with robust appropriateness methodology to guide use of radionuclide imaging in the multimodality imaging context for the cardiovascular care of patients.

Background Epidermolysis bullosa (EB) patient anecdotes and case reports indicate that cannabinoid-based medicines (CBMs) may alleviate pain and pruritus and improve wound healing. CBM use has not been characterized in the EB patient population. Objectives To evaluate CBM use among EB patients, including CBM types, effects on symptoms (e.g., pain and pruritus), disease process (e.g., blistering, wounds, and inflammation), well-being (e.g., sleep, appetite) and concomitant medications. Methods English-speaking EB patients or caregivers completed an online international, anonymous, cross-sectional survey regarding CBM use. Respondents reported the types of CBMs, subsequent effects including perceived EB symptom alteration, changes in medication use, and side effects. Results Seventy-one EB patients from five continents reported using or having used CBMs to treat their EB. Missing question responses ranged between 0 (0%) and 33 (46%). Most used more than one CBM preparation (mean: 2.4 ± 1.5) and route of administration (mean: 2.1 ± 1.1). Topical and ingested were the most common routes. Pain and pruritus were reported retrospectively to decrease by 3 points (scale: 0–10; p overall EB symptoms (95%), pain (94%), pruritus (91%) and wound healing (81%). Most participants (79%) reported decreased use of pain medications. The most common side-effect was dry mouth (44%). Conclusions CBMs improve the perception of pain, pruritus, wound healing, and well-being in EB patients and reduced concomitant medication use. Nevertheless, a direct relation between the use of CBMs and reduction of the above-mentioned symptoms cannot be proven by these data. Therefore, future controlled studies using pharmaceutically standardised CBM preparations in EB are warranted to delineate the risks and benefits of CBMs.

Background: Pilonidal sinus is a blind ending track containing hair follicles within it and is primarily a disease involving sacrococcygeal region. The exact etiology of this disease process is unknown and is still controversial. There are various treatment methods for pilonidal sinus and the preferred method is Limberg flap reconstruction surgery due to its less complications and less recurrence. Materials and Methods: Our study was a prospective study including 28 patients who were admitted for pilonidal sinus and operated by Limberg flap reconstruction surgery at Veer Surendra Sai Institute of Medical Sciences And Research from January 2018 to June 2020. Results: Our study included 28 patients, and the female to male ratio is 1:13. Duration of symptoms had a range from 1-4 months and the mean age of the study population was 28.5 year. Patients underwent Limberg flap reconstruction surgery and 89.28% followed a normal course after surgery , 7.14% developed seroma and 3.57% developed surgical site infection in their post-operative period. Conclusions: Limberg flap reconstruction surgery is the most preferred method of treatment for pilonidal sinus because of its low infection and recurrence rates, better aesthetic results after surgery and short duration of hospital stay. Keywords: Pilonidal sinus, Limberg flap, Sacrococcygeal.

Introduction: The biochemical diagnosis of neuroendocrine tumours (NETs) uses assays of specific and nonspecific markers. Nonspecific markers include, among others, neuron-specific enolase (NSE). The aim of this study was to evaluate NSE in patients with midgut type tumours treated with somatostatin analogues. Material and methods: The study group of patients with NETs of the small intestine included 41 patients. Grade G1 was found in 19 cases, while G2 was seen in the remaining 22 cases. Liver metastases were found in all patients studied. The examined group of patients was treated with somatostatin analogues receiving octreotide LAR at a dose of 30 mg. The control of biochemical parameters was performed every 3 months and imaging examinations every 6 months. The Immuno-Biological Laboratories kit was used for determination of NSE concentration, where reference values were 12.5–25 ng/mL. Results: In the G1 group of patients, the median value of NSE concentration was 134.67 ng/mL, while in the G2 group, the value was 234.55 ng/mL and was significantly higher than in the G1 group (p = 0.003). In the determination of NSE concentration values according to the degree of liver involvement, in the group of patients with 10% liver involvement, the median value of NSE concentration was 143.21 ng/mL, while in the group with 25% liver involvement, the value was 251.82 ng/mL (p < 0.001). In the analysis of NSE concentration assessment in patients with disease progression, the median value was 234.65 ng/mL compared to the group with disease stabilization, where the median NSE value was significantly lower and amounted to 136.27 ng/mL (p < 0.001). Conclusions: In our study, we observed that NSE concentration values were significantly higher among patients with NET midgut type tumour with histological grade G2 and in patients with 25% liver involvement and progression of the disease process.

Objectives Our discussant’s thoughtful consideration of the patient’s case allows for review of three maxims of medicine: Occam’s razor (the simplest diagnosis is the most likely to be correct), Hickam’s dictum (multiple disease entities are more likely than one), and Crabtree’s bludgeon (the tendency to make data fit to an explanation we hold dear). Case presentation A 66-year-old woman with a history of hypertension presented to our hospital one day after arrival to the United States from Guinea with chronic daily vomiting, unintentional weight loss and progressive shoulder pain. Her labs are notable for renal failure, nephrotic range proteinuria and normocytic anemia while her shoulder X-ray shows osseous resorption in the lateral right clavicle. Multiple myeloma became the team’s working diagnosis; however, a subsequent shoulder biopsy was consistent with follicular thyroid carcinoma. Imaging suggested the patient’s renal failure was more likely a result of a chronic, unrelated process. Conclusions It is tempting to bludgeon diagnostic possibilities into Occam’s razor. Presumption that a patient’s signs and symptoms are connected by one disease process often puts us at a cognitive advantage. However, atypical presentations, multiple disease processes, and unique populations often lend themselves more to Hickam’s dictum than to Occam’s razor. Diagnostic aids include performing a metacognitive checklist, engaging analytic thinking, and acknowledging the imperfections of these axioms.

Meng Miao,1 Fang Yuan,2 Xiaotian Ma,3 Haiming Yang,1 Xiang Gao,1 Zhengyu Zhu,4 Jianzhong Bi4 1Department of Neurology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, 266035, People’s Republic of China; 2Department of Health Care, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, 266035, People’s Republic of China; 3Department of Medicine Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, 266035, People’s Republic of China; 4Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, People’s Republic of ChinaCorrespondence: Zhengyu Zhu; Jianzhong BiDepartment of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, People’s Republic of ChinaTel +8617660083488; +8615153178111Email zhuzhengyu_1@hotmail.com; bjz@sdu.edu.cnBackground: Early cognitive impairment after transient ischemic stroke (TIA)/mild ischemic stroke (MIS) is common but easily overlooked. It has been demonstrated that DNA methylation plays a significant role in cognitive impairment and ischemic stroke. Furthermore, it has been reported that the RIN3 gene influences transportation of the amyloid β-protein. However, to our knowledge, there has been no research related to correlations between RIN3 methylation and early-onset cognitive impairment after TIA/MIS. Therefore, this study aimed to investigate this relationship in TIA/MIS patients.Methods: This study include 28 control subjects and 84 patients with TIA/MIS who were evaluated within 7 days of TIA/MIS onset using four single-domain cognitive scales. In addition, DNA methylation of whole blood was tested. RIN3 methylation was compared between TIA/MIS and control groups and between TIA/MIS patients with early cognitive impairment and those without early cognitive impairment. Clinical variables and RIN3 methylation sites with statistical differences were then used to construct a predictive model.Results: Hypomethylation of the RIN3 gene was observed in the whole blood of TIA/MIS patients relative to healthy controls. Furthermore, patients with early cognitive impairment after TIA/MIS had hypomethylation of RIN3 relative to those without early cognitive impairment.Conclusion: RIN3 methylation is strongly associated with TIA/MIS and TIA/MIS with early cognitive impairment. It is possible to influence the disease process by methylation via appropriate lifestyle and clinical interventions, and methylation of RIN3 gene sites may predict the occurrence of TIA/MIS with early cognitive impairment.Keywords: amyloid &Bgr;-protein, cognitive impairment, hypomethylation, ischemic stroke, transportation

Pancreatic ductal adenocarcinoma (PDAC) represents a challenging pathology with very poor outcomes and is increasing in incidence within the general population. The majority of patients are diagnosed incidentally with insidious symptoms and hence present late in the disease process. This significantly affects patient outcomes: the only cure is surgical resection but only up to 20% of patients present with resectable disease at the time of clinical presentation. The use of "omic" technology is expanding rapidly in the field of personalised medicine - using genomic, proteomic and metabolomic approaches allows researchers and clinicians to delve deep into the core molecular processes of this difficult disease. This review gives an overview of the current findings in PDAC using these "omic" approaches and summarises useful markers in aiding clinicians treating PDAC. Future strategies incorporating these findings and potential application of these methods are presented in this review article.

The covid-19 pandemic negatively affects time-dependent care and the course of STEMI in several aspects: Some patients delay seeking emergency care or even do not call it at all because of fear of contracting covid-19 at hospitals. The presentations of STEMI and covid-19 can overlap and mimic each other. Both conditions may coexist. Uncertainty regarding diagnosis may add to delays. Provider΄s concerns about the covid-19 infection or lack of cath lab staff may lead to changes in treatment algorhithms. There may also be delay due to the infection-control measures employed by medical staff. Reduction in non-covid care, overwhelmed emergency medical services and hospitals, staff-absences, and lack of beds may all lead to treatment delay or even inability to provide it. Inflammatory and prothrombotic states in patients with covid-19 increase the risk of developing STEMI as well as that of STEMI complications. Hypoxia due to covid-19 lung disease deepens myocardial ischemia during STEMI and may extend the volume of STEMI and increase the risk of heart failure. Covid myocarditis Conclusion: It is apparent that STEMI in covid-19 infected patients is not the same disease process as STEMI that without covid-19 infection. Patients with STEMI and covid-19 have a higher risk of heart failure, cardiac arrest, cardiogenic shock, greater intracoronary thrombosis and stent thrombosis, resulting in higher cardiac and non-cardiac mortality. Aggressive antithrombotic treatment is recommended. Even in the covid era it is essential to insist on timely treatment of STEMI. Training of cardiac catheterization personnel on how to use personal protective equipment as well as vaccination are crucial to limit the risk of acquiring infection. (English) [ABSTRACT FROM AUTHOR] Infekce covid-19 a covidova pandemie představuji problem pro peci o nemocne se STEMI. Výskyt, průběh, lecbu a prognozu STEMI ovlivňuje covidova epidemie v několika aspektech: „ Cast nemocných z obavy před covidovou nakazou v nemocnici oddaluje přivolani zdravotnicke pomoci, nebo dokonce pomoc vůbec nezavola. Přiznaky STEMI a covid-19 se mohou překrývat a vzajemně napodobovat, navic mohou koexistovat, nejistota při stanoveni diagnozy může vest ke zpožděni lecby. Obava z covidove nakazy zdravotniků nebo nedostatek personalu katetrizacnich laboratoři může vest ke změně lecebných algoritmů. Přetižene zdravotni služby, omezeni „necovidove“ pece, chybějici personal, nedostatek lůžek mohou mit za nasledek prodlevu v lecbě STEMI až nemožnost lecbu poskytnout. Použiti ochranných prostředků proti siřeni covid-19 může vest ke zpožděni lecby. Zanětlivý a protrombotický stav během covidove infekce zvysuje riziko vzniku infarktu myokardu a zvysuje riziko trombotických komplikaci již probihajiciho STEMI. Hypoxie způsobena covidovým postiženim plic prohlubuje ischemii myokardu při AIM, může zvětsit rozsah infarktu a zvysuje riziko srdecniho selhani při AIM. Covidova myokarditida. Zavěr: STEMI u nemocneho s covid-19 neni stejna nemoc jako STEMI bez covid-19. Nemocni s covid-19 a STEMI maji castěji srdecni selhani a srdecni zastavu, rozsahlejsi intrakoronarni trombozu, významně vyssi riziko akutni trombozy stentu, kardiogenniho soku po PCI a významně vyssi nemocnicni kardialni i nekardialni mortalitu. Je indikovana agresivnějsi antitromboticka lecba. I v covidove době je nutna maximalni snaha o co nejrychlejsi zajistěni reperfuzni lecby a dodrženi casových limitů pro jeji provedeni. Velmi důležite jsou nacvik použivani ochranných pomůcek proti siřeni infekce a vakcinace. (Czech) [ABSTRACT FROM AUTHOR] Copyright of Intervencni a Akutni Kardiologie is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE Visual outcomes after postinjection endophthalmitis have been well-studied, but the effect of endophthalmitis on the underlying exudative disease process remains unclear. We investigate the need for continued anti-vascular endothelial growth factor injections after endophthalmitis. METHODS Eyes that developed endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor between January 1, 2016, and May 31, 2018, at a single academic retina practice were identified. Retrospective chart review was performed to determine 1) the proportion of eyes without recurrence of macular edema or subretinal fluid after endophthalmitis and 2) the proportion achieving a 12-week or greater interval between anti-vascular endothelial growth factor injections or exudation after endophthalmitis compared with internal controls before endophthalmitis. RESULTS Of 50 eyes with endophthalmitis, seven (14.0%) had no fluid recurrence at a mean of 98.1 week. Of 43 eyes with recurrence, 48.0% achieved a >12-week recurrence-free interval after endophthalmitis (vs. 8.3% before endophthalmitis; P < 0.0001). Eyes with compared to those without choroidal neovascularization were more likely to achieve this interval (60.5% vs. 8.3%, respectively; P = 0.002). CONCLUSION Endophthalmitis after anti-vascular endothelial growth factor injection is associated with relative stability of the underlying exudation. Further research is necessary to elucidate the mechanism, which may be useful in developing strategies and targets for the treatment of exudative macular diseases.

Characterization of vascular impairment in Best vitelliform macular dystrophy (BVMD) is essential for the development of treatment modalities and therapy trials. As such, we seek to characterize the choriocapillaris (CC) at each stage of the disease process in 22 patients (44 eyes) with a diagnosis of BVMD confirmed by genetic sequencing. We utilize optical coherence tomography angiography (OCTA) images to characterize the CC and correlate our findings to the status of the retinal pigment epithelium (RPE) as observed on short-wavelength fundus autofluorescence (SW-AF) images. We observed that in the vitelliruptive stage, the CC appeared as bright and granular in the area where the vitelliform lesion was present. In the atrophic stage, varying degrees of CC atrophy were observed within the lesion area, with the regions of CC atrophy appearing as hypoautofluorescent on SW-AF images. Our results suggest that the CC impairment observed in the vitelliruptive stage of BVMD progressively culminates in the CC atrophy observed at the atrophic stage. As such, OCTA imaging can be used to characterize CC impairment in BVMD patients as part of diagnosis and tracking of disease progression. Our findings suggest that the best window of opportunity for therapeutic approaches is before the atrophic stage, as it is during this stage that CC atrophy is observed.