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Nephrotic syndrome (NS) has a well-established relationship with hypercoagulability and, while rare, is known to present with unprovoked venous thromboembolism (VTE). Here, we present a case of seemingly unprovoked deep vein thrombosis and pulmonary embolism as presenting features of NS. We explore the challenge of timing diagnostic renal biopsy with necessary therapeutic anticoagulation, particularly in patients who present with unstable or extensive VTE. We also examine relevant factors in selecting an anticoagulant and discuss emerging treatment modalities in NS. This case underscores the complexity of medical decision-making in NS presenting with VTE and highlights the importance of multi-disciplinary consideration of patient-specific risks and benefits., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Thummala et al.)

A major goal of regenerative medicine of the central nervous system is to accelerate the regeneration of nerve tissue, where astrocytes, despite their positive and negative roles, play a critical role. Thus, scaffolds capable of producing astrocytes from neural precursor cells (NPCs) are most desirable. Our study shows that NPCs are converted into reactive astrocytes upon cultivation on coralline-derived calcium carbonate coated with poly-D-lysine (PDL-CS). As shown via nuclei staining, the adhesion of neurospheres containing hundreds of hippocampal neural cells to PDL-CS resulted in disaggregation of the cell cluster as well as the radial migration of dozens of cells away from the neurosphere core. Migrating cells per neurosphere averaged 100 on PDL-CS, significantly higher than on uncoated CS (28), PDL-coated glass (65), or uncoated glass (20). After 3 days of culture on PDL-CS, cell migration plateaued and remained stable for four more days. In addition, NPCs expressing nestin underwent continuous morphological changes from round to spiky, extending and elongating their processes, resembling activated astrocytes. The extension of the process increased continuously during the maturation of the culture and doubled after 7 days compared to day 1, whereas bifurcation increased by twofold during the first 3 days before plateauing. In addition, nestin positive cells' shape, measured through the opposite circularity level correlation, decreased approximately twofold after three days, indicating spiky transformation. Moreover, nestin-positive cells co-expressing GFAP increased by 2.2 from day 1 to 7, reaching 40% of the NPC population on day 7. In this way, PDL-CS promotes NPC differentiation into reactive astrocytes, which could accelerate the repair of neural tissue.

Introduction: The prevalence of disabilities in the general population is not neglectable and gaps in providing quality health service persist between people with and without disabilities. Though life expectancy of persons with disability is increasing, there is an excess of preventable morbidity and mortality. The person with disability has needs and expectations and should be partners in the process of prevention, treatment and follow-up of their health status. According to research, the medical care for the patient with disability does not meet the standards derived from the evidence. Patient safety is a core domain in the quality of care and that is true for the care of persons with disability. Communication, stigma, lack of knowledge, skills and training, are major inhibitors of the provision of high-quality care for the people with disabilities and are considered to be factors responsible for the high incidence of adverse and medical errors in this group of patients. Approaching these topics with critical attention is needed across the span of medical care from the community to the hospital and from prevention to the more complex and sophisticated care offered to the patient with disability.

Biomaterials, especially when coated with adhesive polymers, are a key tool for restorative medicine, being biocompatible and supportive for cell adherence, growth, and function. Aragonite skeletons of corals are biomaterials that support survival and growth of a range of cell types, including neurons and glia. However, it is not known if this scaffold affects neural cell migration or elongation of neuronal and astrocytic processes, prerequisites for initiating repair of damage in the nervous system. To address this, hippocampal cells were aggregated into neurospheres and cultivated on aragonite skeleton of the coral Trachyphyllia geoffroyi (Coral Skeleton (CS)), on naturally occurring aragonite (Geological Aragonite (GA)), and on glass, all pre-coated with the oligomer poly-D-lysine (PDL). The two aragonite matrices promoted equally strong cell migration (4.8 and 4.3-fold above glass-PDL, respectively) and axonal sprouting (1.96 and 1.95-fold above glass-PDL, respectively). However, CS-PDL had a stronger effect than GA-PDL on the promotion of astrocytic processes elongation (1.7 vs. 1.2-fold above glass-PDL, respectively) and expression of the glial fibrillary acidic protein (3.8 vs. and 1.8-fold above glass-PDL, respectively). These differences are likely to emerge from a reaction of astrocytes to the degree of roughness of the surface of the scaffold, which is higher on CS than on GA. Hence, CS-PDL and GA-PDL are scaffolds of strong capacity to derive neural cell movements and growth required for regeneration, while controlling the extent of astrocytic involvement. As such, implants of PDL-aragonites have significant potential as tools for damage repair and the reduction of scar formation in the brain following trauma or disease., Competing Interests: The authors declare no conflict of interest

Following traumatic brain injury, there is no restoration of the lost nervous tissue, mainly due to the formation of a scar. One promising strategy to overcome this hurdle is grafting scaffolds that can disturb the scar blockade, enabling cell invasion into the wound. The aragonite skeleton of corals is useful scaffolds for testing this strategy, being supportive for neural cells in culture. The purpose of this work was to check if a contact between a coralline scaffold and an injured nervous tissue affects scar formation and if this effect can be regulated by engineering the scaffold's surface topology. To address that, hippocampal slices were cultivated on a coral skeleton having two distinct surface shapes: (1) intact skeleton pieces (ISP): porous, microrough surface; (2) grained skeleton (GS): nonporous, macrorough surface. On ISP, slices deformed by engulfing the scaffold's outer surface without penetrating the pores, yet, they preserved their coherence. By contrast, on GS slices were flat, but broken into interconnected small segments of tissue. In addition, whereas on ISP astrocytes were significantly more active and diffusely distributed, on GS reactive astrocytes tightened into a single <90 μm wide scar-like stripe at the slice's periphery. Hence, by grafting coralline scaffolds of predesigned surface roughness and porosity into brain wounds, control over scar tissue formation can be gained, providing an opportunity for cell migration and damage repair. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2295-2306, 2018., (© 2017 Wiley Periodicals, Inc.)

Hypothesis: To assess the frequency distribution of the CYP1A1 and CYP2D6 gene polymorphisms in Israeli Jewish women with cervical cancer., Methods: Forty-three Israeli Jewish women with cervical cancer and 123 healthy Israeli Jewish women were assessed. CYP1A1 (2 alleles) and CYP2D6 polymorphism was analyzed using an allele-specific, polymerase chain reaction-based method., Results: The allele frequency and genotype distribution for the CYP1A1 (2 alleles) and CYP2D6 polymorphism did not reach a level of significance. Smoking was the only independent risk factor for cervical cancer (P = 0.0003)., Conclusion: CYP1A1 and CYP2D6 mutations are not related to an increased risk for cervical cancer in the Jewish Israeli population.

Objective: Previous studies have demonstrated that CYP2D6 polymorphism is associated with liver cirrhosis. The aim of the present study was to find out whether CYP2D6*4, the poor metabolizer allele can predict fibrosis progression rate., Methods: Seventy-five Caucasian patients with chronic hepatitis C infection were recruited. They were divided into two groups, 'fast fibrosers' and 'slow fibrosers', according to Poynard's fibrosis progression curves. Sixty-two patients underwent liver biopsy. Twenty healthy neonates were included as control population. DNA was extracted from peripheral blood and CYP2D6*4 was tested by polymer chain reaction using fluorescent hybridization probes in a lightCycler instrument., Results: Forty-two patients were classified as 'fast fibrosers' and 33 patients as 'slow fibrosers'. The frequency of CYP2D6*4 allele in the 'fast fibrosers' (34.5%) was significantly higher compared with the 'slow fibrosers' (15%) (P-value=0.007). There was no significant difference between the frequency of CYP2D6*4 in the 'slow fibrosers' (15%) compared with the controls (12.5%). Carrier state of CYP2D6*4 was the only covariate that was significantly positively correlated with fast progression to cirrhosis (odds ratio=6.5, P=0.01)., Conclusion: This study indicates for the first time that CYP2D6 genotype might be a significant predictor of liver fibrosis progression rate in chronic hepatitis C patients.

Change in the attitudes of staff or the public towards people with intellectual disability (ID) can impact their life and health, but that change has not been studied among physicians who belong to an ethnic minority undergoing dramatic social and economic transition. The goal of this study was to explore the change of attitudes of Negev Bedouin physicians serving their community and their satisfaction with policy, care, and knowledge in the field of ID. Seventeen community physicians (7 Bedouins and 10 Jewish) were interviewed using a simple questionnaire that consisted of items measuring attitude and satisfaction. The vast majority of the Bedouin and Jewish physicians had positive attitudes toward inclusion of those in the community with ID and were ready to provide the care needed in the community with special assistance. There was a need for further education in ID and more resources. There was a belief that there is discrimination between the Bedouin and Jewish community in the provision of care to people with ID. General dissatisfaction was expressed about the policy, resources, care provision, and expertise offered to Bedouins with ID. More efforts must be directed to empower the physicians with knowledge, expertise, and resources to handle the care of Bedouins with ID in a culturally appropriate way.