Surgery for orbital metastasis from breast carcinoma initially presenting with progressive proptosis

payt.helady61 shared this article with you from Inoreader Surgery for orbital metastasis from breast carcinoma initially presenting with progressive proptosis Via BMJ Case Reports Last 6 Issues We present a 45-year-old woman with metastatic breast disease who initially presented with progressive proptosis of her right eye causing limited motility, diplopia and eye pain. MRI done showed an avidly enhancing right sphenoorbital mass causing displacement in the lateral and superior recti muscles with lysis and infiltration of the greater sphenoid wing and lateral orbital wall. The patient underwent surgery resulting in immediate relief of proptosis and resolution of symptoms. Although surgery is not recommended for orbital metastasis as it is not curative, it should be considered as a treatment option as it can provide relief to patients and improve their quality of life. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vitamin D supplementation prior to in vitro fertilisation in women with polycystic ovary syndrome: a protocol of a multicentre randomised, double-blind, placebo-controlled clinical trial

payt.helady61 shared this article with you from Inoreader Vitamin D supplementation prior to in vitro fertilisation in women with polycystic ovary syndrome: a protocol of a multicentre randomised, double-blind, placebo-controlled clinical trial Via BMJ Open recent issues Introduction Polycystic ovary syndrome (PCOS) is one of the leading causes of female infertility, affecting around 5% of women of childbearing age in China. Vitamin D insufficiency is common in women with PCOS and is associated with lower live birth rates. However, evidence regarding the effectiveness of vitamin D supplementation in women with PCOS is inconclusive. This multicentre randomised, double-blinded, placebo-controlled trial aims to evaluate the effectiveness of vitamin D supplementation prior to in vitro fertilisation (IVF) on the live birth rate in women with PCOS. Methods and analysis We plan to enrol women with PCOS scheduled for IVF. After informed consent, eligible participants will be randomised in a 1:1 ratio to receive oral capsules of 4000 IU vitamin D per day or placebo for around 12 weeks until the day of triggering. All IVF procedures will be carried out routinely in each centre. The primary outcome is live birth after the first embryo transfer. The primary analysis will be by intention-to-treat analysis. To demonstrate or refute that treatment with vitamin D results in a 10% higher live birth rate than treatment with placebo, we need to recruit 860 women (48% vs 38% difference, anticipating 10% loss to follow-up and non-compliance, significance level 0.05 and power 80%). Ethics and dissemination This study has been approved by the Ethics Committee in Women's Hospital of Zhejiang University on 2 March 2020 (reference number: IRB-20200035-R). All participants will provide written informed consent before randomisation. The results of the study will be submitted to scientific conferences and a peer-reviewed journal. Trial registration number NCT04082650. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Needlestick and sharps injuries

payt.helady61 shared this article with you from Inoreader Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study Via BMJ Open recent issues Objective Needlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme. Methods A cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY). Results Over the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning. Conclusion In conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between the occurrence of albuminuria and the risk of early dementia among older people upon health examination: a community-based cohort study in Taiwan

payt.helady61 shared this article with you from Inoreader Association between the occurrence of albuminuria and the risk of early dementia among older people upon health examination: a community-based cohort study in Taiwan Via BMJ Open recent issues Objectives This study aimed to investigate the associations between biochemical markers, renal function, health behaviours and dementia among older people. Design A retrospective cohort study. Setting Community-based health examination database from Taipei city. Participants In total, 35 434 older people were included from February 2005 to December 2012. To assess changes in renal function, we selected participants who attended health examinations at least twice and responded to the AD8 questionnaire in 2012. We excluded those with dementia at baseline. Primary outcome measures Early dementia was assessed using the AD8 questionnaire in 2012. Explanatory variables included demographic factors, health behaviours, biochemical markers and renal function. We used a Cox proportional hazard model to estimate the HR for early dementia onset. Results Individuals with mild albuminuria (HR 1.228; 95% CI 1.066 to 1.414), lower eGFR (HR 1.549; 95% CI 1.319 to 1.820) and higher age (HR 1.022; 95% CI 1.015 to 1.028) were associated with a high risk of early dementia. Older people with no alcohol intake (HR 0.872; 95% CI 0.794 to 0.958), and higher education levels (HR 0.647; 95% CI 0.589 to 0.710) were at a low risk of early dementia. Conclusions Elevated mild albuminuria and low eGFR were associated with a high risk of early dementia in this community-based cohort. Routine health examinations for older people can help screen out the high-risk population, and clinical management might reduce or delay the risk of early dementia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessing mental stress on myocardial perfusion and myocardial blood flow in women without obstructive coronary disease: protocol for a mechanistic clinical trial

payt.helady61 shared this article with you from Inoreader Assessing mental stress on myocardial perfusion and myocardial blood flow in women without obstructive coronary disease: protocol for a mechanistic clinical trial Via BMJ Open recent issues Introduction Two-thirds of women with symptoms of angina have 'angina with no obstructive coronary artery disease' (ANOCA). Growing evidence supports the use of coronary artery function testing for the diagnosis of ANOCA. Research into the prevalence of mental stress-induced myocardial ischaemia (MSIMI) among women with ANOCA is lacking. MSIMI is common in clinically stable patients with coronary artery disease. It is not associated coronary stenosis but is a prognostic risk factor. Here, we describe the rationale and protocol for a mechanistic clinical trial to test the following hypotheses: (1) that MSIMI is more common in women with ANOCA women than in age-matched and sex-matched controls, and (2) MSIMI is associated with mental stress-induced myocardial blood flow (MBF) change but not with adenosine vasodilator stress-induced MBF change. Methods and analysis This is a mechanistic clinical trial. 84 women with confirmed ANOCA and 42 aged-matched healthy women (neither angina symptoms nor coronary stenosis) are to be recruited for mental and adenosine vasodilator stress tests. Positron emission tomography CT with ammonia N-13 will be used to evaluate the myocardial perfusion and MBF changes between stress and rest. MSIMI is defined as a summed difference score (SDS) of ≥3 and adenosine stress-induced myocardial ischaemia is defined as an SDS of ≥4. Other assessments include Reactive Hyperemia Index for microvascular endothelial function, peripheral arterial tonometry or digital vasomotor response, and a series of blood and psychometric tests. Ethics and dissemination This mechanistic clinical trial was approved by the Ethics Committee of Guangdong Provincial People's Hospital. Findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration number NCT03982901; Pre-results. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Circular RNA circ_0004507 contributes to laryngeal cancer progression and cisplatin resistance by sponging miR‐873 to upregulate multidrug resistance 1 and multidrug resistance protein 1

pa.ythelady61 shared this article with you from Inoreader Circular RNA circ_0004507 contributes to laryngeal cancer progression and cisplatin resistance by sponging miR‐873 to upregulate multidrug resistance 1 and multidrug resistance protein 1 Via Head & Neck Abstract Background Circular RNAs (circRNAs) play critical roles in various types of cancer and chemosensitivity. Methods The expression levels of circ_0004507 and microRNA‐873 (miR‐873) were measured by quantitative real‐time polymerase chain reaction (qRT‐PCR). The interaction between circ_0004507 and miR‐873 was predicted by circinteractome and verified by dual‐luciferase reporter assay and RNA pull‐down assay. Xenograft tumor model was established to confirm the biological role of circ_0004507 in vivo. Results circ_0004507 was highly expressed and miR‐873 was lowly expressed in laryngeal cancer tissues. circ_0004507 knockdown or miR‐873 overexpression inhibited cell proliferation, migration and invasion, and increased apoptosis and cisplatin sensitivity in laryngeal cancer cells. miR‐873 was identified as a direct target of circ_0004507. circ_0004507 interference inhibited tumor growth and promoted cisplatin sensitivity by upregulating miR‐873 in vivo. Conclusion Knockdown of circ_0004507 inhibited laryngeal cancer progression and cisplatin resistance by sponging miR‐873, providing a potential target for laryngeal cancer therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors for the development of high‐grade dysplasia and carcinoma in patients with laryngeal squamous cell papillomas: Large retrospective cohort study

pa.ythelady61 shared this article with you from Inoreader Risk factors for the development of high‐grade dysplasia and carcinoma in patients with laryngeal squamous cell papillomas: Large retrospective cohort study Via Head & Neck Abstract Background The incidence and risk factors for the development of high‐grade dysplasia (HG‐D) and laryngeal squamous cell carcinoma (LSCC) were assessed in patients with laryngeal squamous cell papillomas (LSP). Methods Clinical data, human papillomaviruses (HPV) typing, HPV E6/E7 mRNA in situ hybridization, and sequencing of host genes in LSP biopsies of 163 patients were analyzed. Results Progression to HG‐D and LSCC was identified in 21.5% and 4.3% of LSP patients, respectively. A more advanced age at LSP onset and lack of HPV infection were detected as risk factors for the development of HG‐D and LSCC (P < .05). The identification of HG‐D was associated with its progression to LSCC (P < .05). Host gene mutations were identified in 3 of 7 patients with LSCC. Conclusions The histological monitoring of LSP and HPV typing are necessary for early detection of epithelial changes. Further research is needed to elucidate the role of host gene mutations in LSCC transformation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.