Prevalence of other autoimmune diseases in polyglandular autoimmune syndromes type II and III

Polyglandular autoimmune syndromes (PAS) are complex, heterogeneous disorders in which various autoimmune diseases can occur, affecting both endocrine and non-endocrine organs. In this meta-analysis, the prevalence of associated autoimmune disorders was investigated in PAS II and III.A comprehensive search in MEDLINE and Embase databases identified 479 studies with the keywords of PAS II and PAS III. 18 records containing a total of 1312 patients fulfilled our inclusion criteria (original studies reporting at least 10 cases and containing the combination of other autoimmune disorders) and were selected for further analysis. A meta-analysis of prevalence was performed using the random-effects model with the calculation of 95% confidence intervals (CI). Results of each meta-analysis were displayed graphically using forest plots.Distinction between PAS II and PAS III was made in 842 cases, of which 177 and 665 were PAS II and III (21.1 vs 78.9%), respectively. The prevalence of Hashimoto's thyroiditis was significantly higher than that of Graves's disease (39% [95% CI 17-65%] vs. 4% [95% CI 0-10%], respectively; p = 0.001). In PAS II, Addison's disease (AD) coexisted with AITDs, T1DM or the combination of these conditions in 65, 18 and 10% of cases, respectively. In addition, one other endocrine and five non-endocrine organ-specific autoimmune disorders were reported. In PAS III, two other autoimmune endocrinopathies, six non-endocrine organ-specific, and four systemic autoimmune disorders were found in combination with AITDs.AITDs, T1DM and AD are the most common combinations in PAS, thus screening for these conditions seems to be reasonable

Endoscopic ultrasound-guided ethanol and radiofrequency ablation of pancreatic insulinomas: a systematic literature review.

Background: Insulinoma is the most common neuroendocrine neoplasm of the pancreas, characterised by hypoglycaemic symptoms. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and ethanol ablation (EUS-EA) are novel methods for treating insulinoma.We aimed to perform a systematic review to assess the efficacy and safety of EUS-guided ablation techniques for pancreatic insulinomas. Methods: We systematically searched for articles detailing EUS-guided ablations of insulinomas. We performed a qualitative analysis and summarised data on the efficacy and safety of EUS-RFA and EUS-EA techniques. Results: In total, we identified 35 case reports and case series describing 75 patients with insulinomas treatment with EUS-guided ablation. Twenty-seven patients were treated with EUS-RFA, 47 patients with EUS-EA, and 1 patient received EUS-EA and EUS-RFA in the same session. In total, 84 insulinomas were ablated (EUS-RFA: 31, EUS-EA: 53). Most insulinomas were in the head of the pancreas (40%). The clinical success rate for EUS-guided ablation techniques was 98.5%. The median glucose level was 1.95 (Q1-Q3: 1.69-2.13) mmol/L before ablation compared to 6.20 (Q1-Q3: 5.30-7.05) mmol/L after treatment. The median insulin and C-peptide levels before and after RFA/EA were 230 (Q1-Q2: 120-257) pmol/L and 41 (Q1-Q2 35-42) pmol/L; 2077 (Q1-Q2 1644-2459) pmol/L and 819 (Q1-Q2 696-1072) pmol/L, respectively. There were eleven adverse events: seven abdominal pain, two mild acute pancreatitis, one necrotising acute pancreatitis and one local hematoma. All patients recovered, and there were no periprocedural deaths. Conclusions: EUS-guided ablation of insulinoma seems to be a safe and effective treatment and is an alternative to surgical resection in selected cases

Characterization of the regional groundwater flow systems in south Transdanubia (Hungary) to understand karst evolution and development of hydrocarbon and geothermal resources

In South Transdanubia (Hungary), the remarkable geothermal and hydrocarbon resources in the Drava Basin and the hypogene caves at the margin of outcropping carbonate hills were usually investigated separately and their interactions were hitherto neglected. The aim of this study is to give all these groundwater-related resources and phenomena a common framework applying the concept of regional hydraulic continuity, and to complete the regional (i.e., basin-scale) hydraulic assessment of the area based on preproduction archival measured data. Pressure-elevation profiles, tomographic fluid-potential maps and hydraulic cross-sections were constructed to determine the vertical and horizontal fluid-flow conditions. As a result, two kinds of fluid flow systems could be identified. Within the gravitational flow systems, horizontal flow conditions are dominant and the regional flow direction tends toward the S–SE. In deeper basin regions, an overpressured flow system is prevalent, where fluids are driven laterally from the deeper sub-basins towards their margins. Based on the regional-scale evaluation of fluid flow systems, conclusions could be drawn regarding the geothermal and hydrocarbon potential of the area. Additionally, local-scale phenomena could be explained, particularly in the southern foreland of the Villány Hills. Cave formation cannot be related to the present-day flow systems here. In the Harkány area, groundwater chemistry could be explained by fluid contribution from the Drava Basin. A comparison with the marginal Buda Thermal Karst area allows for generalized conclusions regarding the connections between marginal karst reservoirs and the Pannonian Basin

Hydraulic evaluation of the hypogenic karst area in Budapest (Hungary)

The Buda Thermal Karst area, in central Hungary, is in the focus of research interest because of its thermal water resources and the on-going hypogenic karstification processes at the boundary of unconfined and confined carbonates. Understanding of the discharge phenomena and the karstification processes requires clarification of the groundwater flow conditions in the area. Consequently, the aim of the present study was to present a hydraulic evaluation of the flow systems based on analyzes of the archival measured hydraulic data of wells. Pressure vs. elevation profiles, tomographic fluid-potential maps and hydraulic cross sections were constructed, based on the data distribution. As a result, gravitational flow systems, hydraulic continuity, and the modifying effects of aquitard units and faults were identified in the karst area. The location of natural discharge areas could be explained and the hydraulic behavior of the Northeastern Margin Fault of the Buda Hills could be determined. The flow pattern determines the differences in the discharge distribution (one- and two-component) and related cave-forming processes between the Central System (Rózsadomb area) and Southern System (Gellért Hill area) natural discharge areas. Among the premises of hypogenic karstification, regional upward flow conditions were confirmed along the main discharge zone of the River Danube. The flow pattern determines the differences in the discharge distribution (one- and two-component) and related cave-forming processes between the Central System (Rózsadomb area) and Southern System (Gellért Hill area) natural discharge areas. Among the premises of hypogenic karstification, regional upward flow conditions were confirmed along the main discharge zone of the River Danube. The flow pattern determines the differences in the discharge distribution (one- and two-component) and related cave-forming processes between the Central System (Rózsadomb area) and Southern System (Gellért Hill area) natural discharge areas. Among the premises of hy

Academia Europaea Position Paper on Translational Medicine: The Cycle Model for Translating Scientific Results into Community Benefits

INTRODUCTION: Translational science has gained prominence in medicine, but there is still much work to be done before scientific results are used optimally and incorporated into everyday health practice. As the main focus is still on generating new scientific data with financial resources primarily available for that purpose, other activities that are necessary in the transition from research to community benefit are considered less needy. The European Statistical Office of the European Commission has recently reported that 1.7 million people under 75 years of age died in Europe in 2016, with around 1.2 million of those deaths being avoidable through effective primary prevention and public health intervention. Therefore, Academia Europaea, one of the five Pan-European networks that form SAPEA (Science Advice for Policy by European Academies), a key element of the European Commission's Scientific Advice Mechanism (SAM), has launched a project to develop a model to facilitate and accelerate the utilisation of scientific knowledge for public and community benefit. METHODS: During the process, leaders in the field, including prominent basic and clinical researchers, editors-in-chief of high-impact journals publishing translational research articles, translational medicine (TM) centre leaders, media representatives, academics and university leaders, developed the TM cycle, a new model that we believe could significantly advance the development of TM. RESULTS: This model focuses equally on the acquisition of new scientific results healthcare, understandable and digestible summation of results, and their communication to all participants. We have also renewed the definition in TM, identified challenges and recommended solutions. CONCLUSION: The authors, including senior officers of Academia Europaea, produced this document to serve as a basis for revising thinking on TM with the end result of enabling more efficient and cost-effective healthcare