"It feels like I'm managing myself": HIV+ people tracking their personal health information

Nearly 37 million people live with HIV globally and recent advances in medicine have transformed HIV to a chronic disease, if managed. Previous research in Personal Health Informatics has investigated how people self-manage other chronic conditions, such as diabetes, by tracking and reflecting on their health information but there is little knowledge of how people do so for complex and socially stigmatized diseases like HIV. A better understanding of their specialized needs could lead to the development of more appropriate tools to self-manage their condition. Our paper introduces an iterative process model of Personal Health Informatics. We then describe the results of an empirical study involving HIV+ adults aimed at understanding their issues, concerns and actions in each of the stages of this process model. We provide implications for the design of personal informatics tools and open research directions that can lead to better self-management for people living with HIV

Headache as presenting symptom of neurosarcoidosis

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Mass of the b-quark and B-decay constants from Nf=2+1+1 twisted-mass Lattice QCD

We present precise lattice computations for the b-quark mass, the quark mass ratios mb/mc and mb/ms as well as the leptonic B-decay constants. We employ gauge configurations with four dynamical quark flavors, up/down, strange and charm, at three values of the lattice spacing (a ~ 0.06 - 0.09 fm) and for pion masses as low as 210 MeV. Interpolation in the heavy quark mass to the bottom quark point is performed using ratios of physical quantities computed at nearby quark masses exploiting the fact that these ratios are exactly known in the static quark mass limit. Our results are also extrapolated to the physical pion mass and to the continuum limit and read: mb(MSbar, mb) = 4.26(10) GeV, mb/mc = 4.42(8), mb/ms = 51.4(1.4), fBs = 229(5) MeV, fB = 193(6) MeV, fBs/fB = 1.184(25) and (fBs/fB)/(fK/fpi) = 0.997(17).Comment: Version to appear in PRD. Added comments to simulation setup and error budget discussion. 1+20 pages, 9 figure

Mucopexy-recto anal lifting: a standardized minimally invasive method of managing symptomatic hemorrhoids, with an innovative suturing technique and the HemorPex System®

BACKGROUND: Conservative surgery of hemorrhoidal disease is less painful than traditional hemorrhoidectomy, and mucopexy has less risk of serious postoperative complications than stapled hemorrhoidopexy. The aim of this study was to evaluate the safety and effectiveness of a standardized, modified hemorrhoidopexy, named Mucopexy-Recto Anal Lifting (MuRAL) with the HemorPex System (HPS) in patients with symptomatic III and IV degree hemorrhoids. METHODS: Patients were enrolled from May 2013 to Dec 2015 and operated on with the MuRAL technique, based on arterial ligation and mucopexy at 6 locations, using a standardized clockwise/anti-clockwise rotation sequence of the HPS anoscope. Follow-up controls were carried out by independent observers, as follows: a digital exploration 3 weeks after the intervention, digital exploration plus proctoscopy at 3 and 12 months and repeated at a 12 months interval. Patients who did not strictly follow the postoperative controls were excluded from the study. Primary outcome measurement was the recurrence rate. Secondary measurements were: operative time, hospital stay, postoperative pain, postoperative symptoms and satisfaction score. RESULTS: We operated on 126 patients (72 males, mean age 53.9, range 29-83): 87 (69.6%) with III degree and 39 with IV degree hemorrhoids; 13 patients had a MuRAL as a revisional procedure of a previous operation for hemorrhoids. Mean duration of follow-up was 554 days (range 281-1219). Four patients were excluded from the study. One-year recurrence rate was 4.1%. The mean duration of the intervention was 29.5 minutes (range 23-60) and 92 patients (73%) were discharged during the same day of the operation. Pain VAS Score in the first, second and third postoperative day was 3.9, 2.5, and 1.9, respectively. Twenty-two patients (18%), all submitted to spinal anesthesia, had postoperative acute urinary retention. Fecal urgency, observed in 18.8% of patients at the first control, disappeared within one year after the operation. Mean time to return to normal activity was 8 days (range 5 -10). The patient satisfaction scores at one-year follow up were 31.1% excellent, 57.4% good, 7.4% fairly good and 4.1% poor. In patients with III degree hemorrhoids operative time was significantly shorter, postoperative pain better and transient fecal urgency lower than in IV degree patients. In our experience the standardization of MuRAL operation with HPS, turned out to be a safe and effective minimally invasive approach in managing symptomatic III and IV degree hemorrhoids, avoiding the risk of severe complications, with the possibility to perform a redo-MuRAL in the event of recurrence. CONCLUSIONS: In our series up to 88% of the patients reported a good, or excellent one-year satisfaction score. Further comparative randomized studies with longer follow-up period are needed

Topiramat w profilaktyce migreny: dane uzyskane na podstawie analizy zbiorczej i otwartego badania obserwacyjnego

Topiramat zarejestrowano do profilaktycznego leczenia migreny w kilku krajach na podstawie wyników trzech dużych badań randomizowanych, przeprowadzonych metodą podwójnie ślepej próby, w których wykazano, że skuteczność tego leku była znacząco większa niż placebo. Autorzy dokonali przeglądu wyników dwóch badań. W jednym z nich wykorzystano połączone dane z trzech badań kontrolowanych, przeprowadzonych metodą podwójnie ślepej próby, w których stosowano topiramat w dawce 100 mg, natomiast drugie stanowi kontynuację dwóch z wymienionych badań, w formie otwartego badania obserwacyjnego, w którym pacjenci otrzymywali różne dawki topiramatu przez 8 miesięcy w ramach leczenia podtrzymującego. Uzyskane wyniki potwierdzają, że topiramat skutecznie zmniejsza częstość migrenowych bólów głowy i wykazuje korzystny profil bezpieczeństwa

Role and Efficacy of Intraoperative Evaluation of Resection Adequacy in Conservative Breast Surgery

In the present study we considered the histology of 51 patients who have undergone breast conservative surgery and the related 54 re-excisions that were performed in the same surgical procedure or in delayed procedures, in order to evaluate the role of intraoperative re-excisions in completing tumor removal. In 13% of the cases the re excision obtained the resection of the target lesion. In this study, the occurrence of residual neoplastic lesions in intraoperative re-excisions (24%) is lower than in delayed re-excisions (62%; P = .03). The residual lesions that we could find with definitive histology of re excision specimens are related with lesions with ill defined profile. In 77% of the cases of re excision with tumoral residual the lesion was close to the new resection margin, thus the re-excisions couldn't achieve an adequate ablation of the neoplasm. Invasive or preinvasive nature of the main lesion resected for each case and the approach to the evaluation of the first resection specimen adequacy (surgical or radiological) don't affect the rate of tumoral residual in intraoperative re-excisions. In conclusion, our data are consistent with a low efficacy of intraoperative re excision in obtaining a complete removal of the tumor; intraoperative radiologic evaluation of the first resection specimen is however imperative in defining the effective removal of the target lesion

Occipital neurostimulation in primary headaches: update

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Up to 40 % reduction of the GaAs band gap energy via strain engineering in core/shell nanowires

The great possibilities for strain engineering in core/shell nanowires have been explored as an alternative route to tailor the properties of binary III-V semiconductors without changing their chemical composition. In particular, we demonstrate that the GaAs core in GaAs/In(x)Ga(1-x)As or GaAs/In(x)Al(1-x)As core/shell nanowires can sustain unusually large misfit strains that would have been impossible in conventional thin-film heterostructures. The built-in strain in the core can be regulated via the composition and the thickness of the shell. Thick enough shells become almost strain-free, whereas the thin core undergoes a predominantly-hydrostatic tensile strain, which causes the reduction of the GaAs band gap energy. For the highest strain of 7 % in this work (obtained for x=0.54), a remarkable reduction of the band gap by 40 % was achieved in agreement with theoretical calculations. Such strong modulation of its electronic properties renders GaAs suitable for near-infrared nano-photonics and presumably high electron mobility nano-transistors.Comment: 12 pages, 4 figure

Psychiatric screening for migraine patients

Psychiatric disorders in migraine patients have a higher prevalence than general population. The presence of psychiatric comorbidities may influence the complexity of the migraine pictures and be related to medication overuse. Severely impaired chronic migraineurs presenting with medication overuse are a challenge for headache clinics. Psychiatric comorbities, such as dependency-like behaviors, anxiety and mood symptoms, might account for headache-related disability and recurrent relapses into medication overuse after a successful detoxification. Within a sample of 63 chronic migraineurs with medication overuse and severe disability, we investigated to which extent clinical severity, affective states and attitudes about medication impact the overall functioning at time of detoxification. To unravel whether some of these factors could predict their long-term outcome, we followed and retest them 1 year after withdrawal. We hypothesized that the detoxification would have led to a partial improvement and not modified the attitudes toward medication and dependence. Detoxification improves most of the clinical and affective measures, but does not free from significant levels of pain intensity and headache-related disability. The partial benefit from detoxification, the severity bias and the maladaptive cognitive profile led us to believe that subgroups of chronic-relapsing migraineurs deserve a multidisciplinary approach that addresses not only the reduction of clinical severity but also specific cognitive and behavioral impairments