Retroperitoneal hemorrhage caused by enoxaparin-induced spontaneous lumbar artery bleeding and treated by transcatheter arterial embolization: a case report

Lumbar artery bleeding with retroperitoneal hematoma is an uncommon life-threatening complication secondary to enoxaparin use. We present a case of 73-year-old Chinese woman with acute retroperitoneal hemorrhage one month following hip surgery, due to enoxaparine. Enoxaparin induced hemorrhage caused by spontaneous rupture of lumbar artery was suspected and treated successfully by transcatheter arterial embolization

Is deck B a disadvantageous deck in the Iowa Gambling Task?

BACKGROUND: The Iowa gambling task is a popular test for examining monetary decision behavior under uncertainty. According to Dunn et al. review article, the difficult-to-explain phenomenon of "prominent deck B" was revealed, namely that normal decision makers prefer bad final-outcome deck B to good final-outcome decks C or D. This phenomenon was demonstrated especially clearly by Wilder et al. and Toplak et al. The "prominent deck B" phenomenon is inconsistent with the basic assumption in the IGT; however, most IGT-related studies utilized the "summation" of bad decks A and B when presenting their data, thereby avoiding the problems associated with deck B. METHODS: To verify the "prominent deck B" phenomenon, this study launched a two-stage simple version IGT, namely, an AACC and BBDD version, which possesses a balanced gain-loss structure between advantageous and disadvantageous decks and facilitates monitoring of participant preferences after the first 100 trials. RESULTS: The experimental results suggested that the "prominent deck B" phenomenon exists in the IGT. Moreover, participants cannot suppress their preference for deck B under the uncertain condition, even during the second stage of the game. Although this result is incongruent with the basic assumption in IGT, an increasing number of studies are finding similar results. The results of the AACC and BBDD versions can be congruent with the decision literatures in terms of gain-loss frequency. CONCLUSION: Based on the experimental findings, participants can apply the "gain-stay, loss-shift" strategy to overcome situations involving uncertainty. This investigation found that the largest loss in the IGT did not inspire decision makers to avoid choosing bad deck B

Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study.

BackgroundLittle is known on the effectiveness of influenza vaccine in ESRD patients. This study compared the incidence of hospitalization, morbidity, and mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) between cohorts with and without influenza vaccination.MethodsWe used the insurance claims data from 1998 to 2009 in Taiwan to determine the incidence of these events within one year after influenza vaccination in the vaccine (N = 831) and the non-vaccine (N = 3187) cohorts. The vaccine cohort to the non-vaccine cohort incidence rate ratio and hazard ratio (HR) of morbidities and mortality were measured.ResultsThe age-specific analysis showed that the elderly in the vaccine cohort had lower hospitalization rate (100.8 vs. 133.9 per 100 person-years), contributing to an overall HR of 0.81 (95% confidence interval (CI) 0.72-0.90). The vaccine cohort also had an adjusted HR of 0.85 [95% CI 0.75-0.96] for heart disease. The corresponding incidence of pneumonia and influenza was 22.4 versus 17.2 per 100 person-years, but with an adjusted HR of 0.80 (95% CI 0.64-1.02). The vaccine cohort had lowered risks than the non-vaccine cohort for intensive care unit (ICU) admission (adjusted HR 0.20, 95% CI 0.12-0.33) and mortality (adjusted HR 0.50, 95% CI 0.41-0.60). The time-dependent Cox model revealed an overall adjusted HR for mortality of 0.30 (95% CI 0.26-0.35) after counting vaccination for multi-years.ConclusionsESRD patients with HD receiving the influenza vaccination could have reduced risks of pneumonia/influenza and other morbidities, ICU stay, hospitalization and death, particularly for the elderly

Reduction of Ischemic and Oxidative Damage to the Hypothalamus by Hyperbaric Oxygen in Heatstroke Mice

The aims of the present paper were to ascertain whether the heat-induced ischemia and oxidative damage to the hypothalamus and lethality in mice could be ameliorated by hyperbaric oxygen therapy. When normobaric air-treated mice underwent heat treatment, the fractional survival and core temperature at 4 hours after heat stress were found to be 0 of 12 and 34°C ± 0.3°C, respectively. In hyperbaric oxygen-treated mice, when exposed to the same treatment, both fractional survival and core temperature values were significantly increased to new values of 12/12 and 37.3°C ± 0.3°C, respectively. Compared to normobaric air-treated heatstroke mice, hyperbaric oxygen-treated mice displayed lower hypothalamic values of cellular ischemia and damage markers, prooxidant enzymes, proinflammatory cytokines, inducible nitric oxide synthase-dependent nitric oxide, and neuronal damage score. The data indicate that hyperbaric oxygen may improve outcomes of heatstroke by normalization of hypothalamic and thermoregulatory function in mice

Evaluation on the Pharmacological Effect of Traditional Chinese Medicine SiJunZiTang on Stress-Induced Peptic Ulcers

Purpose. To explore the effects of SiJunZiTang (SJZT) on central neurotransmitters and the inhibition of HCl hypersecretion, along with the role of the vagus nerve. From this, the effects of SJZT and its constituent ingredients on inhibiting stress-induced peptic ulcers will be determined. Methods. Methods used to determine SJZT's effectiveness included (1) measuring the antipeptic ulcer effects of varying combinations of the constituents of SJZT; (2) evaluations of monoamine (MA) level in the brain; and (3) measuring the effects of longer-term SJZT treatment. Results. Comparing the control and experimental groups where the rats’ vagus nerves were not cut after taking SJZT orally (500 mg/kg and 1000 mg/kg), the volume of enterogastric juice, free HCl and total acidity all reduce dose-dependently. The group administered SJZT at 1000 mg/kg showed significant reductions (P<0.05). For the experimental groups where the vagus nerves were cut, a comparison with the control group suggests that the group receiving SJZT (500 mg/kg) orally for 21 days demonstrated a cure rate of 34.53%. Conclusion. The results display a correlation between the therapeutic effects of SJZT on stress-induced peptic ulcers and central neurotransmitter levels. Further to this, SJZT can inhibit the hypersecretion of HCl in the stomach, thus inhibiting stress-induced peptic ulcers

Adrenal computed tomography and NP-59 usefulness for diagnosing aldosterone-producing adenomas and idiopathic hyperaldosteronism in primary hyperaldosteronism

AbstractObjectivesTwo major causes of primary aldosteronism are aldosterone-producing adenomas (APA) and idiopathic hyperaldosteronism (IHA). In this study, we attempted to determine the role of NP-59 in identifying APA prior to adrenalectomy, especially when diagnostic computer tomography (CT) is equivocal.MethodsWe performed a retrospective analysis in patients with a clinical diagnosis of primary aldosteronism. The medical records of 36 patients were reviewed, which included 25 patients who had received adrenalectomy. All patients underwent adrenal CT alone or a combination of adrenal CT and NP-59 prior to surgery for the subtyping of primary aldosteronism, based on the protocols established in our institution. The accuracy of the adrenal CT and NP-59 findings was determined by a comparison with the pathologic findings and postoperative outcomes.ResultsTwenty-three patients received unilateral adrenalectomy under the diagnosis of APA. The diagnoses were based on CT findings in 11 patients and on CT and NP-59 findings in 12 patients. The results of pathology were adrenal cortical adenoma in these 23 patients and the positive predictive value was 100%. Blood pressure and potassium levels significantly improved after surgery in these patients (p < 0.01). Serum biochemistry and adrenal size of the limbs and bodies of patients with IHA were not significantly different from those of patients with APA.ConclusionFor the subtyping of primary aldosteronism, the imaging modality of adrenal CT alone or the combination of adrenal CT and NP-59 adrenal scan has a high positive predictive value for APAs. We suggest that all patients undergo an adrenal CT as their initial study, after confirming the diagnosis of primary aldosteronism, and to use NP-59 when adrenal CT findings are atypical or inconclusive. Lateralization by this modality prior to adrenalectomy can reduce unnecessarily invasive examinations such as adrenal venous sampling and also provide excellent treatment outcomes