Acute esophageal necrosis masquerading acute coronary syndrome

Acute esophageal necrosis (AEN) also known as “black esophagus” or “acute necrotizing esophagus” is a rare entity characterized by striking endoscopic findings of circumferential black coloring of the esophagus. AEN most frequently seen in the distal esophagus and can extend proximally along the entire esophagus. Characteristically, the circumferential black mucosa stops abruptly at the EGJ. AEN tends to present as acute upper gastrointestinal bleeding, though other symptoms including dysphagia and epigastric pain have been described. The etiology of AEN is multifactorial including a combination of ischemic insult, mucosal barrier defect, and a backflow injury of gastric secretions. Described is a case of AEN in a patient with history of uncontrolled diabetes who presented with an atypical chest pain mimicking acute coronary syndrome with negative subsequent cardiovascular workup

L'éducation thérapeutique du patient diabétique au travers de la santé mobile: travail de Bachelor

Au travers du modèle de la promotion de la santé (HPM), Nola Perden identifie le rôle de l'individu dans sa rechercher vers la santé la plus optimale avec l'accompagnement des soins infirmiers. Dans un contexte d'augmentation des maladies chroniques et plus précisément du diabète, la santé mobile représente un outil exploitable et prometteur. Les outils technologiques sont présents dans le quotidien de la majorité de la population et ne cessent d'évoluer. La vision de la santé est remaniée, et dans ce sens, la santé mobile voit le jour. L'éducation thérapeutique représente le noyau de la prise en soins du patient atteint de diabète. Par ce moyen, la santé mobile peut accompagner le patient et l'infirmière tout au long du parcours. Les six articles de cette revue de littérature ont été sélectionnés partir des bases de données Pubmed et Cinahl. Ils sont de langue anglaise et ont été publiés entre 2012 et 2019

SPACK FIREWALL RESTRICTION WITH SECURITY IN CLOUD OVER VIRTUAL ENVIRONMENT

ABSTRACT Security issues in cloud concern

High frequency of BRAF V600E mutations in ameloblastoma

Peer reviewe

An Integrin-Dependent Role of Pouch Endoderm in Hyoid Cartilage Development

Pharyngeal endoderm is essential for and can reprogram development of the head skeleton. Here we investigate the roles of specific endodermal structures in regulating craniofacial development. We have isolated an integrinα5 mutant in zebrafish that has region-specific losses of facial cartilages derived from hyoid neural crest cells. In addition, the cranial muscles that normally attach to the affected cartilage region and their associated nerve are secondarily reduced in integrinα5(−) animals. Earlier in development, integrinα5 mutants also have specific defects in the formation of the first pouch, an outpocketing of the pharyngeal endoderm. By fate mapping, we show that the cartilage regions that are lost in integrinα5 mutants develop from neural crest cells directly adjacent to the first pouch in wild-type animals. Furthermore, we demonstrate that Integrinα5 functions in the endoderm to control pouch formation and cartilage development. Time-lapse recordings suggest that the first pouch promotes region-specific cartilage development by regulating the local compaction and survival of skeletogenic neural crest cells. Thus, our results reveal a hierarchy of tissue interactions, at the top of which is the first endodermal pouch, which locally coordinates the development of multiple tissues in a specific region of the vertebrate face. Lastly, we discuss the implications of a mosaic assembly of the facial skeleton for the evolution of ray-finned fish

Molecular and cellular mechanisms underlying the evolution of form and function in the amniote jaw.

The amniote jaw complex is a remarkable amalgamation of derivatives from distinct embryonic cell lineages. During development, the cells in these lineages experience concerted movements, migrations, and signaling interactions that take them from their initial origins to their final destinations and imbue their derivatives with aspects of form including their axial orientation, anatomical identity, size, and shape. Perturbations along the way can produce defects and disease, but also generate the variation necessary for jaw evolution and adaptation. We focus on molecular and cellular mechanisms that regulate form in the amniote jaw complex, and that enable structural and functional integration. Special emphasis is placed on the role of cranial neural crest mesenchyme (NCM) during the species-specific patterning of bone, cartilage, tendon, muscle, and other jaw tissues. We also address the effects of biomechanical forces during jaw development and discuss ways in which certain molecular and cellular responses add adaptive and evolutionary plasticity to jaw morphology. Overall, we highlight how variation in molecular and cellular programs can promote the phenomenal diversity and functional morphology achieved during amniote jaw evolution or lead to the range of jaw defects and disease that affect the human condition

Expression of Msx-1 is suppressed in bisphosphonate associated osteonecrosis related jaw tissue-etiopathology considerations respecting jaw developmental biology-related unique features

<p>Abstract</p> <p>Background</p> <p>Bone-destructive disease treatments include bisphosphonates and antibodies against the osteoclast differentiator, RANKL (aRANKL); however, osteonecrosis of the jaw (ONJ) is a frequent side-effect. Current models fail to explain the restriction of bisphosphonate (BP)-related and denosumab (anti-RANKL antibody)-related ONJ to jaws. Msx-1 is exclusively expressed in craniofacial structures and pivotal to cranial neural crest (CNC)-derived periodontal tissue remodeling. We hypothesised that Msx-1 expression might be impaired in bisphosphonate-related ONJ. The study aim was to elucidate Msx-1 and RANKL-associated signal transduction (BMP-2/4, RANKL) in ONJ-altered and healthy periodontal tissue.</p> <p>Methods</p> <p>Twenty ONJ and twenty non-BP exposed periodontal samples were processed for RT-PCR and immunohistochemistry. An automated staining-based alkaline phosphatase-anti-alkaline phosphatase method was used to measure the stained cells:total cell-number ratio (labelling index, Bonferroni adjustment). Real-time RT-PCR was performed on ONJ-affected and healthy jaw periodontal samples (n = 20 each) to quantitatively compare Msx-1, BMP-2, RANKL, and GAPDH mRNA levels.</p> <p>Results</p> <p>Semi-quantitative assessment of the ratio of stained cells showed decreased Msx-1 and RANKL and increased BMP-2/4 (all p < 0.05) expression in ONJ-adjacent periodontal tissue. ONJ tissue also exhibited decreased relative gene expression for Msx-1 (p < 0.03) and RANKL (p < 0.03) and increased BMP-2/4 expression (p < 0.02) compared to control.</p> <p>Conclusions</p> <p>These results explain the sclerotic and osteopetrotic changes of periodontal tissue following BP application and substantiate clinical findings of BP-related impaired remodeling specific to periodontal tissue. RANKL suppression substantiated the clinical finding of impaired bone remodelling in BP- and aRANKL-induced ONJ-affected bone structures. Msx-1 suppression in ONJ-adjacent periodontal tissue suggested a bisphosphonate-related impairment in cellular differentiation that occurred exclusively jaw remodelling. Further research on developmental biology-related unique features of jaw bone structures will help to elucidate pathologies restricted to maxillofacial tissue.</p

Employee preferences as a significant influence on reward mix determination

Orientation: The ubiquitous challenging economic climate in South Africa and globally makes it incumbent on South African companies to reconsider their current reward policy and practices if they are to maintain and foster global economic competitiveness. This coupled with the fact that motivation in the workplace has always been a conundrum for managers and human resource practitioners alike. This dilemma becomes an obstacle to organisational effectiveness and hinders competitive advantage when employee morale is low and performance levels decrease. Research purpose: The primary aim of this study was to investigate the influencing factors of employee demographics and motivation type on rewards mix preferences. Motivation for the study: The war for talent is accelerating and the globalization of economies and world markets places pressure on companies to perform well and to maintain optimal performance levels. The workplace in South Africa is not exempt from these pressures and the nature of the workplace is changing every day. Employee engagement dynamics are changing and require deeper insight into what appeals to employees, what motivates them to perform and what will retain good resources. This knowledge would further assist organisations to create reward mix programs that appeal to both extrinsic and intrinsically motivated persons as different motivation types are triggered and stimulated by different types of rewards and adds value by examining the effects of demographical factors (such as age, race/ethnicity and gender) on employees’ perspective of reward mix giving depth to existing insights into what drives whom and at what price. Research design, approach and method: This research followed a quantitative, empirical and descriptive study of reward preferences through the administration of an online questionnaire survey via email. The data was analysed using non-parametric test for variance between dependent and independent variables, factor analysis, ANOVA and MANOVA testing.Dissertation (MBA)--University of Pretoria, 2014.pagibs2015Gordon Institute of Business Science (GIBS)Unrestricte