Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence

Background: adhesive capsulitis (AC) results in progressive painful restriction in range of movement and can reduce function and quality of life. Whilst it has been associated with diabetes mellitus (DM), there is considerable variation in the reported prevalence of AC in the diabetic population. The aim of this study is to determine through meta-analysis the prevalence of AC in DM and examine whether it is influenced by type of DM or insulin therapy. We also aim to further establish the prevalence of DM in patients presenting with AC. Methods: we conducted a literature search for terms regarding AC and DM on Embase and Pubmed NCBI. Results: of 5411 articles identified, 18 were selected. Meta-analysis showed that patients with DM were 5 (95% CI 3.2-7.7) times more likely than controls to have AC. The overall prevalence of AC in DM was estimated at 13.4% (95% CI 10.2- 17.2%). Comparison of prevalence in patients on insulin vs other treatments showed no significant difference between the two. Meta-analysis estimated the prevalence of DM in AC at 30% (95% CI 24-37%). Conclusion: to our knowledge this is the first meta-analysis to estimate the overall prevalence of diabetes in a population with AC. A high prevalence of AC exists in DM and equally a high prevalence of DM is present in AC. Screening for DM should be considered in patients presenting with A

Molecular testing for the clinical diagnosis of fibrolamellar carcinoma.

Fibrolamellar carcinoma has a distinctive morphology and immunophenotype, including cytokeratin 7 and CD68 co-expression. Despite the distinct findings, accurate diagnosis of fibrolamellar carcinoma continues to be a challenge. Recently, fibrolamellar carcinomas were found to harbor a characteristic somatic gene fusion, DNAJB1-PRKACA. A break-apart fluorescence in situ hybridization (FISH) assay was designed to detect this fusion event and to examine its diagnostic performance in a large, multicenter, multinational study. Cases initially classified as fibrolamellar carcinoma based on histological features were reviewed from 124 patients. Upon central review, 104 of the 124 cases were classified histologically as typical of fibrolamellar carcinoma, 12 cases as 'possible fibrolamellar carcinoma' and 8 cases as 'unlikely to be fibrolamellar carcinoma'. PRKACA FISH was positive for rearrangement in 102 of 103 (99%) typical fibrolamellar carcinomas, 9 of 12 'possible fibrolamellar carcinomas' and 0 of 8 cases 'unlikely to be fibrolamellar carcinomas'. Within the morphologically typical group of fibrolamellar carcinomas, two tumors with unusual FISH patterns were also identified. Both cases had the fusion gene DNAJB1-PRKACA, but one also had amplification of the fusion gene and one had heterozygous deletion of the normal PRKACA locus. In addition, 88 conventional hepatocellular carcinomas were evaluated with PRKACA FISH and all were negative. These findings demonstrate that FISH for the PRKACA rearrangement is a clinically useful tool to confirm the diagnosis of fibrolamellar carcinoma, with high sensitivity and specificity. A diagnosis of fibrolamellar carcinoma is more accurate when based on morphology plus confirmatory testing than when based on morphology alone

The application of a real-time rapid-prototyping environment for the behavioral rehabilitation of a lost function in rats

Abstract-In this paper we propose a Rapid Prototyping Environment (RPE) for real-time biosignal analysis including ECG, EEG, ECoG and EMG of humans and animals requiring a very precise time resolution. Based on the previous RPE which was mainly designed for developing Brain Computer Interfaces (BCI), the present solution offers tools for data preprocessing, analysis and visualization even in the case of high sampling rates and furthermore tools for precise cognitive stimulation. One application of the system, the analysis of multi-unit activity measured from the brain of a rat is presented to prove the efficiency of the proposed environment. The experimental setup was used to design and implement a biomimetic, biohybrid model for demonstrating the recovery of a learning function lost with age. Throughout the paper we discuss the components of the setup, the software structure and the online visualization. At the end we present results of a real-time experiment in which the model of the brain learned to react to the acquired signals

The Mayer-Rokitansky-Küster-Hauser syndrome (congenital absence of uterus and vagina) – phenotypic manifestations and genetic approaches

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome affects at least 1 out of 4500 women and has for a long time been considered as a sporadic anomaly. Congenital absence of upper vagina and uterus is the prime feature of the disease which, in addition, is often found associated with unilateral renal agenesis or adysplasia as well as skeletal malformations (MURCS association). The phenotypic manifestations of MRKH overlap various other syndromes or associations and thus require accurate delineation. Since MRKH manifests itself in males, the term GRES syndrome (Genital, Renal, Ear, Skeletal) might be more appropriate when applied to both sexes. The MRKH syndrome, when described in familial aggregates, seems to be transmitted as an autosomal dominant trait with an incomplete degree of penetrance and variable expressivity. This suggests the involvement of either mutations in a major developmental gene or a limited chromosomal deletion. Until recently progress in understanding the genetics of MRKH syndrome has been slow, however, now HOX genes have been shown to play key roles in body patterning and organogenesis, and in particular during genital tract development. Expression and/or function defects of one or several HOX genes may account for this syndrome