Surgical Treatment for Unexplained Severe Pain of the Thyroid Gland: Report of Three Cases and Concise Review of the Literature

Painful thyroid has a limited differential diagnosis. In rare cases, no clear cause can be found after careful clinical, biochemical, and radiological analysis. This may lead to extensive patient morbidity and frustration when symptomatic treatment proves insufficient. Hemithyroidectomy or total thyroidectomy may then be the last resort for doctor and patient. Three cases of unexplained painful thyroid which were successfully treated with hemi or total thyroidectomy are presented. In two cases extensive histological evaluation did not yield a satisfactory explanation for the extreme thyroid pain. In one case histological evaluation of the thyroid revealed Hashimoto's thyroiditis. Review of the literature does not mention surgical treatment for unexplained painful thyroid, and only 15 cases of surgical treatment for painful Hashimoto's thyroiditis are presented. Surgical therapy is a successful final option in the treatment of unexplained painful thyroid and painful Hashimoto's thyroiditis

From Bibliophile to Sesquipedalian: Modeling the Role of Reading Experience in Vocabulary and Reading Comprehension

Purpose We investigated the roles of leisure reading and word reading ability in vocabulary and reading comprehension development in 598 adolescents at ages 10, 11, and 12 (285 girls, 313 boys). Method Structural equation modeling was used to test whether word reading was associated with vocabulary and reading comprehension: a) directly; b) indirectly via leisure reading; or c) both. Results We found both direct and indirect effects of word reading on vocabulary: word reading ability directly predicted outcomes, and also predicted the amount of leisure reading, which in turn predicted vocabulary. For reading comprehension we observed direct but not indirect effects of word reading. As expected, vocabulary and reading comprehension outcomes were strongly correlated. Conclusion Our findings demonstrate the direct effect of word reading ability in predicting vocabulary and reading comprehension, and reveal a crucial mediating role of leisure reading in the development of vocabulary

Tracking vocabulary and reading growth in children from lower and higher socioeconomic backgrounds during the transition from primary to secondary education

We examined the relation between socioeconomic status (SES), vocabulary, and reading in middle childhood, during the transition from primary (elementary) to secondary (high) school. Children (N = 279, 163 girls) completed assessments of everyday and curriculum‐related vocabulary, (non)word reading, and reading comprehension at five timepoints from age 10 to 13. Piecewise linear mixed‐effects models showed significant growth in everyday vocabulary and word reading between every time point. Curriculum vocabulary and reading comprehension showed significant growth during the school year, but not during the summer holidays. There were significant effects of SES on all measures except word reading; yet, SES differences did not widen over time. Our findings motivate targeted reading and vocabulary support for secondary school students from lower SES backgrounds

Design and implementation of a twin-family database for behavior genetics and genomics studies.

In this article we describe the design and implementation of a database for extended twin families. The database does not focus on probands or on index twins, as this approach becomes problematic when larger multigenerational families are included, when more than one set of multiples is present within a family, or when families turn out to be part of a larger pedigree. Instead, we present an alternative approach that uses a highly flexible notion of persons and relations. The relations among the subjects in the database have a one-to-many structure, are user-definable and extendible and support arbitrarily complicated pedigrees. Some additional characteristics of the database are highlighted, such as the storage of historical data, predefined expressions for advanced queries, output facilities for individuals and relations among individuals and an easy-to-use multi-step wizard for contacting participants. This solution presents a flexible approach to accommodate pedigrees of arbitrary size, multiple biological and nonbiological relationships among participants and dynamic changes in these relations that occur over time, which can be implemented for any type of multigenerational family study

A Lightweight Architecture for Real-Time Neuronal-Spike Classification

Electrophysiological recordings of neural activity in a mouse's brain are very popular among neuroscientists for understanding brain function. One particular area of interest is acquiring recordings from the Purkinje cells in the cerebellum in order to understand brain injuries and the loss of motor functions. However, current setups for such experiments do not allow the mouse to move freely and, thus, do not capture its natural behaviour since they have a wired connection between the animal's head stage and an acquisition device. In this work, we propose a lightweight neuronal-spike detection and classification architecture that leverages on the unique characteristics of the Purkinje cells to discard unneeded information from the sparse neural data in real time. This allows the (condensed) data to be easily stored on a removable storage device on the head stage, alleviating the need for wires. Synthesis results reveal a >95% overall classification accuracy while still resulting in a small-form-factor design, which allows for the free movement of mice during experiments. Moreover, the power-efficient nature of the design and the usage of STT-RAM (Spin Transfer Torque Magnetic Random Access Memory) as the removable storage allows the head stage to easily operate on a tiny battery for up to approximately 4 days

Lixiviação de metolachlor e diuron em coluna de latossolo amarelo, em condições de laboratório.

Coinfection with HIV adversely impacts every stage of hepatitis C (HCV) infection. Liver damage in HCV infection results from host antiviral responses rather than direct viral pathogenesis. Despite depressed cellular immunity, coinfected patients show accelerated hepatic fibrosis compared with HCV monoinfected patients. This paradox is poorly understood. T-regulatory (Treg) cells (CD4+ and FOXP3+) are hypothesized to limit hepatic damage in HCV. Our hypothesis was that reduced frequency of hepatic Treg in HIV/HCV coinfection compared with HCV monoinfection may explain poorer outcomes. We quantified FOXP3+, CD4+, CD8+ and CD20+ cells in liver biopsies of 35 male subjects matched by age and ISHAK fibrosis score, 12 HIV monoinfected, 11 HCV monoinfected and 12 HIV/HCV coinfected. Cell counts were performed using indirect immunohistochemical staining and light microscopy. HIV/HCV coinfected subjects had fewer hepatic FOXP3+ (P = 0.031) and CD4+ cells (P = 0.001) than HCV monoinfected subjects. Coinfected subjects had more hepatic CD8+ cells compared with HCV monoinfected (P = 0.023), and a lower ratio of FOXP3+ to CD8+ cells (0.08 vs 0.27, P < 0.001). Multivariate analysis showed number of CD4+ cells controlled for differences in number of FOXP3+ cells. Fewer hepatic FOXP3+ and CD4+ cells in HIV/HCV coinfection compared with HCV monoinfection suggests lower Treg activity, driven by an overall loss of CD4+ cells. Higher number of CD8+ cells in HIV/HCV coinfection suggests higher cytotoxic activity. This may explain poorer outcomes in HIV/HCV coinfected patients and suggests a potential mechanism by which highly active antiretroviral therapy may benefit these patients

Evaluating the Clinical Impact and Feasibility of Therapeutic Drug Monitoring of Pazopanib in a Real-World Soft-Tissue Sarcoma Cohort

Introduction and Objective:Pazopanib is registered for metastatic renal cell carcinoma and soft-tissue sarcoma (STS). Its variable pharmacokinetic (PK) characteristics and narrow therapeutic range provide a strong rationale for therapeutic drug monitoring (TDM). Prior studies have defined target levels of drug exposure (≥ 20.5 mg/L) linked to prolonged progression-free survival (PFS), but the added value of using TDM remains unclear. This study investigates the effect of TDM of pazopanib in patients with STS on survival outcomes and dose-limiting toxicities (DLTs) and evaluates the feasibility of TDM-guided dosing. Methods: A TDM-guided cohort was compared to a non-TDM-guided cohort for PFS, overall survival (OS) and DLTs. PK samples were available from all patients, though not acted upon in the non-TDM-guided cohort. We evaluated the feasibility of TDM by comparing the proportion of underdosed patients in our TDM cohort with data from previous publications.Results: A total of 122 STS patients were included in the TDM-guided cohort (n = 95) and non-TDM-guided cohort (n = 27). The average exposure in the overall population was 30.5 mg/L and was similar in both groups. Median PFS and OS did not differ between the TDM-guided cohort and non-TDM-guided cohort (respectively 5.5 vs 4.4 months, p = 0.3, and 12.6 vs 10.1 months, p = 0.8). Slightly more patients in the non-TDM-guided cohort experienced DLTs (54%) compared to the TDM-guided cohort (44%). The proportion of underdosed patients (13.3%) was halved compared to historical data (26.7%). Conclusion: TDM reduced the proportion of patients with subtherapeutic exposure levels by ~ 50%. Nonetheless, the added value of TDM for achieving target trough levels of ≥ 20.5 mg/L for pazopanib on survival outcomes could not be confirmed in STS patients.</p

High prevalence of ACE DD genotype among north Indian end stage renal disease patients

BACKGROUND: The Renin-Angiotensin system (RAS) is a key regulator of both blood pressure and kidney functions and their interaction. In such a situation, genetic variability in the genes of different components of RAS is likely to contribute for its heterogeneous association in the renal disease patients. Angiotensin converting enzyme-1 (ACE-1) is an important component of RAS which determines the vasoactive peptide Angiotensin-II. METHODS: In the present study, we have investigated 127 ESRD patients and 150 normal healthy controls from north India to deduce the association between ACE gene polymorphism and ESRD. The inclusion criteria for patients included a constantly elevated serum creatinine level above normal range (ranging from 3.4 to 15.8) and further the patients were recommended for renal transplantation. A total of 150 normal healthy controls were also genotyped for ACE I/D polymorphism. The criterion of defining control sample as normal was totally based on the absence of any kidney disease determined from the serum creatinin level. Genotyping of ACE I/D were assayed by polymerase chain reaction (PCR) based DNA amplification using specific flanking primers Based on the method described elsewhere. RESULTS: The difference of DD and II genotypes was found highly significant among the two groups (p = 0.025; OR = 3.524; 95%CI = 1.54-8.07). The combined genotype DD v/s ID+II comparison validated that DD genotype is a high risk genotype for ESRD (p = 0.001; OR = 5.74; 95%CI limit = 3.4-8.5). However, no correlation was obtained for different biochemical parameters of lipid profile and renal function among DD and non DD genotype. Interestingly, ~87% of the DD ESRD patients were found hypertensive in comparison to the 65% patients of non DD genotype CONCLUSION: Based on these observations we conclude that ACE DD genotype implicate a strong possible role in the hypertensive state and in renal damage among north Indians. The study will help in predetermining the timing, type and doses of anti-hypertensive therapy for ESRD patients

Treatment of Helminth Co-Infection in Individuals with HIV-1: A Systematic Review of the Literature

Many people living in areas of the world most affected by the HIV/AIDS pandemic are also exposed to other common infections. Parasitic infections with helminths (intestinal worms) are common in Africa and affect over half of the population in some areas. There are plausible biological reasons why treating helminth infections in people with HIV may slow down the progression of HIV to AIDS. Thus, treating people with HIV for helminths in areas with a high prevalence of both HIV and helminth infections may be a feasible strategy to help people with HIV delay progression of their disease or initiation of antiretroviral therapy. After a comprehensive review of the available literature, we conclude that there is not enough evidence to determine whether treating helminth infections in people with HIV is beneficial