Aspirin ; therapeutic use ; Bisoprolol ; therapeutic use ; Cardiomyopathies ; chemically induced ; etiology ; Cardiotonic Agents ; adverse effects ; Chest Pain ; diagnostic imaging ; Dobutamine ; adverse effects ; Echocardiography, Stress ; adverse effects ; Enalapril ; therapeutic use ; Humans ; Male ; Middle Aged ; Simvastatin ; therapeutic use

Acute Disease ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; pathology ; Pancreatitis ; diagnosis ; pathology

A middle-aged lady was treated and followed up for recurrent urinary tract infections (UTI) with increasingly resistant organisms without documentation of interval resolution of infection by negative urine cultures. We discuss the events following the diagnosis of her fourth urinary tract infection. Referral for further evaluation of her urinary tract in view of recurrent UTI showed she had a bladder cancer. The investigation and management of recurrent UTI is reviewed. The link between bladder cancer and recurrent urinary tract infection is also explored.

No abstract available.
Cardiovascular Diseases* ; Echocardiography*

BACKGROUND:Adipose-derived mesenchymal stem cells have the ability to self-renew and have pluripotent potential under specific conditions in vitro, which have broad application prospects in clinical practice. However, isolation and culture of adipose-derived mesenchymal stem cells stil appear to have many difficulties and shortcomings. OBJECTIVE:To isolate and culture rabbit adipose-derived mesenchymal stem cells in vitro in order to study their morphology, cellsurface markers and biological properties as wel as to investigate the osteogenic and adipogenic potentials of adipose-derived mesenchymal stem cells in vitro. METHODS:Primary adipose-derived mesenchymal stem cells were isolated from the subcutaneous adipose tissue of posterior cervical region from New Zealand white rabbits and digested by 0.1%col agenase I. The cells were passaged and amplified by the trypsin digestion. The passage 4 adipose-derived mesenchymal stem cells were induced to differentiate after exposure to adipogenic or osteogenic medium. The oil red O staining, alkaline phosphatase and alizarin red staining were used to detect the results. The cellviability was detected by the cellcounting kit 8 method to drawn the growth curve. cellsurface markers were examined using flow cytometry. RESULTS AND CONCLUSION:The adipose-derived mesenchymal stem cells isolated from the subcutaneous adipose tissue of rabbits exhibited a fusiform adherent growth in a vortex pattern, and had a strong capability of proliferation that could be passaged stably to the 10th generation. Flow cytometry results showed that the cells highly expressed CD29, CD90, CD44, but lowly expressed CD45 and CD34. After adipogenic induction, the adipose-derived mesenchymal stem cells were positive for oil red O staining;after osteogenic induction, the cells were both positive for alkaline phosphatase and alizarin red staining. These findings suggest that the adipose-derived mesenchymal stem cells were successful y isolated and cultured from the subcutaneous adipose tissue of rabbits, and these cells are pluripotent with the potential to differentiate into adipocytes and osteoblasts, which are expected to be ideal seed cells for bone tissue engineering.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Emergency Service, Hospital ; Female ; Humans ; Male ; Middle Aged ; Singapore ; Skin Diseases ; diagnosis ; Tertiary Care Centers ; Young Adult

Henoch-Schönlein purpura (HSP) is an acute, systemic immunoglobulin-medicated small-vessel vasculitis. It is the commonest vasculitis of childhood and is typically characterised by a tetrad of abdominal pain, arthritis, palpable purpura, and renal disease. All patients develop palpable purpura, while 84-90% develop arthritis, 57-58% develop abdominal pain, and 20-54% develop renal involvement. Gastrointestinal symptoms can be the first presenting complaint with the absence of initial purpura, leading to a delay in diagnosis.

Antimicrobial resistance (AMR) increases the morbidity, mortality and costs of treating infectious diseases. (Hawkey and Jones, 2009)1. The threat from resistant organisms is now a global problem, both in the hospital and to some extent in the community. The key drivers are: medical care complexity; widespread antimicrobial use in animal husbandry; antimicrobial contaminated food distribution; international travel, and food distribution of food contaminated with multidrug resistant organism. Strategies for infection control are: good understanding of what needs to be done, consistent application of infection control measures, use of “search and destroy” techniques; and effective antimicrobial stewardship. This paper reviews the current issues and potential solutions.

Background: There is lack of normality data in the literature on the plantar response. Objective: To determine the variability of plantar response in normal population and factors that might contribute to the variability. Methods: We conducted a study of plantar response in healthy subjects aged 19-21 in two phases. First phase was plantar examination with hard strike. Subjects with big toe extension in the fi rst phase were re-examined with light and hard strike in the second phase. Results: 100 subjects recruited in fi rst phase, 19 subjects in second phase. Out of 600 attempts (3 attempts for each foot) with hard strike, responses of the big toe were fl exion (48.3%), extension (11.3%), no movement (39.8%); other toes were fl exion (55.0%), extension (13.0%), no movement (32.0%); ankle was dorsifl exion (30.8%), no movement (59.3%); knee were fl exion (15.7%), no movement (84.3%); hip were fl exion (15.2%), no movement (84.8%). Of those with big toe extension, signifi cantly less had persistent big toe extension with light strike. More (41%) among those with extensor big toe has withdrawal response (with fl exion of the hip and knee) as compared to those with fl exor big toe (18.5%, p<0.05). Interfoot asymmetry was seen in 27% (kappa 0.54). Plantar responses of sequential strikes were mostly consistent, with only 3.5% inter-attempt variability. Conclusion: Plantar response with extensor great toe is seen in about 10% of normal adults, less with lighter strike. Withdrawal response can be a partial explanation to the big toe extensor response in normal adults.

Cold-stimulus headache is a primary headache syndrome which is provoked by an external application or ingestion or inhalation of cold stimulus. It has not been reported to occur secondary to another focal structural brain lesion, or as a reversible illness. This is a report of two women who developed cold-stimulus headache on taking ice cold food after the onset of thalamic hemorrhage. The headache was typical of cold-stimulus headache except a relatively long duration of pain lasting half an hour. There was spontaneous remission after a few months. Our patients suggest that cold-stimulus headache can be secondary to thalamic hemorrhage..