BACKGROUND AND PURPOSE: This study investigated the contribution of white-matter hyperintensities (WMH) and lacunar infarcts (LI) to the risk of Alzheimer's disease (AD) in an elderly cohort in China. METHODS: Older adults who were initially cognitively normal were examined with MRI at baseline, and followed for 5 years. WMH were classified as mild, moderate, or severe, and LI were classified into a few LI (1 to 3) or many LI (≥4). Cognitive function was assessed using the Mini Mental State Examination and the Activities of Daily Living scale. RESULTS: Among the 2,626 subjects, 357 developed AD by the end of the 5-year follow-up period. After adjusting for age and other potential confounders, having only WMH, having only LI, and having both WMH and LI were associated with an increased risk of developing AD compared with having neither WMH nor LI. Moderate and severe WMH were associated with an increased risk of developing AD compared with no WMH. Furthermore, patients with many LI had an increased risk of developing AD compared with no LI. CONCLUSIONS: Having moderate or severe WMH and many LI were associated with an increased risk of developing AD, with this being particularly striking when both WMH and LI were present.
Activities of Daily Living ; Adult ; Aged* ; Alzheimer Disease* ; China* ; Cognition ; Cohort Studies ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Strikes, Employee ; Stroke, Lacunar*

BACKGROUND: Retroperitoneal fibrosis (RPF) is a rare disease characterized by fibroinflammatory tissue in the periaortic or periiliac retroperitoneum, where it frequently encases ureters. There is emerging evidence that a subset of this disease is part of a spectrum of multisystemic autoimmune diseases collectively referred to as “immunoglobulin G4 (IgG4)-related disease”. METHODS: We retrospectively analyzed 27 idiopathic RPF patients and identified a subset as IgG4-related RPF, which we categorized according to recently published comprehensive diagnostic criteria. We compared clinical and laboratory characteristics and response to treatment between the two groups. RESULTS: Of 27 total patients, 16 (59.3%) were diagnosed as having IgG4-related RPF, and these were predominantly male. They were also significantly older and more likely to have other organ involvement, hydronephrosis, and postrenal acute kidney injury (AKI) compared to those with idiopathic RPF. However, there was no difference in response rate to systemic steroid treatment. CONCLUSION: IgG4-related RPF accounts for a substantial portion of RPF cases previously identified as “idiopathic RPF” in Korea. Clinical and laboratory characteristics of IgG4-related RPF are similar to those of idiopathic RPF except for a striking male predominance, older age, and higher incidence of postrenal AKI in IgG4-related RPF. More comprehensive, prospective studies are needed to clearly distinguish IgG4-related RPF from idiopathic RPF based on clinical manifestation and to further assess treatment response and long-term prognosis.
Acute Kidney Injury ; Autoimmune Diseases ; Humans ; Hydronephrosis ; Immunoglobulins ; Incidence ; Korea ; Male ; Prognosis ; Prospective Studies ; Rare Diseases ; Retroperitoneal Fibrosis ; Retrospective Studies ; Strikes, Employee ; Ureter

Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficial colorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all been developed and used worldwide. The pocket-creation method facilitates the resection of tumors in difficult and routine locations. Early detection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques. However, the detection of small, flat-shaped, or faded color lesions remains difficult. Linked color imaging, a novel multi-light technology, facilitates the recognition of minor differences in tissue by enhancing the color contrast between early colorectal neoplasms and surrounding normal mucosa in a bright field of view. The most striking feature of linked color imaging is its ability to display the color of early neoplastic lesions as distinct from inflammatory changes, both of which have similar “redness” when viewed using white light imaging. To increase the detection rate of neoplasms, linked color imaging should be used from the outset for endoscopic observation. Early detection of superficial colorectal tumors can result in decreased mortality from colorectal cancer and maintain a good quality of life for patients.
Colonoscopy ; Colorectal Neoplasms ; Endoscopy ; Humans ; Methods ; Mortality ; Mucous Membrane ; Quality of Life ; SNARE Proteins ; Strikes, Employee

OBJECTIVES: The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison–Randall or Millard technique based on (qualitative) parent/subject and professional assessments. MATERIALS AND METHODS: This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison–Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. RESULTS: Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison–Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison–Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. CONCLUSION: Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison–Randall repairs. Both Millard and Tennison–Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.
Cicatrix ; Cleft Lip ; Evaluation Studies as Topic ; Female ; Hospitals, Teaching ; Humans ; Lip ; Male ; Nose ; Prospective Studies ; Strikes, Employee ; Treatment Outcome

No abstract available.
Flail Chest ; Intestinal Diseases ; Strikes, Employee

No abstract available.
Measles ; Strikes, Employee

Takotsubo syndrome, also known as stress-induced cardiomyopathy, is a transient cardiac syndrome that mimics acute coronary syndrome. This condition should be suspected if the patient presents with chest pain after intense emotional stress, accompanied by an abnormal electrocardiogram, elevated levels of myocardial enzymes, and left ventricular apical akinesia on echocardiography. Coronary angiography should be performed for prompt differentiation from ischemic heart disease. A 77-year-old female presented with traumatic multiple fractures of the left sixth and seventh ribs resulting from a violent strike. Clinical findings of physical examination, laboratory tests, electrocardiogram, and coronary angiography provided the diagnosis of Takotsubo syndrome. We performed conservative management including pain control, and the patient was uneventfully discharged seven days after admission.
Acute Coronary Syndrome ; Aged ; Cardiomyopathies ; Chest Pain ; Coronary Angiography ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Fractures, Multiple ; Humans ; Myocardial Ischemia ; Physical Examination ; Rib Fractures* ; Ribs* ; Stress, Psychological ; Strikes, Employee ; Takotsubo Cardiomyopathy*

Appropriate hoof preparation and symmetry are linked to the well-being of the horse. Previous studies have shown the efficacy of pressure plates (PPs) in delivering objective biomechanical analysis. We aimed to assess the effect of hoof trimming on hoof biomechanics using a PP. Nine clinically sound Arabian horses were walked across a PP while foot strike was recorded by a digital camera. Kinetic and kinematic parameters were recorded before and after trimming. Changes were considered significant when p < 0.05. Vertical force (p = 0.026) and contact pressure (p = 0.006) increased after trimming. Stance-phase duration (p = 0.006), swing-phase duration (p = 0.023), and gait-cycle duration (p = 0.007) decreased significantly post-trimming. The observed changes in kinetic and kinematic parameters were related to hoof trimming. The reported results underline the importance of farriery practice and its effect on hoof biomechanics, which should be considered by both farriers and veterinarians.
Animals ; Biomechanical Phenomena ; Foot ; Hoof and Claw ; Horses ; Humans ; Kinetics ; Strikes, Employee ; Veterinarians

STUDY DESIGN: Comparative cross-sectional study. PURPOSE: We measured the vertical ground reaction force (vGRF) of the hip, knee, and ankle joints during normal gait in normal patients, adolescent idiopathic scoliosis (AIS) patients with a Cobb angle < 40° and in AIS patients with spinal fusion. We aimed to investigate whether vGRF in the aforementioned joints is altered in these three groups of patients. OVERVIEW OF LITERATURE: vGRF of the lower limb joints may be altered in these groups of patients. Although it is known that excessive force in the joints may induce early arthritis, there is limited relevant information in the literatures. METHODS: We measured vGRF of the hip, knee, and ankle joints during heel strike, early stance, mid stance, and toe-off phases in normal subjects (group 1, n=14), AIS patients with Cobb angle < 40° (group 2, n=14), and AIS patients with spinal fusion (group 3, n=13) using a gait analysis platform. Fifteen auto-reflective tracking markers were attached to standard anatomical landmarks in both the lower limbs. The captured motion images were used to define the orientations of the body segments and force exerted on the force plate using computer software. Statistical analysis was performed using independent t-test and analysis of variance to examine differences between the right and left sides as well as those among the different subject groups. RESULTS: The measurements during the four gait phases in all the groups did not show any significant difference (p>0.05). In addition, no significant difference was found in the vGRF measurements of all the joints among the three groups (p>0.05). CONCLUSIONS: A Cobb angle < 40° and spinal fusion did not significantly create imbalance or alter vGRF of the lower limb joints in AIS patients.
Adolescent ; Ankle Joint ; Ankle ; Arthritis ; Cross-Sectional Studies ; Gait ; Heel ; Hip ; Humans ; Joints ; Knee ; Lower Extremity ; Scoliosis ; Spinal Fusion ; Strikes, Employee

OBJECTIVES: Menopause is a transitional time in a woman's life leading to both physical and emotional challenges which affects the quality of life (QOL). Average age of menopause is around 48 years but it strikes Indian women at the age of 40 to 45 years. So, menopausal health demands higher priority in Indian as well as global scenario. The present study was conducted to compare the QOL of postmenopausal women residing in urban and rural communities. METHODS: The study adopted quantitative research approach with comparative survey design. The samples were 100 postmenopausal women from rural urban communities selected using non probability purposive sampling technique. Data was collected by interview using demographic performa and menopause specific QOL. RESULTS: The mean QOL score (X2 = 27.24) of rural women was higher than the mean QOL score (X1 = 26.34) of urban women. The calculated independent ‘t’ value (t = 0.86; P < 0.05) is lesser than the table value (t 98 = 1.980). There was association between QOL of urban postmenopausal women and monthly income of the family (χ2 = 4.023) was statistically significant at 0.05 levels. CONCLUSIONS: There was no significant difference in the QOL of postmenopausal women in rural and urban areas. Indian women are ignorant about the changes taking place in their reproductive system. Religion and culture of our society also inhibits to express these changes. Health care professionals have a great role in addressing these issues to prepare women to face the challenges of reproductive health.
Delivery of Health Care ; Female ; Humans ; Menopause ; Quality of Life ; Reproductive Health ; Rural Population ; Strikes, Employee