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Challenging Tracheobronchial Foreign Body
No full textAspirated foreign bodies present challenges to otolaryngologists. The major issues involve the accurate diagnosis and safe retrieval of the foreign body. The accurate diagnosis might be difficult because the initial choking incidents are not witnessed and the symptoms may mimic other common conditions. The author wishes to share our experience of managing an interesting case of 2.5 year-old-girl who did not have any history of chocking at all and had persistent cough and fever for one month. She has been treated as chest infection with no improvement for three weeks. Plain x-ray was done later and a 10 cm nail was detected in the trachea and the right main bronchus. The nail was removed using the rigid bronchoscopy. We discuss the clinical presentation, diagnosis and treatment as well as a review of the literature
Hepatitis B: An Overlooked STI, a Silent Threat, a Global Disease
No full textIn the Western world, exposure to hepatitis B virus (HBV) occurs in adulthood via sexual or percutaneous transmission. One-third develop acute hepatitis, while half undergo a subclinical course. Both groups acquire antibodies. The remaining 5-10% of adults develop chronic HBV, the majority of whom are immunocompromised (HIV, chronic renal dialysis or immunosuppression). In endemic regions, primary infection occurs perinatally. Nearly 90% of neonates become chronic HBV carriers. While neonates are at high risk in endemic regions, sexual exposure remains the most common risk factor in the United States. Populations at risk are those with infected partners, multiple partners, or same-sex male partners. Untreated, 25-40% of chronically infected individuals develop cirrhosis and hepatocellular carcinoma (HCC).Following the discovery of HBV, Blumberg also developed an HBV vaccine using HBV-infected human plasma. Produced during the AIDS epidemic, while highly efficacious, recombinant vaccine replaced plasma because of concern the plasma could be coinfected.The 1980s yielded another triumph in the fight against HBV. Again, as HIV came to the forefront of public and political attention, research began in the field of anti-HIV drugs. The anti-HBV drugs used today, starting in 1998, were actually discovered to be efficacious in trials developed for HIV patients. HIV-patients coinfected with HBV showed regression of HBV while on HIV therapy. Currently, these therapies delay disease progression and reduce the incidence of HCC. Now armed with both preventative and therapeutic measures for HBV, coupled with increased awareness and education, the eradication of HBV as we move into the 21st century seems within grasp
Editorial
No full textThe inaugural issue of the Journal of Advanced Biotechnology and Bioengineering (JABB)
Beneficial Effects of Exercise Training in Patients with Chronic Heart Failure
No full textSeveral human and experimental studies have been performed to show the effects of exercise training on chronic heart failure (CHF). These studies have shown that exercise improves the adverse pathophysiologic changes which occur with CHF, including enhanced exercise capacity, ventilation, skeletal muscle metabolism, cardiac function, quality of life, and peripheral blood flow. In addition, there is an improved modulation of inflammatory, autonomic, and hormonal dysregulation after exercise training. This review focuses on the current evidence surrounding the beneficial effects of exercise training in CHF patients
Auditory Neuropathy Findings Following Microvascular Decompression Surgery for Trigeminal Nerve Neuralgia: A Case Report
No full textMicrovascular decompression is an established surgical remedy in people suffering from trigeminal neuralgia. Hearing loss secondary to decompression surgeries have been reported in the literature but auditory neuropathy type was rare. Here we present an unusual report of a 35 year old female patient who manifested auditory neuropathy type hearing loss following microvascular decompression for trigeminal neuralgia in the right side. Pure tone audiometry revealed a low frequency hearing loss that returned to normal. Brainstem auditory evoked responses and acoustic reflexes were absent and otoacoustic emissions were present. This case study highlights that auditory neuropathy can also be one of the possible auditory morbidities due to microvascular decompression surgery and emphasizes the importance of intra-operative auditory brainstem monitoring
Diabetes Mellitus and Cancer
No full textDiabetes and cancer are frequent diseases with important impact on human health all the world. Last epidemiologic studies suggests that patients with diabetes are at significantly higher risk for many forms of cancer. Type 2 diabetes and cancer share many risk factors. Increased insulin-like growth factor I (IGF-I) and reactive oxygen species can rol play in carcinogenesis. The systemic chronical inflammation which can result in a protumorigenic conditions. Hyperinsulinemia increases the risk of cancer in healthy people and it can partly explain obesity-cancer risk. The other point of view very important and difficult issue the medical treatment and dietary of diabetic patients with cancer
An Unexpected Epidemic: Schistosomiasis and Strongyloides Infections Detected in an Academic Urban Community GI Practice. A Case Series of 104 patients
No full textA gastroenterologist’s practice in a Boston metropolitan academic community hospital was reviewed for all cases of parasitic disease seen in that practice as part of routine GI referral patterns from October 10, 2009 to September 9, 2013. The practice did not specialize in the treatment of parasitic diseases. 104 patients were identified and evaluated for their methods of diagnosis, treatment, laboratory values and types of parasites. Serological results for all testing done by health care providers at the Cambridge Health Alliance (CHA) for Strongyloides stercoralis and Schistosomiasis (all species) were then reviewed for two one year periods. The study patients had parasitic infections that reflected the infestations endemic in their countries of origin. Language was used as a surrogate for the patient’s country of origin. The methods used for the diagnosis of parasitic infections included serologic studies (98/104: 94.2%), pathological examination of biopsy specimens with serology (19/104: 18.3%), pathological examination alone (6/104: 5.8%) and fecal ova and parasite testing (O&P) (2/104: 1.9%). 93/104 (89.4%) of the patients had a positive serology for Schistosomiasis, Strongyloides or both. None of the Schistosomiasis or Strongyloides patients were detected or confirmed with O&P studies (0/103: 0.0%). Several neoplastic lesions of the gut were noted (16/104: 15.4%), of which 3 (3/104: 2.9%) were adenocarcinomas of the colon. Tissue biopsy is a specific test. Schistosomiasis and Strongyloides serology are sensitive tests. Given the short time needed to treat these infections, and the relatively safe side effect profile for these therapies, the use of antibody and pathological testing with treatment of positive results seems to be a reasonable approach. Evaluation for parasites in asymptomatic, newly arrived immigrants and individuals with a distant history of immigration or travel to areas at risk (especially patients with eosinophilia) should be done as part of their routine health care. Transplant donors originally from endemic areas should have serological examination for Strongyloides stercoralis and Schistosoma species prior to organ transplant or fecal microbiota transplantation (FMT). All patients at risk for these infections should be diagnosed and treated prior to immunosuppressive therapy. This is especially true for patients with Strongyloides, given the unacceptable high mortality rate of hyperinfection syndrome. Such a strategy may prevent the consequences of chronic parasitic infestations and limit a potential public health hazard
Direct Peroral Cholangioscopy using a Small-Caliber Gastroscope: A Case Series
No full textCholangioscopy is a valuable tool that permits direct endoscopic visualization of the bile ducts contributing to precise diagnosis and facilitating therapeutic interventions. This series demonstrates our current experience with direct peroral cholangioscopy by means of an ultraslim gastroscope. We also discuss feasibility as well as, advantages and limitations of this promising technique
Effects of Motor Cortical Stimulation during Planar Reaching Movement
No full textBackground: The purpose was to examine the effects of single pulse transcranial magnetic stimulation (TMS) over primary motor cortex delivered at different times during a center-out reaching task in a robot reaching environment. Methods: Eleven right-handed subjects participated. Movement hotspots and thresholds were determined for each subject, and the stimulation intensity was set at 120% of the movement threshold. TMS was delivered at rest and when subjects performed a series of reaching tasks. The 5 different conditions were: no stimulation, sham stimulation, and stimulation at 150, 500, or 1000 ms post go cue. Outcome measures included TMS-evoked movement during rest and in the 150ms condition, trajectory deviations (no stimulation, sham, and 150ms conditions), and peak velocity (PV), path length, reaction time, acceleration time, and deceleration time for all conditions. Results: When TMS was applied at 150 ms, the evoked path lengths were significantly shorter than at rest and had less deviation than the no-stimulation condition (p < 0.05). Peak velocities were lowest during the no-stimulation condition and highest during the 500ms condition (p < 0.05). Path lengths were significantly shorter during the no-stimulation, sham, and 150ms condition compared to the 500ms and 1000ms conditions. Conclusions: TMS applied during the reaction time phase suppressed movements evoked by TMS, decreased trajectory deviations, and shortened path length, while TMS delivered after movement onset increased PV and path length. TMS stimulation may be delivered to enhance movement parameters and potentially facilitate reach training in the robotic rehabilitation environment