North American Journal of Medicine and Science
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The Effects of Coffee Consumption on the Risk of Heart Failure
Get PDFHeart Failure (HF) has become a major public health problem in both developed and developing countries of the world. Although medical and surgical management has been improved, morbidity and mortality after onset of HF remain substantial; consequently, increasing attention has been drawn to preventing HF by management of lifestyle factors of HF. Coffee consumption is one of the lifestyle factors which has been linked to HF risk. Five prospective studies investigated the association between coffee consumption and the HF risk. However, the results of these studies were inconsistent. The authors conducted a review on the association between coffee consumption and HF risk in order to explore the possible reasons for the discordance and provide future research direction on this topic.
Morphological and Immunohistochemical Features of Angiomyofibroblastoma: A Case Report with Review of the Literature
Get PDFAngiomyofibroblastoma is a rare tumor seen predominantly in women of childbearing age. Here we report a case of angiomyofibroblastoma with unusual immunohistochemical features in a 62-year-old woman. The patient presented with a 9.5 cm mass in her left labium for one year. Microscopic examination of surgically resected specimen showed a well-circumscribed mass with alternating paucicellular and hypercellular areas in the background of an edematous and collagenous stroma with vascular proliferation. Tumor cells showed high nuclear/cytoplasmic ratio, oval nuclei with finely granular chromatin, inconspicuous nucleoli and a few mitoses (3/per 10 High Power Fields). Immunohistochemically, these cells were positive for vimentin, estrogen receptors and progesterone receptors, and negative for CD34, S-100, HMB45, BerEp4, cytokeratins, synaptophysin and E-cadherin. The above immunohistochemical findings helped us to rule out melanoma, adenocarcinoma, neuroendocrine tumors and metastases from the breast origin. Considering the overall morphological features of the tumor, it was diagnostic of angiomyofibroblastoma. Although a literature review shows that angiomyofibroblastomas are generally diffusely positive for desmin and focally positive for α-smooth muscle actin (SMA) with only very rare exceptions, desmin and SMA immunostains were negative in our case. We like to emphasize that it is important to be aware of the potential variations in the immunophenotypes of angiomyofibroblastomas in order to make a correct diagnosis
Do Apparent Overlaps between Schizophrenia and Autistic Spectrum Disorders Reflect Superficial Similarities or Etiological Commonalities?
Get PDFStudy Background: Schizophrenia and autism are both neurodevelopmental disorders that were once considered to be the same disorder expressed in different developmental periods. Although they were separated diagnostically about 40 years ago, they share several clinical and possibly, etiological features. This paper reviews overlaps in four domains of function to consider the issue of whether these similarities are sporadic and likely to represent superficial similarities, or whether the disorders are more likely to share some features in common.Methods: Representative areas of function were reviewed and compared for aspects of cognition (nonverbal reasoning, memory and language), social function (orienting / joint attention, eye contact and theory of mind), brain function (structural differences) and genetics. To facilitate comparisons with schizophrenia, a focus on high functioning autism / Asperger’s disorder was utilized, particularly in the sections on cognition and social function.Results: Significant similarities (and differences) characterized comparisons in each domain. Conclusions: Disturbed function in similar clinical (in cognition and social function), neurobiological (brain volumes) and genetic (e.g., involvement of the same genes or chromosomal locations) domains in autism and schizophrenia supports the hypothesis that while they are distinct disorders, they are not entirely unique. Additional studies of similarities and differences between them may thus shed light on common etiological mechanisms and hopefully, facilitate the development of novel treatment targets
Review of the Multi-Level Factors Contributing to Fruit and Vegetable Consumption in the US
Get PDFThe consumption of fruits and vegetables (F&V) has a significant protective effect in reducing various cardiometabolic diseases. In recent years, the U.S. government has made a lot of effort to promote F&V consumption through different projects and programs, including the MyPyramid food guidance system supported by the USDA’s Center for Nutrition Policy and Promotion, and the Fruits & Veggies More Matters program (previously called the 5-A-Day for Better Health program), supported by the Centers for Disease Control and Prevention (CDC) and other public and private agencies. However, modest success has been achieved in promoting healthy diets among the American public. Only 40% of Americans eat five or more servings of F&V daily. Using a higher-level F&V consumption standard, less than 10% of American adults meet the MyPyramid recommendations. In order to understand the factors affecting F&V consumption and to summarize the factors from different perspectives into a coherent framework, we look at previous research regarding these various factors and their relationship to F&V consumption. The factors coalesce in three main levels: individual factors, household factors and environmental factors. Individual factors include demographics, dietary habits, lifestyle, health status and sensory appeal; household factors are marital status, number of family members, number of children in the family and parenting practices; and environmental factors consist of food prices, food accessibility and availability, social interaction and seasonal factors. All of these factors may positively or negatively affect F&V consumption among different population groups. Our study will help future researchers and policy makers to gain a more comprehensive understanding of this complex issue and develop more effect ideas for addressing it.
Malignant Struma Ovarii Presenting as a Vaginal Mass
Get PDF Malignant struma ovarii encompasses a spectrum of conditions ranging from struma ovarii with microscopic, clinically unimportant papillary carcinoma to cases of struma ovarii with papillary or follicular carcinoma that have metastasized. Recently it has been proposed that highly differentiated follicular carcinoma arising in struma ovarii may resemble non-neoplastic thyroid tissue both in the ovary and at sites of dissemination and metastasis. We report a unique case of a struma ovarii with non-neoplastic appearing thyroid tissue which presented 6 years later as a vaginal metastasis of a typical thyroid-type follicular carcinoma. The present case adds to the spectrum of rare primaries metastasizing to the vagina.
Retinal Microvascular Abnormalities and Cognitive Impairment: Epidemiological Findings
Get PDFRetinal microvascular abnormalities have been associated with age-related systemic processes, such as atherosclerosis, chronic inflammation, endothelial dysfunction, and other conditions. Current epidemiological studies suggested that retinal microvascular abnormalities may be associated with cognitive decline and thereby may provide a target for early detection and prevention of dementia. However, most of previous studies have been cross-sectional and provided only suggestive evidence. Future prospective studies with assessment of cognitive function on specific domains are required to further evaluate the role of retinal microvascular signs in predicting the development of aging-related cognitive decline and dementia
Assessing and Managing Risk for Cardiovascular Disease: A Worldwide Perspective
Get PDFCardiovascular disease (CVD) has become increasingly recognized as a major cause of disability, premature death, and escalating health-care costs throughout the world. The purpose of the present report is to review the most widely used worldwide tools for assessment of the total (absolute, global, integrated) risk of developing CVD during the next 5 or 10 years and to review guidelines for the clinical management of dyslipidemia, hypertension, and dysglycemia that incorporate these tools. The World Health Organization (WHO) / International Society of Hypertension (ISH) risk charts, The Framingham system, Systematic Coronary Risk Evaluation (SCORE) charts, and the PROCAM (PROspective Cardiovascular Munster) Quick Check and Health Check systems are described. Since the use of clinical guidelines based on these tools has some limitations and challenges, alternative or modified approaches for the management of CVD risk factors have been proposed by several researchers recently. Future studies are needed to evaluate the effectiveness of these proposed strategie
Genomic Instability Induced By Human Papillomavirus Oncogenes
Get PDFCervical cancer is one of the leading causes of cancer death in women worldwide. Human papillomavirus (HPV) infection is necessary but not sufficient for the development of cervical cancer. Genomic instability caused by HPV allows cells to acquire additional mutations required for malignant transformation. Genomic instability in the form of polyploidy has been implicated in a causal role in cervical carcinogenesis. Polyploidy not only occurs as an early event during cervical carcinogenesis but also predisposes cervical cells to aneuploidy, an important hallmark of human cancers. Cell cycle progression is regulated at several checkpoints whose defects contribute to genomic instability. The high-risk HPVs encode two oncogenes, E6 and E7, which are essential for cellular transformation in HPV-positive cells. The ability of high-risk HPV E6 and E7 protein to promote the degradation of p53 and pRb, respectively, has been suggested as a mechanism by which HPV oncogenes induce cellular transformation. E6 and E7 abrogate cell cycle checkpoints and induce genomic instability that leads to malignant conversion. Although the prophylactic HPV vaccine has recently become available, it will not be effective for immunosuppressed individuals or those who are already infected. Therefore, understanding the molecular basis for HPV-associated cancers is still clinically relevant. Studies on genomic instability will shed light on mechanisms by which HPV induces cancer and hold promise for the identification of targets for drug development.
Fasting Triglyceride Concentrations are Associated with Early Mortality Following Antiretroviral Therapy in Zambia
Get PDFBackground: In developing countries, 8 to 71% of patients initiating highly active antiretroviral therapy (HAART) die within the first year of treatment. Apart from baseline CD4 count, viral load, hemoglobin, BMI and stage of the disease, there may be other variables that contribute to AIDS-related mortality. We investigated the potential role of nutrition, lipids and insulin resistance-related phenotypes in predicting early mortality. Methods: We recruited 210 HAART-naïve HIV/AIDS patients in Lusaka, Zambia. Dietary intake, anthro-pometric measurement, fasting serum insulin, glucose, and lipid profiles were assessed at baseline. Mortality was assessed after 90 days of follow-up. We used logistic regression models to identify variables associated with mortalit
Helping Mother Die
Get PDFThere are days you will always remember. December 5, 2009 my mother called and told me her friends commented she looked sick. She was jaundiced. I had just seen her on Thanksgiving and she seemed to be herself. She ate the Thanksgiving meal and appeared to have her usual appetite. She also had enjoyed one of our favorite family pastimes with her grandchildren, playing the card game whist. There was a cacophony of laughter coming from the dining room that night for hours as she masterfully played her high bids to victory. During November she was still doing all of her usual activities: line dancing and playing cards at the local senior centers, bowling, ballroom dancing, and singing in the church choir. That is why the phone call that night was somewhat surprising. She had been calling me in the past month with some non specific gastrointestinal complaints that she attributed to her metformin medication. After she consulted with her doctors, she was feeling improved without the medication during the past 2 weeks. Painless jaundice, though, made me very suspicious that she had a serious problem. My instincts would be proven correct