Search

Aims and objectives The aims of the study were to (i) estimate the prevalence of frailty among older adults with type 2 diabetes, and (ii) investigate risk factors associated with frailty in the study group. Background The high prevalence of frailty among older adults and its adverse health impacts including higher risks for physical disabilities and a higher mortality rate is quickly evolving to become an important public health issue. Design A cross-sectional design. Methods Data were collected from the Clinical Diabetes Centre of our study group. Frailty was assessed using the Chinese version of the Tilburg frailty indicator. Other questionnaires included Activities of Daily Living, Mini-Mental State Examination, Taiwan Geriatric Depression Scale and Instrumental Activities of Daily Living. Multivariable logistic regression was established to identify factors associated with frailty. The STrengthening the Reporting of OBservational studies in Epidemiology checklist was used preparing the manuscript. Results A total of 248 subjects were recruited in this study, a total of 66 participants had frailty (26.6%). Our results showed that factors including age, number of chronic diseases, cerebrovascular accident, renal diseases, frequency of falling, frequency of hyperglycaemia, Activities of Daily Living, depression, Mini-Mental State Examination, and Instrumental Activities of Daily Living ≧1 task disability were correlated with frailty in older adults with type 2 diabetes. After adjusting for confounding factors, multivariate logistic regression analyses showed a significant increase in the probability of frailty by 1.72-times when comparing type 2 diabetes subjects with depression to those without depression. Conclusion This study revealed that depression is a significant factor associated with the occurrence of frailty among older adults with type 2 diabetes. Relevance to clinical practice Our results provided strong clinical evidence showing depression as an important factor associated with the risk of frailty in older individuals with type 2 diabetes. We recommend early detection via routine screenings for symptoms of depression during diabetes care to achieve early prevention or the delay of frailty and its implicated adverse health consequences.

Background and Objectives Inflammation has been implicated in the initiation and progression of thyroid cancer. Neutrophil-to-lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. The aim of this study was to examine the relationship between NLR and clinicopathological features in patients with differentiated thyroid cancer. Methods Total white blood cell and differential counts of 159 patients with differentiated thyroid cancer were compared to those of 318 age- and sex-matched controls undergoing thyroidectomy for benign thyroid nodules. Clinicopathological variables, stratified by NLR tertiles, were analyzed. Results There was no difference in NLR between patients having benign and malignant thyroid nodules (P = 0.293). Cancer patients in the higher NLR tertile had significantly larger tumor size (P = 0.004). Higher NLR was observed in patients with high American Thyroid Association (ATA) risk of recurrence. Conclusions High preoperative NLR was associated with increased tumor size and high ATA risk of recurrence in patients with differentiated thyroid cancer. J. Surg. Oncol. 2013;107:493–497. © 2012 Wiley Periodicals, Inc.

Objective The aim of this study was to clarify the role of ostiomeatal complex obstruction in maxillary fungus ball. Study design and setting Comparative study in a hospital setting of the mean Lund-Mackay scores for the anterior ethmoid and frontal sinuses of 54 versus 48 patients with maxillary fungus ball versus chronic unilateral rhinosinusitis, respectively. Results In cases with partial opacification in the maxillary sinus, the anterior ethmoid and frontal sinuses were diseased in the chronic unilateral rhinosinusitis group but not in the maxillary fungus ball group. In cases with total opacification in the maxillary sinuses, all anterior ethmoid and frontal sinuses in both groups were diseased, but the disease condition of the frontal sinuses was significantly less severe in the maxillary fungus ball group ( P Conclusion and significance In this era of evidence-based medicine, we provide statistical data supporting the principle that maxillary fungus ball is not associated with osteomeatal complex obstruction and that another as-yet-unexplained mechanism must be responsible. EBM rating: B-3b

This article presents a theoretical approach to analysing how a country with market power could affect international relations. The liberal view and trade-conflict model claim that if countries seek to protect their trade gains, trade will reduce conflict between pairs of countries, designated “actors” and “targets”. The main purpose of this paper is to examine the effect of market power on the gains from trade. Once the distribution of trade gains is changed between countries, the conflict and cooperation relationships between countries will also alter. We apply the trade-conflict model to derive two propositions as follows: (1) the more monopoly power over exports a monopolistic target has, the greater the amount of actor-to-target conflict; (2) the more monopsony power over imports a monopolistic target has, the greater the amount of actor-to-target conflict. To summarise, these hypotheses will predict that a country with market power reaps the gains from trade and will exhibit less conflict and more cooperation, whilst the country that is exploited will exhibit more conflict and less cooperation.

Salmonella mastitis constitutes an uncommon manifestation of focal salmonellosis, particularly occurring in immunocompetent patients. The entity mimics malignancy in its clinical appearance and sonographic findings. A breast biopsy is required for diagnosis in such conditions. We report a unique case of a suspicious breast mass as the sole clinical manifestation of infection with Salmonella. Despite its rarity, it should be included in the differential diagnosis of breast masses.

Positive and negative symptom (NGS) dimensions were examined for their concordance in 46 coaffected schizophrenic sib-pairs. Results showed that the symptom dimensions of negative symptoms (NGS), delusion-hallucination (DHS), and thought disorganization (TDS) could be formulated. Discrete genetic endowment of these three symptom dimensions was not found as shown by the low concordance in sib pair analysis (kappa = 0.20–0.30). Thirty-seven pairs (80.4%) and 21 pairs (45.7%) had liability, defined by the presence of NGS in any one member of the coaffected sib-pairs, of NGS of “any degree,” and of “severe degree” in 46 sib-pairs, respectively. Both groups had high prevalence (59.1–81.0%) of positive symptoms. Another 9 (19.6%) and 25 (54.3%) pairs had no liability of NGS of “any degree” or of “severe degree” out of 46 sib-pairs, respectively. These two groups had high concordance (kappa = 0.45–1.00) of TDS or DHS between coaffected sib-pairs. Based on the results, it is hypothesized that schizophrenia, as defined by DSM-III-R, may consist of two subtypes: one has liability of NGS and a high prevalence of positive symptoms, while the other has only positive symptoms. Am. J. Med. Genet. 74:1–6, 1997. © 1997 Wiley-Liss, Inc.

A series of δ-lactone ( 1 and 2 ), oxetane ( 3 ) and azetidinone ( 4 and 5 ) analogs were prepared from the HMG CoA synthase inhibitor L-659,699 ((E,E)-11-[3′R-(hydroxymethyl)-4′-oxo-2′R-oxetanyl]-3,5,7R- trimethyl-2,4-undecadienoic acid 1,2 ), which maintained the trans relationship of the ring side chains. The N-tosyl azetidinone analog represents the first reported member of a new series of non β-lactone HMG CoA synthase inhibitors.

Transfection assay of NIH 3T3 cells was performed with DNAs isolated from ten human PHC (primary hepatic cancer) specimens and a hepatoma 7402 cell line. Positive results were obtained in 7402 and in six out of ten PHC DNAs. Human N-ras gene was identified in transfectants from 7402 DNA and transformed cells from three PHC DNA samples, which had passed more than two cycles of transfection. The expression of N-ras was also remarkably enhanced in six out of nine poly(A)+RNA samples isolated from PHC tissues. P21 synthesis was elevated in 7402 cells as well as in transfectants derived from 7402 cells and PHC DNA. In analysis of PHC DNA, rearrangement and amplification of N-ras gene was observed in two PHC samples. The discrepancy of results of the transfection assay and mRNA expression was discussed. Furthermore, c-myc was also highly expressed in most PHC tissues. It implied that the cooperating activity of N-ras and c-myc might be responsible for the malignant phenotypic alteration in some or most cases in human primary liver cancer.

Hepatitis B virus (HBV) DNA in leucocytes from 50 hepatitis patients with various patterns of HBV serological markers and serum HBV DNA and 13 normal controls were examined by Southern blot hybridization with 32P-labeled 3.2 Kb HBV DNA. A free form of HBV DNA was observed in leucocytes of 8 patients, 7 of whom were positive for serum HBeAg, and in 6 patients an integrated form of HBV DNA was identified. HBV DNA was not identified in leucocytes from 13 normal controls. The free form of HBV DNA in leucocytes existed as a heterogenous smear from 2.0 to 3.2 Kb, similar to the pattern in liver and hepatocellular carcinoma cells but different from serum HBV DNA in which the 3.2 Kb band was absent. The banding pattern of the integrated form of HBV DNA in leucocytes varied among different patients. During preparation of white blood cells and purification of HBV DNA probes, it was important to remove plasma contamination and traces of pBR322, respectively. The presence of extrachromosomal DNA sequences partially homologous to pBR322 could cause false results. The presence of a free and integrated form of HBV DNA in leucocytes is important for explaining the biology of HBV, the harbouring and replication sites of extrahepatic origin, the mechanism of recurrent infection, and the rationale of the treatment of hepatitis B.

Thiol-functionalized surfactant micelles (n-C12H25N(+)Me2CH2SH,(Cl(-) ) were used to cleave Z-Trp-Pro p-nitrophenyl dipeptide esters. Marked kinetic distereoselectivity was observed in these reactions. For example at pH 8 and concentrations (approx. 6-7) x 0.001M, the micelllar thiol cleavd the LL substrate 5-6 times more rapidly than its DL disatereomer. This kinetic disatereoselectivity was shown to develop at surfactant concentrations approx. 0.005 M, considerably above the cmc (critical micelle concentration approx. 0. 001 M), i.e., at a second 'critical concentration'. Dynamic light-scattering measurements showed that micelles which had reacted with the LL (but not the DL) substrate underwent a marked increase in apparent hydrodynamic diameter (from approx. 15 to 26 nm) near this second critical concentration. Similar phenomena could be induced upon addition of 0.00002 M LL dipeptide surfactant reaction product to the thiol micelles. Micelles of n-C12H25N(+)Me2CH2CH2OH,C1(-)or n- C12H25N(+)Me3,C1(-) were unresponsive to such additions (light scattering). The results are discussed in terms of molecular and supramolecular interactions between surfactant and solubilizate molecules. Keywords include: Micelles, Stereochemistry, Peptides, and Light scattering.