222,157 results match your criteria insufficiency


J Gynecol Obstet Hum Reprod 2021 Apr 19:102152. Epub 2021 Apr 19.

Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes; Université de Paris, Paris; FHU PREMA, Paris and Colombes; Inserm UMR1137 IAME, Paris FRANCE. Electronic address:

Background: Cervical insufficiency is thought to be responsible for 10% of preterm deliveries. Shirodkar cerclage is among the available techniques ranging from McDonald's to definitive procedures, however the indications for the prevention of preterm births and mid-trimester miscarriages are still poorly delineated.

Objective: To describe the characteristics, obstetrical and neonatal outcomes of pregnancies with Shirodkar cerclage procedures. Read More

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Nifedipine disturbs fetal cardiac function during hypoxemia in a chronic sheep model at near term gestation.

Am J Obstet Gynecol 2021 Apr 19. Epub 2021 Apr 19.

Fetal Medicine Center, Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address:

Background: Nifedipine is widely used drug in pregnancies complicated by maternal hypertensive disorders that can be associated with placental insufficiency and fetal hypoxemia. The evidence regarding fetal myocardial responses to nifedipine in hypoxemia is limited.

Objective: We hypothesized that nifedipine would not impair fetal sheep cardiac function under hypoxemic environment. Read More

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A mutation of the β-domain in POU1F1 causes pituitary deficiency due to dominant PIT-1β expression.

Eur J Endocrinol 2021 Apr 1. Epub 2021 Apr 1.

H Azuma, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan.

Background: POU1F1 encodes both PIT-1α, which plays pivotal roles in pituitary development and GH, PRL and TSHB expression, and the alternatively spliced isoform PIT-1β, which contains an insertion of 26-amino acids (β-domain) in the transactivation domain of PIT-1α due to the use of an alternative splice acceptor at the end of the first intron. PIT-1β is expressed at much lower levels than PIT-1α and represses endogenous PIT-1α transcriptional activity. Although POU1F1 mutations lead to combined pituitary hormone deficiency (CPHD), no patients with β-domain mutations have been reported. Read More

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Vitamin D insufficiency is associated with metabolic syndrome independent of insulin resistance and obesity in young, but not in old adults - Results from The Berlin Aging Study II.

Diabetes Metab Res Rev 2021 Apr 22. Epub 2021 Apr 22.

German Institute for Human Nutrition Potsdam Rehbrücke, Department of Nutrition and Gerontology, Nuthetal, Germany.

Purpose: Age-related changes affect vitamin D absorption and metabolism. Low 25-hydroxyvitamin D concentrations have been reported as risk factor for the development of metabolic syndrome (MetS). However, recent evaluations suggest this association might be explained by obesity or insulin resistance in subjects with MetS. Read More

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[Cushing's syndrome with subsequent tertiary adrenocortical insufficiency after simultaneous multiple intra-articular local glucocorticoid treatment : Keep an eye on hormone deficiency conditions requiring treatment after multiple administrations of local steroids].

Z Rheumatol 2021 Apr 22. Epub 2021 Apr 22.

Klinik für Kinder- und Jugendmedizin, Allgemeine Pädiatrie, Universitätsklinikum Münster, Münster, Deutschland.

After simultaneous multiple local treatment with glucocorticoids at 46 sites a 4‑year-old female patient with newly diagnosed polyarticular juvenile idiopathic arthritis (JIA) initially developed Cushing's syndrome followed by a gradual worsening of her condition and finally an acute high fever urinary tract infection. Iatrogenic adrenocortical insufficiency after multiple intra-articular glucocorticoid administration was diagnosed. The possibility of severe systemic glucocorticoid side effects after extensive local treatment should be included in the regular management of JIA patients. Read More

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Pancreatic Cancer-Associated Pain Management.

Oncologist 2021 Apr 22. Epub 2021 Apr 22.

Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA.

Pain is highly prevalent in patients with pancreatic cancer and contributes to the morbidity of the disease. Pain may be due to pancreatic enzyme insufficiency, obstruction, and/or a direct mass effect on nerves in the celiac plexus. Proper supportive care to decrease pain is an important aspect of the overall management of these patients. Read More

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Laparoscopic versus open surgical management of patients with chronic pancreatitis: Amatched case-control study.

J Minim Access Surg 2021 Feb 27. Epub 2021 Feb 27.

Department of Gastrointestinal Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

Background: The safety and feasibility of laparoscopic surgery in patients with chronic pancreatitis (CP) have been established, but its outcome has not been compared to that of open surgery.

Patients And Methods: This retrospective study was conducted on patients with CP who were treated by a single surgical team from 2012 to 2018. The medical records of patients with surgical treatment of CP were reviewed. Read More

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February 2021

Sacral Insufficiency Fractures in Patients with Spinal Cord Injury: A Report of Two Unusual Cases and Review of Literature.

J Rehabil Med Clin Commun 2019 4;2:1000019. Epub 2019 Oct 4.

Spinal Injury Rehabilitation Centre, Pinderfields General Hospital, Pinderfields, WF1 4DG, United Kingdom.

Objective: Sacral insufficiency fractures should be considered in differential diagnosis as a cause of autonomic dysreflexia and other vague symptoms in patients with spinal cord injury.

Setting: The Supra Regional Tertiary Centre, Midlands Centre for Spinal Injuries, Oswestry, UK.

Method: Outpatient clinic review of 2 patients with long-standing spinal cord injury presenting with vague symptoms of abdominal discomfort, and increased spasms including autonomic dysreflexia in which no evidence of causation was found on clinical examination. Read More

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October 2019

The Quality of Life of Thalassemic Patients: The Role of Endocrine Defect Compensation.

Endocr Metab Immune Disord Drug Targets 2021 Apr 21. Epub 2021 Apr 21.

Endocrine-Metabolic Unit, Sant'Andrea University Hospital, Rome, Italy.

Background: The improvement of beta thalassaemia treatments has led to an increase in life expectancy. This implies the emergence of new comorbidities. Amongst others, endocrine glands are extremely sensitive to iron overload. Read More

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From Obesity to Chronic Kidney Disease: How Can Adipose Tissue Affect Renal Function?

Nephron 2021 Apr 21:1-5. Epub 2021 Apr 21.

Departamento de Ciencias Básicas de la Salud, Área de Bioquímica y Biología Molecular, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.

Obesity is directly associated with an increased risk of developing CKD, regardless of other comorbid conditions. Although the molecular mechanisms that link both diseases are not well established, the role of adipose tissue (AT) is becoming increasingly important in obesity-associated kidney damage. In the context of obesity, lipotoxicity and the alteration of AT secretion profile promote inflammation, oxidative stress, and fibrosis in the kidney, which ultimately leads to impaired renal function. Read More

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Abrogation of mesenchyme-specific TGF-β signaling results in lung malformation with prenatal pulmonary cysts in mice.

Am J Physiol Lung Cell Mol Physiol 2021 Apr 21. Epub 2021 Apr 21.

Department of Surgery, Children's Hospital of Los Angeles, United States.

The TGF-β signaling pathway plays a pivotal role in controlling organogenesis during fetal development. Although the role of TGF-β signaling in promoting lung alveolar epithelial growth has been determined, mesenchymal TGF-β signaling in regulating lung development has not been studied in vivo due to a lack of genetic tools for specifically manipulating gene expression in lung mesenchymal cells. Therefore, the integral roles of TGF-β signaling in regulating lung development and congenital lung diseases are not completely understood. Read More

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Vitamin B status in health and disease: a critical review. Diagnosis of deficiency and insufficiency - clinical and laboratory pitfalls.

Crit Rev Clin Lab Sci 2021 Apr 21:1-31. Epub 2021 Apr 21.

The Nutristasis Unit, Viapath, St. Thomas' Hospital, London, UK.

Vitamin B (cobalamin) is an essential cofactor for two metabolic pathways. It is obtained principally from food of animal origin. Cobalamin becomes bioavailable through a series of steps pertaining to its release from dietary protein, intrinsic factor-mediated absorption, haptocorrin or transcobalamin-mediated transport, cellular uptake, and two enzymatic conversions ( methionine synthase and methylmalonyl-CoA-mutase) into cofactor forms: methylcobalamin and adenosylcobalamin. Read More

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Challenges of treating mixed arterial-venous disease of lower extremities.

J Cardiovasc Surg (Torino) 2021 Apr 21. Epub 2021 Apr 21.

Division of Vascular Surgery, Department of Surgery, University of California Davis, Sacramento, CA, USA.

Introduction: Mixed arterial-venous lower extremity disease (AVLED) poses a unique challenge for clinicians. This review will outline the impact mixed AVLED has on patients and the healthcare system, by reviewing its epidemiology, diagnosis, current treatment, and the challenges encountered implementing therapies.

Evidence Acquisition: An extensive search of current literature from online sources, journals and book chapters identified the current challenges facing the treatment of mixed arterial venous ulcers of the lower extremities and potential solutions to these challenges. Read More

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Scoping review of non-thermal technologies for endovenous ablation for treatment of venous insufficiency.

J Cardiovasc Surg (Torino) 2021 Apr 21. Epub 2021 Apr 21.

Department of Surgery, Division of Vascular and Endovascular Surgery, Zucker School of Medicine at Hofstra/Northwel, Hempstead, NY, USA -

Introduction: The aim of this review article is to compare the outcomes of newer non-thermal endovenous ablation techniques to thermal ablation techniques for the treatment of symptomatic venous insufficiency.

Evidence Acquisition: Three independent reviewers screened PubMed® and EMBASE® databases to identify relevant studies. A total of 1173 articles were identified from database search that met our inclusion criteria. Read More

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Restless Legs Syndrome: Contemporary Diagnosis and Treatment.

Neurotherapeutics 2021 Apr 20. Epub 2021 Apr 20.

Mayo Center for Sleep Medicine, 200 First Street SW, Rochester, MN, 55905, USA.

Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs while at rest, relief upon movement or getting up to walk, and worsened symptom severity at night. RLS may be primary (idiopathic) or secondary to pregnancy or a variety of systemic disorders, especially iron deficiency, and chronic renal insufficiency. Genetic predisposition with a family history is common. Read More

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Effect of contrast medium versus low-molecular-weight dextran for intracoronary optical coherence tomography in renal insufficiency.

Int J Cardiovasc Imaging 2021 Apr 20. Epub 2021 Apr 20.

Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan.

Low-molecular-weight dextran (LMWD) is considered a safe alternative to contrast media to displace blood during optical coherence tomography (OCT) imaging, but concerns remain. The purpose of this study was to investigate whether using LMWD for OCT protects against kidney injury in patients with renal insufficiency compared with contrast media. We retrospectively identified 474 patients with renal insufficiency (estimated glomerular filtration rate < 60 ml/min/1. Read More

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The Role of Biaxial Loading on Smooth Muscle Contractility in the Nulliparous Murine Cervix.

Ann Biomed Eng 2021 Apr 20. Epub 2021 Apr 20.

Department of Biomedical Engineering, Tulane University, 6823 St. Charles Ave, New Orleans, LA, 70118, USA.

Throughout the estrus cycle, the extracellular matrix (ECM) and cervical smooth muscle cells (cSMC) coordinate to accomplish normal physiologic function in the non-pregnant cervix. While previous uniaxial experiments provide fundamental knowledge about cervical contractility and biomechanics, the specimen preparation is disruptive to native organ geometry and does not permit simultaneous assessment of circumferential and axial properties. Thus, a need remains to investigate cervical contractility and passive biomechanics within physiologic multiaxial loading. Read More

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Fusion for subaxial bow hunter's syndrome results in remote osseous remodeling of the hyperostotic growth responsible for vertebral artery compression.

Surg Neurol Int 2021 17;12:104. Epub 2021 Mar 17.

Department of Neurosurgery, Naval Medical Center San Diego, San Diego, California, United States.

Background: The authors present a previously unreported case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) who developed bow hunter's syndrome (BHS) or positional vertebrobasilar insufficiency. In addition, the authors demonstrate angiographic evidence of remote osseous remodeling after segmental fusion without direct decompression of the offending bony growth. BHS is a rare, yet well established, cause of posterior circulation ischemia and ischemic stroke. Read More

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Obstructive ureteric calculus with superimposed infections causing reversible posterior leukoencephalopathy syndrome: A case report.

Medicine (Baltimore) 2021 Apr;100(16):e25589

Department of Medicine, Princefield University, P.O. Box MA 128, Ho-Volta Region, Ghana, West Africa.

Rationale: Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinicoradiological phenomenon first observed 2 decades ago. Reversibility is the hallmark of this rare clinical phenomenon once the triggering pathology is aptly and adequately treated. Tinnitus preceding bilateral hearing loss as a symptomatology of RPLS has not been reported in the literature. Read More

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Independent Operating by General Surgery Residents: An ACS-NSQIP Analysis.

J Surg Educ 2021 Apr 17. Epub 2021 Apr 17.

Department of Graduate Medical Education, Parkview Health, Fort Wayne, Indiana.

Objective: Surgical resident autonomy during training is paramount to independent practice. We sought to determine prevalence of general surgery resident autonomy for surgeries commonly performed on emergency general surgery services and identify trends with time.

Design: We queried ACS-NSQIP for patients undergoing one of 7 emergency general surgery operations. Read More

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Growth hormone improves short stature in children with Shwachman-Diamond syndrome.

Pediatr Endocrinol Diabetes Metab 2021 Apr 21. Epub 2021 Apr 21.

Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, Warsaw, Poland.

Introduction: Shwachman-Diamond syndrome (SDS) is a rare, autosomal recessive multisystemic disorder characterized by pancreatic insufficiency and bone marrow failure. Short stature is a recognized feature of SDS syndrome; however, systemic data concerning recombinant human growth hormone (rGH) treatment are limited. Aim of the study: To assess the effect of rGH treatment in patients with SDS. Read More

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[The application status of optimal medical therapy after percutaneous coronary intervention and its influence on prognosis].

Zhonghua Yi Xue Za Zhi 2021 Apr;101(15):1064-1070

Department of Cardiology I, TEDA International Cardiovascular Hospital, Tianjin 300457, China.

To investigate the application status of optimal medical therapy (OMT) in patients with coronary heart disease after percutaneous coronary intervention (PCI) and its influence on the 1-year prognosis of patients after surgery. Data of 3 812 patients diagnosed with coronary heart disease by coronary angiography and successfully completed PCI in the Department of Cardiology, TEDA International Cardiovascular Hospital from October 2016 to September 2017 were prospectively collected. The OMT status and the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) during the hospitalization and 1, 6, and 12 months after discharge were recorded. Read More

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Late gestation fetal hyperglucagonemia impairs placental function and results in diminished fetal protein accretion and decreased fetal growth.

J Physiol 2021 Apr 20. Epub 2021 Apr 20.

University of Colorado Anschutz Medical Campus, Aurora, CO, United States.

Key Points: Fetal glucagon concentrations are elevated in the setting of placental insufficiency, hypoxia, and elevated stress hormones. Chronically elevated glucagon concentrations in the adult result in profound decreases in amino acid concentrations and lean body mass. Experimental elevation of fetal glucagon concentrations in a late-gestation pregnant sheep results in lower fetal amino acid concentrations, lower protein accretion, and lower fetal weight, in addition to decreased placental function. Read More

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Identifying prognostic factors and developing accurate outcome predictions for in-hospital cardiac arrest by using artificial neural networks.

J Neurol Sci 2021 Apr 18;425:117445. Epub 2021 Apr 18.

Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address:

Background: Accurate estimation of neurological outcomes after in-hospital cardiac arrest (IHCA) provides crucial information for clinical management. This study used artificial neural networks (ANNs) to determine the prognostic factors and develop prediction models for IHCA based on immediate preresuscitation parameters.

Methods: The derived cohort comprised 796 patients with IHCA between 2006 and 2014. Read More

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Quadricuspid Aortic Valve Repair Facilitated by Geometric Ring Annuloplasty.

Innovations (Phila) 2021 Apr 20:15569845211003095. Epub 2021 Apr 20.

Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA.

Quadricuspid aortic valve (QAV) is a rare congenital anomaly often associated with aortic insufficiency. The exact anatomy of QAV is variable, and most cases have undergone aortic valve replacement. With the recognition that aortic valve repair achieves superior patient outcomes as compared to replacement, a systematic approach to autologous reconstruction of QAV is needed. Read More

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The effect of trimetazidine on contrast-induced nephropathy in patients undergoing coronary angiography and/or percutaneous coronary intervention - A systematic review and meta-analysis.

Eur Rev Med Pharmacol Sci 2021 Apr;25(7):3045-3053

Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia.

Objective: In this study, we aimed to evaluate whether the trimetazidine administration before CAG and/or PCI reduces the incidence of contrast-induced nephropathy (CIN). We also aimed to evaluate the factors affecting the effect and the certainty of the evidence.

Materials And Methods: A systematic literature search was performed to obtain studies that assess trimetazidine's effect on the incidence of CIN in CAG/PCI patients up until 21 January 2021 through PubMed, Embase, and Scopus. Read More

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Painless cervical dilation with "hourglass membranes". Conservative management: our experience.

Minerva Obstet Gynecol 2021 Apr 20. Epub 2021 Apr 20.

Department of Anesthesiology and Reanimation, Virgen Macarena Hospital, Seville, Spain.

Background: Cervical competence is currently conceived as a continuous biological process with progressive degrees of insufficiency, this substituting the traditional vision of cervical competence as being present or absent. The most extreme expression of cervical insufficiency is known as "hourglass membranes". Currently no consensus exists regarding the treatment of pregnancies complicated by the protrusion of amniotic membranes; however, the majority of authors agree on recommending bed rest and performing cervical cerclage, known as "emergent cerclage". Read More

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Endocrine toxicities of immune checkpoint inhibitors.

Nat Rev Endocrinol 2021 Apr 19. Epub 2021 Apr 19.

Department of Medicine, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, TN, USA.

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that target two key signalling pathways related to T cell activation and exhaustion, by binding to and inhibiting cytotoxic T lymphocyte antigen 4 (CTLA4) or PD1 and its ligand PDL1. ICIs, such as nivolumab, pembrolizumab and ipilimumab, are approved for the treatment of numerous and diverse cancer types, in various combination regimens, and are now an established cornerstone of cancer therapeutics. Toxicities induced by ICIs are autoimmune in nature and are referred to as immune-related adverse events (irAEs); these events can affect any organ system in an unpredictable fashion. Read More

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Cochrane corner: home or office when treating convergence insufficiency.

Eye (Lond) 2021 Apr 19. Epub 2021 Apr 19.

Department of Orthoptics, Salisbury NHS Foundation Trust, Salisbury, UK.

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Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs.

Sci Rep 2021 Apr 19;11(1):8503. Epub 2021 Apr 19.

Department of Traumatology, Hand, Plastic and Reconstructive Surgery, Center of Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.

Musculoskeletal injuries are the most common reason for surgery in severely injured patients. In addition to direct cardiac damage after physical trauma, there is rising evidence that trauma induces secondary cardiac structural and functional damage. Previous research associates hip fractures with the appearance of coronary heart disease: As 25% of elderly patients developed a major adverse cardiac event after hip fracture. Read More

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