Potential applications of 7 Tesla magnetic resonance imaging in paediatric neuroimaging:Feasibility and challenges

The integration of 7 Tesla magnetic resonance imaging(7 T MRI)in adult patients has marked a revolutionary stride in radiology.In this article we explore the feasibility of 7 T MRI in paediatric practice,emphasizing its feasibility,applications,challenges,and safety considerations.The heightened resolution and tissue contrast of 7 T MRI offer unprecedented diagnostic accuracy,particularly in neuroimaging.Applications range from neuro-oncology to neonatal brain imaging,showcasing its efficacy in detecting subtle structural abnormalities and providing enhanced insights into neurological conditions.Despite the promise,challenges such as high cost,discomfort,and safety concerns necessitate careful consideration.Research suggests that,with precautions,7 T MRI is feasible in paediatrics,yet ongoing studies and safety assessments are imperative.

Glucagon-like peptide 1 receptor agonist:A potential game changer for cholangiocarcinoma

Glucagon-like peptide-1 receptor(GLP-1R)agonist,a subgroup of incretin-based anti-diabetic therapies,is an emerging medication with benefits in reducing blood glucose and weight and increasing cardiovascular protection.Contrarily,concerns have been raised about GLP-1R agonists increasing the risk of particular cancers.Recently,several epidemiological studies reported contradictory findings of incretin-based therapy on the risk modification for cholangiocarcinoma(CCA).The first cohort study demonstrated that incretin-based therapy was associated with an increased risk of CCA.Later studies,however,showed a null effect of incretinbased therapy on CCA risk for dipeptidyl peptidase-4 inhibitor nor GLP-1R agonist.Mechanistically,glucagon-like peptide 1 receptor is multifunctional,including promoting cell growth.High GLP-1R expressions were associated with progressive phenotypes of CCA cells in vitro.Unexpectedly,the GLP-1R agonist showed anti-tumor effects on CCA cells in vitro and in vivo with unclear mechanisms.Our recent report also showed that GLP-1R agonists suppressed the expression of GLP-1R in CCA cells in vitro and in vivo,leading to the inhibition of CCA tumor growth.This editorial reviews recent evidence,discusses the potential effects of GLP-1R agonists in CCA patients,and proposes underlying mechanisms that would benefit from further basic and clinical investigation.

Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

Epidemiological studies of esophageal cancer in the era of genome-wide association studies

Esophageal cancer(EC) caused about 395000 deaths in 2010. China has the most cases of EC and EC is the fourth leading cause of cancer death in China. Esophageal squamous cell carcinoma(ESCC) is the predominant histologic type(90%-95%), while the incidence of esophageal adenocarcinoma(EAC) remains extremely low in China. Traditional epidemiological studies have revealed that environmental carcinogens are risk factors for EC. Molecular epidemiological studies revealed that susceptibility to EC is influenced by both environmental and genetic risk factors. Of all the risk factors for EC, some are associated with the risk of ESCC and others with the risk of EAC. However, the details and mechanisms of risk factors involved in the process for EC are unclear. The advanced methods and techniques used in human genome studies bring a great opportunity for researchers to explore and identify the details of those risk factors or susceptibility genes involved inthe process of EC. Human genome epidemiology is a new branch of epidemiology, which leads the epidemiology study from the molecular epidemiology era to the era of genome wide association studies(GWAS). Here we review the epidemiological studies of EC(especially ESCC) in the era of GWAS, and provide an overview of the general risk factors and those genomic variants(genes, SNPs, miRNAs, proteins) involved in the process of ESCC.

Spontaneous rupture of hepatic hemangiomas:A review of the literature

Hepatic hemangiomas are congenital vascular malformations,considered the most common benign mesenchymal hepatic tumors,composed of masses of blood vessels that are atypical or irregular in arrangement and size. Hepatic hemangiomas can be divided into two major groups:capillary hemangiomas and cavernous hemangiomas These tumors most frequently affect females (80%) and adults in their fourth and fifth decades of life. Most cases are asymptomatic although a few patients may present with a wide variety of clinical symptoms,with spontaneous or traumatic rupture being the most severe complication. In cases of spontaneous rupture,clinical manifestations consist of sudden abdominal pain,and anemia secondary to ahaemoperitoneum. Disseminated intravascular coagulopathy can also occur. Haemodynamic instability and signs of hypovolemic shock appear in about one third of cases. As the size of the hemangioma increases,so does the chance of rupture. Imaging studies used in the diagnosis of hepatic hemangiomas include ultrasonography,dynamic contrast-enchanced computed tomography scanning,magnetic resonance imaging,hepatic arteriography,digital subtraction angiography,and nuclear medicine studies. In most cases hepatic hemangiomas are asymptomatic and should be followed up by means of periodic radiological examination. Sur gery should be restricted to specific situations. Absolute indications for surgery are spontaneous or trau m atic rupture with hemoperitoneum,intratumoral blee ding and consumptive coagulopathy (Kassabach-Merrit syndrome). In a patient presenting with acute abdo minal pain due to unknown abdominal disease,sponta neous rupture of a hepatic tumor such as a hemangio ma should be considered as a rare differential diagnosis.

Relationship of knowledge about osteoporosis with education level and life habits

AIM: To assess possible relationships of knowledge and related factors with educational level and osteoporosisrelated life habits.METHODS: This was a cross sectional study conducted on 268 women(≥ 35 years old) from June 2011 to August 2011. The sample collection was done in outpatient clinics in three university hospitals in Isfahan, Iran. We used a demographic questionnaire containingquestions that evaluated osteoporosis-related life habits, including exercise, smoking, intake of calcium and vitamin D supplements and so on. We also used the Osteoporosis Knowledge Assessment Tool to measure osteoporosis knowledge of women.RESULTS: The mean level of knowledge about awareness of osteoporosis, its risk factors and preventive factors were 56, 55 and 22, respectively. The relationship of education level and awareness of osteoporosis, its risk factors and preventive factors was significant, with R = 0.76, R = 0.73 and R = 0.83, respectively(P < 0.001). The relationship of education level and osteoporosis-related life habits was not significant(R = 0.03 and P = 0.56). The relationship of osteoporosis-related life habits and awareness of osteoporosis and its risk factors was significant, with R = 16%, P = 0.006 and R = 16%, P = 0.008, respectively, but the relationship of osteoporosis-related life habits and preventive factors was not significant(R = 0, P = 0.99).CONCLUSION: Iranian women with a higher education level have significantly better knowledge about osteoporosis than women with a lower educational level but they do not use this knowledge in their life.

Hepatic ischemic preconditioning increases portal vein flow in experimental liver ischemia reperfusion injury

BACKGROUND: Ischemic preconditioning(IPC) has been shown to decrease liver injury and to increase hepatic microvascular perfusion after liver ischemia reperfusion. This study aimed to evaluate the effects of IPC on hemodynamics of the portal venous system. METHODS: Thirty-two rats were randomized into two groups: IPC group and control group. The rats of the IPC group underwent IPC by 10 minutes of liver ischemia followed by 10 minutes of reperfusion before liver ischemia, and the rats of the control group were subjected to 60 minutes of partial liver ischemia. Non-ischemic lobes were resected immediately after reperfusion. The animals were studied at 4 hours and 12 hours after reperfusion. Mean arterial pressure, heart rate, portal vein flow and pressure were analyzed. Blood was collected for the determination of the levels of aspartate aminotransferase, alanine aminotransferase, calcium, lactate, pH, bicarbonate, and base excess. RESULTS: IPC increased the mean portal vein flow at 4 hours and 12 hours after reperfusion. IPC recovered 78% of the meanportal vein flow at 12 hours after reperfusion. IPC decreased the levels of aspartate aminotransferase, alanine aminotransferase and lactate, and increased the levels of ionized calcium, bicarbonate and base excess at 12 hours after reperfusion. CONCLUSIONS: This study demonstrated that IPC increases portal vein flow and enhances hepatoprotective effects in liver ischemia reperfusion. The better recovery of portal vein flow after IPC may be correlated with the lower levels of transaminases and with the better metabolic profile.

Heart rate is an independent predictor of all-cause mortality in individuals with type 2 diabetes: The diabetes heart study

AIM To assess the association of resting heart rate with allcause and cardiovascular disease(CVD) mortality in the Diabetes Heart Study(DHS).METHODS Out of a total of 1443 participants recruited into the DHS, 1315 participants with type 2 diabetes who were free of atrial fibrillation and supraventricular tachycardia during the baseline exam were included in this analysis. Heart rate was collected from baseline resting electrocardiogram and mortality(all-cause and CVD) was obtained from state and national death registry. Kaplan-Meier(K-M) and Cox proportional hazard analyses were used to assess the association.RESULTS The mean age, body mass index(BMI) and systolic blood pressure(SBP) of the cohort were 61.4 ± 9.2 years, 32.0 ± 6.6 kg/m2, and 139.4 ± 19.4 mmHg respectively. Fiftysix percent were females, 85% were whites, 15% were blacks, 18% were smokers. The mean ± SD heart rate was 69.8(11.9) beats per minute(bpm). After a median follow-up time of 8.5 years(maximum follow-up time is 14.0 years), 258 participants were deceased. In K-M analysis, participants with heart rate above the median had a significantly higher event rate compared with those below the median(log-rank P = 0.0223). A one standard deviation increase in heart rate was associated with allcause mortality in unadjusted(hazard ratio 1.16, 95%CI: 1.03-1.31) and adjusted(hazard ratio 1.20, 95%CI: 1.05-1.37) models. Similar results were obtained with CVD mortality as the outcome of interest.CONCLUSION Heart rate is an independent predictor of all-cause mortality in this population with type 2 diabetes. In this study, a 1-SD increase in heart rate was associated with a 20% increase in risk suggesting that additional prognostic information may be gleaned from this ubiquitously collected vital sign.

Psychiatric aspects of brain tumors:A review

Infrequently, psychiatric symptoms may be the only manifestation of brain tumors. They may present with mood symptoms, psychosis, memory problems, personality changes, anxiety, or anorexia. Symptoms may be misleading, complicating the clinical picture. A comprehensive review of the literature was conducted regarding reports of brain tumors and psychiatric symptoms from 1956-2014. Search engines used include Pub Med, Ovid, Psych Info, MEDLINE, and Med Scape. Search terms included psychiatric manifestations/symptoms, brain tumors/neoplasms. Our literature search yielded case reports, case studies, and case series. There are no double blind studies except for post-diagnosis/-surgery studies. Early diagnosis is critical for improved quality of life. Symptoms that suggest work-up with neuroimaging include: new-onset psychosis, mood/memory symptoms, occurrence of new or atypical symptoms, personality changes, and anorexia without body dysmorphic symptoms. This article reviews the existing literature regarding the diagnosis and management of this clinically complex condition.

Awareness of eye complications and prevalence of retinopathy in the first visit to eye clinic among type 2 diabetic patients

AIM:To assess the awareness of eye complications and the prevalence of retinopathy,in the first visit to eye clinic,among type 2 diabetic patients attending a tertiary medical centre in Kuala Lumpur,Malaysia.METHODS:An investigator-administered questionnaire was given to 137 patients with diabetes undergoing first time eye screening in the eye clinic.This was followed by a detailed fundus examination by a senior ophthalmologist to assess for presence of retinopathy.RESULTS:Almost 86% of respondents were aware of diabetic eye complications,especially in patients who had achieved tertiary educational level(96.3%).The majority of the patients(78.8%) were referred by their physicians and only 20.4% came on their own initiative.Many of the patients(43.8%) did not know how frequent they should go for an eye check-up and 72.3% did not know what treatments were available.Lack of understanding on diabetic eye diseases(68.6%) was the main barrier for most patients for not coming for eye screening earlier.Despite a high level of awareness,only 21.9% had recorded HbA1c level of <6.5% while 31.4% were under the erroneous assumption of having a good blood sugar control.A total of 29.2% had diabetic retinopathy in their first visit eye testing.CONCLUSION:In the present study,29.2% of type 2 diabetic patients had retinopathy in their first time eye testing.Although the awareness of diabetic eye complications was high among first time eye screening patients,the appropriate eye care-seeking behavior was comparatively less and should be rectified to prevent the rise of this sight threatening eye disease.

Erythrocytic transglutaminase inhibition hemolysis at presentation of celiac disease

Celiac disease (CD) is a common autoimmune condition.Previously it was considered to be a rare childhood disorder,but is actually considered a relatively common condition,present at any age,which may have multiple complications and manifestations.Hematological disorders of the disease are not uncommon.Among these disorders,the most frequently reported are anemias as a result of iron deficiency,often associated with folate and/or B12 deficiency.Anemias caused by hemolysis are very rarely reported in celiac patients.An 11-year-old girl with a previous uneventful medical history presented with severe hemolytic anemia.Hemolysis was Coombs negative,accompanied by inappropriate low reticulocyte count,despite exaggerated bone marrow hyperplasia of the erythroid precursors which showed normal maturation.Serology for recent infections,including EpsteinBarr virus,parvovirus B19,cytomegalovirus and mycoplasma,were all negative.Levels of serum IgA,IgG and IgM,were all within normal ranges for age.Screeningfor anti-DNA,antinuclear,antineutrophil cytoplasmic,antimicrosomal,antithyroglobulin,and antimitochondrial antibodies and lupus anticoagulants,was negative.She was also negative for human immunodeficiency virus.Conventional therapy with corticosteroids and intravenous immunoglobulin failed.CD was serendipitously discovered upon screening for anti-tissue transglutaminase autoantibodies.The disease was confirmed by biopsy of the small intestine mucosa.The patient recovered with gluten-free diet.A unique case of CD is presented.CD should be serologically screened in each patient with Coombs negative "immune"hemolytic anemia,particularly if accompanied by "reticulocytopenia".A new hemolytic mechanism and very speculative explanation for "reticulocytopenia"are discussed.

Prevalence and Factors Associated with Postpartum Depression during the COVID-19 Pandemic among Women in Jeddah, Saudi Arabia: A Cross-Sectional Study

Background: Postpartum depression is the most common psychological health problem among females;it begins after the birth of the child and can occur at any time during the first year of delivery. The COVID-19 pandemic is a novel virus that is highly infectious and has several negative psychological impacts on individuals globally. Aim: Coronavirus disease 2019 (COVID-19) has been reported to increase the incidence rate of depression. We investigated the prevalence rate and associated factors of postpartum depression (PPD) among women in Jeddah, Saudi Arabia, during the COVID-19 period, thereby attempting to determine whether and how COVID-19 affected PPD. Methods: This is a cross-sectional study that was conducted on women at one week to six months postpartum using an online questionnaire. SPSS program was used for analyzing data. Results: This study included 150 participated women;49.3% were in the age range of 25 - 34 years old. There were 30.7% reported being primigravida. Regarding the level of depression, there were 60.7% reported the presence of depression;the depression was affected by some demographics of females such as the education level (P = 0.021) and other factors related to the COVID-19 pandemic such as visiting the doctor during quarantine (P = 0.049), diagnosis with depression by the doctor (P = 0.006), the impact of the pandemic on depression (P = 0.035), experiencing symptoms of depression during pregnancy (P = 0.005), family history (P = 0.043), and difficulties during childbirth during the pandemic period (P = 0.03). Conclusion: There was a high prevalence of PPD among women during the COVID-19 period, and it was higher than the prevalence of PPD before the COVID-19 period.

Giant squamous cell carcinoma of the gallbladder: A case report

BACKGROUND Gallbladder cancer is the most common malignant tumor of the biliary tract. The majority of cases are adenocarcinoma. Squamous cell carcinoma is the histological type present in 12% of all neoplasias accounting for approximately 12% of gallbladder neoplasms. It can occur in its pure form reaching 1%-3% of the tumors. Many patients are at an advanced stage when diagnosed and have bad therapeutic efficacy. CASE SUMMARY A 45-year-old male patient presented with left flank pain for 1 year and irradiated to the mesogastric region. He denied fever, vomiting, and any other intestinal changes. He reported a weight loss of 10 kg in a period of 7 mo. He denied alcoholism, smoking, drug use, or prior illness. Computed tomography of the abdomen showed in the gallbladder fossa a voluminous mesogastric heterogeneous collection that had a thick and irregular capsule with liquid and gaseous contents. A predominantly hypoattenuating rounded material with partially calcified margins measuring about 2.0 cm related to gallstone was also emphasized. No lymphadenomegalies or free fluid was observed in the abdominal cavity. Patient underwent laparotomy where a huge tumor was observed affecting the transverse colon and gallbladder. This mass was resected en bloc removing gallbladder and transverse colon together with corresponding mesocolon and regional lymphadenectomy. There were no complications in the postoperative period. Although oncological treatment was performed, the patient died 6 mo after surgery. CONCLUSION Squamous cell carcinoma represents a rare disease. Patients often present with large, bulky tumors with involvement of adjacent organs. In spite of progress in surgical techniques and adjuvant chemotherapy, the prognosis remains poor.

Effect of periocular injection of celecoxib and propranolol on ocular level of vascular endothelial growth factor in a diabetic mouse model

AIM： To investigate the effects of periocular injection of propranolol and celecoxib on ocular levels of vascular endothelial growth factor （VEGF） in a diabetic mouse model. METHODS： Forty 4-6wk BALB-C male mice weighing 20-25 g were used. The study groups included： nondiabetic control （group 1）, diabetic control （group 2）, diabetic propranolol （group 3）, and diabetic celecoxib （group 4）. After induction of type 1 diabetes by streptozotocin, propranolol （10 μg） and celecoxib （200 μg dissolved in carboxymethylcellulose 0.5%） were injected periocularly. The ocular level of VEGF was measured in all the study groups using enzyme-linked immuno sorbent assay （ELISA） method. RESULTS： Ocular VEGF level was significantly increased （1.25 fold） in the diabetic control group when compared to the non-diabetic group one week after induction with streptozotocin （P=0.002）. Both periocular propranolol and celecoxib significantly reduced ocular VEGF levels （P=0.047 and P〈0.001, respectively）. The effect was more pronounced with celecoxib, CONCLUSION： The periocular administration of propranolol and celecoxib can significantly reduce ocular VEGF levels in a diabetic mouse model.

Risk profile and outcomes of aortic valve replacement in octogenarians

AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.

Sensory-neural hearing loss in pseudoexfoliation syndrome

AIM:To evaluate relationship between ocular pseudoex-foliation syndrom(PXF) and sensory-neural hearing loss(SNHL).· METHODS:This prospective case-control study was designed on patients who referred to a general ophthalmic clinic at Imam Khomeini Medical Center,Urmia,Iran(March 2010 through November 2010).On routine ophthalmic examination,patients diagnosed with ocular PXF were referred to the ENT department and,selected cases(after evaluating inclusion and exclusion criteria) were referred to Audiometric Department.Pure tone hearing threshold level(HTL) was measured at 1,2,3 kHz for each ear and was compared with International Standard(ISO 7029) median age associated hearing loss at 1,2,3 kHz(AAHL).· RESULTS:Overall 21 of 50 patients(42.0%) had a higher HTL than the ISO 7029 median AAHL at 1,2 and 3kHz,which included 14 ears of 23 patients in the male group(30.4%) and 21 ears of 27 patients in the female group(38.8%).Approximately 12.0% of patients had glaucoma at the same time,however;no significant correlation was found in SNHL prevalence and severity between PXF patient and patients with simultaneous glaucoma.SNHL was more common in patients with ocular PXF compared to their age-sex matched controls(P <0.05).· CONCLUSION:Most of patients with ocular PXF had SNHL compared to their age-sex matched controls,which could be due to PXF fibrils in the inner ear.These findings suggest PXF could be a systemic disease.·

Lateral rectus muscle recession and the vertical palpebral fissure height: to do or not to do inter-muscular septum dissection?

In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus muscle recession were assigned into “with” and “without” intermuscular septum dissection study arms. The VPFH was measured at one-day before surgery and in two weeks and three months, postoperatively. Three months after surgery, significant increase of VPFH was observed in both groups （Paired t-test; P=0.005）. Also, less widening of VPFH was observed in “with intermuscular septum dissection” group （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： 0.48 mm vs 1.34 mm; ANCOVA test; P〈0.001）. However, such results were not observed two weeks post-operatively （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： -0.28 mm vs 0.28 mm; ANCOVA test; P=0.302）. Intermuscular septum dissection is recommended in lateral rectus muscle recession to partially prevent the undesirable increment of VPFH.

Updated bone mineral density status in Saudi patients with inflammatory bowel disease

BACKGROUND Little is known about inflammatory bowel disease(IBD)burden and its impact on bone mineral density(BMD)among adult patients in Saudi Arabia.To the best of our knowledge,our study is the only study to give an update about this health problem in adult Saudi patients with IBD.IBD is a great risk factor for reduced BMD due to its associated chronic inflammation,malabsorption,weight loss and medication side effects.Consequently,screening for reduced BMD among patients with IBD is of utmost importance to curb and control anticipated morbidity and mortality among those patients.AIM To assess the relationship between IBD and BMD in a sample of adult Saudi patients with IBD.METHODS Ninety adult patients with IBD-62 Crohn’s disease(CD)and 28 ulcerative colitis(UC)-were recruited from King Fahad Specialist Hospital gastroenterology clinics in Buraidah,Al-Qassim.All enrolled patients were interviewed for their demographic information and for IBD-and BMD-related clinical data.All patients had the necessary laboratory markers and dual-energy x-ray absorptiometry scans to evaluate their BMD status.Patients were divided into two groups(CD and UC)to explore their clinical characteristics and possible risk factors for reduced BMD.RESULTS The CD group was significantly more prone to osteopenia and osteoporosis compared to the UC group;44%of the CD patients had normal BMD,19%had osteopenia,and 37%had osteoporosis,while 78%of the UC patients had normal BMD,7%had osteopenia,and 25%had osteoporosis(P value<0.05).In the CD group,the lowest t-score showed a statistically significant correlation with body mass index(BMI)(r=0.45,P<0.001),lumbar z-score(r=0.77,P<0.05)and femur z-score(r=0.85,P<0.05).In the UC group,the lowest t-score showed only statistically significant correlation with the lumbar z-score(r=0.82,P<0.05)and femur z-score(r=0.80,P<0.05).The ROC-curve showed that low BMI could predict the lowest t-score in the CD group with the best cut-off value at≤23.43(m/kg2);area under the curve was 0.73(95%CI:0.59–0.84),with a sensitivity of 77%,and a specificity of 63%.CONCLUSION Saudi patients with IBD still have an increased risk of reduced BMD,more in CD patients.Low BMI is a significant risk factor for reduced BMD in CD patients.

Thoracic aorta thickness and histological changes with aging: an experimental rat model

The three main components of the media layer of the aorta are elastic fibers,collagen fibers and smooth muscle cells(SMC).[1]This layer’s elastic properties are major determinants of its biomechanics in health and disease states.[2,3]Age-related changes in such elastic properties are associated with altered hemodynamic parameters,such as systolic hypertension,[4,5]and end-organ damage,[6,7]and are thought to result from changes of its main components.

Neuroplasticity in Spinal Trauma: A Current Narrative Review of Treatments

Neuroplasticity is a condition that is present from birth, being found in the central and peripheral nervous system, in both physiological and pathological terms. Based on the findings, therapeutic and non-therapeutic attempts were tested on spinal cord trauma to recover locomotor function below the level of the injury. The work defined and showed other forms of the term neuroplasticity, talk about some pathological and non-pathological conditions, and, finally, show neuroplasticity and some of its treatments in the spinal cord injury process. A narrative literature review from 2000 to 2020 of the PubMed platform was conducted and analysis of two books for the elaboration of this work. Animal/human studies were included that addressed pathologies, forms of treatment for spinal trauma, and qualis from B1 to A1. Pre-2000 articles, which addressed neuroplasticity only to understand the molecular mechanisms and articles that were not in English, were excluded. As a result, the main molecules and structures that inhibit neuroplasticity were found, and, based on their knowledge, forms of treatments were developed to inhibit these molecules and structures to assist in neuroplasticity and assist in possible functional recovery. It can be concluded that the physiological barriers are already being overcome by the most recent forms of treatment and that soon new studies may propose a form of treatment that is protocoled for all patients.