19302108
Gone astray: Imaging suggested an ovarian tumor, but physicians identified something quite different.
15280827
An Unusual Etiology of Spontaneous Pyometra Perforation; A Case Report
Introduction By presenting this case we aimed to describe an uncommon complication of generalized peritonitis following spontaneous pyometra perforation in untreated cervical carcinoma. Case Presentation This report describes a 60-year-old postmenopausal woman presenting with clinical features mimicking intestinal perforation who was later diagnosed as cervical carcinoma with pyometra perforation at exploratory laparotomy. The patient had good post-operative recovery following drainage and peritoneal lavage. Conclusion Spontaneous pyometra perforation in a case of untreated carcinoma of cervix is a rare condition, yet it should be suspected and kept in the differential diagnosis of acute abdomen in elderly women.
31378323
Immunosuppressive therapy in lung injury due to paraquat poisoning: a meta-analysis.
INTRODUCTION
Immunosuppressive therapy has been shown to improve outcomes in patients with paraquat poisoning. The objective of this study was to evaluate the efficacy of immunosuppressive therapy in the management of lung injury due to paraquat poisoning.


METHODS
We searched the MEDLINE, OVID, and CINAHL databases for relevant studies published from 1980 to 2006. We included studies if (a) the study design was a randomised controlled trial, observational study with historical controls or observational study; (b) the study population included patients with paraquat poisoning, and received immunosuppressive therapy; and (c) the study provided data on mortality. We calculated the survival rate with 95 percent confidence intervals (CI) for observational studies, and relative risk and 95 percent CI for dichotomous outcomes.


RESULTS
12 studies--four non-randomised, six non-randomised comparing historical controls, and two randomised controlled trials--had employed immunosuppressive therapy in the management of paraquat poisoning. The survival rate in the four non-randomised studies (39 patients) was 74.4 percent (95 percent CI 58.9-85.4). The relative risk of immunosuppressive therapy in decreasing mortality with paraquat poisoning was 0.55 (95 percent CI 0.39-0.77) and 0.6 (95 percent CI 0.27-1.34) for the non-randomised studies (comparing historical controls) and randomised controlled studies, respectively. There was significant heterogeneity and evidence of publication bias.


CONCLUSION
One out of four patients (95 percent CI 3-5) were successfully treated with immunosuppressive therapy for paraquat poisoning. However, due to significant heterogeneity and publication bias, a large randomised controlled trial will be required to affirm the role of immunosuppression in paraquat poisoning.
39481152
Magnesium deficiency: does it have a role to play in cataractogenesis?
Magnesium is one of the most important regulatory cation involved in several biological processes. It is important for maintaining the structural and functional integrity of vital ocular tissues such as lens. Presence of high magnesium content especially in the peripheral part of lens as compared to aqueous and vitreous humor has been observed. Magnesium plays significant role as a cofactor for more than 350 enzymes in the body especially those utilizing ATP. Membrane associated ATPase functions that are crucial in regulating the intracellular ionic environment, are magnesium-dependent. Moreover, the enzymes involved in ATP production and hydrolysis are also magnesium-dependent. Magnesium deficiency by interfering with ATPase functions causes increased intracellular calcium and sodium and decreases intracellular potassium concentration. Furthermore, magnesium deficiency is associated with increased oxidative stress secondary to increased expression of inducible nitric oxide synthase and increased production of nitric oxide. Thus the alterations in lenticular redox status and ionic imbalances form the basis of the association of magnesium deficiency with cataract. In this paper we review the mechanisms involved in magnesium homeostasis and the role of magnesium deficiency in the pathogenesis of cataract.
30418051
Heterogeneity in thylakoid membrane proteome of Synechocystis 6803.
Cell-free extracts of Synechocystis 6803 were fractionated by successive ultracentrifugation at 40,000 x g, 90,000 x g and 150,000 x g to obtain the three thylakoid fractions designated as 40k, 90k and 150k fractions respectively. These fractions showed differences in absorption and emission spectra. Nano-LC-ESI-Q-TOF MS analysis identified 123 proteins belonging to membrane as well as cytosolic fraction. Out of these proteins, there were 22 proteins with transmembrane helices and 12 proteins with signal peptide. There were 77 proteins common across all the three fractions. Most of these proteins were subunits of photosynthetic complexes, CF(0)-CF(1) ATP synthase or ribosomal proteins. Among the rest of the proteins, 8 were exclusive to 40k fraction, 3 were exclusive to 90k fraction and 13 were exclusive to 150k fraction. There were 10 proteins common between 40k and 90k fractions and 12 proteins common between 90k and 150k fractions. There were no common proteins detected between 40k and 150 fractions. The results suggested existence of heterogeneity in thylakoids of Synechocystis 6803, which may lead to micro-compartmentation and functional heterogeneity in the thylakoids of this organism as seen previously.
20955522
Ovarian cancer: strategies for overcoming resistance to chemotherapy
Ovarian cancer is responsible for 4% of deaths from cancer in women. Treatment comprises a combination of surgery and chemotherapy, but patients typically experience disease relapse within 2 years of the initial treatment. Further treatment can extend survival, although relapse eventually occurs again. A better understanding of the mechanisms that underlie this drug resistance should allow treatment to be optimized, so that substantial improvements in the outlook for women with this disease can be achieved.
26728348
Diagnostic utility of blood volume monitoring in hemodialysis patients.
BACKGROUND
Assessment of volume state is difficult in hemodialysis patients. Whether continuous blood volume monitoring can improve the assessment of volume state is unclear.


STUDY DESIGN
Diagnostic test study.


SETTINGS & PARTICIPANTS
Asymptomatic long-term hemodialysis patients (n = 150) in 4 university-affiliated hemodialysis units.


INDEX TESTS
Ultrafiltration rate (UFR) divided by postdialysis weight (UFR index), slopes of relative blood volume (RBV), RBV slope corrected for UFR and weight (volume index).


REFERENCE TESTS
Dialysis-related symptoms and echocardiographic signs of volume excess and volume depletion, assessed by using inferior vena cava (IVC) diameter after dialysis and its collapse on inspiration. Volume excess was defined as values in the upper third of IVC diameter or lower third of IVC collapse on inspiration. Volume depletion was defined as values in the lower third of IVC diameter or upper third of IVC collapse on inspiration.


RESULTS
Mean UFR was 8.3 +/- 3.8 (SD) mL/h/kg. Mean RBV slope was -2.32% +/- 1.50%/h. Mean volume index was -0.25% +/- 0.17%/h/mL/h ultrafiltration/kg. Volume index provided the best fit of observed RBV slopes. Volume index was related to dizziness, the need to decrease UFR, and placement in Trendelenburg position. RBV and volume index, but not UFR index, were related to echocardiographic markers of volume excess and depletion. Areas under the receiver operating characteristic curve to predict volume excess were 0.48 (95% confidence interval [CI], 0.33 to 0.63) for UFR index, 0.71 (95% CI, 0.60 to 0.83) for RBV slope, and 0.73 (95% CI, 0.59 to 0.86) for volume index. Areas under the receiver operating characteristic curve to predict volume depletion were 0.56 (95% CI, 0.38 to 0.74) for UFR index, 0.55 (95% CI, 0.38 to 0.72) for RBV slope, and 0.62 (95% CI, 0.48 to 0.76) for volume index.


LIMITATIONS
Dialysis-related symptoms and echocardiographic findings are not validated measures of volume. Our results were not adjusted for demographic or clinical characteristics; performance characteristics of the indices may differ across populations.


CONCLUSIONS
Volume index appears to be a novel marker of volume, but requires validation studies, and its utility needs to be tested in clinical trials.