Rejected

Diabetes mellitus type 2 (T2DM) is characterized by resistance of insulin receptors and/or inadequate insulin secretion resulting in metabolic and structural complications including vascular diseases, arterial hypertension and different behavioral alterations. We aimed to study the effects of the antihypertensive angiotensin AT1 receptor antagonist losartan on the T2DM-induced changes of exploratory behavior, anxiety, nociception and short term memory in normotensive Wistar and spontaneously hypertensive rats (SHRs). The experimental model of T2DM induced by a combination of high fat diet and streptozotocin, decreased exploratory activity and increased the level of carbonylated proteins in selected brain structures in both strains; as well it increased corticosterone level, pain threshold, anxiety-like behavior, and decline short term memory only in SHRs. Losartan treatment alleviated some of the T2DM- induced metabolic complications, abolished the T2DM-induced hypo activity, and normalized the corticosterone level, carbonylated proteins in brain, nociception and memory. Losartan did not exert effect on the anxiety behavior in both strains. We showed that T2DM exerted more pronounced negative effects on the rats with comorbid hypertension as compared to normotensive rats. Overall effects on the studied behavioral parameters are related to decreased exploration of the new environment, increased anxiety-like behavior, and decline in short-term memory. The systemic sub-chronic treatment with an angiotensin AT1 receptor antagonist losartan ameliorated most of these complications.

Data are limited regarding the real-world effectiveness and safety of glecaprevir/pibrentasvir (GLE/PIB) in patients with chronic hepatitis C virus (HCV) infection and severe renal impairment (RI). We aimed to evaluate the performance of GLE/PIB in patients with chronic kidney disease (CKD) stage 4 or 5 in Taiwan. 108 chronic HCV patients with CKD stage 4 (n = 32) or 5 (n = 76) receiving GLE/PIB for 8-12 weeks were retrospectively recruited at 4 academic centers in Taiwan. The effectiveness was determined by sustained virologic response at off-therapy week 12 (SVR ) for evaluable (EP) and per-protocol populations (PP). The safety profiles were also assessed. By EP and PP analyses, the SVR rate was 99.1% (107 of 108 patients; 95% confidence interval (CI): 94.9%-99.8%) and 100% (107 of 107 patients; 95% CI: 96.5%-100%). The SVR rates were 100% (95% CI: 89.3%-100%) and 98.7% (95% CI: 92.9%-99.8%) in patients with CKD stage 4 and 5, respectively. One patient, who declined off-therapy follow-up after permanently discontinuing GLE/PIB at on-treatment week 9 due to scheduled cardiac surgery, had non-virologic failure. Sixteen (14.8%) patients had serious adverse events (AEs), which were judged not related to GLE/PIB. The three most common AEs were pruritus (19.4%), fatigue (15.7%) and nausea (13.9%). None had ≥ 3-fold upper limit of normal for total bilirubin and alanine aminotransferase levels. None of the 9 patients with hepatitis B virus (HBV) coinfection developed HBV-associated hepatitis. In conclusion, GLE/PIB for 8-12 weeks is effective and well-tolerated in HCV patients with severe RI.

The present study aimed to validate the parent-proxy IMPACT-III (IMPACT-III-P) in a sample of youth diagnosed with inflammatory bowel disease (IBD). Parent-proxy report measures are standard for pediatric psychosocial assessment, and the IMPACT-III-P will provide a more comprehensive representation of HRQOL. Reliability and validity analyses were conducted.

The measurement and valuation of health-related quality of life for and by young people are increasingly important, yet research on the impact of study perspective and validity of preferences obtained from young populations remains limited.

A 36-year-old woman with no medical history participated in a trekking in Ladakh up to 5300 m of altitude. She was well acclimatized and presented no previous sign of acute mountain sickness, high altitude pulmonary edema or high altitude cerebral edema. After an intense effort to catch up with her group, she became breathless and complained of visual disturbances, fatigue, dizziness, and confusion. During her descent to a lower altitude (4800 m), with the help of companions, she lost consciousness several times. After a 14-hour sleep, she recovered and all symptoms disappeared so that she was able to walk along with the group for 20 km. On returning home, she went through a battery of examinations that were all normal: cerebral magnetic resonance imaging, Doppler of supra-aortic arteries, 24 hours Holter, and cardiac transthoracic and transesophageal echography. A hypoxia exercise test revealed a hyper-response to hypoxia with severe hypocapnia. The etiology of this neurological episode is discussed (transient embolic ischemic attack, migraine, cerebral edema, and global amnesia). The patchy distribution of neurological symptoms is not in favor of a thrombotic event. The most probable diagnosis proposed is a transient cerebral ischemia due to local cerebral vasoconstriction related to hyperventilation-induced hypocapnia in a context of acute severe exercise. Special attention should be given to subjects who show a hyper-responsiveness to hypoxia before a sojourn at high altitude: they should avoid unnecessary hyperventilation due to any kind of stress, emotion, or exhaustive exercise.

Cataract surgery in ophthalmology is usually done under peribulbar block with a mixture of 0.5% bupivacaine and 2% lidocaine. Several case reports of fatalities associated with bupivacaine has necessitated a search for alternative safe agents. The aim of this study was to compare peribulbar block characteristics using a mixture of 0.5% bupivacaine and 2% lidocaine with a mixture of 0.5% ropivacaine and 2% lidocaine.

We report the first case of retro-odontoid pseudotumor with an isolated symptom of C2-C3 dysesthesia triggered by a traumatic event.

Cetuximab is a chimeric IgG1 monoclonal antibody against epidermal growth factor receptor. It is approved by the European medical agency for the treatment of RAS wild-type metastatic colorectal cancer and metastatic squamous cell cancer of the head and neck. Few cases of aseptic meningitis, primarily associated with the first administration of cetuximab in patients with squamous cell cancer, have been reported. So far, there was only 1 case in a patient with metastatic colorectal cancer. We report on a 50-year-old Caucasian patient with metastatic rectum carcinoma who suffered from headache, fever, and neck stiffness 3 h after the first administration of cetuximab (400 mg/m). CSF examination revealed an excessive pleocytosis with a white blood cell count of 2,433/µL. He was diagnosed with cetuximab-induced aseptic meningitis since clinical symptoms and CSF pleocytosis resolved within days, and further diagnostic workup revealed no infectious cause. Cetuximab-induced aseptic meningitis is a rare and severe drug reaction with predominance in treating squamous cell cancer of the head and neck. Clinical presentation and CSF findings suggest acute meningoencephalitis. In all reported cases, the course of the disease was benign and self-limited. Empiric antimicrobial and antiviral therapy are suggested until infectious causes can be ruled out. A lower dosage of cetuximab and a premedication including antihistamines and glucocorticosteroids may lower the risk of a re-occurrence if cetuximab therapy is continued.

This study aims at the linguistic and cultural adaptation of the Early ARthritis for Psoriatic Patients (EARP) questionnaire into European Portuguese, for psoriatic patients attending dermatology medical examination.

Oxidative stress has been suggested as pathogenesis of oral lichen planus (OLP), implicating the vital role of antioxidants in its treatment. Curcumin, naturally found in turmeric has potent antioxidant and inflammatory properties and can be useful in reducing spread and subsiding burning and pain sensation in patients with OLP. The present study was done to evaluate the role of curcumin in the treatment of symptomatic OLP compared with the control group.