Int J Med Sci
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Hemoglobin A1c (HbA1c) is currently the most commonly used marker for the determination of the glycemic status in people with diabetes and it is frequently used to guide therapy and especially medical treatment of people with diabetes. The measurement of HbA1c has reached a high level of analytical quality and, therefore, this biomarker is currently also suggested to be used for the diagnosis of diabetes. ⋯ Although the high analytical quality of the HbA1c test is widely acknowledged, the clinical relevance of this marker regarding risk reduction of cardiovascular morbidity and mortality is still under debate. In this respect, we argue that glycemic variability as a further risk factor should deserve more attention in the treatment of diabetes.
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Review Case Reports
Strangulated intestinal obstruction secondary to a typical obturator hernia: a case report with literature review.
Obturator hernia is a rare pelvic hernia with incidence of 1%. It's a significant cause of intestinal obstruction in emaciated elderly women. Delayed diagnosis and surgical intervention contributed to its relatively high morbidity and mortality. ⋯ The patient recovered uneventfully and no recurrence occurred during the follow-up. The obturator hernia should be included in the differential diagnosis if clinically suspected. Early diagnosis and prompt surgical treatment are essential to reduce the morbidity and mortality associated with obturator hernia.
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In recent years remarkable progress has been made towards the understanding of proposed hallmarks of cancer development and treatment. However with its increasing incidence, the clinical management of cancer continues to be a challenge for the 21st century. Treatment modalities comprise of radiation therapy, surgery, chemotherapy, immunotherapy and hormonal therapy. ⋯ Celebrating a century of advances since Marie Curie won her second Nobel Prize for her research into radium, 2011 has been designated the Year of Radiation therapy in the UK. Over the last 100 years, ongoing advances in the techniques of radiation treatment and progress made in understanding the biology of cancer cell responses to radiation will endeavor to increase the survival and reduce treatment side effects for cancer patients. In this review, principles, application and advances in radiation therapy with their biological end points are discussed.
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Extensive studies on cross talk between immune and skeletal systems in autoimmune diseases give rise to a new discipline of 'osteoimmunology', which explores the molecular regulation of osteoclasts by immune system. Postmenopausal osteoporosis is recognized as a cytokine driven disease, but the mechanism that how estrogen deficiency interplaying with cytokines to stimulate bone loss remains to be elucidated. ⋯ This review presents current findings and hypothesis to explain estrogen deficiency-stimulated bone loss in a critical interdisciplinary perspective. To better understand the interaction between osteoclasts and immune system in postmenopausal osteoporosis, many of the lessons have been explored in animal models.
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This review summarizes the published as well as unpublished human studies involving Citrus aurantium (bitter orange) extract and its primary protoalkaloid p-synephrine, providing information and an assessment of the safety and efficacy of these widely used products. The results of over 20 studies involving a total of approximately 360 subjects that consumed p-synephrine alone or in combination with other ingredients are reviewed and critiqued. Over 50 % of the subjects involved in these studies were overweight/obese, and approximately two-thirds of these overweight/obese subjects consumed caffeine (132-528 mg/day) in conjunction with p-synephrine (10-53 mg/day). ⋯ Approximately 44 % of the subjects consumed a bitter orange/p-synephrine only product, while the remainder consumed a complex product that contained multiple ingredients in addition to p-synephrine. In general, bitter orange extract alone (p-synephrine) or in combination with other herbal ingredients did not produce significant adverse events as an increase in heart rate or blood pressure, or alter electrocardiographic data, serum chemistry, blood cell counts or urinalysis. p-Synephrine alone as well as in combination products were shown to increase resting metabolic rate and energy expenditure, and modest increases in weight loss were observed with bitter orange extract/p-synephrine-containing products when given for six to 12 weeks. Longer term studies are needed to further assess the efficacy of these products and affirm their safety under these conditions.