Activiteit

Protein S deficiency is a thrombophilia associated with an increased risk of thromboembolism. Previous studies have shown its role as a predisposing factor for venous thromboembolism, but its role in recurrent arterial ischemic stroke remains uncertain. Here we report a patient with recurrent ischemic stroke due to protein S deficiency. Oral anticoagulant treatment with vitamin K antagonist (VKA) drugs is used to treat and prevent thromboembolic events caused by thrombophilia, but it has many limitations, especially in the case of recurrent thromboembolic events. Direct oral anticoagulants (DOACs) have many advantages over VKA. Previous studies have shown that they are safe in cases of thrombophilia, but they are not well studied in recurrent ischemic stroke due to protein S deficiency. In this study our patient was treated with rivaroxaban. Protein S deficiency may be a predisposing factor in recurrent ischemic stroke, and rivaroxaban can be a safe and effective treatment option. Further studies are needed to confirm our findings.Neuropathologic hallmarks of Huntington Disease (HD) include the progressive neurodegeneration of the striatum and the presence of Huntingtin (HTT) aggregates that result from abnormal polyQ expansion of the HTT gene. Whether the pathogenic trinucleotide repeat expansion of the HTT gene causes neurodevelopmental abnormalities has garnered attention in both murine and human studies; however, documentation of discrete malformations in autopsy brains of HD individuals has yet to be described. We retrospectively searched the New York Brain Bank (discovery cohort) and an independent cohort (validation cohort) to determine whether developmental malformations are more frequently detected in HD versus non-HD brains and to document their neuropathologic features. One-hundred and thirty HD and 1600 non-HD whole brains were included in the discovery cohort and 720 HD and 1989 non-HD half brains were assessed in the validation cohort. Cases with developmental malformations were found at 6.4-8.2 times greater frequency ininucleotide repeat expansions of the HTT gene may impact neurodevelopment.

Coronary bypass artery grafting (CABG) has a higher procedural risk of stroke than percutaneous coronary intervention (PCI), but may offer better long-term survival. The optimal revascularization strategy for patients with prior cerebrovascular disease (CEVD) remains unclear.

The SYNTAXES study assessed the vital status out to 10year of patients with three-vessel disease and/or left main coronary artery disease enrolled in the SYNTAX trial. The relative efficacy of PCI vs. CABG in terms of 10year all-cause death was assessed according to prior CEVD. The primary endpoint was 10year all-cause death. The status of prior CEVD was available in 1791 (99.5%) patients, of whom 253 patients had prior CEVD. Patients with prior CEVD were older and had more comorbidities (medically treated diabetes, insulin-dependent diabetes, metabolic syndrome, peripheral vascular disease, chronic obstructive pulmonary disease, impaired renal function, and congestive heart failure), compared with those without prior CEVD. Prior CEVD was an independent predictor of 10year all-cause death (adjusted HR 1.35; 95% CI 1.04-1.73; p = 0.021). Patients with prior CEVD had a significantly higher risk of 10year all-cause death (41.1 vs. 24.1%; HR 1.92; 95% CI 1.54-2.40; p < 0.001). The risk of 10year all-cause death was similar between patients receiving PCI or CABG irrespective of the presence of prior CEVD (p

 = 0.624).

Prior CEVD was associated with a significantly increased risk of 10year all-cause death which was similar in patients treated with PCI or CABG. These results do not support preferential referral for PCI rather than CABG in patients with prior CEVD.

SYNTAX ClinicalTrials.gov reference NCT00114972. SYNTAX Extended Survival ClinicalTrials.gov reference NCT03417050.

SYNTAX ClinicalTrials.gov reference NCT00114972. GSK J4 in vitro SYNTAX Extended Survival ClinicalTrials.gov reference NCT03417050.

Soft-tissue mallet finger occurs due to loss of terminal extensor tendon secondary to rupture of distal phalanx. Although using noninvasive splints for 6-8weeks is the gold standard for conservative treatment of closed soft-tissue mallet injuries, patient compliance is an important factor impacting on patient outcomes. In this study, we used a single Kirschner Wire (K-W) to fix the distal interphalangeal (DIP) joint in extension in those patients failed to comply with routine splinting.

In this prospective study, 190 patients with Doyle type 1 closed soft-tissue mallet finger deformity were included in four groups between 2011 and 2015. These groups were determined according to treatment modalities. Patients in the first group were treated with a finger splint (n = 109). Patients in the second group first received a finger splint and then K-W was applied due to lack of adequate compliance (n = 23). Patients in the third group were treated with K-W only (n = 47), and the fourth group did not accept surgicabe improved.

Internal fixation via K-W may be a suitable treatment option compared to splint therapy for management of closed soft-tissue mallet finger in noncompliant patients. Using this treatment approach, the success rate for patients could satisfactorily be improved.The seemingly ubiquitous presence of plastic debris led to a greater focus on micro- and nanoplastics research derived from the degradation process of macroplastics. The ingestion and consequent accumulation of plastics on the biota are the main concerns. Researchers strive to make assay conditions as close as possible to those of the environment. In this regard, sonication can be applied to de-agglomerate the plastic particles, but this may alter significantly their toxicity. The aim of this study was to understand the effects of the sonication process on the acute toxicity and swimming behavior of polystyrene nanoparticles using Daphnia magna as the test organism. The results show a 2-fold reduction in the acute toxicity after the sonication process; the EC50 of the PSNP-NS was 1.28 ± 0.17 mmol while for PSNP-S the EC50 was 2.77 ± 0.32 mmol, possibly through the formation of an eco-corona on the nanoplastic surface, formed from the ions dispersed in the medium or proteins secreted by the test organisms. The mean swimming distance was reduced when compared to the control group for both the PSNP-S and PSNP-NS.