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Non-alcoholic fatty pancreas disease – practices for clinicians

, CORREAS JM, GILJA OH et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: clinical applications . Ultraschall der Medizin – Eur. J. Ultrasound 2013; 34 (03): 238-253. 53. KUWAHARA T, HIROOKA Y, KAWASHIMA H, OHNO E, YOKOYAMA Y, FUJII T et al. Usefulness of endoscopic ultrasonography-elastography as a predictive tool for the occurrence of pancreatic fistula after pancreatoduodenectomy . J. Hepatobiliary. Pancreat. Sci. 2017; 24 (12): 649-656. 54. BARRETO S.G., DIRKZWAGER I., WINDSOR J.A., PANDANABOYANA S

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The changing pattern of fever of unknown origin in the Republic of North Macedonia

Abstract

Introduction. The study aimed to compare the etiologic spectrum of diseases causing fever of unknown origin (FUO) and methods for definitive diagnosis in a tertiary care hospital in the Republic of North Macedonia during two different time periods.

Patients and methods. There were analysed retrospectively the causes for FUO and final diagnostic approaches in 185 patients with classic FUO that were treated at the University Hospital for Infectious Diseases in Skopje during two time periods. Seventy nine patients were treated during 1991 to 1995 and 106 patients during 2011 to 2015.

Results. When comparing these two periods, infections were present in 46.8% and 29.2% (p = 0.014), non-infective inflammatory disorders in 22.8% and 25.5% (p = 0.674), neoplasms in 10.1% and 13.2% (p = 0.522), miscellaneous in 8.9% and 12.3% (p = 0.461) and undiagnosed cases in 11.4% and 19.8% (p = 0.124), respectively. The most common causes for FUO during the first period were abscesses (8.9%), tuberculosis and systemic lupus erythematosus (7.6% each), whereas in the second period the commonest causes were adult onset Still disease and solid organ neoplasm (7.6% each), polymyalgia rheumatica, abscesses and visceral leishmaniasis (5.7% each). The newer imaging techniques and clinical course evaluation had superior diagnostic significance during the second period.

Conclusion. A changing pattern of diseases causing FUO during the examined periods was evident. Infections continue to be the most common cause but with decreasing incidence when compared to 20 years ago. Even nowadays clinical evaluation and follow-up still remain the vital diagnostic tools in determining the etiology of FUO.

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Medical evaluation and management of male and female voiding dysfunction: a review

. 113 : p. 13-19. 8. THÜROFF, J.W., et al ., EAU guidelines on urinary incontinence. Eur Urol, 2011. 59 (3): p. 387-400. 9. CHUNG, E., D.J. KATZ, AND C. LOVE, Adult male stress and urge urinary incontinence - A review of pathophysiology and treatment strategies for voiding dysfunction in men. Aust Fam Physician, 2017. 46 (9): p. 661-666. 10. FLORATOS, D.L., et al ., Biofeedback vs verbal feedback as learning tools for pelvic muscle exercises in the early management of urinary incontinence after radical prostatectomy. BJU Int, 2002. 89 (7

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The Use of PET-CT in Rheumatology

PET-CT scan and subsequently confirmed by biopsy and culture. Another review by Soussan et al.suggested that it is more sensitive for granulomatous polyangiitis compared with microscopic polyangiitis and eosinophilic granulomatous polyangiitis [ 10 ]. But glomerulonephritis and vasculitis activity on skin, nerve, and eyes could be missed in PET scan. 2.3 Inflammatory myopathy The sensitivity of PET for inflammatory myopathy as reflected by FDG uptake at muscle was only 33–66% [ 11 , 12 ]. It is inferior as a diagnostic tool when compared with

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Glucose Level Estimation in Diabetes Mellitus By Saliva: A Bloodless Revolution

carriage in the saliva of type 2 diabetics: A case-control study. Contemp Clin Dent 2014; 5 :312-17. 11. SYED S, GIRISH K, SREENIVAS R G, CHANDRIKA K, DARSHAN D D, VIJAY G. Salivary alterations in type 1 diabetes mellitus patients: Salivary glucose could be noninvasive tool for monitoring diabetes mellitus . Indian J Dent Res 2014; 25 :420-24. 12. FABRE B, MACCALLINI G, ONETO A, GONZALEZ D, HIRSCHLER V, ARANDA C, et al. Measurement of fasting salivary insulin and its relationship with serum insulin in children. Endocr Connect. 2012; 1 :58

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Depression and anxiety in axial spondyloarthritis

cessation improved depression and anxiety in the long term. The data suggests that smoking cessation and treatment of depression is mutually beneficial. 4 Screening of depression and anxiety in SpA The Chinese version of HADS was validated as a screening tool for depressive and anxiety disorders in axial SpA [ 14 ]. The full-scale HADS yielded an optimal cut-off score of ≥13 in screening for all depressive disorders, with sensitivity of 80.6% and specificity of 72.3%. The HADS anxiety (HADSA) subscale yielded an optimal cut-off of ≥6 in screening for anxiety

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Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

. Gut 2003; 52 :390-2. 15. ELIAKIM R., FISCHER D., SUISSA A., YASSIN K., KATZ D., GUTTMAN N., et al ., Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn’s disease. Eur J Gastroenterol Hepatol 2003; 15 :363-7. 16. LI F., GURUDU S.R., DE PETRIS G., SHARMA V.K., SHIFF A.D., HEIGH R.I., et al ., Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures . Gastrointest Endosc 2008; 68 :174-80. 17

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Circulating anti-phospholipase A2 receptor antibodies as a diagnostic and prognostic marker in Greek patients with idiopathic membranous nephropathy – a retrospective cohort study

REFERENCES 1. OBRISCA B., ISMAIL G., JURUBITA R., BASTON C., ANDRONESI A., MIRCESCU G. Antiphospholipase A2 Receptor Autoantibodies: A Step Forward in the Management of Primary Membranous Nephropathy. Biomed Res Int. 2015; 2015 :249740. 2. BECK L.H. JR., BONEGIO R.G., LAMBEAU G., BECK D.M., POWELL D.W., CUMMINS T.D., et al . M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009; 361 (1):11–21. 3. SVOBODOVA B., HONSOVA E., RONCO P., TESAR V., DEBIEC H. Kidney biopsy is a sensitive tool

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Procalcitonin as a diagnostic and prognostic marker in diabetic foot infection. A current literature review

Abstract

Diabetic foot ulcers (DFUs) are a very common cause of mortality and morbidity. The distinction between infected and non-infected DFU remains a very challenging task for clinicians in everyday practice. Even when infection is documented, the spectrum of diabetic foot infection is wide, ranging from cellulitis and soft tissue infection to osteomyelitis. Procalcitonin (PCT), a well-established sepsis biomarker, has been used in the diagnosis of several infections including osteomyelitis in patients with diabetes mellitus. This review gathers and presents all the relevant data, up until now, regarding the use of PCT as an assessment tool in diabetic patients with foot infection. Current evidence suggests that PCT levels could aid clinicians in distinguishing infected from non-infected DFUs as well as in the distinction between soft tissue infection and bone involvement, but further and larger studies are warranted to confirm these findings.

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Serum ghrelin level is associated with cardiovascular risk score

Abstract

Ghrelin, a newly discovered bioactive peptide, was originally reported to induce growth hormone release. Recent studies have shown beneficial hemodynamic effects of ghrelin in the cardiovascular system to support the wide distribution of its receptors in cardiovascular tissues. The aim of the study was to determine whether cardiovascular risk factors influence plasma ghrelin levels.

Methods. We evaluated in the Rehabilitation Hospital Cluj-Napoca, Cardiology - Department 88 consecutive subjects, 65 (73.86%) being women, with mean age 61.7±10.33 years. We assessed the presence of cardiovascular risk factors (obesity, arterial hypertension, diabetes mellitus, metabolic syndrome, smoking and lipid fractions). Plasma ghrelin levels were determined with a commercial ELISA kit (pg/ml).

Results. After the evaluation of cardiovascular risk factors, we found no statistically significant difference between ghrelin levels in the patients with vs those without cardiovascular risk factors (p>0.05). A negative correlation was found between ghrelin levels and age, r = −0.32 (p <0.05). Using the HeartScore Internet tool we calculated the cardiovascular risk for each patient according to the risk score system (SCORE) for high cardiovascular risk countries. Statistically, the risk of fatal cardiovascular events in the next 10 years was indirectly correlated with the ghrelin levels in each patient - correlation between ghrelin levels and SCORE system r=−0.25, p=0.015. In conclusion, low serum ghrelin concentrations are associated with an increased global cardiovascular risk, calculated based on the European SCORE scale. However, we could not demonstrate a direct relationship between any of the major risk factors and ghrelin.

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