Hemorrhagic Shock as Complication of Intramural Intestinal Bleeding

Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma. Medical treatment was sufficient and there was no need for surgery. Conclusion. Gastrointestinal bleeding associated with shock in patients treated by oral anticoagulant should alert physicians to research a probable MIH. Urgent diagnosis and appropriate medical treatment can avoid surgical interventions.

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Multicriteria Adaptive Observers for Singular Systems with Unknown Time-Varying Parameters

This paper proposes multicriteria adaptive observers for a class of singular systems with unknown time-varying parameters. Two criteria for the disturbance attenuation level and the upper bound of an ultimate invariant set are scalarized into a single cost function and then it is minimized by varying the weight parameter, which creates the optimal trade-off curve or Pareto optimal points. The proposed multicriteria adaptive observers are shown to be able to easily include integral action for better robust performance. It is demonstrated with numerical simulations that the proposed multicriteria adaptive observers provide the good estimation accuracy and allow effective and compromising design by considering two different cost functions simultaneously.

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Semantic Health Knowledge Graph: Semantic Integration of Heterogeneous Medical Knowledge and Services

With the explosion of healthcare information, there has been a tremendous amount of heterogeneous textual medical knowledge (TMK), which plays an essential role in healthcare information systems. Existing works for integrating and utilizing the TMK mainly focus on straightforward connections establishment and pay less attention to make computers interpret and retrieve knowledge correctly and quickly. In this paper, we explore a novel model to organize and integrate the TMK into conceptual graphs. We then employ a framework to automatically retrieve knowledge in knowledge graphs with a high precision. In order to perform reasonable inference on knowledge graphs, we propose a contextual inference pruning algorithm to achieve efficient chain inference. Our algorithm achieves a better inference result with precision and recall of 92% and 96%, respectively, which can avoid most of the meaningless inferences. In addition, we implement two prototypes and provide services, and the results show our approach is practical and effective.

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IJMS, Vol. 18, Pages 391: Identification of Autophagy-Related Genes and Their Regulatory miRNAs Associated with Celiac Disease in Children

Celiac disease (CD) is a severe genetic autoimmune disorder, affecting about one in 100 people, where the ingestion of gluten leads to damage in the small intestine. Diagnosing CD is quite complex and requires blood tests and intestinal biopsy examinations. Controversy exists regarding making the diagnosis without biopsy, due to the large spectrum of manifesting symptoms; furthermore, small-intestinal gastroscopy examinations have a relatively complex management in the pediatric population. To identify novel molecular markers useful to increase the sensitivity and specificity in the diagnosis of pediatric CD patients, the expression levels of two key autophagy executor genes (ATG7 and BECN1) and their regulatory validated miRNAs (miR-17 and miR-30a, respectively) were analyzed by relative quantitative real-time-PCR on a cohort of confirmed CD patients compared to age-related controls. Among the investigated targets, the non-parametric Mann–Whitney U test and ROC analysis indicated the highest significant association of BECN1 with CD status in the blood, while in intestinal biopsies, all of the investigated sequences were positively associated with CD diagnosis. Nomogram-based analysis showed nearly opposite expression trends in blood compared to intestine tissue, while hierarchical clustering dendrograms enabled identifying CD and control subgroups based on specific genes and miRNA expression signatures. Next, using an established in vitro approach, through digested gliadin administration in Caco-2 cells, we also highlighted that the modulation of miR-17 endogenous levels using enriched exosomes increased the intracellular autophagosome content, thereby altering the autophagic status. Altogether, these results highlighted novel molecular markers that might be useful to increase the accuracy in CD diagnosis and in molecular-based stratification of the patients, further reinforcing the functional involvement of the regulation of the autophagy process within a digestive and autoimmune-related disorder as CD.

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IJMS, Vol. 18, Pages 390: Plasma Gelsolin Induced Glomerular Fibrosis via the TGF-β1/Smads Signal Transduction Pathway in IgA Nephropathy

Glomerular fibrosis has been shown to be closely related to the progression and prognosis of IgA nephropathy (IgAN). However, mechanism underlying IgAN glomerular fibrosis remains unclear. Recently, our study showed that plasma gelsolin (pGSN) was decreased in the serum of an IgAN mouse model and that pGSN deposition was found in the glomeruli. Another cytokine, TGF-β1, which is closely related to glomerular fibrosis, was also found to be highly expressed in the glomeruli. In the present study, we report that pGSN induces glomerular fibrosis through the TGF-β1/Smads signal transduction pathway. This is supported by the following findings: human mesangial cells (HMCs) show remarkable morphological changes and proliferation in response to co-stimulation with pGSN and polymeric IgA1 (pIgA1) from IgAN patients compared to other controls. Moreover, ELISA assays showed that more TGF-β1 secretion was found in HMCs supernatants in the co-stimulation group. Further experiments showed increased TGF-β1, Smad3, p-Smad2/3, Smad4, and collagen 1 and decreased Smad7 expression in the co-stimulation group. Our present study implied that the synergistic effect of pGSN and pIgA induced glomerular fibrosis via the TGF-β1/Smads signal transduction pathway. This might be a potential mechanism for the glomerular fibrosis observed in IgAN patients.

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Rughe superficiali- è arrivato anche in Italia il micro-botox

Il botulino ormai utilizzato da vari anni per la correzione delle rughe di espressione della regione frontale e perioculare è ora dopo vari studi utilizzato anche per le rughe superficiali.

La tecnica messa a punto dal dottor Woffles Wu, chirurgo plastico di Singapore è ormai entrata anche in Italia.

A differenza del classico botulino in questo caso si utilizza una concentazione molto più blanda della sostanza sempre diluita in acqua fisiologica, e si inietta a livello dermico con ago sottilissimo.

Si è visto che oltre a migliorare le rughe superficiali ha un vero e proprio effetto antiage, con un neto miglioramento  sulla qualità della pelle.

l'effetto è già visibile dopo 2 giorni dal trattamento e ha una durata di 4/5 mesi. La sedutadura in media 15 minuti e permette di ritornare immediatamente alla normale attività quotidiana . Si può trattare la regione frontale, perioculare le guance e il collo.

Si può inoltre integrare con gli ormai collaudati trattamenti anti-age quali ad esempio i fillers.

 

Per approfondimenti sulla chirurgia plastica ed estetica vai su http://ift.tt/2kjNrxS

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Predicting Presynaptic and Postsynaptic Neurotoxins by Developing Feature Selection Technique

Presynaptic and postsynaptic neurotoxins are proteins which act at the presynaptic and postsynaptic membrane. Correctly predicting presynaptic and postsynaptic neurotoxins will provide important clues for drug-target discovery and drug design. In this study, we developed a theoretical method to discriminate presynaptic neurotoxins from postsynaptic neurotoxins. A strict and objective benchmark dataset was constructed to train and test our proposed model. The dipeptide composition was used to formulate neurotoxin samples. The analysis of variance (ANOVA) was proposed to find out the optimal feature set which can produce the maximum accuracy. In the jackknife cross-validation test, the overall accuracy of 94.9% was achieved. We believe that the proposed model will provide important information to study neurotoxins.

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