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[PMID]: 23671754 [Au] Autor: Donkol RH; Nada AM; Boughattas S [Ad] Address: Ragab Hani Donkol, Department of Radiology, Aseer Central Hospital, Abha 61321, Saudi Arabia. [Ti] Title: Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis. [So] Source: World J Radiol;5(4):178-83, 2013 Apr 28. [Is] ISSN: 1949-8470 [Cp] Country of publication: China [La] Language: eng [Ab] Abstract: AIM: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis and compare it to technetium pertechnetate thyroid scanning. METHODS: Twenty-six patients with thyrotoxicosis were included in the study. Clinical history was taken and physical examination and thyroid function tests were performed for all patients. Thyroid autoantibodies were measured. The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-flow Doppler ultrasonography of the thyroid tissue was performed and spectral flow analysis of both inferior thyroid arteries was assessed. Technetium99 pertechnetate scanning of the thyroid gland was done for all patients. According to thyroid scintigraphy, the patients were divided into two groups: 18 cases with Graves' disease and 8 cases with Hashimoto's thyroiditis. All patients had suppressed thyrotropin. The diagnosis of Graves' disease and Hashimoto's thyroiditis was supported by the clinical picture and follow up of patients. RESULTS: Peak systolic velocities of the inferior thyroid arteries were significantly higher in patients with Graves' disease than in patients with thyroiditis (P = 0.004 in the right inferior thyroid artery and P = 0.001 in left inferior thyroid artery). Color-flow Doppler ultrasonography parameters demonstrated a sensitivity of 88.9% and a specificity of 87.5% in the differential diagnosis of thyrotoxicosis. CONCLUSION: Color Doppler flow of the inferior thyroid artery can be used in the differential diagnosis of thyrotoxicosis, especially when there is a contraindication of thyroid scintigraphy by radioactive material in some patients. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.4329/wjr.v5.i4.178

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[PMID]: 23671893 [Au] Autor: Lange B; Thilsing T; Baelum J; Holst R; Kjeldsen A [Ti] Title: Diagnosing chronic rhinosinusitis: comparing questionnaire-based and clinical-based diagnosis. [So] Source: Rhinology;51(2):128-36, 2013 Jun. [Is] ISSN: 0300-0729 [Cp] Country of publication: Netherlands [La] Language: eng [Ab] Abstract: BACKGROUND: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic and endo- scopic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies the definition is based on symptoms only. The aim of this study was to evaluate the correlation between questionnaire-based and clinical-based CRS. METHODS: Based on the GA2LEN postal survey data a total of 366 persons participated at the follow-up at the Danish centre and provided information on questionnaire-based CRS. At the same occasion the 366 participants underwent clinical inter- view and examination by an otorhinolaryngologist to provide information for a clinical-based CRS diagnosis. The association between questionnaire-based and clinical-based CRS diagnosis was determined using logistic regression models and kappa statistics. RESULTS: Mean age of respondents to the postal questionnaire was 45.3 years and 52.9% were female. Persons with asthma were 8.4 % and 26.2 % were actual smokers. There was moderate agreement between questionnaire-based and clinical- based CRS. Sensitivity and specificity were low comparing questionnaire-based CRS with clinical-based CRS. Incorporation of self reported CRS and medical history in diagnosing CRS by questionnaire increased the agreement, sensitivity, and specifi- city. CONCLUSION: Evaluating the correlation between questionnaire-based and clinical-based CRS showed only moderate agree- ment and questions whether they evaluate the same disease. It brings into consideration that adjustments are needed to justify correlation between questionnaire-based and clinical-based diagnosis of CRS. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.4193/Rhin

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[PMID]: 23650909 [Au] Autor: Enríquez R; Sirvent AE; Padilla S; Noguera-Pons R; Andrada E; Ardoy F; Millán I; Amorós F [Ad] Address: Nephrology Section, Hospital General de Elche , Elche , Spain. [Ti] Title: Nephrotic Syndrome and AA Amyloidosis Revealing Adult-Onset Cryopyrin-Associated Periodic Syndrome. [So] Source: Ren Fail;35(5):738-41, 2013. [Is] ISSN: 1525-6049 [Cp] Country of publication: England [La] Language: eng [Ab] Abstract: Cryopyrin-associated periodic syndrome (CAPS) is due to gain-of-function mutations in the cryopyrin gene, which determines an overactive inflammatory response. AA amyloidosis is a complication of this syndrome. A 53-year-old man was referred to us because of lower limb edema. Past history: at the age of 20, he complained of arthralgia/arthritis and bilateral hypoacusis. At the age of 35, he presented posterior uveitis, several episodes of conjunctivitis, and progressive loss of visual acuity. Laboratory tests disclosed nephrotic syndrome, and renal biopsy showed AA amyloidosis. He was given anakinra with improvement of arthritis. A genetic study revealed the p.D303N mutation in the cryopyrin gene, and he was diagnosed as having AA amyloidosis due to CAPS. Twenty-one months after starting anakinra, the arthritis has disappeared, although nephrotic-range proteinuria persisted. It is important to be aware of cryopyrin-associated periodic syndrome because it can cause irreversible complications, and there is effective therapy. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.3109/0886022X.2013.790300

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[PMID]: 23668655 [Au] Autor: Liddle DG; Connor DJ [Ad] Address: Department of Orthopedics and Rehabilitation, Vanderbilt Sports Medicine, Vanderbilt University Medical Center, 1215 21st Avenue South, 3200 MCE South Tower, Nashville, TN 37232, USA; Department of Internal Medicine, Vanderbilt Sports Medicine, Vanderbilt University Medical Center, 1215 21st Avenue South, 3200 MCE South Tower, Nashville, TN 37232, USA. Electronic address: david.g.liddle@vanderbilt.edu. [Ti] Title: Nutritional supplements and ergogenic AIDS. [So] Source: Prim Care;40(2):487-505, 2013 Jun. [Is] ISSN: 1558-299X [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: Performance enhancing drugs, ergogenic aids, and supplements come in many forms. The financial, personal, social, and health-related impact of these substances has wide and varied consequences. This article reviews common substances and practices used by athletes. It discusses the history, use, effects, and adverse effects of androgenic anabolic steroids, peptide hormones, growth factors, masking agents, diuretics, volume expanders, ß-blockers, amphetamines, caffeine, other stimulants, and creatine. The evidence base behind the use, safety, and efficacy of these items as well as testing for these substances is discussed. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23668645 [Au] Autor: Becker JA; Stumbo JR [Ad] Address: Primary Care Sports Medicine Fellowship, Jewish Hospital and University of Louisville, Louisville, KY, USA; Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA. Electronic address: jon.becker@louisville.edu. [Ti] Title: Back pain in adults. [So] Source: Prim Care;40(2):271-88, 2013 Jun. [Is] ISSN: 1558-299X [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: This article provides a summary of the many causes of back pain in adults. There is an overview of the history and physical examination with attention paid to red flags that alert the clinician to more worrisome causes of low back pain. An extensive differential diagnosis for back pain in adults is provided along with key historical and physical examination findings. The various therapeutic options are summarized with an emphasis on evidence-based findings. These reviewed treatments include medication, physical therapy, topical treatments, injections, and complementary and alternative medicine. The indications for surgery and specialty referral are also discussed. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23668643 [Au] Autor: Sills AK [Ad] Address: Department of Neurosurgery, Vanderbilt University Medical Center, 2009 Mallory lane, Franklin, TN 37067, USA; Department of Orthopedic Surgery, Vanderbilt University Medical Center, 2009 Mallory lane, Franklin, TN 37067, USA. Electronic address: allen.sills@vanderbilt.edu. [Ti] Title: Treatment of head injuries. [So] Source: Prim Care;40(2):253-8, 2013 Jun. [Is] ISSN: 1558-299X [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: Sports-related brain injuries are increasing in incidence and may affect athletes from many different sports. Concussion is the most common form of sports-related head injury and is a form of mild traumatic brain injury. Evaluations of concussed athletes should include careful history, focused neurologic examination, balance testing, and cognitive testing. Postinjury management consists of avoiding aggravating factors until symptoms resolve. Return to play should not begin until all symptoms resolve, and then this should be done in a graduated fashion that avoids recreating symptoms. Research is ongoing concerning the maximum safe number of concussive injuries and any possible long-term sequelae. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23465607 [Au] Autor: White PW; Martin SW; De Jong MC; O'Keeffe JJ; More SJ; Frankena K [Ad] Address: Centre for Veterinary Epidemiology and Risk Analysis (CVERA), Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: Paul.W.White@ucd.ie. [Ti] Title: The importance of 'neighbourhood' in the persistence of bovine tuberculosis in Irish cattle herds. [So] Source: Prev Vet Med;110(3-4):346-55, 2013 Jul 1. [Is] ISSN: 1873-1716 [Cp] Country of publication: Netherlands [La] Language: eng [Ab] Abstract: Local persistence of infection is a key feature of bovine tuberculosis (bTB) among cattle herds in the Republic of Ireland. The aim of this study was to determine the relative importance of 'neighbourhood', specifically farm-to-farm spread and spread from wildlife, in the persistence of bTB by investigating herds having a bTB episode in 2006. A case-control study was conducted on the association between the occurrence of a bTB episode in 2006 and the occurrence of bTB in previous years among neighbouring herd(s) within 1km, while controlling for each herd's bTB history and other risk factors. Neighbouring herds were grouped into three zones, based on distance, and bTB incidence measures summarised within each zone and by calendar year (2001-2005). The incidence of bTB was associated with an increased animal incidence in two subsets of neighbouring herds: (i) herds directly contiguous during the previous 2 years (attributable fraction=0.20), and (ii) herds at a distance of >25m in the previous year (attributable fraction=0.19). Other predictors of bTB in a herd in 2006 included the occurrence of a bTB episode within that herd in any of the previous 5 years, herd size, and the number of animals purchased at age greater than 12 months. An infected wildlife source best explains the existence of a "neighbouring herd risk" for bTB at distances greater than 25m. Further studies will be necessary to determine to what extent neighbouring herd risk within 25m may be confounded by the same wildlife (badger) source. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23205345 [Au] Autor: Hegge HH; Slaets JJ; Cohen-Schotanus J [Ad] Address: Institute for Medical Education, University Medical Centre Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands ; Department of Internal Medicine/Geriatrics, University Medical Centre Groningen, Groningen, the Netherlands. [Ti] Title: Longitudinal training and assessing consultation competence, a role for self reflection on performance. [So] Source: Perspect Med Educ;1(4):207-13, 2012 Nov. [Is] ISSN: 2212-2761 [Cp] Country of publication: Netherlands [La] Language: eng [Ab] Abstract: Medical consultation (patient-doctor encounter), consisting of history taking, physical examination and treatment, is the starting point of any contact between doctor and patient. Learning to conduct a consultation is a complex skill. Both communicative and medical contents need to be applied and integrated. Conducting an adequate consultation is a skill which is gradually learned and perfected during training and career. This article discusses the background and implementation of a longitudinal integrated consultation training programme in clerkships. In the programme, the student's reflection on the consultation plays an important role in education and assessment. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [St] Status: In-Data-Review [do] DOI: 10.1007/s40037-012-0028-x

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[PMID]: 23668875 [Au] Autor: Ramos AA; Vega MA; Valencia HS; García JC; Perez VC [Ad] Address: Neurosurgery Department, General Hospital of Albacete, Albacete, Spain. Electronic address: aida_ar20@hotmail.com. [Ti] Title: Intraparenchymal schwannoma involving the brainstem in a young woman. [So] Source: Pediatr Neurol;48(6):472-4, 2013 Jun. [Is] ISSN: 1873-5150 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: Schwannomas are tumors derived from the Schwann cells, which form the myelin sheath of the peripheral nerves. Fewer than 1% of these tumors occur within the brain parenchyma without arising from the cranial nerves. Only 55 cases have been published after the first recorded case. We report a 17-year-old girl with a 3-month history of unspecific dizziness, unsteadiness, and headache. Magnetic resonance imaging showed a heterogeneous cystic lesion involving midbrain, pons, and left cerebellar peduncle. The patient underwent a retromastoid craniotomy with complete resection of the tumor. Pathologic examination was compatible with intraparenchymal schwannoma. Since the first case of intraparenchymal schwannoma involving the brainstem was described in 1980, only seven others have been reported. Diagnosis of intraparenchymal schwannoma is almost never made preoperatively. Immunohistochemical staining is crucial in distinguishing a Schwannoma from a meningioma, glial tumor, or metastatic tumor. Pathologic findings are those typical of acoustic neurinomas. Histogenesis of intraparenchymal schwannoma remains unclear, and several theories have been proposed to explain their origin. The recognition of this curable tumor and its differentiation from brainstem glioma, which generally has a less favorable outcome, is of obvious importance. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review

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[PMID]: 23671655 [Au] Autor: Kasera R; Singh AB; Lavasa S; Nagendra K; Arora N [Ad] Address: Allergy and Immunology Section, CSIR-Institute of Genomics and Integrative Biology, Delhi, India ; University of Pune, Ganeshkhind, Pune, India. [Ti] Title: Purification and Immunobiochemical Characterization of a 31 kDa Cross-Reactive Allergen from Phaseolus vulgaris (Kidney Bean). [So] Source: PLoS One;8(5):e63063, 2013. [Is] ISSN: 1932-6203 [Cp] Country of publication: United States [La] Language: eng [Ab] Abstract: BACKGROUND: Legumes are a rich source of proteins but are also potential elicitors of IgE-mediated food allergy. This study aimed to isolate and characterize a major allergen of Phaseolus vulgaris (kidney bean) and determine its allergenicity. METHODOLOGY: Kidney bean allergen was purified using Q Sepharose column (anion exchanger) and eluates with high intensity were pooled to purify protein using Superdex 75 (gel filtration) and C18 column (RP-HPLC). Patients with history of kidney bean allergy were skin prick tested (SPT) with crude kidney bean extract and the purified protein. Specific IgE was estimated in sera by enzyme-linked immunosorbent assay (ELISA). Characterization of purified protein and its cross-reactivity was investigated by immunobiochemical methods. Identification of purified protein was carried out by tandem mass spectrometry. PRINCIPAL FINDINGS: Purified protein appeared as a single band at 31 kDa on SDS-PAGE and showed IgE binding to 88% patients' sera by ELISA and immunoblotting. SPT with purified protein identified 78% hypersensitive patients of kidney bean. Significant release of histamine from sensitized basophils was observed after challenge with purified protein. PAS staining suggested it to be a glycoprotein, but no change in IgE binding was observed after periodate oxidation. The 31 kDa protein remained stable for 60 min on incubation with pepsin. The purified protein had high allergenic potential since it required only 102 ng of self protein for 50% IgE inhibition. Mass spectrometric analysis identified it as Phytohemagglutinin. It also showed hemagglutination with human RBCs. Cross-reactivity was observed with peanut and black gram with IC50 of 185 and 228 ng respectively. CONCLUSIONSIGNIFICANCE: A 31 kDa major allergen of kidney bean was purified and identified as phytohemagglutinin with cross-reactivity to peanut and black gram. [Pt] Publication type: JOURNAL ARTICLE [Em] Entry month: 1305 [Js] Journal subset: IM [St] Status: In-Data-Review [do] DOI: 10.1371/journal.pone.0063063

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