Syphilitic hepatitis: an increasingly common presentation of an epidemic disease

Background: Diabetes mellitus type 2 (DMT2) is an endocrine disease of global proportions which is currently affecting 1 in 12 adults in the world, with still increasing prevalence. World Health Organization (WHO) declared this worldwide health problem, as an epidemic disease, to be the only non-infectious disease with such categorization. People with DMT2 are at increased risk of various complications and have shorter life expectancy. The main classes of oral antidiabetic drugs accessible today for DMT2 vary in their chemical composition, modes of action, safety profiles and tolerability. Methods: A systematic search of peer-reviewed scientific literature and public databases has been conducted. We included the most recent relevant research papers and data in respect to the focus of the present review. The quality of retrieved papers was assessed using standard tools. Results: The review highlights the chemical structural diversity of the molecules that have the common target-DMT2. So-called traditional antidiabetics as well as the newest and the least explored drugs include polypeptides and amino acid derivatives (insulin, glucagon-like peptide 1, dipeptidyl peptidase-IV inhibitors, amylin), sulfonylurea derivatives, benzylthiazolidine- 2,4-diones (peroxisome proliferator activated receptor-γ agonists/glitazones), condensed guanido core (metformin) and sugar-like molecules (α-glucosidase and sodium/ glucose co-transporter 2 inhibitors). Conclusion: As diabetes becomes a more common disease, interest in new pharmacological targets is on the rise.

Download Full-text

Obstructive uropathy in the context of ureteroinguinal hernia: experience of challenges in surgical management of an unwell patient

BMJ Case Reports ◽

10.1136/bcr-2020-235060 ◽

2020 ◽

Vol 13 (8) ◽

pp. e235060

Author(s):

Mitchell Egerton Barns ◽

Arvind Vasudevan ◽

Emma Lucy Marsdin

Keyword(s):

Obstructive Uropathy ◽

Anatomical Variation ◽

Surgical Patients ◽

Definitive Treatment ◽

Ureteric Stent ◽

Common Presentation ◽

Iatrogenic Damage ◽

Vesicoureteric Junction ◽

Collecting System

This case exemplifies an unusual anatomical variation of a common presentation and highlights the importance of perioperative diagnosis and planning in complex surgical patients. A 72-year-old comorbid man presented to the emergency department with an infected obstructed right kidney secondary to an obstructing 12 mm vesicoureteric junction calculi. However, imaging also showed concurrent ureteroinguinal hernia associated with a 130 cm-long ureter, too long for conventional treatment with a ureteric stent. Acutely, the patient’s collecting system was decompressed via nephrostomy, but due to the rarity of this anatomical variation, definitive treatment had to be rethought to help reduce the risk of iatrogenic damage and the associated long-term complications.

Download Full-text

Yellow Fever

10.1093/oso/9780198819660.003.0018 ◽

2018 ◽

Author(s):

Samuel K. Cohn, Jr.

Keyword(s):

Yellow Fever ◽

Young Men ◽

Psychological Effects ◽

Epidemic Disease ◽

Us History ◽

Social Clubs ◽

Racial Boundaries ◽

Mass Evacuation

As measured by mass evacuation of cities, yellow fever provoked more fear and panic than any other epidemic disease in US history. This chapter concentrates on two of the most devastating epidemics in US history, yellow fever in Philadelphia in 1793 and in Memphis in 1878. Despite different times, medical ideas, and cultural horizons, their socio-psychological effects were similar: they began in chaos and with acrimony, but quickly sentiments turned, sparking abnegation and compassion that united these cities across ethnic, class, and racial boundaries. In both cities, the protagonists of the new waves of compassion were young men, and in Memphis yellow fever relief centred on established men’s social clubs as well as creating new ones.

Download Full-text

Back to reality: transition techniques from short HMD-based virtual experiences to the physical world

Multimedia Tools and Applications ◽

10.1007/s11042-021-11317-w ◽

2021 ◽

Author(s):

Robin Horst ◽

Ramtin Naraghi-Taghi-Off ◽

Linda Rau ◽

Ralf Dörner

Keyword(s):

Virtual Reality ◽

Virtual World ◽

Visual Cues ◽

User Study ◽

Physical World ◽

Direct Communication ◽

Common Presentation ◽

Presentation Media ◽

Virtual Experiences ◽

Short Times

AbstractEvery Virtual Reality (VR) experience has to end at some point. While there already exist concepts to design transitions for users to enter a virtual world, their return from the physical world should be considered, as well, as it is a part of the overall VR experience. We call the latter outro-transitions. In contrast to offboarding of VR experiences, that takes place after taking off VR hardware (e.g., HMDs), outro-transitions are still part of the immersive experience. Such transitions occur more frequently when VR is experienced periodically and for only short times. One example where transition techniques are necessary is in an auditorium where the audience has individual VR headsets available, for example, in a presentation using PowerPoint slides together with brief VR experiences sprinkled between the slides. The audience must put on and take off HMDs frequently every time they switch from common presentation media to VR and back. In a such a one-to-many VR scenario, it is challenging for presenters to explore the process of multiple people coming back from the virtual to the physical world at once. Direct communication may be constrained while VR users are wearing an HMD. Presenters need a tool to indicate them to stop the VR session and switch back to the slide presentation. Virtual visual cues can help presenters or other external entities (e.g., automated/scripted events) to request VR users to end a VR session. Such transitions become part of the overall experience of the audience and thus must be considered. This paper explores visual cues as outro-transitions from a virtual world back to the physical world and their utility to enable presenters to request VR users to end a VR session. We propose and investigate eight transition techniques. We focus on their usage in short consecutive VR experiences and include both established and novel techniques. The transition techniques are evaluated within a user study to draw conclusions on the effects of outro-transitions on the overall experience and presence of participants. We also take into account how long an outro-transition may take and how comfortable our participants perceived the proposed techniques. The study points out that they preferred non-interactive outro-transitions over interactive ones, except for a transition that allowed VR users to communicate with presenters. Furthermore, we explore the presenter-VR user relation within a presentation scenario that uses short VR experiences. The study indicates involving presenters that can stop a VR session was not only negligible but preferred by our participants.

Download Full-text

How we do it: impacted oesophageal foreign body removal using a dilatation balloon

The Journal of Laryngology & Otology ◽

10.1017/s002221512100178x ◽

2021 ◽

pp. 1-3

Author(s):

P D Chakravarty ◽

T Kunanandam ◽

G Walker

Keyword(s):

Foreign Body ◽

Granulation Tissue ◽

Foreign Bodies ◽

Fluoroscopic Guidance ◽

Tertiary Referral ◽

Foreign Body Removal ◽

Novel Technique ◽

Common Presentation ◽

Reproducible Technique ◽

Rigid Oesophagoscopy

Abstract Background Ingested foreign bodies are a common presentation to paediatric ENT services. Depending on the site, these are usually managed with flexible or rigid oesophagoscopy and retrieval. This paper presents a novel technique for removing a hollow foreign body that could not be removed using conventional means. Method and results After rigid and flexible approaches failed, a guidewire was passed through the foreign body under fluoroscopic guidance and a dilatation balloon passed through the lumen of the object. Inflating the balloon allowed dilatation of the inflamed mucosa above and below the object, facilitating straightforward removal under traction. Conclusion This is a novel and reproducible technique that uses equipment readily available in tertiary referral centres. Employed in this context, the technique enabled removal of an impacted object surrounded by granulation tissue, and would be appropriate for other objects with a lumen.

Download Full-text