At last follow-up, the patient's quality of life had improved by 40 as measured by the 8-item Parkinson's Disease questionnaire PDQ-8 This study could serve partly as a proof that low-frequency SCS is effective in improving pain as well as gait problems in PD patients, which was unlikely a result of a placebo effect © 2020 S Karger AG, BaselOBJECTIVE Precise diagnosis of allergy requires knowledge of the population's food allergy FA spectrum and predictors METHODS Medical charts of Turkish children aged 0-2 years with FA and/or atopic dermatitis AD were reviewed RESULTS A total of 1,389 patients, 912 with FA and 1,140 with AD, were included In the FA group, the most frequently diagnosed FAs were egg white 759, cow's milk 557, tree nuts 315 and sesame 206 The detection of FA in 99 of children with any kind of FA necessitate testing with egg white, cow's milk, hazelnut, sesame, walnut, cashew, and pistachio In the FA group, 727 and 568 had AD and multiple FA respectively Multiple FA 568 vs 498 and hen's egg allergy 855 vs 502, p less then 0005 were more common and cow's milk allergy 514 vs 671, p less then 0005 less common in the AD subgroup of the FA group than in the non-AD subgroup Multiple FA likelihood increases parallel to the severity of AD p less then 005 In the AD group, 582 had an immunoglobulin E-mediated FA The risk of concomitant FA increased as the age at symptom onset of AD decreased OR 0800 [95 CI 0731-0875]; p less then 0001 and the severity of AD increased OR 2350 [95 CI 1898-2911]; p less then 0001 CONCLUSION Although severe and early-onset AD is a predictor of the presence and magnitude of FA in infancy, the spectrum of FA is a reflection of cultural characteristics The clinical presentations of both AD and FA may in fact be an expression of the extent of the immune dysregulation underlying atopy and allergy © 2020 S Karger AG, BaselBACKGROUND Intracytoplasmic lumina ICL are observed in several cancers, including urothelial carcinoma UC We have reported that ICL in urine cytology cICL is more frequent in high-grade UCs than in low-grade UCs; however, the correlation between the presence of ICL and prognosis is unclear OBJECTIVES The aim of this work was to determine the association between cICL and prognosis in bladder cancer METHOD We retrospectively investigated 87 patients with bladder cancer who received a histological diagnosis within 3 months of urine cytology at Kanazawa Medical University between 2003 and 2007 The cytological diagnosis and the number of cICL, histological diagnosis, tumor grade or variant, pT stage, ICL in histological specimens, and immunohistochemistry for mucins were evaluated Data on the treatment type, recurrence, survival, cause of death, and length of follow-up were collected from electronic medical records RESULTS Muscle invasion, high-grade UC, lymph node metastasis, distant metastasis, adjuv a worse prognosis in urine cytology © 2020 S Karger AG, BaselBACKGROUND In 2014, the World Health Organization WHO released a classification system introducing neuroendocrine neoplasms NENs of the female reproductive tract, excluding the ovaries This study aimed to evaluate whether retrospective adaption of the gastroenteropancreatic GEP-NEN classification is feasible for ovarian NENs O-NENs and correlates with prognosis METHODS Sixty-eight patients diagnosed with carcinoid, small cell carcinoma pulmonary type, paraganglioma, non-small/large cell neuroendocrine carcinoma NEC, mixed NEC, or undifferentiated carcinomas at 20 institutions in Japan were included in this retrospective cross-sectional study We identified O-NENs through central pathological review using a common slide set, followed by reclassification according to WHO 2010 guidelines for GEP-NENs A proportional hazards model was used to assess the association of prognostic factors age, stage, performance status, histology, and residual disease with overall survival OS and progression-free survival PFS RESULTS Of the 68 enrolled patients, 48 were eligible for analysis All carcinoids n = 32 were reclassified as NET G1/G2, whereas 14 of 16 carcinomas were reclassified as NEC/mixed adeno-NEC MANEC Fisher's exact test, p less then 001 The OS/PFS was 490/425 months and 65/39 months for NET G1/G2 and NEC/MANEC, respectively Histology revealed that NEC/MANEC was associated with increased risk of death HR = 480; 95 CI, 393-586; p less then 001 and disease progression HR = 516; 95 CI, 554-480; p less then 001  https//wwwselleckchemcom/products/fluspirilenehtml  CONCLUSION Retrospective adaption of GEP-NEN classification to O-NENs is feasible and correlates well with the prognosis of O-NENs This classification could be introduced for ovarian tumors UMIN Clinical Trials Registry number UMIN000019754 © 2020 S Karger AG, BaselOBJECTIVE Diabetic cardiomyopathy DCM is a serious complication of type 2 diabetes mellitus T2DM, resulting in unfavorable prognosis Icariin ICA is a major flavonoid isolated from the traditional oriental herbal medicine Epimedium that has been recently proved to show potential therapeutic efficacy on T2DM The aim of this study was to investigate the underlying mechanism of how ICA improved DCM in rat models METHODS To corroborate myocardial improvement by ICA, we managed to establish the T2DM rat model by streptozotocin STZ administration and high-glucose-high-fat diet RESULTS The rats with T2DM showed severe insulin resistance, left ventricular dysfunction, aberrant lipids deposition, cardiac inflammation, and fibrosis compared with the control group All these pathological symptoms were ameliorated by the treatment of ICA The levels of extracellular matrix proteins of heart tissue significantly declined in ICA-treated rats CONCLUSION ICA may exert as a protector in T2DM-induced DCM by reducing extracellular matrix proteins in the heart tissue, implicating its potential role for the treatment of human DCM © 2020 S Karger AG, BaselA time-dependent loss of cell solute protects against lethal cerebral edema in hyponatremia This adaptation, which makes survival possible when the serum sodium concentration is extremely low, also makes the brain vulnerable to injury if chronic gt;48 hours hyponatremia is corrected more rapidly than lost brain solutes can be recovered Rapid correction of chronic hyponatremia results in programmed cell death of astrocytes and oligodendrocytes and presents clinically with a delayed onset of neurological findings, known as the osmotic demyelination syndrome This iatrogenic complication can be avoided by limiting correction of hyponatremia to less then 8 mEq/L per day © 2019 S Karger AG, BaselThe etiology of hyponatremia is often multifactorial The most common causes include hypovolemia from gastrointestinal GI or other fluid losses, thiazide diuretics, and SIAD [] The management of hypovolemic hyponatremia starts with confirming its presence and determining the underlying cause Correction focuses on the appropriate use of isotonic fluid to effect volume repletion while avoiding an overly rapid rise in serum [Na+] concentration © 2019 S Karger AG, BaselHyponatremia is the commonest electrolyte deficiency in clinical practice Of the many causes of hyponatremia, syndrome of inappropriate antidiuresis SIAD is the commonest Glucocorticoid deficiency, due to central/secondary adrenal insufficiency, is the key differential diagnosis for SIAD, as it presents with a similar biochemical picture of euvolemic hyponatremia and inappropriate urinary concentration The underlying mechanisms for the development of hyponatremia in glucocorticoid deficiency are 1 impaired renal water handling in the absence of circulating cortisol and 2 increased plasma concentrations of arginine vasopressin AVP, despite hypo-osmolality The original diagnostic criteria for SIAD emphasized that normal adrenal reserve was essential for its diagnosis, in recognition of the similar biochemical presentation of SIAD and glucocorticoid deficiency This has been emphasized in all of the recently published clinical guidelines However, data from the literature suggest that clinicians ignore the measurement of plasma cortisol concentration in both clinical practice and research protocols The reported prevalence of glucocorticoid deficiency in patients presenting with euvolemic hyponatremia may, therefore, be underestimated and patients with a dangerous, but treatable cause of hyponatremia are inevitably missed In this chapter, we will review the physiopathology of hyponatremia in the setting of glucocorticoid deficiency We will discuss the differential diagnosis of euvolemic hyponatremia and review the prevalence of glucocorticoid deficiency in patients with hyponatremia © 2019 S Karger AG, BaselIn the evolutionary process, the successful adaptation of living organisms initially to an aqueous and thereafter to an arid terrestrial environment posed radically different challenges to the maintenance of water balance Whereas the former required defense against water excess, the latter called for water conservation To meet such challenges, the mammalian nephron evolved mechanisms for increasing both water excretion by diluting and water conservation by concentrating the urine This chapter reviews the process whereby the osmosensors control thirst and the secretion of the antidiuretic hormone vasopressin to allow for either urinary dilution or concentration and thereby delicately maintain tonicity of body fluids within a very narrow range Central to this process is the now well-defined cellular pathway whereby vasopressin renders the collecting duct, water permeable Disorders of vasopressin secretion and action result in disturbances of body fluids tonicity, which are clinically recognized as abnormalities in reduced plasma sodium concentration or hyponatremia © 2019 S Karger AG, BaselIn clinical practice, several medications such as diuretics, psychotropic drugs, and anticonvulsants have been reported to be a frequent cause of hyponatremia Drugs may cause hyponatremia either by affecting the homeostasis of sodium and water eg, diuretics or by altering the water homeostasis as a consequence of the syndrome of inappropriate secretion of antidiuretic hormone On the contrary, drugs commonly prescribed in everyday clinical practice, including proton pump inhibitors, antibiotics, angiotensin-converting enzyme inhibitors, hypoglycemic agents and, amiodarone, have been infrequently 'incriminated' as causes of hyponatremia Therefore, in the diagnostic approach of patients with low serum [Na+] levels, meticulous history taking and recording of pharmacotherapy is warranted to identify potentially culprit medications Taking into account the adverse outcomes associated with even mild hyponatremia ie, impaired cognition, falls and fractures, mortality, recognition of drug-induced hyponatremia is of vital importance, while responsible agents should be discontinued and "re-challenge" should be avoided by informing the patient and involved caregivers © 2019 S Karger AG, BaselThe clinical administration of GABAergic medications leads to hypotension which has classically been attributed to the modulation of neuronal activity in the central and peripheral nervous systems However, certain types of peripheral smooth muscle cells have been shown to express GABAA receptors, which modulate smooth muscle tone, by the activation of these chloride channels on smooth muscle cell plasma membranes Limited prior studies demonstrate that non-human large-caliber capacitance blood vessels mounted on a wire myograph are responsive to GABAA ligands We questioned whether GABAA receptors are expressed in human resistance arteries and whether they modulate myogenic tone We demonstrate the novel expression of GABAA subunits on vascular smooth muscle from small-caliber human omental and mouse tail resistance arteries We show that GABAA receptors modulate both plasma membrane potential and calcium responses in primary cultured cells from human resistance arteries Lastly, we demonstrate functional physiologic modulation of myogenic tone via GABAA receptor activation in human and mouse arteries