Interoperative measurements using magnetic sensors is a valuable technique in cancer surgery for finding magnetic tracers. Here we present a fiber-coupled nitrogen-vacancy (N-V) center magnetometer capable of detecting iron oxide suspension (MagTrace from Endomagnetics Ltd.) used in breast cancer surgeries. Detection of an iron mass as low as 0.56~mg has been demonstrated, 100 times less than that of a recommended dose at a maximum distance of 5.8~mm. Detection of an iron concentration as low as 2.8 mg/ml has also been demonstrated, 20 times less than a recommended dose. The maximum working distance from the sensor can be as large as 14.6~mm for higher concentrations. The sensor head has a maximum diameter of 10~mm which would allow it to be used for endoscopy, laparoscopy and interoperative surgery.
Type 2 diabetes mellitus (T2DM), a chronic condition commonly observed in adults, particularly among the elderly, is characterized by a dysfunctional insulin response that impairs blood glucose regulation, resulting in persistent hyperglycemia. Ginseng, a medicinal plant with significant economic value and a longstanding history of therapeutic use in Asia, has shown efficacy against various diseases. Extensive clinical and experimental studies highlight ginsenosides, its primary bioactive compounds, for their multiple therapeutic effects across a range of conditions, including endocrine, cardiovascular, and central nervous system disorders. Various ginsenoside types have demonstrated potential in lowering blood glucose levels, reducing insulin resistance, and alleviating complications through the modulation of key protein targets and signaling pathways. This review consolidates the pharmacological actions and mechanisms of distinct ginsenosides in managing diabetes and its complications, offering a theoretical foundation for further pharmacological research and novel drug development for T2DM treatment, while also providing robust theoretical support for future clinical applications.
Background Objective measurements estimated that 1.57 billion people globally had hearing loss in 2019. However, where audiologists are sparse, self-reported measures have been suggested as alternatives to assess burden. Moreover, research suggests this number varies by gender, due to biological and social mechanisms. Further refining our knowledge of the global prevalence of hearing loss will provide better understanding of which groups are most affected and how to best allocate resources.Methods Using Gateway to Global Ageing data and the South African National Income Dynamics Study, we estimated the prevalence and men:women ratio of self-reported hearing loss and hearing aid use for 28 countries. Hearing loss was measured as having fair/poor hearing or reporting hearing aid use. We included 664 580 observations of individuals aged 50+ years.Results We found that the four countries with the highest levels of hearing loss (China 65%, South Korea 39%, Mexico 33%, Brazil 31%) also had the lowest reported hearing aid use (as low as 1% in China). Though men were more likely than women to report hearing loss in nearly all countries, especially in regions with higher hearing aid use (USA, Northern/Western Europe), China, South Korea and South Africa reported no gender difference. As the prevalence of hearing loss and hearing aid use increased with age, gender differences generally decreased.Conclusion International variation underscores the importance of country context in shaping perceived hearing and hearing aid use. Regions with high levels of hearing loss and low hearing aid use may be especially amenable to interventions.
Medicine (General), Infectious and parasitic diseases
Giacomo Buso, Thomas Weber, Christos Fragoulis
et al.
Background Acute blood pressure (BP) elevations are common in emergency settings and are traditionally classified into hypertensive urgencies (HU) and hypertensive emergencies (HE). Malignant hypertension (MHT) represents a severe form of HE characterised by small vessel damage. Although international guidelines provide clear definitions and treatment strategies, real-world data have shown persistent fragmentation and heterogeneity in the diagnosis and management of these patients.Methods A web-based, anonymous survey promoted by the European Society of Hypertension (ESH) was distributed among physicians from 18 European and 4 non-European countries. The questionnaire assessed definitions, diagnostic work-up, BP measurement practices, and therapeutic strategies for HU, HE, and MHT.Results Sixty–four participants in 56 centres completed the survey. HU was correctly defined as a severe BP elevation without acute clinically symptomatic hypertension-mediated organ damage (A-HMOD) by 45.3% of respondents. Small cuffs were available to 79.7% and extra-large cuffs to 70.3% of respondents.. Intravenous antihypertensive therapy was used for HE by 88.7% of participants, while 20.6% also used intravenous drugs for HU. Parenteral clonidine and sublingual nifedipine were prescribed by 29.7% and 26.6% of respondents, respectively. Definitions and therapeutic approaches for MHT varied substantially, with 62.9% adopting a recently proposed definition involving at least three target organ damages in patients with BP >200/120 mmHg.Conclusions This international survey highlights considerable variability in the definition, diagnostic work-up, and therapeutic management of acute BP elevations, emphasising the need for harmonised protocols and further education.
Diseases of the circulatory (Cardiovascular) system
Background: We aimed to assess knowledge of emergency department (ED) physicians regarding the classification and treatment of angioedema and to evaluate the impact of a training program on this knowledge base. Methods: A total of 11 questions about angioedema and its types were posed to ED physicians from various hospitals, either in person or via e-mail, before the implementation of an educational module on the subject (pre-test). Following a brief training period, the ED physicians were presented with the same set of questions once again (post-test). The reliability between the repeated tests were estimated using intraclass correlation coefficients (ICC). Item difficulty was calculated separately for each question in both the pre-test and post-test. Results: A total of 541 ED physicians participated in the pre-test survey, and 162 of them declined to participate in the post-test survey. The remaining 379 participated in the post-test survey as well. The ICC between the repeated tests indicated a moderate level of reliability (mean ICC = 0.5; 0.42–0.57; lower and upper 95% confidence intervals). The mean item difficulty was 0.36 in the pre-test, indicating that the items had an appropriate level of difficulty. In the post-test, the mean item difficulty increased to 0.57, suggesting that the items were generally easier, likely reflecting improved knowledge or skills following the intervention. The level of knowledge regarding the clinical features of different types of angioedema was found to be inadequate. Following the training period, there was a notable increase in the number of correct answers, with a statistically significant difference (p = 0.002). Similarly, a remarkable increase was observed in the number of respondents who indicated that bradykinin-mediated-angioedema should be considered in cases of unresponsiveness to antihistamine and-corticosteroid treatment (p < 0.001). Regarding queries about hereditary angioedema (HAE), the majority of ED physicians had no prior experience in treating a patient with HAE, and only a small number were familiar with the symptoms of HAE. Following the training ED physicians demonstrated enhanced knowledge of HAE symptoms and diagnostic criteria (p < 0.001). Similarly, a notable enhancement in familiarity with HAE attack treatments was observed when the inquiries related to these treatments were compared between the pre-test and post-test phases (p < 0.001). Conclusion: In light of the potential lethality of attacks mediated by bradykinin, a training program should include the recognition of rare types of angioedema, with a particular emphasis on HAE disease.
Kanankira A Nnko, Raphael T Pima, Calvin J Baraka
et al.
Verrucous carcinoma is a well-recognized low-grade variant of squamous cell carcinoma. Cutaneous, oral, and anogenital forms exist. Exposure to persistent chronic irritation, inflammation, and repeated injury, as well as carcinogenic agents such as human papillomavirus infection, smoking, and alcohol use, are established risk factors. These neoplasms occur mostly in the oral cavity. The usual extraoral sites include the larynx, esophagus, genitals, and perineum. It is an extremely uncommon site of occurrence for the extraoral chin region. This unusual location makes the index case unique. Other uncommon sites reported include finger and foot. Case studies of verrucous carcinoma with huge tumor sizes are rare. Although it can be destructive locally, verrucous carcinoma typically does not spread to distant sites. Wide surgical excision with free margins is the most common treatment approach with a favorable prognosis. These tumors are likely to recur if they are incompletely excised, and recurred lesions tend to be more aggressive clinically as compared to their original counterparts. Herein, the authors describe a case of a huge oral verrucous carcinoma localized on the chin of a 43-year-old female patient. The clinical course, diagnostics, and proposed treatment have been discussed with the existing available literature.