https://www.giejournal.org/article/S0016-5107(01)70371-9/pdf

Total enteroscopy with a nonsurgical steerable double-balloon method

HCN cation channel mRNA expression was determined in the rabbit heart and neonatal and adult rat ventricle using RNase protection assays. In the rabbit SA node, the dominant HCN transcript is HCN4, representing >81% of the total HCN message. HCN1 is also expressed, representing >18% of the total HCN mRNA. Rabbit Purkinje fibers contained almost equal amounts of HCN1 and HCN4 transcripts with low levels of HCN2, whereas rabbit ventricle contained predominantly HCN2. The SA node contained 25 times the total HCN message of Purkinje fibers and 140 times the total HCN message of ventricle. No reports of hyperpolarization-activated current (If) exist in rabbit Purkinje fibers, and we could not record If in rabbit ventricular myocytes. To investigate the possible role of isoform switching in determining the voltage dependence of If, we determined the prevalence of HCN isoforms in neonatal and adult rat ventricle. We had previously determined the threshold for activation of If to be approximately -70 mV in neonatal rat ventricle and -113 mV in adult rat ventricle. In both neonatal and adult rat ventricle, only HCN2 and HCN4 transcripts are present. The ratio of HCN2 to HCN4 is approximately 5:1 in the neonate and 13:1 in the adult. Taken together, these results suggest that different cardiac regions express different isoforms of the HCN family. The HCN1 and HCN4 isoforms are most closely associated with a depolarized threshold for If activation, whereas the HCN2 isoform is associated with a more negative activation curve.

UltraRapid Communication Distribution and Prevalence of Hyperpolarization-Activated Cation Channel (HCN) mRNA Expression in Cardiac Tissues

1.0 Introduction

2.0 Formulation of guidelines

2.1 Grading of recommendations

2.2 Scheduled review

3.0 Summary of recommendations

4.0 Types of small bowel enteroscopy

4.1 Enteroscopy using a colonoscope

4.2 Sonde enteroscopy

4.3 Push enteroscopy

4.4 Intraoperative enteroscopy

4.5 Double balloon (push and pull) enteroscopy

5.0 Capsule endoscopy

5.1. Technique

5.2 Indications for capsule endoscopy

5.3 Complications of capsule endoscopy

5.4 Patency capsule

6.0 Service provision and training

References

The small bowel has historically been a difficult area to examine due to its anatomy, location and relative tortuosity. Examination beyond the duodenojejunal flexure is of importance in a number of small bowel disorders. Before the advent of enteroscopy or capsule endoscopy, radiographic studies had been the main investigative modality of the small bowel. Barium follow-through and enteroclysis permits indirect examination of the small bowel but has a low diagnostic yield particularly in the context of obscure gastrointestinal bleeding.1–3

Capsule endoscopy and enteroscopy are now the preferred methods to examine the small bowel in most situations. These guidelines are intended to provide an evidence based document describing endoscopic investigation of small bowel disorders.

These guidelines were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) and have been produced by the small bowel and endoscopy sections of the BSG. The guidelines have been produced to conform to the North of England evidence based guidelines development project.4 5 They have been drawn up from a Medline, Embase and Ovid literature search using terms “enteroscopy”, “push enteroscopy”, “intraoperative enteroscopy”, “double balloon enteroscopy” and “capsule endoscopy”. There have been 180 peer review studies, seven review articles, 58 case reports and letters, and one set of American guidelines on enteroscopy.6 The literature search for capsule endoscopy includes 100 peer review studies, 51 review articles, 74 …

Guidelines on small bowel enteroscopy and capsule endoscopy in adults

Small intestinal neoplasms are uncommonly encountered in clinical practice They may occur sporadically, in association with genetic diseases (eg, familial adenomatous polyposis coli or Peutz-Jeghers syndrome), or in association with chronic intestinal inflammatory disorders (eg, Crohn's disease or celiac sprue) Benign small intestinal tumors (eg, leiomyoma, lipoma, hamartoma, or desmoid tumor) usually are asymptomatic but may present with intussusception Primary malignancies of the small intestine-including adenocarcinoma, leiomyosarcoma, carcinoid, and lymphoma-may present with intestinal obstruction, jaundice, bleeding, or pain Extraintestinal neoplasms may involve the intestine via contiguous spread or peritoneal metastasis Hematogenous metastases to the intestine from an extraintestinal primary are unusual and are most typical of melanoma Because the small intestine is relatively inaccessible to routine endoscopy, diagnosis of small intestinal neoplasms is often delayed for months after onset of symptoms When the diagnosis is suspected, enteroclysis is the most useful imaging study Small bowel endoscopy (enteroscopy) is increasingly widely available and may permit earlier, nonoperative diagnosis

Small Intestinal Neoplasms

We may not be able to make you love reading, but statistics for epidemiology will lead you to love reading starting from now. Book is the window to open the new world. The world that you want is in the better stage and level. World will always guide you to even the prestige stage of the life. You know, this is some of how reading will give you the kindness. In this case, more books you read more knowledge you know, but it can mean also the bore is full.

Statistics in epidemiology

Polycystic ovary syndrome (PCOS), or Stein-Leventhal syndrome, is a common endocrine disorder defined by two of the three following features: i) oligoovulation or anovulation, ii) clinical and/or biochemical signs of hyperandrogenism, or iii) polycystic ovaries, once the related endocrinological and gynaecological disorders have been excluded. PCOS does not exclusively involve the reproductive apparatus , it has a complex number of systemic relevancy symptoms. It leads to Metabolic Syndrome, with severe consequences on the cardiovascular apparatus. Many clinical studies have underlined the connection between PCOS and the cardiovascular risk profile of such female patients, due to a lipid/glucose altered metabolism, hypertension, systemic inflammatory condition (assessable by markers such as VES, TNF-alfa, citokines and C-reactive protein (hsPCR) levels), and vascular injuries. Considering the early onset of the disease, PCOS could be considered as a real cardiovascular risk factor which affects the quality of life seriously. The current review aimed to point out the main connections between PCOS and cardiovascular risk factors according to the latest findings coming from literature data analysis, and try to depict the great influences that such a common disease can have on the patients' health integrity.

Cardiovascular Risk in Women With PCOS

Hyperpolarization and Cyclic Nucleotide (HCN) -gated channels represent the molecular correlates of the “funny” pacemaker current (If), a current activated by hyperpolarization and considered able to influence the sinus node function in generating cardiac impulses. HCN channels are a family of six transmembrane domain, single pore-loop, hyperpolarization activated, non-selective cation channels. This channel family comprises four members: HCN1-4, but there is a general agreement to consider HCN4 as the main isoform able to control heart rate. This review aims to summarize advanced insights into the structure, function and cellular regulation of HCN channels in order to better understand the role of such channels in regulating heart rate and heart function in normal and pathological conditions. Therefore, we evaluated the possible therapeutic application of the selective HCN channels blockers in heart rate control.

https://www.mdpi.com/1420-3049/17/4/4225/pdf

HCN Channels and Heart Rate

Laparoscopically assisted total enteroscopy: a new approach to small intestinal diseases.

Venous echo-color-Doppler (ECD) showed that chronic cerebrospinal venous insufficiency (CCSVI) syndromeis related to multiple sclerosis (MS). Study aims were to assess interobserver variability in ultrasound evaluation of MSpatients and to relate echo-markers to MS clinical symptoms and the disability degree. 277 MS patients (117 men, meanage 43.05+10.04 years) admitted to the Neurology Department of Bari University General Hospital, underwent clinical,Expanded Disability Status Scale (EDSS) evaluation, and a cerebro-venous system ECD evaluation. Two operators reevaluated32 patients to calculate interobserver variability. McNemar test confirmed the procedure reproducibilitybetween two operators (p=ns). Septa/membranes correlated with deep cerebral veins reflux [right: 16% absence vs. 58%presence, p<0.0001; left: 26% vs. 50%, p<0.0001]; their absence in Primary Progressive (PP) MS form [right: 11% vs.2%, p<0.001; left: 12% vs. 2%, p<0.001]. Internal jugular veins (IJVs) reflux absence was in Relapsing-remitting (RR)form [right: 60% vs. 74%, p=0.036; left: 56% vs. 85%, p<0.0001] like hemodynamically significant stenosis [right: 57%vs. 69%, p=0.033; left: 49% vs. 73%, p<0.001] not present in PP [right: 11% vs. 2%, p<0.001; left: 10% vs. 3%, p=0.009].A supine IJVs blocked flow was related to the EDSS class [right: 4.8±1.5 vs. 5.4±1.4, p=0.006; left: 4.7±1.6 vs. 5.5±1.2,p<0.0001]; its absence was linked to RR [right: 60% vs. 76%, p=0.016; left: 58% vs. 79%, p<0.001]. ECD has animportant value in MS patients with IJV anomalies detection and a good interobserver procedure reproducibility. MS isassociated with CCSVI, although further studies are needed.

Multigate Quality Doppler Profiles and Morphological/Hemodynamic Alterations in Multiple Sclerosis Patients

Background: The study aim was to test the accuracy (intra and interobserver variability), sensitivity, and specificity of a simplified noninvasive ultrasound methodology for mapping superficial and deep veins of the lower limbs. Methods: 62 consecutive patients, aged 62 ± 11 years, were enrolled. All underwent US- examinations, performed by two different investigators, of both legs, four anatomical parts, and 17 veins, to assess the interobserver variability of evaluation of superficial and deep veins of the lower limbs. Results: Overall the agreement between the second versus the first operator was very high in detecting reflux (sensitivity 97.9, specificity 99.7, accuracy 99.5; P = 0.80 at McNemar test). The higher CEAP classification stages were significantly associated with reflux (odds ratio: 1.778, 95% confidence interval: 1.552–2.038; P , 0.001) as well as with thrombosis (odds ratio: 2.765, 95% confidence interval: 1.741–4.389; P , 0.001). Thus, our findings show a strict association between the symptoms of venous disorders and ultrasound evaluation results for thrombosis

/pdf/doppler-ultrasound-venous-mapping-of-the-lower-limbs-38krq3zz7t.pdf

Rosa Carbonara

Papers

Cardiovascular Risk in Women With PCOS

HCN Channels and Heart Rate

Laparoscopically assisted total enteroscopy: a new approach to small intestinal diseases.

Multigate Quality Doppler Profiles and Morphological/Hemodynamic Alterations in Multiple Sclerosis Patients

Doppler ultrasound venous mapping of the lower limbs