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Clinical Reasoning: An 82-year-old man with worsening gait

An 82-year-old man with hypothyroidism presented with difficulty walking.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmune diseases, Gait disorders/ataxia, Stiff person syndrome RESIDENT AND FELLOW SECTION Source Type: research

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Conclusion: Plasma miR-146a levels correlated with the severity of coronary atherosclerosis and increased with TSH slightly elevated in patients with CHD. Thus, miR-146a may have good predictive value for CHD among individuals with elevated TSH levels.Cell Physiol Biochem 2018;45:226 –236
Source: Cellular Physiology and Biochemistry - Category: Cytology Source Type: research
It has become a familiar scene at athletic events: sugar and carb-fests before and during marathons, triathlons, swimming competitions, and other sports among amateurs and professionals, even high school athletes and grade school soccer players. They do it for energy and enhanced athletic performance, having been told that loading up on carbs is the ticket to winning. This common practice is based on decades-old flawed studies that reported that athletes experienced reduced performance when deprived of carbohydrates, performance restored upon restoration of carbohydrates. Thus was born the notion of “carb-loading&rdq...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: BLOOD SUGAR Car Loading Carbohydrates Undoctored Wheat Belly Wheat Belly Lifestyle Wheat Belly/Undoctored Cruise carb loading Dr. Davis exercise Wheat Belly Total Health Source Type: blogs
Authors: Bo M, Erre GL, Niegowska M, Piras M, Taras L, Longu MG, Passiu G, Sechi LA Abstract OBJECTIVES: Rheumatoid arthritis (RA) is a chronic disease characterised by a pro-inflammatory cytokines linked erosive joint damage and by humoral and cellular response against a broad range of self-peptides. Molecular mimicry between Epstein-Barr virus (EBV), Mycobacterium avium subsp. paratuberculosis (MAP) and host peptides has long been regarded as an RA pathogenetic mechanism. Using bioinformatic analysis we identified high sequence homology among interferon regulatory factor 5 (IRF5), EBV antigen BOLF1 and MAP antige...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
I read with interest the letter from Benvenga about the risk of undertreated hypothyroidism due to impaired intestinal absorption of levothyroxine caused by orally taken medications. Despite the scarcity of the available evidence to shed light on pharmacokinetic changes near the end of life, several studies have suggested that the optimal absorption of medications is often compromised as death approaches and as the number of ingested medications increases.1 In our retrospective cohort of 511,843 older adults who died between 2007 and 2013,2 we found that during the last month of life, 4.0% were exposed to levothyroxine and...
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Letter Source Type: research
I read with interest the article by Morin et  al1 and the associated editorial,2 concurring with both. My clinical research also involves undertreated hypothyroidism due to impaired intestinal absorption of levothyroxine caused by orally taken medications3 (see PubMed for other articles). Primary hypothyroidism is a very prevalent disorder, m uch more than hyperthyroidism, and its frequency increases with age. Undertreated hypothyroidism concerns approximately 20% of levothyroxine-treated patients and most frequently is caused by co-ingestion of antacids (either absorbable or nonabsorbable), calcium, or iron salts.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Letter Source Type: research
People eating adiet featuring plenty of fibre-rich foods such as muesli may experience better bone health and a lower risk of autoimmune diseases. This is according to a new study from Germany's Friedrich-Alexander-Universität Erlangen-Nürnberg, which has shed light on how a healthy diet rich in fibre can alter the behaviour of intestinal bacteria in a way that has a positive impact on chronic inflammatory joint diseases. How does fibre-rich food improve bone health? Published in the journal Nature Communications, the study looked at mice to examine the effect that diet has on the composition of intestinal ba...
Source: Arthritis Research UK - Category: Rheumatology Source Type: news
AbstractHard tissue homeostasis is regulated by the balance between bone formation by osteoblasts and bone resorption by osteoclasts. This physiologic process allows adaptation to mechanical loading and calcium homeostasis. Under pathologic conditions, however, this process is ill-balanced resulting in either over-resorption or over-formation of hard tissue. Local over-resorption by osteoclasts is typically observed in osteolytic metastases of malignancies, autoimmune arthritis, and giant cell tumor of bone (GCTB). In tumor-related local osteolysis, tumor-derived osteoclast-activating factors induce bone resorption not by ...
Source: Histochemistry and Cell Biology - Category: Biomedical Science Source Type: research
AbstractSpinocerebellar ataxia type 2 (SCA2) is an autosomal dominant neurodegenerative disease involving the cerebellum and characterized by a typical motor syndrome. In addition, the presence of cognitive impairment is now widely acknowledged as a feature of SCA2. Given the extensive connections between the cerebellum and associative cerebral areas, it is reasonable to hypothesize that cerebellar neurodegeneration associated with SCA2 may impact on the cerebellar modulation of the cerebral cortex, thus resulting in functional impairment. The aim of the present study was to investigate and quantitatively map the pattern o...
Source: Journal of Neurology - Category: Neurology Source Type: research
Molecules, Vol. 23, Pages 200: Tamm–Horsfall Protein is a Potent Immunomodulatory Molecule and a Disease Biomarker in the Urinary System Molecules doi: 10.3390/molecules23010200 Authors: Tsai-Hung Wu Ko-Jen Li Chia-Li Yu Chang-Youh Tsai Tamm–Horsfall protein (THP), or uromodulin (UMOD), is an 80–90-kDa phosphatidylinositol-anchored glycoprotein produced exclusively by the renal tubular cells in the thick ascending limb of the loop of Henle. Physiologically, THP is implicated in renal countercurrent gradient formation, sodium homeostasis, blood pressure regulation, and a defense molecule agai...
Source: Molecules - Category: Chemistry Authors: Tags: Review Source Type: research
Ben shared his 3-week experience living the Wheat Belly lifestyle after being diagnosed with celiac disease: “My family doctor diagnosed me with celiac and wheat allergies. These pictures were taken 3 weeks apart: prior to the diagnosis and three weeks later, a photo of me after following the Wheat Belly books that my doctor recommended I get. “I still feel like I eat like a king. I am just a lot more cautious about what I put into my body and I am seeing the results!” You can see that Ben’s face shows the changes we expect to see as inflammation recedes: reduced cheek and around-the-eyes edema, la...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Wheat Belly Success Stories celiac gluten grains Inflammation Source Type: blogs
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