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Padova, Italy

Introduction: There are only limited data about the change of cholesterol levels at population level in Hungary. Aim: The aim of the authors was to compare current serum cholesterol levels to those measured 20 years ago in residents of a village in Békés County, Hungary. Method: Using a database of a general ptactitioner, serum cholesterol levels of 778 persons who participated in a screening program in 1994 in the village Méhkerék in Békés County were compared to those obtained 20 years later from 392 randomly selected persons matching age and gender. Results: The serum total cholesterol level of persons over 50 years was decreased by 5.9%, from 5.94±1.41 to 5.59±1.33 mmol/L (p≥0.01), while it remained unchanged in persons younger than 50 years of age. Conclusions: The decrease of serum cholesterol level observed in patients over 50 years of age can be a consequence of the widely used lipid lowering medication. The lack of change in persons below 50 years of age draws the attention that principles of primary prevention (diet, regular physical activity) should be used more consistently, and medical therapy should be applied when it is recommended by the guidelines. Source

Jennings C.,Oxford Institute of Clinical Psychology Training | Hewitt O.,Dr.
Tizard Learning Disability Review | Year: 2015

Purpose: Cognitive behaviour therapy (CBT) is currently one of the recommended treatments for depression for the general population and guidance recommends that people with a learning disability should have access to the same treatments as people without a learning disability. The purpose of this paper is to identify, outline and evaluate current research on the effectiveness of CBT for depression for people with a learning disability. The clinical, service and research implications are considered. Design/methodology/approach: A systematic search was conducted and five relevant articles were identified for critical review. Findings: There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities. Research limitations/implications: The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms. Practical implications: Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression. Originality/value: This paper provides a comprehensive and up to date review of the current literature regarding the use of CBT for depression for people with a learning disability. This will be of value to clinicians working with people with a learning disability as well as those commissioning services. © Emerald Group Publishing Limited, ISSN 1359-5474. Source

Lote H.,Dr. | Bhosle J.,Royal Marsden Hospital | Thway K.,Royal Marsden Hospital | Newbold K.,Royal Marsden Hospital | O'Brien M.,Royal Marsden Hospital
Case Reports in Oncology | Year: 2014

Poorly differentiated cancers are a diagnostic and therapeutic challenge in oncology. New therapies are needed for patients with poorly differentiated thyroid carcinoma (PDTC) or anaplastic thyroid cancer, as these patients often present with advanced disease and effective systemic treatment options are currently limited. Epidermal growth factor (EGFR) mutations may occur in PDTC more often than previously thought. However, there are fewer than 6 cases reported in the literature where EGFR tyrosine kinase inhibitors (TKIs) (such as erlotinib or gefitinib) were used to target EGFR mutations in PDTC. Here, we present the case of a 79-year-old male with metastatic PDTC with an EGFR mutation who responded to treatment with the selective EGFR TKI erlotinib, with a progression-free survival of more than 11 months. A lung primary rather than a thyroid primary was initially detected. We suggest that the EGFR status should be analysed at diagnosis in any patient with a poorly differentiated tumour. The presence of an EGFR mutation may provide an effective therapeutic pathway for these patients. This pathway requires further investigation and consideration in the future. © 2014 S. Karger AG, Basel. Source

Karamanolis G.P.,Dr. | Daikos G.L.,Athens Medical School | Xouris D.,Athens Medical School | Goukos D.,Athens Medical School | And 2 more authors.
Digestion | Year: 2014

Background: Increasingly, over time, antibiotic resistance is considered a problem for the efficacy of H. pylori eradication treatment. The aim of our study was to evaluate the changes in clarithromycin and levofloxacin resistance of H. pylori strains in Greek patients in two different time periods (in 2000 and in 2010). Methods: Gastric biopsies of consecutive H. pylori-positive patients were investigated retrospectively. Mutations in H. pylori 23S rRNA and gyrA genes associated with resistance to clarithromycin and quinolones, respectively, were determined by allelic specific polymerase chain reaction. Results: In the first time period (2000), H. pylori resistance patterns were evaluated in 50 and in the second period (2010) in 57 patients. During the first time period 30 and 0% of patients were infected with clarithromycin- or quinolone-resistant strains, respectively. In the second time period (2010), the percentage of patients infected with clarythromycin or quinolone resistance strains increased to 42 and 5.3%, respectively. Conclusions: Our study showed an increase in the prevalence of both clarithromycin and quinolones resistance of H. pylori. Although the resistance rate to quinolones increased over the years, it is relatively low justifying its use for the eradication of H. pylori infections. © 2015 S. Karger AG, Basel. Source

Stewart W.,Laboratory Medicine Building | McNamara P.H.,St Jamess Hospital | Lawlor B.,St Jamess Hospital | Hutchinson S.,St Jamess Hospital | Farrell M.,Dr.
QJM | Year: 2016

The association between exposure to head injury and increased risk of neurodegenerative disease, specifically chronic traumatic encephalopathy (CTE), is widely recognized. Historically, this was largely considered a phenomenon restricted to boxers, with more recent case series identifying further 'high risk' individuals, such as former American footballers, or military personnel. However, in all cases thus far reported, it is clear that it is the exposure to head injury which is associated with increased dementia risk, and not the circumstances or environment of exposure. As such, there is considerable potential for under-recognition of CTE in patients presenting with neurodegenerative disease, particularly where head injury exposure might have been historical and through sport. This article reviews current understanding of CTE and, via an illustrative case in rugby union, highlights the value of a detailed history on head injury and also draws attention to imaging studies in assessing patients with neurodegenerative disease. © The Author 2015. Source

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