Stimulation of the peristaltic activity of the ureter is a pathogenetically substantiated component of the lithokinetic effect. The aim of the work was to study the effects of electrical impulse stimulation on ureteral motility in patients with urolithiasis. 47 patients with urolithiasis, aged 27-59 years, with unilateral ureteral stones, up to 5 mm in size, were studied. The patients underwent translumbar electrical impulse stimulation according to the original method. The results were assessed by the change in the frequency of ureteral emissions and the duration of the interval between two consecutive ureteral emissions. As a result of the method used, there is an increase in the average frequency of ureteral ejections from 1.38±0.49 to 2.20±0.84 minutes (p<0.05), a decrease in the average duration of the interval between two consecutive ureteral ejections from 44.48 ±7 .89 to 27.96±3.89 seconds (p<0.05). The impact was well tolerated by patients. There were no changes in hemodynamic parameters. Transdermal exposure to single electric stimuli of a rectangular shape has significant effect in patients with urolithiasis as electric pulse stimulation helps to increase the peristaltic activity of the ureter by initiating additional peristaltic waves. To achieve this effect, it is advisable to apply range of 15-30 mA at a time moment corresponding to the last third of the interval between ureteral emissions, when applying stimulating electrodes in the lumbar region, in the area of the projection of the renal pelvis and the proximal ureter.

Gastrointestinal tumors are common tumors in the digestive system. Early diagnosis of gastrointestinal tumors is the key to improve prognosis and curative effect of patients with tumors. Compared with other methods of examination and diagnosis, ultrasound examination has the advantages of simple operation, non-invasive, economical, and repeatable operation. With the advancement of ultrasound technology and the development of ultrasound contrast agents, ultrasound examination is more and more applied to gastrointestinal examination. Ultrasound cannot only observe the gastrointestinal wall, but also evaluate the surrounding lesions and metastases, as well as preoperative analysis and postoperative follow-up of gastrointestinal tumors. We reviewed the diagnostic applications of ultrasound in gastrointestinal tumors.

Mandibular fractures are among the most common maxillofacial fractures observed in emergency rooms and are mainly caused by road accidents. The clinical features of mandibular fractures include malocclusion and loss of mandibular function. Panoramic radiography is usually limited to isolated lesions, whereas computed tomography is the tool of choice for all other facial traumatic events. No reference standard classification system for the different types of mandibular fractures is defined. Therapeutic options include a conservative approach or surgical treatment based on the anatomic area and the severity of fracture. The main purpose of this pictorial review is to illustrate a practical description of the pathophysiology of mandibular fractures and describe both the imaging techniques to recognise them and the therapeutic indications.

Renal arterial embolization (RAE) performed for the treatment of renal masses has been proven to be a safe and effective technique, with several decades of experience. RAE is well tolerated with few complications, particularly if the time interval from embolization to surgery is reduced to less than 48 hours. Review of the literature suggests that RAE is also extremely effective for palliation of symptoms in the setting of nonoperative advanced stage renal cell carcinoma. In addition, this technique plays a large role in the management of angiomyolipomas that are symptomatic or at risk of spontaneous rupture. To date, RAE has not been evaluated in a randomized controlled setting, which has contributed to its underutilization. All of these potential benefits warrant the need for prospective studies for further validation.

Rheumatoid arthritis (RA) is an autoimmune chronic disease with joint and systemic inflammation and it has been found that interleukin-6 (IL-6) plays a key role in RA. Indeed, various clinical studies have proved that the first-in-class IL-6 inhibitor, tocilizumab, a humanized anti-IL-6 receptor monoclonal antibody, showed outstanding efficacy in RA. Areas covered: We review here the role of IL-6 in the inflammatory conditions and how IL-6 contributes to pathogenesis of RA, what induces IL-6 and how IL-6 expression is regulated. Furthermore, clinical studies of tocilizumab for RA are summarized, Expert commentary: We review and discuss the prospects for future applications of IL-6 targeting therapy and new therapeutic strategies targeting IL-6. Finally, we discuss relevant issues with regard to the clinical management of IL-6 blockade in RA.

Strokes within pediatric populations are considered to be the 10th leading cause of death in the United States of America, with over half of such events occurring in children younger than one year of life. The multifactorial etiopathology that has an influence on stroke development and occurrence signify the importance of the timely recognition of both modifiable and non-modifiable factors for adequate diagnostic and treatment approaches. The early recognition of a stroke and stroke risk in children has the potential to advance the application of neuroprotective, thrombolytic, and antithrombotic interventions and rehabilitation strategies to the earliest possible timepoints after the onset of a stroke, improving the outcomes and quality of life for affected children and their families. The recent development of molecular genetic methods has greatly facilitated the analysis and diagnosis of single-gene disorders. In this review, the most significant single gene disorders associated with pediatric stroke are presented, along with specific therapeutic options whenever they exist. Besides monogenic disorders that may present with stroke as a first symptom, genetic polymorphisms may contribute to the risk of pediatric and perinatal stroke. The most frequently studied genetic risk factors are several common polymorphisms in genes associated with thrombophilia; these genes code for proteins that are part of the coagulation cascade, fibrolysis, homocystein metabolism, lipid metabolism, or platelets. Single polymorphism frequencies may not be sufficient to completely explain the stroke causality and an analysis of several genotype combinations is a more promising approach. The recent steps forward in our understanding of the disorders underlying strokes has given us a next generation of therapeutics and therapeutic targets by which to improve stroke survival, protect or rebuild neuronal connections in the brain, and enhance neural function. Advances in DNA sequencing and the development of new tools to correct human gene mutations have brought genetic analysis and gene therapy into the focus of investigations for new therapeutic options for stroke patients.

In a prospective study, 178 patients with tumours of the salivary glands were examined both clinically and by ultrasound. All patients have since been operated upon, and the diagnosis was confirmed histologically. The diagnostic accuracy of clinical examination is compared with that of ultrasound. Every tumour of the salivary glands could be diagnosed by ultrasound. In the benign group, an exact diagnosis of the tumour type was possible in 83% of cases. In the malignant group an exact diagnosis was only possible in 57% of cases. Furthermore, it is possible with ultrasound to recognise multiple and bilateral tumours, to determine whether a tumour is intra- or extraglandular, and to show the nature of the tumour (cyst, abscess, central necrosis) to a much greater extent than with clinical examination alone. In addition, a fairly good assessment of the cervical and intraglandular lymph nodes is obtained. We believe that ultrasound is of great importance in the diagnosis of tumours of the salivary glands.

We are currently in the midst of an epidemic of metabolic disorders, which may, in part, be explained by excess fructose intake. This theory is supported by epidemiological observations as well as experimental studies in animals and humans. Rising consumption of fructose has been matched with growing rates of hypertension, leading to concern from public health experts. At this stage, the mechanisms underlying fructose-induced hypertension have not been fully characterized and the bulk of our knowledge is derived from animal models. Animal studies have shown that high-fructose diets up-regulate sodium and chloride transporters, resulting in a state of salt overload that increases blood pressure. Excess fructose has also been found to activate vasoconstrictors, inactivate vasodilators, and over-stimulate the sympathetic nervous system. Further work is required to determine the relevance of these findings to humans and to establish the level at which dietary fructose increases the risk of developing hypertension

Infectious mononucleosis (IM) is a common viral infection that typically causes fever, pharyngitis, and lymphadenopathy in young patients. The Epstein-Barr virus (EBV) is the most common cause of IM, followed by cytomegalovirus (CMV). Given that serological testing is associated with limitations regarding its accuracy, availability, and time to receive results, clinical differentiation based on symptoms, signs, and basic tests would be useful. We evaluated whether clinical findings could be used to differentiate EBV-IM from CMV-IM. In this single-center retrospective case-control study, we evaluated >14-year-old patients with serologically confirmed EBV-IM or CMV-IM during 2006–2017. We compared the patients’ symptoms, physical findings, blood counts, and serum biomarkers to create three regression models: model 1 (symptoms and signs), model 2 (model 1 plus sonographic hepatosplenomegaly and blood counts), and model 3 (model 2 plus hepatobiliary biomarkers). Among the 122 patients (72.6%) with EBV-IM and 46 patients (27.4%) with CMV-IM, the median age was 25 years and 82 patients (48.8%) were male. The median age was 10 years older in the CMV-IM group (p < 0.001) and the median interval from onset to visit was 5 days longer in the CMV-IM group (p < 0.001). Logistic regression revealed that EBV-IM was predicted by younger age, short onset-to-visit interval, lymphadenopathy, tonsillar white coat, hepatosplenomegaly, atypical lymphocytosis, and elevations of lactate dehydrogenase and gamma-glutamyl transferase. All regression models had areas under the curve of >0.9. History and physical findings, especially when used with atypical lymphocytosis and sonographic hepatosplenomegaly, can help physicians differentiate EBV-IM from CMV-IM.