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Medicines, Volume 8, Issue 3 (March 2021) – 3 articles

Cover Story (view full-size image): An extremely unusual finding is reported, which was discovered incidentally during a routine pathologic evaluation of a fallopian tube, surgically removed on the grounds of ectopic pregnancy. A minute yellowish nodule was situated inside the wall of the fallopian tube, which corresponded to ectopic adrenal cortex, as verified by microscopical examination. Research of the available English literature on this subject confirmed the rareness of the entity that was encountered. This case is presented because of its uniqueness, aiming to raise awareness on a rare condition that is discussed along with potential diagnostic dilemmas, prognostic significance, and possible complications. View this paper
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Article
A Goal Intervention Improves Language Fluency: Evidence from Parkinson’s Disease and Healthy Aging
Medicines 2021, 8(3), 15; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8030015 - 22 Mar 2021
Cited by 1 | Viewed by 1663
Abstract
Background: Parkinson’s disease [PD] is associated with reduced motor and cognitive initiation, and decreased goal-directed behavior including language generation. The current study investigated a novel goal intervention for language generation impairments in PD patients. Methods: Twenty-one PD patients and 22 healthy controls, [...] Read more.
Background: Parkinson’s disease [PD] is associated with reduced motor and cognitive initiation, and decreased goal-directed behavior including language generation. The current study investigated a novel goal intervention for language generation impairments in PD patients. Methods: Twenty-one PD patients and 22 healthy controls, matched for gender, age, and education, completed a cognitive baseline and language generation tasks (complex scene descriptions and phonemic/semantic word fluency) with standard and adapted instructions, which implements a target ‘goal’. In addition, participants completed self-report questionnaires for apathy and mood. Results: PD patients performed more poorly on two of three language generation tasks. The goal intervention was effective in increasing both the PD patient and healthy control groups’ language generation. However, there was no differential benefit of increased goal specificity and difficulty for PD patients. As a group, PD patients reported higher levels of apathy and depression than healthy controls. Specifically, PD patients with executive apathy were more likely to have language generation impairments than PD patients without executive apathy and controls. Apathy subscales and goal benefit were unrelated. Conclusions: The goal intervention was effective for PD patients and older adults, suggesting that enhanced goal specificity and difficulty may benefit individuals with PD or those aging naturally. Full article
(This article belongs to the Special Issue Parkinson’s Disease and Beyond: Challenges and Perspectives)
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Case Report
Adrenal Cortical Rests in the Fallopian Tube: Report of a Case and Review of the Literature
Medicines 2021, 8(3), 14; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8030014 - 12 Mar 2021
Viewed by 1519
Abstract
We report an extremely unusual finding discovered incidentally during a routine pathologic evaluation of a fallopian tube, surgically removed on the grounds of ectopic pregnancy. We came across a minute yellowish nodule situated within the wall of the salpinx, which corresponded to ectopic [...] Read more.
We report an extremely unusual finding discovered incidentally during a routine pathologic evaluation of a fallopian tube, surgically removed on the grounds of ectopic pregnancy. We came across a minute yellowish nodule situated within the wall of the salpinx, which corresponded to ectopic adrenal cortex, as verified by microscopical examination, and coexisted with salpingitis isthmica nodosa. A research of the available English literature on this subject confirmed the rareness of the entity we encountered. This case is presented because of its uniqueness, aiming to raise awareness of a rare condition which is discussed along with potential diagnostic dilemmas, its prognostic significance, and possible complications. Full article
(This article belongs to the Section Endocrinology and Metabolic Disorders)
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Article
A Predictive Risk Score to Diagnose Adrenal Insufficiency in Outpatients: A 7 Year Retrospective Cohort Study
Medicines 2021, 8(3), 13; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8030013 - 10 Mar 2021
Viewed by 1452
Abstract
Background: The diagnosis of adrenal insufficiency (AI) requires dynamic tests which may not be available in some institutions. This study aimed to develop a predictive risk score to help diagnose AI in outpatients with indeterminate serum cortisol levels. Methods: Five hundred and seven [...] Read more.
Background: The diagnosis of adrenal insufficiency (AI) requires dynamic tests which may not be available in some institutions. This study aimed to develop a predictive risk score to help diagnose AI in outpatients with indeterminate serum cortisol levels. Methods: Five hundred and seven patients with intermediate serum cortisol levels (3–17.9 µg/dL) who had undergone ACTH (adrenocorticotropin) stimulation tests were included in the study. A predictive risk score was created using significant predictive factors identified by multivariable analysis using Poisson regression clustered by ACTH dose. Results: The seven predictive factors used in the development of a predictive model with their assigned scores are as follows: chronic kidney disease (9.0), Cushingoid appearance in exogenous steroid use (12.0), nausea and/or vomiting (6.0), fatigue (2.0), basal cortisol <9 µg/dL (12.5), cholesterol <150 mg/dL (2.5) and sodium <135 mEq/L (1.0). Predictive risk scores range from 0–50.0. A high risk level (scores of 19.5–50.0) indicates a higher possibility of having AI (positive likelihood ratio (LR+) = 11.75), while a low risk level (scores of <19.0) indicates a lower chance of having AI (LR+ = 0.09). The predictive performance of the scoring system was 0.82 based on the area under the curve. Conclusions: This predictive risk score can help to determine the probability of AI and can be used as a guide to determine which patients need treatment for AI and which require dynamic tests to confirm AI. Full article
(This article belongs to the Section Endocrinology and Metabolic Disorders)
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