Medical Principles and Practice Journal Impact Factor & Information

Publisher: Karger

Journal description

Medical Principles and Practiceí is a general medical journal that focuses on recent advances made in basic medical sciences and clinical practice. It reflects the broad spectrum of work conducted by scientists and physicians from around the world at the Kuwait University faculty of medicine since its foundation in 1976. The international character of their contributions has resulted in the journal attracting original papers, reviews, reports and short communications not only from Kuwait and the Middle East, but also from the international scientific and medical communities as a whole.

Current impact factor: 1.11

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.113
2012 Impact Factor 0.963
2011 Impact Factor 0.887
2010 Impact Factor 1.069
2009 Impact Factor 0.824
2008 Impact Factor 0.583
2007 Impact Factor 0.542
2006 Impact Factor 0.442
2005 Impact Factor 0.566
2004 Impact Factor 0.319
2003 Impact Factor 0.194
2002 Impact Factor 0.141
2001 Impact Factor 0.106
2000 Impact Factor 0.097
1999 Impact Factor 0.263
1998 Impact Factor 0.125

Impact factor over time

Impact factor

Additional details

5-year impact 0.97
Cited half-life 5.00
Immediacy index 0.18
Eigenfactor 0.00
Article influence 0.23
Website Medical Principles and Practice website
ISSN 1423-0151
OCLC 164576043
Material type Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • On author's personal website or institutional website
    • Server must be non-commercial
    • Publisher's version/PDF may be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Creative Commons Attribution Non-Commercial License 3.0
    • All titles are open access journals
    • This policy is an exception to the default policies of 'Karger'
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Our investigation was designed to examine the signaling pathway involved in the enhancement of vascular endothelial growth factor (VEGF) release by β-adrenoceptor agonists. Human U937 cells differentiated into macrophages were primed with lipopolysaccharide (LPS) in the absence or presence of β-adrenoceptor agonists and antagonists. The VEGF released and the intracellular cyclic adenosine monophosphate (cAMP) generated were assayed by ELISA. Where necessary, differences between mean values were tested for significance using Student's t test. Isoprenaline, procaterol and salbutamol concentration-dependently enhanced the release of VEGF induced by LPS in U937 cells. R*,R*-(±)-4-[2-[(2-(3-chlorophenyl)-2-hydroxyethyl)amino]propyl]phenoxyacetic acid (BRL 37344), a selective β3-adrenoceptor agonist, did not enhance VEGF release. Using isoprenaline as an agonist, propranolol, ICI 118551 and atenolol produced a parallel rightward shift of the concentration-response curve with no reduction in the maximum response. The -logKB values were 8.12 ± 0.17, 8.03 ± 0.05 and 7.23 ± 0.05 for propranolol, ICI 118551 and atenolol, respectively, indicating the possible involvement of both β1- and β2-adrenoceptor subtypes. Isoprenaline and prostaglandin E2 concentration-dependently increased cAMP generation in U937 cells. Isoprenaline, db-cAMP and 6-Bnz-cAMP, a protein kinase A (PKA) activator, all enhanced VEGF release induced by LPS, and this effect was abolished by KT 5720 and Rp-cAMPS, which are both selective PKA inhibitors, suggesting that PKA is the downstream effector of cAMP activity. 8-CPT-cAMP, a selective activator of the Epac system, had no effect on VEGF release induced by LPS, indicating that the Epac pathway played no role in the release process. In this study, we established that β1- and β2- but not β3-adrenoceptors mediated cAMP-dependent enhancement of VEGF release induced by LPS in differentiated U937 cells, and that PKA was the downstream effector of cAMP activity. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 07/2015; DOI:10.1159/000433540
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    ABSTRACT: The aim of this study was to investigate the impact of overlapping functional gastrointestinal disorder (FGID) on the quality of life of patients with nonerosive reflux disease (NERD) and erosive esophagitis (EE). Data from patients with NERD and EE were collected between January 2009 and March 2010. These cases were further stratified into the subgroups of overlapping NERD-functional dyspepsia (FD), NERD-irritable bowel syndrome (IBS), EE-FD, EE-IBS, and NERD or EE alone according to the symptoms. All patients completed the modified Chinese GERDQ and the SF-36 questionnaires. Of the 222 enrolled patients, 96 (43.2%) had NERD and 126 (56.8%) had EE. Overlap of FGID occurred in 43.8-45.8% of the NERD patients, and in 41.3-44.4% of EE cases. The impact of overlapping FGID on patient quality of life was greater in the patients with overlapping NERD-FD compared to those with NERD alone (mean SF-36 total scores 59 vs. 72, adjusted p = 0.025) and the cases with overlapping EE-FD compared to those with EE alone (mean SF-36 total scores 53.19 vs. 73.11, adjusted p = 0.047). There were no significant differences between the individuals with overlapping NERD/EE-IBS and those with NERD/EE alone. There was a high prevalence of overlapping FGID, with both FD and IBS, among the GERD patients. The individuals with overlapping GERD and FD had lower quality of life scores than those with GERD alone. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431370
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    ABSTRACT: To evaluate the effect of luminous intensity on contrast vision under different ocular conditions. Ninety eyes of 45 persons were included in this study as follows: 30 healthy eyes, 30 eyes with cataract simulation (using translucent glasses), and 30 myopic eyes. Contrast sensitivity was examined using 5 spatial frequencies (1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree) of sine wave contrast test optotypes for 4 light intensities (34, 68, 154, and 240 cd/m(2)). The mean linear contrast sensitivities averaged over the frequencies for each of the 4 light intensities were: healthy eyes: 59 ± 11, 72 ± 16, 79 ± 23, and 80 ± 19; myopic eyes: 52 ± 13, 67 ± 15, 73 ± 21, and 75 ± 18, and cataract simulation eyes: 15 ± 7, 21 ± 8.6, 28.7 ± 13, and 28.6 ± 13, respectively. The linear contrast sensitivities averaged over the light intensities for each of the 5 spatial frequencies were: healthy eyes: 78, 87, 117, 59, and 21; myopic eyes: 65, 84, 109, 54, and 29, and cataract simulation eyes: 37, 41, 28, 8, and 2. The light intensity level had a positive effect on the contrast sensitivity of the examined eyes, except for eyes with cataract simulation, where even the maximum light intensity did not improve the contrast vision. This indicates that patients with cataracts require increased contrast of text rather than brighter illumination to improve the quality of their vision. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000433489
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    ABSTRACT: To compare the changes in anti-malondialdehyde-modified low-density lipoprotein (MDA-LDL) IgG levels among patients undergoing off-pump and on-pump coronary artery bypass grafting (CABG) or valvuloplasty. A total of 38, 39 and 34 patients who underwent off-pump CABG, on-pump CABG and valvuloplasty, respectively, were enrolled in this study. Serum anti-MDA-LDL IgG values were measured 24 h before and after the operative procedures and at discharge. Echocardiography was also done before surgery and before discharge. The results were compared with values from 50 healthy controls. In all patients, a reduction in antibody titers was observed post-operatively. However, the decrease was significant only in the off-pump CABG - before surgery: 42.33 (25.83-58.51), after surgery: 30.86 (16.36-51.33) and at discharge: 10.96 (6.82-23.57; p = 0.027). There was a significant positive association between anti-MDA-LDL IgG levels and ejection fraction (r = 0.248, p = 0.036) and a negative association with E/E', a marker of pulmonary capillary wedge pressure, in the coronary patients (r = -0.345, p = 0.012), but no significant associations were found in patients with valvular heart disease. Serum anti-MDA-LDL IgG levels were associated with cardiac function indices in coronary patients undergoing CABG. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431178
  • Medical Principles and Practice 06/2015; DOI:10.1159/000431369
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    ABSTRACT: This study was carried out in order to ascertain whether or not Hurricane Katrina and related factors (i.e. the amount of rainfall) influenced the male-to-female birth ratio (M/F). Monthly births by gender for the affected states (Alabama, Florida, Louisiana and Mississippi) for January 2003 to December 2012 were obtained from the Centers for Disease Control and Prevention (CDC Wonder, Atlanta, Ga., USA). Precipitation data was obtained from the US National Weather Service. Ordinary linear logistic regression was used for trend analysis. A p value ≤0.05 was taken to represent a statistically significant result. Of the total of 3,903,660 live births, 1,996,966 (51.16%) were male and 1,906,694 (48.84%) were female. Significant seasonal variation was noted (the maximum M/F in May was 1.055, the minimum M/F in September was 1.041, p = 0.0073). There was also a separate and significant rise in M/F 8-10 months after the storm (April to June 2006, peak M/F 1.078, p = 0.0074), which translated to an approximate deficit of 800 girls compared to 46,072 girls born in that period if the M/F increase was theoretically only due to a girls' deficit in the denominator of the ratio. This spike was only present in Alabama, Louisiana and Mississippi, all of which received heavy rainfall. Florida did not receive heavy rainfall and experienced no such M/F spike. In this study there was a dose-response relation between the amount of rainfall after Hurricane Katrina and the monthly sex ratio of live births in the US states of Alabama, Louisiana and Mississippi 8-10 months later. The well-known yet unexplained distinct sex ratio seasonality may be due to natural or man-made radiation contained in the rain. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431363
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    ABSTRACT: We aimed to investigate the effect of smoking on the osmotic pressure (OP) of human dental pulp tissue. Sixty male dental patients (smokers and nonsmokers) scheduled for root canal treatment for prosthodontics were included in the study. Fifteen patients (1 premolar tooth/patient) were allocated to each of the following groups according to their smoking habits, i.e. group 1: ≤10 cigarettes/day, group 2: 11-20 cigarettes/day, group 3: >20 cigarettes/day and group 4: nonsmoking controls. Apical pulp tissues were removed via coronal access. Pulp tissue supernatants were obtained to measure the pulpal OP by means of a semimicro digital osmometer. One-way analysis of variance and the post hoc Duncan test were used to analyze the differences in OP between groups. Regression analysis was used to determine the relationship between the number of cigarettes smoked daily and the pulpal OP. The mean (± SD) OP value decreased as cigarette consumption increased: group 4 (268.00 ± 10.09 mosm/kg) > group 1 (259.20 ± 7.16 mosm/kg) > group 2 (248.90 ± 2.23 mosm/kg) > group 3 (239.90 ± 7.40 mosm/kg). The OP differed significantly between groups (p < 0.01), and a significant negative correlation was found between cigarette consumption and pulpal OP (r = -0.809, p < 0.01). In this study, the OP decreased as the number of cigarettes smoked increased. In clinical examination, there may be misdiagnosis of pulpal conditions in smokers (even in healthy pulp tissue) due to the effect of altered OP on pulpal tissue reactions. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431325
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    ABSTRACT: We aimed to investigate the expression of interleukin 12 (IL-12) family cytokines (IL-12, IL-23, IL-27 and IL-35) and their relevant cytokines (IFN-γ, IL-4, IL-17A and IL-10) in patients with chronic immune thrombocytopenia (cITP) as well as the effect of high-dose dexamethasone (HD-DXM) treatment on this expression. DXM was administered orally at a dose of 40 mg per day for 4 consecutive days to 38 patients with cITP. We measured the plasma levels of IL-12p70, IL-23, IL-27, IFN-γ, IL-4 and IL-17A before and after treatment and also in 36 matched healthy controls, by means of FlowCytomix™ technology. The plasma levels of IL-10 and IL-35 were measured by enzyme-linked immunosorbent assay. Significantly higher plasma levels of IL-12p70, IL-23, IL-27, IFN-γ and IL-17A were observed in cITP patients than in controls (p < 0.01), and after HD-DXM treatment, these levels decreased significantly (p < 0.01). However, significantly lower plasma levels of IL-4, IL-10 and IL-35 were observed in cITP patients than in controls (p < 0.01); after the HD-DXM treatment, these levels had increased significantly in the cITP patients (p < 0.01). Moreover, the cytokine levels of patients who attained a complete response returned to the levels of normal controls (p > 0.05) but were not corrected in the patients who had no response (p < 0.01). The patients with cITP had abnormal expression of the IL-12 family cytokines and their relevant cytokines levels, and HD-DXM treatment corrected the derangement of plasma cytokines. Measuring cytokine levels may help in the clinical assessment of cITP. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000433472
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    ABSTRACT: This study was designed to identify the effect of rivaroxaban, a direct factor Xa inhibitor, on trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats. Twenty-four female Wistar rats were divided into 4 groups of 6 each. Group 1 received TNBS + rivaroxaban, group 2 received TNBS + methylprednisolone, group 3 received TNBS and group 4 received a saline enema. Colitis was induced in the rats by the intracolonic administration of TNBS. Rivaroxaban and methylprednisolone were given by oral gavage daily for 7 days. The rats were killed 7 days after the induction of colitis. Rivaroxaban and methylprednisolone significantly reduced gross damage and histopathological scores. Rivaroxaban was more effective than methylprednisolone in terms of microscopic mucosal healing. Rivaroxaban attenuated the accumulation of malonyldialdehyde (MDA) and transforming growth-factor β1 (TGF-β1) and the activites of myeloperoxidase (MPO), matrix metalloproteinase-3 and tissue inhibitor of metalloproteinases-1. Methylprednisolone reduced only the activity of MPO and the accumulation of MDA and TGF-β1. Superoxide dismutase activity showed a restoration to normal levels after rivaroxaban and methylprednisolone administration. Rivaroxaban showed a therapeutic effect in the TNBS model of experimental colitis, and it seemed to be at least as effective as methylprednisolone. This effect may be brought about by the inhibition of oxidative stress and metalloproteinase activity associated with tissue injury and remodeling. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431361
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    ABSTRACT: The aim of the study was to investigate the effect of intragastric balloon therapy on left ventricular function and left ventricular mass in a cohort of morbidly obese patients. A prospective trial was performed in a cohort of 17 class II and class III morbidly obese individuals. The intragastric balloon was retained in the stomach for an average of 6 months. Conventional and tissue Doppler echocardiography were performed in all patients before and after the procedure. The mean age of the study participants was 36 ± 10 years (range: 18-55). The mean body mass index was significantly decreased following the intragastric balloon insertion procedure (44 ± 8 vs. 38 ± 5, p < 0.001). The left ventricular mass index and left atrial volume index were significantly decreased following the procedure (112 ± 21 vs. 93 ± 17, p = 0.001 and 20 ± 6 vs. 14 ± 5, p = 0.02, respectfully). In addition, the ratio of mitral peak early diastolic velocity to tissue Doppler-derived peak diastolic velocity and tissue Doppler echocardiography-derived left ventricular myocardial performance index were decreased significantly following the procedure (9.5 ± 1.9 vs. 7.7 ± 1.5, p = 0.002 and 0.57 ± 0.11 vs. 0.46 ± 0.06, p = 0.001, respectively). Intragastric balloon therapy resulted in significant weight reduction in morbidly obese patients. This weight reduction was associated with improved left ventricular function. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431177
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    ABSTRACT: To assess the erosive potential of various soft drinks by measuring initial pH and titratable acidity (TA) and to evaluate enamel surface roughness using different exposure times. The initial pH of the soft drinks (group 1: Coca-Cola; group 2: orange juice; group 3: Cedevita; group 4: Guarana, and group 5: strawberry yoghurt) was measured using a pH meter, and TA was measured by titration with NaOH. Enamel samples (n = 96), cut from unerupted human third molars, were randomly assigned to 6 groups: experimental (groups 1-5) and control (filtered saliva). The samples were exposed to 50 ml of soft drinks for 15, 30 and 60 min, 3 times daily, during 10 days. Between immersions, the samples were kept in filtered saliva. Enamel surface roughness was measured by diamond stylus profilometer using the following roughness parameters: Ra, Rq, Rz, and Ry. Data were analyzed by one-way ANOVA, Tukey's post hoc and Student-Newman-Keuls post hoc tests. The pH values of the soft drinks ranged from 2.52 (Guarana) to 4.21 (strawberry yoghurt). Orange juice had the highest TA, requiring 5.70 ml of NaOH to reach pH 7.0, whereas Coca-Cola required only 1.87 ml. Roughness parameters indicated that Coca-Cola had the strongest erosion potential during the 15 min of exposure, while Coca-Cola and orange juice were similar during 30- and 60-min exposures. There were no significant differences related to all exposure times between Guarana and Cedevita. Strawberry yoghurt did not erode the enamel surface regardless of the exposure time. All of the tested soft drinks except yoghurt were erosive. Erosion of the enamel surfaces exposed to Coca-Cola, orange juice, Cedevita, and Guarana was directly proportional to the exposure time. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000433435
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    ABSTRACT: To compare specific characteristics and clinical outcomes of monomicrobial necrotizing fasciitis caused by Aeromonashydrophila and Klebsiella pneumoniae. Cases of monomicrobial necrotizing fasciitis caused by A. hydrophila (n = 11) and K. pneumoniae (n = 7) over an 8-year period were retrospectively reviewed. Differences in mortality, patient characteristics, clinical presentations, and laboratory data were compared between the A. hydrophila and the K. pneumoniae groups. The clinical signs and symptoms at the time of presentation did not differ significantly (p > 0.05) between the two groups. The A. hydrophila group had a significantly shorter interval between contact and admission (1.55 ± 0.52 vs. 5.14 ± 2.12 days, p < 0.001) and significant lower total white blood cell counts (10,245 ± 5,828 vs. 19,014 ± 11,370 cells/mm(3), p < 0.045) than the K. pneumoniae group in the emergency room. Hepatic dysfunction was associated with mortality in patients with A. hydrophila infection, while diabetes mellitus was associated with mortality in patients with K. pneumoniae infection. Overall, 5 (45.5%) patients in the A. hydrophila group and 3 (42.8%) in the K. pneumoniae group died. The initial clinical course of A. hydrophila monomicrobial necrotizing fasciitis was characterized by more rapidly progressive disease than that of the K. pneumoniae infection. Patients with hepatic dysfunction and necrotizing fasciitis should be suspected of having A. hydrophila infection, and diabetic patients with necrotizing fasciitis should be suspected of having K. pneumoniae infection initially. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431094
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    ABSTRACT: In this study, we surveyed patients with advanced non-small-cell lung cancer (NSCLC) who were undergoing tyrosine kinase inhibitor (TKI)-targeted therapy. Our aim was to determine whether epidermal growth factor receptor (EGFR) mutations in serum circulating tumor (ct)DNA are useful prognostic markers for NSCLC. Sujects and Methods: Serum samples were collected from 300 patients with NSCLC that included adenocarcinoma (ADC, n = 155) and squamous cell carcinoma (SCC, n = 145). DNA was extracted from the sera for the nested polymerase chain reaction (PCR) amplification of EGFR exons 18, 19 and 21 mutations. Direct sequencing of the PCR products was carried out in an automated 3730 sequencer. The EGFR exons 18, 19 and 21 were successfully detected in the serum samples of 300 NSCLC patients. No EGFR mutation was found in the blood samples regardless of the characteristics of gender, age, ADC and SCC status or smoking history. No mutations in EGFR exons 18, 19 or 21 were identified in the serum ctDNA of these advanced-stage NSCLC patients undergoing TKI-targeted therapy. More studies are needed on the use of EGFR mutations in serum ctDNA as guidance for TKI-targeted therapy. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; DOI:10.1159/000431326
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    ABSTRACT: To report a case of multiple sclerosis (MS) with delirium as the first presentation. A 34-year-old female was referred to our department with an acute onset of drowsiness, withdrawal from routine activities and aggression, followed by neurologic deficits after a couple of days. Clinical and radiographic examinations were performed, leading to the initial diagnosis of MS. A vast range of differential diagnoses was excluded to confirm the diagnosis of MS. Neurological examination and appropriate imaging enabled the diagnosis of MS with delirium in this patient followed by the appropriate treatment. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; 24(4). DOI:10.1159/000430446
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    ABSTRACT: To evaluate the effects of space maintainers on plaque accumulation, periodontal health and oral microflora. The study participants comprised 38 patients aged 4-10 years requiring either fixed or removable space maintainers. Plaque index, gingival index, bleeding on probing index, candidal colonization and Enterococcus faecalis were recorded just before the application of space maintainers (T0) and during treatment at the 1st (T1), 3rd (T2) and 6th (T3) month. The gingival and bleeding on probing index scores increased significantly (gingival index from 0.20 ± 0254 to 0.54 ± 0417 and bleeding on probing index from 7.18 ± 9.946 to 18.07 ± 14.074) in the regions with fixed space maintainers at T3 (p < 0.01). The mean Candida counts also increased (for removable appliances from 1.90 ± 3.638 to 1.98 ± 3.318, p < 0.05, and for fixed appliances from 4.25 ± 4.587 to 4.52 ± 4.431, p < 0.001). The salivary E. faecalis counts at T3 also increased significantly with the use of fixed and removable appliances (for removable appliances from 5.93 ± 2.65 to 85.53 ± 34.1 and for fixed appliances from 4.95 ± 2.94 to 123.59 ± 29.51, p < 0.001). A positive correlation was found between the plaque (r = 0.67), gingival (r = 0.76) and bleeding on probing index scores (r = 0.76) and the candidal colonization for the fixed space maintainers (p < 0.01, p < 0.001). In this study, both fixed and removable space maintainers led to an increase in the number of microorganisms in the oral cavity as well as to increases in the periodontal index scores. Patients should be informed that space maintainers may serve as a source of infection and that special attention must be given to their oral hygiene. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; 24(4). DOI:10.1159/000430787
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    ABSTRACT: We report the second case of gastric adenocarcinoma associated with type B lactic acidosis. An 81-year-old man presenting with upper gastrointestinal bleeding was found to have an advanced gastric adenocarcinoma. He had persistently elevated serum lactate attributed to malignancy-associated type B lactic acidosis as a diagnosis of exclusion. As he remained clinically stable with a near-normal pH, his elevated lactate was not specifically treated. This patient had an unusual type B lactic acidosis associated with gastric cancer. In the absence of signs and symptoms of other etiologies of lactic acidosis, physicians should consider malignancy-associated type B lactic acidosis. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 06/2015; 24(4). DOI:10.1159/000430445
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    ABSTRACT: The anti-diabetic and oral hypoglycaemic agent metformin, first used clinically in 1958, is today the first choice or 'gold standard' drug for the treatment of type 2 diabetes and polycystic ovary disease. Of particular importance for the treatment of diabetes, metformin affords protection against diabetes-induced vascular disease. In addition, retrospective analyses suggest that treatment with metformin provides therapeutic benefits to patients with several forms of cancer. Despite almost 60 years of clinical use, the precise cellular mode(s) of action of metformin remains controversial. A direct or indirect role of adenosine monophosphate (AMP)-activated protein kinase (AMPK), the fuel gauge of the cell, has been inferred in many studies, with evidence that activation of AMPK may result from a mild inhibitory effect of metformin on mitochondrial complex 1, which in turn would raise AMP and activate AMPK. Discrepancies, however, between the concentrations of metformin used in in vitro studies versus therapeutic levels suggest that caution should be applied before extending inferences derived from cell-based studies to therapeutic benefits seen in patients. Conceivably, the effects, or some of them, may be at least partially independent of AMPK and/or mitochondrial respiration and reflect a direct effect of either metformin or a minor and, as yet, unidentified putative metabolite of metformin on a target protein(s)/signalling cascade. In this review, we critically evaluate the data from studies that have investigated the pharmacokinetic properties and the cellular and clinical basis for the oral hypoglycaemic, insulin-sensitising and vascular protective effects of metformin. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 05/2015; DOI:10.1159/000381643
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    ABSTRACT: To report a single-incision laparoscopic cholecystectomy (SILC) for a patient with cholecystitis that required endoscopic nasogallbladder drainage (ENGBD). A 75-year-old man was diagnosed with moderate acute cholecystitis and underwent antiplatelet therapy for a history of brain infarction. An ENGBD was performed as an initial treatment for his cholecystitis. After recovery from the cholecystitis, a SILC was performed using a SILS Port with an additional forceps. Because neither Rouviere's sulcus nor Calot's triangle could be identified with a favorable laparoscopic view, the fundus-first procedure was selected. The patient's postoperative course was uneventful, and he was discharged from the hospital on day 3 after surgery. In this case of a patient who had cholecystitis that required ENGBD, a SILC was successful performed using a combination of SILS Port with additional forceps and fundus-first procedure. © 2015 S. Karger AG, Basel.
    Medical Principles and Practice 05/2015; DOI:10.1159/000430951