Type A insulin resistance (IR) syndrome is a severe IR form caused by insulin receptor (INSR) gene defects. Anti-diabetic drugs including high-dose insulin and insulin-sensitizing agents often fail to control associated hyperglycemia. Therapy with recombinant human insulin-like growth factor 1 can be more effective, but it is expensive. We report a case of type A IR syndrome with an in-frame INSR heterozygous deletion (ΔLeu999) that was treated with a combination of conventional therapy and ipragliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. Treatment reduced HbA1c levels (10.0 to 7.5%) and induced weight loss (54.4 to 52.0 kg) within 2 months, and the effects were sustained for over 3 years. SGLT2 inhibitors might be useful to normalize blood glucose in type A IR syndrome by reducing body weight and ameliorating glucotoxicity. This article is protected by copyright. All rights reserved.PURPOSE A novel radiochromic PRESAGE sheet (Heuris Inc.) with 3 mm thickness has been developed as a measurement tool for 2D dosimetry. Its inherent ability to conform to irregular surfaces makes this dosimeter advantageous for patient surface dosimetry. This study is a comprehensive investigation into the PRESAGE sheet's dosimetric characteristic, accuracy and its potential use as a dosimeter for clinical applications. METHODS The characterization of the dosimeter included evaluation of the temporal stability of the dose linearity, reproducibility, measurement uncertainties, dose rate, energy, temperature and angular dependence, lateral response artifacts, percent depth dose curve, and 2D dose measurement. Dose distribution measurements were acquired for regular square fields on a flat and irregular surface and an irregular modulated field on the smooth surface. All measurements were performed using an Epson 11000XL high-resolution scanner. RESULTS The examined dosimeters exhibit stable linear response, stancals, Inc. on behalf of American Association of Physicists in Medicine.INTRODUCTION Symptomatic osteoarthritis (OA) in the knee is defined as the presence of OA radiographic features in combination with knee symptoms. Pain has not been shown to correlate meaningfully to radiographic severity. We aimed to determine the relationship between a tear of the anterior cruciate ligament (ACL) with knee symptoms and radiographic OA. METHODS A within-person, between-knee cross-sectional study of 37 participants from the Osteoarthritis Initiative (OAI) with a complete or partial ACL tear detected on magnetic resonance imaging in 1 knee (index knee) were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and radiographs of both knees, 1 with an ACL tear and one without (control knee) were scored for OA severity (Kellgren-Lawrence Grading) and symptoms. A generalized estimating equation with linear regression was used to compare symptom scores within individuals as well as to radiographic severity. RESULTS Thirty-seven individuals (40% female, average age = 60.7years, body mass index = 31.0 kg/m2 ) reported no difference in knee symptoms (WOMAC pain odds ratio [OR] =1.92, 95%CI 0.699-5.248, P = .21; KOOS symptoms OR = 2.12, 95%CI 0.740-6.065, P = .09), stiffness (OR = 1.67, 95%CI 0.653-5.583, P = .35) or functional disability (OR = 1 0.97, 95%CI 0.515-7.508, P = .32) in the knee that exhibited an ACL tear compared to the control knee. Only knee function and disability (WOMAC Disability OR = 1.12, 95%CI 1.003-1.249, P = .04) were associated with radiographic severity between index and control knees. CONCLUSION Individuals did not report an increase in knee pain, stiffness or disability in their ACL-deficient knee. Only disability was associated with worsening severity of radiographic OA in ACL-deficient knees. © 2020 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.AIMS Patients with advanced heart failure (AdHF) who are ineligible for heart transplantation (HTx) can become candidates for treatment with a left ventricular assist device (LVAD) in some countries, but not others. This reflects the lack of a systematic analysis of the usefulness of LVAD systems in this context, and of their benefits, limitations and cost-effectiveness. The SWEdish evaluation of left Ventricular Assist Device (SweVAD) study is a Phase IV, prospective, 11 randomized, non-blinded, multicentre trial that will examine the impact of assignment to mechanical circulatory support with guideline-directed LVAD destination therapy (GD-LVAD-DT) using the HeartMate 3 (HM3) continuous flow pump vs. guideline-directed medical therapy (GDMT) on survival in a population of AdHF patients ineligible for HTx. METHODS A total of 80 patients will be recruited to SweVAD at the seven university hospitals in Sweden. The study population will comprise patients with AdHF (New York Heart Association class IIIB-IV, INTERMACS profile 2-6) who display signs of poor prognosis despite GDMT and who are not considered eligible for HTx. Participants will be followed for 2 years or until death occurs. Other endpoints will be determined by blinded adjudication. Patients who remain on study-assigned interventions beyond 2 years will be asked to continue follow-up for outcomes and adverse events for up to 5 years. CONCLUSION The SweVAD study will compare survival, medium-term benefits, costs and potential hazards between GD-LVAD-DT and GDMT and will provide a valuable reference point to guide destination therapy strategies for patients with AdHF ineligible for HTx. © 2020 The Authors.European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.AIMS/INTRODUCTION Type 2 diabetes mellitus (T2DM) is a specific risk factor for intracranial atherosclerosis.  https://www.selleckchem.com/products/guanidine-thiocyanate.html  The purpose of this study is to investigate the relationship between T2DM, especially uncontrolled glycemia and intracranial plaque characteristics using high-resolution magnetic resonance imaging (HR-MRI). MATERIALS AND METHODS A total of 263 patients (182 male; mean age = 62.6 ± 11.5 years) with intracranial atherosclerotic plaques detected on HR-MRI from December 2017 to March 2019 were included in this study. Patients were divided into different groups first, patients with and without T2DM; second, diabetic patients with uncontrolled glycemia (glycated hemoglobin level ≥7.0%) and controlled glycemia; third, diabetic patients with the duration of 10 years. Comparisons of plaque features between groups were made, respectively. RESULTS T2DM was diagnosed in 118 (44.9%). Diabetic patients had significantly greater prevalence of enhanced plaque, greater maximum plaque length, maximum wall thickness, and more severe luminal stenosis than nondiabetic patients.