Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a systemic bone-forming condition prevalent in older adults. Abnormal radiographic findings of the spine are ...essential to a DISH diagnosis. The disease is often not included in the differential diagnosis of dysphagia in primary-care practices. Disorders of the cervical spine rarely cause dysphagia but are in fact common manifestations of DISH. The purpose of this brief report is to: (1) provide an overview of DISH; (2) examine dysphagia in the context of DISH through presentation of a case report; and (3) broaden the recognition of DISH for diagnostic purposes.
•There are over 44 million adults over age 50 who have or are at risk for osteoporosis, and this number will double by the year 2025.1•Only 15% of hip fracture patients can walk across a room unaided after 6 months, and 1 in 5 previously independent patients will need long term care.(1, 4).•Providers identify lack of time, lack of charting short cuts, and lack of prevention-only visits as reasons that osteoporosis prevention (OP) doesn't occur regularly.•Use of tools such as computerized prompts, risk assessment tools such as the FRAX tool, and prescription pads with OP recommendations increases provision of OP by busy providers.
A new technique for the assay of carbohydrates is described in which separation and quantification of neutral saccharides, aminosaccharides, glycuronic acids, and disaccharides may be accomplished in ...less than 50 min of total run time. This method involves optimized anion-exchange liquid chromatography coupled with integrated pulse amperometric detection. Complex carbohydrates from various sources, including dietary supplements, were hydrolyzed in a dilute solution of trifluoroacetic acid, freeze-dried, and reconstituted in water containing 2-deoxygalactose as the internal standard. The solution was filtered and separated on CarboPac PA20 column. The eluted saccharides were detected by oxidation on a gold electrode with quadruple-pulsed integrated amperometry. The calibration plots for the saccharides were linear with an average correlation coefficient of 0.999. Method precision regarding peak retention time and resolution used in the peak identifications was verified. With this method, previously difficult-to-separate saccharides, such as galactosamine, glucosamine, and N-acetylglucosamine, were successfully resolved from the neutral saccharides rhamnose, arabinose, and galactose. Mannose was also resolved from xylose, and de-acetylation of aminosaccharides prior to separation was not necessary. This technique provides an accurate and efficient means to assay carbohydrates in dietary supplements, which new federal regulations will soon mandate.
The bright and understudied classical Be star HD 6226 has exhibited multiple outbursts in the last several years during which the star grew a viscous decretion disk. We analyze 659 optical spectra of ...the system collected from 2017-2020, along with a UV spectrum from the Hubble Space Telescope and high cadence photometry from both TESS and the KELT survey. We find that the star has a spectral type of B2.5IIIe, with a rotation rate of 74% of critical. The star is nearly pole-on with an inclination of \(13.4\) degree. We confirm the spectroscopic pulsational properties previously reported, and report on three photometric oscillations from KELT photometry. The outbursting behavior is studied with equivalent width measurements of H\(\alpha\) and H\(\beta\), and the variations in both of these can be quantitatively explained with two frequencies through a Fourier analysis. One of the frequencies for the emission outbursts is equal to the difference between two photometric oscillations, linking these pulsation modes to the mass ejection mechanism for some outbursts. During the TESS observation time period of 2019 October 7 to 2019 November 2, the star was building a disk. With a large dataset of H\(\alpha\) and H\(\beta\) spectroscopy, we are able to determine the timescales of dissipation in both of these lines, similar to past work on Be stars that has been done with optical photometry. HD 6226 is an ideal target with which to study the Be disk-evolution given its apparent periodic nature, allowing for targeted observations with other facilities in the future.
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