An International Standard for holotranscobalamin (holoTC): international collaborative study to assign a holoTC value to the International Standard for vitamin B12 and serum folate

Authors: Thorpe, Susan J. / Rigsby, Peter / Roberts, Graham / Lee, Anne / Hamilton, Malcolm / Craig, David


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Q7E3pa
via IFTTT

Osteocalcin as a potential risk biomarker for cardiovascular and metabolic diseases

Authors: Magni, Paolo / Macchi, Chiara / Sirtori, Cesare R. / Corsi Romanelli, Massimiliano Marco


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Q7E5xr
via IFTTT

BRAF analysis before surgery for papillary thyroid carcinoma: correlation with clinicopathological features and prognosis in a single-institution prospective experience

Authors: Galuppini, Francesca / Pennelli, Gianmaria / Vianello, Federica / Censi, Simona / Zambonin, Laura / Watutantrige-Fernando, Sara / Manso, Jacopo / Nacamulli, Davide / Lora, Ornella / Pelizzo, Maria Rosa / Rugge, Massimo / Barollo, Susi / Mian, Caterina


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Kc4v5c
via IFTTT

Raman Spectroscopic Characterization of Packaged L. pneumophila Strains Expelled by T. thermophila

Analytical Chemistry

DOI: 10.1021/acs.analchem.5b04699

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1PlCRRV
via IFTTT

Welding, a risk factor of lung cancer: the ICARE study

Objectives

We investigated the relationship between lung cancer and occupational exposure to welding activity in ICARE, a population-based case–control study.

Methods

Analyses were restricted to men (2276 cases, 2780 controls). Welding exposure was assessed through detailed questionnaires, including lifelong occupational history. ORs were computed using unconditional logistic regression, adjusted for lifelong cigarette smoking and occupational exposure to asbestos.

Results

Among the regular welders, welding was associated with a risk of lung cancer (OR=1.7, 95% CI 1.1 to 2.5), which increased with the duration (OR=2.0, 95% CI 1.0 to 3.9 when duration >10 years), and was maximum 10–20 years since last welding. The risk was more pronounced in case of gas welding (OR=2.0, 95% CI 1.2 to 3.3), when the workpiece was covered by paint, grease, or other substances (OR=2.0, 95% CI 1.2 to 3.4) and when it was cleaned with chemical substances before welding. No statistically significant increase in lung cancer risk was observed among occasional welders.

Conclusions

Although these results should be confirmed, we showed that type of welding and mode of workpiece preparation are important determinants of the lung cancer risk in regular welders.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1msOqME
via IFTTT

Second to Fourth Digit Ratios in Plastic Surgery

No abstract available

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mjxuIF
via IFTTT

Identification of a founder BRCA1 mutation in the Moroccan population

Abstract

Breast cancer (BC) is the most frequent cancer among women in Morocco. However, the role of the most prevalent BC-predisposing genes, BRCA1 and BRCA2, has been largely unexplored. To help define the role of BRCA1 in breast cancer in Morocco, we characterized the first potential BRCA1 founder mutation in this population. Genetic testing of BRCA1 and BRCA2 in BC high-risk families identified mutation BRCA1 c.5309G>T, p.(Gly1770Val) or G1770V in five independent families from Morocco, suggesting a founder effect. To confirm this hypothesis, haplotype construction was performed using seven intragenic and flanking BRCA1 microsatellite markers. Clinical data were also compiled. Clinical data from carriers of mutation G1770V correspond to data from carriers of BRCA1 pathogenic mutations. Microsatellite analysis showed a common haplotype for the five families in a region comprising 1.54Mb, confirming G1770V as the first specific founder BRCA1 mutation in the Moroccan population.

Our findings contribute to a better understanding of BC genetics in the Moroccan population. Nevertheless, comprehensive studies of mutation G1770V in large series of BC patients from Morocco are needed to assess the real prevalence of this mutation and to improve genetic testing and risk assessment in this population.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QVXULw
via IFTTT

Decision-making for non-invasive prenatal testing for Down syndrome: Hong Kong Chinese women's preferences for individual versus relational autonomy

Abstract

Individual autonomy in antenatal screening is internationally recognised and supported. Policy and practice guidelines in various countries place emphasis on the woman's right to make her own decision and are related to concepts such as self-determination, independence, and self-sufficiency. In contrast, the dominant perspective in Chinese medical ethics suggests that the family is pivotal in making medical decisions, hence providing support for relational autonomy. This study explored Hong Kong Chinese pregnant women's preferences for individual versus relational autonomy for non-invasive prenatal testing (NIPT) for Down syndrome. A qualitative study carried out using semi-structured interviews with 36 women who had undertaken NIPT in Hong Kong. The findings show that most Hong Kong Chinese women valued aspects of both relational and individual autonomy in decision-making for NIPT. Women expected support from doctors as experts on the topic and wanted to involve their husband in decision-making while retaining control over the outcome. Somewhat surprisingly, the findings do not provide support for the involvement of family members in decision-making for NIPT. The adequacy of current interpretations of autonomy in prenatal testing policies as an individual approach needs discussion, where policy developers need to find a balance between individual and relational approaches.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20LIX6D
via IFTTT

February 2016 Issue Highlights

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20VQw7y
via IFTTT

Energy Consumption Optimization for Mobile Robots Motion Using Predictive Control

Abstract

Operation of mobile robots in off-road environment requires the attention to the torque saturation problem that occurs in the wheels DC motors while climbing hills. In the present work, off-road conditions are utilized to benefit while avoiding torque saturation. Energy optimization algorithm using predictive control is implemented on a two-DC motor-driven wheels mobile robot while crossing a ditch. The predictive control algorithm is simulated and compared with the PID control and the open-loop control. Predictive control showed more capability to avoid torque saturation and noticeable reduction in the energy consumption. Furthermore, using the wheels motors armature current instead of the supply voltage as control variable in the predictive control showed more efficient speed control. Simulation results showed that in case of known ditch dimensions ahead of time, the developed algorithm is feasible. Experimental examination of the developed energy optimization algorithm is presented. The experimental results showed a good agreement with the simulation results. The effects of the road slope and the prediction horizon length on the consumed energy are evaluated. The analytical study showed that the energy consumption is reduced by increasing the prediction horizon until it reaches a limit at which no more energy reduction is obtained. This limit is proportional to the width of the ditch in front of the mobile robot. Curve fitting is applied to the obtained results to address further the effect of the parameters on the energy consumption.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1XiO5K9
via IFTTT

Swarm Distribution and Deployment for Cooperative Surveillance by Micro-Aerial Vehicles

Abstract

The task of cooperative surveillance of pre-selected Areas of Interest (AoI) in outdoor environments by groups of closely cooperating Micro Aerial Vehicles (MAVs) is tackled in this paper. In the cooperative surveillance mission, finding distributions of the MAVs in the environment to properly cover the AoIs and finding feasible trajectories to reach the obtained surveillance locations from the initial depot are crucial tasks that have to be fulfilled. In addition, motion constraints of the employed MAVs, environment constraints (e.g. non-fly zones), and constraints imposed by localization of members of the groups need to be satisfied in the planning process. We formulate the task of cooperative surveillance as a single high-dimensional optimization problem to be able to integrate all these requirements. Due to numerous constraints that have to be satisfied, we propose to solve the problem using an evolutionary-based optimization technique. An important aspect of the proposed method is that the cooperating MAVs are localized relatively to each other, rather than using a global localization system. This increases robustness of the system and its deploy-ability in scenarios, in which compact shapes of the MAV group with short relative distances are required.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1T7KLRv
via IFTTT

GPS Denied UAV Routing with Communication Constraints

Abstract

A novel GPS denied routing problem for UAVs is described, where the UAVs cooperatively navigate through a restricted zone deployed with noncommunicating Unattended Ground Sensors (UGS). The routing algorithm presenting in this paper ensures the UAVs maintain strict contact with at least one UGS, which allows the UGS act as beacons for relative navigation eliminating the need for dead reckoning. This problem is referred to as the Communication Constrained UAV Routing Problem (CCURP). Two architectures for cooperative navigation of two or three UAVs are considered. For the two UAV problem, a \(\frac {9}{2}\) -approximation algorithm is developed. The three UAV problem is transformed into a one-in-a-set Traveling Salesman Problem (TSP), which is solved as a regular asymmetric TSP using existing methods after applying a second transformation. Computational results corroborating the performance bounds are presented.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1nXamk8
via IFTTT

Fluid interpretation of some models of f ( R ) theory of gravity

Abstract

In the modified theory of gravity, the equivalence of \(\frac{1}{R}\) or \(R^2\) or \(R^{3/2}\) interaction with an ideal fluid in Friedmann–Lemaitre–Robertson–Walker background reduces the field equations to a set of second order equations in terms of density \(\rho \) and pressure p of the fluid with \(p=p(\rho )\) . The second order equations yield the evolution identical to the solution obtained from higher derivative gravity. The universe is radiation dominated at sufficiently large densities, while at smaller densities it is accelerating. The \(R^2\) term also shows a deSitter solution.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1XiO74J
via IFTTT

Structural, optical and electrical properties of V 2 O 5 xerogel thin films

Abstract

In the present work V₂O₅ xerogel thin films are deposited on quartz substrate by using a cost effective sol–gel based dip coating method. Films of thickness ~122, 224 and 284 nm are grown as the number of dipping varies from one to three. Phase analyses of the thin films are investigated by X-ray diffraction technique. The microstructural characterization is carried out by electron microscopy techniques. Crystalline, phase pure V₂O₅ thin films with uniform nanoporous microstructure are grown in the present work. Solar transmittance and reflectance of films are measured by UV–VIS–NIR spectrophotometer. The optical band gap, refractive index and extinction coefficient of the films are also evaluated. Further, the average solar absorptance and IR emittance are evaluated by solar spectrum reflectometer and emissometer, respectively. The solar transmittance and optical band gap decrease with the increase in film thickness from 122 to 284 nm while reverse trend is observed for solar absorptance. Refractive index (~1.95) and IR emittance (~0.75) of the nanoporous V₂O₅ xerogel thin films on quartz substrate are almost independent of film thickness. The sheet resistance value slightly decreases from ~1.6 × 10⁶ to ~2.6 × 10⁵ ohm/cm² as the thickness of the V₂O₅ xerogel thin film increases from 112 to 284 nm.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1T7KJcd
via IFTTT

État de santé des mineurs isolés étrangers accueillis en Gironde entre 2011 et 2013

Résumé

L'absence de recommandations médicales spécifiques pour la prise en charge des mineurs isolés étrangers (MIE) entraîne de grandes disparités selon les départements d'accueil. En étudiant leur état de santé global nous souhaitons aider à promouvoir l'idée d'un guide de bonnes pratiques pour leur prise en charge sanitaire. Notre étude décrit des données obtenues à partir d'un bilan médical systématique proposé aux MIE accueillis en Gironde entre janvier 2011 et décembre 2013. 235 MIE ont été inclus, dont 143 ont des dossiers complets. Les pathologies les plus fréquemment retrouvées, et/ou les plus graves, étaient les parasitoses digestives, les bilharzioses, les filarioses, l'hépatite B, la carence martiale, le déficit en G6PD et les caries dentaires. Sur le plan psychiatrique 45 % des MIE présentaient un tableau clinique compatible avec un état de stress post traumatique. Les MIE cumulent les risques sanitaires des populations vulnérables que sont les adolescents et les réfugiés clandestins. Ils requièrent donc une attention particulière et adaptée dès leur entrée sur le territoire.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20oQSBm
via IFTTT

Central nervous system and cervical spine abnormalities in Apert syndrome

Abstract

Purpose

Apert syndrome characterized by acrocephalosyndactyly is a rare autosomal dominant congenital malformation with a prevalence of 1/65,000 births. With an extensive range of phenotypic and developmental manifestations, its management requires a multidisciplinary approach. A variety of craniofacial, central nervous system (CNS), and cervical spine abnormalities have been reported in these patients. This study aimed to determine the incidence of these CNS abnormalities in our case series.

Methods

Retrospective review of Australian Craniofacial Unit (ACFU) database for Apert patients was performed. Data collected that included demographics, place of origin, age at presentation, imaging performed, and images were reviewed and recorded. Where available, developmental data was also recorded.

Results

Ninety-four patients seen and managed at the ACFU had their CNS and cervical spine abnormalities documented. The main CNS abnormalities were prominent convolutional markings (67 %), ventriculomegaly (48 %), crowded foramen magnum (36 %), deficient septum pellucidum (13 %), and corpus callosum agenesis in 11 %. Major C-spine findings were present in 50.8 % of patients and included fusion of posterior elements of C5/C6 (50 %) and C3/4 (27 %). Multilevel fusion was seen in 20 %. Other abnormalities were C1 spina bifida occulta (7 %) and atlanto-axial subluxation (7 %).

Conclusion

Multiple CNS and cervical spine (c-spine) abnormalities are common in Apert syndrome. The significance of these abnormalities remains largely unknown. Further research is needed to better understand the impact of these findings on growth, development, and treatment outcomes.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Lhd5dL
via IFTTT

Telemetric intracranial pressure monitoring: a noninvasive method to follow up children with complex craniosynostoses. A case report

Abstract

Introduction

There are no reliable noninvasive methods of monitoring ICP. Most assessments are made by indirect measures and are difficult to follow over time. Invasive studies can be used but up until now have required in-hospital transcutaneous measurements. Accurate ICP recordings over longer periods of time can be very valuable in timing different surgical procedures in syndromal cases. This case shows that telemetric ICP monitoring can be used for long-term follow-up in patients that may need repeated surgeries related to their craniosynostosis condition.

Case report

In this report, the telemetric ICP probe (Raumedic Neurovent-P-tel) was implanted before surgery and was used for repeated "noninvasive" ICP recordings pre- and postoperatively in a patient with craniosynostosis. The patient was an eight-year-old girl with pansynostosis with only the right lambdoid suture open. A telemetric ICP probe was implanted the day before cranial vault remodeling and the ICP was monitored pre- and postoperatively. The ICP was above 15 mmHg 72.2 % of the monitoring time before surgery, and the amplitude of the curve was greater than normal suggesting impaired compliance. Direct postoperative ICP was normal, and the amplitude was lower. The ICP was then monitored both in out-patient clinic and in four longer hospital stays. Both the values and the curves were analyzed, and the time with ICP above 15 mmHg decreased over time, and the waveform amplitude of the curves improved.

Conclusion

This "noninvasive" way of recording ICP is a feasible and helpful tool in decision-making and intervening in patients with craniosynostosis.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Q7vBqe
via IFTTT

Wire fixation of internal distractor for cranial vault remodeling

Abstract

Background

Posterior cranial vault distraction osteogenesis is currently used to enlarge the cranial volume and control the intracranial pressure. This procedure carries the risk of hardware dislocation, and especially in infants, as their skull being thin, the screws may damage the underlying dura.

Technical note

In this paper, the authors describe a simple method to fixate the internal distractor to the skull vault in case of thin calvaria using metallic wires.

Discussion

This method allows a strong and tight application of the distractor to the osteotomy margins and reduces the risks of loosening of the device and the risk of dural tears. It is particularly useful in young children or in case of diffuse digitate impressions with areas of reduced thickness of the skull bone.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20oQPW9
via IFTTT

Modified concentric craniotomy for the removal of a huge calvarial metastatic tumor: technical note

Abstract

Background

It is challenging for neurosurgeons to remove huge tumors involving the skull that may possibly invade the dura or intracranial neural tissue. In this situation, excision of the tumor may cause profound blood loss, unexpected opening of the dura, or neurological injury. We describe a technique of craniotomy in a pediatric patient to avoid surgical complications.

Methods

A 15-year-old boy had a huge metastatic calvarial Ewing's sarcoma. We removed the tumor successfully with modified concentric craniotomy. First, two oval burr holes are made on both sides of the tumor. The inner craniotomy uses the internal margin of the oval holes, while the outer cut uses the outer margins. The skull bone in between the two craniotomies is removed easily in two pieces and the dura surrounding the tumor can be exposed early in the procedure. In this way, the huge skull tumor can be removed en bloc under direct vision to avoid unwanted complications. Minimal blood and bone loss can be achieved.

Results

Blood transfusion was not necessary during the surgery. The patient did not have new neurological symptoms and signs after surgery.

Conclusions

The goal of the modified concentric craniotomy is to develop an accessible margin of the dura surrounding the bulky tumor in the early phase of surgery. Blood and bone loss can be reduced significantly.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/23Xa4uJ
via IFTTT

Progressive frontal morphology changes during the first year of a modified Pi procedure for scaphocephaly

Abstract

Purpose

The purpose of this study was to quantify the changes in frontal morphology in patients with scaphocephaly treated with a modified Pi procedure.

Methods

Consecutive scaphocephalic patients (n = 13) who underwent surgery before 12 months of age that had more than 1 year of follow-up and standard preoperative, 3-month, and 1-year photographs were included. Anthropometric measurements were used to document the craniofacial index. Computerized photogrammetric analyses of five craniofacial angles (bossing angle, nasofrontal angle, angle of facial convexity, and angle of total facial convexity) were also performed.

Results

Comparisons of the preoperative and postoperative direct anthropometric measurements of the cephalic index showed a significant (all p < 0.05) increase in the postoperative period, with no significant differences in early versus late postoperative period comparisons. Comparisons of the preoperative and postoperative computerized photogrammetric measurements of the craniofacial angles showed a significant (all p < 0.05) reduction (bossing angle, angle of facial convexity, and angle of total facial convexity) and increase (nasofrontal angle) in the early and late postoperative periods.

Conclusions

Frontal morphology significantly changed over the first year of the modified Pi procedure.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20oQS4o
via IFTTT

Comparison of surgical exposure and maneuverability associated with microscopy and endoscopy in the retrolabyrinthine and transcrusal approaches to the retrochiasmatic region: a cadaveric study

Abstract

Background

The retrolabyrinthine and transcrusal approaches (RLA and TCA, respectively) are the two most often used posterior transpetrosal approaches that are used to treat lesions in the retrochiasmatic region. Endoscopes are increasingly used in neurosurgical practice. To determine whether a difference exists between the two transpetrosal approaches in the retrochiasmatic region, we evaluated and compared the exposure and maneuverability associated with the microscope and the endoscope in these approaches.

Methods

Seven formalin-fixed cadaveric heads were dissected bilaterally through the two approaches: four for evaluation and three injected with colored latex for photography. The retrochiasmatic region was divided into four sub-compartments: the compartment before the infundibulum, which was further divided into two parts, (1) the ipsilateral and (2) the contralateral compartments; (3) the retroinfundibulum compartment; (4) the third ventricle. After each approach, exposure and maneuverability of the structures in these four compartments obtained by microscopy and endoscopy were scored under a guidance of a numerical grading system for further comparison.

Results

The TCA provided better exposure and maneuverability at the retrochiasmatic region than the RLA in both the microscopy model [scores of 39.75 ± 2.12 and 32.38 ± 2.56 respectively (p < 0.05)] and the endoscopy model [scores of 82.13 ± 3.40 and 43.75 ± 1.67 respectively (p < 0.05)].

Conclusions

The TCA is better than the RLA at offering exposure and manipulation to structures in the retrochiasmatic region, especially in patients whose lesion is located high into the third ventricle and/or expanded into the contralateral part. Endoscopes may be helpful in TCA in terms of exposing and maneuvering structures in the contralateral and interpeduncle fossa areas. However, in RLA, not enough room is available for simultaneously maneuvering an endoscope and a surgical instrument.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/23WYUG9
via IFTTT

Thank you list 2015

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1msw0vB
via IFTTT

Facile and Sensitive Fluorescence Sensing of Alkaline Phosphatase Activity with Photoluminescent Carbon Dots Based on Inner Filter Effect

Analytical Chemistry

DOI: 10.1021/acs.analchem.5b04193

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1XiO48P
via IFTTT

Bone Samples Extracted from Embalmed Subjects Are Not Appropriate for the Assessment of Bone Quality at the Molecular Level Using Raman Spectroscopy

Analytical Chemistry

DOI: 10.1021/acs.analchem.5b04400

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1T7KEWa
via IFTTT

Statistical Correlations between NMR Spectroscopy and Direct Infusion FT-ICR Mass Spectrometry Aid Annotation of Unknowns in Metabolomics

Analytical Chemistry

DOI: 10.1021/acs.analchem.5b02889

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1SgqGJH
via IFTTT

Lymphome gastrique : aspects endoscopiques et échoendoscopiques

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1XiE1R6
via IFTTT

Comment prendre en charge les tumeurs carcinoïdes gastriques ?

Résumé

Les tumeurs neuroendocrines bien différenciées de l'estomac sont principalement fundiques. Les deux situations fréquentes sont: 1/ les tumeurs multiples associées à une gastrite chronique fundique auto-immune (maladie de Biermer) (type 1) où l'hypergastrinémie réactionnelle est responsable d'une hyperplasie des cellules endocrines fundiques puis du développement de ces tumeurs ; et 2/ les tumeurs uniques dites sporadiques (type 3) qui apparaissent en dehors de tout contexte particulier (pas d'hypergastrinémie, pas d'atrophie fundique, pas d'hyperplasie des cellules endocrines fundiques). Les tumeurs de type 1 sont presque toujours bénignes, multiples, de petite taille (<1 cm). Habituellement, elles ne nécessitent aucune exploration complémentaire et peuvent être laissées en place et être surveillées ; les explorations (échoendoscopie, scintigraphie des récepteurs de la somatostatine) étant limitées aux tumeurs de plus de 1 cm. Les tumeurs de type 3 sont le plus souvent invasives, malignes et doivent être traitées carcinologiquement comme un cancer de même taille. Les exceptionnelles tumeurs de type 2 sont associées au syndrome de Zollinger-Ellison et à la néoplasie endocrine multiple de type 1. Le rôle du gastroentérologue est donc essentiellement de différencier les tumeurs de types 1 et 3, c'est-à-dire faire ou éliminer le diagnostic de maladie de Biermer et ne pas induire une morbimortalité qui est presque nulle pour les tumeurs de type 1.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20LtAez
via IFTTT

Intraspecific functional trait variability does not result in higher fitness under thermal stress in a free-living marine nematode

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QVIxCw
via IFTTT

Analysis of uterine activity in nonpregnant women by electrohysterography: a feasibility study

With an overall effectiveness below 30%, in vitro fertilization (IVF) is in urgent need for improvements, especially in view of the increasing trend in postponing childbirth in developed societies. Abnormal contraction of the uterus may underlie impaired fertility and unsuccessful IVF. However, currently, there is no method for quantitative assessment of uterine activity and guidance of dedicated intervention. Analysis of the electrohysterogram (EHG) has been extensively used in pregnancy for quantifying uterine contractions. In this paper, we evaluate, for the first time, the use of EHG analysis for characterizing contractions in women in two different phases of the menstrual cycle, when the uterus is expected to be active and quiescent. In this preliminary study, by estimating the time evolution of the EHG signal energy, we derive the contraction frequency, fC, as a possible marker for quantifying the activity of the uterus and discriminate between active and quiescent status. Ultrasound (US) image sequences are simultaneously recorded and visually analyzed for a qualitative validation of the results. The high correlation (0.91) between fC obtained by EHG and US analysis and the measured different values of fC in the two phases motivate further research to confirm the value of EHG analysis for contraction quantification in nonpregnant women.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QVIwP6
via IFTTT

Clinical and radiological outcomes of lumbar posterior subtraction osteotomies are correlated to pelvic incidence and FBI index

Abstract

Purpose

Pedicle subtraction osteotomy (PSO) is one of the surgical options for treating alignment disorders of the fused spine (due to post-surgical fusion or related to arthritis). It enables satisfactory sagittal realignment and improved function due to economic sagittal balance. The aim of this study was to analyze clinical and radiological results of PSO after a minimum follow-up of 2 years and demonstrate the benefit of sub-group analysis as a function of pelvic incidence (PI).

Methods

A descriptive prospective single center study of 63 patients presenting with spinal global malalignment who underwent correction by PSO. Function was assessed by the Oswestry disability index (ODI), a visual analog scale of lumbar pain (VAS) and a SF-36 questionnaire. Radiographic analyses of pre- and post-operative pelvic-spinal parameters were performed on X-rays obtained by EOS^® imaging after 3D modeling. Global analysis and analysis of sub-groups as a function of pelvic incidence were performed and the full balance integrated index (FBI) was calculated.

Results

this series showed a marked clinical improvement and significant progress of functional scores. Global post-operative radiological analysis showed a significant improvement in all pelvic and spinal parameters. The mean correction obtained after PSO was 31.7° ± 8.4°, hence global improvement of lumbar lordosis of 22°. The sagittal vertical angle (SVA) decreased from +9 cm before surgery to +4.3 cm after surgery. Sub-group analysis demonstrated greater improvement in pelvic tilt, sacral slope and spinal parameters of patients with a small or moderate pelvic incidence; all had an FBI index <10°. Most of the pelvic and spinal parameters of patients with a large pelvic incidence were insufficiently corrected and they had an FBI index >10°

Conclusion

PSO is a surgical procedure enabling correction of multiplane rigid spinal deformities that require major sagittal correction. It was seen to be highly effective in patients with a small or moderate pelvic incidence (PI <60°) but was sometimes less effective in patients with large pelvic incidence due to insufficient lordosis correction. Clinical results were highly correlated with the value of the FBI index.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1KFzCFY
via IFTTT

Chirurgie im Spannungsfeld von Technik, Ethik und Ökonomie

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1os0W0G
via IFTTT

Gastroduodenale und rektale neuroendokrine Neoplasien

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1msAKRP
via IFTTT

Adhesion molecules expression in CLL: Potential impact on clinical and hematological parameters

Publication date: Available online 9 February 2016
Source:Journal of the Egyptian National Cancer Institute
Author(s): Azza M. Kamel, Nahla M. El-Sharkawy, Randa A. Osman, Eman K. Abd El-Fattah, Essam El-Noshokaty, Thoraya Abd El-Hamid, Eman Z. Kandeel
BackgroundB-cell chronic lymphocytic leukemia (CLL) is marked by the accumulation of CD5+ B lymphocytes within the blood, bone marrow (BM), and secondary lymphoid tissues. Abnormalities in the expression and function of cell adhesion molecules may account for the patterns of intra-nodal growth and hematogenous spread of the malignant cells. Chemokines and integrin-mediated adhesion and trans-endothelial migration (TEM) are central aspects in trafficking and retention of hematopoietic cells in the BM and lymphoid organs.Aim of the workThis work was conducted to study adhesion molecules status in CLL and its potential impact on both hematological and clinical parameters.Patients and methodsThe study included 78 newly diagnosed CLL patients. Immunophenotyping was performed on peripheral blood using the chronic lymphoid panel. Adhesion molecules (CD11a, CD11b, CD49d, CD49C, CD29 and CD38) were tested using monoclonal antibodies and analyzed by Flow Cytometry.ResultsPositive correlation was encountered between adhesion molecules: CD38 with CD49d (r=0.25, p=0.028), CD11a with CD11b, CD49d and CD29 (r=0.394, p=0.001; r=0.441, p=<0.01 and r=0.446, p<0.01 respectively) and CD29 with CD49c and CD49d (r=0.437, p<0.01; r=0.674, p<0.01 respectively).CD49c showed negative correlation with Rai staging (r=−0.269, p=0.033). CD11a and CD29 showed a significant relation with splenomegaly (p=0.04 and 0.03 respectively) and CD49d showed a significant relation with lymphadenopathy (p=0.02).ConclusionThe level of different adhesion molecules expression in CLL is apparently reflected on the potential migratory behavior of the leukemic cells to different organs.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1QVHYbY
via IFTTT

Proprioceptive ability at the lips and jaw measured using the same psychophysical discrimination task

Abstract

In the human face, the muscles and joints that generate movement have different properties. Whereas the jaw is a conventional condyle joint, the facial musculature has neither distinct origin nor insertion points, and the muscles do not contain muscle spindle proprioceptors. This current study aims to compare the proprioceptive ability at the orofacial muscles with that of the temporomandibular joint (TMJ) in 21 neuro-typical people aged between 18 and 65 years. A novel psychophysical task was devised for use with both structures that involved a fixed 30.5 mm start separation followed by closure onto stimuli of 5, 6, 7, 8 mm diameter. The mean proprioceptive score when using the lips was 0.84 compared to 0.79 at the jaw (p < 0.001), and response error was lower by 0.1 mm. The greater accuracy in discrimination of lip movement is significant because, unlike the muscles controlling the TMJ, the orbicularis oris muscle controlling the lips inserts on to connective tissue and other muscle, and contains no muscle spindles, implying a different more effective, proprioceptive mechanism. Additionally, unlike the lack of correlation previously observed between joints in the upper and lower limbs, at the face the scores from performing the task with the two different structures were significantly correlated (r = 0.5, p = 0.018). These data extend the understanding of proprioception being correlated for the same left and right joints and correlated within the same structure (e.g. ankle dorsiflexion and inversion), to include use-dependant proprioception, with performance in different structures being correlated through extended coordinated use. At the lips and jaw, it is likely that this arises from extensive coordinated use. This informs clinical assessment and suggests a potential for coordinated post-injury training of the lips and jaw, as well as having the potential to predict premorbid function via measurement of the uninjured structure, when monitoring progress and setting clinical rehabilitation goals.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/23VZap5
via IFTTT

Acceptability and preference of three inhalation devices assessed by the Handling Questionnaire in asthma and COPD patients

Abstract

Background

The patients' criteria of preference for inhalation devices can affect the extent of their adherence to treatment and outcomes.

Aim of this study was to assess and compare the patients' preference and acceptability (PPA) for Breezhaler and Genuair (both Dry Powder Inhalers), and for Respimat (a Soft Mist Inhaler) in asthma and COPD out-patients by means of the Handling Questionnaire.

Methods

The Handling Questionnaire is a validated instrument which allows the investigation of different domains of PPA; it also takes into account the patients' age and gender, together with their previous experience with the inhalation devices and their previous education approach to them. Differences in terms of preference, acceptance and usability were assessed by linear and logistic regressions in order to evaluate factors influencing the proper actuation.

Results and Discussion

Data from 333 patients were collected: Genuair and Respimat were the most liked and perceived as the easiest to use at glance by patients, but also as the least problematic according to the patients' and nurse's judgments. Mean number of attempts for achieving the first effective actuation was the highest with Breezhaler (2.6 vs 1.6; p <0.0001). Linear regressions showed that longer the explanation, higher was the number of attempts to the first proper actuation (0.58 additional attempts every 10 s increase in the first explanation, p <0.0001). Devices requiring less manoeuvres for the actuation were used properly after less attempts (0.38 increase in the number of attempts every additional manoeuvres, p <0.0001). Respimat proved to be the most indicated in COPD patients since it was the most liked and its successful rate at first attempt was the highest. Logistic regressions confirmed these data. Previous experience with DPIs and/or MDIs did not affect the patient preference and acceptability, independently whether suffering from asthma or COPD.

Conclusions

Substantial differences are existing in patient's preference and acceptability for inhalation devices, mainly related to the handling and the understanding of the different devices.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20LuasD
via IFTTT

Monitoring burst suppression in critically ill patients: Multi-centric evaluation of a novel method

Publication date: Available online 9 February 2016
Source:Clinical Neurophysiology
Author(s): Franz Fürbass, Johannes Herta, Johannes Koren, M. Brandon Westover, Manfred M. Hartmann, Andreas Gruber, Christoph Baumgartner, Tilmann Kluge
ObjectiveTo develop a computational method to detect and quantify burst suppression patterns (BSP) in the EEGs of critical care patients. A multi-center validation study was performed to assess the detection performance of the method.MethodsThe fully automatic method scans the EEG for discontinuous patterns and shows detected BSP and quantitative information on a trending display in real-time. The method is designed to work without setting any patient specific parameters and to be insensitive to EEG artifacts and periodic patterns. For validation a total of 3982 hours of EEG from 88 patients were analyzed from three centers. Each EEG was annotated by two reviewers to assess the detection performance and the inter-rater agreement.ResultsAverage inter-rater agreement between pairs of reviewers was κ=0.69. On average 22% of the review segments included BSP. An average sensitivity of 90% and a specificity of 84% were measured on the consensus annotations of two reviewers. More than 95% of the periodic patterns in the EEGs were correctly suppressed.ConclusionA fully automatic method to detect burst suppression patterns was assessed in a multi-center study. The method showed high sensitivity and specificity.SignificanceClinically applicable burst suppression detection method validated in a large multi-center study.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1XiD8Io
via IFTTT

New Approach for Inhibition of HIV Entry: Modifying CD4 Binding Sites by Thiolated Pyrimidine Derivatives

Abstract

Thiolated pyrimidine derivatives have been synthetized and their antiretroviral effect against human immunodeficiency virus type 1 (HIV-1_IIIB) and HIV-1 chimeric pseudovirions have been quantitatively determined in cell-based viral infectivity assays including syncytium inhibition assay as well as a single-cycle viral infection assay on HeLaCD4-LTR/ß-gal cells. Pseudotype virions prepared bearing HIV-1 envelope preference for CCR5 coreceptor, CXCR4 coreceptor or for both, respectively, with a HIV-1 core containing luciferase reporter gene were able to infect susceptible cells but are replication defective so unable to replicate in the cells . Data indicate that thiolated pyrimidine derivatives inhibited effectively virally induced cell fusion in vitro as well as infectivity of primary HIV-1IIIB strain and HIV-1 pseudovirions using chemokine receptors CCR5 or CXCR4 or both for virus entry a dose dependent manner. Inhibition was selective, depended on the pseudovirus coreceptor preference. Our results suggest that some of these sulfur containing pyrimidines interact with redoxactive -SH groups required for successful HIV entry, including a redox active disulfide in the CD4 molecule as well as -SH groups in HIV viral envelope gp120. This mode of action is unique representing a new class of potential HIV entry inhibitors.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1O2oy0F
via IFTTT

Effects of Standardised Fermented Papaya Gel on Clinical Symptoms, Inflammatory Cytokines, and Nitric Oxide Metabolites in Patients with Chronic Periodontitis: An Open Randomised Clinical Study

The clinical efficacy of topical administration of standardised fermented papaya gel (SFPG), known to have antioxidant and anti-inflammatory properties, versus conventional therapy was evaluated in a group of 84 patients with moderate-to-severe periodontitis, randomly assigned to control group () undergoing traditional pharmacologic/surgical protocols or to experimental group (), additionally treated with intragingival pocket SFPG (7 g) applications (15 min daily for 10 days). Patients undergoing SFPG treatment showed significant (), durable improvement of three major clinical indices of disease severity: reduced bleeding (day 7), plaque and gingival conditions (day 14), and consistent gingival pocket depth reduction (day 45). Proinflammatory nitric oxide metabolites reached normal values in plasma (day 14) and gingival crevicular fluid (GCF) at day 45 with SFPG applications compared to controls that did not reach normalisation. Levels of highly increased proinflammatory (IL-1B, IL-6) and suppressed anti-inflammatory (IL-10) cytokines normalised in the SFPG group by days 14 (plasma) and 45 (GCF), but never in the control group. Although not acting directly as antibiotic, SFPG acted in synergy with human granulocytes blocking adaptive catalase induction in S. aureus in response to granulocyte-derived oxidative stress, thus enhancing intracellular bacterial killing.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1nYcfgq
via IFTTT

A Mutation in IL4RA Is Associated with the Degree of Pathology in Human TB Patients

The contribution of interleukin- (IL-) 4 receptor-alpha- (Rα-) dependent events in the pathogenesis of tuberculosis (TB) is controversial. We have recently shown IL-13 overexpression in mice to cause recrudescent Mtb replication and centrally necrotizing granulomas strongly resembling pathology of human TB. A deletion of IL-4Rα completely abrogates TB tissue pathology in these mice. To validate our results in human TB patients, we here determined the association of distinct variants of the IL4, IL13, IL4RA, IL13RA1, and IL13RA2 genes with cavity formation in a large Ghanaian cohort of HIV-negative individuals with newly diagnosed pulmonary TB. In fact, the structural variant of the IL4RA I50V, previously shown to result in enhanced signal transduction, was significantly associated with greater cavity size, and a variant of IL13RA2 was associated with disease in females. To evaluate whether the human-like TB pathology in IL-13-overexpressing mice is specifically mediated through the IL-4Rα subunit, we analyzed IL-13 transgenic mice with a genetic ablation of the IL-4Rα. In these mice, the IL-13-mediated increased susceptibility, human-like pathology of collagen deposition around centrally necrotizing granulomas, and alternative macrophage activation were abolished. Together, our genetic association study in human TB patients further supports the assumption that IL-13/IL-4Rα-dependent mechanisms are involved in mediating tissue pathology of human TB.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1LgQo9A
via IFTTT

Prophylactic vaccines are potent activators of monocyte-derived dendritic cells and drive effective anti-tumor responses in melanoma patients at the cost of toxicity

Abstract

Dendritic cell (DC)-based immunotherapy is explored worldwide in cancer patients, predominantly with DC matured with pro-inflammatory cytokines and prostaglandin E₂. We studied the safety and efficacy of vaccination with monocyte-derived DC matured with a cocktail of prophylactic vaccines that contain clinical-grade Toll-like receptor ligands (BCG, Typhim, Act-HIB) and prostaglandin E₂ (VAC-DC). Stage III and IV melanoma patients were vaccinated via intranodal injection (12 patients) or combined intradermal/intravenous injection (16 patients) with VAC-DC loaded with keyhole limpet hemocyanin (KLH) and mRNA encoding tumor antigens gp100 and tyrosinase. Tumor antigen-specific T cell responses were monitored in blood and skin-test infiltrating-lymphocyte cultures. Almost all patients mounted prophylactic vaccine- or KLH-specific immune responses. Both after intranodal injection and after intradermal/intravenous injection, tumor antigen-specific immune responses were detected, which coincide with longer overall survival in stage IV melanoma patients. VAC-DC induce local and systemic CTC grade 2 and 3 toxicity, which is most likely caused by BCG in the maturation cocktail. The side effects were self-limiting or resolved upon a short period of systemic steroid therapy. We conclude that VAC-DC can induce functional tumor-specific responses. Unfortunately, toxicity observed after vaccination precludes the general application of VAC-DC, since in DC maturated with prophylactic vaccines BCG appears to be essential in the maturation cocktail.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1WefZFR
via IFTTT

How Does Outcomes Research Help Advance Our Knowledge of Patient Outcomes in Hepatopancreaticobiliary Surgery?

Abstract

Randomized controlled trials have historically been regarded as the gold standard of modern clinical research tools, allowing us to elucidate the efficacy of novel therapeutics in an unparalleled manner. However, when attempting to generalize trial results to broader populations, it becomes apparent that the unexplained outcome variability exists among treatment recipients, suggesting that randomized controlled trials harbor inherent limitations. Herein, we explore the benefits of health services (outcomes) research utilization in addressing variation in patient outcomes following surgical intervention in the non-randomized setting, with a specific focus on hepatopancreaticobiliary surgery outcomes. To achieve this, we have constructed a framework that outlines the complex interactions existing between therapeutic, patient, and provider factors that subsequently lead to variation in outcomes. By exploring examples in the current literature, we have highlighted the areas where the knowledge is currently lacking and can be further strengthened through the application of outcomes research. Furthermore, we have attempted to demonstrate the utility of alternative study designs in the investigation of novel clinical questions currently unanswered in the field of hepatopancreaticobiliary surgery.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1KFwfPl
via IFTTT

We need to be (much) better

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1PldAr0
via IFTTT

Analysis of Flow Field in Mechanical Aortic Bileaflet Heart Valves Using Finite Volume Method

Abstract

Under physiological conditions, the opening and closing of the leaflets of an implanted artificial heart valve (AHV) affects the blood components and therefore may cause various complications to the patient such as hemolysis or platelet activation. In this paper, a computational fluid model is presented. The regional distribution of flow shear stress in an AHV is analyzed using computational fluid dynamics and AHV performance is evaluated in terms of the variation of flow velocity and pressure when blood passes the leaflets in the aortic valve. The results suggest that for the design of a mechanical AHV, the maximum opening angle and internal orifice diameter should be increased to improve the fluid structure interaction and decrease the possibility of damage to blood components. Finally, the fluid stress distribution of the AHV leaflet structure was calculated and analyzed under pulsating flow conditions.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20Lu98d
via IFTTT

Programming biology: expanding the toolset for the engineering of transcription

Transcription is a complex and dynamic process representing the first step in gene expression that can be readily controlled through current tools in molecular biology. Elucidating and subsequently controlling transcriptional processes in various prokaryotic and eukaryotic organisms have been a key element in translational research, yielding a variety of new opportunities for scientists and engineers. This chapter aims to give an overview of how the fields of molecular and synthetic biology have contributed both historically and presently to the state of the art in transcriptional engineering. The described tools and techniques, as well as the emerging genetic circuit engineering discipline, open the door to new advances in the fields of medical and industrial biotechnology.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1XiEJ0N
via IFTTT

Novel DNA and RNA elements

Impressive advances in the field of synthetic biology go hand in hand with the discovery, design, and use of novel DNA and RNA elements. Efficient synthesis of large oligonucleotides and double-stranded DNA parts, chip-based synthesis of DNA libraries, and a detailed understanding of fundamental biological mechanisms and increased capacities in bioinformatics enable new findings and applications. In this chapter, reengineered and model-based designed DNA parts such as promoters, terminators, and aptamers, which can be used for controlled gene expression, are discussed. Furthermore, recent advances in the RNA world concerning small RNAs, ribozymes, and riboswitches and novel applications of synthetic nucleotide sequences in the form of DNA walkers and DNA machines are emphasized. The knowledge and experiences gained in the investigations of large numbers of natural and novel DNA and RNA parts have built the foundation for the design of new functions of polynucleotides and model-based regulation of gene and pathway expression.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/20Lu8RC
via IFTTT

The gnotobiotic brine shrimp (Artemia franciscana) model system reveals that the phenolic compound pyrogallol protects against infection through its prooxidant activity

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1KbQzrV
via IFTTT

Porcine EEF1A1 and EEF1A2 genes: genomic structure, polymorphism, mapping and expression

Eukaryotic translation elongation factor 1 alpha (EEF1A) plays a key role in protein synthesis. In higher vertebrates EEF1A occurs in two isoforms, EEF1A1 and EEF1A2, encoded by distinct genes. The purpose of this study was to compare the two porcine genes as for the genomic sequence, gene organization and mRNA expression in different tissues, as well as to search for polymorphism and chromosomal assignment. Standard methods of DNA and mRNA analysis were used. We determined the complete genomic sequence of the porcine EEF1A1 and EEF1A2 genes. The two genes differ in the lengths of transcription units (3102 and 8588 bp, respectively), but have similar genomic organization and their coding sequences are highly similar (78 % identity of coding sequences and 92.4 % identity of amino acid sequences). Several polymorphisms in the two genes were detected. EEF1A1 and EEF1A2 were mapped to SSC1p11.1 and SSC17q23.3, respectively. mRNA of EEF1A1 was expressed in all studied tissues (the highest expression was in 44-day fetal muscle and low expression in adult liver and brain), while EEF1A2 was expressed only in skeletal-muscle, tongue, heart, diaphragm and brain tissues. EEF1A2 was not expressed in fetal muscle tissue (44 days). In this paper results are provided on genomic sequences, genomic organization, polymorphism, chromosomal assignment and spatial and temporal expressions of the porcine EEF1A1 and EEF1A2 genes. Novel polymorphisms were described in both genes. Porcine EEF1A2 was studied for the first time.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1msxc2f
via IFTTT

Morphometric study of the two fused primary ossification centers of the clavicle in the human fetus

Abstract

Purposes

A satisfactory understanding of the clavicle development may be contributing to both the diagnosis of its congenital defects and prevention of perinatal damage to the shoulder girdle. This study was carried out to examine the transverse and sagittal diameters, cross-sectional area and volume of the two fused primary ossification centers of the clavicle.

Methods

Using the methods of CT, digital-image analysis and statistics, the size for two fused primary ossification centers of the clavicle in 42 spontaneously aborted human fetuses at ages of 18–30 weeks was studied.

Results

Without any male–female and right-left significant differences, the best fit growth models for two fused primary ossification centers of the clavicle were as follows: y = −31.373 + 15.243 × ln(age) ± 1.424 (R ² = 0.74) for transverse diameter, y = −7.945 + 3.225 × ln(age) ± 0.262 (R ² = 0.78), y = −4.503 + 2.007 × ln(age) ± 0.218 (R ² = 0.68), and y = −4.860 + 2.117 × ln(age) ± 0.200 (R ² = 0.73) for sagittal diameters of the lateral, middle and medial ends respectively, y = −31.390 + 2.432 × age ± 4.599 (R ² = 0.78) for cross-sectional area, and y = 28.161 + 0.00017 × (age)⁴ ± 15.357 (R ² = 0.83) for volume.

Conclusions

With no sex and laterality differences, the fused primary ossification centers of the clavicle grow logarithmically in both transverse and sagittal diameters, linearly in cross-sectional area, and fourth-degree polynomially in volume. Our normative quantitative findings may be conducive in monitoring normal fetal growth and screening for inherited faults and anomalies of the clavicle in European human fetuses.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1RpyyYo
via IFTTT

An undetected common renal arterial trunk: surgical consequences and morbidity analysis

Abstract

We present a patient with a recurrent precaval left renal artery, stemming from a right-sided common trunk renal artery. The patient was a 44-year male who presented with a post-traumatic grade IV renal injury. After 3 months without renal function improvement and repeated urinary tract infection, a laparoscopic nephrectomy of the affected right kidney was performed, without upfront identification of the vascular variation, resulting in ischemia of the remaining left kidney. An anastomosis of the common renal trunk and the distal left renal artery was created in between the abdominal aorta and the inferior vena cava. This case describes the importance of upfront detection of renal vascular variations using the appropriate imaging techniques.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1V3DfWJ
via IFTTT

Cadaveric study of anterior and posterior elbow endoscopy portals for endoscopic distal biceps repair: comparative anatomy-at-risk

Abstract

Purpose

The purpose of this study was to describe neurovascular structures-at-risk during establishment of five portals for access to distal biceps tendon (DBT) in cubital fossa, and to establish relative safety of these portal sites for such access. We hypothesized that all five portals are safe for endoscopic DBT exploration.

Methods

Ten fresh frozen cadaveric elbows were dissected after placement of portals at five potential sites (four anterior, one posterior). Nine neurovascular structures (CV, cephalic vein; LCN, lateral cutaneous nerve; LV, leash of vessels; RN, radial nerve; SRN, superficial radial nerve; PIN, posterior interosseous nerve; RA, radial artery; BA, brachial artery; MN, median nerve) were dissected, and their distances from portal sites were measured. Statistical analysis was performed to determine relative portal safety, and risk of injury to neurovascular structures in relation to each portal was analyzed.

Results

Structures that were significantly "at risk" were RA (p = 0.006), SRN (p = 0.002), and PIN (p = 0.004). RA was significantly "at risk" of injury from portal 4 (p = 0.009). Similarly, SRN was "at risk" from portal 3 (p = 0.036), and the PIN was "at risk" from portal 2 (p = 0.003).

Conclusions

Portal 1 (parabiceps portal) was safe for all neurovascular structures, however, portals 2–4 were significantly closer to neurovascular structures. RA, SRN, and PIN were significantly "at risk" as compared to other structures amongst the portals studied. Portal 5 was relatively safe for SRN and PIN.

Clinical relevance

Portals 1 (parabiceps portal) and 5 (distal posterior) can be safely placed for endoscopic access to the DBT. Portal 4 (open distal anterior) may be used after careful open dissection and under direct vision. Portals 2 and 3 are not recommended for elbow endoscopy.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1LgXmLQ
via IFTTT