upper respiratory tract infection; +39 new citations

39 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

upper respiratory tract infection

These pubmed results were generated on 2016/04/28

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Endoscopic endonasal anatomy of the ophthalmic artery in the optic canal.

Endoscopic endonasal anatomy of the ophthalmic artery in the optic canal.

Acta Neurochir (Wien). 2016 Apr 27;

Authors: Zoli M, Manzoli L, Bonfatti R, Ruggeri A, Mariani GA, Bacci A, Sturiale C, Pasquini E, Billi AM, Frank G, Cocco L, Mazzatenta D

Abstract
BACKGROUND: The endoscopic endonasal opening of the optic canal has been recently proposed for tumors with medial invasion of this canal, such as tuberculum sellae meningiomas. Injury of the ophthalmic artery represents a dramatic risk during this maneuver. Therefore, the aim of this study was to analyze the endoscopic endonasal anatomy of the precanalicular and canalicular portion of this vessel, discussing its clinical implication.
METHODS: The course of the ophthalmic artery was analyzed through five endoscopic endonasal dissections, and 40 nonpathological consecutive MRAs were reviewed.
RESULTS: The ophthalmic artery arises from the intradural portion of the supraclinoid internal carotid artery, in 93 % of cases about 1.9 mm (range: 1-3) posterior to the falciform ligament. At the entrance into the optic canal, the ophthalmic artery is located infero-medially to the optic nerve in 13 % of cases. In 50 % of these cases the artery moves infero-laterally along its course, remaining in a medial position in the others. In cases with an non medial entrance of the ophthalmic artery, it runs infero-lateral to the optic nerve for its entire canalicular portion, with just one exception.
CONCLUSION: The endoscopic endonasal approach gives a direct, extensive and panoramic view of the course of the precanalicular and canalicular portion of the ophthalmic artery. Dedicated high-field neuroimaging studies are of paramount importance in preoperative planning to evaluate the anatomy of the ophthalmic artery, reducing the risk of jeopardizing the vessel, particularly for those uncommon cases with an infero-medial course of the artery.

PMID: 27117907 [PubMed - as supplied by publisher]

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Combined Surgical Approach to Giant Cholesteatoma: A Case Report and Literature Review.

Combined Surgical Approach to Giant Cholesteatoma: A Case Report and Literature Review.

Ann Otol Rhinol Laryngol. 2016 Apr 26;

Authors: Cazzador D, Favaretto N, Zanoletti E, Martini A

Abstract
OBJECTIVES: Cholesteatomas can grow to a remarkable size before clinically making their presence felt. Managing giant cholesteatomas and their complications can become a challenge for the otological surgeon.
METHODS: We describe a case of a giant congenital cholesteatoma of the mastoid in an adult. The lesion extended to the sigmoid sinus, jugular bulb, carotid canal, occipital condyle, and the lateral portion of the first cervical vertebra. Surgical excision was performed using a combined microscopic and endoscopic surgical approach.
RESULTS: Our combined surgical technique enabled a more accurate removal of the cholesteatoma than a microscopic approach alone, with no surgical complications or damage to the structures affected by the disease.
CONCLUSIONS: Using endoscopic instruments to manage giant cholesteatomas can help to avoid complications and improve surgical radicality.

PMID: 27117903 [PubMed - as supplied by publisher]

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The enhancing effect of a laser photochemotherapy with cisplatin or zolendronic acid in primary human osteoblasts and osteosarcoma cells in vitro

Background

Photodynamic therapies (PDT) have become increasingly popular in the adjuvant treatment of different tumour entities. Chemotherapeutic agents, such as cisplatin may be used in combination with low-level laser therapy (LLLT) as laser photochemotherapy. The aim of this study was to investigate the effect of LLLT on cell bioviability of normal and malignant bone cells under chemotherapeutic conditions with either cisplatin or zolendronic acid in vitro.

Methods

Primary human osteoblasts (HOB) and an osteosarcoma cell line (Saos-2) were treated with different concentrations of zolendronic acid or cisplatin and irradiated twice with a diode laser (wavelength 670 nm, 120 s, energy outputs of 100mW/cm², continuous wave mode). Cell viability was tested by XTT-assay and via histomorphological analysis.

Results

LLLT alone increased bioviability for both cell lines. LLLT lowered HOB viability at the three highest concentrations of cisplatin and zolendronic acid. For Saos-2, LLLT reduced cell viability at every concentration of cisplatin. In cases of incubation with zolendronic acid, similar to osteoblasts, LLLT lowered cell viability at the highest concentration only.

Conclusions

Based on the conditions of this study, laser photochemotherapy may be able to raise the cytotoxicity of cisplatin and zolendronic acid in benign and malignant bone cells. This could be of interest in the development of new therapeutic treatment modalities against neoplastic bone diseases like osteosarcoma.

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Adrenal Metastasis from Uterine Papillary Serous Carcinoma.

Adrenal Metastasis from Uterine Papillary Serous Carcinoma.

Am J Case Rep. 2016;17:289-94

Authors: Singh Lubana S, Singh N, Tuli SS, Seligman B

Abstract
BACKGROUND Uterine papillary serous carcinoma (UPSC) is a highly malignant form of endometrial cancer with a high propensity for metastases and recurrences even when there is minimal or no myometrial invasion. It usually metastasizes to the pelvis, retroperitoneal lymph nodes, upper abdomen, and peritoneum. However, adrenal metastases from UPSC is extremely rare. Here, we present a case of UPSC with adrenal metastasis that occurred 6 years after the initial diagnosis. CASE REPORT A 60-year-old woman previously diagnosed with uterine papillary serous carcinoma at an outside facility presented in September of 2006 with postmenopausal bleeding. She underwent comprehensive surgical staging with FIGO (International Federation of Gynecology and Obstetrics) stage 2. Post-operatively, the patient was treated with radiation and chemotherapy. The treatment was completed in April of 2007. The patient had no evidence of disease until July 2009 when she was found to have a mass highly suspicious for malignancy. Subsequently, she underwent right upper lobectomy. The morphology of the carcinoma was consistent with UPSC. She refused chemotherapy due to a previous history of chemotherapy-induced neuropathy. The patient was followed up with regular computed tomography (CT) scans. In October 2012 a new right adrenal nodule was seen on CT, which showed intense metabolic uptake on positron emission tomography (PET)/CT scan. The patient underwent right adrenalectomy. Pathology of the surgical specimen was consistent with UPSC. CONCLUSIONS UPSC is an aggressive variant of endometrial cancer associated with high recurrence rate and poor prognoses. Long-term follow-up is needed because there is a possibility of late metastases, as in this case.

PMID: 27117594 [PubMed - in process]

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Hydraphiles Enhance Antimicrobial Potency Against Escherichia coli, Pseudomonas aeruginosa, and Bacillus subtilis

Publication date: Available online 27 April 2016
Source:Bioorganic & Medicinal Chemistry
Author(s): Mohit B. Patel, Evan C. Garrad, Ariel Stavri, Michael R. Gokel, Saeedeh Negin, Joseph W. Meisel, Zachary Cusumano, George W. Gokel
Hydraphiles are synthetic amphiphiles that form ion-conducting pores in liposomal membranes. These pores exhibit open-close behavior when studied by planar bilayer conductance techniques. In previous work, we showed that when co-administered with various antibiotics to the DH5α strain of E. coli, they enhanced the drug's potency. We report here potency enhancements at low concentrations of hydraphiles for the structurally and mechanistically unrelated antibiotics erythromycin, kanamycin, rifampicin, and tetracycline against Gram negative E. coli (DH5α and K-12) and Pseudomonas aeruginosa, as well as Gram positive Bacillus subtilis. Earlier work suggested that potency increases correlated to ion transport function. The data presented here comport with the function hydraphiles to enhance membrane permeability in addition to, or instead of, their known function as ion conductors.

Graphical abstract

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Functional interaction of CCAAT/enhancer-binding-protein-α basic region mutants with E2F transcription factors and DNA

Publication date: Available online 27 April 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Elisabeth Kowenz-Leutz, Anja Schuetz, Qingbin Liu, Maria Knoblich, Udo Heinemann, Achim Leutz
The transcription factor CCAAT/enhancer-binding protein α (C/EBPα) regulates cell cycle arrest and terminal differentiation of neutrophils and adipocytes. Mutations in the basic leucine zipper domain (bZip) of C/EBPα are associated with acute myeloid leukemia. A widely used murine transforming C/EBPα basic region mutant (BRM2) entails two bZip point mutations (I294A/R297A). BRM2 has been discordantly described as defective for DNA binding or defective for interaction with E2F. We have separated the two BRM2 mutations to shed light on the intertwined reciprocity between C/EBPα-E2F-DNA interactions. Both, C/EBPα I294A and R297A retain transactivation capacity and interaction with E2F-DP. The C/EBPα R297A mutation destabilized DNA binding, whereas the C/EBPα I294A mutation enhanced binding to DNA. The C/EBPα R297A mutant, like BRM2, displayed enhanced interaction with E2F-DP but failed to repress E2F-dependent transactivation although both mutants were readily suppressed by E2F1 for transcription through C/EBP cis-regulatory sites. In contrast, the DNA binding enhanced C/EBPα I294A mutant displayed increased repression of E2F-DP mediated transactivation and resisted E2F-DP mediated repression. Thus, the efficient repression of E2F dependent S-phase genes and the activation of differentiation genes reside in the balanced DNA binding capacity of C/EBPα.



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Polymerization of a Photocleavable Monomer Using Visible Light

The polymerization of the photocleavable monomer, o-nitrobenzyl methacrylate (NBMA), is investigated using photoinduced electron/energy transfer reversible addition-fragmentation chain transfer polymerization. The polymerizations under visible red (λ _max = 635 nm, 0.7 mW cm⁻²) and yellow (λ _max = 560 nm, 9.7 mW cm⁻²) light are performed and demonstrate rational evidence of a controlled/living radical polymerization process. Well-defined poly(o-nitrobenzyl methacrylate) (PNBMA) homopolymers with good control over the molecular weight and polymer dispersity are successfully synthesized by varying the irradiation time and/or targeted degree of polymerization. Chain extension of a poly(oligo(ethylene glycol) methyl ether methacrylate) macro-chain transfer agent with NBMA is carried out to fabricate photocleavable amphiphilic block copolymers (BCP). Finally, these self-assembled BCP rapidly dissemble under UV light suggesting the photoresponsive character of NBMA is not altered during the polymerization under yellow or red light. Such photoresponsive polymers can be potentially used for the remote-controlled delivery of therapeutic compounds.

The facile synthesis of low dispersity photocleavable polymers are demonstrated for the first time using a novel photopolymerization approach. Under a visible light stimulus (530–655 nm), poly(o-nitrobenzyl methacrylate) polymers are readily synthesized using a metal-based or organic photoredox catalyst with good polymerization control.

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"Zhonghua Yi Xue Za Zhi"[jour]; +16 new citations

16 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Zhonghua Yi Xue Za Zhi"[jour]

These pubmed results were generated on 2016/04/28

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Implementation of the thin layer agar method for diagnosis of smear-negative pulmonary tuberculosis in a setting with a high prevalence of human immunodeficiency virus infection in Homa Bay, Kenya

The objective of this study was to evaluate the performance of a low-cost method, the thin layer agar (TLA) method, for the diagnosis of smear-negative patients. This prospective study was performed in Homa Bay District Hospital in Kenya. Out of 1,584 smear-negative sputum samples, 212 (13.5%) were positive by culture in Lowenstein-Jensen medium (LJ) and 220 (14%) were positive by the TLA method. The sensitivities of LJ and TLA were 71% and 74%, respectively. TLA could become an affordable method for the diagnosis of smear-negative tuberculosis in resource-limited settings, with results available within 2 weeks.

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Rapid detection of Mycobacterium tuberculosis resistance to second-line drugs by use of the manual mycobacterium growth indicator tube system

The objective of this study was to evaluate the manual mycobacterium growth indicator tube (MGIT) system for the testing of Mycobacterium tuberculosis susceptibility to second-line drugs compared to the proportion method. One hundred eighty-eight M. tuberculosis isolates were tested for susceptibility to ofloxacin, kanamycin, ethionamide, and capreomycin by the manual MGIT, and results were compared to those obtained with the proportion method on 7H11 agar, considered a reference method. Results for ofloxacin and capreomycin were excellent, with 100% accuracy, and a result of 99.4% accuracy was achieved for kanamycin. For ethionamide, accuracy was lower, with a result of 86.7% compared to that of the proportion method. We proposed the following critical concentrations for the drugs: for ofloxacin, 2.0 mu g/ml; for kanamycin, 2.5 mu g/ml; for ethionamide, 5 mu g/ml; and for capreomycin, 2.5 mu g/ml. The time required to obtain results was an average of 8 days by the manual MGIT and 3 weeks by the reference method. Our results show that the manual MGIT is an accurate method for the rapid susceptibility testing of M. tuberculosis to second-line drugs. There is no need for a machine when using the manual MGIT, and results can be read with a simple UV lamp or with a semiquantitative reader, which considerably reduces the cost of the method.

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Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries.

Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries.

Thyroid. 2016 Apr 26;

Authors: la Cour JL, Andersen UB, Sørensen CH, Nygaard B, Jensen LT

Abstract
<b>Background and Aim:</b> Atherosclerosis evolves or accelerates when arteries are exposed to ionizing radiation, both early and late after exposure. Radioiodine therapy of benign thyroid disease exposes the carotid arteries to 4-50 Gy/GBq and may thereby increase the risk of atherosclerosis. Increased risk of cerebrovascular events is reported after radioiodine therapy. We aimed to study whether atherosclerosis develops early or late after radioiodine therapy of benign thyroid disease. <b>Method:</b> We examined patients treated for benign thyroid disorders (nontoxic goitre, adenoma and hyperthyroidism) with ultrasound for the main outcome, carotid intima media thickness (CIMT), and for plaque presence (plaque presence only in late damage). Signs of early damage from radioiodine were studied in 39 radioiodine-treated patients, who were examined before treatment and at 1, 3, 6 and12 months after treatment. Late changes were studied in a cross-sectional case-control design with radioiodine-treated patients as cases (n=193) and patients treated with surgery as controls (n=95). Data were analysed with repeated measurement for longitudinal data, and with multivariate regression for cross-sectional data. Results were adjusted for age, sex, cholesterol, smoking status, known atherosclerotic disease and BMI. <b>Results:</b> We found no changes in CIMT in the patients followed prospectively for one year after treatment with radioactive iodine for benign thyroid disease (p=0.58). In the study on late effects, there was no difference in CIMT (p=0.25) or presence of plagues (p=0.70) between those treated with radioactive iodine and those treated with surgery (9.8 and 5.6 years since treatment, respectively). Furthermore, the level of thyroid stimulating hormone (TSH) did not influence these atherosclerosis markers. <b>Conclusion:</b> We were not able to detect early changes in CIMT in patients treated with radioactive iodine for benign thyroid disease. We found no signs of late effects of radioactive iodine on CIMT or plague presence after ten years of follow-up. The radiation to the carotid arteries by radioactive iodine therapy for benign thyroid disease may therefore have no or low effect on atherosclerotic burden of the carotid arteries in general.

PMID: 27117943 [PubMed - as supplied by publisher]

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Prognostic significance of pulsatile tinnitus in cervical artery dissection.

Prognostic significance of pulsatile tinnitus in cervical artery dissection.

Eur J Neurol. 2016 Apr 27;

Authors: Kellert L, Kloss M, Pezzini A, Debette S, Leys D, Caso V, Thijs VN, Bersano A, Touzé E, Tatlisumak T, Traenka C, Lyrer PA, Engelter ST, Metso TM, Grond-Ginsbach C, Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) study group

Abstract
BACKGROUND AND PURPOSE: Our aim was to investigate whether pulsatile tinnitus (PT) in cervical artery dissection (CeAD) has prognostic significance.
METHODS: All CeAD patients from the CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) study with documentation of PT were analysed. The presence of PT was systematically assessed using a standardized questionnaire. Stroke severity at admission was defined according to the National Institutes of Health Stroke Scale (NIHSS). Excellent outcome after 3 months was defined as a modified Rankin Scale of 0-1.
RESULTS: Sixty-three of 778 patients (8.1%) reported PT. PT+ patients presented less often with ischaemic stroke (41.3% vs. 63.9%, P < 0.001), more often with dissection in the internal carotid artery (85.7% vs. 64.2%, P = 0.001), less often with vessel occlusion (19.0% vs. 34.1%, P = 0.017) and more often with excellent outcome at 3 months (92.1% vs. 75.4%, P = 0.002). Logistic regression analysis identified PT as an independent predictor of excellent outcome after 3 months [odds ratio (OR) 3.96, 95% confidence interval (CI) 1.22-12.87] adjusted to significant outcome predictors NIHSS on admission (OR 0.82, 95% CI 0.79-0.86), Horner syndrome (OR 1.95, 95% CI 1.16-3.29) and vessel occlusion (OR 0.62, 95% CI 0.40-0.94) and to non-significant predictors age, sex, pain and location of CeAD.
CONCLUSION: The presence of PT in CeAD is associated with a benign clinical course and predicts a favourable outcome.

PMID: 27120261 [PubMed - as supplied by publisher]

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Is Metal-On-Metal Total Hip Arthroplasty Associated With Neurotoxicity?

Is Metal-On-Metal Total Hip Arthroplasty Associated With Neurotoxicity?

J Arthroplasty. 2016 Apr 1;

Authors: Bala A, Penrose CT, Seyler TM, Randell TR, Wellman SS, Bolognesi MP

Abstract
BACKGROUND: Isolated case reports in the literature describe systemic neurologic side effects associated with metal-on-metal (MOM) bearing surfaces, yet the incidence of these effects have not been evaluated beyond individual cases. The purpose of this study was to compare new diagnoses of these side effects described in isolated cases in large patient cohorts of MOM vs metal on polyethylene (MOP).
METHODS: We queried the entire Medicare database from 2005 to 2012. Total hip arthroplasty (THA) and bearing surface were determined using International Classification of Diseases, 9th revision procedure codes. Patients with 5-year follow-up were selected. Using International Classification of Diseases, 9th revision codes, we identified new diagnoses of previously reported neurologic side effects: peripheral neuropathy, sensorineural hearing loss, visual impairment, paresthesias, tinnitus, and vertigo. Comorbidities and demographics were collected. Odds ratios, CIs, and P values were calculated.
RESULTS: Overall, 29,483 MOM THAs and 23,587 age- and gender-matched MOP THAs were identified. The average Charlson Comorbidity Index was 5 for both groups. MOM and MOP patients had 26 of 30 identical prevalence of Elixhauser-measure comorbidities. There was no statistically significant difference in new diagnoses of any of the side effects at any time point between the 2 groups over 5 years.
CONCLUSION: This study represents, to our knowledge, the first longitudinal analysis of systemic neurotoxicity after THA in a large cohort of patients. The results of our study suggest that on the large scale, neurologic side effects previously described do not occur as a common attributable complication. Rather, these cases may be due to individual patient hypersensitivity to metal ions.

PMID: 27118351 [PubMed - as supplied by publisher]

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International regulatory needs for development of an IATA for non-genotoxic carcinogenic chemical substances.

International regulatory needs for development of an IATA for non-genotoxic carcinogenic chemical substances.

ALTEX. 2016 Apr 27;

Authors: Jacobs MN, Colacci A, Louekari K, Luijten M, Hakkert BC, Paparella M, Vasseur P

Abstract
Although regulatory requirements for carcinogenicity testing of chemicals vary according to product sector and regulatory jurisdiction, the standard approach starts with a battery of genotoxicity tests. If any of the in vivo genotoxicity tests are positive, a lifetime rodent cancer bioassay may be requested, which allows the detection of non-genotoxic carcinogens (NGTxC). However, under most chemical regulations the cancer bioassay is rarely requested, specific requests to obtain information on non-genotoxic mechanisms of carcinogenicity are few, and there are no OECD approved screening methods. When the in vitro genotoxicity battery is negative, usually no further carcinogenicity testing is requested. Consequently NGTxC might remain unidentified and therefore the risks they may pose to human health will not be managed. In contrast to genotoxic carcinogens NGTxCact through a large variety of specific mechanisms, and a panel of tests covering multiple biological traits will be needed. The development of an Integrated Approach to Testing and Assessment (IATA) of NGTxC could assist regulatory decision makers. We examine what NGTxC are and discuss chemical regulatory requirements and limitations. With a strong drive to reduce animal testing and costs in mind, it is essential that proper and robust alternatives for animal testing (3Rs) methods for addressing non-genotoxic modes of action are developed and used. Therefore relevant in vitro mechanisms and assays are described and tentatively organized in levels of information, indicating both a possible structure of the future IATA for NGTxC and associated OECD Test Guideline development priorities.

PMID: 27120445 [PubMed - as supplied by publisher]

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Mutation analysis of metastatic melanomas in the central nervous system: results of a panel of 5 genes in 48 cases.

Mutation analysis of metastatic melanomas in the central nervous system: results of a panel of 5 genes in 48 cases.

Clin Neuropathol. 2016 Apr 27;

Authors: Gamsizkan M, Yilmaz I, Simsek HA, Onguru O, Griffin A, Tihan T

Abstract
Melanocytic lesions in the central nervous system (CNS) may be primary to the site but are more commonly metastases from cutaneous primaries. In fact, melanomas are one of the most common malignancies that can metastasize to the brain, and some patients may not have a diagnosis of melanoma prior to the discovery of the CNS lesion. In such cases, identifying the primary site may be challenging. We reviewed the archives of a large referral center for melanocytic tumors involving the CNS and selected 48 patients for this study based on our inclusion criteria. We used sequencing to identify mutation status of these tumors and compared these with clinicopathological features. Mutations in exon 9, 11, 13, 17, and 18 of KIT gene, exon 15 of BRAF gene, exon 2 and 3 of NRAS gene, exon 4 and 5 of GNAQ and GNA11 genes were analyzed. Mutations in BRAF-exon 15 were the most common among tumors (58.3%). NRAS-exon 2 and NRAS-exon 3 mutations were detected in 3 and 7 cases, respectively. GNAQ-exon 4, GNAQ-exon 5 and GNA11-exon 5 mutation were present in 1 tumor each. Eight tumors were wild type for all 5 genes, and 6 of these were not known primary despite a work-up and clinical follow-up. Only 1 of these tumors showed a mutation in exon 11 of KIT gene. When compared to primary melanocytic lesions of the CNS, metastatic melanomas were characterized by BRAF gene mutations and wild-type GNAQ and GNA11 genes.

PMID: 27117140 [PubMed - as supplied by publisher]

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An ARHGEF10 deletion is highly associated with a juvenile-onset inherited polyneuropathy in Leonberger and Saint Bernard dogs.

Related Articles

An ARHGEF10 deletion is highly associated with a juvenile-onset inherited polyneuropathy in Leonberger and Saint Bernard dogs.

PLoS Genet. 2014 Oct;10(10):e1004635

Authors: Ekenstedt KJ, Becker D, Minor KM, Shelton GD, Patterson EE, Bley T, Oevermann A, Bilzer T, Leeb T, Drögemüller C, Mickelson JR

Abstract
An inherited polyneuropathy (PN) observed in Leonberger dogs has clinical similarities to a genetically heterogeneous group of peripheral neuropathies termed Charcot-Marie-Tooth (CMT) disease in humans. The Leonberger disorder is a severe, juvenile-onset, chronic, progressive, and mixed PN, characterized by exercise intolerance, gait abnormalities and muscle atrophy of the pelvic limbs, as well as inspiratory stridor and dyspnea. We mapped a PN locus in Leonbergers to a 250 kb region on canine chromosome 16 (Praw = 1.16×10-10, Pgenome, corrected = 0.006) utilizing a high-density SNP array. Within this interval is the ARHGEF10 gene, a member of the rho family of GTPases known to be involved in neuronal growth and axonal migration, and implicated in human hypomyelination. ARHGEF10 sequencing identified a 10 bp deletion in affected dogs that removes four nucleotides from the 3'-end of exon 17 and six nucleotides from the 5'-end of intron 17 (c.1955_1958+6delCACGGTGAGC). This eliminates the 3'-splice junction of exon 17, creates an alternate splice site immediately downstream in which the processed mRNA contains a frame shift, and generates a premature stop codon predicted to truncate approximately 50% of the protein. Homozygosity for the deletion was highly associated with the severe juvenile-onset PN phenotype in both Leonberger and Saint Bernard dogs. The overall clinical picture of PN in these breeds, and the effects of sex and heterozygosity of the ARHGEF10 deletion, are less clear due to the likely presence of other forms of PN with variable ages of onset and severity of clinical signs. This is the first documented severe polyneuropathy associated with a mutation in ARHGEF10 in any species.

PMID: 25275565 [PubMed - indexed for MEDLINE]

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Is it necessary to assess fluent symptoms, duration of dysfluent events and physical concomitants when identifying children who have speech difficulties?

Howell, P; Mirawdeli, A; Is it necessary to assess fluent symptoms, duration of dysfluent events and physical concomitants when identifying children who have speech difficulties? Clinical Linguistics and Phonetics 10.1080/02699206.2016.1179345 . (In press).

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Characterisation of a post-entry restriction to HIV in human cells.

Marchant, D.; (2005) Characterisation of a post-entry restriction to HIV in human cells. Doctoral thesis, University of London. Green open access

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Aspects of the control of polyphosphoinositide metabolism by ADP-ribosylation factors and diacylglycerols.

Mansilla, B.P.; (2005) Aspects of the control of polyphosphoinositide metabolism by ADP-ribosylation factors and diacylglycerols. Doctoral thesis, University of London. Green open access

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Zeolite modified metal oxides for gas sensing.

Mann, D.P.; (2005) Zeolite modified metal oxides for gas sensing. Doctoral thesis, University of London. Green open access

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What are the real waiting times for therapeutic management of head and neck cancer: a study in the general population in the north-west of France.

What are the real waiting times for therapeutic management of head and neck cancer: a study in the general population in the north-west of France.

Eur Arch Otorhinolaryngol. 2016 Apr 27;

Authors: Guizard AV, Dejardin O, Launay L, Bara S, Lapôtre-Ledoux B, Babin E, Launoy G, Ligier K

Abstract
Head and neck cancers (HNC) have a poor prognosis and a long treatment delay may have a negative impact on this. Some studies have investigated the determinants of this delay but not in the general population and rarely taking into account socio-economic factors. A high-resolution population-based study about cancer management was conducted, using registries in the north-west of France, on HNC diagnosed between 2008 and 2010. The median time between diagnosis and multidisciplinary team meeting (DMI) (N = 1631) was 14 days (Q1: 7 to Q3: 26). The median time between diagnosis and first treatment (DTI) (N = 1519) was 35 days (Q1: 21 to Q3: 54). When the first treatment was radiotherapy, the interval was 54.5 days (Q1: 40 to Q3: 71). In multivariate analysis, DTI was associated with the type of first treatment and place of treatment. For advanced stage HNC, DTI was associated with comorbidities, topography of the cancer and socio-economic status, underprivileged patients being treated later than privileged ones. Given the French governmental cancer plans which set out to coordinate care pathways via nursing coordinators and to improve the availability of radiotherapy, the waiting times observed in this study still seem long. The optimal care pathway should include adapted social management but the DTI was still longer for underprivileged patients.

PMID: 27119321 [PubMed - as supplied by publisher]

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Narrative skills of children treated for brain tumours: The impact of tumour and treatment related variables on microstructure and macrostructure.

Narrative skills of children treated for brain tumours: The impact of tumour and treatment related variables on microstructure and macrostructure.

Brain Inj. 2016 Apr 27;:1-14

Authors: Docking K, Munro N, Marshall T, Togher L

Abstract
OBJECTIVE: The narrative skills of children with brain tumours were examined. Influence of tumour location, radiotherapy, time post-treatment and presence of hydrocephalus was also investigated, as well as associations between narrative and language abilities.
METHOD: Seventeen children (aged 5;6-14;11) treated for brain tumour and their matched controls completed a narrative assessment and comprehensive language testing. Audio recorded narratives were analysed for microstructure and macrostructure elements. Between-group comparisons were conducted. Narrative elements were explored in association with tumour and treatment-related variables. Correlation analysis examined relationships between narrative scores and language test performance.
RESULTS: While significant differences were not found between two groups of children across narrative elements, sub-group comparisons revealed marginal differences in macrostructure related to tumour location and hydrocephalus. Children treated with methods other than radiotherapy showed a significant increase in number of mazes in their narratives compared to children who received radiotherapy. Strong positive correlations also existed between narrative elements and language performance.
CONCLUSION: Preliminary findings highlight the importance of investigating narrative abilities as part of a comprehensive language assessment. Macrostructure should be routinely examined where children are diagnosed with either posterior fossa tumour or hydrocephalus or have undergone surgery and/or chemotherapy for brain tumour.

PMID: 27119976 [PubMed - as supplied by publisher]

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Stroke and aphasia quality-of-life scale-39: Reliability and validity of the Turkish version.

Stroke and aphasia quality-of-life scale-39: Reliability and validity of the Turkish version.

Int J Speech Lang Pathol. 2016 Apr 27;:1-7

Authors: Noyan-ErbaŞ A, Toğram B

Abstract
PURPOSE: The aim of this study was to adapt the stroke and aphasia quality-of-life scale-39 (SAQoL-39) to the Turkish language and carry out a reliability and validity study of the instrument in a group of patients with aphasia.
METHOD: The study was a descriptive study and contained three phases: adaptation of the SAQoL-39 to the Turkish language, administration of the scale to 30 aphasia patients and reliability and validity studies of the scale. Internal consistency was assessed with Cronbach's alpha and test-re-test reliability was explored (n = 14). The adaptation process was completed based on inter-rater agreement on the translated items and within the scope of final editing by the authors of the study.
RESULT: The SAQoL-39 in Turkish exhibited high test-re-test reliability (ICC =0.97) as well as acceptability with minimal missing data (0-1.4). This instrument exhibited high internal consistency (Cronbach's α = 0.70-0.97), domain-total correlations (r = 0.76-0.85) and inter-domain correlations (r = 0.40-0.68).
CONCLUSION: The analysis shows that the Turkish version of SAQoL-39 is a scale that is highly acceptable, valid and reliable and can be easily used in evaluating the quality-of-life of Turkish people with aphasia.

PMID: 27118117 [PubMed - as supplied by publisher]

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Children Who Use Communication Aids Instructing Peer and Adult Partners During Play-Based Activity.

Children Who Use Communication Aids Instructing Peer and Adult Partners During Play-Based Activity.

Augment Altern Commun. 2016 Apr 27;:1-15

Authors: Batorowicz B, Stadskleiv K, von Tetzchner S, Missiuna C

Abstract
Little is known about how children with severe motor impairments who use communication aids provide instructions when given control over interaction. In this study, 35 children - 18 who used communication aids and 17 who used natural speech - were videotaped in play-based activities. Both groups successfully instructed partners to build replications of models the partners could not see. The results demonstrate that children using communication aids can also have an active role in play-based activities using language, but that their experience with activities may be limited and their instructions may take longer to give. The children who used natural speech provided more detailed instructions and were more successful in guiding their partners. Creating opportunities for active participation in play may be important for the development of communicative autonomy.

PMID: 27117795 [PubMed - as supplied by publisher]

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Dexmedetomidine and Mannitol for Awake Craniotomy in a Pregnant Patient.

Related Articles

Dexmedetomidine and Mannitol for Awake Craniotomy in a Pregnant Patient.

Anesth Analg. 2015 May;120(5):1099-103

Authors: Handlogten KS, Sharpe EE, Brost BC, Parney IF, Pasternak JJ

Abstract
We describe the use of dexmedetomidine for an awake neurosurgical procedure in a pregnant patient and quantify the effect of mannitol on intrauterine volume. A 27-year-old woman underwent a craniotomy, with intraprocedural motor and speech mapping, at 20 weeks of gestation. Sedation was maintained with dexmedetomidine. Mannitol at 0.25 g/kg IV was administered to control brain volume during surgery. Internal uterine volume was estimated at 1092 cm before surgery and decreased to 770 and 953 cm at 9 and 48 hours, respectively, after baseline assessment. No adverse maternal or fetal effects were noted during the intraoperative period or up to 48 hours postoperatively.

PMID: 25899274 [PubMed - indexed for MEDLINE]

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Stroke and aphasia quality-of-life scale-39: Reliability and validity of the Turkish version

10.3109/17549507.2015.1126641<br/>AyŞin Noyan-ErbaŞ

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The efficacy of submucosal corticosteroid injection and dilatation in subglottic stenosis of different aetiology.

The efficacy of submucosal corticosteroid injection and dilatation in subglottic stenosis of different aetiology.

J Laryngol Otol. 2016 Apr 27;:1-6

Authors: Wierzbicka M, Tokarski M, Puszczewicz M, Szyfter W

Abstract
OBJECTIVE: To determine the long-term efficacy of submucosal corticosteroid injection plus dilatation for subglottic stenosis as a single modality treatment in granulomatosis with polyangiitis and relapsing polychondritis, as compared with idiopathic subglottic stenosis and traumatic subglottic stenosis.
METHOD: Patients who underwent dilatation for autoimmune causes were identified. Corticosteroid injection into the submucosa of a stenotic segment was followed by serial dilatation. Definitive improvement was defined as good airway patency for more than 24 months with no further procedures needed. Clinical, demographic and procedural data were recorded.
RESULTS: Patients (n = 45) were divided into three subglottic stenosis groups: traumatic (n = 24), idiopathic (n = 9) and autoimmune (n = 12). Patients were treated with dilatations, with a median follow-up time of 76 months. Six patients were tracheostomy-dependent. There were no statistical differences in the number of final improvements between autoimmune, idiopathic and traumatic groups, with values of 75, 56 and 71 per cent, respectively. There was no statistical difference between granulomatosis with polyangiitis plus relapsing polychondritis and idiopathic subglottic stenosis in terms of decannulation rates.
CONCLUSION: Granulomatosis with polyangiitis and relapsing polychondritis patients have better improvement rates than patients with other subglottic stenosis types.

PMID: 27117724 [PubMed - as supplied by publisher]

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Sudden sensorineural hearing loss is associated with chronic rhinosinusitis: population-based study.

Sudden sensorineural hearing loss is associated with chronic rhinosinusitis: population-based study.

J Laryngol Otol. 2016 Apr 27;:1-5

Authors: Hung SH, Lin HC, Kao LT, Wu CS, Chung SD

Abstract
BACKGROUND: This study aimed to evaluate the association of chronic rhinosinusitis with sudden sensorineural hearing loss using a population-based database.
METHODS: Sampled subject data were obtained from the Taiwan Longitudinal Health Insurance Database 2000. A total of 3325 patients with sudden sensorineural hearing loss were identified and 9975 controls were randomly selected. A conditional logistic regression was used to calculate the odds ratio for having been previously diagnosed with chronic rhinosinusitis, for cases and controls.
RESULTS AND CONCLUSION: The adjusted odds ratio of having prior chronic rhinosinusitis among cases compared to controls was 1.36 (95 per cent confidence interval = 1.16-1.60). The significant relationship between sudden sensorineural hearing loss and chronic rhinosinusitis was most pronounced among those patients aged 44 years or less (compared to controls) (odds ratio = 2.18; 95 per cent confidence interval = 1.63-2.92). However, the significant relationship between sudden sensorineural hearing loss and prior chronic rhinosinusitis was not sustained for patients older than 60 years compared to controls.

PMID: 27117586 [PubMed - as supplied by publisher]

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Anticancer Therapy: Light-Activated Hypoxia-Responsive Nanocarriers for Enhanced Anticancer Therapy (Adv. Mater. 17/2016)

A light-activated hypoxia-responsive drug-delivery vehicle is described by Q.-D. Shen, Z. Gu, and co-workers on page 3313. This conjugated-polymer-based nanocarrier can be activated by photoirradiation, producing singlet oxygen (¹O₂) and inducing hypoxia to promote release of its cargo inside tumor cells for enhanced anticancer efficacy.

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The role of dendritic cells in immune regulation of nasal polyps.

The role of dendritic cells in immune regulation of nasal polyps.

Histol Histopathol. 2016 Apr 27;:11773

Authors: Liang Z, Yang T, Xu W, Huang Y, Jiang L, Yin Z, Qin G

Abstract
Nasal polyps (NPs) are caused by a variety of immune cells and inflammatory cells. However, as the most potent antigen-presenting cells in the immune system, the role of dendritic cells (DCs) in NPs is still unclear. In the present research, we studied the role of DCs in immune regulation of NPs. Thirty patients with NPs, who served as the experimental group, received systemic and local glucocorticoids for 4-7 d, and specimens were collected prior to hormone treatment and during surgery. Normal middle turbinate mucosa tissues from 18 patients who underwent nasal septum surgery were collected as controls. The expression levels of CD83, tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and eosinophils (EOS) in NP tissues before and after glucocorticoid therapy and in control middle turbinate mucosa tissues were studied. After glucocorticoid therapy, the expression levels of CD83, TNF-α, IL-4 and EOS decreased significantly. In addition, the expression of IL-4 was lower than that of TNF-α, reversing the Th2 cytokine-dominant condition. CD83 and EOS showed a positive correlation. DCs participated in the development and progression of NPs and could promote the generation of Th2 cytokines. After interference by glucocorticoid therapy, DCs could inhibit the expression of Th2 cytokines and induce secretion of Th1 cytokines. DCs and EOS thus might both play roles in promoting the development and progression of NPs, but the underlying mechanism requires further study.

PMID: 27117506 [PubMed - as supplied by publisher]

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Dietary intake and risk of asthma in children and adults: protocol for a systematic review and meta-analysis

Diet has been proposed to modulate the risk of asthma in children and adults. An increasing body of epidemiological studies have been published in the last year investigating the association between dietary i...

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SPEECH THERAPY INTERVENTION IN MORBIDLY OBESE UNDERGOING FOBI-CAPELL GASTROPLASTY METHOD.

SPEECH THERAPY INTERVENTION IN MORBIDLY OBESE UNDERGOING FOBI-CAPELL GASTROPLASTY METHOD.

Arq Bras Cir Dig. 2016 Mar;29(1):43-47

Authors: Gonçalves RF, Zimberg E

Abstract
BACKGROUND: The rehabilitation of complications related to oral feeding, resulting from gastroplasty is the competence of the speech therapist, to intervene in mastication and swallowing functions, aiming at quality of life.
AIM: Check in the postoperative period the efficiency of stimulation, independent judges in readiness for re-introduction of solid food in morbidly obese undergoing gastroplasty.
METHOD: Cross-sectional study of descriptive and quantitative evaluated mastication and quality of life of 70 morbidly obese patients undergoing gastroplasty, and a group of 35 obese suffered speech therapy.
RESULTS: In the evaluation of mastication for group 1 (pre and post speech therapy), the results show that, except for the lack of chewing, the other variables, such as food court, type of mastication, mastication rhythm, jaw movements, bolus size, excessive mastication and fluid intake, demonstrate statistical insignificance. In evaluating the quality of life when compared groups 1 and 2, the results from the questionnaire on quality of life in dysphagia (SWAL-QoL - Quality of Life in Swallowing) total and 11 domains assessed in the questionnaire, were statistically significant. With these results, the group 2 presented unfavorable conditions for quality of life.
CONCLUSION: The stimulation protocol, independent judges in readiness for re-introduction of solid food of these patients in the postoperative period, applied in these conditions of the study, was not the distinguishing factor of the rehabilitation process for the observed period.

PMID: 27120739 [PubMed - as supplied by publisher]

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High-Resolution Manometry in Clinical Practice.

High-Resolution Manometry in Clinical Practice.

Gastroenterol Hepatol (N Y). 2015 Jun;11(6):374-84

Authors: Carlson DA, Pandolfino JE

Abstract
High-resolution manometry (HRM) is the primary method used to evaluate esophageal motor function. Displayed and interpreted by esophageal pressure topography (EPT), HRM/ EPT provides a detailed assessment of esophageal function that is useful in the evaluation of patients with nonobstructive dysphagia and before foregut surgery. Esophageal motility diagnoses are determined systematically by applying objective metrics of esophageal sphincter and peristaltic function to the Chicago Classification of esophageal motility disorders. This article discusses HRM study, EPT interpretation, and the translation of EPT findings into clinical practice. Examples are provided to illustrate several clinical challenges.

PMID: 27118931 [PubMed]

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Biomechanics of Pharyngeal Deglutitive Function Following Total Laryngectomy.

Biomechanics of Pharyngeal Deglutitive Function Following Total Laryngectomy.

Otolaryngol Head Neck Surg. 2016 Apr 26;

Authors: Zhang T, Szczesniak M, Maclean J, Bertrand P, Wu PI, Omari T, Cook IJ

Abstract
OBJECTIVE: Postlaryngectomy, pharyngeal weakness, and pharyngoesophageal junction (PEJ) restriction are the candidate mechanisms of dysphagia. The aims were, in laryngectomees, whether (1) hypopharyngeal propulsion is reduced and/or PEJ resistance is increased, (2) dilatation improves dysphagia, and (3) whether symptomatic improvement correlates with reduced PEJ resistance.
DESIGN: Multidisciplinary cross-sectional study.
SETTING: Tertiary academic hospital.
SUBJECTS AND METHODS: Swallow biomechanics were assessed in 30 laryngectomees. Patients were stratified into severe dysphagia (Sydney Swallow Questionnaire >500) and mild/nil dysphagia (Sydney Swallow Questionnaire ≤500). Average hypopharyngeal peak (contractile) pressure (hPP) and hypopharyngeal intrabolus pressure (hIBP) were measured from high-resolution manometry with concurrent videofluoroscopy based on barium swallows (2.5 and 10 mL). In consecutive 5 patients, measurements were repeated after dilatation.
RESULTS: Dysphagia was reported by 87%, and 57% had severe and 43% had mild/nil dysphagia. hIBP increased with larger bolus volumes (P < .0001), while hPP stayed stable and PEJ diameter plateaued at 9 mm. Laryngectomees had lower hPP (110 ± 14 vs 170 ± 15 mm Hg; P = .0162) and higher hIBP (29 ± 5 vs 6 ± 5 mm Hg; P = .156) than controls. There were no differences in hPP between patient groups. However, hIBP was higher in severe than in mild/nil dysphagia (41 ± 10 vs 13 ± 3 mm Hg; P = .02). Predilation hIBP (R(2) = 0.97) and its decrement postdilatation (R(2) = 0.98) well predicted symptomatic improvement.
CONCLUSIONS: PEJ resistance correlates better with dysphagia severity than peak pharyngeal pressure and is more sensitive to bolus sizes than PEJ diameter. Both baseline PEJ resistance and its decrement following dilatation are strong predictors of treatment outcome. PEJ resistance is vital to detect, as it is reversible and can predict the response to dilatation regimens.

PMID: 27118816 [PubMed - as supplied by publisher]

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Penetrating Neck Trauma: An Unusual Case Presentation and Review of the Literature.

Penetrating Neck Trauma: An Unusual Case Presentation and Review of the Literature.

Ann Otol Rhinol Laryngol. 2016 Apr 26;

Authors: McCrary HC, Nielsen TJ, Goldstein SA

Abstract
OBJECTIVES: The aim of this report is to describe a case of a retained projectile metal object to the neck that occurred after airbag deployment during a motor vehicle accident.
METHODS: Case report with literature review.
RESULTS: After a motor vehicle accident on the interstate, a 19-year-old man presents to the emergency department for several open extremity fractures, a neck laceration, and a C1 lateral mass fracture. The trauma surgery team repaired the neck laceration with no further evidence of injury. Several weeks later on follow-up, the patient presents with dysphagia and pain when turning his head to the right. A repeat computed tomography angiography (CTA) scan revealed a metallic foreign body in the left posterior pharyngeal, prevertebral soft tissues, which was subsequently removed during exploratory surgery 2 months after his initial accident.
CONCLUSIONS: This is the first report, to our knowledge, of a projectile metal object to the neck that may be related to airbag deployment. The car involved in this accident was under recall for airbags that were associated with projectile objects, which warrants further investigation into the possible risks of such airbags.

PMID: 27117904 [PubMed - as supplied by publisher]

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Prospective analysis of functional swallowing outcome after resection of T2 glottic carcinoma using transoral laser surgery and external vertical hemilaryngectomy.

Prospective analysis of functional swallowing outcome after resection of T2 glottic carcinoma using transoral laser surgery and external vertical hemilaryngectomy.

Eur Arch Otorhinolaryngol. 2016 Apr 27;

Authors: Nasef HO, Thabet H, Piazza C, Del Bon F, Eid M, Banna ME, Nicolai P

Abstract
56 patients affected by T2 glottic carcinoma were treated in two institutes using transoral laser microsurgery (TLM) in 40 cases and vertical hemilaryngectomy in 16 cases between September 2012 and September 2015. In the TLM group, different subtypes of type V cordectomy were used according to the extent of tumor. In the vertical hemilaryngectomy group, classical operation was used in most of the cases and the resection was extended in few cases. Analysis of post-operative swallowing function was done using videofluoroscopy (VFS), functional endoscopic evaluation of swallowing, and subjectively using MD Anderson dysphagia inventory. Objective evaluation of swallowing has been made by obtaining different measures from VFS (pharyngeal transit time, pharyngeal constriction ratio, and hyoid displacement for example). Analysis also included the need and duration of tracheostomy and nasogastric tube, ICU admission, and hospitalization time. Statistical analysis was performed with the Mann-Whitney U and Pearson Chi-square tests. Comparison of incidence of aspiration and swallowing outcome showed significantly better results in the laser group than in the vertical group (p < 0.001). The duration of ICU, tracheostomy, nasogastric tube, and hospital stay was also significantly shorter in the laser group (p < 0.001). This study shows that TLM had significantly better overall postoperative outcome than vertical hemilaryngectomy. It was associated with significantly shorter hospital stay and less need for tracheostomy, nasogastric tube, and ICU admission). Measures obtained from VFS are useful for detection and follow-up of postoperative aspiration, because it is a definitive technique for anatomical and physiological study of swallowing.

PMID: 27117690 [PubMed - as supplied by publisher]

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The Rapid Aspiration Screening in Suspected Stroke Part 1: Development and Validation.

The Rapid Aspiration Screening in Suspected Stroke Part 1: Development and Validation.

Arch Phys Med Rehabil. 2016 Apr 23;

Authors: Daniels SK, Pathak S, Rosenbek JC, Morgan RO, Anderson JA

Abstract
OBJECTIVES: To develop and validate a nurse-administered screening tool to identify aspiration risk in patients with suspected stroke.
DESIGN: Validity study comparing evidence-based swallowing screening items with videofluoroscopic swallowing study (VFSS).
SETTINGS: The study was completed in a certified primary stroke center in a major metropolitan medical facility.
PARTICIPANTS: Consecutive patients (N=250) admitted with suspected stroke.
INTERVENTIONS: Patients were administered evidence-based swallowing screening items by nurses. A VFSS was completed within 2 hours of swallowing screening.
MAIN OUTCOME MEASURE: Validity relative to identifying VFSS determined aspiration for each screening item and for various combinations of items.
RESULTS: Aspiration was identified in 29 of the 250 participants. Logistic regression revealed age (p=0.012), dysarthria (p=0.001), abnormal volitional cough (p=0.030), and signs related to trial water swallow (p=0.021) to be significantly associated with aspiration. Validity was then determined based on the best combination of significant items for predicting aspiration. Results revealed that age >70, or dysarthria, or signs related to trial water swallow (i.e., cough, throat clear, wet vocal quality, and inability to continuously swallow 90ml water) yielded 93% sensitivity and 98% negative predictive value.
CONCLUSIONS: The final validated tool, Rapid Aspiration Screening for Suspected Stroke (RAS(3)), is a valid nurse-administered tool to detect risk of aspiration in patients presenting with suspected stroke.

PMID: 27117382 [PubMed - as supplied by publisher]

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The Rapid Aspiration Screening in Suspected Stroke Part 2: Initial and Sustained Nurse Accuracy and Reliability.

The Rapid Aspiration Screening in Suspected Stroke Part 2: Initial and Sustained Nurse Accuracy and Reliability.

Arch Phys Med Rehabil. 2016 Apr 23;

Authors: Anderson JA, Pathak S, Rosenbek JC, Morgan RO, Daniels SK

Abstract
OBJECTIVES: The aim of this study was to determine registered nurses' (RNs) ability to obtain and maintain accurate procedural skills and reliable interpretation of the Rapid Aspiration Screening for Suspected Stroke (RAS(3)).
DESIGN: Prospective, observation study SETTING: A certified primary stroke center in a major metropolitan facility PARTICIPANTS: A total of 15 RNs were recruited and trained in the administration and interpretation of the screening items under study to develop the RAS(3).
INTERVENTIONS: RNs completed a total of 239 screenings of patients admitted with suspected stroke over a 2 year period. RNs administered the swallowing screening items (SSI) and interpreted the patient's response for each item. Independent to the RN, a speech-language pathologist simultaneously interpreted the stroke participant's response to each SSI.
MAIN OUTCOME MEASURES: Reliability of interpretation and accuracy of administering SSIs RESULTS: Average accuracy rate for administration of the RAS3 was 98.33% with the overall accuracy rate for each procedural task ranging from 95.42% to 100%. For the specific SSIs that formed the RAS(3), dysarthria and a positive sign after water swallow, reliability was very high (k=0.817). Accuracy rate for administration and reliability in interpretation of the SSIs improved as the RNs gained experience, and both were maximized at 20 screening opportunities.
CONCLUSIONS: RNs demonstrate both excellent accuracy in procedural administration and reliability in item interpretation of the RAS(3). With feedback and repeated opportunities to practice, maintenance of skills is achievable.

PMID: 27117381 [PubMed - as supplied by publisher]

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Data analyses and perspectives on laparoscopic surgery for esophageal achalasia.

Related Articles

Data analyses and perspectives on laparoscopic surgery for esophageal achalasia.

World J Gastroenterol. 2015 Oct 14;21(38):10830-9

Authors: Tsuboi K, Omura N, Yano F, Hoshino M, Yamamoto SR, Akimoto S, Masuda T, Kashiwagi H, Yanaga K

Abstract
In general, the treatment methods for esophageal achalasia are largely classified into four groups, including drug therapy using nitrite or a calcium channel blocker, botulinum toxin injection, endoscopic therapy such as endoscopic balloon dilation, and surgery. Various studies have suggested that the most effective treatment of esophageal achalasia is surgical therapy. The basic concept of this surgical therapy has not changed since Heller proposed esophageal myotomy for the purpose of resolution of lower esophageal obstruction for the first time in 1913, but the most common approach has changed from open-chest surgery to laparoscopic surgery. Currently, the laparoscopic surgery has been the procedure of choice for the treatment of esophageal achalasia. During the process of the transition from open-chest surgery to laparotomy, to thoracoscopic surgery, and to laparoscopic surgery, the necessity of combining antireflux surgery has been recognized. There is some debate as to which type of antireflux surgery should be selected. The Toupet fundoplication may be the most effective in prevention of postoperative antireflux, but many medical institutions have selected the Dor fundoplication which covers the mucosal surface exposed by myotomy. Recently, a new endoscopic approach, peroral endoscopic myotomy (POEM), has received attention. Future studies should examine the long-term outcomes and whether POEM becomes the gold standard for the treatment of esophageal achalasia.

PMID: 26478674 [PubMed - indexed for MEDLINE]

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Impact of Overlapping Functional Gastrointestinal Disorders on the Presentation and Quality of Life of Patients with Erosive Esophagitis and Nonerosive Reflux Disease.

Related Articles

Impact of Overlapping Functional Gastrointestinal Disorders on the Presentation and Quality of Life of Patients with Erosive Esophagitis and Nonerosive Reflux Disease.

Med Princ Pract. 2015;24(5):491-5

Authors: Lee SW, Chang CS, Lien HC, Peng YC, Wu CY, Yeh HZ

Abstract
OBJECTIVE: 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).
MATERIALS AND METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.

PMID: 26137901 [PubMed - indexed for MEDLINE]

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Evidence-based treatment of frequent heartburn: the benefits and limitations of over-the-counter medications.

Related Articles

Evidence-based treatment of frequent heartburn: the benefits and limitations of over-the-counter medications.

J Am Assoc Nurse Pract. 2014 Jun;26(6):330-9

Authors: McRorie JW, Gibb RD, Miner PB

Abstract
PURPOSE: This review summarizes the pharmacological effects of over-the-counter (OTC) heartburn drugs, and the implications for treating frequent heartburn.
DATA SOURCES: PubMed and SCOPUS were searched across all years to identify well-controlled, randomized clinical studies that assessed mechanism of action and efficacy.
CONCLUSIONS: Antacids can transiently neutralize acid in the esophagus, but do not significantly affect gastric pH or prevent subsequent heartburn episodes. Histamine-2 receptor antagonists (H2 RAs) rapidly develop tolerance with repeat dosing, and exhibit an analgesic effect that may provide heartburn relief while leaving the esophagus exposed to acid. Proton pump inhibitors (PPIs) provide a sustained inhibition of gastric acid production, and are superior to antacids and H2 RAs for control of gastric acid and treatment of frequent heartburn.
IMPLICATIONS FOR PRACTICE: When recommending therapies for frequent heartburn, it is of particular importance to understand the strengths and weaknesses of available OTC medications. Antacids and H2 RAs are not recommended for treatment of frequent heartburn, while OTC PPIs are both indicated for, and effective for, treatment of frequent heartburn. A PPI dose of 20 mg is optimal for empiric treatment of frequent heartburn, and consistent with the 2013 treatment guidelines established by the American College of Gastroenterology (ACG) for treatment with a minimum effective dose.

PMID: 24825071 [PubMed - indexed for MEDLINE]

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Quantitative means for differentiating renal obstruction by analysing renography by compartmental modelling of renal fluid flow rate.

Quantitative means for differentiating renal obstruction by analysing renography by compartmental modelling of renal fluid flow rate.

Nucl Med Commun. 2016 Apr 26;

Authors: Suriyanto, Ng EY, Say XJ, Ng CE, Yan XS, Kumar SD

Abstract
OBJECTIVE: The aim of this study was to investigate the accuracy of using a newly developed index, the ratio of urine outflow to renal pelvis volume U/V2 (1/s), in evaluating renal obstruction and determining the severity of obstruction.
PATIENTS AND METHODS: A total of 42 patients' renograms (80 kidneys) were studied. Compartmental modelling was used to model the behaviour of tracers flowing through the kidney. The derived model led to the formation of the normalized urine flow rate U/V2. An analysis was carried to test the accuracy of the developed index by comparing the developed model and the clinical evaluation of renograms. The Support Vector Machine algorithm was implemented to predict the renal obstruction status.
RESULTS: From the comparison performed between the index and the clinical evaluation from certified experts, it was shown that a higher value of index U/V2 indicated a normal kidney, whereas a lower value indicated an obstructed kidney. The classifier developed could provide a 100% accurate diagnosis of differentiated unobstructed kidneys (42/42) and obstructed kidney (18/18). For further classification of obstructed kidneys, the system grouped the samples into slightly obstructed cases with an accuracy of 100% (9/9) and heavily obstructed cases with an accuracy of 89% (8/9).
CONCLUSION: The use of the single parameter U/V2 could produce the diagnosis of renal obstruction with a high level of accuracy. This method has the potential to be used as a benchmark to distinguish the severity level of the renal obstruction.

PMID: 27119455 [PubMed - as supplied by publisher]

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Comparison of sedation method in pediatrics cardiac catheterization

OBJECTIVE: Purpose of this study is to compare the effects of various anaesthetic combinations on hemodynamics, sedation level, recovery period and complications in the patients which undergo pediatric cardiac catheterization.

PATIENTS AND METHODS: Four groups of anaesthetic combinations was created. The groups are classified as propofol-ketamine (group 1), propofol-dexmedetomidine (group 2), dexmedetomidine-ketamine (group 3), midazolam-ketamine (group 4) (for each group n=20). Baseline heart rate (HR), mean arterial blood pressure (MAP), respiratory rate (RR), peripheral oxygen saturation (SpO2) were recorded. This parameters values were recorded at 0., 5., 10., 15., 20., 25., 30. minutes; and the groups were compared according to these measurements data.

RESULTS: For heart rate, Group 2 and 3 reduce the HR more than the drugs of Group 1 and 4 (p < 0.05). The SpO2 values of Group 1 were measured to have 5% further reduction compared to the Group 2 and 3; and Group 4 has the same SpO2 recordings compared to the Group 3 (p < 0.05). Comparing the recovery times; Group 4 was found to have the highest recovery time compared to the other drug groups. It is found that additional doses are needed for recovery in Group 4 (p < 0.008). Side effects were lowest for Group 3 and highest for Group 4.

CONCLUSIONS: Considering the complication rates, it is concluded that Group 3 is spotted as the better sedation method among the other groups. In terms of additional propofol dose, Group 1 would be the better choice. Thus, the clinician should choose the suitable methods for the patient.

L'articolo Comparison of sedation method in pediatrics cardiac catheterization sembra essere il primo su European Review.

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The role of dendritic cells in immune regulation of nasal polyps.

The role of dendritic cells in immune regulation of nasal polyps.

Histol Histopathol. 2016 Apr 27;:11773

Authors: Liang Z, Yang T, Xu W, Huang Y, Jiang L, Yin Z, Qin G

Abstract
Nasal polyps (NPs) are caused by a variety of immune cells and inflammatory cells. However, as the most potent antigen-presenting cells in the immune system, the role of dendritic cells (DCs) in NPs is still unclear. In the present research, we studied the role of DCs in immune regulation of NPs. Thirty patients with NPs, who served as the experimental group, received systemic and local glucocorticoids for 4-7 d, and specimens were collected prior to hormone treatment and during surgery. Normal middle turbinate mucosa tissues from 18 patients who underwent nasal septum surgery were collected as controls. The expression levels of CD83, tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and eosinophils (EOS) in NP tissues before and after glucocorticoid therapy and in control middle turbinate mucosa tissues were studied. After glucocorticoid therapy, the expression levels of CD83, TNF-α, IL-4 and EOS decreased significantly. In addition, the expression of IL-4 was lower than that of TNF-α, reversing the Th2 cytokine-dominant condition. CD83 and EOS showed a positive correlation. DCs participated in the development and progression of NPs and could promote the generation of Th2 cytokines. After interference by glucocorticoid therapy, DCs could inhibit the expression of Th2 cytokines and induce secretion of Th1 cytokines. DCs and EOS thus might both play roles in promoting the development and progression of NPs, but the underlying mechanism requires further study.

PMID: 27117506 [PubMed - as supplied by publisher]

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The administration sequence of propofol and remifentanil does not affect the ED50 and ED95 of rocuronium in rapid sequence induction of anesthesia: a double-blind randomized controlled trial

OBJECTIVE: The topic of drug administration sequence in rapid sequence induction (RSI) is still an object of interest in terms of rocuronium effectiveness. The aim of this prospective, randomized trial was to evaluate the effect of administration sequence of propofol and remifentanil on ED50 and ED95 of rocuronium in a RSI model.

PATIENTS AND METHODS: Eighty-four patients were randomized into Group Remifentanil (Group R, n = 43), where induction of general anesthesia started with remifentanil (2 µg/kg) and followed by propofol (2 mg/kg) and rocuronium administrations; and Group Propofol (Group P, n = 41), where induction of general anesthesia started with propofol and followed by remifentanil and rocuronium. First patients in each group were paralyzed by 0.8 mg/kg rocuronium. In case of acceptable intubation as evaluated according to the criteria described by Viby-Mogensen et al, rocuronium dose was decreased by 0.1 mg/kg for the next patient; otherwise, rocuronium dose was increased by 0.1 mg/kg. After three crossover points, increments or decrements in rocuronium dosage were set to 0.05 mg/kg. The process was repeated until a total of ten crossover points were obtained.

RESULTS: The ED50 and ED95 doses of rocuronium were similar in Group R (0.182 mg/kg, and 0.244 mg/kg, respectively) and Group P (0.121 mg/kg, and 0.243 mg/kg, respectively) according to 95% CI of the estimates. There was no statistically significant difference in terms of clinically acceptable intubation conditions between the two groups (56.1% in Group R vs. 59% in Group P, p = 0.795).

CONCLUSIONS: The choice of administration sequence of propofol and remifentanil does not have an impact on estimated ED50 and ED95 of rocuronium in providing acceptable intubation conditions in the RSI technique.

L'articolo The administration sequence of propofol and remifentanil does not affect the ED50 and ED95 of rocuronium in rapid sequence induction of anesthesia: a double-blind randomized controlled trial sembra essere il primo su European Review.

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Comparative performance of thin layer agar and Löwenstein-Jensen culture for diagnosis of tuberculosis

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Primary culture of Mycobacterium ulcerans from human tissue specimens after storage in semisolid transport medium

Tissue specimens collected from patients with clinically suspected Buruli ulcer treated in two Buruli ulcer treatment centers in Benin between 1998 and 2004 were placed in semisolid transport medium and transported at ambient temperature for microbiological analysis at the Institute of Tropical Medicine in Antwerp, Belgium. The impact of the delay before microbiological analysis on primary culture of Mycobacterium ulcerans was investigated. The length of storage in semisolid transport medium varied from 6 days to 26 weeks. Of the 1,273 tissue fragments positive for M. ulcerans DNA by an IS2404-specific PCR, 576 (45.2%) yielded positive culture results. The sensitivity of direct smear examination was 64.6% (822/1,273 tissue fragments). The median time required to obtain a positive culture result was 11 weeks. Positive cultures were obtained even from samples kept for more than 2 months at ambient temperatures. Moreover, there was no reduction in the viability of M. ulcerans, as detected by culture, when specimens remained in semisolid transport medium for long periods of time (up to 26 weeks). We can conclude that the method with semisolid transport medium is very robust for clinical specimens from patients with Buruli ulcer that, due to circumstances, cannot be analyzed in a timely manner. This transport medium is thus very useful for the confirmation of a diagnosis of Buruli ulcer with specimens collected in the field.

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Rapid and inexpensive detection of multidrug-resistant Mycobacterium tuberculosis with the nitrate reductase assay using liquid medium and direct application to sputum samples

For rapid and low-cost detection of multidrug-resistant (MDR) Mycobacterium tuberculosis, we applied the nitrate reductase assay (NRA) using a liquid medium directly to sputum samples. A total of 179 sputum samples were analyzed by the NRA, and results were compared to those obtained by the indirect proportion method (IPM) as a standard reference. Out of 144 specimens for which comparable results were available, only one discrepant result was obtained: MDR by NRA but susceptible by the IPM. In total 56% of the results were obtained in 10 days by the NRA. NRA performed in liquid medium is rapid and inexpensive and can be easily implemented in low-income countries.

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Rapid drug resistance detection in Mycobacterium tuberculosis: a review of colourimetric methods

Several new methods to detect drug resistance in Mycobacterium tuberculosis have been proposed in recent years. Colourimetric methods that use redox indicators or the nitrate reduction assay have received increasing attention because of their simplicity and the absence of any requirement for sophisticated equipment or highly trained personnel. Several studies have evaluated their accuracy and performance in comparison with reference standard methods, particularly for the detection of resistance to rifampicin and isoniazid, which are the two most important drugs used for the treatment of tuberculosis. This review describes the development, evaluation and implementation of these methods as rapid alternative tests for the detection of multidrug resistance in M. tuberculosis. Based on published evidence and the high accuracy of colourimetric methods for detecting drug resistance in M. tuberculosis, these methods seem to be appropriate for implementation in high-burden low-resource countries.

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