Hajigholi, M; Persson, CM; Wirström, ES; Black, JH; Bergman, P; Olofsson, AOH; Olberg, M; Hajigholi, M; Persson, CM; Wirström, ES; Black, JH; Bergman, P; Olofsson, AOH; Olberg, M; Wyrowski, F; Coutens, A; Hjalmarson, Å; Menten, KM; - view fewer (2016) On the accretion process in a high-mass star forming region: A multitransitional THz Herschel-HIFI study of ammonia toward G34.26+0.15. Astronomy & Astrophysics , 585 , Article A158. 10.1051/0004-6361/201526451 . Green open access
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τετάρτη 25 Μαΐου 2016
On the accretion process in a high-mass star forming region: A multitransitional THz Herschel-HIFI study of ammonia toward G34.26+0.15
Hyperfractionated Intensity-modulated Radiotherapy (IMRT) Versus Conventional Fraction IMRT for Patients With Loco-regionally Recurrent Nasopharyngeal Carcinoma.
Conditions: Nasopharyngeal Neoplasms; Mortality; Quality of Life; Complications
Interventions: Radiation: Hyperfractionated IMRT; Radiation: Conventional Fraction IMRT
Sponsor: Sun Yat-sen University
Recruiting - verified May 2016
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Interventions: Radiation: Hyperfractionated IMRT; Radiation: Conventional Fraction IMRT
Sponsor: Sun Yat-sen University
Recruiting - verified May 2016
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The role of spectral detail in the binaural transfer function on perceived externalization in a reverberant environment
Individual binaural room impulse responses (BRIRs) were recorded at a distance of 1.5 m for azimuth angles of 0° and 50° in a reverberant room. Spectral details were reduced in either the direct or the reverberant part of the BRIRs by averaging the magnitude responses with band-pass filters. For various filter bandwidths, the modified BRIRs were convolved with broadband noise and listeners judged the perceived position of the noise when virtualized over headphones. Only reductions in spectral details of the direct part obtained with filter bandwidths broader than one equivalent rectangular bandwidth affected externalization. Reductions in spectral details of the reverberant part had only little influence on externalization. In both conditions, externalization was not as pronounced at 0° as at 50°. To characterize the auditory processes that may be involved in the perception of externalization, a quantitative model is proposed. The model includes an echo-suppression mechanism, a filterbank describing the frequency selectivity in the cochlea and a binaural stage that measures the deviations of the interaural level differences between the considered input and the unmodified input. These deviations, integrated across frequency, are then mapped to a value that corresponds to the perceived externalization.
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On the sampling criterion for structural radiation in fluid
When experimentally investigating the sound radiating from vibrating structures the surface is discretised into elemental areas also referred to as patches in which the surface vibrations are considered uniform. In many cases the structural Nyquist criterion imposes very small patch sizes which turn the experimental analysis into an overwhelmingly elaborate and error-prone task. The possibility to use a coarse sampling scheme for the surface velocity can greatly enhance the practical feasibility of such experimental investigations. Here the special case of a simply supported baffled plate excited by a broadband point force is considered. It is shown that accurate approximations of the radiated power may be obtained well beyond the frequency limit imposed by the structural Nyquist sampling criterion, provided the complex-valued vibration field is averaged over each patch. This is due to the fact that the structural wave components with wavenumbers greater than the acoustic wavenumber tend to be averaged out, owing to the mutual canceling of areas which vibrate out-of-phase within each patch, leaving only those components that contribute significantly to the radiated sound. It turns out, however, that this canceling process is not complete and that an error is introduced by the spatial aliasing. An analytical expression is derived allowing one to quantify this error and to optimise the patch size given a desired accuracy level and frequency range for the assessment of the radiated power. The proposed sampling criterion not only allows one to significantly reduce the measurement efforts when the radiation of vibro-acoustic systems are experimentally investigated but can also be applied to reduce the size of numerical models for weakly coupled structural-acoustic systems.
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Eliciting the most prominent perceived differences between microphones
The attributes contributing to the differences perceived between microphones (when auditioning recordings made with those microphones) are not clear from previous research. Consideration of technical specifications and expert opinions indicated that recording five programme items with eight studio and two microelectromechanical system microphones could allow determination of the attributes related to the most prominent inter-microphone differences. Pairwise listening comparisons between the resulting 50 recordings, followed by multi-dimensional scaling analysis, revealed up to 5 salient dimensions per programme item; 17 corresponding pairs of recordings were selected exemplifying the differences across those dimensions. Direct elicitation and panel discussions on the 17 pairs identified a hierarchy of 40 perceptual attributes. An attribute contribution experiment on the 31 lowest-level attributes in the hierarchy allowed them to be ordered by degree of contribution and showed brightness, harshness, and clarity to always contribute highly to perceived inter-microphone differences. This work enables the future development of objective models to predict these important attributes.
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Indexing head movement during speech production using optical markers
Optical marker tracking integrated with electromagnetic articulometry was used to assess the movement extent of various points on (a) forehead skin and (b) points on a head-mounted apparatus, relative to a fixed point just above the upper incisors, and to compare the accuracy of the two different approaches to indexing head position during speech production. Both methods can provide a satisfactory index of head position. If skin-affixed markers are used, a minimum of 4 is recommended. Locations for optimal marker placement are identified.
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Real-time assessment of fatigue in patients with multiple sclerosis: How does it relate to commonly used self-report fatigue questionnaires?
Publication date: Available online 24 May 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Martin Heine, Lizanne Eva van den Akker, Lyan Blikman, Trynke Hoekstra, Erik van Munster, Olaf Verschuren, Anne Visser-Meily, Gert Kwakkel
Objectivesto (1) assess real-time patterns of fatigue; (2) assess the association between a real-time fatigue score (RTFS) and three commonly used questionnaires (Checklist Individual Strength[CIS], fatigue subscale; Modified Fatigue Impact Scale[MFIS]; and Fatigue Severity Scale[FSS]); and (3) establish factors that confound the association between RTFS and conventional fatigue questionnaires in patients with Multiple Sclerosis [MS].Designcross-sectional studySettingDutch MS-specialized outpatient facilityParticipantsAmbulant patients with MS (N = 165) experiencing severe self-reported fatigue.InterventionsNot applicable.Main outcome measuresA real-time fatigue score (RTFS) was assessed by sending participants four text messages on a particular day ('How fatigued do you feel at this moment?'; range 0-10). Latent class growth mixed modeling was used to determine diurnal patterns of fatigue. Regression analyses were used to assess the association between the mean RTFS and the CIS fatigue subscale, MFIS, and FSS. Significant associations were tested for candidate confounders such as disease severity, work status, and sleepiness.ResultsFour significantly different fatigue profiles were identified by RTFS, namely a stable high (N=79), increasing (N=57), stable low (N=16), and decreasing (N=13). The conventional questionnaires correlated poorly (r<.300) with the RTFS. The Epworth Sleepiness Scale significantly reduced the regression coefficient between the RTFS and conventional questionnaires, ranging from 15.4 to 35%.ConclusionsPerceived fatigue showed four different diurnal patterns in patients with MS. Severity of sleepiness is an important confounder to take into account in the assessment of fatigue.
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A Case Based Approach to Clinical Genetics of Thoracic Aortic Aneurysm/Dissection
Thoracic aortic aneurysm/dissection (TAAD) is a potential lethal condition with a rising incidence. This condition may occur sporadically; nevertheless, it displays familial clustering in >20% of the cases. Family history confers a six- to twentyfold increased risk of TAAD and has to be considered in the identification and evaluation of patients needing an adequate clinical follow-up. Familial TAAD recognizes a number of potential etiologies with a significant genetic heterogeneity, in either syndromic or nonsyndromic forms of the manifestation. The clinical impact and the management of patients with TAAD differ according to the syndromic and nonsyndromic forms of the manifestation. The clinical management of TAAD patients varies, depending on the different forms. Starting from the description of patient history, in this paper, we summarized the state of the art concerning assessment of clinical/genetic profile and therapeutic management of TAAD patients.
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Introduction
Publication date: Available online 24 May 2016
Source:Annales de Chirurgie Plastique Esthétique
Author(s): Véronique Duquennoy-Martinot
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Les particularités du lipofilling chez l’enfant
Publication date: Available online 24 May 2016
Source:Annales de Chirurgie Plastique Esthétique
Author(s): C. Baptista, B. Bertrand, C. Philandrianos, N. Degardin, D. Casanova
Le lipofilling ou transfert de tissu graisseux est défini comme une technique de comblement des tissus mous par injection de graisse autologue. Le principe de base du lipofilling repose sur un prélèvement de tissu graisseux, suivi d'une réinjection après traitement de celui-ci. Le lipofilling a pour objectif principal le comblement d'un défect volumique, mais il améliorerait également la trophicité cutanée. La spécificité du lipofilling chez l'enfant repose essentiellement sur ses indications. Les complications de la réinjection de tissu graisseux autologue chez l'enfant sont les mêmes que celles de l'adulte : on distingue les complications à court terme (per- et périopératoires) de celles à moyen et long terme. Le prélèvement de tissu graisseux représente le principal facteur limitant de la technique, devant le faible pourcentage de masse grasse de l'enfant. Les indications du lipofilling chez d'enfant peuvent être spécifiques ou similaires à celles de l'adulte. Il faut distinguer deux types d'indications : les indications d'ordre cosmétique, dans lesquelles l'objectif du lipofilling est la correction d'un défect volumique, qu'il soit acquis (d'origine iatrogène, post-traumatique, cicatriciel) ou malformatif (dysplasie otomandibulaire, craniosténose, syndrome de Parry Romberg, syndrome de Poland, pectus excavatum…). Les indications fonctionnelles ont pour objectif la correction d'une insuffisance vélaire ou d'une lagophtalmie. Dans la pratique pédiatrique, le lipofilling est devenu une alternative de choix aux techniques classiques, de par sa fiabilité, son innocuité, sa reproductibilité et ses bons résultats.Lipofilling or fat grafting transfer is defined as a technique of filling soft tissue by autologous fat grafting. The basic principle of lipofilling is based on a harvest of adipose tissue, followed by a reinjection after treatment. Lipofilling main objective is a volume defect filling, but also improving cutaneous trophicity. Lipofilling specificities among children is mainly based on these indications. Complications of autologous fat grafting among children are the same as those in adults: we distinguish short-term complications (intraoperative and perioperative) and the medium and long-term complications. The harvesting of fat tissue is the main limiting factor of the technique, due to low percentage of body fat of children. Indications of lipofilling among children may be specific or similar to those in adults. There are two types of indications: cosmetic, in which the aim of lipofilling is correcting a defect density, acquired (iatrogenic, post-traumatic scar) or malformation (otomandibular dysplasia, craniosynostosis, Parry Romberg syndrom, Poland syndrom, pectus excavatum…). The aim of functional indications is correcting a velar insufficiency or lagophthalmos. In the paediatric sector, lipofilling has become an alternative to the conventional techniques, by its reliability, safety, reproducibility, and good results.
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European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update
Background: Since the publication of the European League Against Rheumatism recommendations for the pharmacological treatment of psoriatic arthritis (PsA) in 2012, new evidence and new therapeutic agents have emerged. The objective was to update these recommendations. Methods: A systematic literature review was performed regarding pharmacological treatment in PsA. Subsequently, recommendations were formulated based on the evidence and the expert opinion of the 34 Task Force members. Levels of evidence and strengths of recommendations were allocated. Results: The updated recommendations comprise 5 overarching principles and 10 recommendations, covering pharmacological therapies for PsA from non-steroidal anti-inflammatory drugs (NSAIDs), to conventional synthetic (csDMARD) and biological (bDMARD) disease-modifying antirheumatic drugs, whatever their mode of action, taking articular and extra-articular manifestations of PsA into account, but focusing on musculoskeletal involvement. The overarching principles address the need for shared decision-making and treatment objectives. The recommendations address csDMARDs as an initial therapy after failure of NSAIDs and local therapy for active disease, followed, if necessary, by a bDMARD or a targeted synthetic DMARD (tsDMARD). The first bDMARD would usually be a tumour necrosis factor (TNF) inhibitor. bDMARDs targeting interleukin (IL) 12/23 (ustekinumab) or IL-17 pathways (secukinumab) may be used in patients for whom TNF inhibitors are inappropriate and a tsDMARD such as a phosphodiesterase 4-inhibitor (apremilast) if bDMARDs are inappropriate. If the first bDMARD strategy fails, any other bDMARD or tsDMARD may be used. Conclusions: These recommendations provide stakeholders with an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes in PsA, based on a combination of evidence and expert opinion.
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Gastric lap-band infection due to Mycobacterium abscessus presenting as new-onset ascites in a cirrhotic patient
10.3109/23744235.2016.1143116<br/>Allon Kahn
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Parvovirus B19 congenital infection
10.3109/23744235.2016.1163731<br/>Raúl Gilarranz
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Effect of feeding mixed microbial culture fortified with trace minerals on ruminal fermentation, nutrient digestibility, nitrogen and trace mineral balance in Sheep
Background: The aim of the present study was to determine the effects of feeding trace mineralsfortified mixed microbial culture (TMC) on ruminal fermentation, nutrient digestibility, blood electrolyte status, nitrogen balance, and trace mineral balance in sheep. Methods: Mixed microbes [0.6 % (v/w) of Enterobacter sp., Bacillus sp., Lactobacillus sp., and Saccharomyces sp.] were cultured with 99 % feedstuffs and 0.4 % trace minerals including zinc and copper for ensiling. Six sheep (a mean body weight of 46.5 ± 1.2 kg) were fed two diets: a control diet (concentrate mix and rye straw) and an experimental diet (a control diet + 3.1 % TMC). Results: TMC feeding did not induce negative effects on ruminal fermentation, nutrient digestibility, blood electrolytes, and nitrogen balance in sheep. Feeding with TMC increased the intake of trace minerals (p < 0.05) and did not affect absorption of trace minerals in the whole digestive tract. Feeding with TMC increased fecal excretion and absorbable intake, and retention of zinc and copper (p < 0.05) by 71 % and 77 %, respectively. Conclusion: Feeding with TMC resulted in higher zinc and copper bioavailability and retention without any adverse effects on sheep performance.
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Sirtuin functions and modulation: from chemistry to the clinic
Sirtuins are NAD + -dependent histone deacetylases regulating important metabolic pathways in prokaryotes and eukaryotes and are involved in many biological processes such as cell survival, senescence, proliferation, apoptosis, DNA repair, cell metabolism, and caloric restriction. The seven members of this family of enzymes are considered potential targets for the treatment of human pathologies including neurodegenerative diseases, cardiovascular diseases, and cancer. Furthermore, recent interest focusing on sirtuin modulators as epigenetic players in the regulation of fundamental biological pathways has prompted increased efforts to discover new small molecules able to modify sirtuin activity. Here, we review the role, mechanism of action, and biological function of the seven sirtuins, as well as their inhibitors and activators.
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Changes of retinal flow volume after intravitreal injection of bevacizumab in branch retinal vein occlusion with macular edema: a case series
Background: Although intravitreal injection of bevacizumab (IVB) is effective for macular edema in patients with branch retinal vein occlusion (BRVO), the changes of retinal hemodynamics remain unclear. We investigated retinal hemodynamic changes in BRVO patients after IVB by performing laser speckle flowgraphy (LSFG). Methods: In 35 BRVO patients with macular edema, the relative flow volume (RFV) of the retinal artery and vein passing through the optic disc was measured in both the occluded and non-occluded regions of the retina before IVB and 1 month after IVB by LSFG. The ischemic region of retina was measured with the Scion Image program and the severity of retinal ischemia was assessed by dividing the non-perfused area by the disc area. Results: Macular edema improved significantly by 1 month after IVB. The venous RFV ratio showed a significant increase in the non-occluded region at 1 month after IVB. There was a significant negative correlation between the venous RFV ratio and the severity of retinal ischemia in the occluded region. On the other hand, arterial RFV ratio showed no significant change after IVB in either the occluded or non-occluded region. In addition, there was no significant correlation between the arterial RFV ratio and the severity of retinal ischemia in either the occluded or non-occluded region. Conclusions: These results suggest that an increase of retinal venous outflow after IVB may possibly influence the resolution of macular edema and that the response of venous outflow after IVB depends on the severity of retinal ischemia in the occluded region.
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Acid–base balance, serum electrolytes and need for non-invasive ventilation in patients with hypercapnic acute exacerbation of chronic obstructive pulmonary disease admitted to an internal medicine ward
Background: Hypoventilation produces or worsens respiratory acidosis in patients with hypercapnia due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these patients acid–base and hydroelectrolite balance are closely related. Aim of the present study was to evaluate acid–base and hydroelectrolite alterations in these subjects and the effect of non-invasive ventilation and pharmacological treatment. Methods: We retrospectively analysed 110 patients consecutively admitted to the Internal Medicine ward of Cava de' Tirreni Hospital for acute exacerbation of hypercapnic chronic obstructive pulmonary disease. On admission all patients received oxygen with a Venturi mask to maintain arterial oxygen saturation at least >90 %, and received appropriate pharmacological treatment. Non-Invasive Ventilation (NIV) was started when, despite optimal therapy, patients had severe dyspnea, increased work of breathing and respiratory acidosis. Based on Arterial Blood Gas (ABG) data, we divided the 110 patients in 3 groups: A = 51 patients with compensated respiratory acidosis; B = 36 patients with respiratory acidosis + metabolic alkalosis; and C = 23 patients with respiratory acidosis + metabolic acidosis. 55 patients received only conventional therapy and 55 had conventional therapy plus NIV. Results: The use of NIV support was lower in the patients belonging to group B than in those belonging to group A and C (25 %, vs 47 % and 96 % respectively; p < 0.01). A statistically significant association was found between pCO 2 values and serum chloride concentrations both in the entire cohort and in the three separate groups. Conclusions: Our study shows that in hypercapnic respiratory acidosis due to AECOPD, differently from previous studies, the metabolic alkalosis is not a negative prognostic factor neither determines greater NIV support need, whereas the metabolic acidosis in addition to respiratory acidosis is an unfavourable element, since it determines an increased need of NIV and invasive mechanical ventilation support.
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Veterinarians’ role in clients’ decision-making regarding seriously ill companion animal patients
Background: When companion animals become seriously ill clients may have doubts about treatment choices, if any, and turn to veterinarians for help. But how should veterinarians reply? Influence on clients' decision-making may or may not be acceptable—depending on one's attitude to principles such as 'paternalism', 'respect for autonomy' and 'shared decision-making'. This study takes as a starting point a situation where the animal is chronically ill, or aged, with potentially reduced animal welfare and client quality of life, and thus where clients need to consider treatment options or euthanasia. It is assumed throughout that both veterinarians and clients have the animals' best interest at heart. The purpose of the study was to explore the challenges these situations hold and to investigate how clients experience veterinary influence. A second aim was to reflect on the ethical implications of the role of veterinarians in these situations. Qualitative interviews were conducted with 12 dog owners considering treatment or euthanasia of their chronically ill or aged dogs. Results: Challenges relating to the dog and to the client were identified. Some situations left the interviewees hesitant, e.g. if lacking a clear cut-off point, the dog appeared normal, the interviewee felt uncertain about treatments or animal welfare, or experienced conflicting concerns. Some interviewees found that veterinarians could influence their decisions. Such influence was received in different ways by the interviewees. Some interviewees wanted active involvement of the veterinarian in the decision-making process, and this may challenge a veterinarian's wish to respect client autonomy. Conclusions: Different preferences are likely to exist amongst both veterinarians and clients about veterinary involvement in clients' decision-making, and such preferences may vary according to the situation. It is suggested, that one way to handle this challenge is to include respect for client preference on veterinary involvement under a wider understanding of respect for autonomy, and to apply models of shared decision-making to veterinary practice. In any case there is a need to further explore the challenges these situations raise, and for the veterinary profession to engage in more formal and structured deliberation over the role of veterinarians in relation to clients' decision-making.
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Obstructive sleep apnea presenting as pseudopheochromocytoma.
| Related Articles |
Obstructive sleep apnea presenting as pseudopheochromocytoma.
Pan Afr Med J. 2016;23:75
Authors: Marmouch H, Arfa S, Graja S, Slim T, Khochtali I
Abstract
A 52-year-old female with a history of poorly controlled resistant hypertension was admitted to our hospital with severe hypertension. She had a history of fatigue and intermittent episodes of palpitations. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels (3,5 times the upper normal levels). This case was presenting with a clinical and biochemical picture indistinguishable from that of pheochromocytoma. However, neither computed tomography nor meta-iodo-benzyl-guanidine scintigraphy detected any catecholamine-producing tumor in or outside the adrenal glands. Our patient was screened with full polysomnography because of heavy snoring, daytime somnolence and obesity. It revealed severe obstructive sleep apnea syndrome. After three months of continuous positive airway pressure therapy, the patient experienced resolution of his presenting symptoms, improved blood pressure control and normalization of his urinary catecholamine levels. This case highlights sleep disordered breathing as a potentially reversible cause of pseudo-pheochromocytoma.
PMID: 27217898 [PubMed - in process]
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A Rare Case of Spontaneous Pneumocephalus Associated with Nontraumatic Cerebrospinal Fluid Leak.
A Rare Case of Spontaneous Pneumocephalus Associated with Nontraumatic Cerebrospinal Fluid Leak.
Case Rep Neurol Med. 2016;2016:1828461
Authors: Baba M, Tarar O, Syed A
Abstract
Introduction. Spontaneous nontraumatic pneumocephalus (PNC) and cerebrospinal fluid (CSF) leaks are both very uncommon conditions. We report a rare case of spontaneous pneumocephalus associated with CSF leak secondary to right sphenoid sinus bony defect without history of trauma. Case Description. 51-year-old Hispanic female with past medical history of hypertension and idiopathic intracranial hypertension (Pseudotumor Cerebri) presented to the emergency room complaining of headache and clear discharge from the right nostril. Physical examination was significant for right frontal sinus tenderness and clear discharge from right nostril. Computed Tomography (CT) scan of the brain showed moderate amount of extra-axial air within the right cerebral hemisphere indicative of pneumocephalus. CT scan of facial bones showed bony defect along the right sphenoid sinus with abnormal CSF collection. The patient was started on intravenous antibiotics for meningitis prophylaxis and subsequently underwent transsphenoidal repair of cerebrospinal fluid leak with abdominal fat graft. CSF rhinorrhea stopped completely after the surgery with near complete resolution of pneumocephalus before discharge. Conclusions. Early identification of pneumocephalus and surgical intervention can help decrease the morbidity and avoid possible complications. Idiopathic intracranial hypertension, although rare, can lead to CSF leak and pneumocepahlus.
PMID: 27217961 [PubMed]
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The nasofrontal beak: A consistent landmark for superior septectomy during Draf III drill out.
The nasofrontal beak: A consistent landmark for superior septectomy during Draf III drill out.
Am J Rhinol Allergy. 2016 May;30(3):230-4
Authors: Craig JR, Petrov D, Khalili S, Brooks SG, Lee JY, Adappa ND, Palmer JN
Abstract
INTRODUCTION: Cerebrospinal fluid (CSF) leak occurs in 1-11% of endoscopic Draf III, or endoscopic modified Lothrop, procedures. CSF leak can occur during surgery during a superior nasal septectomy. This study investigated whether the posterior edge of the nasofrontal beak (NFB) at the level of the internal frontal ostium is a safe landmark to use to avoid skull base injury when beginning the superior septectomy.
METHODS: Preoperative computed tomography maxillofacial scans were reviewed from 100 patients from the University of Pennsylvania sinus surgery data base. The narrowest anteroposterior distance between the posterior edge of the NFB and the anterior aspect of the olfactory fossa (OF) at the level of the internal frontal ostium was measured in each patient. Measurements were taken in the midline and to the left and right of midline. Six fresh cadaver heads were also dissected to evaluate these relationships.
RESULTS: On computed tomography analysis, the NFB was anterior to the OF on the left and right of the midline in 100% of the patients, with mean distances of 6.04 and 6.41 mm, respectively. The NFB was anterior to the OF in the midline in 98% of patients, with a mean distance of 9.02 mm. In all six cadavers, the posterior edge of the NFB was anterior to the OF in the midline and to the left and right of midline at the level of the internal frontal ostia.
CONCLUSIONS: During Draf III, the posterior edge of the NFB was a reliable landmark for avoiding iatrogenic CSF leak during the superior septectomy.
PMID: 27216356 [PubMed - in process]
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The auditory space in the motor system.
 | Related Articles |
The auditory space in the motor system.
Neuroscience. 2015 Sep 24;304:81-9
Authors: Cattaneo L, Barchiesi G
Abstract
Sensory events in the space around us trigger specific motor patterns directed toward or away from the spatial location of the sensory source. Spatially-defined sensorimotor associations are well-known in the visual domain but less so for the auditory modality. In particular no spatially-directed audio-motor association has been described for the upper limb. We tested the instantaneous directional tuning of the corticospinal system by means of single-pulse transcranial magnetic stimulation (TMS) over the left motor cortex in 16 healthy volunteers while at rest. We recorded the lateral accelerations of the TMS-evoked movement by means of an accelerometer placed on the forearm. Acoustic stimuli (pure tone frequency=1000Hz, duration=50ms) coming from 25 different directions lying in the axial anterior half-plane at the height of the participant's ears were played on earphones. The entire set of sound directions covered a span of 160° (±80° where 0° is the frontal direction) at a fixed azimuth angle. Six different intervals between sound onset and TMS (0, 25, 50, 100, 150 and 200ms) were tested for each sound direction. Significant correlations were found between sound origin and TMS-evoked arm accelerations only when TMS was delivered 50ms prior to sound onset. We show the presence in the upper limb motor system of auditory spatial tuning. Sound information accesses the motor system at very short latency, potentially compatible with both a subcortical and a cortical origin of the response. The use of TMS-evoked accelerations allowed us to disclose a strict directional tuning in audio-motor associations.
PMID: 26208840 [PubMed - indexed for MEDLINE]
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Novel endoscopic multi-firing-clip applicator for endoscopic closure of large colonic perforations.
Novel endoscopic multi-firing-clip applicator for endoscopic closure of large colonic perforations.
Minim Invasive Ther Allied Technol. 2016 May 24;:1-8
Authors: Ge S, Song C, Yan S, Ai L, Xu J, Li M, Hu B, Cuschieri A
Abstract
BACKGROUND: Existing endoclip closure devices have difficulty in closing large colonic perforation. We developed a novel endoscopic multi-firing-clip applicator (EMFCA) system to address these limitations, and report on its initial evaluation.
MATERIAL AND METHODS: The functionality and efficacy of the prototype EMFCA equipped with re-openable clamp and preloaded with four clips were assessed using standardized 1.5 cm incisions created in ex-vivo porcine colonic segments. Endoscopic closure of the lacerations with two, three and four clips (n = five for each group) was followed by measurement of the leakage pressure of the three groups. Finite element analysis (FEA) was performed to validate the clip behavior and reliability during deployment.
RESULTS: All 15 perforations were sealed without leakage until fully distended. The leakage pressures of colonic lacerations sealed with two, three, and four clips were 26.1 ± 2.8 mmHg, 37.3 ± 7.3 mmHg and 42.3 ± 7.4 mmHg, respectively. The mean operation time to deploy one clip was 25.4 ± 5.2 seconds. On FEA, the deformation of the shape of the clip matched that of the intended design, with each clip sustaining a maximum stress of 648.5 MPa without any material failure during deployment.
CONCLUSIONS: These initial results confirm the efficacy of the EMFCA prototype system for endoscopic closure of colonic perforations.
PMID: 27218136 [PubMed - as supplied by publisher]
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Genetic and phenotypic characterization of complex hereditary spastic paraplegia.
Genetic and phenotypic characterization of complex hereditary spastic paraplegia.
Brain. 2016 May 23;
Authors: Kara E, Tucci A, Manzoni C, Lynch DS, Elpidorou M, Bettencourt C, Chelban V, Manole A, Hamed SA, Haridy NA, Federoff M, Preza E, Hughes D, Pittman A, Jaunmuktane Z, Brandner S, Xiromerisiou G, Wiethoff S, Schottlaender L, Proukakis C, Morris H, Warner T, Bhatia KP, Korlipara LV, Singleton AB, Hardy J, Wood NW, Lewis PA, Houlden H
Abstract
The hereditary spastic paraplegias are a heterogeneous group of degenerative disorders that are clinically classified as either pure with predominant lower limb spasticity, or complex where spastic paraplegia is complicated with additional neurological features, and are inherited in autosomal dominant, autosomal recessive or X-linked patterns. Genetic defects have been identified in over 40 different genes, with more than 70 loci in total. Complex recessive spastic paraplegias have in the past been frequently associated with mutations in SPG11 (spatacsin), ZFYVE26/SPG15, SPG7 (paraplegin) and a handful of other rare genes, but many cases remain genetically undefined. The overlap with other neurodegenerative disorders has been implied in a small number of reports, but not in larger disease series. This deficiency has been largely due to the lack of suitable high throughput techniques to investigate the genetic basis of disease, but the recent availability of next generation sequencing can facilitate the identification of disease-causing mutations even in extremely heterogeneous disorders. We investigated a series of 97 index cases with complex spastic paraplegia referred to a tertiary referral neurology centre in London for diagnosis or management. The mean age of onset was 16 years (range 3 to 39). The SPG11 gene was first analysed, revealing homozygous or compound heterozygous mutations in 30/97 (30.9%) of probands, the largest SPG11 series reported to date, and by far the most common cause of complex spastic paraplegia in the UK, with severe and progressive clinical features and other neurological manifestations, linked with magnetic resonance imaging defects. Given the high frequency of SPG11 mutations, we studied the autophagic response to starvation in eight affected SPG11 cases and control fibroblast cell lines, but in our restricted study we did not observe correlations between disease status and autophagic or lysosomal markers. In the remaining cases, next generation sequencing was carried out revealing variants in a number of other known complex spastic paraplegia genes, including five in SPG7 (5/97), four in FA2H (also known as SPG35) (4/97) and two in ZFYVE26/SPG15 Variants were identified in genes usually associated with pure spastic paraplegia and also in the Parkinson's disease-associated gene ATP13A2, neuronal ceroid lipofuscinosis gene TPP1 and the hereditary motor and sensory neuropathy DNMT1 gene, highlighting the genetic heterogeneity of spastic paraplegia. No plausible genetic cause was identified in 51% of probands, likely indicating the existence of as yet unidentified genes.
PMID: 27217339 [PubMed - as supplied by publisher]
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Brain arteriovenous malformations: implications of CEACAM1-positive inflammatory cells and sex on hemorrhage.
Brain arteriovenous malformations: implications of CEACAM1-positive inflammatory cells and sex on hemorrhage.
Neurosurg Rev. 2016 May 23;
Authors: Neyazi B, Herz A, Stein KP, Gawish I, Hartmann C, Wilkens L, Erguen S, Dumitru CA, Sandalcioglu IE
Abstract
Brain arteriovenous malformations (bAVMs) are severe conditions which, upon rupture, cause debilitating neurological deficits and even death. The exact cellular and molecular mechanisms associated with bAVM rupture are currently unclear. The objective of this study was to explore the potential role of CEA-related cell adhesion molecule-1 (CEACAM1) in bAVM pathophysiology. Expression and localization of CEACAM1 were assessed immunohistochemically in tissue microarrays from bAVM patients (n = 60). The association of CEACAM1 with clinical parameters was analyzed with Spearman's rank correlation coefficient and chi-square test. The predictive value of CEACAM1 was tested using logistic regression analysis. CEACAM1 was highly expressed in tissue-infiltrating neutrophil granulocytes. High levels of CEACAM1-positive cells were associated with bAVM rupture (hemorrhage), but not with arteriovenous malformation (AVM) size, preoperative embolization, or seizure. This association was significant (p = 0.029, chi-square) in male but not in female patients, and high CEACAM1-positive immune infiltration showed predictive significance for hemorrhage in male bAVM patients only (OR = 6.50, 95 % CI 1.09-38.63, p = 0.040). Within the ruptured bAVM group, patients with a short hemorrhage to surgery (HTS) time interval had higher levels of CEACAM1 immune infiltration than patients with long HTS. This decrease in the levels of CEACAM1 immune infiltration between the HTS short and HTS long groups was, however, significant only in female patients (p = 0.022, chi-square). Our findings substantiate the role of inflammation in the pathophysiology of bAVM and suggest the presence of sexual dimorphism in this disease.
PMID: 27215911 [PubMed - as supplied by publisher]
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Fatal Cervical Spine Injury From Diving Accident.
 | Related Articles |
Fatal Cervical Spine Injury From Diving Accident.
Am J Forensic Med Pathol. 2015 Sep;36(3):216-8
Authors: Voland C, Vilarino R, Grabherr S, Lobrinus JA, Palmiere C
Abstract
Spinal cord injuries result after diving into shallow water, often after incautious jumps head first into water of unknown depth during recreational or sport activities. Mortality is generally due to upper cervical trauma. The authors present a case of a diving-related death in a young woman who underwent medicolegal investigations. The measured water depth at the supposed dive site was 1.40 m. Postmortem radiology and autopsy revealed fractures of the body and the posterior arch of the fifth cervical vertebra, a fracture of the right transverse process of the sixth cervical vertebra and hemorrhages involving the cervical paraspinal muscles. Neuropathology showed a posterior epidural hematoma involving the whole cervical region and a symmetric laceration of the spinal cord located at the fourth and fifth cervical vertebra level, surrounded by multiple petechial hemorrhages. Toxicology revealed the presence of ethanol in both blood and urine samples. The death was attributed to cervical spine fracture (C5-C6), spinal cord contusion, and subsequent drowning. This case highlights the usefulness of postmortem radiology, examination of the deep structures of the neck, toxicology, neuropathology, and a detailed research of signs of drowning to formulate appropriate hypotheses pertaining to the cause and mechanism of death.
PMID: 26108039 [PubMed - indexed for MEDLINE]
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Quickstats: Age-adjusted suicide rates for females and males, by method - National Vital Statistics System, United States, 2000 and 2014
Morbidity and Mortality Weekly Report
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Acute heart failure with and without acute coronary syndrome: Clinical correlates and prognostic impact (From the HEARTS registry)
BMC Cardiovascular Disorders
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Learning curves for ultrasound assessment of lumbar puncture insertion sites: When is competency established?
The Journal of Emergency Medicine
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Development of a new Emergency Medicine Spinal Immobilization Protocol for trauma patients and a test of applicability by German emergency care providers
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Remote preconditioning protects early renal functions in low risk cardiac surgery patients
Journal of Cardiothoracic and Vascular Anesthesia
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Ilizarov arthrodesis as a salvage procedure in infected posttraumatic arthritic ankle: experience in 11 patients
Current Orthopaedic Practice
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Rapid Response Team activation in New Zealand hospitals: A multicentre prospective observational study
Anesthesia and Intensive Care
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Non-invasive mechanical ventilation in elderly patients: A narrative review
Geriatrics and Gerontology International
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Statin-induced liver Injury in an area endemic for hepatitis B virus infection: Risk factors and outcome analysis
British Journal of Clinical Pharmacology
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Influence of volume administration on Doppler-based renal resistive index, renal hemodynamics and renal function in medical intensive care unit patients with septic-induced acute kidney injury: A pilot study
International Urology and Nephrology
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Evaluating posterior cruciate ligament injury by using two-dimensional ultrasonography and sonoelastography
Knee Surgery, Sports Traumatology, Arthroscopy
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Moderate traumatic brain injury, acute phase course and deviations in physiological variables: An observational study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Sustaining critical care: Using evidence-based simulation to evaluate ICU management policies
Health Care Management Science
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