Αρχειοθήκη ιστολογίου

Παρασκευή 8 Ιουλίου 2016

A Mouse Model of Latent Tuberculosis Infection to Study Intervention Strategies to Prevent Reactivation

by Andreas Kupz, Ulrike Zedler, Manuela Stäber, Stefan H. E. Kaufmann

Infection with Mycobacterium tuberculosis (Mtb) is the leading cause of death in human immunodeficiency virus (HIV)+ individuals, particularly in Sub-Saharan Africa. Management of this deadly co-infection is a significant global health challenge that is exacerbated by the lack of efficient vaccines against both Mtb and HIV, as well as the lack of reliable and robust animal models for Mtb/HIV co-infection. Here we describe a tractable and reproducible mouse model to study the reactivation dynamics of latent Mtb infection following the loss of CD4+ T cells as it occurs in HIV-co-infected individuals. Whereas intradermally (i.d.) infected C57BL/6 mice contained Mtb within the local draining lymph nodes, depletion of CD4+ cells led to progressive systemic spread of the bacteria and induction of lung pathology. To interrogate whether reactivation of Mtb after CD4+ T cell depletion can be reversed, we employed interleukin (IL)-2/anti-IL-2 complex-mediated cell boost approaches. Although populations of non-CD4 lymphocytes, such as CD8+ memory T cells, natural killer (NK) cells and double-negative (DN) T cells significantly expanded after IL-2/anti-IL-2 complex treatment, progressive development of bacteremia and pathologic lung alterations could not be prevented. These data suggest that the failure to reverse Mtb reactivation is likely not due to anergy of the expanded cell subsets and rather indicates a limited potential for IL-2-complex-based therapies in the management of Mtb/HIV co-infection.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29sUTob
via IFTTT

Hearing Impairment Affects Dementia Incidence. An Analysis Based on Longitudinal Health Claims Data in Germany

by Thomas Fritze, Stefan Teipel, Attila Óvári, Ingo Kilimann, Gabriele Witt, Gabriele Doblhammer

Recent research has revealed an association between hearing impairment and dementia. The objective of this study is to determine the effect of hearing impairment on dementia incidence in a longitudinal study, and whether ear, nose, and throat (ENT) specialist care, care level, institutionalization, or depression mediates or moderates this pathway. The present study used a longitudinal sample of 154,783 persons aged 65 and older from claims data of the largest German health insurer; containing 14,602 incident dementia diagnoses between 2006 and 2010. Dementia and hearing impairment diagnoses were defined according to International Classification of Diseases, Tenth Revision, codes. We used a Kaplan Meier estimator and performed Cox proportional hazard models to explore the effect of hearing impairment on dementia incidence, controlling for ENT specialist care, care level, institutionalization, and depression. Gender, age, and comorbidities were controlled for as potential confounders. Patients with bilateral (HR = 1.43, p

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29VrX6I
via IFTTT

Following the Ions through a Mass Spectrometer with Atmospheric Pressure Interface: Simulation of Complete Ion Trajectories from Ion Source to Mass Analyzer

TOC Graphic

Analytical Chemistry
DOI: 10.1021/acs.analchem.6b00461
ancham?d=yIl2AUoC8zA


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uEmB9
via IFTTT

Aging effect on plasma metabolites and hormones concentrations in riding horses

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
K. Kawasumi, M. Yamamoto, M. Koide, Y. Okada, N. Mori, I. Yamamoto, T. Arai.
Age effects on plasma metabolites, hormone concentrations, and enzyme activities related to energy metabolism were investigated in 20 riding horses. Animals were divided into two groups: young (3-8 years) and aged (11-18 years). They were clinically healthy, and not obese. Plasma adiponectin (ADN) concentrations in aged horses were significantly lower than those in young horses (mean±SE, 6.5±1.3 µg mL-1 vs, 10.9±1.7 µg mL-1, Mann-Whitney U test, respectively; P=0.0233). Plasma non-esterified fatty acid levels and Insulin and malondialdehyde concentrations in aged group tended to increase compared to those in young group although there were not significant differences statistically. In aged group, malate dehydrogenase/lactate dehydrogenase (M/L) ratio, which is considered an energy metabolic indicator, did not change significantly compared to that in young group. Present data suggest that aging may negatively affect nutrition metabolism, but not induce remarkable changes in M/L ratio in riding horses.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ruV1L
via IFTTT

Human Staphylococcus aureus lineages among Zoological Park residents in Greece

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
E. Drougka, A. Foka, D. Posantzis, N. Giormezis, E.D. Anastassiou, E. Petinaki, I. Spiliopoulou.
Staphylococcus aureus is a part of the microbiota flora in many animal species. The clonal spread of S. aureus among animals and personnel in a Zoological Park was investigated. Samples were collected from colonized and infected sites among 32 mammals, 11 birds and eight humans. The genes mecA, mecC, lukF/lukS-PV (encoding Panton-Valentine leukocidin, PVL) and tst (toxic shock syndrome toxin-1) were investigated by PCR. Clones were defined by Multilocus Sequence Typing (MLST), spa type and Pulsed-Field Gel Electrophoresis (PFGE). Seven S. aureus isolates were recovered from four animals and one from an employee. All were mecA, mecC and tstnegative, whereas, one carried the PVL genes and was isolated from an infected Squirrel monkey. Clonal analysis revealed the occurrence of seven STs, eight PFGE and five spa types including ones of human origin. Even though a variety of genotypes were identified among S. aureus strains colonizing zoo park residents, our results indicate that colonization with human lineages has indeed occurred.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uEWPn
via IFTTT

Dual function of the hemagglutinin H5 fused to chicken CD154 in a potential strategy of DIVA against avian influenza disease: preliminary study

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
A.G. Pose, E.S. Rodríguez, A.C. Méndez, J.N. Gómez, A.V. Redondo, E.R. Rodríguez, E.M.G. Ramos, A.Á. Gutiérrez, M.P.R. Moltó, D.G. Roche, Y.S. Ugalde, A.M. López.
In this study we demonstrated that the vaccine candidate against avian influenza virus H5N1 based on the hemagglutinin H5 (HA) fused to the chicken CD154 (HACD) can also be used for differentiating infected from vaccinated animals (DIVA). As the strategy of DIVA requires at least two proteins, we obtained a variant of the nucleoprotein (NP49-375) in E. coli. After its purification by IMAC, the competence of the proteins NP49-375 and HACD as coating antigens in indirect ELISA assays were tested by using the sera of chickens immunized with the proteins HA and HACD and the reference sera from several avian influenza subtypes. Together with these sera, the sera from different species of birds and the sera of chickens infected with other avian viral diseases were analyzed by competition ELISA assays coated with the proteins NP49-375 and HACD. The results showed that the segment CD154 in the chimeric protein HACD did not interfere with the recognition of the molecule HA by its specific antibodies. Also, we observed variable detection levels when the reference sera were analyzed in the ELISA plates coated with the protein NP49-375. Moreover, only the antibodies of the reference serum subtype H5 were detected in the ELISA plates coated with the protein HACD. The competition ELISA assays showed percentages of inhibition of 88-91% for the positives sera and less than 20% for the negative sera. We fixed the cut-off value of these assays at 25%. No antibody detection was observed in the sera from different species of birds or the sera of chickens infected with other avian viral diseases. This study supported the fact that the ELISA assays using the proteins NP49-375 and HACD could be valuable tools for avian influenza surveillance and as a strategy of DIVA for counteracting the highly pathogenic avian influenza virus H5N1 outbreaks.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ruBQA
via IFTTT

Determination of cadmium, lead and mercury residual levels in meat of canned light tuna (Katsuwonus pelamis and Thunnus albacares) and fresh little tunny (Euthynnus alletteratus) in Libya

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
S.K. Abolghait, A.M. Garbaj.
Surveillance for mercury (Hg), lead (Pb) and cadmium (Cd) contamination in tuna products is crucial for consumer food safety. Hg, Pb and Cd contaminants were monitored in a total of 60 specimens of fresh little tunny (Euthynnus alletteratus) and popular brands of skipjack and yellowfin (Katsuwonus pelamis and Thunnus albacares) canned tuna commercially available in Tripoli, Libya. Direct Mercury Analyzer (DMA-80) was implemented for determination of total Hg level and graphite furnace atomic absorption spectrometry (GFAAS) was employed for determination of Cd and Pb concentrations. The results indicated that Hg had the highest concentration level and Cd had the lowest concentration level either in tested canned tuna or fresh little tunny samples. The average concentration of Hg in fresh little tunny samples was 1.185 ± 0.968 mg kg-1 wet weight (ww) and often exceeded the standard permissible limit. In addition, canned yellowfin tuna had the lowest levels of Cd (0.027 ± 0.026 mg kg-1 ww), Pb (0.075 ± 0.071) and Hg (0.163 ± 0.122 mg kg-1 ww). Results of the current surveillance indicated that canned skipjack and yellowfin tuna sold in Tripoli markets show contaminant levels well under the European thresholds adopted for Cd, Pb and Hg. However, consumption of large quantities of Mediterranean little tunny products significantly increases human exposure to the risk of Hg toxicity.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uECQS
via IFTTT

Pyloro-duodenal hernia with formation of enterocutaneous fistula in a buffalo calf following a dog attack

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
G. Kamalakar, V. Devi Prasad, J. Devaratnam, A.Ganeshan.
A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ruJ2J
via IFTTT

Detection of antibodies against Chlamydophila abortus in Costa Rican sheep flocks

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
R. Villagra-Blanco, G. Dolz, D. Montero-Caballero, J.J. Romero-Zúñiga.
A total of 359 sheep samples from 15 flocks were analyzed for the presence of antibodies against Chlamydophila abortus using a commercial Enzyme linked Immunosorbent Assay (ELISA). Antibodies were detected in 19 (5.29%) sheep from 12 (80%) flocks. Seropositive animals were found in all analyzed regions (Central, Chorotega, Atlantic Huetar, North Huetar and Central Pacific) determining prevalence between 0.28% and 4.4%, and intra-flock positivity between 3.7% and 25.0%. The survey revealed two risk factors associated with seropositivity; introducing animals (males and females), embryos, or semen from other farms or from abroad without any sanitary certification, and flocks not having quarantine areas or separated boxes for diseased animals. No clinical signs of disease were observed in positive seroreactors. C. abortus seems to be present in Costa Rica in a very low prevalence in sheep flocks. Further studies, to isolate the bacteria are required. Finally, implementation of control measures to prevent the spread of C. abortus is recommended.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uEDUC
via IFTTT

Intravenous lipid emulsion and dexmedetomidine for treatment of feline permethrin intoxication: a report from 4 cases

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
G. Ceccherini, F. Perondi, I. Lippi, G. Grazia, V. Marchetti.
Four cases of feline permethrin intoxication are described. The cause of intoxication is the application of canine permethrin spot-on product (Advantix®, Bayer) by the owners. Principal clinical guidelines recommends the use of anticonvulsant drugs to treat seizures or neurological symptoms after initial stabilization and dermal decontamination. The use of lipid emulsion had an increasing interest in the last decade for treatment of toxicosis caused by lipophylic drugs as reported in human and in veterinary medical practices. All cats presented in this study, were treated with intravenous lipid emulsion (ILE) at variable dosages, and dexmedetomidine was also administered by intravenous way. No adverse reaction such as thrombophlebitis, overload circulation or others was noticed during and after administration of ILE. Dexmedetomidine was proved to be helpful in tranquillizing the cats. All cats were discharged in good condition faster than other cases treated without their use.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ruFzJ
via IFTTT

Double filtration plasmapheresis in a dog with multiple myeloma and hyperviscosity syndrome

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
I. Lippi, F. Perondi, S.J. Ross, V. Marchetti, G. Lubas, G. Guidi.
A 12 year old, 38 kg, mix-breed, intact male dog presented with a 20 day history of clinical signs consistent with hyperviscosity syndrome secondary to multiple myeloma. The dog received three double filtration plasmapheresis treatments on day 0, 7 and 22 after presentation. A significant (p


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uEuAv
via IFTTT

Haemato-biochemical and endocrine profiling of north western Himalayan Gaddi sheep during various physiological/reproductive phases

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
A. Sharma, P. Kumar, M. Singh, N.K. Vasishta.
The study was aimed to provide baseline data regarding haemato-biochemical and endocrine profiling of Gaddi sheep found in north western Himalayan region of Himachal Pradesh, India. Each random sample was collected from 45 Gaddi sheep reared in government sheep breeding farm Tal, Hamirpur, India, during various reproductive phases viz. anestrus, breeding season and post partum period. Haematology revealed significantly higher (P


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ruAfB
via IFTTT

Growth performance and certain body measurements of ostrich chicks as affected by dietary protein levels during 2–9 weeks of age

2016-07-08T11-00-55Z
Source: Open Veterinary Journal
Kh.M. Mahrose, A.I. Attia, I.E. Ismail, D.E. Abou-Kassem, M.E. Abd El-Hack.
The present work was conducted to examine the effects of dietary crude protein (CP) levels (18, 21 and 24%) on growth performance (Initial and final body weight, daily body weight gain, feed consumption, feed conversion and protein efficiency ratio) during 2-9 weeks of age and certain body measurements (body height, tibiotarsus length and tibiotarsus girth) at 9 weeks of age. A total of 30 African Black unsexed ostrich chicks were used in the present study in simple randomized design. The results of the present work indicated that initial and final live body weight, body weight gain, feed consumption, feed conversion of ostrich chicks were insignificantly affected by dietary protein level used. Protein efficiency ratio was high in the group of chicks fed diet contained 18% CP. Results obtained indicated that tibiotarsus girth was decreased (P≤0.01) with the increasing dietary protein level, where the highest value of tibiotarsus girth (18.38 cm) was observed in chicks fed 18% dietary protein level. Body height and tibiotarsus length were not significantly different. In conclusion, the results of the present study indicate that ostrich chicks (during 2-9 weeks of age) could grow on diets contain lower levels of CP (18%).


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uEHnu
via IFTTT

Evidence That Bimanual Motor Timing Performance Is Not a Significant Factor in Developmental Stuttering

Purpose
Stuttering involves a breakdown in the speech motor system. We address whether stuttering in its early stage is specific to the speech motor system or whether its impact is observable across motor systems.
Method
As an extension of Olander, Smith, and Zelaznik (2010), we measured bimanual motor timing performance in 115 children: 70 children who stutter (CWS) and 45 children who do not stutter (CWNS). The children repeated the clapping task yearly for up to 5 years. We used a synchronization-continuation rhythmic timing paradigm. Two analyses were completed: a cross-sectional analysis of data from the children in the initial year of the study (ages 4;0 [years;months] to 5;11) compared clapping performance between CWS and CWNS. A second, multiyear analysis assessed clapping behavior across the ages 3;5–9;5 to examine any potential relationship between clapping performance and eventual persistence or recovery of stuttering.
Results
Preschool CWS were not different from CWNS on rates of clapping or variability in interclap interval. In addition, no relationship was found between bimanual motor timing performance and eventual persistence in or recovery from stuttering. The disparity between the present findings for preschoolers and those of Olander et al. (2010) most likely arises from the smaller sample size used in the earlier study.
Conclusion
From the current findings, on the basis of data from relatively large samples of stuttering and nonstuttering children tested over multiple years, we conclude that a bimanual motor timing deficit is not a core feature of early developmental stuttering.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29wyc2L
via IFTTT

What does the structure reveal about a colony collapse disorder-associated virus

Colony collapse disorder (CCD) has caused such a profound drop in honeybee populations that even the U.S. Congress is addressing the issue: Senator Jeff Merkley (D-Oregon) has proposed the Pollinator Recovery Act to preserve pollinator habitat. The rapid decline in these important pollinators af...

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29o61iz
via IFTTT

Implementation of Child Death Review in the Netherlands: results of a pilot study

Background: Child mortality in the Netherlands declined gradually in the past decades. In total 1130 children and youth aged 0 to 19 years died in 2014 (i.e. 29.4 per 100,000 live births). A better understanding of the background and the circumstances surrounding the death of children as well as the manner and cause of death may lead to preventive measures. Child Death Review (CDR) is a method to systematically analyze child deaths by a multidisciplinary team to identify avoidable factors that may have contributed to the death and to give directions for prevention. CDR could be an addition to further reduce avoidable child deaths in the Netherlands. The purpose of this study is to explore the strengths, weaknesses, opportunities and threats (SWOT) of the pilot-implementation of CDR in a Dutch region. The results are translated in recommendations for future implementation of the CDR method in the Netherlands. Methods: Children who lived in the pilot region and died aged 29 days after birth until 2 years were, after parental consent, included for reviewing by a regional CDR team. Eighteen logs and seven transcribed records of CDR meetings concerning 6 deceased children were analyzed using Atlas ti. The SWOT framework was used to identify important themes. Results: The most important strengths identified were the expertise of and cooperation within the CDR team and the available materials. An important weakness was the poor cooperation of some professional groups. The fact that parents and professionals endorse the objective of CDR was an important opportunity. The lack of statutory basis was a threat. Conclusions: Many obstacles need to be taken away before large-scale implementation of CDR in the Netherlands becomes possible. The most important precondition for implementation is the acceptance among professionals and the statutory basis of the CDR method.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29nqy7i
via IFTTT

A descriptive study of the participation of children and adolescents in activities outside school

Background: Knowledge about patterns of participation can be used to highlight groups of children and adolescents with low attendance, or low involvement in activities and who may therefore be at risk of mental or physical health concerns. This study used the Children's Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activity of Children (PAC) to describe the patterns of participation of children and adolescents in activities outside mandated school in Victoria, Australia. Methods: A cross-sectional survey of Victorian children and adolescents was conducted. Eligible participants were aged 6 to 18 years, enrolled in mainstream schools, with sufficient English language skills to complete the questionnaires. Parents of participants completed a demographic questionnaire. Sample representativeness was assessed against Victorian population statistics for gender, school type, language spoken at home and socio-economic status. Data for the CAPE and PAC were summarised using descriptive statistics. Patterns of activity diversity by age were assessed using curve estimation, with additional analyses to describe differences between genders. Results: Of 9337 potential participants targeted through school advertising, 512 agreed (5.5 % consent rate), and 422 questionnaires were returned (82.4 % response rate). The sample was representative in terms of gender and language. Compared to the Victorian population, a slightly higher proportion of participants attended Government and Catholic schools and there was evidence of marginally greater socioeconomic resources than the population average.A broad range of recreational, active physical, social, skill-based and self-improvement activities were completed by all age groups. There was a reduction in the number and enjoyment of recreational activities with increasing age. In contrast, there was relative stability in intensity, frequency and preference scores across the age-groups for all activity types. Female participants typically took part in more activities (higher diversity scores), more intensely, with higher enjoyment and had higher preferences for each activity type than males, with the exception of active physical activities. Conclusions: This study provides evidence of the participation patterns of typically developing children and adolescents in activities outside school. The findings have implications for researchers, clinicians and educators for comparative purposes and to inform future research.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29AvUQp
via IFTTT

Novel compound heterozygous mutations in CNGA1in a Chinese family affected with autosomal recessive retinitis pigmentosa by targeted sequencing

Background: About 37 genes have been reported to be involved in autosomal recessive retinitis pigmentosa, a hereditary retinal disease. However, causative genes remain unclear in a lot of cases. Methods: Two sibs of a Chinese family with ocular disease were diagnosed in Eye and ENT Hospital of Fudan University. Targeted sequencing performed on proband to screen pathogenic mutations. PCR combined Sanger sequencing then performed on eight family members including two affected and six unaffected individuals to determine whether mutations cosegregate with disease. Results: Two affected members exhibited clinical features that fit the criteria of autosomal recessive retinitis pigmentosa. Two heterozygous mutations (NM000087, p.Y82X and p.L89fs) in CNGA1 were revealed on proband. Affected members were compound heterozygotes for the two mutations whereas unaffected members either had no mutation or were heterozygote carriers for only one of the two mutations. That is, these mutations cosegregate with autosomal recessive retinitis pigmentosa. Conclusions: Compound heterozygous mutations (NM000087, p.Y82X and p.L89fs) in exon 6 of CNGA1are pathogenic mutations in this Chinese family. Of which, p.Y82X is firstly reported in patient with autosomal recessive retinitis pigmentosa.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29nqcxt
via IFTTT

Census tract based income level and lipid levels in urban pediatric primary care: a retrospective study

Background: Lower socioeconomic status has been associated with adverse lipid levels in adult populations. Childhood dyslipidemia is a risk factor for future cardiovascular disease. However, studies examining relationships between socioeconomic indicators and lipid levels in children are limited. To examine the relationship between income level and lipid levels in childhood. Methods: We conducted a retrospective chart review of primary care patients, ages 2 to 18 years, who had lipid levels drawn at two large pediatric practices in Boston, MA between August 01, 2008 and August 31, 2010. Income level was determined using geocoding census tract data. Analysis was performed using t-test, Anova and Spearman correlation coefficients. BMI percentile, age, sex, race/ethnicity, and site were adjusted for on multivariate analyses. Results: Reviewing 930 charts of patients with measured lipid levels, 730 had a valid address, no previously diagnosed lipid disorder and met other study eligibility criteria. Mean total cholesterol level did not vary by income level (low 155.5 mg/dl ±26.9, moderate 153.5 mg/dl ±30.4, middle 155.3 mg/dl ±26.6 and high income 155.5 mg/dl ±27.9; p = .87) on multivariate analysis. Income level was not related to LDL, HDL, or triglycerides. Conclusions: In this analysis of children cared for in two urban pediatric primary practices, there was no association between income level determined by census tract and lipid levels in childhood. If confirmed in prospective investigations in other geographical locations, income level may not be a key driver of childhood lipid levels.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29AvXf9
via IFTTT

Enhancement of the Initial Growth Rate of Agricultural Plants by Using Static Magnetic Fields

53967fig1.jpg

The goal of this protocol is to demonstrate the acceleration of the initial growth rate of plants by applying static magnetic fields with no external energy.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29ArNCm
via IFTTT

On the use of geometric and harmonic means with the generalized cross-correlation in the time domain to improve noise source maps

Microphone array techniques are an efficient tool to detect acoustic source positions. The delay and sum beamforming is the standard method. In the time domain, the generalized cross-correlation can be used to compute the noise source map. This technique is based on the arithmetic mean of the spatial likelihood functions. In this study, the classical arithmetic mean is replaced by the more standard generalized mean. The noise source maps provide by the arithmetic, geometric and harmonic means are compared in the case of numerical and experimental data obtained in a reverberant room. The geometric and harmonic means provide the best noise source maps with no side lobes and a better source level estimation.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29sKaKs
via IFTTT

Rapid auditory learning of temporal gap detection

The rapid initial phase of training-induced improvement has been shown to reflect a genuine sensory change in perception. Several features of early and rapid learning, such as generalization and stability, remain to be characterized. The present study demonstrated that learning effects from brief training on a temporal gap detection task using spectrally similar narrowband noise markers defining the gap (within-channel task), transfer across ears, however, not across spectrally dissimilar markers (between-channel task). The learning effects associated with brief training on a gap detection task were found to be stable for at least a day. These initial findings have significant implications for characterizing early and rapid learning effects.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29VfAr8
via IFTTT

Joint inversion for transponder localization and sound-speed profile temporal variation in high-precision acoustic surveys

This letter develops a Bayesian inversion for localizing underwater acoustic transponders using a surface ship which compensates for sound-speed profile (SSP) temporal variation during the survey. The method is based on dividing observed acoustic travel-time data into time segments and including depth-independent SSP variations for each segment as additional unknown parameters to approximate the SSP temporal variation. SSP variations are estimated jointly with transponder locations, rather than calculated separately as in existing two-step inversions. Simulation and sea-trial results show this localization/SSP joint inversion performs better than two-step inversion in terms of localization accuracy, agreement with measured SSP variations, and computational efficiency.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29sL2OQ
via IFTTT

Correction method for averaging slowly time-variant room impulse response measurements

Various methods exist for room acoustic measurements. To increase the signal-to-noise-ratio (SNR), averaging of repeated room impulse responses (RIR) can be performed under the assumption of time-invariant systems. Associated with a study of the Paris Notre Dame cathedral, time-variances due to minute temperature changes were observed which confounded results of averaged RIRs, producing significantly shorter reverberation times. A correction method for such time-variance of the acoustic system is proposed, based on time-stretching. Following correction, reverberation times of averaged RIRs were comparable to expected tolerance ranges for measurements, well within one just noticeable difference, while also exhibiting a mid-frequency SNR gain of 8 dB.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29VfEan
via IFTTT

Early detection of Haemonchus contortus infection in sheep using three different faecal occult blood tests

2016-07-08T10-30-17Z
Source: Open Veterinary Journal
A.V. Rodríguez, V. Goldberg, H. Viotti, G. Ciappesoni.
Haemonchus contortus is a blood-sucking parasite causing the presence of faecal occult blood (FOB). The objective was to study three different FOB tests in order to have a new indicator of H. contortus infection in sheep that could be included in the genetic evaluation system as an alternative selection criterion to faecal worm egg count (FEC). A total of 29 Corriedale lambs were experimentally infected with 10.000 larvae of H. contortus. Stool samples were recorded for FEC and FOB tests (Hexagon, Hematest® and Multistix®), blood for packed cell volume (PCV), haemoglobin, white and red blood cell count (RBC), and FAMACHA© for scoring anaemia. At the end of the experiment lambs were slaughtered to worm burden count. Field infection was achieved in 309 Merino lambs under natural parasite challenge. FEC data were normalized through logarithmic transformation (LnFEC). Pearson correlation was estimated to examine the relationship between all traits. The three tests were able to detect the presence of FOB at day 11. FEC, PCV and RBC decreased to sub-normal values from day 18. FAMACHA© score 3 was considered to be indicative of anaemia. Most of the correlations were of high magnitude, with the exception of Multistix® test that was moderately correlated with haematological parameters, LnFEC and FEC. In field infection, most samples were negative to FOB tests and the correlations were lower than those calculated under experimental infection. In conclusion, FOB tests were able to detect haemonchosis earlier than FEC under high experimental parasite challenge. However, they were not able to detect FOB under natural mixed parasite challenge. FAMACHA© and PCV demonstrated to be good indicators of Haemonchosis, having moderate to high correlations with FEC.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29noHjb
via IFTTT

The effects of topical nasal steroids on continuous positive airway pressure compliance in patients with obstructive sleep apnea: a systematic review and meta-analysis

Abstract

Objectives

The purpose of the study was to conduct a systematic review and meta-analysis in patients with obstructive sleep apnea (OSA), evaluating effects of topical nasal steroids on continuous positive airway pressure (CPAP) machine use and nasal symptoms.

Search methods

Data source: A comprehensive search of Pubmed, Scopus, Web of Science, and the Cochrane Library was performed through April 2016. Manual searches and subject matter expert input were also obtained. Studies assessing effects of nasal steroids on CPAP machine use in adults, which reported quantitative outcome data of CPAP compliance, were included.

Results

Two studies (144 patients) met inclusion criteria. Both were randomized, placebo-controlled clinical trials (RCT). Pooled fixed effects analysis did not identify a statistically significant difference between both the groups for average duration of CPAP machine use per night. But there was an overall increase in the usage of 0.4 h (95 % confidence interval (CI) (−0.20, 1.00); P = 0.19) in favor of nasal steroids. Difference of percentage of nights with CPAP use was not demonstrated (mean difference 0.06, 95 % CI (−0.27, 0.39); P = 0.71). There was also no significant difference in nasal symptoms (mean difference 0.63, 95 % CI (−0.11, 1.36), P = 0.1).

Conclusion

Nasal steroids showed benefits on CPAP use, but did not reach statistical significance. Data was based on meta-analysis of RCTs of 4-week follow-up in unselected OSA patients. Future controlled studies with selected group and longer follow-up duration are needed to confirm the benefits of nasal steroid on CPAP compliance in OSA patients.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29wtSjV
via IFTTT

Amphotericin B Associated Pulmonary Complications in Chronic Granulomatous Disease Patients

cover.gif?v=1&s=2f48734538e656187f3fe89d



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29CcfBh
via IFTTT

Awareness of intramuscular capillary type hemangioma in the differential diagnosis of soft-tissue tumors in children



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29E1T0P
via IFTTT

Reply to: Vitamin insufficiencies/deficiencies in relation to sickle cell disease severity and associated morbidity



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29Cc0X7
via IFTTT

Facial manifestations of Epstein–Barr virus-related lymphoproliferative disease in childhood acute lymphoblastic leukemia in remission: Two atypical presentations

Abstract

Epstein–Barr virus-related lymphoproliferative disease (EBV-LPD) rarely occurs in patients with acute lymphoblastic leukemia (ALL), who have not received hematopoietic transplantation. We describe EBV-LPD manifesting as facial lesions in two children with ALL in remission. One patient was a 16-year-old male with T-cell ALL with an EBV-positive angiocentric polymorphous lip lesion presenting as right-sided facial swelling. The other patient was a 12-year-old male with B-cell ALL with an EBV-positive polymorphous lymphoplasmacytic infiltrate presenting as bilateral dacryoadenitis. Neither patient had known primary immunodeficiencies. Both cases improved with immunosuppressant de-escalation. These cases suggest that immunosuppression induced by maintenance chemotherapy is sufficient to promote EBV-LPD.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29E2e3N
via IFTTT

Genome-wide miRNA profiling of Oral Lichenoid Disorders and Oral Squamous Cell Carcinoma

Abstract

Objective

Dissect the aberrant microRNA profile of oral lichenoid disorders (OLD) by analyzing the larger set of OLD samples tested so far.

Materials and methods

MicroRNA expression profiles were assessed using TLDA card in 32 samples (16 OLD, 8 OSCC and 8 control). The findings were validated using RT-qPCR in an independent cohort of 91 samples.

Results

We identified 20 differentially expressed microRNAs in OLD of which several are functionally related to cell proliferation, response to organic substances or immune processes. Further validation of the top ranked microRNAs, revealed that they were all aberrantly expressed in OLD.

Conclusion

We have identified a new microRNA signature associated with OLD that may provide a meaningful basis for better understanding the physiopathology of the disease. In addition, we validated seven microRNAs whose expression showed to be higher in OLD tissue in comparison with the controls and OSCC tissues.

This article is protected by copyright. All rights reserved.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29saEya
via IFTTT

Microfluidic Device to Test Electric Fields on Cancer Cells

electric-field-cancer-cells

At the post-grad research collaboration called Singapore-MIT Alliance for Research and Technology (SMART), a team has developed a microfluidic device for testing how electric fields influence living cells. The main goal for the technology is to identify the nature of the electric fields that best disrupt the activity of cancer cells, the growth and multiplication of which has been shown in the past to be influenced by external electric fields. Potentially, there's a chance that electrodes could be used in the future to simply stop and even kill cancer cells completely from outside the body, but more realistically in a minimally invasive fashion.

For now there's a lot of work to be done to test different kinds of cells under different electric field strengths and frequencies, and there's already some results the team has obtained.

Some details from MIT:

The researchers fabricated the device from PDMS, a widely used, gel-like polymer, and patterned small channels across the device. They then developed a conductive mixture made from micron-sized silver flakes and PDMS, which they cured, then injected into two channels in the device to form two tiny, separate electrodes. In the region between the electrodes, they injected hydrogels with breast or lung cancer cells as well as small tumor masses. The researchers also injected healthy human endothelial cells. The hydrogels created a three-dimensional matrix to mimic the extracellular environment.

The team subjected each cell type in the 3-D matrix to alternating electric fields at frequencies of 150 or 200 kilohertz, continuously, at an intensity of 1.1 volts per centimeter.

In the absence of an electric field, [research scientist Andrea] Pavesi says the cancer cells begin to proliferate and spread within two days. However, he and [research scientists Giulia] Adriani observed a significant slowdown in tumor progression after three days of continuous electric field stimulation: Proliferation was markedly reduced, while small masses of lung cancer cells did not disperse indicating an inhibition of their metastatic potential. What's more, healthy endothelial cells in the same device were left unaffected. The researchers hypothesize that healthy cells may require different frequencies to be influenced by an electric field, as their size and electrical properties are far different from that of cancer cells.

Study in journal Scientific Reports: Controlled electromechanical cell stimulation on-a-chip…

MIT's news office: New microfluidic device offers means for studying electric field cancer therapy…

This post Microfluidic Device to Test Electric Fields on Cancer Cells appeared first on Medgadget.

Medgadget?d=yIl2AUoC8zA Medgadget?d=qj6IDK7rITs Medgadget?i=U2Sw3NHOeqQ:uNqxa6qGcVs:gIN9


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29GYdxT
via IFTTT

Individual differences in the time course of reward processing: Stage-specific links with depression and impulsivity

S03010511.gif

Publication date: Available online 7 July 2016
Source:Biological Psychology
Author(s): Brittni K. Novak, Keisha D. Novak, Donald R. Lynam, Dan Foti
Reward dysfunction has been implicated in a wide range of psychological disorders, including internalizing and externalizing psychopathology. Basic neuroscience research has shown that reward is a multistage process, yet it is unclear how specific stages relate to individual differences in reward sensitivity. The current study utilized event-related potentials elicited during a monetary incentive task to parse sub-stages within anticipatory and consummatory reward processing. Effects of depressive symptoms and trait impulsivity were examined at each sub-stage (N=92). Reward anticipation modulated neural activity across three sub-stages: cue detection (cue-P3), approach behavior (contingent negative variation, CNV), and outcome anticipation (stimulus preceding negativity). Reward delivery modulated activity across two sub-stages: initial evaluation (reward positivity, RewP), and allocation of attention (feedback-P3). Sensation seeking predicted faster reaction times, as well as cue-P3 and RewP amplitudes. Depression and lack of premeditation interacted to predict CNV and RewP amplitudes. Results demonstrate that individual differences in reward functioning are stage-specific.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uxzrb
via IFTTT

Expectancy Influences on Attention to Threat Are Only Weak and Transient: Behavioral and Physiological Evidence

S03010511.gif

Publication date: Available online 7 July 2016
Source:Biological Psychology
Author(s): Tatjana Aue, Léa A.S. Chauvigné, Mirko Bristle, Hadas Okon-Singer, Raphaël Guex
Can prior expectancies shape attention to threat? To answer this question, we manipulated the expectancies of spider phobics and nonfearful controls regarding the appearance of spider and bird targets in a visual search task. We observed robust evidence for expectancy influences on attention to birds, reflected in error rates, reaction times, pupil diameter, and heart rate (HR). We found no solid effect, however, of the same expectancies on attention to spiders; only HR revealed a weak and transient impact of prior expectancies on the orientation of attention to threat. Moreover, these asymmetric effects for spiders versus birds were observed in both phobics and controls. Our results are thus consistent with the notion of a threat detection mechanism that is only partially permeable to current expectancies, thereby increasing chances of survival in situations that are mistakenly perceived as safe.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29rnTKm
via IFTTT

Temperament differentially influences early information processing in men and women: Preliminary electrophysiological evidence of attentional biases in healthy individuals

S03010511.gif

Publication date: Available online 7 July 2016
Source:Biological Psychology
Author(s): Nina M. Pintzinger, Daniela M. Pfabigan, Lorenz Pfau, Ilse Kryspin-Exner, Claus Lamm
Preferential processing of threat-related information is a robust finding in anxiety disorders. The observation that attentional biases are also present in healthy individuals suggests factors other than clinical symptoms to play a role. Using a dot-probe paradigm while event-related potentials were recorded in 59 healthy adults, we investigated whether temperament and gender, both related to individual variation in anxiety levels, influence attentional processing. All participants showed protective attentional biases in terms of enhanced attention engagement with positive information, indexed by larger N1 amplitudes in positive compared to negative conditions. Taking gender differences into account, we observed that women showed enhanced attention engagement with negative compared to neutral information, indicated by larger P2 amplitudes in congruent than in incongruent negative conditions. Attentional processing was influenced by the temperament traits negative affect and effortful control. Our results emphasize that gender and temperament modulate attentional biases in healthy adults.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29uxe7Z
via IFTTT

Rapid Response: Paramedic preparation, response to police shot at mass gatherings

What happened: Snipers shot and killed five Dallas police officers. Seven police officers and two bystanders were also shot and injured during a protest of officer-involved shootings in Minnesota and Louisiana earlier this week.

Why it's significant: This is the most deadly law enforcement incident since Sept. 11, 2001. Police officers are public safety brothers and sisters to EMTs and paramedics. They respond with us, call us for help and more than ever they begin medical care — AED use, naloxone administration and tourniquet application — before we arrive.

Top takeaways: This loss of life is heartbreaking and tragic. As we mourn their deaths, worry about the injured officers and try to understand the cowardice of the shooters, we also need to consider our own preparation for responding to incidents at protests, as well as our day-to-day responses to civilians in need of medical care.

1. Mourn and honor the dead
Take a moment, privately or with your colleagues, to pray or think about the loss of life in Dallas. Internalization or the impact of the stress from an event like this is unique to each of us. How you mourn, pay tribute and manage stress from the event is also unique. Manage stress in a way that helps you move forward as a paramedic, partner, parent or spouse.

2. Be conspicuous at all times
In too many response areas, paramedics in blue or black uniforms are indistinguishable from police officers. Be conspicuous in your uniform selection, donning of high-visibility outerwear and parking the ambulance.

As you enter a scene, especially a building, call out regularly, "paramedics coming in" or "paramedics, here to help." Or use some phrase that announces your presence as a caregiver. Repeat throughout the incident, especially if a crowd is gathering, that you are a paramedic and are there to help.

When posting in the ambulance, at protests or as part of normal operations, consider locations that offer cover or concealment. Or pick high-visibility locations.

Regardless of the location, at least one member of the crew has to have their head up, not buried in a smartphone, and their eyes open, scanning their surroundings. Agencies with a predictable posting routine — schedule and locations — need to add variability and randomness to the posting pattern.

3. Be cautious and calm
More and more agencies are making the decision to equip paramedics with body armor. This is a reasonable precaution for every response and especially important when responding to or staging at mass gatherings that are or may become violent.

If your agency is considering an EMS body armor purchase, be thoughtful to the color and lettering. Red, green or light blue with bold 'EMS' or 'PARAMEDIC' distinguishes personnel as caregivers and not combatants.

If you are staging at a protest, be aware that as the crowd moves, grows or disperses the ingress and egress routes for ambulances change. Be situationally aware of the options to drive right, left, forward or backwards.

Don't match the emotional intensity of the crowd or the police officers. Yelling, "Calm the f…' down," never works and your surging adrenaline narrows your field of vision and perception of risks in a volatile environment.

4. Constantly remind the public that medics are the helpers
Every day is an opportunity to remind the public through face-to-face interactions, social network postings and media appearances that paramedics are the helpers. When anyone, civilian or police officer, is sick or injured we will respond, assess and treat with all of the skills and resources we have.

Learn more about mass gatherings and EMS safety. And share your top takeaways in the comments for EMS response to violence at protests and mass gatherings.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29GKVSd
via IFTTT

Inside EMS Special Podcast: How to prepare for and respond to violence at protests

Download this podcast on iTunes, SoundCloud or via RSS feed

In this special episode of the Inside EMS podcast host Chris Cebollero and EMS1 Editor-in-Chief Greg Friese discuss the shooting deaths of five Dallas police officers during a protest Thursday night. Cebollero describes the lessons, success and mistakes he made as the Christian Hospital EMS chief during the violence and riots in Ferguson, Missouri. Cebollero makes important points about force protection, staging of ambulances and personnel, awareness of ingress and egress routes, stress management, utilizing unified command, and regularly briefing personnel.

Listen to the show and share your comments and resources for EMS operations at mass gatherings that turn violent in the comments.

Additional reading and resources



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29sBt2o
via IFTTT

Subtypes of mild cognitive impairment in patients with Parkinson's disease: evidence from the LANDSCAPE study

Objective

Inconsistent results exist regarding the cognitive profile in patients with Parkinson's disease with mild cognitive impairment (PD-MCI). We aimed at providing data on this topic from a large cohort of patients with PD-MCI.

Methods

Sociodemographic, clinical and neuropsychological baseline data from patients with PD-MCI recruited in the multicentre, prospective, observational DEMPARK/LANDSCAPE study were analysed.

Results

269 patients with PD-MCI (age 67.8±7.4, Unified Parkinson's Disease Rating Scale (UPDRS-III) scores 23.2±11.6) were included. PD-MCI subtypes were 39.4% non-amnestic single domain, 30.5% amnestic multiple domain, 23.4% non-amnestic multiple domain and 6.7% amnestic single domain. Executive functions were most frequently impaired. The most sensitive tests to detect cognitive dysfunctions were the Modified Card Sorting Test, digit span backwards and word list learning direct recall. Multiple stepwise regression analyses showed that global cognition, gender and age, but not education or disease-related parameters predicted PD-MCI subtypes.

Conclusions

This study with the so far largest number of prospectively recruited patients with PD-MCI indicates that non-amnestic PD-MCI is more frequent than amnestic PD-MCI; executive dysfunctions are the most typical cognitive symptom in PD-MCI; and age, gender and global cognition predict the PD-MCI subtype. Longitudinal data are needed to test the hypothesis that patients with PD-MCI with specific cognitive profiles have different risks to develop dementia.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29s5ang
via IFTTT

Thoracic aortic dissection and heritability: forensic implications



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29sLKf1
via IFTTT

Diagnosestellung und Therapie des Restless-Legs-Syndroms

Zusammenfassung

Das Restless-Legs-Syndrom (RLS), auch als Willis-Ekbom-Erkrankung bezeichnet, ist mit einer Prävalenz zwischen 1 und 10 % eine häufige schlafbezogene neurologische Erkrankung, die im Alter zunimmt. Kernsymptome sind Bewegungsdrang der Beine, Parästhesien, Verstärkung der Beschwerden in Ruhe, Besserung durch Bewegung und eine Zunahme der Symptome abends oder nachts. Schlafstörungen sind dabei häufig. Oft liegt eine positive Familienanamnese bei der idiopathischen Form vor. Begleiterkrankungen oder Auslöser können Eisenmangel, terminale Niereninsuffizienz, Schwangerschaft, Polyneuropathie oder Psychopharmaka sein. Bei unbekannter Ätiologie scheinen genetische Vulnerabilität, dysfunktionale dopaminerge Neurotransmission und Veränderungen des zentralen Eisenstoffwechsels pathophysiologisch wichtig zu sein. Neben nichtmedikamentösen Maßnahmen kommen L‑Dopa, Dopaminagonisten, Opioide oder Antikonvulsiva zur Anwendung. Beim sekundären bzw. komorbiden RLS ist die Behandlung der Grunderkrankung vorrangig.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29mK8oQ
via IFTTT

Decreasing procedure times with a standardized approach to ELVO cases

Background

Embolectomy is the standard of care for emergent large vessel occlusion (ELVO), and needs to be done as quickly as possible for the best possible outcomes. Optimization of workflow and process is certainly paramount. One aspect of this is process improvement to standardize as much as possible the procedure in order to decrease variability among operators, which breeds familiarity for the entire team.

Objective

To evaluate the impact of a standardized approach to ELVO cases in decreasing times from groin puncture to first deployment of a stent-retriever and final recanalization.

Methods

A retrospective review of 83 consecutive patients consisting of a pre-standardization phase (group 1) and those after standardization (group 2). The standardization process involved all three neurointerventional radiologists agreeing on a standard approach to the cases and to the equipment to be used. Times from groin puncture to first deployment of the stent-retriever and from puncture to final reperfusion were evaluated. Angiographic outcomes were scored using the Modified Thrombolysis in Cerebral Ischemia (mTICI) score. Complications from intracranial catheter manipulation (such as wire perforation) were also recorded. Clinical outcomes were assessed based on admission and discharge National Institute of Health Stroke Scale score.

Results

There were 22 patients in group 1 and 61 patients in group 2. Mean times from groin puncture to first deployment were 39.8 min in group 1 and 20 min in group 2, a difference which was statistically significant (p<0.0001). Overall times from puncture to final recanalization were reduced from 68.2 to 37 min, also a statistically significant difference (p<0.001). There were no cases of intraprocedural complications such as wire perforation or subarachnoid hemorrhage.

Conclusions

A standardized approach to the equipment used and process for ELVO cases at a single institution can dramatically reduce procedure times.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29wnlG6
via IFTTT

Long term durability and outcomes of carotid stenting and carotid endarterectomy

Purpose

To evaluate the long term durability and outcomes of carotid angioplasty and stenting (CAS) compared with carotid endarterectomy (CEA).

Methods

Using multiple comprehensive databases, we searched for randomized controlled trials comparing CAS with CEA for carotid stenosis. Studies were classified according to symptom status: symptomatic, asymptomatic, or all inclusive stenosis. Postprocedural ipsilateral stroke, restenosis/occlusion after revascularization, procedural stroke/death/myocardial infarction (MI), and postprocedural ipsilateral stroke were evaluated. Subgroup analysis was performed according to follow-up duration.

Results

22 studies were included and classified for meta-analyses in relation to specific outcomes. The maximum follow-up duration was 10 years. The risk of postprocedural ipsilateral stroke in CEA was equivalent to that in CAS, irrespective of symptom status or follow-up time points. The CAS group had a greater risk of restenosis/occlusion after revascularization compared with CEA in studies of all inclusive stenosis. A similar tendency was found in studies of symptomatic stenosis, but without statistical significance. However, subgroup analysis showed that the risk of restenosis/occlusion in CAS decreased gradually with time, to the extent that these risks became comparable 1 year after the procedure. Procedural stroke/death/MI and postprocedural ipsilateral stroke occurred more frequently in the CAS group in studies of symptomatic stenosis although not in studies of asymptomatic or all inclusive stenosis. However, this association did not persist when studies were divided according to follow-up time points.

Conclusions

Although CAS may be more strongly associated with periprocedural stroke/death compared with CEA, it could be a good alternative to CEA in terms of long term durability and outcomes.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29obCWc
via IFTTT

Image Cross-Correlation Analysis of Time Varying Flows

TOC Graphic

Analytical Chemistry
DOI: 10.1021/acs.analchem.6b01143
ancham?d=yIl2AUoC8zA


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29nJ4NO
via IFTTT

Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral center

Abstract

Rationale

The European Position Paper on Sinusitis (EPOS) guidelines provide composite criteria to evaluate chronic rhinosinusitis (CRS) control, taking into consideration the severity of patients' symptoms, aspect of nasal mucosa and medical intake as parameters of chronic rhinosinusitis (CRS) control.

Objectives

To study the degree of CRS control using novel EPOS control criteria at 3-5 years after a functional endoscopic sinus surgery (FESS), and correlate these data to symptoms scores.

Methods

Adult CRS patients (n=560) who had undergone bilateral FESS for chronic inflammatory sinonasal disease 3-5 years prior to the study were included. Patients received a postal questionnaire asking for control items according to EPOS control criteria, Visual Analogue Scale (VAS) scores for total and individual sinonasal symptoms, Sino-Nasal Outcome Test (SNOT)-22, Short Form (SF)-36 questionnaires.

Measurements and main results

19.5% of CRS patients were well controlled, with 36.8% of patients being partly controlled and 43.7% uncontrolled. The levels of control corresponded to mean total VAS, SNOT-22 and SF-36 scores. Subgroup analysis revealed that female gender, aspirin intolerance and revision FESS were associated with higher prevalence of uncontrolled CRS, whereas allergy, asthma and smoking status did not alter the percentage of patients in each category of control. In 81 patients attending the outpatient clinic, nasal endoscopy changed classification in only 4 patients (4.9%).

Conclusions

Based on the novel EPOS control criteria, at least 40% of CRS patients are uncontrolled at 3-5 years after FESS. Therefore, better treatment strategies leading to higher disease control are warranted in CRS care.

This article is protected by copyright. All rights reserved.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29tjNmd
via IFTTT

Atopic dermatitis, atopic eczema or eczema? A systematic review, meta-analysis and recommendation for uniform use of “atopic dermatitis”

Abstract

Background

The lack of standardized nomenclature for atopic dermatitis (AD) creates unnecessary confusion for patients, health care providers and researchers. It also negatively impacts accurate communication of research in the scientific literature. We sought to determine the most commonly used terms for AD.

Methods

A systematic review of the MEDLINE, EMBASE and LILACS (1945-2016) for the terms AD, atopic eczema (AE) and multiple other eczematous disorders.

Results

In MEDLINE, 33,060 were identified, of which 21,299 (64.4%) publications used the term "AD", 15,510 (46.9%) "eczema" and only 2,471 (7.5%) AE. Most of these publications used the term AD (82.0%) or eczema (70.8%) without additional nomenclature; only 1.2% used AE alone. Few publications used the terminology "childhood eczema", "flexural eczema", "infantile eczema", "atopic neurodermatitis" or "Besnier's prurigo" AD was rarely used until the late 1970s, after which it became the most commonly used of the 3 terms and continuously increased until 2015. AE decreased between 2008 and 2015. AD was the most commonly used term in studies across almost all publication types, languages, and journals.

Conclusion

AD is the most commonly used term, and appears to be increasing in popularity. Given that eczema is a nonspecific term that describes the morphological appearance of several forms of dermatitis, we strongly suggest the use of a more specific term, atopic dermatitis, in publications, health care clinician training, and patient education. Support from researchers, reviewers and editors is key to success.

This article is protected by copyright. All rights reserved.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29s3Alp
via IFTTT

Airway Microbiota and the Implications of Dysbiosis in Asthma

Abstract

The mucosal surfaces of the human body are typically colonized by polymicrobial communities seeded in infancy and are continuously shaped by environmental exposures. These communities interact with the mucosal immune system to maintain homeostasis in health, but perturbations in their composition and function are associated with lower airway diseases, including asthma, a developmental and heterogeneous chronic disease with various degrees and types of airway inflammation. This review will summarize recent studies examining airway microbiota dysbioses associated with asthma and their relationship with the pathophysiology of this disease.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29GNfbT
via IFTTT

Eosinophil ETosis and DNA Traps: a New Look at Eosinophilic Inflammation

Abstract

The traditional paradigm of eosinophils as end-stage damaging cells has mainly relied on their release of cytotoxic proteins. Cytokine-induced cell survival and secretion of granular contents from tissue-dwelling eosinophil are thought to be important mechanisms for eosinophilic inflammatory disorders, although the occurrence of cytolysis and its products (i.e., free extracellular granules) has been observed in affected lesions. Recent evidence indicates that activated eosinophils can exhibit a non-apoptotic cell death pathway, namely extracellular trap cell death (ETosis) that mediates the eosinophil cytolytic degranulation. Here, we discuss the current concept of eosinophil ETosis which provides a new look at eosinophilic inflammation. Lessons from eosinophilic chronic rhinosinusitis revealed that ETosis-derived DNA traps, composed of stable web-like chromatin, contribute to the properties of highly viscous eosinophilic mucin and impairments in its clearance. Intact granules entrapped in DNA traps are causing long-lasting inflammation but also might have immunoregulatory roles. Eosinophils possess a way to have post-postmortem impacts on innate immunity, local immune response, sterile inflammation, and tissue damage.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29AcmtP
via IFTTT

What Ancestry Can Tell Us About the Genetic Origins of Inter-Ethnic Differences in Asthma Expression

Abstract

Differences in asthma prevalence have been described across different populations, suggesting that genetic ancestry can play an important role in this disease. In fact, several studies have demonstrated an association between African ancestry with increased asthma susceptibility and severity, higher immunoglobulin E levels, and lower lung function. In contrast, Native American ancestry has been shown to have a protective role for this disease. Genome-wide association studies have allowed the identification of population-specific genetic variants with varying allele frequency among populations. Additionally, the correlation of genetic ancestry at the chromosomal level with asthma and related traits by means of admixture mapping has revealed regions of the genome where ancestry is correlated with the disease. In this review, we discuss the evidence supporting the association of genetic ancestry with asthma susceptibility and asthma-related traits, and highlight the regions of the genome harboring ancestry-specific genetic risk factors.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29GNrb4
via IFTTT

A rare case of urinary bladder endometriosis along with ureteric and ureterovesical junction involvement following cesarean section

2016-07-08T09-25-03Z
Source: Case Study and Case Report
Kalpana Singh, Geetam Bharti, Vijoy Kumar, Anshul Garg, Abhay Kumar, Pranay Kumar.
Urinary tract endometriosis is a rare condition involving 1% of woman having pelvic endometriosis with predominantly urinary bladder involvement (84%). We report a case of urinary bladder endometriosis presenting as a polypoidal tumor in the left posterolateral wall of the urinary bladder base and left ureteo-vesical junction and left lower ureter. A 25 year old woman with history of two LSCS, presented with chief complaints of severe dysuria, burning micturition, suprapubic pain and left sided flank pain. In Ultrasound and CT Urography there was severe hydronephrosis of left kidney with marked cortical thinning and approx 10×17 mm soft tissue density mass near left uretrovesical junction causing obstruction to left uretric opening leading to left uretric dilatation. Cystoscopy showed 0.3x0.5 cm polypoidal, reddish blue coloured lesion around area of left uretric opening. Transurethral resection of polypoidal lesion was done and HPE showed features of papillary cystitis. Follow up shows recurrence of the mass at same place with mildly asymmetric mural thickening of the posterolateral wall of bladder base and VUJ with grossly hydronephrotic left kidney showing parenchymal thinning and delayed and reduced excretion of contrast in collecting system in CT urography. Exploration followed by complete excision of the mass from the left lower ureter and urinary bladder with left ureteroneocystostomy was done.Histopathological examination of excised mass was suggestive of endometriosis. Subsequently she was put on hormonal therapy on which she is doing well. Clinicians should suspect urinary tract endometriosis in woman in reproductive age group, presenting with urinary symptoms, especially following Cesarean section.Thorough history, physical examination, and imaging can potentially help in the diagnosis. Main goals of the treatment should be preservation of renal function, relief of obstruction and prevention of recurrence.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29wmu82
via IFTTT

Incorporating Shared Decision Making into Perioperative Care of Older Adults

Abstract

Purpose of review

Older patients represent a growing and significant portion of the surgical population. Due to age-related changes in physiology and the presence of multiple comorbidities, older patients are more likely to experience complications, functional decline, increased care needs, and decreased independence following surgery. Identification of risk factors preoperatively permits early use of prevention strategies to mitigate risk, which translates into optimal postoperative outcomes.

Recent findings

Preexisting cognitive impairment is identified in 30% of patients undergoing elective surgery, and is associated with long-term postoperative cognitive dysfunction. Assessment for the presence of comorbidities, medication history, nutritional status, and frailty is critical. Patient preference, treatment goals, and advanced directives should be discussed and documented preoperatively. Post-hospital disposition requires significant planning, with emphasis on efficient transition of care and early post-operative follow-up.

Summary

Multidisciplinary perioperative assessment and appropriate management of the elderly surgical population are of paramount importance.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29s2sOM
via IFTTT