Αρχειοθήκη ιστολογίου

Πέμπτη 21 Ιουλίου 2016

Assessing the inhalation cancer risk of particulate matter bound polycyclic aromatic hydrocarbons (PAHs) for the elderly in a retirement community of a mega city in North China

Abstract

Assessment of the health risks resulting from exposure to ambient polycyclic aromatic hydrocarbons (PAHs) is limited by the lack of environmental exposure data among different subpopulations. To assess the exposure cancer risk of particulate carcinogenic polycyclic aromatic hydrocarbon pollution for the elderly, this study conducted a personal exposure measurement campaign for particulate PAHs in a community of Tianjin, a city in northern China. Personal exposure samples were collected from the elderly in non-heating (August–September, 2009) and heating periods (November–December, 2009), and 12 PAHs individuals were analyzed for risk estimation. Questionnaire and time-activity log were also recorded for each person. The probabilistic risk assessment model was integrated with Toxic Equivalent Factors (TEFs). Considering that the estimation of the applied dose for a given air pollutant is dependent on the inhalation rate, the inhalation rate from both EPA exposure factor book was applied to calculate the carcinogenic risk in this study. Monte Carlo simulation was used as a probabilistic risk assessment model, and risk simulation results indicated that the inhalation-ILCR values for both male and female subjects followed a lognormal distribution with a mean of 4.81 × 10−6 and 4.57 × 10−6, respectively. Furthermore, the 95 % probability lung cancer risks were greater than the USEPA acceptable level of 10−6 for both men and women through the inhalation route, revealing that exposure to PAHs posed an unacceptable potential cancer risk for the elderly in this study. As a result, some measures should be taken to reduce PAHs pollution and the exposure level to decrease the cancer risk for the general population, especially for the elderly.



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Histopathological and biochemical investigations of protective role of honey in rats with experimental aflatoxicosis

Natural honey (honey) is considered as a part of traditional medicine all over the world. It has both antimicrobial and antioxidant properties, useful in stimulation of wounds and burns healing and gastric ulc...

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Disparities in HIV clinic care across Europe: findings from the EuroSIDA clinic survey

Although advances in HIV medicine have yielded increasingly better treatment outcomes in recent years, HIV-positive people with access to antiretroviral therapy (ART) still face complex health challenges. The ...

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Keeping children safe: New guide for preventing child accidental injuries in the under fives

University of Nottingham News

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Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Medicine

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Resource use and health care costs of copd patients at the end of life: a systematic review

Journal of Pain and Symptom Management

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Association of model for end-stage liver disease score with mortality in emergency general surgery patients

JAMA Surgery

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Research into the effect Of SGLT2 inhibition on left ventricular remodelling in patients with heart failure and diabetes mellitus (REFORM) trial rationale and design

Cardiovascular Diabetology

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An observational study using ultrasound to assess physiological changes following fluid bolus administration in paediatric sepsis in the emergency department

BMC Pediatrics

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Psychological treatment may be effective in reducing self-harm

University of Oxford News

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The effects of school-based lifestyle interventions on body mass index and blood pressure: A multivariate multilevel meta-analysis of randomized controlled trials

Obesity Reviews

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Levetiracetam versus phenytoin for seizure prophylaxis following traumatic brain injury: A systematic review and meta-analysis

CNS Drugs

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An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers

Journal of Pain and Symptom Management

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Emerging collaboration between palliative care specialists and mechanical circulatory support teams: a qualitative study

Journal of Pain and Symptom Management

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Does receiving care in a medical home reduce racial/ethnic disparities in ED visits among children with asthma in the United States

Journal of Child Health Care

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Medicaid health home reducing costs and reliance on emergency department: Evidence from Iowa

Medical Care

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Acetaminophen versus liquefied ibuprofen for control of pain during separation in orthodontic patients: a randomized triple blinded clinical trial

Acta Medica Iranica

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GW researchers create conceptual model for acute, unscheduled care

George Washington School of Medicine and Health Sciences News

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Pain and functional status in patients with ventricular assist devices

Journal of Pain and Symptom Management

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Rise in avoidable diabetes hospital visits

University of Leicester News

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Contribution of electronic excitation to the structural evolution of ultrafast laser-irradiated tungsten nanofilms

Murphy, ST; Giret, Y; Daraszewicz, SL; Lim, AC; Shluger, AL; Tanimura, K; Duffy, DM; (2016) Contribution of electronic excitation to the structural evolution of ultrafast laser-irradiated tungsten nanofilms. Physical Review B , 93 (10) , Article 104105. 10.1103/PhysRevB.93.104105 . Green open access

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Translocation of iron from lysosomes to mitochondria during acetaminophen-induced hepatocellular injury: Protection by starch-desferal and minocycline

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Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Jiangting Hu, Andaleb Kholmukhamedov, Christopher C. Lindsey, Craig C. Beeson, Hartmut Jaeschke, John J. Lemasters
Acetaminophen (APAP) overdose causes hepatotoxicity involving mitochondrial dysfunction and the mitochondrial permeability transition (MPT). Iron is a critical catalyst for ROS formation, and reactive oxygen species (ROS) play an important role in APAP-induced hepatotoxicity. Previous studies show that APAP disrupts lysosomes, which release ferrous iron (Fe2+) into the cytosol to trigger the MPT and cell killing. Here, our aim was to investigate whether iron released from lysosomes after APAP is then taken up into mitochondria via the mitochondrial electrogenic Ca2+, Fe2+ uniporter (MCFU) to cause mitochondrial dysfunction and cell death. Hepatocytes were isolated from fasted male C57BL/6 mice. Necrotic cell killing was assessed by propidium iodide fluorimetry. Mitochondrial membrane potential (ΔΨ) was visualized by confocal microscopy of rhodamine 123 (Rh123) and tetramethylrhodamine methylester (TMRM). Chelatable Fe2+ was monitored by quenching of calcein (cytosol) and mitoferrofluor (MFF, mitochondria). ROS generation was monitored by confocal microscopy of MitoSox Red and plate reader fluorimetry of chloromethyldihydrodichlorofluorescein diacetate (cmH2DCF-DA). Administered 1h before APAP (10mM), the lysosomally targeted iron chelator, starch-desferal (1mM), and the MCFU inhibitors, Ru360 (100nM) and minocycline (4µM), decreased cell killing from 83% to 41%, 57% and 53%, respectively, after 10h. Progressive quenching of calcein and MFF began after ~4h, signifying increased cytosolic and mitochondrial chelatable Fe2+. Mitochondria then depolarized after ~10h. Dipyridyl, a membrane-permeable iron chelator, dequenched calcein and MFF fluorescence after APAP. Starch-desferal, but not Ru360 and minocycline, suppressed cytosolic calcein quenching, whereas starch-desferal, Ru360 and minocycline all suppressed mitochondrial MFF quenching and mitochondrial depolarization. Starch-desferal, Ru360 and minocycline also each decreased ROS formation. Moreover, minocycline 1h after APAP decreased cell killing by half. In conclusion, release of Fe2+ from lysosomes followed by uptake into mitochondria via MCFU occurs during APAP hepatotoxicity. Mitochondrial iron then catalyzes toxic hydroxyl radical formation, which triggers the MPT and cell killing. The efficacy of minocycline post-treatment shows minocycline as a possible therapeutic agent against APAP hepatotoxicity.



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Immediate Wheal Reactivity to Autologous Sweat in Atopic Dermatitis Is Associated with Clinical Severity, Serum Total and Specific IgE and Sweat Tryptase Activity

Background: Sweating can worsen atopic dermatitis (AD). The purpose of this work was to study the associations between reactivity to autologous sweat and the clinical severity of AD as well as investigate the possible wheal-inducing factors of sweat. Methods: Intracutaneous skin tests with autologous sweat were performed on 50 AD patients and 24 control subjects. In skin biopsies, tryptase and PAR-2 were enzyme and immunohistochemically stained. The associations between skin test reactivity and sweat histamine concentration, tryptase or chymase activity levels, tryptase or PAR-2 expression and AD clinical severity or IgE levels were investigated. Results: The wheal reactions in the intracutaneous tests with autologous sweat were positive, weakly positive and negative in 38, 34 and 28% of the AD patients, respectively, and in 4, 46 and 50% of the healthy controls, respectively (p = 0.008). In AD, the wheal reaction was associated significantly with clinical severity, serum total and specific IgE levels and sweat tryptase activity, but not with sweat histamine and chymase. In nonlesional AD skin, the percentage of PAR-2+ mast cells (MCs) or the number of tryptase+ MCs did not differ significantly between the intracutaneous test reactivity groups. Conclusion: Reactivity to autologous sweat correlates with the clinical severity of AD, and tryptase may be one of the factors involved in the sweat-induced wheal.
Int Arch Allergy Immunol 2016;170:84-91

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Changes in the Expression of MicroRNA in the Buildup Phase of Wasp Venom Immunotherapy: A Pilot Study

Background: Allergen-specific immunotherapy is the most effective method of treatment in allergy to wasp venom. However, its mechanism of action is still not fully understood. The aim of this study is to describe changes in microRNA (miRNA) expression in patients undergoing the buildup phase of venom immunotherapy. Methods: The study group comprised 7 adult patients with a history of severe systemic reactions after stinging by a wasp. In all patients, sensitization to wasp venom had been confirmed by skin tests and serum IgE. The buildup phase of wasp venom immunotherapy (VIT) was conducted according to an ultrarush protocol. In blood samples collected before and 24 h after completing the VIT buildup phase, 740 miRNAs were assessed. Results: Of the 740 miRNAs, 440 were detected in the study group, and in 5 expression was significantly changed after the buildup phase of VIT: miR-370, miR-539, miR-502-3p, miR-299, and miR-29c. Another 62 miRNAs changed 2-fold in some patients (nonsignificant), including increases in miR-143 (stimulating FOXp3 expression) and let-7d (reducing expression of IL-13, IL-6, and TLR4), and decreases in proinflammatory miR-301, miR-146b, miR-106, and miR-485. Conclusions: Several changes in miRNA expression have been found as a result of the buildup phase of wasp VIT, with lower expression of some miRNAs involved in allergic inflammation and higher expression of those possibly involved in tolerance induction. However, the role of the most significant changes is uncertain.
Int Arch Allergy Immunol 2016;170:97-100

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Role of galectin-1 in urinary bladder urothelial carcinoma cell invasion through c-Jun N-terminal protein kinase pathway

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Abstract

Human galectin-1 is a member of galectin family, proteins with conserved carbohydrate-recognition domains that bind galactoside. Galectin-1 is highly expressed in various tumors and participates in various oncogenic processes. However, detailed description of the function of galectin-1 in urinary bladder urothelial carcinoma has not been provided nowadays. Our previous cohort investigation demonstrated that galectin-1 is associated with tumor invasiveness and a possible independent prognostic marker of urinary bladder urothelial carcinoma. The present study was to clarify the relevance of galectin-1 expression level to tumor progression and invasion. In order to decipher a mechanism for the contribution of galectin-1 to the malignant behaviour of urinary bladder urothelial carcinoma, two bladder cancer cell lines (T24 and J82) was established with knockdown galectin-1 expression by short-hairpin siRNA. Bladder cancer cells with gelectin-1 gene silencing exhibited reduced cell proliferation, lower invasive capability and lower clonogenicity. Extensive signalling pathway studies indicated that galectin-1 participated in bladder cancer cell invasion through mediating the activity of matrix metalloproteinase 9 via Ras─Rac1─MAP/ERK kinase kinase 4─c-Jun N-terminal protein kinase─AP1 signaling pathway. Our functional analyses of gelectin-1 in urinary bladder urothelial carcinoma provided novel insight into the critical role of gelectin-1 in tumour progression and invasion. These results revealed that silencing galectin-1-mediated MAP kinase signaling pathway presented a novel strategy for bladder cancer therapy.

This article is protected by copyright. All rights reserved.



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Socioeconomic factors’ effect on return to work after first stroke

Objective

The objective of this nationwide study was to analyze how functional status and socioeconomic status affect return to work (RTW) among younger patients with first-time stroke in a Sweden.

Material and methods

This register-based cohort study included employed patients aged 25–55 with first-time stroke between 2008 and 2011 and primary outcome was RTW within 1 year after stroke. Data regarding functional status and employment status were retrieved from the Swedish Stroke Register, Riksstroke, and socioeconomic data (income, education, and country of birth) from Statistics Sweden.

Results

We included 2539 patients who had answered the question on RTW, and 1880 (74.0%) had RTW within 12 months. Patients with low income (69.9% in lowest income group vs 79.9% in highest group, P<.001), patients born in countries outside the Nordic countries (Sweden 75.5%, Nordic countries 74.3%, European countries 61.7%, other countries 57.3%, P<.001), and the youngest patients (25–34, 63.1%; 35–44, 75.9%; 45–55, 74.3%; P=.008) were less likely to RTW. Pain, low mood, and answering the questionnaire with help were more common in low socioeconomic groups, and when adjusting for these variables, together with age and sex, income and country of birth were no longer independent predictors for RTW.

Conclusion

Patients with low socioeconomic status less often RTW 1 year after stroke.Impaired functional status after stroke is more common in patients with lower socioeconomic status and mediates socioeconomic differences in RTW. Improvement of functional status should be targeted to facilitate RTW among stroke patients with low socioeconomic status.



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Involvement of tau phosphorylation in traumatic brain injury patients

Objectives

Traumatic brain injury (TBI) results in significant morbidity and mortality throughout the world. In TBI patients suffering cognitive, emotional, and behavioral deficits, the leading cause derives from the physical injury to the central nervous system (CNS) that impairs brain function.

Materials and Methods

Here, we applied a targeted approach to understand the potential mechanisms of neuron damage after TBI. Tau protein phosphorylation was compared in the brain tissues collected from patients underwent brain surgery based on the assessment of brain injury extent by Glasgow Coma Scale (GCS).

Results

The results indicated that the levels of phosphorylated tau were significantly higher in the severe and extremely severe TBI groups, compared to the moderate group of patients. Phosphorylated, but not the total tau protein was uniquely correlated with the GCS score (R2=.7849, P<.01) in 142 TBI patients. Consistently, the activities of key players associated with tau hyperphosphorylation GSK-3β and PP2A showed parallel correlations with the severity of TBI as well.

Conclusion

These data suggest that the enhanced tau protein phosphorylation occurs upon severe neuron injures and may contribute to the pathological structural changes of CNS leading to brain damage of TBI.



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Thyroid Ophthalmopathy, Dermopathy, and Acropachy

Figure 1.

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Pembrolizumab-Induced Demyelinating Polyradiculoneuropathy

To the Editor: Pembrolizumab and nivolumab, two humanized antibodies against programmed cell death 1 (PD-1) receptor, were recently approved for the treatment of unresectable or metastatic melanoma and for other cancers. We report two cases of severe demyelinating polyradiculoneuropathy that…

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Risk factors, clinical presentation and prognosis of mixed candidaemia: a population-based surveillance in Spain

Summary

The low incidence of mixed candidaemia (MC) may have precluded a better knowledge of its clinical presentation. The aim of the study was to analyse the risk factors, clinical presentation and prognosis of MC episodes. A comparison between MC and monomicrobial candidaemia within a prospective programme on candidaemia was performed in 29 hospitals between April 2010 and May 2011. In fifteen episodes of candidaemia corresponding to 15 patients, out of 752, two species of Candida (1.9%) were isolated. MC was more frequent in patients with HIV infection (12%, P = 0.038) and those admitted due to extensive burns (23%, P = 0.012). The Candida species most frequently identified in MC were C. albicans 12 patients (40%), C. glabrata seven patients (23.3%) and C. parapsilosis six patients (20%). Early mortality was higher (nine patients, 60%) in patients with MC than in patients with MMC (223 patients, 30.3%, P = 0.046). In conclusion, MC was was independently associated with increased mortality even after considering other prognostic factors. MC is an infrequent event that is more common in HIV infection and in patients suffering from burns, and is associated with increased mortality.



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Referral pattern of children with short stature to a pediatric endocrine clinic in Kuwait

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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Increased GLP-1 response to oral glucose in pre-pubertal obese children

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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In children with autoimmune thyroid diseases the association with Down syndrome can modify the clustering of extra-thyroidal autoimmune disorders

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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Dietary fructose intake in obese children and adolescents: relation to procollagen type III N-terminal peptide (P3NP) and non-alcoholic fatty liver disease

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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A phase I trial of cabozantinib and gemcitabine in advanced pancreatic cancer

Summary

Background Cabozantinib and gemcitabine improve tumor control in pancreatic ductal adenocarcinoma (PDAC) in preclinical models through c-Met inhibition. We sought to determine the maximum tolerated dose (MTD) of this combination in patients with advanced PDAC. Methods Patients with ≤1 prior treatment and adequate performance status were eligible. Cabozantinib was given orally once daily, beginning day (−)7 and continued with gemcitabine given intravenously on days 1, 8, and 15 every 28 days. Dose level was assigned using Time to Event Continual Reassessment Method (TITE-CRM). Primary endpoint was MTD, defined as the highest dose level at which ≤25 % of patients incurred a dose-limiting toxicity (DLT). Secondary endpoints included response rate, progression-free survival (PFS), overall survival (OS) and urinary biomarker assessment. Results Twelve patients were enrolled and treated with 10 patients evaluable for DLT. The probability of DLT was >25 % for all dose levels tested, and thus an MTD was not determined. DLTs included grade 3 ALT/AST elevations and thrombocytopenia. Three patients had partial responses, but each discontinued therapy due to toxicity. Median PFS and OS were 4.7 (95 % CI: 1.4–9.7) and 10.1 months (95 % CI: 3.6–20.6). Exploratory biomarker analysis showed correlation of c-Met and VEGF levels with response. Conclusions An MTD for the combination was not established. Cabozantinib and gemcitabine appear impractical for further development due to DLT at low doses and continuing toxicities with ongoing therapy. Acknowledging the small sample size, responses were seen suggesting further investigation of c-Met inhibition in PDAC may be warranted.



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Selective laser melting of titanium alloy enables osseointegration of porous multi-rooted implants in a rabbit model

Osseointegration refers to the direct connection between living bone and the surface of a load-bearing artificial implant. Porous implants with well-controlled porosity and pore size can enhance osseointegrati...

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Thyroid Ophthalmopathy, Dermopathy, and Acropachy

Figure 1.

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Nodular Lymphoid Hyperplasia

Figure 1.

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A phase I trial of cabozantinib and gemcitabine in advanced pancreatic cancer

Summary

Background Cabozantinib and gemcitabine improve tumor control in pancreatic ductal adenocarcinoma (PDAC) in preclinical models through c-Met inhibition. We sought to determine the maximum tolerated dose (MTD) of this combination in patients with advanced PDAC. Methods Patients with ≤1 prior treatment and adequate performance status were eligible. Cabozantinib was given orally once daily, beginning day (−)7 and continued with gemcitabine given intravenously on days 1, 8, and 15 every 28 days. Dose level was assigned using Time to Event Continual Reassessment Method (TITE-CRM). Primary endpoint was MTD, defined as the highest dose level at which ≤25 % of patients incurred a dose-limiting toxicity (DLT). Secondary endpoints included response rate, progression-free survival (PFS), overall survival (OS) and urinary biomarker assessment. Results Twelve patients were enrolled and treated with 10 patients evaluable for DLT. The probability of DLT was >25 % for all dose levels tested, and thus an MTD was not determined. DLTs included grade 3 ALT/AST elevations and thrombocytopenia. Three patients had partial responses, but each discontinued therapy due to toxicity. Median PFS and OS were 4.7 (95 % CI: 1.4–9.7) and 10.1 months (95 % CI: 3.6–20.6). Exploratory biomarker analysis showed correlation of c-Met and VEGF levels with response. Conclusions An MTD for the combination was not established. Cabozantinib and gemcitabine appear impractical for further development due to DLT at low doses and continuing toxicities with ongoing therapy. Acknowledging the small sample size, responses were seen suggesting further investigation of c-Met inhibition in PDAC may be warranted.



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Catalytic One-Pot Diastereoselective Michael-Initiated Ring-Closure of Methyl Ketones with 3-Bromochromones: Synthesis of Cyclopropa[b]chromanones

A one-pot diastereoselective base-catalyzed Michael-initiated ring-closure (MIRC) of activated methyl ketones with 3-bromochromones to give cyclopropa[b]chromanones is described. Three asymmetric centres are generated in the new cyclopropa[b]chromanone skeleton. Stereochemistry studies based on NMR spectroscopy and single-crystal X-ray diffraction analysis revealed the trans configuration of the cyclopropane ring, with the (1R,1aS,7aR)/(1S,1aR,7aS) pair of enantiomers, as was further confirmed by chiral HPLC. The use of acetone in our reaction produced a 1-acetyl-substituted cyclopropa[b]chromanone that can undergo a subsequent MIRC reaction with a second molecule of 3-bromochromone to give the first described 1,1′-carbonylbis(cyclopropa[b]chromanone) dimers as a meso form.

Thumbnail image of graphical abstract

A one-pot diastereoselective base-catalyzed Michael-initiated ring closure (MIRC) of activated methyl ketones with 3-bromochromones to give cyclopropa[b]chromanones is described. 1-Acetyl-substituted cyclopropa[b]chromanones undergo a consecutive MIRC reaction with a second molecule of 3-bromochromone to give the first described 1,1′-carbonylbis(cyclopropa[b]chromanone) dimers as a meso form.



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Influenza Virus Induces Inflammatory Response in Mouse Primary Cortical Neurons with Limited Viral Replication

Unlike stereotypical neurotropic viruses, influenza A viruses have been detected in the brain tissues of human and animal models. To investigate the interaction between neurons and influenza A viruses, mouse cortical neurons were isolated, infected with human H1N1 influenza virus, and then examined for the production of various inflammatory molecules involved in immune response. We found that replication of the influenza virus in neurons was limited, although early viral transcription was not affected. Virus-induced neuron viability decreased at 6 h postinfection (p.i.) but increased at 24 h p.i. depending upon the viral strain. Virus-induced apoptosis and cytopathy in primary cortical neurons were not apparent at 24 h p.i. The mRNA levels of inflammatory cytokines, chemokines, and type I interferons were upregulated at 6 h and 24 h p.i. These results indicate that the influenza virus induces inflammatory response in mouse primary cortical neurons with limited viral replication. The cytokines released in viral infection-induced neuroinflammation might play critical roles in influenza encephalopathy, rather than in viral replication-induced cytopathy.

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Drug utilisation in medical intensive care unit: a retrospective analysis from a tertiary care teaching hospital

2016-07-21T02-54-44Z
Source: International Journal of Basic & Clinical Pharmacology
Arathy R, Jiyo Chacko, Santosh Pillai, Anish Bhanu, Ruby Raphael, Jalajakumari M.
Background: The World Health Organisation has defined drug utilization study as the marketing, distribution, prescription and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences. The objective was to evaluate drug utilization pattern in medical intensive care unit (MICU) in a tertiary care teaching hospital. Methods: A retrospective observational study was conducted in MICU for adult patients admitted from October to December 2013. Data collected was analyzed for demographics, indication, duration of stay, World Health Organisation (WHO) prescribing indicators including anatomical therapeutic chemical classification and defined daily dose (DDD). Results: A six hundred encounters from 63 male and 44 female patients with a mean age of 60.88±16.87 were studied. Average duration of stay was 5.61±3.88 days. The common indications for admission were dyspnoea 20 (18.69%), upper gastrointestinal bleed 16 (14.95%), cerebrovascular accident 14 (13.08%) and sepsis 13 (12.15%). Total number of drugs prescribed was 246. Total drug encounters were 7695. Average number of drugs per encounter was 12.83. Percentage of drugs prescribed by generic name was 38.21%, 44.7% and 40.65% of the drugs were prescribed from National and WHO essential medicine list respectively. Among the drugs prescribed 65.44%, 32.93% and 17.48% were oral, injectable and fixed dose combination preparations respectively. Percentage of encounters resulting in prescription of an antibiotic and an injection were 59% and 85.83% respectively. The most commonly prescribed drugs were pantoprazole (100%), human regular insulin (52.83%), piperacillin+tazobactam (45%) and ceftriaxone (38%). Their DDD/100 bed days were found to be 83.79, 12.78, 12.50, and 17.81 respectively. Conclusions: Overall the prescribing pattern seems to be rational but may be further strengthened by increasing generic drug prescription, judicious use of pantoprazole and periodic longitudinal surveillance studies.


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Comparison of cardiovascular safety of escitalopram and sertraline based on electrocardiographic alterations: a pharmacovigilance study

2016-07-21T02-54-44Z
Source: International Journal of Basic & Clinical Pharmacology
Balwant K. Choure, Girish T. Raparti, Jayprakash B. Ramanand, Jyoti B. Tapase, Praveenkumar T. Patil, Nitin N. Puram, Rama R. Bhosale.
Background: Escitalopram and sertraline are the most commonly prescribed antidepressant drugs, belongs to SSRI class. Both the drugs are long been considered as free from cardiovascular adverse effects. Recently number of studies reported potential association between these drugs and pronounced cardiovascular adverse effects. ECG changes like prolongation of QT interval are frequently used as markers for the increased risk of a fatal cardiac arrhythmia. The potential cardiovascular adverse reaction profile of both these drugs is little studied in Indian rural population. Methods: This was a 6 weeks prospective open label observational study carried out in a drug naive 209 patients receiving either escitalopram (n=106) or sertraline (n=103). ECG parameters like heart rate, RR interval, PQ/PR interval, QRS duration and QTc interval, were obtained directly from the digital machine recordings, additionally the QT interval was measured manually with the help of caliper. Statistical analysis was done by using Statistical software SPSS 17.0. Results: Out of 209 drugs naive patients, 12 from escitalopram group and 10 patients from Sertraline were lost to follow-up. Hence ECG recordings of the remaining 94 patients under escitalopram group, 93 patients under sertraline group were used for study analysis. The ECG alterations caused by the escitalopram were compared with that caused by sertraline. It was observed that the differences between the ECG alterations caused by either of escitalopram or sertraline were statistically non-significant. Conclusions: It was concluded, at therapeutic doses neither of the drugs have the potential risk of drug induced arrhythmias, throughout the study.


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Prospective study of blood lipid parameters in patients with type-2 diabetes mellitus and its correlation with the glycated hemoglobin

2016-07-21T02-49-55Z
Source: International Journal of Advances in Medicine
Kumar Prafull Chandra, Dhirendra Kumar Shukla.
Background: Patients with type 2 diabetes mellitus (T2DM) are accompanied (many a time ignored) by dyslipidemia; such patients are the easy targets for the development of cardiovascular disease (CVD). An early treatment to normalize abnormal lipid levels can reduce the CVD and related mortality. The aim was to measure blood lipid parameters in patients with T2DM and their relation with the glycemic control. Methods: Prospective study including 124 T2DM patients in the Department of Medicine, Mayo Institute of Medical sciences, Barabanki, Uttar Pradesh, India between January 2016 to June 2016. Brief history, examination and investigations including fasting plasma glucose (FPG), post prandial blood glucose (PPG), glycated hemoglobin (HbA1c), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were done. Correlation was obtained for lipid parameters between patients having HbA1c


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Synthesis of Figure-of-Eight Helical BisBODIPY Macrocycles and Their Chiroptical Properties

CrossMark.jpg

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC05439K, Communication
Makoto Saikawa, Takashi Nakamura, Junji Uchida, Masaki Yamamura, Tatsuya Nabeshima
A macrocyclic bisBODIPY (bis(boron-dipyrromethene)) complex [1B2] with a figure-of-eight helicity was synthesized and successfully resolved. [1B2] was proven to be one of the most efficient red-emitting CPL (circularly polarized luminescence)...
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Optical coherence tomography parameters predictive of visual outcome after anti-VEGF therapy for retinal vein occlusion



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Mysterious Myofibroblast: A Cell with Diverse Origin and Multiple Functions

2016-07-21T02-41-17Z
Source: Journal of Interdisciplinary Histopathology
Sowmya Rao, Jagadish Rao, Jyothi B.M, Varsha V.K.
Myofibroblasts are one of the most controversial cells in recent times. Ever since its first discovery, numerous discussions have been done on its illusive nature and functions. They are commonly considered as smooth muscle like fibroblasts. Their presence and distribution in normal and pathological conditions are still not clear since they are difficult to identify with the routine histological techniques. Recent studies have shown their ubiquitous presence in the body tissues hence suggesting their important role in both physiological functioning and pathological conditions. This review discusses briefly the cell in terms of its definition, possible precursors; mechanism involved in its modulation, most importantly how to differentiate it from its nearest counterparts such as fibroblasts and smooth muscle cells and finally its fundamental role in physiology and pathology.


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The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study

Abstract

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project's mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment.



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Stellenwert der autologen Fetttransplantation in der ästhetischen Chirurgie des Mammakarzinoms

Zusammenfassung

Die autologe Fetttransplantation gilt als sekundär rekonstruktives Verfahren und hat als Therapieziel eine Verbesserung der Lebensqualität. Beim Lipofilling wird autologes Fett in den Empfängersitus übertragen, um die Weichteilkontur der Empfängerregion zu optimieren. Brustkrebs ist die häufigste Krebserkrankung der Frau. Dank individualisierter Behandlungsmethoden steigen zwar die Heilungsraten, aber immer mehr Frauen müssen viele Jahre mit den Ergebnissen und Folgen der Operation leben. Auch wenn die Operationsverfahren immer differenzierter und an den individuellen Situs adaptiert sind, kommt es zu Narben, Defekten oder Einziehungen und Volumenverlust der Brust, durch eine nachfolgende Radiatio werden diese häufig verstärkt. Autologes Fett eignet sich zur Verstärkung des Weichteilmantels und zur Verbesserung der Kontur sowie auch der Hautperfusion und zum Volumenausgleich. Damit eignet Fett sich zur Rekonstruktion der Brust sowohl nach Mastektomie und Lappenplastik oder nach haut- und nippelsparender Mastektomie und Implantateinlage. Auch nach brusterhaltender Therapie eines Mammakarzinoms können Defekte, Asymmetrien und Narbenkonstriktionen mit Eigenfett kompensiert werden. Zu beachten ist, dass Fett ausschließlich in eine gesunde Brust transplantiert werden darf. Vor der autologen Fetttransplantation sollte ein Residualtumor oder ein Rezidiv sicher ausgeschlossen werden. Je länger die Karenzzeit zwischen der Onkochirurgie und dem Fetttransfer ist, desto höher ist die Sicherheit. Der Erfolg dieser Methode ist von profunden Kenntnissen der Methode, einer sorgfältigen Ausführung jedes einzelnen Behandlungsschrittes abhängig. Gemessen wird er an Parametern wie unbeeinträchtigte Beurteilbarkeit der Brust in der Bildgebung, Volumenstabilität und onkologische Sicherheit.



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Pembrolizumab-Induced Demyelinating Polyradiculoneuropathy

To the Editor: Pembrolizumab and nivolumab, two humanized antibodies against programmed cell death 1 (PD-1) receptor, were recently approved for the treatment of unresectable or metastatic melanoma and for other cancers. We report two cases of severe demyelinating polyradiculoneuropathy that…

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