Recently, we read with great interest the paper entitled "Various Mechanistic Pathways Representing the Aging Process Are Altered in COPD" in CHEST (January 2016) by Rutten et al,1 in which the authors showed in an excellent work that several biomedical signaling pathways were probably involved in the aging process of patients with COPD. Interestingly, soluble klotho significantly decreased in patients with COPD compared with those in the smoking or nonsmoking control groups. It has been widely recognized that klotho has two subunits consisting of α-klotho and β-klotho that separately trigger distinct physiological actions by binding to its coreceptors fibroblast growth factor (FGF) 23 and FGF21.2 Although FGF23 and FGF21 are individually implicated in the pathogenesis of chronic kidney disease and obesity,3 it cannot be ignored that abnormalities in FGF23 or FGF21, or both, would also be implicated in the underlying mechanisms of the aging process in COPD. More importantly, klotho deficiency may elicit a vicious result of resistance of FGF 23 and FGF21, since decreased klotho could not provide adequate binding sites for FGF 23 and FGF21.2,3 Relative increased levels of FGF23 and FGF21 would exert deletion effects on physiological functions.3 Based on these findings, we suggest that excessive levels of FGF23 or FGF21, or both, are also probably involved in the mechanisms of the COPD-related aging process. It is likely, therefore, that detecting levels of FGF23 or FGF21, or both, may favor the observation of the aging process of individuals with COPD. To the best of our knowledge, there is no study reporting the role of FGF23 or FGF21 in COPD. Subsequent investigations on the role of FGF-klotho signaling in the COPD-associated aging process are needed.
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Παρασκευή 5 Αυγούστου 2016
A Randomized Controlled Trial of a Novel Sheath Cryoprobe for Bronchoscopic Lung Biopsy in a Porcine Model
Background
Transbronchial forceps biopsy (FBx) has been the preferred method for obtaining bronchoscopic lung biopsy specimens. Cryoprobe biopsy (CBx) has been shown to obtain larger and higher quality samples, but is limited by its inability to retrieve the sample through the working channel of the bronchoscope, requiring the bronchoscope to leave the airway for sample retrieval. Objective
We evaluated a novel device using a sheath cryobiopsy (SCBx). This method allows for specimen retrieval through the working channel of the bronchoscope, with the scope remaining inside the airway. Methods
This prospective, randomized controlled, single-blinded porcine study compared a 1.1-mm SCBx probe, a 1.9-mm CBx probe, and 2.0-mm FBx forceps. Assessment of histologic accessibility, sample quantity and quality, number of attempts to acquire and retrieve samples, cryoprobe activation time, fluoroscopy activation time, technical feasibility, and complications were compared. Results
Samples adequate for standard pathologic processing were retrieved with 82.1% of the SCBx specimens, 82.9%% of the CBx specimens, and 30% of the FBx specimens. The histologic accessibility of both SCBx (P = .0002) and CBx (P = .0003) was superior to FBx. Procedure time for FBx was faster than for both SCBx and CBx, but SCBx was significantly faster than CBx (P Conclusionsfrom #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2aO8uqr
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Donor-Derived T-Cell Large Granular Lymphocytic Leukemia in a Patient With Peripheral T-Cell Lymphoma
T-cell large granular lymphocytic (T-LGL) leukemia after hematopoietic stem cell transplantation (SCT) is rare and its natural history and clinical outcome have not been well described. We report the clinical, morphologic, immunophenotypic, and molecular features of a case of donor-derived T-LGL leukemia in a 16-year-old man who received allogeneic SCT for peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). The patient presented with persistent neutropenia and splenomegaly 9 months after SCT when the chimerism study showed a 100% donor pattern. A splenectomy revealed T-LGL leukemia. Flow cytometric analysis showed an aberrant T-cell population positive for CD3, CD5 (dim, subset), CD7, CD8, CD16 (subset), CD57, CD94 (dim, partial), and T-cell receptor (TCR) αβ, and negative for CD4, CD26, CD56, and TCR. Molecular studies showed monoclonal TCRβ and TCR gene rearrangements. Both the immunophenotype and molecular profile of the T-LGL leukemia were different from the pre-SCT PTCL. Sequencing analysis for STAT3 exon 21 did not reveal any mutation in both pre-SCT and post-SCT specimens. The patient did not receive any treatment for T-LGL leukemia; however, his count progressively increased after splenectomy, despite the presence of persistent T-LGL leukemia in the bone marrow. There was no evidence of recurrent PTCL. We propose an algorithm to diagnose this rare post-SCT neoplasm.
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Predictors of In-Hospital Mortality in Patients With Metastatic Cancer Receiving Specific Critical Care Therapies
Background: In-hospital mortality is high for critically ill patients with metastatic cancer. To help patients, families, and clinicians make an informed decision about invasive medical treatments, we examined predictors of in-hospital mortality among patients with metastatic cancer who received critical care therapies (CCTs). Patients and Methods: We used the 2010 California Healthcare Cost and Utilization Project: State Inpatient Databases to identify admissions of patients with metastatic cancer (age ≥18 years) who received CCTs, including invasive mechanical ventilation (IMV), tracheostomy, percutaneous endoscopic gastrostomy (PEG) tube, acute use of dialysis, and total parenteral nutrition (TPN). We first described the characteristics and outcomes of patients who received any CCTs. We then used multivariable logistic regression models with generalized estimating equations (to account for clustering within hospitals) to identify predictors of in-hospital mortality among patients who received any CCTs. Results: For 2010, we identified 99,085 admissions among patients with metastatic cancer. Of these, 9,348 (9.4%) received any CCT during hospitalization; 50% received IMV, 15% PEG tube, 8% tracheostomy, 40% TPN, and 8% acute dialysis. Inpatient mortality was 30%. Of patients who received any CCT and survived to discharge, 27% were discharged to a skilled nursing facility. Compared with patients who died, costs of care were $3,019 higher for admissions in which patients survived the hospitalization. Predictors of in-hospital mortality included non-white race (vs whites), lack of insurance (vs Medicare), unscheduled admissions, principal diagnosis of infections (vs cancer-related), greater burden of comorbidities, end-stage renal disease, liver disease and lung cancer (vs other cancers). Conclusions: Although more studies are needed to better understand risks and benefits of specific treatments in the setting of specific cancer types, these data will help to inform decision-making for patients with metastatic cancer who become critically ill.
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NCCN Guidelines Insights: Melanoma, Version 3.2016
The NCCN Guidelines for Melanoma have been significantly revised over the past few years in response to emerging data on a number of novel agents and treatment regimens. These NCCN Guidelines Insights summarize the data and rationale supporting extensive changes to the recommendations for systemic therapy in patients with metastatic or unresectable melanoma.
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Associations Between End-of-Life Cancer Care Patterns and Medicare Expenditures
Background: The purpose of this study was to examine the extent to which patterns of intensive end-of-life care explain geographic variation in end-of-life care expenditures among cancer decedents. Methods: Using the SEER-Medicare database, we identified 90,465 decedents who were diagnosed with cancer in 2004–2011. Measures of intensive end-of-life care included chemotherapy received within 14 days of death; more than 1 emergency department visit, more than 1 hospitalization, or 1 or more intensive care unit (ICU) admissions within 30 days of death; in-hospital death; and hospice enrollment less than 3 days before death. Using hierarchical generalized linear models, we estimated risk-adjusted expenditures in the last month of life for each hospital referral region and identified key contributors to variation in expenditures. Results: The mean expenditure per cancer decedent in the last month of life was $10,800, ranging from $8,300 to $15,400 in the lowest and highest expenditure quintile areas, respectively. There was considerable variation in the percentage of decedents receiving intensive end-of-life care intervention, with 41.7% of decedents receiving intensive care in the lowest quintile of expenditures versus 57.9% in the highest quintile. Regional patterns of late chemotherapy or late hospice use explained only approximately 1% of the expenditure difference between the highest and lowest quintile areas. In contrast, the proportion of decedents who had ICU admissions within 30 days of death was a major driver of variation, explaining 37.6% of the expenditure difference. Conclusions: Promoting appropriate end-of-life care has the potential to reduce geographic variation in end-of-life care expenditures.
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NCCN's Commitment to Medication Safety: The Vincristine Initiative
The mission of NCCN is to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Improving medication safety is an important aspect of fulfilling this mission. In September 2014, the NCCN Best Practices Committee began a medication safety initiative to improve the safe use of vincristine. This article describes and discusses this initiative.
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Biomarkers in Colorectal Cancer Screening
Colorectal cancer (CRC) is the third most common cause of cancer death in men and women in the United States. The main goals of screening are to prevent carcinogenesis (via adenoma detection and removal) and detect cancer at an early, curable stage. CRC mortality is steadily dropping in the United States, partly because of greater screening utilization. However, nearly 1 in 3 average-risk people are not up to date with standard CRC screening recommendations. This review surveys a wide range of CRC biomarkers in various stages of development, which may offer attractive risk stratification tools; a few have reached the commercial stage. If widely accepted, these tools may contribute to shift CRC screening practices away from 1-step colonoscopy to a 2-step risk stratification process of predictive biomarker measurements followed by colonoscopy for lower-risk patients with a positive result. Such strategies could potentially increase the rate of CRC screening.
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NCCN Framework for Resource Stratification: A Framework for Providing and Improving Global Quality Oncology Care
More than 14 million new cancer cases and 8.2 million cancer deaths are estimated to occur worldwide on an annual basis. Of these, 57% of new cancer cases and 65% of cancer deaths occur in low- and middle-income countries. Disparities in available resources for health care are enormous and staggering. The WHO estimates that the United States and Canada have 10% of the global burden of disease, 37% of the world's health workers, and more than 50% of the world's financial resources for health; by contrast, the African region has 24% of the global burden of disease, 3% of health workers, and less than 1% of the world's financial resources for health. This disparity is even more extreme with cancer. NCCN has developed a framework for stratifying the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) to help health care systems in providing optimal care for patients with cancer with varying available resources. This framework is modified from a method developed by the Breast Health Global Initiative. The NCCN Framework for Resource Stratification (NCCN Framework) identifies 4 resource environments: basic resources, core resources, enhanced resources, and NCCN Guidelines, and presents the recommendations in a graphic format that always maintains the context of the NCCN Guidelines. This article describes the rationale for resource-stratified guidelines and the methodology for developing the NCCN Framework, using a portion of the NCCN Cervical Cancer Guideline as an example.
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IJMS, Vol. 17, Pages 1271: The FKBP5 Gene Affects Alcohol Drinking in Knockout Mice and Is Implicated in Alcohol Drinking in Humans
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What makes a difference for disadvantaged girls?: investigating the interplay between group composition and positive youth development in sport
It has been suggested that group composition can influence the experiences of individual group members in social programmes (Weiss, 1998). The purpose of the present study was to examine the relationship between peer group composition in sports programmes and positive youth development (PYD) in disadvantaged girls, as well as to determine whether it was moderated by personal characteristics. Two hundred young women aged between 10 and 24 completed a questionnaire including, among others, the "Youth Experience Survey for Sport" (YES-S) (MacDonald, Cote, Eys, & Deakin, 2012) and questions regarding participants' socio-economic characteristics (i.e., nationality, education, family situation). Multilevel regression analyses were performed to take into account the hierarchical data structure. At the group level, a higher percentage of girls from a low educational track and with a migration background predicted greater PYD, as indicated by higher levels of personal and social skills, cognitive skills and goal setting. Results showed interaction effects between the respondents' family structures on the participant and team levels. The overall statistical models for the different developmental domains accounted for variance ranging from 14.7% (personal and social skills) to 30.3% (cognitive skills). Results indicated that the extent to which disadvantaged girls derive benefits from their participation in sport also depends on the group composition. The interaction effects between the group composition and individual characteristics suggest that when girls participate in a group of similar peers, those from non-intact families will derive more benefits than their counterparts from intact families.
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Morphological and molecular identification of nasopharyngeal bot fly larvae infesting red deer ( Cervus elaphus ) in Austria
Abstract
Nasopharyngeal myiases are caused by larvae of bot flies (Diptera: Oestridae), which have evolved a high specificity for their hosts. Bot flies (n = 916) were collected from 137 (57.6 %) out of 238 red deer (Cervus elaphus) hunted in Vorarlberg and Tyrol (Western Austria). After being stored in 75 % ethanol, larvae were identified to species level and developmental stage using morphological and morphometric keys. Larvae were also molecularly characterized by polymerase chain reaction (PCR) amplification and partial sequencing of the mitochondrial cytochrome oxidase subunit I gene. Morphological and molecular analysis allowed identification of larvae as Cephenemyia auribarbis and Pharyngomyia picta. Genetic variations were also examined within the specimens collected in both geographical locations.
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Antimalarial potential of leaves of Chenopodium ambrosioides L.
Abstract
In an effort to identify novel therapeutic alternatives for the treatment of malaria, the present study evaluated the antimalarial effect of the crude hydroalcoholic extract (HCE) from the leaves of Chenopodium ambrosioides L. For this purpose, the molecular affinity between the total proteins from erythrocytes infected with Plasmodium falciparum and HCE or chloroquine was evaluated by surface plasmon resonance (SPR). Subsequently, the plasmodicidal potential of HCE was assessed in a P. falciparum culture. Using BALB/c mice infected with Plasmodium berghei intraperitoneally (ip.), we evaluated the effects of ip. treatment, for three consecutive days (day 7, 8, and 9 after infection), with chloroquine (45 mg/kg) or HCE (5 mg/kg), considering the survival index and the parasitaemia. The groups were compared to an untreated control group that receives only PBS at the same periods. The results indicated that HCE could bind to the total proteins of infected erythrocytes and could inhibit the parasite growth in vitro (IC50 = 25.4 g/mL). The in vivo therapeutic treatment with HCE increased the survival and decreased the parasitaemia in the infected animals. Therefore, the HCE treatment exhibited a significant antiplasmodial effect and may be considered as a potential candidate for the development of new antimalarial drugs.
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Microbiota from Rhabditis regina may alter nematode entomopathogenicity
Abstract
Here we report the presence of the entomopathogenic nematode Rhabditis (Rhabditoides) regina affecting white grubs (Phyllophaga sp. and Anomala sp.) in Mexico and R. regina-associated bacteria. Bioassays were performed to test the entomopathogenic capacity of dauer and L2 and L3 (combined) larval stages. Furthermore, we determined the diversity of bacteria from laboratory nematodes cultivated for 2 years (dauer and L2–L3 larvae) and from field nematodes (dauer and L2–L3 larvae) in addition to the virulence in Galleria mellonella larvae of some bacterial species from both laboratory and field nematodes. Dauer and non-dauer larvae of R. regina killed G. mellonella. Bacteria such as Serratia sp. (isolated from field nematodes) and Klebsiella sp. (isolated from larvae of laboratory and field nematodes) may explain R. regina entomopathogenic capabilities. Different bacteria were found in nematodes after subculturing in the laboratory suggesting that R. regina may acquire bacteria in different environments. However, there were some consistently found bacteria from laboratory and field nematodes such as Pseudochrobactrum sp., Comamonas sp., Alcaligenes sp., Klebsiella sp., Acinetobacter sp., and Leucobacter sp. that may constitute the nematode microbiome. Results showed that some bacteria contributing to entomopathogenicity may be lost in the laboratory representing a disadvantage when nematodes are cultivated to be used for biological control.
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Sinuolinea niloticus n. sp., a myxozoan parasite that causes disease in Nile tilapia ( Oreochromis niloticus )
Abstract
Sinuolinea species are myxozoans of the order Bivalvulida, suborder Variisporina, and family Sinuolineidae, which can be parasites for freshwater and marine fish. The aim of this study was to describe the occurrence of Sinuolinea niloticus n. sp. infecting Nile tilapia (Oreochromis niloticus) from aquaculture and from river sources with morphological and molecular analyses. Between March 2010 and November 2012, 116 Nile tilapia were randomly sampled from aquaculture net fishing (n = 56) in Mira Estrela, São Paulo, and from the Capivari River (n = 60) in Botucatu, São Paulo. The fishes that were sampled were examined by necropsy, microscopic observation and molecular techniques for detection and identification of the myxozoan causing disease in tilapia. All of the tissues that were sampled for analysis showed the presence of the parasite. It was observed by microscopy that the myxozoan belongs to the Sinuolinea genus. This identification was performed based on morphological characteristics and histopathology findings, such as structures consistent with myxozoan in the interstices in all analysed tissues, coagulative necrosis, haemorrhage, inflammatory processes, presence of melano-macrophages and eosinophils. The results of the molecular analyses revealed that the myxozoan detected and identified in this study is sister to a group of other Sinuolinea species. Because this is the first report of this parasite in Nile tilapia, the parasite was named S. niloticus n. sp. This is the first report of a Sinuolinea species in Brazil and in tilapia.
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Cumulative risk of false positive test in relation to breast symptoms in mammography screening: a historical prospective cohort study
Abstract
Mammography has been found effective as the primary screening test for breast cancer. We estimated the cumulative probability of false positive screening test results with respect to symptom history reported at screen. A historical prospective cohort study was done using individual screening data from 413,611 women aged 50–69 years with 2,627,256 invitations for mammography screening between 1992 and 2012 in Finland. Symptoms (lump, retraction, and secretion) were reported at 56,805 visits, and 48,873 visits resulted in a false positive mammography result. Generalized linear models were used to estimate the probability of at least one false positive test and true positive at screening visits. The estimates were compared among women with and without symptoms history. The estimated cumulative probabilities were 18 and 6 % for false positive and true positive results, respectively. In women with a history of a lump, the cumulative probabilities of false positive test and true positive were 45 and 16 %, respectively, compared to 17 and 5 % with no reported lump. In women with a history of any given symptom, the cumulative probabilities of false positive test and true positive were 38 and 13 %, respectively. Likewise, women with a history of a 'lump and retraction' had the cumulative false positive probability of 56 %. The study showed higher cumulative risk of false positive tests and more cancers detected in women who reported symptoms compared to women who did not report symptoms at screen. The risk varies substantially, depending on symptom types and characteristics. Information on breast symptoms influences the balance of absolute benefits and harms of screening.
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Effect of selective serotonin reuptake inhibitors use on endocrine therapy adherence and breast cancer mortality: a population-based study
Abstract
The purpose of the study was to investigate whether the concomitant use of selective serotonin reuptake inhibitors (SSRI) with tamoxifen influences the risk of death due to breast cancer, and we also investigated the association between SSRI use and adherence to oral endocrine therapy (ET). We analyzed data from BCBaSe Sweden, which is a database created by the data linkage of Registries from three different regions of Sweden. To investigate the association between ET adherence and SSRI use, we included all women who were diagnosed with non-distant metastatic ER-positive invasive breast cancer from July 2007 to July 2011 and had at least one dispensed prescription of oral tamoxifen or aromatase inhibitor. To investigate the role of concurrent administration of SSRI and tamoxifen on breast cancer prognosis, we performed a nested case–control study. In the adherence cohort, 9104 women were included in the analyses. Women who received SSRI, either before or after breast cancer diagnosis, were at higher risk for low adherence to ET. However, when the overlapping period between SSRI use and ET was >50 %, no excess risk for low adherence was observed. Non-adherence (<80 %) to ET was significantly associated with worse breast cancer survival (OR 4.07; 95 % CI 3.27–5.06). In the case–control study, 445 cases and 11125 controls were included. The concomitant administration of SSRI and tamoxifen did not influence breast cancer survival, neither in short-term (OR 1.41; 95 % CI 0.74–2.68) nor in long-term SSRI users (OR 0.85; 95 % CI 0.35–2.08). Concomitant SSRI and tamoxifen use does not seem to increase risk for death due to breast cancer. Given the positive association between continuing antidepressive pharmacotherapy for a longer period of time and adherence to ET, it is essential to capture and treat depression in breast cancer patients to secure adherence to ET.
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Network inference and community detection, based on covariance matrices, correlations and test statistics from arbitrary distributions
Bartlett, TE; (2016) Network inference and community detection, based on covariance matrices, correlations and test statistics from arbitrary distributions. Communications in Statistics - Theory and Methods (In press).
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Quantitative EEG parameters correlate with the progression of human prion diseases
Franko, E; Wehner, T; Joly, O; Lowe, J; Porter, MC; Kenny, J; Thompson, A; Franko, E; Wehner, T; Joly, O; Lowe, J; Porter, MC; Kenny, J; Thompson, A; Rudge, P; Collinge, J; Mead, S; - view fewer (2016) Quantitative EEG parameters correlate with the progression of human prion diseases. Journal of Neurology, Neurosurgery & Psychiatry 10.1136/jnnp-2016-313501 . (In press). Green open access
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Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents
van Harmelen, A-L; Gibson, JL; St Clair, MC; Owens, M; Brodbeck, J; Dunn, V; Lewis, G; van Harmelen, A-L; Gibson, JL; St Clair, MC; Owens, M; Brodbeck, J; Dunn, V; Lewis, G; Croudace, T; Jones, PB; Kievit, RA; Goodyer, IM; - view fewer (2016) Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents. PLoS ONE , 11 (5) , Article e0153715. 10.1371/journal.pone.0153715 . Green open access
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Highly acid-durable carbon coated Co3O4 nanoarrays as efficient oxygen evolution electrocatalysts
Yang, X; Li, H; Lu, A-Y; Min, S; Idriss, Z; Hedhili, MN; Huang, K-W; Yang, X; Li, H; Lu, A-Y; Min, S; Idriss, Z; Hedhili, MN; Huang, K-W; Idriss, H; Li, L-J; - view fewer (2016) Highly acid-durable carbon coated Co3O4 nanoarrays as efficient oxygen evolution electrocatalysts. Nano Energy , 25 pp. 42-50. 10.1016/j.nanoen.2016.04.035 .
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The changing graduate labour market: analysis using a new indicator of graduate jobs
Green, F; Henseke, G; (2016) The changing graduate labour market: analysis using a new indicator of graduate jobs. IZA Journal of Labor Policy , 5 , Article 14. 10.1186/s40173-016-0070-0 . Green open access
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Structural priming in artificial languages and the regularisation of unpredictable variation
Fehér, O; Wonnacott, E; Smith, K; (2016) Structural priming in artificial languages and the regularisation of unpredictable variation. Journal of Memory and Language 10.1016/j.jml.2016.06.002 . (In press). Green open access
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Heterogenized Water Oxidation Catalysts Prepared by Immobilizing Kläui-Type Organometallic Precursors
Pastori, G; Wahab, K; Bucci, A; Bellachioma, G; Zuccaccia, C; Llorca, J; Idriss, H; Pastori, G; Wahab, K; Bucci, A; Bellachioma, G; Zuccaccia, C; Llorca, J; Idriss, H; Macchioni, A; - view fewer (2016) Heterogenized Water Oxidation Catalysts Prepared by Immobilizing Kläui-Type Organometallic Precursors. Chemistry - A European Journal 10.1002/chem.201602008 . (In press).
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ESSFN Mission
Stereotact Funct Neurosurg 2016;94:200
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WSSFN Society News
Stereotact Funct Neurosurg 2016;94:198
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Pyoderma gangraenosum
Zusammenfassung
Das Pyoderma gangraenosum (PG) ist charakterisiert durch plötzlich auftretende, schmerzhafte Wunden mit erythematösem, unterminiertem Randsaum. Die Ursache ist nicht vollständig verstanden, die Erkrankung wird zu den neutrophilen Dermatosen gezählt. Aufgrund fehlender spezifischer diagnostischer und therapeutischer Marker handelt es sich zumeist um eine Ausschlussdiagnose. Eine assoziierte Erkrankung wie Diabetes mellitus, eine chronisch entzündliche Darmerkrankung, eine rheumatoide Arthritis, maligne sowie Erkrankungen des metabolischen Syndroms liegt in weit über 50 % aller Fälle vor. Das therapeutische Regime besteht aus der Suppression der inflammatorischen Aktivität, der Therapie der Begleiterkrankungen, der Förderung der Wundheilung und der Schmerztherapie. Als First-line-Therapie werden derzeit Glukokortikosteroide und/oder Ciclosporin A empfohlen. Eine kontrollierte Studie zu Infliximab gibt Hinweis auf die Wirksamkeit von TNF-α-Antagonisten. Aufgrund der Chronizität, oft komplizierten Verläufen und einer hohen Rezidivrate ist eine gut verträgliche Therapie von großer Bedeutung.
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Short sleep duration is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females
Abstract
Purpose
The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population.
Methods
Cross-sectional data of 20,505 individuals aged 35–64 years from Taizhou longitudinal study was used. Logistic regression models were used to calculate odds ratios (ORs) for the risk of pre-hypertension and hypertension in association with sleep duration.
Results
Short sleep duration was associated with high systolic and diastolic blood pressure in comparison with sleep duration of 7–8 h in females. Short sleep duration was also associated with an increased risk of hypertension in females. Age-stratified analysis showed that as compared with sleep duration of 7–8 h, sleep duration <6 h increased risk of hypertension after controlling for multiple covariates with an OR of 1.766 (1.024–2.775) in early middle-aged females of 35–44 years. More importantly, sleeping less than 6 h is associated with increased risk of pre-hypertension in females of this age category, after controlling for multiple covariates with an OR of 1.769 (1.058–2.958).
Conclusions
Sleeping less than 6 h a day is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. The high-risk populations require sufficient sleep, which could probably prevent the increased risk of pre-hypertension as well as hypertension.
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Safety analysis of laparoscopic endoscopic cooperative surgery versus endoscopic submucosal dissection for selected gastric gastrointestinal stromal tumors: a propensity score-matched study
Abstract
Background
Laparoscopic endoscopic cooperative surgery (LECS) is a safe alternative to endoscopic submucosal dissection (ESD) for select gastric gastrointestinal stromal tumors (GISTs) that are <2 cm in size. To date, there have been no randomized studies comparing the feasibility of these two techniques. Therefore, we compared their feasibility and safety using the propensity score matching method in this study.
Methods
This was a single-center, retrospective, propensity score-matched study of patients who underwent resection of selected gastric GISTs between 2004 and 2014. All patients underwent curative resection for pathologically diagnosed small gastric GISTs. The primary aim was to determine intraoperative complications and postoperative courses. To overcome selection biases, we performed a 1:1 match using five covariates, including age, gender, body mass index, Charlson comorbidity index, and tumor location, to generate propensity scores.
Results
In total, 32 patients treated with LECS and 102 patients treated with ESD were balanced into 30 pairs. The rate of intraoperative complications was significantly lower in the LECS group than in the ESD group (P = 0.029). LECS patients had less intraoperative bleeding than did ESD patients (15.0 ml [range 9.5–50.0 ml] vs. 43.5 ml [range 22.3–56.0 ml], P = 0.004). The two groups had similar postoperative courses. There was no difference in the reoperation rate between the two groups (P = 0.112). The ESD group had a shorter operating time than did the LECS group (41.5 min vs. 96.5 min, P < 0.001). However, during a follow-up of 57.9 (±28.9) months, the recurrence rate did not differ significantly between the two groups (0.0 vs. 6.7 %, respectively; P = 0.256).
Conclusions
LECS for selected gastric GIST patients is feasible and is associated with a better intraoperative outcome and an equal postoperative course compared with the results of ESD.
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Bilateral areolar endoscopic Sistrunk operation: a novel technique for thyroglossal duct cyst surgery
Abstract
Background
Sistrunk operation of the thyroglossal duct is a procedure for the removal of a cyst, the middle part of the hyoid bone and tract towards the foramen caecum. Unavoidably, this procedure results in a scar on the skin in the neck area. By performing a bilateral areolar endoscopic Sistrunk operation, this study is the first to develop a procedure that can solve the aesthetic problem. This operation results in both an excellent cosmetic result and the successful treatment of TGDC.
Methods
A three-port technique was performed in this operation: 10-mm port for 30°, 10-mm laparoscope, 5-mm port for the instrument at the left circumareolar area and 5-mm port located at the right circumareolar area. Insufflation pressure of CO2 gas was set at 6 mm Hg. The surgical working space was located over the breast tissue and pectoralis muscles, towards the anterior neck to the hyoid bone. The steps employed for resection were similar to a conventional Sistrunk operation using standard laparoscopic instruments and hook scissors.
Results
A series of 11 patients were successfully treated using this novel technique with neither conversion to open surgery nor surgical complications. Average operative time was 88.54 min (ranging from 60 to 130 min). Average blood loss was 35 mL. (ranging from 15 to 67 mL). Patients were discharged in an average of 2.36 days after the procedure (ranging from 2 to 3 days).
Conclusion
This novel technique for TGDC Sistrunk surgery using an areolar approach is feasible, safe and effective. The benefit of this technique is the cosmetic result, which leaves no scarring on the neck after wound healing and may provide a new method for optimal aesthetic results.
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A new method (the “Pincers maneuver”) for lymphadenectomy along the right recurrent laryngeal nerve during thoracoscopic esophagectomy in the prone position for esophageal cancer
Abstract
Background
In esophageal squamous cell carcinoma, the number of dissected lymph nodes (LNs), including those along the recurrent laryngeal nerves (RLNs), influences prognosis and nodal staging accuracy. However, dissection of LNs along the RLN increases the risk of complications, especially RLN palsy. Therefore, complete dissection of these LNs with prevention of RLN palsy is recommended. We present herein a new method for lymphadenectomy along the right RLN, named the Pincers maneuver, during thoracoscopic esophagectomy in the prone position (TEP).
Methods
The fundamental concept in this new method is to first exfoliate the two-dimensional membrane (lateral pedicle), which includes the right RLN, LNs along the right RLN, and the primary esophageal artery, from the right side of the trachea toward the neck. Using a Pincers strategy, closing in from the inner and outer sides of the two-dimensional membrane (lateral pedicle), lymphadenectomy along the right RLN toward the right inferior thyroid artery should be easy. This technique was evaluated in 30 consecutive cases of TEP for squamous cell cancer.
Results
There were 15 patients who underwent the new method (Pincers maneuver; Pm) and 15 patients who underwent the conventional method (Cm). There were no significant differences between the two groups in the duration of the thoracic procedure and dissection along the right RLN. No intraoperative and postoperative morbidity related to the right RLN was observed in either group. The Pm group had a higher number of dissected LNs along the right RLN than the Cm group (6.3 vs 3.1, p = 0.044).
Conclusions
The Pincers maneuver for lymphadenectomy along the right RLN during TEP is technically safe and feasible. It increases the number of dissected LNs along the right RLN.
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Sublattice dependent magnetic response of dual Cr doped graphene monolayer: a full potential approach
Abstract
In the present scenario, many researchers are exploring the possibility of inducing a magnetic channel in graphene by introducing various types of defects. To examine the Cr–Cr interactions in dual Cr doped graphene monolayer for magnetic response and spin polarization, the first-principles density functional theory based calculations are performed. Further, the possibility of achieving 100 % spin polarization in various possible configurations of dual Cr-doping have been explored. Dual doping of Cr atoms in graphene monolayer preferring ferromagnetic ordering, generates a spin magnetic state with a local moment of ~4.00 µB. Depending upon the relative position of two Cr impurities in graphene, the ground states of doped systems are found be ferromagnetic, antiferromagnetic or paramagnetic. The origin of particular magnetic state observed in all possible dual Cr-doping configurations has been explained on the basis of RKKY indirect exchange interactions.
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QCD phase-transition and chemical freezeout in nonzero magnetic field at NICA
Abstract
Because of relativistic off-center motion of the charged spectators and the local momentum-imbalance experienced by the participants, a huge magnetic field is likely generated in high-energy collisions. The influence of such short-lived magnetic field on the QCD phase-transition(s) is analysed. From Polyakov linear-sigma model, we study the chiral phase-transition and the magnetic response and susceptibility in dependence on temperature, density and magnetic field strength. The systematic measurements of the phase-transition characterizing signals, such as the fluctuations, the dynamical correlations and the in-medium modifications of rho-meson, for instance, in different interacting systems and collision centralities are conjectured to reveal an almost complete description for the QCD phase-structure and the chemical freezeout. We limit the discussion to NICA energies.
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Texas EMT Basic San Antonio TX - U.S. Safety Services
ARE YOU A TEXAS EMT LOOKING FOR PART TIME EMPLOYMENT" U.S. Safety Services is a San Antonio based company that is hiring event medics and industrial medics in San Antonio, TX. Applicants need to be at a minimum, a Texas Certified EMT with a valid CPR/AED card, valid driver's license & social security card. Applicants must have a high school diploma or GED. Applicant will need to be flexible ...
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Part Time EMT in Temple Tx - U.S. Safety Services
U.S. Safety Services is a San Antonio based company that has a contract to provide BLS medical services to a Manufacturing site in Temple Texas. Applicants need to be at a minimum, a Texas Certified EMT with a valid CPR/AED card, valid driver's license & social security card. Applicants must have a high school diploma or GED. Applicant will need to be flexible to work different shifts at ...
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Stabilisation of Metastable Polymorphs: The Case of Paracetamol Form III
Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC05006A, Communication
DOI: 10.1039/C6CC05006A, Communication
Ian J Scowen, Gareth R Williams, Richard Telford, colin seaton, Simon Gaisford, Alexander Clout, Chidera Okoye, Asma BM Buanz, Timothy J. Prior, Tasnim Munshi
The design of a melt synthesis of the first air-stable formulation of the metastable form III of paracetamol is derived from thermo-spectroscopic and thermo-diffraction experiments. Melt crystallisation in the presence...
The content of this RSS Feed (c) The Royal Society of Chemistry
The design of a melt synthesis of the first air-stable formulation of the metastable form III of paracetamol is derived from thermo-spectroscopic and thermo-diffraction experiments. Melt crystallisation in the presence...
The content of this RSS Feed (c) The Royal Society of Chemistry
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Diet quality in European pre-schoolers: evaluation based on the diet quality indices and association with gender, socio-economic status and overweight: the ToyBox-study
OBJECTIVE: To study diet quality among pre-schoolers using the Diet Quality Index (DQI) and to investigate differences according to gender, socio-economic status (SES) and overweight/obesity status. DESIGN: Kindergarten-based cross-sectional survey within the ToyBox-study. A standardized protocol was used and parents/caregivers self-reported sociodemographic data and a semi-quantitative FFQ. A total DQI and its four subcomponents (diversity, quality, equilibrium and meal index) were calculated based on this FFQ. High total DQI scores indicate better diet quality than low scores. Results of the total DQI and the subcomponents were reported as percentages of maximum scores (100 %). SETTING: Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). SUBJECTS: European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7063). RESULTS: The mean total DQI score was 68·3 %. Mean scores of the subcomponents were 61·7 % for diversity, 56·5 % for quality, 65·4 % for equilibrium and 89·7 % for the meal index. Pre-schoolers of lower-SES backgrounds had lower scores on the total DQI and all its subcomponents. No clear differences were found by gender and overweight status. Results differed slightly according to country. CONCLUSIONS: Pre-schoolers scored low on the total DQI and especially on dietary quality, as energy-dense, low-nutritious food items were more often consumed than highly nutritious food items. Furthermore, already in pre-schoolers lower-SES mothers were less likely to provide a good diet quality and this was consistent for all four subcomponents of the total DQI. Food intake in pre-schoolers should be enhanced, especially in pre-schoolers of lower-SES backgrounds.
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Depletion of Dicer promotes epithelial ovarian cancer progression by elevating PDIA3 expression
Abstract
Dicer is an essential component of the microRNA (miRNA) processing machinery whose low expression is associated with advanced stage and poor clinical outcome in epithelial ovarian cancer. To investigate the functional relevance of Dicer in epithelial ovarian cancer and to identify its downstream effectors, two-dimensional gel electrophoresis combined with mass spectrometry was used for proteomic profiling. Dicer depletion promoted ovarian cancer cell proliferation and migration accompanied by a global upregulation of proteins. Twenty-six proteins, 7 upregulated and 19 downregulated, were identified. The functions of the identified proteins and their interactions were bioinformatically analyzed. Among them, protein disulfide-isomerase A3 (PDIA3) was considered to be a potential target protein of Dicer. PDIA3 repression by siRNA could significantly relieve the proliferation- and migration-promoting effect mediated by Dicer depletion in vitro and in vivo. Moreover, the miRNAs targeting PDIA3 were decreased in cells with Dicer depletion. In summary, low Dicer expression contributes to epithelial ovarian cancer progression by elevating PDIA3 expression.
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MicroRNA-137 represses FBI-1 to inhibit proliferation and in vitro invasion and migration of hepatocellular carcinoma cells
Abstract
The pro-oncogene factor that binds to inducer of short transcripts-1 (FBI-1), which is encoded by ZBTB7A gene and belongs to POK (POZ/BTB and KrÜppel) protein family, has been shown to enhance hepatocellular carcinoma (HCC) cells proliferation and multi-drug resistance (MDR) process. However, the possibility that FBI-1 is a therapeutic target for further HCC treatment remains poorly determined. In the current study, two microRNA (miRNA) target prediction programs (TargetScan and MiRanda) were used to identify miR-137 as a potential regulator of FBI-1. Our results showed that expression of miR-137 was downregulated, while FBI-1 was upregulated in clinical HCC specimens, compared with paired non-tumor specimens. Overexpression of miR-137 via adenoviral vector inhibited the proliferation and anchorage-independent growth of HCC cells, HepG2 and MHCC-97H. Our data also showed that miR-137 repressed endogenous expression level of FBI-1, as well as Notch-1 and Survivin. MiR-137 also inhibited in vitro invasion and migration of HCC cells and attenuated their epithelial-mesenchymal transition (EMT) process. Moreover, miR-137 suppressed the growth rate of HepG2 cells in nude mice model. Overexpression of miR-137 via its adenoviral vector enhanced the sensitivity of HepG2 cells to anti-tumor drugs and attenuated the MDR process of a resistance cell line HepG2/adriamycin (ADR). Thus, FBI-1 downregulation mediated by miR-137 overexpression may be a potential strategy for HCC treatment.
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