Transported vs. local contributions from secondary and biomass burning sources to PM2.5

Publication date: November 2016
Source:Atmospheric Environment, Volume 144
Author(s): Bong Mann Kim, Jihoon Seo, Jin Young Kim, Ji Yi Lee, Yumi Kim
The concentration of fine particulates in Seoul, Korea has been lowered over the past 10 years, as a result of the city's efforts in implementing environmental control measures. Yet, the particulate concentration level in Seoul remains high as compared to other urban areas globally. In order to further improve fine particulate air quality in the Korea region and design a more effective control strategy, enhanced understanding of the sources and contribution of fine particulates along with their chemical compositions is necessary. In turn, relative contributions from local and transported sources on Seoul need to be established, as this city is particularly influenced by sources from upwind geographic areas. In this study, PM2.5 monitoring was conducted in Seoul from October 2012 to September 2013. PM2.5 mass concentrations, ions, metals, organic carbon (OC), elemental carbon (EC), water soluble OC (WSOC), humic-like substances of carbon (HULIS-C), and 85 organic compounds were chemically analyzed. The multivariate receptor model SMP was applied to the PM2.5 data, which then identified nine sources and estimated their source compositions as well as source contributions. Prior studies have identified and quantified the transported and local sources. However, no prior studies have distinguished contributions of an individual source between transported contribution and locally produced contribution. We differentiated transported secondary and biomass burning sources from the locally produced secondary and biomass burning sources, which was supported with potential source contribution function (PSCF) analysis. Of the total secondary source contribution, 32% was attributed to transported secondary sources, and 68% was attributed to locally formed secondary sources. Meanwhile, the contribution from the transported biomass burning source was revealed as 59% of the total biomass burning contribution, which was 1.5 times higher than that of the local biomass burning source. Four-season average source contributions from the transported and the local sources were 28% and 72%, respectively.

Graphical abstract

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Aviation-attributable ozone as a driver for changes in mortality related to air quality and skin cancer

Publication date: November 2016
Source:Atmospheric Environment, Volume 144
Author(s): Sebastian D. Eastham, Steven R.H. Barrett
Aviation is a significant source of tropospheric ozone, which is a critical UV blocking agent, an indirect precursor to the formation of particulate matter, and a respiratory health hazard. To date, investigations of human health impacts related to aviation emissions have focused on particulate matter, and no global estimate yet exists of the combined health impact of aviation due to ozone, particulate matter and UV exposure changes. We use a coupled tropospheric-stratospheric chemical-transport model with a global aviation emissions inventory to estimate the total impact of aviation on all three risk factors. We find that surface ozone due to aviation emissions is maximized during hemispheric winter due to the greater wintertime chemical lifetime of ozone, but that a smaller enhancement of 0.5 ppbv occurs during summertime. This summertime increase results in an estimated 6,800 premature mortalities per year due to ozone exposure, over three times greater than previous estimates. During the winter maximum, interaction with high background NOx concentrations results in enhanced production of nitrate aerosol and increased annual average exposure to particulate matter. This ozone perturbation is shown to be the driving mechanism behind an additional 9,200 premature mortalities due to exposure to particulate matter. However, the increase in tropospheric ozone is also found to result in 400 fewer mortalities due to melanoma skin cancer in 2006. This is the first estimate of global melanoma mortality due to aviation, and the first estimate of skin cancer mortality impacts due to aviation using a global chemical transport model.



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Editorial board

Publication date: October 2016
Source:Atmospheric Environment, Volume 142





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Middle ear ventilation status postoperatively after translabyrinthine resection of vestibular schwannoma with mastoid obliteration and Eustachian tube occlusion: is the Eustachian tube enough to ventilate the middle ear without the mastoid air cell system?

Gas pressure balance is essential for maintaining normal middle ear function. The mucosal surfaces of the middle ear, the mastoid air cell system (MACS), and the Eustachian tube (ET) play a critical role in th...

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Transient resistance to DNA damaging agents is associated with expression of microRNAs-135b and -196b in human leukemia cell lines.

Related Articles

Transient resistance to DNA damaging agents is associated with expression of microRNAs-135b and -196b in human leukemia cell lines.

Int J Biochem Mol Biol. 2016;7(2):27-47

Authors: Ho TT, He X, Mo YY, Beck WT

Abstract
The acquisition of resistance to anticancer drugs is widely viewed as a key obstacle to successful cancer therapy. However, detailed knowledge of the initial molecular events in the response of cancer cells to these chemotherapeutic and stress responses, and how these lead to the development of chemoresistance, remains incompletely understood. Using microRNA array and washout and rechallenge experiments, we found that short term treatment of leukemia cells with etoposide led a few days later to transient resistance that was associated with a corresponding transient increase in expression of ABCB1 mRNA, as well as microRNA (miR)-135b and miR-196b. This phenomenon was associated with short-term exposure to genotoxic agents, such as etoposide, topotecan, doxorubicin and ionizing radiation, but not agents that do not directly damage DNA. Further, this appeared to be histiotype-specific, and was seen in leukemic cells, but not in cell lines derived from solid tumors. Treatment of leukemic cells with either 5-aza-deoxycytidine or tricostatin A produced similar increased expression of ABCB1, miR-135b, and miR-196b, suggesting a role for epigenetic regulation of this phenomenon. Bioinformatics analyses revealed that CACNA1E, ARHGEF2, PTK2, SIAH1, ARHGAP6, and NME4 may be involved in the initial events in the development of drug resistance following the upregulation of ABCB1, miR-135b and miR-196b. In summary, we report herein that short-term exposure of cells to DNA damaging agents leads to transient drug resistance, which is associated with elevations in ABCB1, miR-135b and miR-196b, and suggests novel components that may be involved in the development of anticancer drug resistance.

PMID: 27570640 [PubMed]

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Pesg PNH diagnosis, follow-up and treatment guidelines.

Related Articles

Pesg PNH diagnosis, follow-up and treatment guidelines.

Am J Blood Res. 2016;6(2):19-27

Authors: Sahin F, Akay OM, Ayer M, Dal MS, Ertop S, Ilhan O, Karakus V, Ozcan MA, Ozkocaman V, Ozsan H, Salim O, Tobu M, Tombak A, Tuglular TF, Yilmaz M, Unal A, Yenerel MN, Saydam G

Abstract
PNH Education and Study Group (PESG) have been established in December 2013 as a non-profit, independent, medical organization www.pesg.org. Paroxysmal Nocturnal Hemoglobinuria (PNH) is a multi-systemic disease that should be treated with a multidisciplinary approach. Patients may apply to the clinics other than the hematology due to variability and diversity of clinical findings which lower the rate of diagnosis due to low awareness about PNH. PNH might be overlooked and diagnosis might be delayed. Regarding these, PESG was established with the collaboration of Immunology, Cardiology, Thorax Diseases (Pulmonology), Neurology, Gastroenterology, General Surgery and Urology specialists in addition to hematologists dealing with PNH. The PESG study group aims to increase the awareness about PNH, including training activities about PNH, strengthening the relations between clinics and planning of clinical studies as a goal. It is the first professional organization focusing on PNH, in Turkey.In this guideline, we want to facilitate the diagnosis attributes of physicians from all specializations that deal with PNH and its systemic complications. One can perceive this as a tailor made guideline of international guidelines but not a compilation.

PMID: 27570707 [PubMed]

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The effect of aliskiren on the renal dysfunction following unilateral ureteral obstruction in the rat.

The effect of aliskiren on the renal dysfunction following unilateral ureteral obstruction in the rat.

Int J Physiol Pathophysiol Pharmacol. 2016;8(2):70-7

Authors: Hammad FT, Lubbad L

Abstract
PURPOSE: To investigate the effect of blocking renin-angiotensin system by direct renin inhibition using aliskiren on the renal dysfunction following reversible unilateral ureteral obstruction (UO).
METHODS: Wistar rats underwent reversible left UO for 72 hours. Group-Alsk (n=12) received aliskiren (30 mg/kg/day) dissolved in water starting one day before creating UO and continued until the terminal experiment five days post reversal when renal functions were measured using clearance techniques. Group-Vx (n=12) underwent similar protocol but had water only. Gene expression analysis of some markers of kidney injury was measured using PCR technique.
RESULTS: In Group-Vx, renal blood flow (RBF) and glomerular filtration rate (GFR) in the left kidney were significantly lower than the right kidney (1.82±0.12 vs. 3.19±0.40, P=0.001 and 0.81±0.08 vs. 1.44±0.09, P=0.004, respectively). However, left fractional excretion of sodium (FENa) was higher than the right FENa (0.80±0.15 vs. 0.55±0.04, P=0.05). Comparing the left obstructed kidney in Group-Alsk vs. Group-Vx, RBF and GFR were higher in Group-Alsk (2.44±0.30 vs. 1.82±0.12, P=0.049 and 1.02±0.11 vs. 0.81±0.08, P=0.07, respectively). The left renal FENa was lower in Group-Alsk but did not reach statistical significance (0.54±0.07 vs. 0.80±0.15, P=0.07). Aliskiren also decreased the gene expressions of NGAL, KIM-1 and p53.
CONCLUSION: Direct renin inhibition by aliskiren appears to have protective effect on the renal dysfunction and on the markers of renal injury following UO indicating a potential clinical benefit of this agent. Further, this data and the previous studies indicate that blocking renin-angiotensin system at any level has a protective effect in obstructive nephropathy.

PMID: 27570581 [PubMed]

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Sphingolipids in spinal cord injury.

Sphingolipids in spinal cord injury.

Int J Physiol Pathophysiol Pharmacol. 2016;8(2):52-69

Authors: Jones ZB, Ren Y

Abstract
Spinal cord injury (SCI) is a debilitating condition that affects millions of individuals worldwide. Despite progress over the last few decades, the molecular mechanisms of secondary SCI that continue to occur days and weeks after the original trauma remain poorly understood. As a result, current therapies for SCI are only marginally effective. Sphingolipids, a diverse class of bioactive lipids, have been shown to regulate SCI repair and key secondary injury processes such as apoptosis, ischemia and inflammation. This review will discuss the numerous roles of sphingolipids and highlight the potential of sphingolipid-targeted therapies for SCI.

PMID: 27570580 [PubMed]

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A multicenter, randomized, split-face clinical trial evaluating the efficacy and safety of chromophore gel-assisted blue light phototherapy for the treatment of acne

Abstract

Background

Although a variety of laser/light-based devices have been reported to be effective for the treatment of acne, long-term data on efficacy and safety in the management of moderate and severe inflammatory acne is lacking. The objective of this 12-week clinical trial was to evaluate the efficacy and safety of the KLOX BioPhotonic System, a LED blue light device using specific photo-converter chromophores, in the treatment of moderate to severe acne vulgaris.

Methods

One patient hemiface was randomly selected to receive 6 weeks of treatment (twice weekly) with the LED light and the photo-converter chromophores whereas the contralateral hemiface was not treated with the BioPhotonic System. All patients were provided with a skin cleanser and a non-comedogenic cream with ultraviolet protection to be used on the entire face during the treatment period. Following completion of the 6-week treatment period, the patient was followed for an additional 6 weeks. Efficacy was assessed through changes in acne severity using the Investigator's Global Assessment (IGA) scale and inflammatory acne lesion counts, both evaluated against baseline at weeks 6 and 12. Safety was assessed through physical exam, vital signs, laboratory evaluations, and physician and patient reporting of adverse events.

Results

A reduction of at least two grades in IGA scale severity was demonstrated in 51.7% of patients at week 12. Furthermore, at week 12, subjects with a baseline IGA grade of 3 (moderate) demonstrated a success rate (2 or greater grade drop) of 45.3% whereas patients with a baseline IGA grade of 4 (severe) demonstrated a success rate of 61.1%. Acne inflammatory lesion counts confirmed these results, with a reduction of at least 40% of lesions in 81.6% of treated hemifaces after 12 weeks. Treatment was considered as safe and well tolerated, with no serious adverse event and no patient discontinuation from the study from any adverse event. Patients' quality of life was also improved with a decrease of pain linked to acne after the 6-week treatment period.

Conclusions

The BioPhotonic System comprised of LED blue-light phototherapy and photo-converter chromophores was found to be efficacious and safe, with a sustained clinical response at 12 weeks for the management of moderate to severe facial inflammatory acne.

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Middle ear ventilation status postoperatively after translabyrinthine resection of vestibular schwannoma with mastoid obliteration and Eustachian tube occlusion: is the Eustachian tube enough to ventilate the middle ear without the mastoid air cell system?

Abstract

Background

Gas pressure balance is essential for maintaining normal middle ear function. The mucosal surfaces of the middle ear, the mastoid air cell system (MACS), and the Eustachian tube (ET) play a critical role in this process; however, the extent that each of these factors contributes to overall middle ear ventilation is unknown. The objective of this study was to determine if the ET alone can maintain normal middle ear pressure without the MACS. To do this, we reviewed subjects who had their MACS completely removed with translabyrinthine (TL) surgery for vestibular schwannoma.

Methods

A retrospective chart review was done to collect pre and postoperative tympanometry data from patients who underwent resection of vestibular schwannoma. Data from the operative side was compared to the non-operative side at 2 years post-op.

Results

Twenty-four patients were included in this study. Of these, 63 % achieved a type A tympanogram at 2 years post-op in the TL resection group, implying an ability to maintain middle ear pressure in the absence of a mastoid cavity. Because some had negative pressures post TL resection, the average change in pre and postoperative pressure was -37.5 daPa for the operative side and 7.8 daPa for the non-operative side. This was significantly different.

Discussion

The difference for change in pre and postoperative pressure and compliance between operative and non-operative side might be expected from the ET plugging during TL resection. However, more interesting are those patients in whom the ET presumably reopens, and in these subjects, despite having no mastoid compartment at all, and the space obliterated with fat, they were still able to maintain normal ventilation of the middle ear space.

Conclusion

Our findings imply that the ET alone is adequate to ventilate at least the reduced middle ear space following TL surgery in most subjects, and perhaps in 100 % if the ET hadn't been plugged during surgery. Hence, the mastoid air cell system, even when healthy, is not needed to maintain air in the middle year cleft.

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Analysis of Chlorination, Nitration, and Nitrosylation of Tyrosine and Oxidation of Methionine and Cysteine in Hemoglobin from Type 2 Diabetes Mellitus Patients by Nanoflow Liquid Chromatography Tandem Mass Spectrometry

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b02663

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Potential Clinical Applications of 18 F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Mammography in Breast Cancer

Abstract

The whole-body positron emission tomography (PET)/magnetic resonance (MR) scan is a cutting edge technology providing comprehensive structural information from MR imaging and functional features from PET in a single session. Recent research findings and clinical experience have shown that ¹⁸F-fluorodeoxyglucose (FDG) whole-body PET/MR imaging has a diagnostic performance comparable with or superior to that of PET/CT in the field of oncology, including for breast cancer. In particular, FDG PET/MR mammography in the prone position with the breast hanging in a pendant manner can provide more comprehensive information about the metabolism, anatomy, and functional features of a breast lesion than a whole-body PET/MR scan. This article reports on current state-of-the-art PET/MR mammography in patients with breast cancer and the prospects for potential application in the future.

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Induction of the mesenchymal to epithelial transition by demethylation-activated microRNA-125b is involved in the anti-migration/invasion effects of arsenic trioxide on human chondrosarcoma

Abstract

Background

In addition to treating acute promyelocytic leukemia, arsenic trioxide (ATO) suppresses other solid tumors, including chondrosarcoma. However, the effects of ATO on metastasis in chondrosarcoma cells, and the underlying molecular mechanisms remain unclear.

Methods

The effects of ATO on the migratory and invasive capacities of chondrosarcoma cells were investigated by Wound healing, Transwell and EMT assays. The expression of miR-125b in human chondrosarcoma tissues and cell lines was detected by real-time PCR analysis. Bisulfite sequencing analysis (BSP) was used to detect the effects of ATO on the expression of miR-125b. The gain-of-function and loss-of-function experiments were performed on chondrosarcoma cell lines to investigate the effects of miR-125b on chondrosarcoma invasion, and to determine whether signal transducer and activator of transcription 3(Stat3) mediates these effects. Dual-luciferase reporter assay was used to identify whether Stat3 is a direct target of miR-125b.

Results

MiR-125b was significantly downregulated in human metastatic chondrosarcoma tissues and cell lines but not in non-metastatic chondrosarcoma tissues. ATO up-regulates the expression of miR-125b by the demethylation of DNA. ATO induces MET and attenuates the invasive capacities of chondrosarcoma cells through miR-125b. Stat3 was verified as a direct target of miR-125b, which is involved in ATO regulating EMT-associated traits.

Conclusions

These findings, for the first time, provides evidence that the miR-125b-mediated inhibition of Stat3 is involved in the ATO-induced attenuation of metastasis in chondrosarcoma cells.

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Interplay between intergrin-linked kinase and ribonuclease inhibitor affects growth and metastasis of bladder cancer through signaling ILK pathways

Abstract

Background

Integrin-linked kinase (ILK) is a multifunctional adaptor protein which is involved with protein signalling within cells to modulate malignant (cancer) cell movement, cell cycle, metastasis and epithelial–mesenchymal transition (EMT). Our previous experiment demonstrated that ILK siRNA inhibited the growth and induced apoptosis of bladder cancer cells as well as increased the expression of Ribonuclease inhibitor (RI), an important cytoplasmic protein with many functions. We also reported that RI overexpression inhibited ILK and phosphorylation of AKT and GSK3β. ILK and RI gene both locate on chromosome 11p15 and the two genes are always at the adjacent position of same chromosome during evolution, which suggest that ILK and RI could have some relationship. However, underlying interacting mechanisms remain unclear between them. Here, we postulate that RI might regulate ILK signaling pathway via interacting with ILK.

Methods

Co-immunoprecipitation, GST pull-down and co-localization under laser confocal microscope assay were used to determine the interaction between ILK and RI exogenously and endogenously. Furthermore, we further verified that there is a direct binding between the two proteins by fluorescence resonance energy transfer (FRET) in cells. Next, The effects of interplay between ILK and RI on the key target protein expressions of PI3K/AKT/mTOR signaling pathway were determined by western blot, immunohistochemistry and immunofluorescence assay in vivo and in vitro. Finally, the interaction was assessed using nude mice xenograft model.

Results

We first found that ILK could combine with RI both in vivo and in vitro by GST pull-down, co-immunoprecipitation (Co-IP) and FRET. The protein levels of ILK and RI revealed a significant inverse correlation in vivo and in vitro. Subsequently, The results showed that up-regulating ILK could increase cell proliferation, change cell morphology and regulate cell cycle. We also demonstrated that the overexpression of ILK remarkably promoted EMT and expressions of target molecules of ILK signaling pathways in vitro and in vivo. Finally, we found that ILK overexpression significantly enhanced growth, metastasis and angiogenesis of xenograft tumor; Whereas, RI has a contrary role compared to ILK in vivo and in vitro.

Conclusions

Our findings, for the first time, directly proved that the interplay between ILK and RI regulated EMT via ILK/PI3K/AKT signaling pathways for bladder cancer, which highlights the possibilities that ILK/RI could be valuable markers together for the therapy and diagnosis of human carcinoma of urinary bladder.

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The Influence of the CB1 Receptor Ligands on the Schizophrenia-Like Effects in Mice Induced by MK-801

Abstract

A growing body of psychiatric research has emerged, focusing on the role of endocannabinoid system in psychiatric disorders. For example, the endocannabinoid system, via cannabinoid CB (CB1 and CB2) receptors, is able to control the function of many receptors, such as N-methyl-d-aspartate (NMDA) receptors connected strictly with psychosis or other schizophrenia-associated symptoms. The aim of the present research was to investigate the impact of the CB1 receptor ligands on the symptoms typical for schizophrenia. We provoked psychosis-like effects in mice by an acute administration of NMDA receptor antagonist, MK-801 (0.1–0.6 mg/kg). An acute administration of MK-801 induced psychotic symptoms, manifested in the increase in locomotor activity (hyperactivity), measured in actimeters, as well as the memory impairment, assessed in the passive avoidance task. We revealed that an acute injection of CB1 receptor agonist, oleamide (5–20 mg/kg), had no influence on the short- and long-term memory-related disturbances, as well as on the hyperlocomotion in mice, provoking by an acute MK-801. In turn, an amnestic effects or hyperactivity induced by an acute MK-801 was attenuated by an acute administration of AM 251 (0.25–3 mg/kg), a CB1 receptor antagonist. The present findings confirm that endocannabinoid system is able to modify a variety of schizophrenia-like responses, including the cognitive disturbances and hyperlocomotion in mice. Antipsychotic-like effects induced by CB1 receptor antagonist, obtained in our research, confirm the potential effect of CB1 receptor blockade and could have important therapeutic implications on clinical settings, in the future.

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Prognostic role of negative plasma EBV DNA level in patients with NPC

I read with great interest the study published by Lu et al. [1]. Authors very nicely evaluated the prognostic effect of combining tumor volume with pre-treatment plasma Epstein-Barr virus DNA (EBV DNA) in patients treated with intensity-modulated radiotherapy in nasopharyngeal carcinoma (NPC) patients. Briefly, they analyzed 3 different threshold values for probable prognostic role of gross tumor volume of nasopharynx and plasma EBV DNA level. They found that 20cc and 6800 copies/mL are threshold values for a statistically significant difference.

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Surface electromyography of myopotential oversensing provoked by simultaneous straining and leftward twisting in a patient with an implantable cardioverter defibrillator

Abstract

An important step in diagnosing myopotential oversensing is to confirm its reproducibility using specific provocation maneuvers. Although most maneuvers involve the co-contraction of many muscles, no attempt has been made to assess relevant muscle activities by electromyography. We describe a case with an implantable cardioverter defibrillator (ICD) whose myopotential oversensing was provoked by simultaneous straining and leftward twisting. Simultaneous recordings from real-time ICD telemetry and myopotentials of the rectus abdominis, oblique abdominis, and diaphragm on electromyography during the provocation maneuvers were conducted. It was shown that all three muscles contracted simultaneously during the provocation maneuvers; the diaphragm activity was the main source of noise oversensing, and the twist itself caused oversensing possibly due to the change in the position of the lead. In conclusion, the electromyographic assessment of relevant muscle activities may be useful in assessing each muscle's role and its contribution to myopotential oversensing, especially in a patient whose myopotential oversensing requires complex maneuvers to be provoked.

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Right atrial approach for repairing a posterior ventricular septal rupture: a case report

Abstract

Background

Ventricular septal rupture (VSR) is a life-threatening complication following acute transmural myocardial infarction. Posteriorly located ruptures are one of the main predictors of poor prognoses because of the surgical difficulties associated with this location.

Case presentation

A 72-year-old man with a posterior VSR underwent surgical repair via the right atrial approach. The patient's postoperative course was uneventful, and echocardiography showed no residual shunt flow. He was discharged on postoperative day 37.

Conclusion

By temporally detaching the tricuspid valve leaflet, this approach provides a better view and handling space within the posterior ventricular septum than the trans-ventricular approach. Additionally, avoiding a ventricular incision can better preserve postoperative ventricular function.

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Pedunculated tragal dermoid cyst misdiagnosed as an accessory tragus

I encountered an ovoid mass that blocked the opening of a patient's right ear, and initially thought that it was an accessory tragus. Unusually, the cyst had developed on the tragus of the ear and was pedunculated with a linear stalk from the tragal cartilage. To the best of my knowledge, this is the first report of a dermoid cyst that involved the tragal cartilage, and was completely excised.

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Re: Minimal invasive treatment using patient-specific template for pediatric mandibular fracture: “wing-splint” by CAD/CAM technology

I read the paper by JW Lee, et al. with interest.1 The treatment of mandibular fractures in children is influenced by many factors, such as the eruption of teeth, the presence of short roots, the developing tooth buds, and growth, particularly at the time of mixed dentition.

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A qualitative study of the allergy testing experiences, views and preferences of adult patients

Patients can be tested for IgE sensitivities with in vivo or in vitro testing, but patients' experiences of different allergy test modalities have not been studied. The objective of this study was to investiga...

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Cost utility of ERCP-based modalities for the diagnosis of cholangiocarcinoma in primary sclerosing cholangitis

Cholangiocarcinoma (CCA) is a leading cause of morbidity and mortality in patients with primary sclerosing cholangitis (PSC). Although several ERCP-based diagnostic modalities are available for diagnosing CCA, it is unclear whether one modality is more cost-effective than the others. The primary aim of this study was to compare the cost-effectiveness of ERCP-based techniques for diagnosing CCA in patients with PSC-induced biliary strictures.

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The correlation between blood calcium level, hematoma volume, stroke severity and prognosis in patients with acute cerebral hemorrhage

OBJECTIVE: The objective of the present study was to determine the correlation between blood calcium level, hematoma volume and stroke severity in the prognosis of acute cerebral hemorrhage patients.

PATIENTS AND METHODS: We selected 125 patients with acute cerebral hemorrhage admitted within 24 hours of symptom onset. Blood calcium levels were assessed by standard biochemical methods. Hematoma volume was measured by quantitative computed tomography. NIHSS (National Institutes of Health Stroke Scale) scores at one month, and the differences in survival rate and survival period at follow-up visits were assessed.

RESULTS: Hematoma volume and NIHSS scores of the hypocalcemic group were higher than those of the hypercalcemic group. Those of the normocalcemic group were the lowest, and the differences were statistically significant (p <0.05). The survival rate and survival period of the normocalcemic group were higher than those of the other two groups and the differences were statistically significant (p <0.05). The logistics regression analysis showed that the APACHE II score, blood calcium level upon admission and hematoma volume were independent risk factors for survival (p <0.05).

CONCLUSIONS: If blood calcium level is too low or too high, hematoma volume and stroke severity of acute cerebral hemorrhage patients may increase and is related to long-term survival.

L'articolo The correlation between blood calcium level, hematoma volume, stroke severity and prognosis in patients with acute cerebral hemorrhage sembra essere il primo su European Review.

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"J BUON"[jour]; +38 new citations

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

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These pubmed results were generated on 2016/08/30

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

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Lateral Firefighter/EMT - Snoqualmie Fire Department

SNOQUALMIE, CITY OF, FIRE DEPARTMENT 37600 SE SNOQUALMIE PARKWAY SNOQUALMIE, WASHINGTON 98065 Updated: August 24, 2016 Classification: Lateral Firefighter/EMT The City of Snoqualmie is currently building an eligibility list for Lateral Firefighter/EMT. The Department is anticipating one (1) vacancy in the near future and hopes to fill it in late 2016 / early 2017. This position requires FireTEAM through ...

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Continuous ambulatory adductor canal catheters for patients undergoing knee arthroplasty surgery

To determine after knee arthroplasty surgery the feasibility of discharging patients home on postoperative day 1 with continuous adductor canal blocks.

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Geriatrie: interdisziplinäre Kooperation und fachübergreifender Wissenserwerb

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Simulation of developing human neuronal cell networks

Microelectrode array (MEA) is a widely used technique to study for example the functional properties of neuronal networks derived from human embryonic stem cells (hESC-NN). With hESC-NN, we can investigate the...

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High rate of hepatitis B viral breakthrough in elderly non-Hodgkin lymphomas patients treated with Rituximab based chemotherapy

Rituximab-containing chemotherapies are offered to elderlies for treatment of non-Hodgkin lymphomas (NHL). From 0.7 to 27% of patients with "resolved" HBV infection develop HBV reactivation and related hepatitis during Rituximab-containing chemotherapies. Currently, several antiviral drugs are available for the prophylaxis of patients at risk for HBV reactivation, which include lamivudine, tenofovir, entecavir, and adefovir. Viral breakthrough may occur during therapy, which is defined as an abrupt increase in serum HBV DNA levels after a period of persistent suppression.

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The multidisciplinary management of gastro-oesophageal junction tumours

The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe.

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Variations in the distance between the cricoid cartilage and targets of stellate ganglion block in neutral and extended supine positions: an ultrasonographic evaluation

Abstract

Purpose

Anatomic variations complicate surface landmark-guided needle placement, thereby increasing nerve blockade failure rate. However, little is understood about how anatomic distances change under different clinical conditions. As the cricoid cartilage is an easy and accurate landmark, we investigated changes in distance between the sixth or seventh cervical transverse processes (C6TP or C7TP) and the cricoid cartilage in neutral and extended supine positions.

Methods

Forty-two patients (16 men, 26 women) were included in this study. Distances between the cricoid cartilage and C6TP/C7TP were measured using ultrasonography with the patient in neutral and extended supine positions.

Results

C6TP and C7TP were caudally located at 6.0 ± 8.1 and 15.1 ± 7.2 mm, respectively, from the cricoid cartilage in the neutral supine position, and at 15.2 ± 8.0 and 25.3 ± 8.0 mm, respectively, in the extended supine position. In the extended supine position, the cricoid cartilage was more cephalad than C6TP and C7TP in all patients. The distance from the cricoid cartilage to C6TP was 12.1 ± 7.6 mm in men and 17.2 ± 7.7 mm in women.

Conclusion

C6TP and C7TP are located approximately 15 and 25 mm, respectively, caudal to the cricoid cartilage in the extended supine position. Our results highlight the fact that there can be significant anatomic variation between the extended and neutral supine positions used in stellate ganglion block, which should be kept in mind when devising easily identifiable and palpable surface landmarks.

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Nationwide epidemiological study of insomnia in Japan

• A Japanese nationwide epidemiological study of insomnia with new criteria.• The prevalence of insomnia was 12.2% in men and 14.6% in women.• Insomnia-associated factors (men): unemployment, and poor mental health.• Insomnia-associated factors (women): age, years of schooling, and poor mental health.• There were no significant associations between insomnia and season or region.

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Sleep quality in temporomandibular disorder cases

• The prevalence of poor sleep quality was 60.3% in temporomandibular disorder (TMD) patients.• Sleep quality was significantly impaired in TMD patients with dysfunctional pain.• Sleep quality was similar in TMD patients with pain-free diagnoses and healthy controls.• Sleep quality assessment is suggested in TMD patients with pain-related diagnoses.• Sleep quality assessment is highly recommended when dysfunctional pain is present.

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Basal Cell Carcinoma of the Nipple-Areola Complex.

No abstract available

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Commentary on Cutting Out the Tracts.

No abstract available

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Long-Pulsed 532-Nm Neodymium-Doped Yttrium Aluminium Garnet Laser for Treatment of Facial Plane Warts in 160 Yemeni Patients.

BACKGROUND: Warts in general and plane warts in particular pose a therapeutic challenge for dermatologists. Many treatment modalities exist, with variable success rates, side effect profiles, and precautions. The long-pulsed 532-nm neodymium-doped yttrium aluminium garnet (LP Nd:YAG) laser has not been previously used for this indication. OBJECTIVE: This study was conducted to assess the efficacy and safety of the LP Nd:YAG laser for treating facial plane warts. MATERIALS AND METHODS: A total of 160 Yemeni patients (62 women, 98 men; age range, 5-55 years) were exposed to 1 laser treatment session with the following parameters: wavelength, 532 nm; pulse duration, 20 millisecond; spot size, 2 to 3 mm; and fluence, 25 J/cm2. The end point was graying or whitening of the lesion. Color photographs were taken before and immediately after treatment and at follow-up visits 1, 4, and 16 weeks after the laser session. RESULTS: An overall clearance rate of 92% after only one session was achieved, with minimal and transient side effects. CONCLUSION: The LP Nd:YAG laser is safe and effective for treating facial plane warts, with a success rate of 92% after only one session. (C) 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Impact of tissue sampling on accuracy of Ki67 immunohistochemistry evaluation in breast cancer

Gene expression studies have identified molecular subtypes of breast cancer with implications to chemotherapy recommendations. For distinction of these types, a combination of immunohistochemistry (IHC) marker...

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Are EMTs resilient enough?

By Bryan Fass

While even normal people outside of public safety experience job-related stress as a fact of life, it seems like ours is much worse. Those of us who've in the business for a while can remember a time where the topic of stress and stress management were never discussed. Thankfully, EMS has taken a great leap forward bringing to light the depth and severity of our mental health.

Stress can be good and bad. Exercise induced stress is good. It forces our body to grow, heal and improve. The stress you experience prior to a protocol test increases your mental acuity.

The trouble starts when the stress response is constant and your body has no time to reset and rebalance. As call volumes have increased, so have resiliency issues for EMS providers.

As a paramedic and as a strength coach I have often wondered what has changed.

• Why has the rate of suicide and mental health issues increased"
• Is it the call volume, is it the type of calls or have we changed"

Next read these questions. I want to spark a conversation. Share your answers with me in the comments or send me an email. Together, we can hopefully steer the profession in a healthier direction.

• Is our inability to handle stress because we have lost the ability to separate from the job"
• Have we lost the ability for physical outlets to help manage the stress"
• Are we poisoning ourselves with a toxic combination of overtime, poor eating habits and reliance on stimulants"

I can recall as a green medic running my first pediatric traumatic arrest. Sure, I had read about it, studied it and even did hours of training in the NICU. Yet having to manage the scene, intubate the child while en route, start compressions, start an IO and then carry a child I knew was deceased into the emergency department was very foreign to me.

I recall standing there as the trauma team worked the child, being expected to calmly and accurately give a report and then go write my patient care report. I had no training for that and no way to manage those emotions. Yes, that call weighed on me the rest of the shift, but I pushed on.

Exercise to increase resiliency
However as soon as my shift ended I drove right to the gym and hammered myself with an epic workout; that was and is my outlet, my relief valve. Studies show that exercise, any exercise, calms the mind and releases endorphins that help promote wellness [1, 2, 3].

Exercise is by far the best medicine for building resiliency. The data is clear. Any exercise is beneficial with cardiovascular exercise shown to be slightly superior. As I have said in multiple EMS1 columns move well and move often but just move.

Another issue is our addiction to technology. When I was a street medic you were connected only if you had a Nextel phone (the walkie talkie phone). Now there is an app for constant communication. I often wonder if after a series of difficult calls when an EMT should disconnect from the stressor and find an outlet if the news feeds, photos, texts and instant messages that flood in slowly elevate the long-term stress response.

Disconnect from the world and get after it. The stronger you are and the more fit you are, the less pain you experience. Exercise will boost your resiliency and help to improve your sleep and nutrition.

Let's face it: the EMS diet is not so good. Not only do you have to contend with the call volume and missed meals; bringing your food with you will fix that. We also have to deal with stress eating and fatigue eating. There is a reason that you crave the foods that are bad, and understanding why is the first step.

Eat better to improve resiliency
The overconsumption of sugars and caffeine plus a diet devoid of beneficial nutrition when tied into the over stimulation of the stress response throws the serotonin, cortisol, adrenalin response and more importantly the recovery process so far out of whack that we are essentially poisoning ourselves and making ourselves vulnerable to the cumulative dangers of bad stress [4]. Soldiers that died by suicide were 62 percent more likely to have extremely low levels of DHA (the good fat in fish and chia/flax that helps your brain) then soldiers that did not attempt suicide [5].

On top of that, too many first responders are self-medicating with alcohol and drugs. This destroys the allostatic balance leading responders into a deep, dark hole.

A key to boosting resiliency in EMS requires that EMT's have a physical outlet for their stress. Tie in good nutrition that heals, and you can boost your resiliency and wellness at the same time.

References

1. Perspectives in Rehabilitation. Exercise therapy improves both mental and physical health in patients with major depression. DOI: 10.3109/09638288.2014.972579. Knapen, Davy Vancampfort, Yves Moriën and Yannick Marchal. Pages 1490-1495
2. Exercise and well-being: a review of mental and physical health benefits associated with physical activity Penedo, Frank J; Dahn, Jason R
3. http://ift.tt/2bzVlli
4. http://ift.tt/1GsrWTc
5. Lewis, Michael et.al. "Suicide of active duty us military and omegs-3 fatty acid status. The Journal of Clinical Psychiatry 72.12 (2011): 1585.

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My children don’t know their father before PTSD

By Lea Farrow, Uniform Stories Contributor

It has been almost five years since my husband was diagnosed with PTSD. In a lot of ways, it feels like a lifetime. And for our children, it has literally been their lifetime.

I knew my husband for nine years before his official diagnosis. However, I really only knew my husband for five years before the signs of the disorder started to show.

My husband has been a paramedic for 15 years. His PTSD didn't arrive overnight. It was an insidious process after years of answering extremely traumatic calls, and receiving very little support or education through the service about ongoing stress management.

Many of the jobs that led to my husband's PTSD were pediatric calls. The job that triggered his major collapse was a horrific pediatric death. At the time, we had two small children of our own, our daughter was almost 3 and our son was not yet 1.

The day my husband came home from work a broken man, he fell to pieces in the kitchen. It wasn't that I hadn't seen him cry before, but we could have both drowned in his tears that night.

Although I tried my best, I couldn't protect our children from every episode that ripped through our house. Sometimes the pain would burst out of my husband so suddenly and ferociously, that all I could do was huddle my kids until the storm passed. Our daughter would ask, "Mommy, what's happening" Daddy is really scaring me…"

I had to accept the reality that my children were not safe alone with their father. One day I was torn away from work by a desperate phone call, and rushed home to a find a shattered man, only barely holding on. I often ask, do our children remember that day" Do they remember the raw anguish coursing wildly out of their father, who scarcely had enough strength left to direct it away from us" I sure do.

We found new ways to manage as a couple and as a family. I helped my husband begin to earn back the trust from his children and he found help for his PTSD (when he was ready to accept it). We have come a long way in the years since, but PTSD is still very much with us. It'll be with us always. And our children sadly bear witness to some of its worst moments. They don't know a life without PTSD overshadowing it.

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EMS needs planning, preparation to mitigate the effects of terrorist attacks

In June 2016 the National Academy of Medicine released a discussion paper that looked at the challenges of an EMS response to a major terror attack. In the paper, "Health and Medical Response to Active Shooter and Bombing Events," members of the National Academies of Sciences, Engineering, and Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Disasters described potential best practices on how to respond effectively to sudden, dramatic mass casualty events, based on data gleaned from recent attacks in Europe and the U.S.

Most of us are still relatively complacent about what we would do in case of a Boston or Aurora style attack in our community. Indeed, chances are very remote that such attacks will occur.

However, in such cases, the actions of dispatch centers and field personnel may play a critical role in the victims' chances of survival. It is common sense that EMS, fire and law enforcement personnel should jointly prepare and train for a variety of sudden mass casualty events.

Work together, train together
As the National Academy of Medicine discussion paper implies, a variety of political, fiscal and bureaucratic barriers exist to hinder the development of such plans. Both government and private sector agencies charged with public safety and public health must put aside territorial differences and work together to determine who will respond, how teams will operate and where patients should be transported, all in a very short operational period.

Bleeding control is a major priority when managing large numbers of injured patients after an attack. In many situations, direct pressure bandages and tourniquets can rapidly control bleeding, and free up field providers to provide care to other injured victims.

Unfortunately, ambulances and engine companies often do not carry enough trauma supplies to handle more than a few victims simultaneously. Disaster caches or trailers can be helpful, but only if they can be rapidly moved to the scene within minutes of the initial dispatch.

Rural and remote areas
Rural regions face especially difficult challenges in a mass casualty response. Underfunded agencies and scattered resources can hinder an adequate response.

One simple solution is to have policies in place that initiate mutual aid from neighboring agencies automatically at the initial response, rather than waiting precious minutes for the first responding units to arrive. This would include air medical services, volunteer organizations and even agencies that are a fair distance away from the incident, but would be expected to respond in large scale events.

The delay in sending an appropriate response level can result in lives lost. Dispatch protocols should be developed that result in an adequate number of units and personnel being sent to initial reports of a major event, similar to fire service alarm assignments.

This can reduce the human judgment factor during dispatch and improve the chances of getting off on the right foot early in the incident. If it turns out that the incident is smaller than reported, no harm is created in downgrading the response.

Cooperation with receiving facilities
Emergency departments and hospitals will not be immune to the effects of a large scale event. Not only do such facilities have to be able to rapidly scale up their internal disaster response, they must also work in cooperation with each other to spread the multitude of patients around the region.

While field operations may perform the initial sorting and destination decisions, resources such as staff, blood products and equipment may be rapidly depleted, necessitating a rapid region-wide response by other facilities and organizations. Again, interagency agreements, policies and procedures should be in place to facilitate complex decision making processes.

No one wants to think about a major violent event happening in their community. As EMS providers, we have to prepare for the worst, and hope for the best. As the National Academy of Medicine paper points out, continuous planning and preparation will be the major tools used by field providers and agencies alike in mitigating the effects of a terror attack.

Health and Medical Response to Active Shooter and Bombing Events

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Prescription Fill Adherence in Pediatric Asthma: Are Privately Insured Children at Increased Risk?

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


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Management of Acute Cough in Children: Where Do We Go From Here?

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


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Correlation is Not Causation: Electrical Analysis of St. Jude Implant Shows Normal Pacing

St. Jude Merlin Error Indicators Are Not Evidence of Malfunction

Battle of the bands: Here's what we listened to while writing this summary.

Here's an abbreviated technical analysis of some claims by Muddy Waters and St. Jude regarding pacemaker/defibrillator security. We will show you why correlation is not causation in the sense that a scary-looking screen is not a reliable indicator of a clinically relevant security problem. We did this analysis based on our experience over the last ten years analyzing pacemaker and defibrillator security and our experience building cardiac arrhythmia simulators for humanitarian pacemaker reuse. Read more at our ancient research website. Or see our index of previous blog posts on medical device security. This is a fun extracurricular activity for our team at the University of Michigan and Virta Labs, and we may post more thoughts before we return to our regular lives baking hearth breads and helping hospitals with cybersecurity risks.

The Muddy Waters report of August 25 showed a screenshot which they say shows an "apparent malfunction." They also say that red error marks "are also indicators that the device is malfunctioning." We were curious about these claims and decided to see if we could produce the same onscreen displays without causing any malfunction. This summary shows the screenshot is correlated with normal pacing and sensing, suggesting that the Muddy Waters report misinterprets clinical relevance of the screenshot.

Figure 1: Our experiment shows that a Merlin programmer screenshot from p. 17 of the Muddy Waters report is not supportive evidence of a successful attack. The top photo shows our reproduction of the Merlin programmer screen photo, but without causing changes to the pacing pulses. Our end-to-end oscilloscope measurements (bottom photo) show that pacing pulses continue normally despite the three benign alerts that are expected when not connected to cardiac tissue.

Hypothesis: The Merlin programmer screen photo on page 17 of the Muddy Waters report is not supportive evidence of appearing "to have caused the device to pace at a rapid rate."

Approach: Produce the same on-screen screen output, and externally measure electrical signals to test safety and effectiveness of pacing and sensing.

Result: We reliably produced the same screen output while the implant continued to pace normally.

Material: St. Jude Medical Fortify Assura ICD, Merlin programmer (software version 22.0.1 rev1)

Clinical validation: Verified by Dr. Thomas Crawford, a cardiologist and a clinical electrophysiologist at the University of Michigan Health System's Frankel Cardiovascular Center.

Commentary:

To verify pacing, we configured the device to emit 40 bpm pacing pulses at 2.5 V, then connected a clipped lead (~20 cm) to the V (IS-1 Bi) sense/pace port, connected an oscilloscope to the clipped lead with 50 Ω probes, and visually confirmed that the device was emitting 40 pulses per minute (Figure 1 right). To verify sensing, we used a signal generator to produce a 0.5 Hz square wave (consisting of 2 events, a rising then a falling edge, for a total of 1 event per second or 60 pbm) at 2 mV which we fed into the sense/pace port via the same lead; the programmer recognized a 60 bpm beat as expected. We tested other square-wave frequencies between 0.5 Hz and 2 Hz to verify that the sensing worked as expected.

To reproduce the markers that the Muddy Waters report highlights as indicators of a successful attack, we introduced benign electrical noise on the sense/pace port via the clipped lead by connecting the lead to a separately grounded oscilloscope (i.e., not grounded to the "can" of the device, which typically acts as ground). This noise was sufficient to trigger the "VS2" markers on the programmer screen, indicating that the device sensed a "ventricular beat." While sampling the 40 bpm pacing output as described above, we reproduced the count of three alerts visible in the Muddy Waters report's screen photo: two alerts from high impedance on two leads (since those were not connected to cardiac tissue), and one indicating "ventricular noise reversion." The pacing and sensing continued to function normally. ■

The team from the University of Michigan and Virta Labs is continuing to investigate the contrasting claims by Muddy Waters and St. Jude Medical. To receive notifications of updates, follow the Archimedes Center for Medical Device security @ARC_MedSec and @DrKevinFu on Twitter. Virta Labs also plans to issue a separate white paper.

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Primer development to obtain complete coding sequence of HA and NA genes of influenza A/H3N2 virus

Influenza is an acute respiratory illness and has become a serious public health problem worldwide. The need to study the HA and NA genes in influenza A virus is essential since these genes frequently undergo ...

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The Danish Neuro-Oncology Registry: establishment, completeness and validity

The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe ...

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A review on Sero diversity and antimicrobial resistance patterns of Shigella species in Africa, Asia and South America, 2001–2014

Shigella, gram negative bacterium, is responsible for Shigellosis/bacillary dysentery. It is a global concern although it predominates in developing countries. These are Shigella dysen...

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Comparison of endoscopic based diagnosis with Helicobacter urease test for Helicobacter pylori infection

Helicobacter pylori is an important risk factor for gastritis, peptic ulcers and gastric cancer. The prevalence in developed countries is lower than 40 % but higher than 80 % in some d...

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Household satisfaction with a community-based health insurance scheme in Ethiopia

Community-based health insurance (CBHI) schemes are an emerging tool for providing financial protection against health-related poverty. In Ethiopia, CBHI is being piloted in 13 districts, but community experie...

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Johns Hopkins Opens Unique Comprehensive Care Center for Zika Virus Led by the Wilmer Eye Institute

As the number of patients with Zika virus grows worldwide, Johns Hopkins Medicine announces the opening of the new Johns Hopkins Zika Center, dedicated to caring for pregnant women and newborn babies, but also men and women of all ages with the mosquito-borne and sexually transmitted virus.

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Prescription Fill Adherence in Pediatric Asthma: Are Privately Insured Children at Increased Risk?

Pediatric Allergy, Immunology, and Pulmonology , Vol. 0, No. 0.


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