This webinar presents the results of research on the battery drain of wireless streaming hearing aids with features like ear-to-ear communication and feedback management engaged and in various listening situations including streaming Apps. This session will provide audiologists with an understanding of different battery chemistries including primary disposable cells and rechargeable batteries designed for hearing aids and conclude with counseling recommendations for patients fit with wireless streaming hearing aids.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2quuCQe
via IFTTT
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Δευτέρα 29 Μαΐου 2017
Battery Life: Counseling Patients about Their Wireless Streaming Hearing Aids
Spatially-segmented undersampled MRI temperature reconstruction for transcranial MR-guided focused ultrasound
Volumetric thermometry with fine spatiotemporal resolution is desirable to monitor MR-guided focused ultrasound (MRgFUS) procedures in the brain, but requires some form of accelerated imaging. Accelerated MR t...
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ri1NFN
via IFTTT
Haemobilia due to hepatic artery pseudoaneurysm
An 83-year-old woman with a history of hepaticoduodenostomy 20 years ago was admitted with upper gastrointestinal bleeding. Emergency upper gastrointestinal endoscopy revealed multiple blood clots over the stomach and first and second parts of the duodenum. The cannulation of the biliary tree with a flexible end-viewing endoscope exposed the presence of blood clot inside biliary lumen and a semipedunculated polyp which, at first, appeared to be the cause of haemorrhage. A few days after polypectomy, patient was discharged home, however, was admitted again with massive bleeding and selective angiography demonstrated a pseudoaneurysm of left hepatic artery. Angioembolisation was performed and haemorrhage was stopped afterwards.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s8OIwB
via IFTTT
Haemobilia due to hepatic artery pseudoaneurysm
An 83-year-old woman with a history of hepaticoduodenostomy 20 years ago was admitted with upper gastrointestinal bleeding. Emergency upper gastrointestinal endoscopy revealed multiple blood clots over the stomach and first and second parts of the duodenum. The cannulation of the biliary tree with a flexible end-viewing endoscope exposed the presence of blood clot inside biliary lumen and a semipedunculated polyp which, at first, appeared to be the cause of haemorrhage. A few days after polypectomy, patient was discharged home, however, was admitted again with massive bleeding and selective angiography demonstrated a pseudoaneurysm of left hepatic artery. Angioembolisation was performed and haemorrhage was stopped afterwards.
http://ift.tt/2s8OIwB
Giant cell tumor in the sphenoid sinus and ethmoid sinus during childhood, and it is thought that optic atrophy was caused by compressive optic neuropathy.
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s8UmPq
via IFTTT
Pleiotrophin, a target of miR-384, promotes proliferation, metastasis and lipogenesis in HBV-related hepatocellular carcinoma
Abstract
Hepatitis B virus (HBV) infection plays a crucial role and is a major cause of hepatocellular carcinoma (HCC) in China. microRNAs (miRNAs) have emerged as key players in hepatic steatosis and carcinogenesis. We found that down-regulation of miR-384 expression was a common event in HCC, especially HBV-related HCC. However, the possible function of miR-384 in HBV-related HCC remains unclear. The oncogene pleiotrophin (PTN) was a target of miR-384. HBx inhibited miR-384, increasing PTN expression. The PTN receptor N-syndecan was highly expressed in HCC. PTN induced by HBx acted as a growth factor via N-syndecan on hepatocytes and further promoted cell proliferation, metastasis and lipogenesis. PTN up-regulated sterol regulatory element-binding protein 1c (SREBP-1c) through the N-syndecan/PI3K/Akt/mTORC1 pathway and the expression of lipogenic genes, including fatty acid synthesis (FAS). PTN-mediated de novo lipid synthesis played an important role in HCC proliferation and metastasis. PI3K/AKT and an mTORC1 inhibitor diminished PTN-induced proliferation, metastasis and lipogenesis. Taken together, these data strongly suggest that the dysregulation of miR-384 could play a crucial role in HBV related to HCC, and the target gene of miR-384, PTN, represents a new potential therapeutic target for the prevention of hepatic steatosis and further progression to HCC after chronic HBV infection.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qwmXgr
via IFTTT
Extracellular vesicles do not contribute to higher circulating levels of soluble LRP1 in idiopathic dilated cardiomyopathy
Abstract
Idiopathic dilated cardiomyopathy (IDCM) is a frequent cause of heart transplantation. Potentially valuable blood markers are being sought, and low-density lipoprotein receptor-related protein 1 (LRP1) has been linked to the underlying molecular basis of the disease. This study compared circulating levels of soluble LRP1 (sLRP1) in IDCM patients and healthy controls and elucidated whether sLRP1 is exported out of the myocardium through extracellular vesicles (EVs) to gain a better understanding of the pathogenesis of the disease. LRP1 α chain expression was analysed in samples collected from the left ventricles of explanted hearts using immunohistochemistry. sLRP1 concentrations were determined in platelet-free plasma by enzyme-linked immunosorbent assay. Plasma-derived EVs were extracted by size-exclusion chromatography (SEC) and characterized by nanoparticle tracking analysis and cryo-transmission electron microscopy. The distributions of vesicular (CD9, CD81) and myocardial (caveolin-3) proteins and LRP1 α chain were assessed in SEC fractions by flow cytometry. LRP1 α chain was preferably localized to blood vessels in IDCM compared to control myocardium. Circulating sLRP1 was increased in IDCM patients. CD9- and CD81-positive fractions enriched with membrane vesicles with the expected size and morphology were isolated from both groups. The LRP1 α chain was not present in these SEC fractions, which were also positive for caveolin-3. The increase in circulating sLRP1 in IDCM patients may be clinically valuable. Although EVs do not contribute to higher sLRP1 levels in IDCM, a comprehensive analysis of EV content would provide further insights into the search for novel blood markers.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rPPD7S
via IFTTT
Genetic variations at the human growth hormone receptor (GHR) gene locus are associated with idiopathic short stature
Abstract
GH plays an essential role in the growing child by binding to the growth hormone receptor (GHR) on target cells and regulating multiple growth promoting and metabolic effects. Mutations in the GHR gene coding regions result in GH insensitivity (dwarfism) due to a dysfunctional receptor protein. However, children with idiopathic short stature (ISS) show growth impairment without GH or GHR defects. We hypothesized that decreased expression of the GHR gene may be involved. To test this, we investigated whether common genetic variants (microsatellites, SNPs) in regulatory regions of the GHR gene region were associated with the ISS phenotype. Genotyping of a GT-repeat microsatellite in the GHR 5′UTR in a Montreal ISS cohort (n = 37 ISS, n = 105 controls) revealed that the incidence of the long/short (L/S) genotype was 3.3× higher in ISS children than controls (P = 0.04, OR = 3.85). In an Italian replication cohort (n = 143 ISS, n = 282 controls), the medium/short (M/S) genotype was 1.9× more frequent in the male ISS than controls (P = 0.017, OR = 2.26). In both ISS cohorts, logistic regression analysis of 27 SNPs showed an association of ISS with rs4292454, while haplotype analysis revealed specific risk haplotypes in the 3′ haploblocks. In contrast, there were no differences in GT genotype frequencies in a cohort of short stature (SS) adults versus controls (CARTaGENE: n = 168 SS, n = 207 controls) and the risk haplotype in the SS cohort was located in the most 5′ haploblock. These data suggest that the variants identified are potentially genetic markers specifically associated with the ISS phenotype.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qwuL1F
via IFTTT
Giant cell tumor in the sphenoid sinus and ethmoid sinus during childhood, and it is thought that optic atrophy was caused by compressive optic neuropathy.
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
http://ift.tt/2s8UmPq
Larynx motion considerations in partial larynx volumetric modulated arc therapy for early glottic cancer
Abstract
Introduction
To assess laryngeal motion in early glottic cancer in order to determine safe margins for partial larynx volumetric modulated arc therapy (PL-VMAT), and to quantify dosimetric advantages of PL-VMAT.
Methods
This prospective study included T1-2N0 glottic cancers treated with whole larynx VMAT (WL-VMAT). Pre- and mid-treatment 4D-computed tomography (4D-CT) and dynamic magnetic resonance imaging (MRI) allowed for assessment of larynx swallowing and respiratory motion. For 10 patients with lateralized lesions, PL-VMAT plans were calculated using margins derived from 4D-CT analysis.
Results
Twenty patients were accrued from 2014 to 2016. Mean amplitude of larynx swallowing excursion was 23 mm and 6 mm in the superior and anterior directions, respectively. Mean respiratory motion reached 4 mm and 2 mm in superior-inferior and antero-posterior directions, respectively. Pre-treatment 4D-CT analysis identified one patient with planning CT acquired during swallowing. Mid-treatment 4D-CT revealed larynx shift relative to vertebrae in 30% of cases. PL-VMAT allowed for significant reduction of mean doses to ipsilateral carotid, contralateral carotid, thyroid gland, contralateral arytenoid and larynx. Using 8 mm internal margin for PL-VMAT, swallowing resulted in clinical target volume excursion beyond 95% isodose line during ≤1.5% of total treatment time in all patients.
Conclusion
Although swallowing motion is rare, rapid and easily suppressed by patients, there is a risk of systematic miss-targeting if planning CT is acquired during swallowing. Larynx position shift relative to vertebrae occurs in 1/3 of patients over the course of radiotherapy. With soft-tissue image guidance and margins accounting for respiratory motion, PL-VMAT allows safe reduction of dose to organs at risk.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2r6dfnI
via IFTTT
Giant cell tumor in the sphenoid sinus and ethmoid sinus during childhood, and it is thought that optic atrophy was caused by compressive optic neuropathy.
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Impaired immune function in children and adults with Fanconi anemia
Abstract
Background
Fanconi anemia (FA) is a rare genetic disorder characterized by genome instability, bone marrow failure, and cancer predisposition. Previously, small studies have reported heterogeneous immune dysfunction in FA.
Procedure
We performed a detailed immunologic assessment in a large FA cohort who have not undergone bone marrow transplantation or developed malignancies. Comprehensive quantitative and functional immunologic assessment of 29 FA individuals was compared to healthy age-matched controls.
Results
Compared to non-FA persons of similar ages, FA individuals showed lower absolute total B cells (P < 0.001), lower memory B cells (P < 0.001), and decreased IgM (P < 0.001) but normal IgG. NK cells (P < 0.001) and NK cytotoxicity (P < 0.001) were decreased. CD4+ T cells were decreased (P = 0.022), while CD8+ T cell and absolute T-cell numbers were comparable. Cytotoxic T cells (P < 0.003), and antigen proliferation response to tetanus (P = 0.019) and candida (P = 0.019), were diminished in FA. Phytohemagglutinin responses and plasma cytokines were normal. Within FA subjects, adults and older children (≥10 years) exhibited higher CD8+ T cells than younger children (P = 0.004). Documented atypical infections were infrequent, although oral human papilloma virus (HPV) prevalence was higher (31% positive) in FA.
Conclusions
Overall, these results demonstrate a high rate of significant humoral and cellular immune dysfunction. Continued longitudinal study of immune function is critical to understand evolution with age, bone marrow failure, and cancer development.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2r6i0gV
via IFTTT
Identifying metrics of success for transitional care practices in childhood cancer survivorship: A qualitative study of survivorship providers
Abstract
Background
Long-term survival in childhood cancer is excellent. Most survivors will have a therapy-related chronic condition, yet very few receive survivor-focused care as they transition from adolescence to young adulthood. The purpose of this study is to identify indicators of success in current transitional care practices for young adult survivors of childhood cancer as defined by all members of survivorship care teams.
Procedure
An exploratory, phenomenologic qualitative study was conducted with key informants from medical teams involved in transitional care of childhood cancer survivors. Data were collected through phone interviews with providers from both pediatric and adult care settings.
Results
A multidisciplinary study sample of 29 participants from three institutions identified two major themes with multiple subthemes. The first major theme was that providers must be good communicators, and it emphasized the importance of having good relationships throughout the transition of care to optimize effective communication. The second major theme was that models of care must include well-established partners throughout the healthcare system that promote accessible subspecialty care with streamlined referrals and patient navigation services.
Conclusions
From the perspective of experienced pediatric- and adult-centered providers at three different institutions delivering life-long transitional care for childhood cancer survivors, the optimal model of care must be built around facilitating communication among all key stakeholders and emphasizing patient-friendly services that minimize patient stressors.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qB2NRx
via IFTTT
Determination of the protein expression profiles of Propsilocerus akamusi (Tokunaga) Malpighian tubules response to cadmium stress by iTRAQ coupled LC–MS/MS
Publication date: Available online 29 May 2017
Source:Journal of Proteomics
Author(s): Xianyun Zheng, Zhiying Xie, Shu Wang, Pipeng Lin
Propsilocerus akamusi (Tokunaga) is an important prey species for fish and aquatic birds, which represent an important link in the aquatic food chain as other species of Chironomidae. Malpighian tubules (MT) play an important role in metabolism and detoxification of harmful compounds and metal accumulation. Our previous studies have reported that P. akamusi have an extraordinary resistance to Cd. In this paper, iTRAQ-based proteomics technology was first used to study the differential proteomics of MT of Propsilocerus akamusi under sublethal Cd stress for different time courses. 118 differential expressed proteins (DEPs) were identified through LC–MS/MS and further classified into 26 GO functional groups. Our results showed that metabolic process was the main biological functional categories. Cluster of orthologous groups of proteins (COG) analysis was also performed based on the number of unique proteins identified in each functional category, 22 metabolism-related DEPs were identified. P. akamusi adapted to Cd stress mainly by inducing the processes of lipid metabolism of MT and lipid may play a possible protection role in cadmium resistance in MT. The results provide important information for research on molecular mechanisms of Cd-stress adaption in Malpighian tubules of P. akamusi.Biological significancePropsilocerus akamusi (old species name: Tokunagayusurika akamusi) is an important prey species for fish and aquatic birds, which represent an important link in the aquatic food web as other species of Chironomidae. Malpighian tubules constitute a versatile organ which is able to exert excretory of chemical compounds, acting in the insect metabolism and detoxification of harmful compounds and metal accumulation. Our previous studies have reported that P. akamusi have an extraordinary resistance to Cd. However, up to now, there has been a lack of research on the molecular mechanisms of adaption to Cd stress in the Malpighian tubules of this species. Study on the adaptive mechanisms to Cd stress in Malpighian tubules of Propsilocerus akamusi through comparative proteome analysis is one important way to solve this problem. The aim of the present study was to understand the molecular mechanisms of adaption of the Malpighian tubules of P. akamusi exposed to Cd stress and assess the high expression of proteins involved in cellular adaptation to Cd stress. This will provide information about how this organ is responding to disturbances of contaminated ecosystems.
Graphical abstract
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qAJDLI
via IFTTT
Proteomic fingerprinting of mistletoe (Viscum album L.) via combinatorial peptide ligand libraries and mass spectrometry analysis
Publication date: Available online 29 May 2017
Source:Journal of Proteomics
Author(s): María Vergara-Barberán, María Jesús Lerma-García, Maria Nicoletti, Ernesto Francisco Simó-Alfonso, José Manuel Herrero-Martínez, Elisa Fasoli, Pier Giorgio Righetti
Combinatorial peptide ligand libraries (CPLLs), coupled to mass spectrometry (MS) analysis, have been used to investigate in depth the proteome of Viscum album L. (VA), commonly named European mistletoe, in order to provide a first proteomic fingerprinting. For this purpose, the proteins were captured via CPLLs at two different pH values (acidic and neutral). A total of 648 non-redundant proteins were identified by using two different databases. The two pH values, chosen for bead incubations, have contributed to increment the capture ability: 56% and 31% of CPLLs species were respectively recognized at pH7.2 and at pH2.2. Finally the biological function of identified proteins was evaluated in order to understand their role on human health and the potential benefits of mistletoe extracts in medicine.SignificanceViscum album L. (VA) extracts are recently used as supporting medicine for cancer therapy, improving patients' survival and increasing their quality of life in medicine. These anticancer effects are investigated and they are probably due to mistletoe's capability to favor tumor cell's death and to modulate the immune system. Although the increasing interest in VA medical benefits, the role of its components in human health remains unclear. In order to exploit this aspect, it is important to comprehensively study proteins present in Viscum album L. (VA) extracts. Nevertheless, since plant proteomics analysis is in most cases handicapped by the presence of high-abundance proteins masking the detection of the low-abundance ones, it is important to overcome this challenge. In this sense, combinatorial peptide ligand libraries (CPLLs) have been used to reduce the dynamic protein concentration range to enable the identification of a higher amount of proteins than employing conventional methods. In this work, a total of 648 non-redundant proteins were identified: 56% and 31% of CPLLs species were respectively recognized at pH7.2 and at pH2.2. This deep proteome identification was useful to investigate the biological functions of proteins in order to evaluate their potential role in human health.
Graphical abstract
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qBkYXm
via IFTTT
Structural and activity variability of fractions with different charge density and chain length from pharmaceutical heparins
Abstract
Heparin is a structurally complex polysaccharide used as a clinical anticoagulant. It is comprised of a heterogeneous mixture of polysaccharide chains having a variety of sequences and lengths. The production methods and regulatory controls of pharmaceutical heparins have changed over the years. This study assesses the structural and activity uniformity of the polysaccharide chains comprising two contemporary heparin products. The heparin fractions with different sizes and charges were separated with size exclusion and ion exchange chromatography. The fractions were analyzed for their molecular weight properties, di- and tetrasaccharide compositions, and anti-factor IIa and anti-factor-Xa activities. The distribution of these properties through chains of different lengths and ones with different charge density were compared. The results demonstrate that with the increase in heparin purity, activity and molecular weight required by the current pharmacopeia, the uniformity of pharmaceutical heparin products have increased.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sghcnn
via IFTTT
How fear can develop out of others’ traumas
What happens in the brain when we see other people experiencing a trauma or being subjected to pain? Well, the same regions that are involved when we feel pain ourselves are also activated when we observe other people who appear to be going through some painful experience. This is shown in a study from Karolinska Institutet published in Nature Communications. But we are sensitive to different degrees to learning fear from other people and one explanation would appear to be found in the endogenous opioid system. Seeing others express pain or anxiety can give us important information about things around us that are dangerous and should be avoided. Sometimes, however, we can develop fear of situations that, rationally speaking, are not dangerous. The opioid system is supposed to alleviate pain and fear but it does not work as effectively in all of us, which might be one of the reasons why some people develop anxiety syndrome merely by seeing others experience a trauma. The opioid system affects how sensitive we are "Some people are over-sensitive to this form of social learning. Our study shows that the endogenous opioid system affects how sensitive we are and may explain why some people develop post-traumatic stress disorder (PTSD) merely by observing others who are experiencing traumatic events. After terror attacks, sensitive people might be afraid even if they themselves were not present," says main author Jan Haaker, associated researcher at Karolinska Institutet's Department of Clinical Neuroscience. In a double-blind study, the researchers altered the brain's internal chemistry in 22 healthy subjects by using a pharmaceutical substance to block the opioid system. 21 subjects were given an inactive placebo. The subjects then watched a video where other people were subjected to electric shocks. Continued to react as if they were surprised The brain normally updates its knowledge of danger based on whether we are surprised, but when the opioid system was blocked, the people continued to react as if they were surprised even though they knew the electric shock would come. And the response was amplified even when they continued to watch other people being subjected to shocks. The response increased in regions of the brain such as the amygdala, the periaqueductal gray and the thalamus, which seems to indicate that the same functions as in self-perceived pain were involved. Communication also increased between these and other regions of the brain that were previously linked to the ability to understand other individuals' experiences and thoughts. "When the people participating in the experiment were themselves subjected to threatening stimuli that they had previously associated with other people's pain, they perspired more and displayed more fear than those who had been given a placebo. This enhanced learning was even visible three days after the social learning episode," says research team leader Andreas Olsson, senior lecturer at Karolinska Institutet's Department of Clinical Neuroscience. The study contributes to greater understanding of the psychology behind fear. The researchers hope that the new findings will eventually mean that people with anxiety conditions will be able to be given better, more individual-adapted clinical help. The study was financed by the European Research Council (ERC), the Knut and Alice Wallenberg Foundation and the German Research Foundation (DFG). Publication "Endogenous opioids regulate social threat learning in humans" Jan Haaker, Jonathan Yi, Predrag Petrovic and Andreas Olsson Nature Communications, online 25 May 2017. doi:10.1038/ncomms15495
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s8Jp0h
via IFTTT
“Influence of possible predictor variables on the outcome of primary oral squamous cell carcinoma: a retrospective study of 392 consecutive cases at a single centre”— methodological issues
We read the paper by Loeffelbein and colleagues, published online in the International Journal of Oral and Maxillofacial Surgery in December 2016, with enthusiasm1. The authors aimed to examine tumour-specific and patient-related risk factors in a large single-centre cohort, i.e., factors that have a considerable effect on postoperative survival following ablative tumour surgery with elective neck dissection and immediate microvascular reconstruction in oral squamous cell carcinoma. It was concluded that postoperative survival does not depend only on tumour-related characteristics.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s8G01s
via IFTTT
The Cisplatin Total Dose and Concomitant Radiation in Locoregionally Advanced Head and Neck Cancer: Any Recent Evidence for Dose Efficacy?
Opinion statement
Concurrent chemoradiotherapy (CRT) with high-dose (100 mg/m2), single-agent cisplatin is considered the standard of care for locoregionally advanced head and neck cancer (LAHNC). Poor compliance often due to significant treatment-related toxicities observed during CRT regimen has stimulated research efforts to examine for evidence of the optimal cumulative cisplatin dose and schedule. The findings from this systematic literature review demonstrate that there are insufficient prospective, randomized controlled data to determine the optimal total dose (and schedule) of cisplatin to administer concomitantly with radiotherapy in the treatment of LAHNC. Given the clinical challenges associated with administering concurrent CRT with single-agent high-dose cisplatin, as well as the long-term toxicities accompanying this treatment, an examination of the available literature for evidence of dose efficacy is of continued clinical interest. Moving forward, it is critical that researchers include complete descriptions of key disease and treatment variables (i.e. treatment compliance and HPV status) to inform and strengthen clinical decisions. The substantial heterogeneity of LAHNC has led to the focus of recent research efforts to risk-stratify using a combination of clinical and molecular markers (e.g. HPV status). Thus, the optimal total dose (and schedule) of cisplatin may need to be modified to reflect the specific characteristics of the individual patient subpopulations being treated. At present, CRT remains the standard of care for LAHNC, but this field is rapidly evolving. National and international clinical trials are ongoing to evaluate treatment de-intensification in favourable risk patient subsets and treatment intensification in poor-risk patient subsets, these will provide evidence-based guidance to individualize therapy with the ultimate goal of improving patient outcomes.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qvl4k7
via IFTTT
Overview of the 8th Edition TNM Classification for Head and Neck Cancer
Opinion Statement
The main purpose of the TNM system is to provide an anatomic-based classification to adequately depict cancer prognosis. Accurate cancer staging is important for treatment selection and outcome prediction, research design, and cancer control activities. To maintain clinical relevance, periodical updates to TNM are necessary. The recently published 8th edition TNM classification institutes the following changes to the staging of head and neck (excluding thyroid cancer): new stage classifications [HPV-related oropharyngeal cancer (HPV+ OPC) and soft tissue sarcoma of the head and neck (HN-STS)] and modification of T and N categories [T and N categories for nasopharyngeal cancer (NPC), T categories for oral cavity squamous cell carcinomas (OSCC), N categories for non-viral related head and neck cancer and unknown primary (CUP), and T categories for head and neck cutaneous carcinoma]. These changes reflect better understanding tumor biology and clinical behavior (e.g., HPV+ OPC and HN-STS), improved outcomes associated with technical advances in diagnosis and treatment (e.g., NPC), evolving knowledge about additional prognostic factors and risk stratification from research and observation (e.g., inclusion of depth of invasion variable for OSCC, inclusion of extranodal extension variable for all non-viral head and neck cancer, and reintroduction of size criteria for non-Merkel cell cutaneous carcinoma of the head and neck). This review summarizes the changes and potential advantages and limitations/caveats associated with them. Further evidence is needed to evaluate whether these changes would result in improvement in TNM stage performance to better serve the needs for clinical care, research, and cancer control.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rOYvdV
via IFTTT
Prognostic Value of Perineural Invasion in Resected Gastric Cancer Patients According to Lauren Histotype
Abstract
The purpose of this study is to investigate perineural invasion (PNI) as a prognostic factor in gastric cancer patients. 455 patients submitted to extended (D2 or more) lymphadenectomy (median number of 39 retrieved lymph nodes, range: 15–140) between 1995 and 2012 were retrospectively studied. Patients were categorized in two groups according to the PNI status, and PNI positivity was assessed in presence of cancer cells in the perinerium or the neural fascicles using hematoxylin and eosin staining. Median follow-up for surviving patients was 80.3 months. Survival analysis was performed by univariate and multivariate analysis, using a Cox proportional hazards model. 162 patients (33.9%) had positive PNI; this was strongly associated with advanced stages of disease, residual tumor, lymphovascular invasion, Lauren diffuse-mixed histotype and tumor size. Five-year cancer-related survival was 65,7% and 20,6% in PNI negative vs. positive groups, respectively (p < 0.001). The prognostic impact of PNI at univariate analysis was particularly evident in patients submitted to R0 surgery, early as well as advanced stage, advanced nodal stage and T status. At multivariate analysis, PNI did not result statistically significant in the overall series, but emerged as an independent prognostic factor in the group of patients with Lauren intestinal histotype (p = 0.005, hazard ratio: 1.99, 95% confidence interval 1.24–3.19). PNI is related to advanced stage and poor long-term survival in gastric cancer, and may serve as an adjunctive prognostic factor in the intestinal histotype.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rhWBBS
via IFTTT
Mibelas 24 Fe Chewable Tablets by Lupin Pharmaceuticals Inc.: Recall - Out of Sequence Tablets and Missing Expiry/Lot Information
Audience: Family Practice, Health Professional, Consumers ISSUE: Lupin Pharmaceuticals Inc. announced a recall of lot L600518, Exp 05/18 of Mibelas 24 Fe (Norethindrone Acetate and Ethinyl Estradiol 1 mg/0.02 mg chewable and ferrous fumarate 75 mg)...
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qu7hhM
via IFTTT
Prognostic Value of Perineural Invasion in Resected Gastric Cancer Patients According to Lauren Histotype
Abstract
The purpose of this study is to investigate perineural invasion (PNI) as a prognostic factor in gastric cancer patients. 455 patients submitted to extended (D2 or more) lymphadenectomy (median number of 39 retrieved lymph nodes, range: 15–140) between 1995 and 2012 were retrospectively studied. Patients were categorized in two groups according to the PNI status, and PNI positivity was assessed in presence of cancer cells in the perinerium or the neural fascicles using hematoxylin and eosin staining. Median follow-up for surviving patients was 80.3 months. Survival analysis was performed by univariate and multivariate analysis, using a Cox proportional hazards model. 162 patients (33.9%) had positive PNI; this was strongly associated with advanced stages of disease, residual tumor, lymphovascular invasion, Lauren diffuse-mixed histotype and tumor size. Five-year cancer-related survival was 65,7% and 20,6% in PNI negative vs. positive groups, respectively (p < 0.001). The prognostic impact of PNI at univariate analysis was particularly evident in patients submitted to R0 surgery, early as well as advanced stage, advanced nodal stage and T status. At multivariate analysis, PNI did not result statistically significant in the overall series, but emerged as an independent prognostic factor in the group of patients with Lauren intestinal histotype (p = 0.005, hazard ratio: 1.99, 95% confidence interval 1.24–3.19). PNI is related to advanced stage and poor long-term survival in gastric cancer, and may serve as an adjunctive prognostic factor in the intestinal histotype.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rhWBBS
via IFTTT
Mechanical Stimulation of the HT7 Acupuncture Point to Reduce Ethanol Self-Administration in Rats
Background. Alcoholism, which is a disabling addiction disorder, is a major public health problem worldwide. The present study was designed to determine whether the application of acupuncture at the Shenmen (HT7) point suppresses voluntary alcohol consumption in addicted rats and whether this suppressive effect is potentiated by the administration of naltrexone. Methods. Rats were initially trained to self-administer a sucrose solution by operating a lever. A mechanical acupuncture instrument (MAI) for objective mechanical stimulation was used on rats whose baseline response had been determined. In addition, the effect of HT7 acupuncture on beta-endorphin concentration and ethanol intake via naltrexone were investigated in different groups. Results. We found that ethanol intake and beta-endorphin level in rats being treated with the MAI at the HT7 point reduced significantly. The treatment of naltrexone at high doses reduced the ethanol intake and low-dose injection of naltrexone in conjunction with the MAI also suppressed ethanol intake. Conclusions. The results of the current study indicate that using the MAI at the HT7 point effectively reduces ethanol consumption in rats. Furthermore, the coadministration of the MAI and a low dose of naltrexone can produce some more potent reducing effect of ethanol intake than can acupuncture alone.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s85tId
via IFTTT
Traumatic diaphragmatic hernia—17 years experience
Abstract
Background
Objective of this study is to review our experience in the management of traumatic diaphragmatic hernias over 17 years.
Methods
Following Ethical Committee clearance, records of all patients who underwent traumatic diaphragmatic hernia surgery at Shanthabai Devarao Shivaram (SDS) Tuberculosis Research Centre and Rajiv Gandhi Institute of Chest Diseases, Bengaluru, India from January 1998 to December 2015 were reviewed. Data collected and analyzed were clinical presentation, mode of diagnosis, intraoperative findings and the postoperative clinical outcomes.
Results
Sixty patients underwent traumatic diaphragmatic hernia repair during this period. Age ranged between 10 and 80 years. The most common presentation was dyspnea. Blunt trauma was the cause in 52 (86.67%) cases and penetrating trauma in 8 (13.33%) cases. The diagnosis was within 24 h in 45 (75%) cases and in 15 (25%) cases the diagnosis was made after 24 h. Thoracotomy was the preferred approach for the repair in the absence of associated abdominal injuries. The most common site of rupture was the central tendon. The perioperative mortality was 8.33%. The hospital stay ranged between 5 and 84 days (mean 22 days).
Conclusion
Right-sided diaphragmatic hernias are notorious to be missed on initial evaluation. Despite advances in diagnostic modalities, chest X-ray still continues to be useful in the diagnosis of traumatic ruptures. A high index of suspicion, together with the knowledge of mechanism of trauma is the key factor for the correct diagnosis.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2r4BJ0w
via IFTTT
Airborne gamma-ray spectrometry data processing using 1.5D inversion
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): Eugene Druker
Standard processing of Airborne Gamma-Ray Spectrometry data generally gives good results when the measurement conditions are almost constant within several footprint area sizes, with the possible exception of flight height variations in a small range. In practice, deviations, such as large or abrupt changes of flight height and/or rugged terrain are not so rare and lead to certain problems. This article proposes a different approach where the solutions of inverse problems are used for data processing. The approach is quite natural in the processing of field data measured along the flight lines: it explicitly takes into account 1.5D survey models and flight parameters – from topography to sources distribution on the surface. Also, it clearly demonstrates that the inverse problem of the Airborne Gamma-Ray Spectrometry does not have a unique solution. This feature can be used in accordance with the underlying geological problem since various formulations of inverse problems can lead to various geological solutions. The use of the approach is illustrated by several examples given for flight lines and survey areas. This approach can be particularly useful in situations where geological, geophysical and/or geographic survey conditions are far from the standard assumptions.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rhHeJU
via IFTTT
Longitudinal study of quality of life in advanced cancer patients on home parenteral nutrition
Abstract
Since there is little knowledge regarding the quality of life (QoL) of cancer patients on home parenteral nutrition (HPN), we planned a prospective, longitudinal, double-center study to investigate the changes of QoL in these patients. One hundred and eleven adult cancer patients who were candidates for HPN following the indications of the European guidelines were consecutively enrolled. For QoL analysis, EORTC QLQ-C30 questionnaires were filled at the HPN start and after 1, 2, 3, and 4 months, and scores changes over time were analyzed according to the univariate mixed-effects linear model for repeated measures. Most patients had gastrointestinal cancers, were severely malnourished, and were in stage IV; two-thirds were still receiving oncologic treatments. Median weight loss over 3 months and body mass index were 11.7% and 20.7, respectively. Median survival was 4.7 (1–42) months; 67 and 34% of patients survived 3 and 6 months, respectively. Global QoL, physical functioning, role functioning, emotional functioning, appetite loss, and fatigue scores had a statistically significant trend over time (P < 0.001, P < 0.001, P = 0.007, P < 0.001, P = 0.004, P = 0.022, respectively). At the univariate analyses, the determinants significantly associated with changes in trend over time for physical, role, and emotional functioning were oncologic treatments (P < 0.001, P = 0.014, P = 0.040, respectively) and for appetite loss they were weight loss and Karnofsky performance status (P = 0.003, P = 0.023, respectively). Global QoL, physical, role, and emotional functioning improved during HPN even in advanced cancer patients on oncologic treatments.
In this prospective, longitudinal study that included 111 adults advanced cancer patients, global quality of life, physical functioning, role functioning, and emotional functioning had a statistically significant trend over time. At the univariate analyses, the determinants significantly associated with changes in trend over time for physical, role, and emotional functioning were oncologic treatments. Global quality of life improved during home parenteral nutrition even in advanced cancer patients on oncologic treatments.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qtYaxF
via IFTTT
Low-level laser therapy (780 nm) combined with collagen sponge scaffold promotes repair of rat cranial critical-size defects and increases TGF-β, FGF-2, OPG/RANK and osteocalcin expression
Summary
The aim of this study was to evaluate the effect of collagen sponge scaffold (CSS) implantation associated with low-level laser therapy (LLLT) on repairing bone defects. A single 5-mm cranial defect was surgically created in forty Wistar rats, which then received one of the following four interventions (n = 10 per group): no treatment (G0); bone defect implanted with collagen sponge scaffold (CSS) alone (G1); defect treated with low-level laser therapy (LLLT) (wavelength 780 nm; total energy density 120 J/cm2; power 50 mW) alone (G2); and CSS associated with LLLT treatment (G3). After surgery, animals in each group were euthanized at 21 days and 30 days (n = 5 per euthanasia time group). Bone formation was monitored by X-ray imaging analysis. Biopsies were collected and processed for histological analysis and immunohistochemical evaluation of transforming growth factor-beta (TGF-β), fibroblast growth factor-2 (FGF-2), osteoprotegerin (OPG) and receptor activator of nuclear factor ƙ (RANK). Osteocalcin (OCN) was detected by immunofluorescence analysis. Compared to the G0 group, defects in the 30-day G3 group exhibited increased bone formation, both by increase in radiopaque areas (P < 0.01) and by histomorphometric analysis (P < 0.001). The histopathological analysis showed a decreased number of inflammatory cells (P < 0.001). The combined CCS + LLLT (G3) treatment also resulted in the most intense immunostaining for OPG, RANK, FGF-2 and TGF-β, and the most intense and diffuse OCN immunofluorescent labelling at 30 days postsurgery (G3 vs. G0 group, P < 0.05). Therefore, the use of CCS associated with LLLT could offer a synergistic advantage in improving the healing of bone fractures.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rz7wIB
via IFTTT
Laparoscopic ischemic conditioning of the stomach increases neovascularization of the gastric conduit in patients undergoing esophagectomy for cancer
Background and Objectives
Gastric ischemic preconditioning has been proposed to improve blood flow and reduce the incidence of anastomotic complications following esophagectomy with gastric pull-up. This study aimed to evaluate the effect of prolonged ischemic preconditioning on the degree of neovascularization in the distal gastric conduit at the time of esophagectomy.
Methods
A retrospective review of a prospectively maintained database identified 30 patients who underwent esophagectomy. The patients were divided into three groups: control (no preconditioning, n = 9), partial (short gastric vessel ligation only, n = 8), and complete ischemic preconditioning (left and short gastric vessel ligation, n = 13). Microvessel counts were assessed, using immunohistologic analysis to determine the degree of neovascularization at the distal gastric margin.
Results
The groups did not differ in age, gender, BMI, pathologic stage, or cancer subtype. Ischemic preconditioning durations were 163 ± 156 days for partial ischemic preconditioning, compared to 95 ± 50 days for complete ischemic preconditioning (P = 0.2). Immunohistologic analysis demonstrated an increase in microvessel counts of 29% following partial ischemic preconditioning (P = 0.3) and 67% after complete ischemic preconditioning (P < 0.0001), compared to controls.
Conclusions
Our study indicates that prolonged ischemic preconditioning is safe and does not interfere with subsequent esophagectomy. Complete ischemic preconditioning increased neovascularization in the distal gastric conduit.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qwgB0x
via IFTTT
Comparison of the prognostic values of selected inflammation based scores in patients with medullary thyroid carcinoma: A pilot study
Background
The significance of inflammation based scores including the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), and plasma fibrinogen remains unclear in medullary thyroid carcinoma (MTC). We aimed to compare the prognostic value of these scores.
Methods
Seventy-eight patients newly diagnosed as MTC with operation in our institution from May 2009 to September 2016 were retrospectively evaluated. Receiver operating characteristic (ROC) curves and Kaplan-Meier analyses were calculated to compare the prognostic value of these scores.
Results
Increased PLR was predictive of lymph node metastasis (AUC = 0.644, P = 0.022), capsule invasion (AUC = 0.666, P = 0.007), advanced tumor stages (AUC = 0.657, P = 0.011), and recurrence (AUC = 0.655, P = 0.049). Increased fibrinogen was predictive of lymph node metastasis (AUC = 0.669, P = 0.006) and capsule invasion (AUC = 0.631, P = 0.038). Reduced PNI was predictive of recurrence (AUC = 0.655, P = 0.049). Kaplan-Meier analyses and Cox regression analysis revealed that PLR was a significant predictor for recurrence.
Conclusions
PLR, fibrinogen, and PNI are all predictive. Specially, PLR is superior to other inflammation based scores in terms of prognostic ability.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rPL65h
via IFTTT
Recurrence patterns of retroperitoneal leiomyosarcoma and impact of salvage surgery
Background
Optimal treatment strategies for retroperitoneal leiomyosarcoma (RPLMS), particularly recurrent disease, are unknown.
Methods
We searched the tumor registry at The University of Texas MD Anderson Cancer Center (MDACC) to identify patients with RPLMS treated between 1994 and 2013.
Results
We identified 172 patients with a diagnosis of a RPLMS. Among the 85 patients who underwent complete resection included in the survival analysis, the median overall survival (OS) was 8.3 years (95% confidence interval [CI], 5.7-12.3), 5-year local recurrence rate was 21%, and 5-year distant metastasis rate was 47%. Among 114 patients who experienced recurrence, patients who underwent salvage surgery for recurrent disease had longer OS after recurrence than patients who did not undergo salvage surgery (median survival after recurrence 5.6 vs 3.3 years, 3-year OS rates after recurrence 72.6% vs 58.1%, HR 0.402 [95%CI, 0.243-0.666]; P = 0.0004). Whether salvage surgery was performed for local or distant recurrence was not associated with OS. Patients who had a longer disease-free interval (≥12 months) had better progression-free survival after salvage surgery than those who had a shorter interval (HR, 0.437 [95%CI, 0.244-0.783]; P = 0.0055).
Conclusions
We recommend that salvage surgery be considered for selected patients with local or distant recurrence of RP LMS.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qwgC4B
via IFTTT
TGFβ pathway deregulation and abnormal phospho-SMAD2/3 staining in hereditary cerebral hemorrhage with amyloidosis-Dutch type
Abstract
Hereditary cerebral hemorrhage with amyloidosis-Dutch type (HCHWA-D) is an early onset hereditary form of cerebral amyloid angiopathy (CAA) pathology, caused by the E22Q mutation in the amyloid β (Aβ) peptide. Transforming Growth Factor β1 (TGFβ1) is a key player in vascular fibrosis and in the formation of angiopathic vessels in transgenic mice. Therefore we investigated whether the TGFβ pathway is involved in HCHWA-D pathogenesis in human postmortem brain tissue from frontal and occipital lobes. Components of the TGFβ pathway were analyzed with quantitative RT-PCR. TGFβ1 and TGFβ Receptor 2 (TGFBR2) gene expression levels were significantly increased in HCHWA-D in comparison to the controls, in both frontal and occipital lobes. TGFβ-induced pro-fibrotic target genes were also upregulated. We further assessed pathway activation by detecting phospho-SMAD2/3 (pSMAD2/3), a direct TGFβ down-stream signaling mediator, using immunohistochemistry. We found abnormal pSMAD2/3 granular deposits specifically on HCHWA-D angiopathic frontal and occipital vessels. We graded pSMAD2/3 accumulation in angiopathic vessels and found a positive correlation with the CAA load independent of the brain area. We also observed pSMAD2/3 granules in a halo surrounding occipital vessels, which was specific for HCHWA-D. The result of this study indicates an upregulation of TGFβ1 in HCHWA-D, as was found previously in AD with CAA pathology. We discuss the possible origins and implications of the TGFβ pathway deregulation in the microvasculature in HCHWA-D. These findings identify the TGFβ pathway as a potential biomarker of disease progression and a possible target of therapeutic intervention in HCHWA-D. This article is protected by copyright. All rights reserved.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sfDmGj
via IFTTT
Rapid amyloid-β oligomer and protofibril accumulation in traumatic brain injury
ABSTRACT
Objective: Deposition of amyloid-β (Aβ) is central to Alzheimer's disease (AD) pathogenesis and associated with progressive neurodegeneration in traumatic brain injury (TBI). We analysed predisposing factors for Aβ deposition including monomeric Aβ40, Aβ42 and Aβ oligomers/protofibrils, Aβ species with pronounced neurotoxic properties, following human TBI.
Methods: Highly selective ELISAs were used to analyse N-terminally intact and truncated Aβ40 and Aβ42, as well as Aβ oligomers/protofibrils, in human brain tissue, surgically resected from severe TBI patients (n=12; mean age 49.5 ± 19 years) due to life-threatening brain swelling/haemorrhage within one week post-injury. The TBI tissues were compared to post-mortem AD brains (n=5), to post-mortem tissue of neurologically intact subjects (n=4) and to cortical biopsies obtained at surgery for idiopathic normal pressure hydrocephalus patients (iNPH; n=4).
Results: The levels of Aβ40 and Aβ42 were not elevated by TBI. The levels of Aβ oligomers/protofibrils in TBI were similar to those in the significantly older AD patients and increased compared to neurologically intact and iNPH controls (P<0.05). Moreover, TBI patients carrying the AD risk genotype Apolipoprotein E epsilon3/4 (APOE ε3/4; n=4) had increased levels of Aβ oligomers/protofibrils (P<0.05) and of both N-terminally intact and truncated Aβ42 (P<0.05) compared to APOE ε3/4-negative TBI patients (n=8). Neuropathological analysis showed insoluble Aβ aggregates (commonly referred to as Aβ plaques) in three TBI patients, all of whom were APOE ε3/4 carriers.
Interpretation: Soluble intermediary Aβ aggregates form rapidly after TBI, especially among APOE ε3/4 carriers. Further research is needed to determine whether these aggregates aggravate the clinical short- and long-term outcome in TBI. This article is protected by copyright. All rights reserved.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rhuH9h
via IFTTT
Sleep quality subtypes predict health-related quality of life in children
Source:Sleep Medicine, Volume 35
Author(s): Christopher A. Magee, Laura Robinson, Carol Keane
ObjectiveThis paper aimed to investigate whether distinct sleep quality subtypes predicted health-related quality of life in a nonclinical sample of children.MethodsThis paper utilized data from two waves of the Longitudinal Study of Australian Children, a cohort study that follows a representative population of children in Australia. This paper examined data from Waves 4 and 5 of the LSAC (covering the period 2010–2012) and included 3974 children aged 10–11 years at Wave 4 (51.4% male). Multiple dimensions of sleep quality were assessed using a combination of child- and parent-reported measures. Health-related quality of life (HRQOL) was assessed through the Pediatric Quality of Life Inventory.ResultsLatent class analysis indicated six distinct sleep quality classes in children, namely good sleep, moderate sleep quality, mild sleep disturbances, short sleep, long sleep, and disordered sleep. In general, the disordered sleep and minor sleep disturbance classes had poorer HRQOL, which worsened over time. The long sleep and moderate sleep quality classes also showed some decreases in HRQOL over time.ConclusionsThis study demonstrates that there are distinct sleep quality subtypes in children that could have implications for HRQOL. These findings may inform future strategies to promote improved sleep and HRQOL in children.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2re7ums
via IFTTT
Personalized Consent Flow in Contemporary Data Sharing for Medical Research: A Viewpoint
Background. Health data personally collected by individuals with wearable devices and smartphones is becoming an important data source for healthcare, but also for medical research. Objective. To describe a new consent model that allows people to control their personally collected health data and determine to what extent they want to share these for research purposes. Methods. We developed, in close collaboration with patients, researchers, healthcare professionals, privacy experts, and an accredited Medical Ethical Review Committee, an innovative concept called "personalized consent flow" within a research platform connected to a personal health record. The development was an iterative process with informal meetings, semistructured interviews, and surveys. The final concept of the personalized consent flow was reviewed by patients and improved and approved by the same patients in a focus group. Results. This concept could result in optimal control for individual users, since they will answer questions about how they will share data. Furthermore, it enables users to collect data for specific studies and add expiration dates to their data. This work facilitates further discussion about dynamic and personalized consent. A pilot study with the personalized consent model is currently being carried out.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sfDvcO
via IFTTT
Role of cholinergic receptors in memory retrieval depends on gender and age of memory
Source:Behavioural Brain Research, Volume 331
Author(s): Habiba Rashid, Aamra Mahboob, Touqeer Ahmed
The phenomenon of utilizing information acquired in the past to make decision and performance in present depends on memory retrieval, which is affected in retrograde amnesia. Role of cholinergic receptors in memory retrieval is not much explored. In this study we evaluated the gender specific role of cholinergic receptors, i.e. muscarinic and nicotinic receptors, in memory retrieval in young Balb/c mice. Acute (only one injection, 30min before test) and sub-chronic (five days) muscarinic blockade (using scopolamine=1mg/kg) before test impaired retrieval of contextual fear memory in male (31.45±5.39% and 33.36±3.78% respectively) and female mice (22.88±5.73%; P<0.05), except sub-chronically treated female group (33.31±4.90%; P>0.05). Only sub-chronic nicotinic receptor antagonism (using methyllycaconitine MLA=87.5μg/kg and dihydro β erythroidine DHβE=1mg/kg) in female showed significantly higher freezing response than control during contextual fear memory retrieval (60.85±7.71% and 40.91±7.53% respectively; P<0.001). Acute and sub-chronic muscarinic antagonism (but not nicotinic antagonism) impaired spatial memory retrieval in male (P<0.05) but not in female mice (P>0.05). There was no effect of acute and sub-chronic cholinergic receptor antagonism on discriminating novel object from the familiar one in male and female mice, however, nicotinic receptor blockade affected the working memory of all male and female mice on test day compared to the training sessions. Our results suggested that cholinergic receptors involvement in retrieving spatial and fear memories depends on the age of the memory and gender.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qtz81y
via IFTTT
Effect of PICALM rs3851179 polymorphism on the default mode network function in mild cognitive impairment
Source:Behavioural Brain Research, Volume 331
Author(s): Ding-Ming Sun, Hai-Feng Chen, Qi-Long Zuo, Fan Su, Feng Bai, Chun-Feng Liu
Alterations in default mode network (DMN) functional connectivity (FC) might accompany the dysfunction of Alzheimer's disease (AD). Indeed, episodic memory impairment is a hallmark of AD, and mild cognitive impairment (MCI) has been associated with a high risk for AD. Phosphatidylinositol-binding clathrin assembly protein (PICALM) (rs3851179) has been associated with AD; in particular, the A allele may serve a protective role, while the G allele serves as a strong genetic risk factor. Therefore, the identification of genetic polymorphisms associated with the DMN is required in MCI subjects. In all, 32 MCI subjects and 32 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) and a genetic imaging approach. Subjects were divided into four groups according to the diagnosis (i.e., MCI and HCs) and the PICALM rs3851179 polymorphism (i.e., AA/AG genotype and GG genotype). The differences in FC within the DMN between the four subgroups were explored. Furthermore, we examined the relationship between our neuroimaging measures and cognitive performance. The regions associated with the genotype-by-disease interaction were in the left middle temporal gyrus (LMTG) and left middle frontal gyrus (LMFG). These changes in LMFG FC were generally manifested as an "inverse U-shaped curve", while a "U-shaped curve" was associated with the LMTG FC between these four subgroups (all P<0.05). Furthermore, higher FC within the LMFG was related to better episodic memory performance (i.e., AVLT 20min DR, rho=0.72, P=0.044) for the MCI subgroups with the GG genotype. The PICALM rs3851179 polymorphism significantly affects the DMN network in MCI. The LMFG and LMTG may be associated with opposite patterns. However, the altered LMFG FC in MCI patients with the GG genotype was more sensitive to episodic memory impairment, which is more likely to lead to a high risk of AD.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2relEnj
via IFTTT
Water and T-maze protocols are equally efficient methods to assess spatial memory in 3xTg Alzheimer’s disease mice
Source:Behavioural Brain Research, Volume 331
Author(s): K.E. Davis, K. Burnett, J. Gigg
Rodent spatial memory is commonly tested using the water-maze; however, there is a potential confound of stress on learning in this behavioural paradigm. This is particularly relevant when testing spatial memory in models of neurodegeneration, such as the 3xTg mouse model for Alzheimer's disease. Here, we first confirmed that 3xTgAD mice express fear conditioning and then compared the performance of young and middle-aged mice on short-duration versions of the radial arm water-maze (RAWM) and the minimally stressful T-maze spontaneous alternation task. Our main questions were: (1) does the reliance on stressors in water-maze training mask the true cognitive ability of 3xTgAD mice; and (2) are 3xTgAD mice similarly impaired in water-maze and T-maze protocols. Firstly, male and female 3xTgAD mice displayed intact freezing responses in both contextual and Pavlovian fear conditions. As male 3xTgAD mice displayed relatively enhanced fear responses the remaining tests were performed using only female 3xTgAD and control mice in order to equate for response to stressors. We found that alternation rates after both short and long delays were impaired at both ages in female 3xTgAD mice, indicative of robust spatial working memory deficits. For RAWM, again performance deficits were found in young 3xTgAD mice. As both tasks had similar efficacy at revealing early spatial memory deficits, we suggest that spontaneous behavioural protocols be prioritised over water maze testing in models such the 3xTgAD mouse as the former provide a far less stressful but equally effective alternative.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2relQTD
via IFTTT
Enriched environment alters the behavioral profile of tenascin-C deficient mice
Source:Behavioural Brain Research, Volume 331
Author(s): V. Stamenkovic, I. Milenkovic, N. Galjak, V. Todorovic, P. Andjus
Tenascin-C (TnC) is an extracellular matrix glycoprotein implicated in a variety of processes ranging from brain development to synaptic plasticity in the adult vertebrates. Although the role of the TnC gene in regulation of behavior has been investigated, it remained elusive how TnC deficiency interacts with the environment in shaping the behavioral phenotype. To address this, 3-week-old TnC+/+ and TnC-/- male mice were housed over an 8-week period in standard conditions (SC), or enriched environment (EE). A comprehensive battery of tests was used in behavioral phenotyping. When housed in SC, TnC−/− mice showed spontaneous nocturnal hyperactivity, as well as poor sensorimotor coordination and low swimming velocity. However, housing of TnC−/− mice in EE abolished hyperlocomotion, led to faster habituation to novel environment, strengthened the grasp of fore limbs and partially improved movement coordination, while the swimming ability remained deficient. Conversely, TnC deficiency attenuated both the beneficial effects of EE on learning/memory capacity and the anxiolytic effect of EE in reducing the level of acrophobia. This study expands the existing knowledge about the phenotype associated with TnC deficiency, and reveals that the effect of genetic background on the behavioral response could be altered by post-weaning housing in a highly stimulating environment.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qtutga
via IFTTT
Validation of the Lithuanian Version of the Speech Handicap Index
The objective is to study the cultural adaptation and validation of the Speech Handicap Index (SHI) questionnaire to the Lithuanian language.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2r5DP0g
via IFTTT
Recovery From Heavy Vocal Loading in Women With Different Degrees of Functional Voice Problems
This is a longitudinal, case-control clinical trial.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qAMiVG
via IFTTT
The Exploration of an Objective Model for Roughness With Several Acoustic Markers
In voice assessment, the evaluation of voice quality is a major component in which roughness has received wide acceptance as a major subtype of abnormal voice quality. The aim of the present study was to develop a new multivariate acoustic model for the evaluation of roughness.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2r5JgMB
via IFTTT
Detection of gastric atrophy by circulating pepsinogens: A comparison of three assays
Abstract
Background
Circulating levels of pepsinogens have been used in high gastric cancer-risk Asian and European populations to triage endoscopic evaluation for more severe pathology. There are different analytic methods with uncertain correlations. We therefore compared diagnostic performance of three commonly used pepsinogen assays to detect histologically confirmed gastric atrophy.
Methods
We tested plasma samples from adult patients with (n=50) and without (n=755) moderate or severe gastric corpus atrophy, as determined histologically by consensus of three expert pathologists. A single laboratory measured pepsinogens I (PgI) and II (PgII) using commercially available assays: two ELISA assays produced by Biohit (Finland) and Vector Best (Russia), and a latex agglutination assay from Eiken (Japan). Quantitative correlations were assessed by Spearman statistics. Receiver operating characteristic (ROC) curves vs histological diagnosis were calculated using both the manufacturers' and optimized cutoffs.
Results
Pepsinogen levels were highly correlated among the assays (pairwise Rhos: PgI≥0.84, PgII≥0.87; all P-values<.01). Based on manufacturers' cutoffs, sensitivities, specificities and areas under the ROC curve for detecting moderate to severe histological corpus atrophy by PgI/PgII were 44%/91%/0.70, 56%/84%/0.76, and 52%/90%/0.77 for Biohit, Vector Best and Eiken, respectively. Cutoffs optimized by ROC or data mining analyses did not substantially improve test performance.
Conclusions
Commercial assays for pepsinogen have good relative agreement but are imperfect tests for clinical diagnosis of gastric atrophy.
Impact
Pepsinogen testing alone does not provide sufficient information for gastric cancer risk stratification. Future investigations should focus on other potential markers, in combination with pepsinogens.
http://ift.tt/2rhxjEd
Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy
Sleep during pregnancy involves a physiological challenge to provide sufficient gas exchange to the fetus. Enhanced ventilatory responses to hypercapnia and hypoxia may protect from deficient gas exchange, but sleep-disordered breathing (SDB) may predispose to adverse events. The aim of this study was to analyze sleep and breathing in healthy pregnant women compared to non-pregnant controls, with a focus on CO2 changes and upper-airway flow limitation.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qtHjL4
via IFTTT
Efficacy and safety of almorexant in adult chronic insomnia: a randomized placebo-controlled trial with an active reference
The orally active dual OX1R and OX2R antagonist, almorexant, targets the orexin system for the treatment of primary insomnia. This clinical trial assessed the effect of almorexant on sleep maintenance and other sleep endpoints, and its safety and tolerability in adults.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rehQm6
via IFTTT
Gray matter abnormalities of the dorsal posterior cingulate in sleep walking
This study aimed to determine whether voxel-based analysis of T1 weighted magnetic resonance imaging (MRI) and diffusion tensor imaging is able to detect alterations of gray and white matter morphometry as well as measures of mean diffusivity and fractional anisotropy in patients with non-rapid eye movement parasomnia.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qtTeIU
via IFTTT
Postnatal treatment of women with narcolepsy who choose to breastfeed-time for a reappraisal?
Primum non-nocere, (first, do no harm) a loose translation of a line from the Hippocratic oath that most physicians take upon graduating from medical school, should be a guiding principle of medical practice. [1] In obstetrics and pediatrics, this philosophy was fashionable in terms of advising postpartum women concerning nursing who were on long-term medications. Generally, this was not to mix pharmaceutical agents with breastfeeding. This was a no win dilemma (ie, a Sophie's Choice) for many women who were being treated for chronic illnesses; choosing between taking their medications and forgoing nursing, and therefore, depriving their baby of the benefits of breast milk (or to nurse and stop their medications, and run the risk of exacerbating their underlying condition).
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2re9paD
via IFTTT
Sex and age differences in the associations between sleep behaviors and all-cause mortality in older adults: results from the National Health and Nutrition Examination Surveys
Our aim was to examine sex- and age-specific relationships of sleep behaviors with all-cause mortality rates.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2qtHRk4
via IFTTT
The relationship between weight change and daytime sleepiness: the Sleep Heart Health Study
Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2relcpg
via IFTTT
Laparoscopic sigmoidectomy combined with uterus excision for colouterine fistula caused by sigmoid colon diverticulitis: A case report
Abstract
A case of colouterine fistula caused by colonic diverticulitis that was successfully treated laparoscopically is presented. A 74-year-old woman visited us with lower abdominal discomfort and vaginal excretion with minor fecal contamination. Mild tenderness was observed in her lower abdomen. Blood examinations revealed elevated white blood cell count and C-reactive protein. Sigmoid colon diverticulitis was revealed on CT, and her condition was diagnosed as colouterine fistula. Hinchey classification was stage I. After 2 weeks of conservative therapy, her symptoms were reduced, and the white blood cell count and C-reactive protein level decreased. However, fecal contaminated vaginal excretion continued. The patient underwent laparoscopic sigmoidectomy combined with uterus excision, and she has been in good health for the 3 years since the operation. Although colouterine fistula is usually treated with open surgery, patients with controlled and well-localized inflammation may be good candidates for a laparoscopic approach.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rPvuPz
via IFTTT
Gillies temporal incision: an alternate approach to superficial temporal artery biopsy
The main complications of a biopsy of the superficial temporal artery using a standard preauricular approach include scars on the face, weakness of the temporal branch of the facial nerve, and the possible harvest of a disease-free segment of artery. We describe a modification of the Gillies temporal approach, which when placed at the junction of the frontal and parietal branch can be easily modified to harvest either branch. It avoids scarring to the face as it is hidden within the hairline. The incision placed with specific measurements and palpation is easily reproducible.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ryZNdq
via IFTTT
Re: Wrong tooth extraction: an examination of ‘Never Event’ data
I read with interest the recent study by Pemberton et al concerning wrong tooth extractions.1 In many ways it is surprising that extraction of a wrong tooth is the most common wrong site event, given that many of these procedures are done under local anaesthesia and the patient often knows which tooth or teeth are to be removed. Although the authors were not able to comment on the causes, as with many cases of human error, they are likely to be multifactorial. Ineffective communication is widely regarded as one of the highest causes of error.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s8fa9O
via IFTTT
An evaluation of motion mitigation techniques for pancreatic SBRT
Ablative radiation therapy can be beneficial for pancreatic cancer, and motion mitigation helps to reduce dose to nearby organs-at-risk. Here, we compared two competing methods of motion mitigation—abdominal compression and respiratory gating.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sfl2NC
via IFTTT
The Exploration of an Objective Model for Roughness With Several Acoustic Markers
Publication date: Available online 29 May 2017
Source:Journal of Voice
Author(s): Ben Barsties v. Latoszek, Marc De Bodt, Ellen Gerrits, Youri Maryn
ObjectiveIn voice assessment, the evaluation of voice quality is a major component in which roughness has received wide acceptance as a major subtype of abnormal voice quality. The aim of the present study was to develop a new multivariate acoustic model for the evaluation of roughness.MethodIn total, 970 participants with dysphonia and 88 participants with normal voice were included. Concatenated voice samples of continuous speech and sustained vowel [a:] were perceptually judged on roughness severity. Acoustic analyses were conducted on the voiced segments of the continuous speech sample plus sustained vowel as well. A stepwise multiple linear regression analysis was applied to construct an acoustic model of the best acoustic predictors. Concurrent validity, diagnostic accuracy, and cross-validation were verified on the basis of Spearman correlation coefficient (rs), several estimates of the receiver operating characteristics plus the likelihood ratio, and iterated internal cross-correlations.ResultsSix experts were included for perceptual analysis based on acceptable rater reliability. Stepwise multiple regression analysis yielded a 12-variable acoustic model. A marked correlation was identified between the model and the perceptual judgment (rs = 0.731, P = 0.000). The cross-correlations confirmed a high comparable degree of association. However, the receiver operating characteristics and likelihood ratio results showed the best diagnostic outcome at a threshold of 2.92, with a sensitivity of 51.9% and a specificity of 94.9%.ConclusionsCurrently, the newly developed roughness model is not recommended for clinical practice. Further research is needed to detect the acoustic complexity of roughness (eg, multiplophonia, irregularity, chaotic structure, glottal fry, etc).
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ryG5yk
via IFTTT
Recovery From Heavy Vocal Loading in Women With Different Degrees of Functional Voice Problems
Publication date: Available online 29 May 2017
Source:Journal of Voice
Author(s): Susanna Whitling, Viveka Lyberg-Åhlander, Roland Rydell
Type of StudyThis is a longitudinal, case-control clinical trial.ObjectivesThis study aims to track recovery time following a vocal loading task (VLT) imposing vocal fatigue and to explore if patients with functional dysphonia (FD) are worse affected by vocal loading, and if these patients take longer than others to recover.MethodsFifty (n = 50) female participants in four vocal subgroups on a spectrum of everyday vocal loading and functional voice complaints, including n = 20 patients with FD, took part in a clinical VLT, inflicting vocal fatigue through loud speech in ambient noise. Short-term recovery was explored through self-assessment of unspecified voice problems every 15 minutes for 2 hours following loading. Long-term recovery was tracked through self-assessments of specific voice symptoms during 3 days following vocal loading. Effects of heavy vocal loading were evaluated through voice recordings, long-time-average spectrum, perceptual assessments, and assessments of digital imaging performed pre- and post vocal loading.ResultsPatients with FD did not return to baseline for unspecified voice problems within 2 hours of vocal loading and were worse affected by vocal loading than other groups. Women with high everyday vocal loading with no voice complaints identified vocal loading more evidently than other groups. Long-term recovery took 7–20 hours for all groups.ConclusionsShort-term recovery is slower for patients with FD and these patients are worse affected by a VLT than others.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s878xp
via IFTTT
Validation of the Lithuanian Version of the Speech Handicap Index
Publication date: Available online 29 May 2017
Source:Journal of Voice
Author(s): Ruta Pribuisiene, Vykintas Liutkevicius, Kipras Pribuisis, Virgilijus Uloza
ObjectiveThe objective is to study the cultural adaptation and validation of the Speech Handicap Index (SHI) questionnaire to the Lithuanian language.MethodsCultural adaptation and validation of the translated Lithuanian version of the SHI (SHI-LT) was performed as described by the Scientific Advisory Committee of the Medical Outcomes Trust. The SHI-LT was completed by 46 patients after total laryngectomy and by 60 healthy subjects of the control group. Validity and reliability of the SHI-LT were evaluated.ResultsThe SHI-LT showed a statistically significant high internal consistency and test-retest reliability (Cronbach's α = 0.96–0.98). Good validity of SHI-LT was reflected by statistically significant (P < 0.001) difference between the mean scores of the patients and control groups (74.7 ± 26.9 and 5.5 ± 6.5, respectively). No age or gender dependence of SHI-LT was found (P > 0.05). Receiver operating characteristic test indicated that SHI-LT scores exceeding 17.0 points (cutoff value) distinguish patients from healthy controls, with a sensitivity of 97.8% and specificity of 95.0%.ConclusionSHI-LT is considered to be a valid and reliable speech assessment tool for Lithuanian-speaking patients after laryngectomy.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ryG3Xe
via IFTTT
The Exploration of an Objective Model for Roughness With Several Acoustic Markers
Source:Journal of Voice
Author(s): Ben Barsties v. Latoszek, Marc De Bodt, Ellen Gerrits, Youri Maryn
ObjectiveIn voice assessment, the evaluation of voice quality is a major component in which roughness has received wide acceptance as a major subtype of abnormal voice quality. The aim of the present study was to develop a new multivariate acoustic model for the evaluation of roughness.MethodIn total, 970 participants with dysphonia and 88 participants with normal voice were included. Concatenated voice samples of continuous speech and sustained vowel [a:] were perceptually judged on roughness severity. Acoustic analyses were conducted on the voiced segments of the continuous speech sample plus sustained vowel as well. A stepwise multiple linear regression analysis was applied to construct an acoustic model of the best acoustic predictors. Concurrent validity, diagnostic accuracy, and cross-validation were verified on the basis of Spearman correlation coefficient (rs), several estimates of the receiver operating characteristics plus the likelihood ratio, and iterated internal cross-correlations.ResultsSix experts were included for perceptual analysis based on acceptable rater reliability. Stepwise multiple regression analysis yielded a 12-variable acoustic model. A marked correlation was identified between the model and the perceptual judgment (rs = 0.731, P = 0.000). The cross-correlations confirmed a high comparable degree of association. However, the receiver operating characteristics and likelihood ratio results showed the best diagnostic outcome at a threshold of 2.92, with a sensitivity of 51.9% and a specificity of 94.9%.ConclusionsCurrently, the newly developed roughness model is not recommended for clinical practice. Further research is needed to detect the acoustic complexity of roughness (eg, multiplophonia, irregularity, chaotic structure, glottal fry, etc).
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ryG5yk
via IFTTT
Validation of the Lithuanian Version of the Speech Handicap Index
Source:Journal of Voice
Author(s): Ruta Pribuisiene, Vykintas Liutkevicius, Kipras Pribuisis, Virgilijus Uloza
ObjectiveThe objective is to study the cultural adaptation and validation of the Speech Handicap Index (SHI) questionnaire to the Lithuanian language.MethodsCultural adaptation and validation of the translated Lithuanian version of the SHI (SHI-LT) was performed as described by the Scientific Advisory Committee of the Medical Outcomes Trust. The SHI-LT was completed by 46 patients after total laryngectomy and by 60 healthy subjects of the control group. Validity and reliability of the SHI-LT were evaluated.ResultsThe SHI-LT showed a statistically significant high internal consistency and test-retest reliability (Cronbach's α = 0.96–0.98). Good validity of SHI-LT was reflected by statistically significant (P < 0.001) difference between the mean scores of the patients and control groups (74.7 ± 26.9 and 5.5 ± 6.5, respectively). No age or gender dependence of SHI-LT was found (P > 0.05). Receiver operating characteristic test indicated that SHI-LT scores exceeding 17.0 points (cutoff value) distinguish patients from healthy controls, with a sensitivity of 97.8% and specificity of 95.0%.ConclusionSHI-LT is considered to be a valid and reliable speech assessment tool for Lithuanian-speaking patients after laryngectomy.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ryG3Xe
via IFTTT
An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity
Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Nagihan Bilal, Selman Sarica, Ergül Belge Kurutas, Ebru Findikli, İsrafil Orhan, Erkan Oner, Adem Doganer, Saime Sagiroglu, Mehmet Akif Kilic
ObjectivesAlthough there has been much research into the cause of stuttering, it has not yet been fully clarified. There is known to be a close relationship between stress severity and stuttering. The aim of this study was to evaluate the levels of oxidative and nitrosative stress by comparing a stuttering group and a control group. It was also aimed to evaluate the relationship between the oxidative and nitrosative stress levels and the severity of the stutter.MethodsThe study included a total of 80 individuals, comprising a study group of 40 and a control group of 40. The severity of the stutter in the patient group was evaluated with the Stuttering Severity Instrument 3 (SSI). Blood samples were taken from both the patient and control groups and malondialdehyde (MDA), 3 nitrotyrosine (3-NT), nitric oxide (NO), catalase (CAT), and superoxide dismutase (SOD) concentrations were examined.ResultsIn the stuttering patients, MDA, 3-NT, NO, CAT, and SOD activity were determined to be statistically significantly higher than those of the control group (all p:0.001). In the ROC analysis, there was good diagnostic value for NO, with the area under the curve as 1.0. A direct, positive, statistically significant correlation was determined between SSI points and MDA values (r = 0.317, p = 0.046).ConclusionThe results of the study showed that the oxidative and nitrosative stress levels of the stuttering patients were higher than those of the control group. With 100% sensitivity and specificity, it is thought that NO in particular could be important for the diagnosis and treatment of these patients. As the severity of the stutter increased, so there was an increase in MDA, suggesting that MDA is important in stuttering.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rhoZEd
via IFTTT
Local effects of epidermal growth factor on the wound healing in esophageal anastomosis: An experimental study
Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Ayşe Bülbül Adam, Mustafa Yaşar Özdamar, Hacı Hasan Esen, Engin Günel
ObjectiveIn this study with the experimental model of primary repair of esophageal atresia(EA), we investigated the effects of the epidermal growth factor(EGF) on wound healing in the anastomosis of EA.Materials and methodsForty rabbits that were performed a resection of a 1-cm segment of the cervical esophagus followed by the end-to-end anastomosis were divided into four groups. Group I (7-day group) and III (21-day group), the control groups, had no EGF applied to the anastomosis. In group II (7-day group) and group III (21-day group), all around the anastomoses were locally covered with 100 μg/kg EGF. Group 1, 2 and 3, 4 were sacrificed on the 7th and 21st day, respectively. We investigated and compared with bursting pressure, vascularization around the anastomotic line by histopathology, inflammation, and fibroblast granulation as well as hydroxyproline level by biochemical.ResultsNo significant difference was found at vascularization and inflammation between all of the groups (p > 0.05). Considering the critical parameters of the groups, at bursting pressure difference was found between group 1 and 2 as well as 3 and (p < 0.05). At fibroblast granulation and hydroxyproline level, no difference was found between group 1 and 2 (p > 0.05) but the difference between group 3 and 4 (p < 0.05).ConclusionEGF might be useful in preventing anastomotic leakage of esophageal atresia in primary anastomosis of esophageal atresia by accelerating wound healing process and increasing the stability of the anastomotic line.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sfeyP1
via IFTTT
Airway stenting in a child with spondyloepiphyseal dysplasia congenita: 13-Year survival
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Raffaella Nenna, Fabio Midulla, Laura Masi, Giacomo Maria Bacci, Antonella Frassanito, Roberto Baggi, Maria Luisa Brandi, Stefano Avenali, Lorenzo Mirabile, Paola Serio
We describe the case of a boy with spondyloepiphyseal dysplasia congenita. At birth, he experienced severe respiratory distress necessitating tracheotomy. Endoscopy done because mechanical ventilation failed to resolve desaturations disclosed severe tracheo-bronchomalacia. A Polyflex silicone stent was placed in the trachea (replaced by Y-Dumon stent) and 2 Palmaz metallic stents in the mainstem bronchi (overlapped with 2 Jomed stents 5 years later). Airway stenting guaranteed a suitable respiratory status and allowed a child who was expected to die at birth, to reach 13.5 years old in good conditions.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sf7yS0
via IFTTT
Recovery From Heavy Vocal Loading in Women With Different Degrees of Functional Voice Problems
Source:Journal of Voice
Author(s): Susanna Whitling, Viveka Lyberg-Åhlander, Roland Rydell
Type of StudyThis is a longitudinal, case-control clinical trial.ObjectivesThis study aims to track recovery time following a vocal loading task (VLT) imposing vocal fatigue and to explore if patients with functional dysphonia (FD) are worse affected by vocal loading, and if these patients take longer than others to recover.MethodsFifty (n = 50) female participants in four vocal subgroups on a spectrum of everyday vocal loading and functional voice complaints, including n = 20 patients with FD, took part in a clinical VLT, inflicting vocal fatigue through loud speech in ambient noise. Short-term recovery was explored through self-assessment of unspecified voice problems every 15 minutes for 2 hours following loading. Long-term recovery was tracked through self-assessments of specific voice symptoms during 3 days following vocal loading. Effects of heavy vocal loading were evaluated through voice recordings, long-time-average spectrum, perceptual assessments, and assessments of digital imaging performed pre- and post vocal loading.ResultsPatients with FD did not return to baseline for unspecified voice problems within 2 hours of vocal loading and were worse affected by vocal loading than other groups. Women with high everyday vocal loading with no voice complaints identified vocal loading more evidently than other groups. Long-term recovery took 7–20 hours for all groups.ConclusionsShort-term recovery is slower for patients with FD and these patients are worse affected by a VLT than others.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2s878xp
via IFTTT
Local effects of epidermal growth factor on the wound healing in esophageal anastomosis: An experimental study
Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Ayşe Bülbül Adam, Mustafa Yaşar Özdamar, Hacı Hasan Esen, Engin Günel
ObjectiveIn this study with the experimental model of primary repair of esophageal atresia(EA), we investigated the effects of the epidermal growth factor(EGF) on wound healing in the anastomosis of EA.Materials and methodsForty rabbits that were performed a resection of a 1-cm segment of the cervical esophagus followed by the end-to-end anastomosis were divided into four groups. Group I (7-day group) and III (21-day group), the control groups, had no EGF applied to the anastomosis. In group II (7-day group) and group III (21-day group), all around the anastomoses were locally covered with 100 μg/kg EGF. Group 1, 2 and 3, 4 were sacrificed on the 7th and 21st day, respectively. We investigated and compared with bursting pressure, vascularization around the anastomotic line by histopathology, inflammation, and fibroblast granulation as well as hydroxyproline level by biochemical.ResultsNo significant difference was found at vascularization and inflammation between all of the groups (p > 0.05). Considering the critical parameters of the groups, at bursting pressure difference was found between group 1 and 2 as well as 3 and (p < 0.05). At fibroblast granulation and hydroxyproline level, no difference was found between group 1 and 2 (p > 0.05) but the difference between group 3 and 4 (p < 0.05).ConclusionEGF might be useful in preventing anastomotic leakage of esophageal atresia in primary anastomosis of esophageal atresia by accelerating wound healing process and increasing the stability of the anastomotic line.
http://ift.tt/2sfeyP1
An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity
Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Nagihan Bilal, Selman Sarica, Ergül Belge Kurutas, Ebru Findikli, İsrafil Orhan, Erkan Oner, Adem Doganer, Saime Sagiroglu, Mehmet Akif Kilic
ObjectivesAlthough there has been much research into the cause of stuttering, it has not yet been fully clarified. There is known to be a close relationship between stress severity and stuttering. The aim of this study was to evaluate the levels of oxidative and nitrosative stress by comparing a stuttering group and a control group. It was also aimed to evaluate the relationship between the oxidative and nitrosative stress levels and the severity of the stutter.MethodsThe study included a total of 80 individuals, comprising a study group of 40 and a control group of 40. The severity of the stutter in the patient group was evaluated with the Stuttering Severity Instrument 3 (SSI). Blood samples were taken from both the patient and control groups and malondialdehyde (MDA), 3 nitrotyrosine (3-NT), nitric oxide (NO), catalase (CAT), and superoxide dismutase (SOD) concentrations were examined.ResultsIn the stuttering patients, MDA, 3-NT, NO, CAT, and SOD activity were determined to be statistically significantly higher than those of the control group (all p:0.001). In the ROC analysis, there was good diagnostic value for NO, with the area under the curve as 1.0. A direct, positive, statistically significant correlation was determined between SSI points and MDA values (r = 0.317, p = 0.046).ConclusionThe results of the study showed that the oxidative and nitrosative stress levels of the stuttering patients were higher than those of the control group. With 100% sensitivity and specificity, it is thought that NO in particular could be important for the diagnosis and treatment of these patients. As the severity of the stutter increased, so there was an increase in MDA, suggesting that MDA is important in stuttering.
http://ift.tt/2rhoZEd
Airway stenting in a child with spondyloepiphyseal dysplasia congenita: 13-Year survival
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Raffaella Nenna, Fabio Midulla, Laura Masi, Giacomo Maria Bacci, Antonella Frassanito, Roberto Baggi, Maria Luisa Brandi, Stefano Avenali, Lorenzo Mirabile, Paola Serio
We describe the case of a boy with spondyloepiphyseal dysplasia congenita. At birth, he experienced severe respiratory distress necessitating tracheotomy. Endoscopy done because mechanical ventilation failed to resolve desaturations disclosed severe tracheo-bronchomalacia. A Polyflex silicone stent was placed in the trachea (replaced by Y-Dumon stent) and 2 Palmaz metallic stents in the mainstem bronchi (overlapped with 2 Jomed stents 5 years later). Airway stenting guaranteed a suitable respiratory status and allowed a child who was expected to die at birth, to reach 13.5 years old in good conditions.
http://ift.tt/2sf7yS0
Novel highly porous magnetic hydrogel beads composed of chitosan and sodium citrate: an effective adsorbent for the removal of heavy metals from aqueous solutions
Abstract
This research focuses on the removal of heavy metal ions from aqueous solutions using magnetic chitosan hydrogel beads as a potential sorbent. Highly porous magnetic chitosan hydrogel (PMCH) beads were prepared by a combination of in situ co-precipitation and sodium citrate cross-linking. Fourier transform infrared spectroscopy indicated that the high sorption efficiency of metal cations is attributable to the hydroxyl, amino, and carboxyl groups in PMCH beads. Thermogravimetric analysis demonstrated that introducing Fe3O4 nanoparticles increases the thermal stability of the adsorbent. Laser confocal microscopy revealed highly uniform porous structure of the resultant PMCH beads, which contained a high moisture content (93%). Transmission electron microscopy micrographs showed that the Fe3O4 nanoparticles, with a mean diameter of 5 ± 2 nm, were well dispersed inside the chitosan beads. Batch adsorption experiments and adsorption kinetic analysis revealed that the adsorption process obeys a pseudo-second-order model. Isotherm data were satisfactorily described by the Langmuir equation, and the maximum adsorption capacity of the adsorbent was 84.02 mg/g. Energy-dispersive X-ray spectroscopy and X-ray photoelectron spectra analyses were performed to confirm the adsorption of Pb2+ and to identify the adsorption mechanism.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2rh9210
via IFTTT
Human health impact assessment of exposure to particulate matter: an AirQ software modeling
Abstract
The aim of this study was to assess the health impacts related to particulate matter less than 10 μm (PM10) exposure in the city of Yazd, Iran. For this aim, AirQ 2.2.3 software was used to model relationship between short-term exposure to PM10 and disease cases proposed by the World Health Organization (WHO). The annual mean concentration of PM10 was 97 μg/m3. The maximum concentration value of PM10 was measured during the summer (731 μg/m3). 4.988% (95%CI: 3.381–6.542%) of the total mortality, 7.3% (95%CI; 4.19–10.21%) of cardiovascular mortality, and 10.21% (95%CI; 4.19–14.89%) of respiratory mortality were related to the PM10 concentrations. Consequently, the AirQ software can provide valuable information about the importance of air pollution and the substantial impacts of PM10 on the society for policymakers.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2sfsB72
via IFTTT
Εγγραφή σε:
Αναρτήσεις (Atom)