Scalp Block: Tool for Diagnosis in Postoperative Headache of Unknown Origin.

No abstract available

http://ift.tt/2gM6EeM

Role of anesthesia in endovascular stroke therapy.

Purpose of review: Recent randomized clinical trials have demonstrated strong efficacy of endovascular therapy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions; in the USA alone, tens of thousands of patients annually may benefit. The impact of the type of anesthesia used during mechanical thrombectomy on patient outcomes remains controversial. This review discusses the current literature on the effects of anesthesia type on patient outcome following endovascular stroke therapy. Recent findings: EVT is the standard of treatment for intracranial large vessel occlusions. Recent studies show that general anesthesia is associated with negative clinical outcome in AIS patients undergoing EVT. Two of the possible mechanisms of this finding are systolic hypotension and hypocapnia. However, the only published randomized controlled studies to date, sedation vs. intubation for endovascular stroke treatment and anesthesia during stroke showed no difference in short-term clinical outcome between EVT patients treated with general anesthesia and conscious sedation and improved longer-term outcome in the general anesthesia group. Summary: Retrospective reports, and the 2015 American Heart Association/American Stroke Association Guideline (focused update of the 2013 guidelines for the early management of patients with AIS regarding endovascular treatment) based on these reports, are in favor of sedation (conscious sedation) over general anesthesia for endovascular stroke thrombectomy. However, the two randomized controlled prospective studies published provide inconclusive evidence as to the best anesthetic practice for endovascular stroke therapy. More randomized clinical trials are needed to optimize anesthetic patient care in AIS. Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2vlisYT

Dermoscopy is useful for the diagnosis of milia-like idiopathic calcinosis cutis

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12675

Survey of Australian dermatologists’ perceptions and experiences with isotretinoin-induced depression and suicide

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12602

Eczema exacerbation caused by Coxsackie virus A6

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12677

Mohs micrographic surgery using paraffin sections for the treatment of dermatofibroma of the face: A preliminary case series

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12601

Facial annular elastolytic giant cell granuloma treated with pulsed dye laser and intralesional polydeoxyribonucleotide

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12688

Localised longitudinal erythronychia caused by subungual capillary hemangioma

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12576

Fixed drug eruption probably induced by azithromycin

http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Fajd.12563

Role of Computed Tomography Findings in the Quest of Understanding Origin of Antrochoanal Polyp

Abstract

Aetio pathogenesis of antrochoanal polyp (ACP) remains unclear. Correlation of clinical, computed tomography (CT) and histopathological findings is attempted in this study for understanding of their origin. A retrospective chart and image review of 22 patients having ACP was done for clinical, histopathological and CT findings on affected and non affected side for extent of opacificattion, thickness of alveolar bone (AB) in the region of medial wall and the floor of maxillary sinus. Also, widening of accessory ostium was measured and compared. The mean of average thickness of AB medially on affected side was [30.91/11.27] [mean (mm)/SD)] compared to non affected side [55.60/20.74] p = 0.0001 (p < 0.05). The vertical AB thickness at floor on affected side [34.05/14.69] versus [68.14/35.29] p = 0.0001. Ipsilateral side accessory ostium widening on affected was measuring [91.45/57.00] against [55.32/38.96] p = 0.018. The additional CT findings in present study showed reduction in thickness of AB in the medial part and floor of maxillary sinus region. These findings to our knowledge have not been reported in the literature till date. The reduction in bone thickness of AB substantiates theory of antral cyst in origin of ACP. However, their association with embryonic dental lamellae needs further evaluation.

http://ift.tt/2uEOu44

Functioning metastatic paraganglioma of the urinary bladder in a 10-year-old child

Paragangliomas of the urinary bladder are very rare tumours representing less than 1% of bladder tumours. Preoperative diagnosis is essential to avoid perioperative complications related to catecholamine release. A high index of suspicion should be maintained when the classical symptoms of voiding-related paroxysms of headache, palpitation and dizziness are present. We present a rare case of malignant paraganglioma of the urinary bladder in a 10-year-old boy. The patient had the classic presentation. We review the radiological diagnostic tools and findings of this rare entity.

http://casereports.bmj.com/cgi/content/short/2017/jul19_2/bcr-2017-220533?rss=1

Abundant dystrophic calcifications mimicking aortic valve abscess in a patient undergoing elective aortic valve replacement

Dystrophic calcifications of the aortic valve may cause symptomatic aortic stenosis and account for a significant portion of patients who undergo elective valve replacement. Calcifications appearing grossly as a cloudy fluid surrounding the aortic valve leaflets are an uncommon finding. Normally, calcified aortic valves are characterised by large, nodular masses within the aortic cusps. We report a case of dystrophic calcifications on a stenotic aortic valve encountered intraoperatively, which was suggestive of infective endocarditis and abscess formation. Aortic valve leaflets and necrotic-appearing thymic lymph node tissue were submitted for histology and special stains. Cultures were negative and histology did not show evidence of infection. Tissue histology demonstrated extensive dystrophic calcifications, which were polarised to reveal abundant calcium oxalate crystals. The benign nature of this unique pathological finding ruled out any suspicion of infection, avoiding a prolonged course of intravenous antibiotics in this patient.

http://casereports.bmj.com/cgi/content/short/2017/jul19_2/bcr-2017-220368?rss=1

Very early great saphenous vein graft aneurysm treated by percutaneous coronary intervention under ChromaFlo imaging guidance

A 73-year-old man, who had undergone coronary artery bypass grafting (CABG) 10 days prior, presented with a great saphenous vein graft aneurysm (SVGA). CT revealed the increasing size of the aneurysm. Since the SVGA occurred immediately after CABG and there were no other complications, the aneurysm was treated percutaneously. While intravascular ultrasonography (IVUS) and optical coherence tomography failed to detect the entry point, an IVUS catheter with the addition of ChromaFlo imaging clearly revealed the entry point, size and length of the SVGA. To prevent migration and edge restenosis associated with covered stents, the covered stent (3.0x19 mm) was superimposed on a drug-eluting stent (3.0x28 mm) that covered the entry site. A follow-up study demonstrated the absence of flow into the aneurysm.

http://casereports.bmj.com/cgi/content/short/2017/jul19_2/bcr-2017-220443?rss=1

Arthroscopic excision of an intra-articular osteoid osteoma in the elbow joint

An osteoid osteoma is a rare, small, benign and painful tumour occurring in the extra-articular portion of long bones seen most commonly in the lower extremities. This is a case report of a 23-year-old female patient who underwent arthroscopic resection of an intra-articular osteoid osteoma. The nidus was completely removed by arthroscopic excision. The diagnosis was confirmed by postoperative histopathological analysis. In the case presented we have shown that intra-articular arthroscopy can be successful in the surgical management of benign bony lesions involving the elbow joint. We also present a review of the literature which reports on similar cases or intra-articular disease, preferred methods of surgical management and limitations in histopathological specimen acquisition for diagnosis.

http://casereports.bmj.com/cgi/content/short/2017/jul19_2/bcr-2017-220868?rss=1

Long-term peritoneal port-catheter in a patient with cardiac ascites

A peritoneal port-catheter was inserted in a 70-year-old man because of repeated paracentesis due to cardiac ascites. Instead of frequent hospital admissions, the patient could drain his ascites at home, which dramatically improved his quality of life and enabled him to perform his daily activities.

http://casereports.bmj.com/cgi/content/short/2017/jul19_2/bcr-2017-219258?rss=1

Serum levels of squamous cell carcinoma antigens 1 and 2 reflect disease severity and clinical type of atopic dermatitis in adult patients

Publication date: Available online 19 July 2017
Source:Allergology International
Author(s): Tomoko Okawa, Yukie Yamaguchi, Kenzen Kou, Junya Ono, Yoshinori Azuma, Noriko Komitsu, Yusuke Inoue, Masumi Kohno, Setsuko Matsukura, Takeshi Kambara, Shoichiro Ohta, Kenji Izuhara, Michiko Aihara
BackgroundRecent studies have indicated that serum levels of squamous cell carcinoma antigen (SCCA) 1 and 2 induced by type 2 cytokines such as IL-4 and IL-13, are increased in patients with atopic dermatitis (AD). However, no clinical studies have analyzed serum levels of SCCA2 in larger series of AD patients or their association with various clinical characteristics. This study was performed to clarify whether serum levels of SCCA2 are associated with disease severity and clinical phenotypes of adult AD patients.MethodsAn enzyme-linked immunosorbent assay was performed to examine serum SCCA2 levels in 240 adult patients with AD and 25 healthy controls in this study. Serum SCCA2 levels were analyzed with clinical characteristics and laboratory parameters including thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), blood eosinophils, total IgE, and specific IgE (Japanese cedar pollen, Dermatophagoides farina, Candida, malassezia, Staphylococcal enterotoxin B). Expression of SCCA2 in AD eruption was examined by immunohistochemistry. The effect of treatment on serum SCCA2 was also assessed.ResultsSerum SCCA2 level showed a positive correlation with disease severity, levels of TARC, LDH, eosinophil counts, and IgE levels. Robust expression of SCCA2 was detected in the supra basal keratinocytes in the epidermis of AD patients. Serial measurements of serum SCCA2 revealed decreased levels of SCCA2 after treatment for AD.ConclusionsSerum SCCA2 levels reflected disease severity and clinical type of AD. Serum SCCA2 may thus be a relevant biomarker for AD.



http://rss.sciencedirect.com/action/redirectFile?&zone=main&currentActivity=feed&usageType=outward&url=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%3F_ob%3DGatewayURL%26_origin%3DIRSSSEARCH%26_method%3DcitationSearch%26_piikey%3DS1323893017301016%26_version%3D1%26md5%3D0b7d7b4f5185bb3be8406d5473b773ef

Immediate-type allergic reactions to local anesthetics

Publication date: Available online 19 July 2017
Source:Allergology International
Author(s): Naomi Nakamura, Risa Tamagawa-Mineoka, Koji Masuda, Norito Katoh




http://rss.sciencedirect.com/action/redirectFile?&zone=main&currentActivity=feed&usageType=outward&url=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%3F_ob%3DGatewayURL%26_origin%3DIRSSSEARCH%26_method%3DcitationSearch%26_piikey%3DS1323893017301041%26_version%3D1%26md5%3D50ea2dd505eb0f7517eb84f3b5399638

Expression of planar cell polarity genes during mouse tooth development

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Nobuko Obara, Yuko Suzuki, Kazuharu Irie, Shunichi Shibata
ObjectivePlanar cell polarity (PCP) refers to the cell polarity across the tissue plane and controls various cell behaviors and structures. Although the expression of several PCP signaling components has been detected in tooth germs, knowledge of the gene expression patterns of these PCP components during tooth development remains incomplete. The aim of this study is to characterize the temporal and spatial changes in PCP gene expression during tooth development.DesignExpression of Celsr1 and 2, Fzd3 and 6, Vangl1 and 2, and Dvl1-3 genes was analyzed in mouse molar germs from the bud to the bell stage using in situ hybridization.ResultsAt the bud stage, all target genes were expressed in all areas of the tooth bud. In the enamel organ at the cap stage, expression of Fzd3 was suppressed in the enamel knot, whereas Fzd6 was strongly expressed there. Expression of Vangl2 was strongly expressed in the inner dental epithelium from the cap stage onwards. In the inner dental epithelium, strong expression of Fzd3, Dvl2 and Vangl2 was noted at the early bell stage, and of Celsr1, Fzd3, Fzd6, Vangl2 and Dvl2 at the bell stage. Furthermore, differentiated odontoblasts strongly expressed Celsr1, Vangl2, and Dvl2.ConclusionThe gene expression patterns delineated in this study improve our understanding of the role(s) of PCP components during tooth development.



http://ift.tt/2thl5cB

Role of Computed Tomography Findings in the Quest of Understanding Origin of Antrochoanal Polyp

Abstract

Aetio pathogenesis of antrochoanal polyp (ACP) remains unclear. Correlation of clinical, computed tomography (CT) and histopathological findings is attempted in this study for understanding of their origin. A retrospective chart and image review of 22 patients having ACP was done for clinical, histopathological and CT findings on affected and non affected side for extent of opacificattion, thickness of alveolar bone (AB) in the region of medial wall and the floor of maxillary sinus. Also, widening of accessory ostium was measured and compared. The mean of average thickness of AB medially on affected side was [30.91/11.27] [mean (mm)/SD)] compared to non affected side [55.60/20.74] p = 0.0001 (p < 0.05). The vertical AB thickness at floor on affected side [34.05/14.69] versus [68.14/35.29] p = 0.0001. Ipsilateral side accessory ostium widening on affected was measuring [91.45/57.00] against [55.32/38.96] p = 0.018. The additional CT findings in present study showed reduction in thickness of AB in the medial part and floor of maxillary sinus region. These findings to our knowledge have not been reported in the literature till date. The reduction in bone thickness of AB substantiates theory of antral cyst in origin of ACP. However, their association with embryonic dental lamellae needs further evaluation.

http://ift.tt/2uEOu44

Results of Screening in Familial Non-Medullary Thyroid Cancer

Thyroid , Vol. 0, No. 0.


http://ift.tt/2uBzWCM

Long-term outcome of eosinophilic fasciitis: A cross-sectional evaluation of 35 patients

Eosinophilic fasciitis (EF) is a connective tissue disease with an unknown long-term course.

http://ift.tt/2uBcWUp

Treatment of pharyngotympanic tube dysfunction

Eustachian tube dysfuntion intends to describe a variety of signs, symptoms, and physical findings that result from the impairment of ET function. A large variety of methods have been employed to assess ET function in the literature. Due to the lack of high level evidence, it is difficult to draw conclusions on the effectiveness of medical and surgical treatments. There are various medical and surgical interventions available for chronic obstructive ET dysfunction including balloon Eustachian tuboplasty (BET) and laser or microdebrider tuboplasty.

http://ift.tt/2ucwAFk

Dietary Inflammatory Index and Renal Cell Carcinoma Risk in an Italian Case-Control Study.

Related Articles

Dietary Inflammatory Index and Renal Cell Carcinoma Risk in an Italian Case-Control Study.

Nutr Cancer. 2017 Jul 18;:1-7

Authors: Shivappa N, Hébert JR, Rosato V, Rossi M, Montella M, Serraino D, La Vecchia C

Abstract
BACKGROUND: The relation between diet-related inflammation and renal cell carcinoma (RCC) has not been investigated.
METHODS: In this study, we explored the association between the dietary inflammatory index (DII) and RCC in an Italian case-control study conducted between 1992 and 2004. Cases were 767 patients with incident, histologically confirmed RCC. Controls were 1534 subjects admitted to the same hospitals as cases for various acute, nonneoplastic conditions. The DII was computed based on dietary intake assessed using a reproducible and valid 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models conditioned on age, sex, and center, and adjusted for recognized confounding factors, including total energy intake.
RESULTS: Subjects in the highest quartile of DII scores (i.e., with the most proinflammatory diets) had a higher risk of RCC compared to subjects in the lowest quartile [OR 1.41, 95% confidence interval (CI) 1.02, 1.97; p-trend = 0.04)]. Apparently stronger associations were observed among females (OR 1.68, 95% CI 0.93, 3.03), subjects aged <60 yr (OR 1.77, 95% CI 1.05, 2.98), body mass index ≥25 kg/m(2) (OR 1.64, 95% CI 1.07, 2.51), and ever smokers (OR 1.66, 95% CI 1.08, 2.57), in the absence of significant heterogeneity.
CONCLUSION: A proinflammatory diet is associated with increased RCC risk.

PMID: 28718670 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ts4qY3
via IFTTT

Hydroxytyrosol Induces Apoptosis and Cell Cycle Arrest and Suppresses Multiple Oncogenic Signaling Pathways in Prostate Cancer Cells.

Related Articles

Hydroxytyrosol Induces Apoptosis and Cell Cycle Arrest and Suppresses Multiple Oncogenic Signaling Pathways in Prostate Cancer Cells.

Nutr Cancer. 2017 Jul 18;:1-11

Authors: Zubair H, Bhardwaj A, Ahmad A, Srivastava SK, Khan MA, Patel GK, Singh S, Singh AP

Abstract
SCOPE: Hydroxytyrosol (HT), a polyphenol from olives, is a potential anticancer agent. This study was designed to evaluate the anticancer activity of HT against prostate cancer cells, and the mechanism thereof.
METHODS AND RESULTS: Treatment of LNCaP and C4-2 prostate cancer cells with HT resulted in a dose-dependent inhibition of proliferation. This was in contrast to HT's ineffectiveness against normal prostate epithelial cells RWPE1 and PWLE2, suggesting cancer-cell-specific effect. HT induced G1/S cell cycle arrest, with inhibition of cyclins D1/E and cdk2/4 and induction of inhibitory p21/p27. HT also induced apoptosis, as confirmed by flow cytometry, caspase activation, PARP cleavage, and BAX/Bcl-2 ratio. It inhibited the phosphorylation of Akt/STAT3, and induced cytoplasmic retention of NF-κB, which may explain its observed effects. Finally, HT inhibited androgen receptor (AR) expression and the secretion of AR-responsive prostate-specific antigen.
CONCLUSION: Castration-resistant prostate cancers retain AR signaling and are often marked by activated Akt, NF-κB, and STAT3 signaling. Our results establish a pleiotropic activity of HT against these oncogenic signaling pathways. Combined with its nontoxic effects against normal cells, our results support further testing of HT for prostate cancer therapy.

PMID: 28718667 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tsjuVL
via IFTTT

Prevalence of Low Vitamin D in Patients with Breast Cancer in a Predominantly Hispanic Population at the American-Mexican Border.

Related Articles

Prevalence of Low Vitamin D in Patients with Breast Cancer in a Predominantly Hispanic Population at the American-Mexican Border.

Nutr Cancer. 2017 Jul 18;:1-6

Authors: Farrag SE, Dwivedi AK, Otoukesh S, Badri NJ, Sanchez LA, Nahleh ZA

Abstract
INTRODUCTION: Low level of vitamin D (VD) has been linked with a higher risk of cancers. The aim of this study was to assess the prevalence of low VD in patients with breast cancer in a predominantly Mexican Hispanic/Latino patient population, a fast growing and relatively understudied population.
MATERIALS/METHODS: We sought to evaluate the serum VD levels in breast cancer patients diagnosed at the Texas Tech University Breast Cancer Center in El Paso, TX, between May 2013 and May2014 via a retrospective chart review of the Electronic Medical Records.
RESULTS: We identified a total of 83 consecutive breast cancer patients with available VD levels. Mean age 57 yr, 94% were Hispanics. VD was insufficient (<30 ng/ml) in 86% of patients (95% CI: 0.76-0.92) and it was deficient (<20 ng/ml) in 39% (95% CI: 0.28-0.50).
CONCLUSION: VD deficiency is widely prevalent in Hispanic/Latino patients with breast cancer. This is quite alarming in view of possible increased risk of cancer with low VD and potentially worse cancer outcomes. This calls for increased efforts to screen for, diagnose, and treat VD deficiency in this patient population. Further pharmacogenomics studies are warranted to explore the underlying etiology of VD deficiency in this paradoxically sunny region.

PMID: 28718665 [PubMed - as supplied by publisher]

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trSd5x
via IFTTT

Modelling the effects of water diversion and combined sewer overflow on urban inland river quality

Abstract

In order to assist and optimize the operation of a clean water diversion project for the medium-sized inland rivers in Chaohu, China, an integrated hydrodynamic and water quality model was used in this study. Sixteen diversion scenarios and five sewage interception scenarios were defined to assess the improvement of water quality parameters including ammonia nitrogen (NH₃-N), total phosphorus (TP) and chemical oxygen demand (COD) under different diverted water flows, diverting times, diverting points, diverting routines and sewage interception proportions. An index of pollutant removal rate per unit diverted water flow (PRUWF) was proposed to evaluate the effect of the clean water diversion. Results show that operating conditions played important roles in water quality improvement of medium-sized inland rivers. The optimal clean water diversion was operated under the conditions of a flow rate of 5 m³/s for 48 h with an additional constructed bridge sluice. A global sensitivity analysis using the Latin Hypercube One-Factor-at-a-Time (LH-OAT) method was conducted to distinguish the contributions of various driving forces to inland river water restoration. Results show that sewage interception was more important than diverted water flow and diverting time with respect to water quality improvement, especially for COD.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vEcnpA
via IFTTT

The trajectory of bone surface modification studies in paleoanthropology and a new Bayesian solution to the identification controversy

Publication date: September 2017
Source:Journal of Human Evolution, Volume 110
Author(s): Jacob A. Harris, Curtis W. Marean, Kiona Ogle, Jessica Thompson
A critical issue in human evolution is how to determine when hominins began incorporating significant amounts of meat into their diets. This fueled evolution of a larger brain and other adaptations widely considered unique to modern humans. Determination of the spatiotemporal context of this shift rests on accurate identification of fossil bone surface modifications (BSM), such as stone tool butchery marks. Multidecade-long debates over the agents responsible for individual BSM are indicative of systemic flaws in current approaches to identification. Here we review the current state of BSM studies and introduce a novel probabilistic approach to identifying agents of BSM. We use control assemblages of bones modified by modern agents to train a multivariate Bayesian probability model. The model then identifies BSM agents with associated uncertainties, serving as the basis for a predictive probabilistic algorithm. The multivariate Bayesian approach offers a novel, probabilistic, and analytical method for BSM research that overcomes much of the bias that has typified previous, more qualitative approaches.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vEfnSO
via IFTTT

A randomized, double-blind, placebo controlled trial of sublingual immunotherapy with house-dust mite extract for allergic rhinitis

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trEBap
via IFTTT

Dollars, dust, and Draf

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2u9CrcD
via IFTTT

Sinonasal T2R-mediated nitric oxide production in response to Bacillus cereus

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trzhnz
via IFTTT

The personal financial burden of chronic rhinosinusitis: A Canadian perspective

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ua46dK
via IFTTT

The relationship between chronic rhinosinusitis and metabolic syndrome

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trON2S
via IFTTT

Central compartment atopic disease

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2u9zKbd
via IFTTT

Association between symptoms of allergic rhinitis with decreased general health‐related quality of life

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trvvuw
via IFTTT

Influence of hyaluronan nasal dressing on clinical outcome after endoscopic sinus surgery: A systematic review and meta-analysis

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2u9UShm
via IFTTT

Septal extension graft in “closed” revision rhinoplasty: A simplified technique

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ts0ruD
via IFTTT

Surgical treatment of chronic rhinosinusitis after sinus lift

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trngPc
via IFTTT

Endoscopic septoplasty: “How I do it”

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2u9CGVe
via IFTTT

Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2trOMfk
via IFTTT

Proteolytic effects of gingipains on trefoil factor family peptides

Abstract

Objectives

The present study was aimed to determine whether trefoil factor family (TFF) peptides which were generally considered to be resistant to proteolysis could be digested by gingipains, a major proteinases produced by Porphyromonas gingivalis.

Materials and methods

Recombinant human TFF1, TFF2, and TFF3 peptides were used as substrates. Gingipains including arginine gingipain (RgpB) and lysine gingipain (Kgp) were used as enzymes. Trypsin was used as a control protease. Matrix-assisted laser desorption/ionization with time-of-flight/time-of-flight (MALDI-TOF/TOF) and liquid chromatography mass spectrometry (LC-MS) were used for analyzing peptide mass signals and amino acid sequences of digested TFF peptides.

Results

MALDI-TOF/TOF analyses demonstrated that Kgp, RgpB, and trypsin were able to cleave TFF1 and TFF2 peptides, resulting in different patterns of digested fragments. However, impurity in recombinant TFF3 peptide substrates affected the interpretations of enzymatic reaction by MALDI-TOF/TOF. LC-MS analyses demonstrated that identified fragments of TFF1, TFF2, and TFF3 from digestion by gingipains were similar to those by trypsin.

Conclusions

Using MALDI-TOF/TOF and LC-MS, the present study provides new information that gingipains containing trypsin-like activities are able to digest TFF peptides.

Clinical relevance

The proteolytic effects of gingipains on TFF peptides may be responsible for reduction of salivary TFF peptides in chronic periodontitis patients. Further investigations to determine the pathological effects of gingipains on TFF peptides in saliva and periodontal tissues of patients with chronic periodontitis would be of interest.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uKnRvj
via IFTTT

Evaluation of the effects of photobiomodulation on vertebras in two rat models of experimental osteoporosis

Abstract

The aim of this study was to evaluate the effects of photobiomodulation (PBM) on cancellous bone in rat models of ovariectomized induced osteoporosis (OVX-D) and glucocorticoid-induced osteoporosis (GIOP). The experiment comprised of nine groups. A group of healthy rats was used for baseline evaluations. The OVX-D rats were further divided into groups as follows: control rats with osteoporosis, OVX-D rats that received alendronate (1 mg/kg 60 days), OVX-D rats treated with pulsed wave laser (890 nm, 80 Hz, 900 s, 0.0061 W/cm², 5.5 J/cm², three times a week, 60 days), and OVX-D rats treated with alendronate + pulsed laser. Dexamethasone was administered to the remaining rats that were split into four groups: control, alendronate-treated rats, laser-treated rats, and GIOP rats treated with alendronate + laser. T12, L1, L2, and L3 vertebrae were subjected to laser. Results of the current study demonstrated that OVX-D and GIOP significantly decreased some stereological parameters, and type 1 collagen gene expression compared to the healthy group. There was a significant increase in osteoclast number in both OVX-D and glucocorticoid administration compared to the healthy group. However, the detrimental effect of the OVX-D procedure on bone was more serious than glucocorticoid administration. Results showed that laser alone had a detrimental effect on trabecular bone volume, and cortical bone volume in groups GIOP and OVX-D compared to those in the healthy group. Alendronate significantly improved total vertebral bone volume, trabecular bone volume, and cortical bone volume, in GIOP and OVX-D groups compared to the laser-treated groups. Furthermore, the alendronate + laser in OVX-D rats and GIOP rats produced significantly increased osteoblast number and type 1 collagen gene expression and caused a significant decrease in osteoclast number compared to the controls.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tgR7pj
via IFTTT

Sensitive Electrochemical Detection of Nitric Oxide Release from Cardiac and Cancer Cells via a Hierarchical Nanoporous Gold Microelectrode

Analytical Chemistry

DOI: 10.1021/acs.analchem.7b01430

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uKl1Xn
via IFTTT

Hybrid PbS Quantum Dot/Nanoporous NiO Film Nanostructure: Preparation, Characterization, and Application for a Self-Powered Cathodic Photoelectrochemical Biosensor

Analytical Chemistry

DOI: 10.1021/acs.analchem.7b01557

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDRYRE
via IFTTT

Sleep deprivation predisposes allergic mice to develop neutrophilic lung inflammation

Publication date: Available online 19 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jethe Nunes de Oliveira Filho, Juliana de Souza Apostolico, David Anibal Garrido Andrade, Francieli Ruiz da Silva, Edgar Ruz Fernandes, Monica Levy Andersen, Alexandre Castro Keller, Daniela Santoro Rosa
BackgroundAlthough different studies associated sleep deprivation with systemic inflammatory changes, the effect of sleep duration on the pathology of allergic chronic diseases is poorly understood.ObjectiveTo evaluate the influence of sleep deprivation on allergen-induced pulmonary inflammation.MethodsOvalbumin (OVA)-sensitized C57BL/6 mice were exposed to a first set of intranasal OVA challenge under sleep deprivation (SD) or healthy sleep (HS) conditions followed by a second OVA challenge, one week apart. Some groups were subjected to corticoid treatment with dexamethasone.ResultsOVA-sensitized SD mice developed a more severe airway inflammation than the HS allergic group. Analysis of lung parenchyma revealed that the inflammation in SD allergic mice was marked by an influx of neutrophils (mainly) and eosinophils and secretion of IL-6, TNF-α, and IL-17, in contrast to the eosinophilic inflammation and IL-4 production observed in HS allergic mice. The same cytokine profile was observed in ex vivo culture of cervical lymph nodes cells and splenocytes, indicating that in allergic mice SD favors immune responses towards a pro-inflammatory Th17 profile. This idea is supported by the fact that disruption of IL-17 signaling (IL-17RA^-/-) prevented airway neutrophilia in allergic SD mice. Furthermore, SD allergic mice became refractory to corticoid treatment, in contrast to HS allergic group.ConclusionCollectively, our data show that sleep quality participates in the progression of allergen-induced eosinophilic lung inflammation to corticoid refractory neutrophilic manifestation.

Teaser

Sleep plays a pivotal role in immune system homeostasis. Sleep disturbances influence immune-mediated allergic responses and improving sleep quality may contribute to asthma management.


http://ift.tt/2uB3znJ

Phosphatase Wip1 controls the development of Th9 cells and allergic airway inflammation

Publication date: Available online 19 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Peng Wang, Huiting Su, Lianjun Zhang, Hui Chen, Xuelian Hu, Fan Yang, Jun Lu, Lianfeng Zhang, Yong Zhao
BackgroundAllergic asthma is one of the most common diseases worldwide, resulting in a burden of diseases. No available therapeutic regimens can cure asthma so far.ObjectiveTo identify new molecular targets for Th9 cells-mediated allergic airway inflammation.MethodsWild-type p53-induced phosphatase 1 (Wip1) gene knockout mice, Wip1 inhibitor-treated mice and ovalbumin (OVA)-induced allergic airway inflammation mouse models were employed to characterize the roles of Wip1 in allergic airway inflammation. The induction of Th cell subsets in vitro, real-time PCR, immunoblots, luciferase assay and ChIP assays were employed to determine the regulatory pathways of Wip1 in Th9 differentiation.ResultsWe herein demonstrate that Wip1-deficient mice are less prone to allergic airway inflammation as indicated by the decreased pathological alterations in lungs. Short-term treatment of Wip1-specific inhibitor significantly ameliorates allergic inflammation progression. Intriguingly, Wip1 selectively impaired Th9 cell but not Th1, Th2 and Th17 cell differentiation. Biochemical assays show that Wip1 deficiency increases c-Jun/c-Fos activity in a JNK-dependent manner and that c-Jun/c-Fos directly binds to Il-9 promoter and inhibits Il-9 transcription.ConclusionPhosphatase Wip1 controls Th9 cell development through regulating c-Jun/c-Fos activity on Il-9 promoter and is important for the pathogenesis of allergic airway inflammation. These findings shed lights on the previously unrecognized roles of Wip1 in Th9 cell differentiation. The inhibitory effects of a Wip1 inhibitor on the pathogenesis of allergic airway inflammation may have important implications for clinical application of Wip1 inhibitors in allergy therapies.

Graphical abstract

Teaser

Phosphatase Wip1 specifically regulates Th9 cell differentiation and Wip1 inhibition may represent a promising strategy to treat allergic airway inflammation.


http://ift.tt/2vl4VAj

Sleep deprivation predisposes allergic mice to develop neutrophilic lung inflammation

Publication date: Available online 19 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jethe Nunes de Oliveira Filho, Juliana de Souza Apostolico, David Anibal Garrido Andrade, Francieli Ruiz da Silva, Edgar Ruz Fernandes, Monica Levy Andersen, Alexandre Castro Keller, Daniela Santoro Rosa
BackgroundAlthough different studies associated sleep deprivation with systemic inflammatory changes, the effect of sleep duration on the pathology of allergic chronic diseases is poorly understood.ObjectiveTo evaluate the influence of sleep deprivation on allergen-induced pulmonary inflammation.MethodsOvalbumin (OVA)-sensitized C57BL/6 mice were exposed to a first set of intranasal OVA challenge under sleep deprivation (SD) or healthy sleep (HS) conditions followed by a second OVA challenge, one week apart. Some groups were subjected to corticoid treatment with dexamethasone.ResultsOVA-sensitized SD mice developed a more severe airway inflammation than the HS allergic group. Analysis of lung parenchyma revealed that the inflammation in SD allergic mice was marked by an influx of neutrophils (mainly) and eosinophils and secretion of IL-6, TNF-α, and IL-17, in contrast to the eosinophilic inflammation and IL-4 production observed in HS allergic mice. The same cytokine profile was observed in ex vivo culture of cervical lymph nodes cells and splenocytes, indicating that in allergic mice SD favors immune responses towards a pro-inflammatory Th17 profile. This idea is supported by the fact that disruption of IL-17 signaling (IL-17RA^-/-) prevented airway neutrophilia in allergic SD mice. Furthermore, SD allergic mice became refractory to corticoid treatment, in contrast to HS allergic group.ConclusionCollectively, our data show that sleep quality participates in the progression of allergen-induced eosinophilic lung inflammation to corticoid refractory neutrophilic manifestation.

Teaser

Sleep plays a pivotal role in immune system homeostasis. Sleep disturbances influence immune-mediated allergic responses and improving sleep quality may contribute to asthma management.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uB3znJ
via IFTTT

Phosphatase Wip1 controls the development of Th9 cells and allergic airway inflammation

Publication date: Available online 19 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Peng Wang, Huiting Su, Lianjun Zhang, Hui Chen, Xuelian Hu, Fan Yang, Jun Lu, Lianfeng Zhang, Yong Zhao
BackgroundAllergic asthma is one of the most common diseases worldwide, resulting in a burden of diseases. No available therapeutic regimens can cure asthma so far.ObjectiveTo identify new molecular targets for Th9 cells-mediated allergic airway inflammation.MethodsWild-type p53-induced phosphatase 1 (Wip1) gene knockout mice, Wip1 inhibitor-treated mice and ovalbumin (OVA)-induced allergic airway inflammation mouse models were employed to characterize the roles of Wip1 in allergic airway inflammation. The induction of Th cell subsets in vitro, real-time PCR, immunoblots, luciferase assay and ChIP assays were employed to determine the regulatory pathways of Wip1 in Th9 differentiation.ResultsWe herein demonstrate that Wip1-deficient mice are less prone to allergic airway inflammation as indicated by the decreased pathological alterations in lungs. Short-term treatment of Wip1-specific inhibitor significantly ameliorates allergic inflammation progression. Intriguingly, Wip1 selectively impaired Th9 cell but not Th1, Th2 and Th17 cell differentiation. Biochemical assays show that Wip1 deficiency increases c-Jun/c-Fos activity in a JNK-dependent manner and that c-Jun/c-Fos directly binds to Il-9 promoter and inhibits Il-9 transcription.ConclusionPhosphatase Wip1 controls Th9 cell development through regulating c-Jun/c-Fos activity on Il-9 promoter and is important for the pathogenesis of allergic airway inflammation. These findings shed lights on the previously unrecognized roles of Wip1 in Th9 cell differentiation. The inhibitory effects of a Wip1 inhibitor on the pathogenesis of allergic airway inflammation may have important implications for clinical application of Wip1 inhibitors in allergy therapies.

Graphical abstract

Teaser

Phosphatase Wip1 specifically regulates Th9 cell differentiation and Wip1 inhibition may represent a promising strategy to treat allergic airway inflammation.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vl4VAj
via IFTTT

Tense Marking in the English Narrative Retells of Dual Language Preschoolers

Purpose

This longitudinal study investigated the emergence of English tense marking in young (Spanish–English) dual language learners (DLLs) over 4 consecutive academic semesters, addressing the need for longitudinal data on typical acquisition trajectories of English in DLL preschoolers.

Method

Language sample analysis was conducted on 139 English narrative retells elicited from 39 preschool-age (Spanish–English) DLLs (range = 39–65 months). Growth curve models captured within- and between-individual change in tense-marking accuracy over time. Tense-marking accuracy was indexed by the finite verb morphology composite and by 2 specifically developed adaptations. Individual tense markers were systematically described in terms of overall accuracy and specific error patterns.

Results

Tense-marking accuracy exhibited significant growth over time for each composite. Initially, irregular past-tense accuracy was higher than regular past-tense accuracy; over time, however, regular past-tense marking outpaced accuracy on irregular verbs.

Conclusions

These findings suggest that young DLLs can achieve high tense-marking accuracy assuming 2 years of immersive exposure to English. Monitoring the growth in tense-marking accuracy over time and considering productive tense-marking errors as partially correct more precisely captured the emergence of English tense marking in this population with highly variable expressive language skills.

Supplemental Materials

http://ift.tt/2tIdOly

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ucf9EC
via IFTTT

Changing the Properties of Multipotent Mesenchymal Stromal Cells by IFNγ Administration

We studied changes in the population of human multipotent mesenchymal stromal cells activated by IFNγ. The cells were cultured under standard conditions; IFNγ was added in various concentrations for 4 h or over 2 passages. It was shown that the total cell production significantly decreased after long-term culturing with IFNγ, but 4-h exposure did not affect this parameter. After 4-h culturing, the expression levels of IDO1, CSF1, and IL-6 increased by 300, 7, and 2.4 times, respectively, and this increase persisted 1 and 2 days after removal of IFNγ from the culture medium. The expression of class I and II MHC (HLA) on cell surface practically did not change immediately after exposure to IFNγ, but during further culturing, HLA-ABC (MHC I) and HLA-DR (MHC II) expression significantly increased, which abolished the immune privilege in these cells, the property allowing clinical use of allogenic multipotent mesenchymal stromal cells. Multipotent mesenchymal stromal cells can suppress proliferation of lymphocytes. The degree of this suppression depends on individual properties of multipotent mesenchymal stromal cell donor. Treatment with IFNγ did not significantly affect the intensity of inhibition of lymphocyte proliferation by these cells.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uEgwwB
via IFTTT

Anti-Inflammatory and Analgesic Activities of the Complex of Flavonoids from Lychnis chalcedonica L.

Anti-inflammatory and analgesic activities of the complex of flavonoids from Lychnis chalcedonica L. were studied in the models of acute aseptic inflammation induced by carrageenan, histamine, and serotonin and acetic acid-induced painful chemical stimulation. It is demonstrated that course treatment with flavonoids derived from Lychnis chalcedonica L. produced a stable pharmacological effect comparable with that of the reference anti-inflammatory drug diclofenac.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDMVAx
via IFTTT

Regenerative Potential of Spermatogonial Stem Cells, Endothelial Progenitor Cells, and Epithelial Progenitor Cells of C57Bl/6 Male Mice with Metabolic Disorders

The properties of spermatogonial stem cells, endothelial progenitor cells, and the epithelial progenitors of C57Bl/6 mice under conditions of metabolic disorders were studied using the model of busulfan-induced suppression of spermatogenesis and in vitro culture technique. Spermatogonial stem cells CD117—CD90⁺ and epithelial progenitors CD45—CD31—Sca-1⁺CD49f⁺ derived from the testes of mice with metabolic disturbances demonstrated 17- and 28-fold increase in the respective cell mass and generated cell colonies in vitro. In contrast, spermatogonial stem cells with immune phenotype CD51—CD24⁺CD52⁺ had reduced selfrenewal capacity. Spermatogonial stem cells CD117—CD90⁺ and CD117⁺CD90⁺ as well as endothelial progenitors CD45—CD31⁺ derived from the testes of donor mice with metabolic disorders demonstrated high transplantation capacity in C57Bl/6 mouse testes damaged by cytostatic busulfan.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uE4ovA
via IFTTT

Virtual Experimental Validation of Dynamic Osteosynthesis in the Treatment of Fractures of the Proximal Femur

Volume model of transtrochanteric fracture of the femoral bone fixed by Targon PF dynamic fixator was studied by the finite element analysis. The following parameters were measured: magnitude and direction of displacement of system elements, pressure between fragments, and von Mises stress distribution in the fixator depending on support screw plunging into the sleeve. The results indicate that stability of the bone-nail system increases during fracture union and 10-mm shortening of the femoral neck axis, which is seen from a decrease in system deformation under load by 16.8%, stress in the implant by 20.2%, and pressure in the zone of fragments contact by 19.8%.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDFycA
via IFTTT

Dipeptidyl Peptidase 4 Inhibitors Diprotin A and Sitagliptin Administered on Weeks 2-3 of Postnatal Development Modulate Monoamine Metabolism in the Striatum of Adult Rats

The levels of monoamines and their metabolites in brain structures of adult (3-month-old) rats with emotional and motivational disorders induced by inhibitors of dipeptidyl peptidase 4 (DPP-4; EC 3.4.14.5) diprotin A and sitagliptin on weeks 2-3 of postnatal development (postnatal days 5-18) were studied by HPLC with electrochemical detection. A significant decrease in the level of serotonin metabolite, 5-hydroxyindoleacetic acid, and a pronounced tendency towards reduced serotonin level were detected in the striatum of rats in both study groups. In adult rats treated with diprotin A during the neonatal period, a tendency towards activation of dopamine metabolism was observed (judging from DOPAC/DA ratio). The levels of monoamines and their metabolites in the frontal cortex, hypothalamus, and amygdala remained unchanged. The findings suggest that administration of DPP-4 inhibitors during the neonatal period induces long-term dysfunction of the serotonergic and dopaminergic systems of the brain.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uEdgRS
via IFTTT

A Study of the Protective Properties of an Antibody-Based Antidote Metabolizing Organophosphorus Pesticide Paraoxon

A catalytic antibody A17 and its mutants highly efficiently interact with organophosphorus pesticide paraoxon. In this work, we studied the protective properties of antibody A17-K47 in paraoxon poisoning using a mouse model. The optimal paraoxon dose simulating the acute toxic effect of organophosphorus compounds was 550 μg/kg. The pharmacokinetic parameters of A17-K47 antibody were t_1/2distr =7.2±1.4 min, t_1/2el =330±20 min. The antibody did not cause toxic effects when administered at a ten-fold calculated therapeutic dose (610 mg/kg). The drug did not reduce mortality from acute paraoxon poisoning; however, the absence of drug toxicity opens up prospects for its use in symptomatic treatment of chronic paraoxon poisoning.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDTNOm
via IFTTT

Mechanisms of Sensitivity of Soft Tissue Sarcoma Cells to Temozolomide

We studied the mechanisms of sensitivity of soft tissue sarcoma cells to alkylating agent temozolomide. The mechanisms of tumor cell sensitivity to temozolomide are complex and are determined by not only the level of O6-methylguanine-DNA-methyltransferase (MGTM) expression, but also activity of oncosuppressor protein p53. A-673 Ewing's sarcoma cells were found to be the most sensitive to temozolomide, whereas temozolomide-treated SK-LMS-1 leiomyosarcoma cells exhibited signs of cell aging.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uEhsRu
via IFTTT

Immunolocation of Heme Oxygenases in the Walls of Cerebral Arteries of Various Diameters in Rats

The distribution of two enzymes involved in the formation of carbon monoxide, heme oxygenases 1 and 2, in the pial branches of orders I-V of the middle cerebral artery basin and in intracerebral vessels was studied in adult Wistar rats. Immunohistochemical studies detected hemeoxygenase-2 in the endothelium of the small pial and intracerebral arterioles and in myocytes of pial branches I-III. Heme oxygenase 1, an inducible form of the enzyme, is normally not expressed in the cerebral vessels, but the enzyme is expressed in response to sodium metaarsenite. In this case, heme oxygenase markers are detected in myocytes of pial arteries I-II and in the endothelium of small pial and intracerebral vessels. Sodium meta-arsenite is inessential for immunolocation and quantitative distribution of heme oxygenase 2 in the vessels.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDQM0J
via IFTTT

Study of Proliferative Activity of Vaginal Epithelium in Women with Stress Urinary Incontinence Treated by Er:YAG Laser

The expression of Ki-67 proliferation marker was studied in vaginal biopsy specimens from women with stress urinary incontinence treated using a Fotona nonablative erbium laser. Cells expressing Ki-67 were located in all cases in the parabasal and basal levels of stratified squamous epithelium, the index of labeled nuclei before Er:YAG laser exposure was 19.05±2.86%. After 1-2 months of laser therapy, the index of labeled nuclei in the epithelium increased significantly and reached 31.79±2.25%. These changes were interpreted as a result of epithelial-stromal interactions. Presumably, the increase in proliferative activity of the vaginal epithelium after exposure to Er:YAG laser was due to the presence of an appreciable level of synthetically active fibroblasts in the subepithelial stroma.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uE2Ku0
via IFTTT

Cysteine-Containing Peptides Stimulate Monocyte Migration through NADPH-Oxidase Activation

We analyzed migration of monocytes under the effect of apocinin (NADPH inhibitor) and PD98059 (blocker of extracellular MEK/ERK kinase involved in Nox4 oxidase-mediated migration of monocytes). Migration of monocytes stimulated by cysteine-containing peptides (fragments of chemokines with free thiol group MCP-1 and fractalkine) was completely inhibited by apocinin and MEK/ERK blocker. It is assumed that the stimulating effect of cysteine-containing peptides on monocyte migration is mediated by the NADPH-oxidase system, in particular, Nox4.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDCwF5
via IFTTT

Characteristics of Mel Ibr Melanoma Line Subclone after Treatment with Chicken Embryo Extract

We continue analysis of the phenotype of human melanoma cell Mel Ibr subclone obtained previously by treatment of the parental cell line by chicken embryo extract. The present study is focused on detection of markers of epithelial-mesenchymal transition that determine enhanced metastatic and invasive potential of malignant tumors of various locations. Analysis of the expression of E-cadherin and vimentin genes in the subclone and parental cells detected activation of epithelial-mesenchymal transition in the subclone. Immunological markers CD90, CD271, and CD95 were present in the parental population, but were not detected on the subclone cells. In contrast to the parental line, cells of the analyzed subclone retain viability in serum-free medium and formed vessel-like structures characteristic of vasculogenic mimicry.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tIftHR
via IFTTT

Delayed Results of Experimental Afobazole Therapy in Rats after Acute Myocardial Infarction

Delayed cardioprotective effects of anxiolytic Afobazole (15 mg/kg, intraperitoneally for 14 days) were evaluated using dynamic echocardiographic recordings on days 2, 15, 56, and 98 after experimental myocardial infarction modeling (rat model of acute myocardial ischemia). The cardiotropic activity of Afobazole is assumed to be related to its agonistic effects on σ₁ receptor of cardiomyocytes. It was found that animals treated with Afobazole had no signs of heart failure by the end of observation, as evidenced by left ventricular ejection fraction.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDCuwX
via IFTTT

Genetic Engineering of Native Chain Combinations of B-Cell Repertoires on the Surface of Methylotrophic Yeasts Pichia pastoris

We designed genetic constructs for exposing Fab-fragment library of natively paired single cell B-cell receptors on the surface of Pichia pastoris yeast cells. We have previously obtained the A17 antibody in our laboratory [6]. In this study we showed that the newly designed genetic constructs provide a compatible level of A17 antibody Fab fragment on the surface of yeast cells as well as in the case of vectors containing DNA fragments corresponding to each chain of the antibody. The data suggest that the developed approach for constructing immunoglobulin gene libraries is adequate and fully convenient for studying properties of the real human B-lymphocyte repertoire.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDFxW4
via IFTTT

Intranasal Insulin Restores Metabolic Parameters and Insulin Sensitivity in Rats with Metabolic Syndrome

We studied the effect of 10-week treatment with intranasal insulin (0.5 IU/day) on glucose tolerance, glucose utilization, lipid metabolism, functions of pancreatic β cells, and insulin system in the liver of rats with cafeteria diet-induced metabolic syndrome. The therapy reduced body weight and blood levels of insulin, triglycerides, and atherogenic cholesterol that are typically increased in metabolic syndrome, normalized glucose tolerance and its utilization, and increased activity of insulin signaling system in the liver, thus reducing insulin resistance. The therapy did not affect the number of pancreatic islets and β cells. The study demonstrates prospects of using intranasal insulin for correction of metabolic parameters and reduction of insulin resistance in metabolic syndrome.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uEgfdg
via IFTTT

Sodium Dodecyl Sulfate Cytotoxicity towards HaCaT Keratinocytes: Comparative Analysis of Methods for Evaluation of Cell Viability

Viability of keratinocytes of HaCaT immortalized line incubated with sodium dodecyl sulfate for 3 min, 1 and 48 h, was studied by light microscopy, MTT test, and neutral red absorption test. The IC₅₀ values were determined for each of the studied lengths of exposure. HaCaT cells exhibited a dose-dependent decrease of viability under the effect of sodium dodecyl sulfate, proportional to the length of exposure. The values measured by different methods (MTT test and neutral red absorption test) varied, the differences were determined by the duration of exposure to sodium dodecyl sulfate. The dispersion of values for 1 and 48 h exposure, obtained by MTT method, was greater than of the values obtained by neutral red absorption test.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDCrkL
via IFTTT

Approaches to Controlled Co-Amplification of Genes for Production of Biopharmaceuticals: Study of the Insertion and Amplification Dynamics of Genetic Cassettes in the Genome of Chinese Hamster Ovary Cells during Co-Expression of Compatible Pair of Plasmids

Plasmid vector family p1.1 based on non-coding regions of Chinese hamster housekeeping gene EEF1A and concatemer of Epstein—Barr virus terminal repeat increases the frequency of genome integration and provides rapid amplification of the target genes in the genome. For a pair of fluorescent proteins eGFP and mCherry it was shown that p1.1 vectors bearing dihydrofolate reductase and glutamine synthetase selection markers upon co-transfection into CHO DG44 cell line allow obtaining a polyclonal cell population in which ~70% of cells express both genes. The subsequent one-step gene amplification of the genome-integrated genetic cassettes under the selective pressure of increased concentrations of methotrexate can increase the expression of both integrated genes up to 8.2% eGFP and 9.9% mCherry of total protein. This approach can be used for the development of cell lines for the production of functional heterodimeric proteins, e.g. polypeptide hormones and therapeutic antibodies.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vkA5rT
via IFTTT

Effect of Phenibut and Glufimet, a Novel Glutamic Acid Derivative, on Respiration of Heart and Brain Mitochondria from Animals Exposed to Stress against the Background of Inducible NO-Synthase Blockade

Increased oxygen consumption by heart and brain mitochondria in the absence of ADP and reduced mitochondrial respiration in the presence of ADP were observed in rats exposed to stress simulated by suspension by the dorsal neck skin fold for 24 h, which attests to uncoupling of substrate oxidation and ATP synthesis and can cause electron drain from the respiratory chain, formation of ROS, and oxidative damage to cell structures. Blockade of inducible NO synthase with aminoguanidine (single intraperitoneal dose of 50 mg/kg before stress exposure) increased coupling of respiration and oxidative phosphorylation in heart and brain mitochondria of rats exposed to immobilization-painful stress, which was especially pronounced in cardiomyocytes. The test compounds glufimet (single intraperitoneal dose of 29 mg/kg before stress exposure) and phenibut (single intraperitoneal dose of 50 mg/kg before stress exposure) limited stress-induced mitochondrial damage against the background of inducible NO synthase blockade and without it, which was seen from increased respiratory control ratio in comparison with that in untreated rats exposed to stress (control).

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uKpTM3
via IFTTT

Optimal Positioning of the Nipple–Areola Complex in Men Using the Mohrenheim-Estimated-Tangential-Tracking-Line (METT-Line): An Intuitive Approach

Abstract

Introduction

The reconstruction of the body shape after post-bariatric surgery or high-grade gynecomastia involves, besides skin tightening, the repositioning of anatomical, apparent landmarks. The surgeon usually defines these during the preoperative planning. In particular, the positions of the nipple–areola complexes (NAC) should contribute to the gender-appropriate appearance. While in the female breast numerous methods have been developed to determine the optimal position of the NACs, there are only a few, metric and often impractical algorithms for positioning the nipples and areoles in the male. With this study, we show the accuracy of the intuitive positioning of the nipple–areola complex in men.

Material and Methods

From a pre-examined and measured quantity of 10 young and healthy men, six subjects were selected, which corresponded, on the basis of their chest and trunk dimensions, to the average of known data from the literature. The photographed frontal views were retouched in two steps. Initially, only the NACs were removed and the chest contours were left. In a second step, all contours and the navel were blurred. These pictures were submitted to resident and consultant plastic surgeons, who were asked to draw the missing NACs without any tools. The original positions of the nipples were compared with the inscriptions. Furthermore, the results were compared between the contoured and completely retouched pictures and between the residents and consultants.

Results

A total of 8 consultants and 7 residents were included. In the contoured and completely retouched images, a significant deviation of the marked positions of the missing features was found. The height of the NAC was determined somewhat more precisely than the vertical position. There was no significant difference between the contoured and completely retouched images, with a discretely more accurate tendency on the contoured images. In comparison with the professional experience, the consultants were tangentially more precise, but without a statistically significant impact.

Discussion

The intuitive determination of the NACs is a challenge for the plastic surgeon. In this study, a statistically significant deviation was seen in almost all dimensions, although the clinical relevance cannot be conclusively assessed. We found a positional relationship of the NAC to the infraclavicular groove ("Mohrenheim pit") in the vertical and 4–4.5 cm above the submammary fold. The position of the NAC can be satisfactorily determined by a combination of plastic surgical intuition, patient wishes and practical metric methods using the Mohrenheim-Estimated-Tangential-Tracking-Line (METT-Line).

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors http://ift.tt/18t7xNj.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tHZPMQ
via IFTTT

No Superior Adaptations to Carbohydrate Periodization in Elite Endurance Athletes.

Purpose: The present study investigated the effects of periodic CHO restriction on endurance performance and metabolic markers in elite endurance athletes. Methods: Twenty-six male elite endurance athletes (VO2max: 65.0 ml O2[BULLET OPERATOR]kg-1[BULLET OPERATOR]min-1) completed 4 weeks of regular endurance training, while matched and randomized into two groups training with (Low) or without (High) carbohydrate (CHO) manipulation three days a week. The CHO manipulation days consisted of a 1-hr high intensity bike session in the morning, recovery for 7 hrs while consuming isocaloric diets containing either high CHO (414+/-2.4 g) or low CHO (79.5+/-1.0 g), and a 2-hr moderate bike session in the afternoon with or without CHO. VO2max, maximal fat oxidation and power output during a 30-min time trial (TT) were determined before and after the training period. The TT was undertaken after 90 mins of intermittent exercise with CHO provision before the training period and both CHO and placebo after the training period. Muscle biopsies were analyzed for glycogen, citrate synthase (CS) and [beta]-hydroxyacyl-coenzyme A dehydrogenase (HAD) activity, carnitine palmitoyltransferase (CPT1b) and phosphorylated acetyl-CoA carboxylase (pACC). Results: The training effects were similar in both groups for all parameters. On average, VO2max and power output during the 30-min TT increased by 5 +/- 1% (P

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDQQ0a
via IFTTT

Associations of Physical Activity Intensities with Markers of Insulin Sensitivity.

Background: Objectively measured physical activity (PA) intensity has traditionally been categorised as light, moderate and vigorous using laboratory calibrated cut-points. The relative contribution of time spent across a spectrum of accelerometer-determined intensities on health outcomes is less clear. Purpose: To assess the relationship between objectively measured PA intensity on a continuous scale and markers of insulin sensitivity. Methods: Participants at high risk of type 2 diabetes were recruited from primary care (Leicestershire, UK). PA was measured using an ActiGraph accelerometer. Fasting and post-challenge glucose and insulin levels were assessed using an oral glucose tolerance test. Insulin sensitivity (IS) was calculated using the Matsuda-IS and HOMA-IS indices. Log-linear regression modelling was used to assess the relationship between PA intensity, in 500 count per min (cpm) increments, with markers of IS. Models were controlled for known confounders. Results: Complete data were available for 569 participants. PA intensity was favourably associated with fasting and 2 hour insulin and IS, with the association increasing in magnitude with each 500 cpm increment. Differences in HOMA-IS per 10 min of PA ranged from 12.4% (95% confidence intervals 3.7, 21.8%) to 26.8% (11.0, 44.7%) within the moderate-intensity PA category (from 2000-2499 cpm to 3500-3999 cpm). For Matsuda IS, these differences were 22.0% (10.3, 34.9%) and 34.7% (13.9, 59.3%) respectively. Significant associations for fasting insulin were no longer observed after controlling for BMI, whereas differences associated with 2 hour insulin and IS were attenuated but still significant. Conclusion: PA of any intensity may positively influence glucose regulation and insulin sensitivity in individuals at high risk of T2DM in a dose-response manner. Further research is required to identify the intensity thresholds at which clinically relevant benefits occur in this population. (C) 2017 American College of Sports Medicine

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uDS1ja
via IFTTT

Reduced Neuromuscular Performance in Amenorrheic Elite Endurance Athletes.

Introduction: Secondary functional hypothalamic amenorrhea (SFHA) is common among female athletes, especially in weight-sensitive sports. The aim of this study was to investigate the link between SFHA and neuromuscular performance in elite endurance athletes. Methods: Sixteen eumenorrheic (EUM) and 14 SFHA athletes from national teams and competitive clubs participated. Methods included gynecological examination; body composition (DXA);; resting metabolic rate and work efficiency; exercise capacity; knee muscular strength (KMS) and knee muscular endurance (KME); reaction time (RT); blood sampling performed on the 3rd-5th day of the menstrual cycle, and 7-day assessment of energy availability. Results: SFHA athletes had lower estrogen (0.12 +/-0.03 vs. 0.17 +/-0.09 nmol/L, p

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uEdick
via IFTTT

The earliest evidence of coloured ornaments in China: The ochred ostrich eggshell beads from Shuidonggou Locality 2

Publication date: December 2017
Source:Journal of Anthropological Archaeology, Volume 48
Author(s): Africa Pitarch Martí, Yi Wei, Xing Gao, Fuyou Chen, Francesco d'Errico
Beads are a communication technology used by humans to transmit information on the wearer identity to members of the same or neighbouring groups by means of a shared symbolic language. Here we focus on the earliest evidence from Eastern Asia of a communication technology – the production of artificially coloured beads – that has allowed humans to further complexify the messages conveyed by personal ornaments, and associate, to some extent, the performance characteristics of beads and pigment. We study six ochred ostrich eggshell beads (OESB) from Shuidonggou Locality 2 (SDG2), Cultural Layer (CL) 2, China, dated to c. 31kyrcalBP. Analysis of the beads manufacturing technique, size, and wear, combined with SEM-EDS and µ-Raman spectroscopy (µ-RS) study of well-preserved red residues sampled on the beads and sediment from CL2 indicate that these beads come from body ornaments and that red residues are the remnant of a pigmented compound coating the beads at the time they were worn by the SDG Palaeolithic visitors. SDG2-CL2 red stained OESBs thus represent, with the red stained bone disk from Xiaogushan, the earliest consistent evidence of pigment use for symbolic activities from China. Results also identify variations in the composition of the pigmental compound used to colour the beads that closely match differences in bead technology, size, and style. We argue that such a hitherto unknown consistency in bead production and decoration may reflect technological, morphological, and pigment coating standardisation at the individual level, standardisation in technology associated with variation in morphology and pigment at the group level, and substantial differences in these three domains at inter-group level.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tFIYtR
via IFTTT

Medical Graduate’s Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship

Abstract

Exposure to otorhinolaryngology in India has been shadowed by an inadequate curriculum. Our study brings forth the lacunae in medical education setup related to ENT. We introspect why the subject is not a first choice for specialization. 100 medical graduates were assessed at the end of internship postings for: (1) subject knowledge, (2) basic and emergency procedures, (3) diagnosis and investigation of common and emergency conditions. 84% take ENT as a minor subject. Least awareness is seen regarding its relation with skull base, head and neck and plastic surgery. Very few knew about advanced surgeries and instruments in the field. Majority rejected ENT as a primary choice and its upgradation as major subject. Routine and emergency procedures based on ENT were not a matter of ease by majority of subjects. Post internship doctors lagged in doing basic clinical and diagnostic steps. Diagnosis of various pathologies was not a skill of majority of subjects under study. A lack of basic knowledge of important emergency conditions in ENT was noticed. Our study points at inadequate training in ENT and under estimation of its scope. The outcome raises a need to revise the curriculum and methodology to come at par with world standards, reflecting its true expanse and tremendous scope.

http://ift.tt/2vkfWly

Medical Graduate’s Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship

Abstract

Exposure to otorhinolaryngology in India has been shadowed by an inadequate curriculum. Our study brings forth the lacunae in medical education setup related to ENT. We introspect why the subject is not a first choice for specialization. 100 medical graduates were assessed at the end of internship postings for: (1) subject knowledge, (2) basic and emergency procedures, (3) diagnosis and investigation of common and emergency conditions. 84% take ENT as a minor subject. Least awareness is seen regarding its relation with skull base, head and neck and plastic surgery. Very few knew about advanced surgeries and instruments in the field. Majority rejected ENT as a primary choice and its upgradation as major subject. Routine and emergency procedures based on ENT were not a matter of ease by majority of subjects. Post internship doctors lagged in doing basic clinical and diagnostic steps. Diagnosis of various pathologies was not a skill of majority of subjects under study. A lack of basic knowledge of important emergency conditions in ENT was noticed. Our study points at inadequate training in ENT and under estimation of its scope. The outcome raises a need to revise the curriculum and methodology to come at par with world standards, reflecting its true expanse and tremendous scope.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vkfWly
via IFTTT

Blockchain technology for improving clinical research quality

Reproducibility, data sharing, personal data privacy concerns and patient enrolment in clinical trials are huge medical challenges for contemporary clinical research. A new technology, Blockchain, may be a key...

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ubOVlH
via IFTTT

Quantification of Hand Motor Symptoms in Parkinson’s Disease: A Proof-of-Principle Study Using Inertial and Force Sensors

Abstract

This proof-of-principle study describes the methodology and explores and demonstrates the applicability of a system, existing of miniature inertial sensors on the hand and a separate force sensor, to objectively quantify hand motor symptoms in patients with Parkinson's disease (PD) in a clinical setting (off- and on-medication condition). Four PD patients were measured in off- and on- dopaminergic medication condition. Finger tapping, rapid hand opening/closing, hand pro/supination, tremor during rest, mental task and kinetic task, and wrist rigidity movements were measured with the system (called the PowerGlove). To demonstrate applicability, various outcome parameters of measured hand motor symptoms of the patients in off- vs. on-medication condition are presented. The methodology described and results presented show applicability of the PowerGlove in a clinical research setting, to objectively quantify hand bradykinesia, tremor and rigidity in PD patients, using a single system. The PowerGlove measured a difference in off- vs. on-medication condition in all tasks in the presented patients with most of its outcome parameters. Further study into the validity and reliability of the outcome parameters is required in a larger cohort of patients, to arrive at an optimal set of parameters that can assist in clinical evaluation and decision-making.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tgA46N
via IFTTT

Medical Graduate’s Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship

Abstract

Exposure to otorhinolaryngology in India has been shadowed by an inadequate curriculum. Our study brings forth the lacunae in medical education setup related to ENT. We introspect why the subject is not a first choice for specialization. 100 medical graduates were assessed at the end of internship postings for: (1) subject knowledge, (2) basic and emergency procedures, (3) diagnosis and investigation of common and emergency conditions. 84% take ENT as a minor subject. Least awareness is seen regarding its relation with skull base, head and neck and plastic surgery. Very few knew about advanced surgeries and instruments in the field. Majority rejected ENT as a primary choice and its upgradation as major subject. Routine and emergency procedures based on ENT were not a matter of ease by majority of subjects. Post internship doctors lagged in doing basic clinical and diagnostic steps. Diagnosis of various pathologies was not a skill of majority of subjects under study. A lack of basic knowledge of important emergency conditions in ENT was noticed. Our study points at inadequate training in ENT and under estimation of its scope. The outcome raises a need to revise the curriculum and methodology to come at par with world standards, reflecting its true expanse and tremendous scope.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vkfWly
via IFTTT

Medical Graduate’s Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship

Abstract

Exposure to otorhinolaryngology in India has been shadowed by an inadequate curriculum. Our study brings forth the lacunae in medical education setup related to ENT. We introspect why the subject is not a first choice for specialization. 100 medical graduates were assessed at the end of internship postings for: (1) subject knowledge, (2) basic and emergency procedures, (3) diagnosis and investigation of common and emergency conditions. 84% take ENT as a minor subject. Least awareness is seen regarding its relation with skull base, head and neck and plastic surgery. Very few knew about advanced surgeries and instruments in the field. Majority rejected ENT as a primary choice and its upgradation as major subject. Routine and emergency procedures based on ENT were not a matter of ease by majority of subjects. Post internship doctors lagged in doing basic clinical and diagnostic steps. Diagnosis of various pathologies was not a skill of majority of subjects under study. A lack of basic knowledge of important emergency conditions in ENT was noticed. Our study points at inadequate training in ENT and under estimation of its scope. The outcome raises a need to revise the curriculum and methodology to come at par with world standards, reflecting its true expanse and tremendous scope.

http://ift.tt/2vkfWly

The Effectiveness of a Simulation-Based Flipped Classroom in the Acquisition of Laparoscopic Suturing Skills in Medical Students—A Pilot Study

Publication date: Available online 19 July 2017
Source:Journal of Surgical Education
Author(s): Hsin-Yi Chiu, Yi-No Kang, Wei-Lin Wang, Hung-Chang Huang, Chien-Chih Wu, Wayne Hsu, Yiu-Shun Tong, Po-Li Wei
ObjectiveTo evaluate the effectiveness of a simulation-based flipped classroom in gaining the laparoscopic skills in medical students.DesignAn intervention trial.SettingTaipei Medical University Hospital, an academic teaching hospital.Participants and MethodsFifty-nine medical students participating in a 1-hour laparoscopic skill training session were randomly assigned to a conventional classroom (n = 29) or a flipped classroom approach (n = 30) based on their registered order. At the end of the session, instructors assessed participants' performance in laparoscopic suturing and intracorporeal knot-tying using the assessment checklist based on a modified Objective Structured Assessment of Technical Skills tool.ResultsStudents in the flipped group completed more numbers of stitches (mean [M] = 0.47; standard deviation [SD] = 0.507) than those in the conventional group (M = 0.10; SD = 0.310) (mean difference: 0.37; 95% CI: 0.114-582; p = 0.002). Moreover, students in the flipped group also had higher stitch quality scores (M = 7.17; SD = 2.730) than those in the conventional group (M = 5.14; SD = 1.767) (mean difference = 2.03; 95% CI: 0.83-3.228; p = 0.001). Meanwhile, students in the flipped group had higher pass rates for the second throw (p < 0.001), third throw (p = 0.002), appropriate tissue reapproximation without loosening or strangulation (p < 0.001), needle cut from suture under direct visualization (p = 0.004), and needle safely removed under direct visualization (p = 0.018) than those in the conventional group.ConclusionsComparing with traditional approach, a simulation-based flipped classroom approach may improve laparoscopic intracorporeal knot-tying skill acquisition in medical students.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uE1Xcf
via IFTTT

Are Residents Prepared for Surgical Cases? Implications in Patient Safety and Education

Publication date: Available online 18 July 2017
Source:Journal of Surgical Education
Author(s): Minh-Bao Mundschenk, Elizabeth B. Odom, Trina D. Ghosh, Grant M. Kleiber, Andrew Yee, Kamlesh B. Patel, Susan E. Mackinnon, Marissa M. Tenenbaum, Donald W. Buck
ObjectiveIn surgical education, the areas of focus and evaluation are skewed toward technical skill and operative knowledge; less emphasized is familiarity with the patient's medical history. The purposes of this study were to characterize how surgical trainees prepare for cases and to determine the comprehensiveness of their preparation.DesignA 27-question survey was created through a web-based software program and distributed to all resident physicians and fellows in the Departments of Surgery, Neurosurgery, and Otolaryngology at our institution. Survey responses were collected anonymously and analyzed. Institutional review board exemption was obtained.SettingThis study was performed at Washington University in St. Louis, Missouri, at an institutional hospital setting.ParticipantsThe survey was distributed to current surgical trainees at Washington University in St. Louis in the Departments of Surgery, Neurosurgery, and Otolaryngology. Further, 130 of 169 surgical residents and fellows completed the survey.ResultsMost respondents (96%) taught themselves case preparation. Only 57% of respondents reviewed the patients medical record before every surgery. Although most respondents (83%) felt they were prepared or very prepared from a patient-specific standpoint, only 24% felt that their handoff of a patient to on-call colleagues was comprehensive enough to include all pertinent aspects of a patient's history and expected perioperative course. From a technical perspective, most residents (63%) felt they were prepared or very prepared, and this level of comfort increased with postgraduate year; 76% of respondents would not feel comfortable telling their attending they were not adequately prepared.ConclusionsAlthough most trainees feel prepared or very prepared for cases from a patient-specific regard, only half review the patient's medical record before every surgery. Furthermore, almost all trainees have taught themselves how to prepare for surgery. This represents a critical gap in residency education and an opportunity to improve patient safety and quality of care.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2u9evGB
via IFTTT

Rotator Cuff Muscles - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim's animated educational video describing muscles of the rotator cuff.


Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC

Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
http://ift.tt/1HCFAla

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader https://www.youtube.com/watch?v=O3hZ5tscM00
via IFTTT

Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada

Publication date: Available online 18 July 2017
Source:American Journal of Infection Control
Author(s): Wrechelle Ocampo, Rose Geransar, Nancy Clayden, Jessica Jones, Jill de Grood, Mark Joffe, Geoffrey Taylor, Bayan Missaghi, Craig Pearce, William Ghali, John Conly
BackgroundWard closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain.PurposeTo understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada.MethodsA Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis.ResultsA total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an "appropriate," "sometimes appropriate," or "not appropriate" strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak.DiscussionResults suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tgm7We
via IFTTT

Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015: A national survey of sharps injuries and mucocutaneous blood exposures among health care workers in US hospitals

Publication date: Available online 18 July 2017
Source:American Journal of Infection Control
Author(s): T. Grimmond, L. Good
BackgroundNational blood exposure (BE) surveys are valuable to health care facilities striving to reduce percutaneous sharps injuries (SIs) or mucocutaneous (MC) exposures among their health care workers (HCWs). In the Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015 we surveyed hospital BE incidence among members of the Association of Occupational Health Professionals in Healthcare.MethodsA 23-item electronic survey requested 2015 data on total SI and MC; SI in nurses, doctors, and surgery; staffed beds; teaching status; full time equivalent staff (FTE), nurse FTE, average daily census (ADC), and adjusted patient days (APD).ResultsOne hundred eighty-one hospitals in 34 states reported 9,343 BE (71% SI and 29% MC exposures). SI rates were 25.2/100 ADC (17.5 in nonteaching hospitals and 30.4 in teaching hospitals), 2.1/100 FTE (significantly less than that in 2001), 3.2/100 nurse FTE, 0.36/1,000 APD, and 38% occurred during surgery. MC exposure incidence rates were 10.5/100 ADC (8.6 in nonteaching hospitals and 11.7 in teaching hospitals), 0.86/100 FTE, and 0.14/1000 APD.ConclusionsBE incidence rates have fallen slowly but significantly since 2001, but the reduction is far less than hoped. Occupied beds (ie, ADC) has become a less-useful denominator. We estimate more than 300,000 HCWs sustain SIs annually in hospital and nonhospital settings. Greater resources are needed for more frequent and correct use of safety devices, training to competency, and root-cause investigation of all SIs.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uAgtlQ
via IFTTT

Letter to the editor on “Antimicrobial copper alloys decreased bacteria on stethoscope surfaces”

Publication date: Available online 18 July 2017
Source:American Journal of Infection Control
Author(s): Marko Predic, Stefanie Buchanan




from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tgbSS6
via IFTTT

A proposal for appropriate countermeasures to infectious diseases in schools

Publication date: Available online 19 July 2017
Source:American Journal of Infection Control
Author(s): Seok-Ju Yoo




from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tgnW5H
via IFTTT

What do visitors know and how do they feel about contact precautions?

Publication date: Available online 18 July 2017
Source:American Journal of Infection Control
Author(s): Grace Seibert, Tola Ewers, Anna K. Barker, Adam Slavick, Marc-Oliver Wright, Linda Stevens, Nasia Safdar
Patients with Clostridium difficile infection (CDI) are placed in contact precautions. We surveyed 31 visitors of CDI patients to understand their compliance, knowledge, and perceptions of contact precautions. Although most visitors knew where to find the required personal protective equipment, only 42% were fully compliant with gown and gloves. Family members accounted for 90% of visitors, and roughly half of the reasons given for not gowning were related to a lack of perceived risk for family members. Nursing staff are fundamental sources of personal protective equipment (PPE) information for visitors; however, we found variation in staff communication regarding need for visitor PPE use.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uABkWf
via IFTTT

Nonocclusive Sweat Collection Combined with Chemical Isotope Labeling LC–MS for Human Sweat Metabolomics and Mapping the Sweat Metabolomes at Different Skin Locations

Analytical Chemistry

DOI: 10.1021/acs.analchem.7b01988

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tg6fDh
via IFTTT

Thresholds for Volume and Expansion in Intraparenchymal Hemorrhage: Predictors of Neurologic Deterioration and Mortality

Publication date: October 2017
Source:World Neurosurgery, Volume 106
Author(s): Darian R. Esfahani, Caitlin A. Radnis, Ahmed E. Hussein, Sepideh Amin-Hanjani, Fady T. Charbel, Ali Alaraj
ObjectiveSpontaneous intraparenchymal hemorrhage (IPH) is a common neurosurgical emergency, with hemorrhage size and expansion associated with poor clinical outcomes. In this study, radiologic risk factors and specific IPH volume thresholds were calculated to identify heightened risk of neurologic deterioration and mortality.MethodsA consecutive review of all patients with nontraumatic IPH transferred to a tertiary academic neurosurgery service was performed over 2 years. IPH volume, hemorrhage location, presence of intraventricular hemorrhage, hydrocephalus, anticoagulant use, and neurologic status were reviewed. A maximum Youden index was calculated to determine thresholds of initial IPH volume and expansion most predictive of deterioration and mortality.ResultsA total of 202 transfers were studied. Both initial IPH volume at the outside hospital and IPH expansion were correlated with neurologic deterioration and death. The most predictive threshold for mortality was 32 mL of initial IPH volume (area under the curve 0.758, P < 0.001, confidence interval 1.012–1.035) and 1 mL of expansion. The threshold for neurologic deterioration was 18 mL of initial volume (area under the curve 0.690, P = 0.004, confidence interval 1.004–1.025) and 1 mL of expansion. Both intraventricular hemorrhage and hydrocephalus were independently associated with elevated risk for deterioration and mortality, while anticoagulant use was associated with neurologic deterioration.ConclusionsVolume and growth of IPH are significant predictors of neurologic deterioration and death. An initial volume over 32 mL is associated with increased mortality risk, whereas risk of neurologic deterioration appears to peak at a smaller volume of 18 mL. Any measurable IPH expansion suggests elevated risk of deterioration and mortality.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vD0O1V
via IFTTT

Subarachnoid Hemorrhage in Advanced Age: Comparison of Patients Aged 70–79 Years and 80 Years and Older

Publication date: October 2017
Source:World Neurosurgery, Volume 106
Author(s): Nina Brawanski, Franziska Kunze, Markus Bruder, Stephanie Tritt, Christian Senft, Joachim Berkefeld, Volker Seifert, Jürgen Konczalla
BackgroundClinical routine shows an increasing admission rate of elderly patients suffering from subarachnoid hemorrhage (SAH).ObjectiveAim of the study was to identify differences in outcome and prognostic factors to better anticipate clinical course and therefore treat this special subgroup better.MethodsWe retrospectively compared patients aged 70–79 and older than 80 years (80+). Patients were entered into a prospectively collected database. Between 1999 and June 2014, 191 patients aged ≥70 years suffered from SAH. We stratified between patients aged from 70 to 79 years (n = 138) and 80+ years (n = 53). Outcome was assessed by modified Rankin Scale 6 months after SAH.ResultsDuring the observation period, the rate of elderly patients increased from 9% to 24%. Patients aged 80+ years less often showed significant early hydrocephalus, cerebral vasospasm, and shunt dependence. A total of 51% of all patients were treated by coiling, whereupon also treatment modality had no influence on outcome. By comparing clinical outcomes, no significant differences could be detected. However, mortality rate was not significantly greater in patients 80+ years. Clinical status at time of admission statistically was a prognostic factor in elderly patients as well as the extent of blood clots and an early hydrocephalus. Patients aged 80+ years suffered less from severe cerebral vasospasm, which statistically was no prognostic factor for a favorable outcome in this group.ConclusionsPatients aged 80+ years with SAH also can achieve a favorable outcome. There was no difference in clinical outcome comparing both groups, but several pathophysiological mechanisms in elderly patients (especially 80+ years) seem to have a positive influence on typical complications after SAH, such as cerebral vasospasm, early hydrocephalus, and shunt dependence.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDdQfW
via IFTTT

Trends in Management of Intracranial Meningiomas: Analysis of 49,921 Cases from Modern Cohort

Publication date: October 2017
Source:World Neurosurgery, Volume 106
Author(s): Vijay Agarwal, Brandon A. McCutcheon, Joshua D. Hughes, Matthew L. Carlson, Amy E. Glasgow, Elizabeth B. Habermann, Quoc-Bao Nguyen, Michael J. Link, Jamie J. Van Gompel
ObjectiveWe sought to characterize patterns and treatment for intracranial meningiomas in the Surveillance, Epidemiology, and End Results set of cancer registries.MethodsSEER data was queried from 2004–2012 for cases of intracranial meningioma using appropriate topography and histology codes.ResultsA total of 49,921 patients with intracranial meningioma were identified. The vast majority of cases were associated with a benign histology (n = 47,047, 94.2%). There were 21,145 patients (42.4%) who underwent surgical management, 2783 who received radiation alone (5.6%), and 25,993 who underwent surveillance only (52.1%). Surgical management decreased in frequency from 48.8% of all cases in 2004 to 38.3% of cases in 2012 (P < 0.001). Radiation alone remained stable over time with a range of 4.8%−6.3% of cases. Observation increased from 45.0% of cases in 2004 to 56.7% of cases in 2012 (P < 0.001). On unadjusted analysis, surgical management was associated with younger age and larger tumor size. The incidence of tumors <2 cm in size increased significantly over the study period from 29.7% in 2004 to 41.7% in 2012 (P < 0.001). After adjusting for tumor size, multivariable analysis demonstrated that the odds of observation as a primary management strategy were greater in 2012 relative to 2004 (odds ratio 1.33, 95% confidence interval 1.21–1.45).ConclusionThe incidence of intracranial meningiomas increased, while tumor size at the time of diagnosis decreased. Moreover, the number undergoing no treatment increased as a treatment strategy and was more likely employed for older patients, those of African-American race, and those with smaller tumors.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uDASWG
via IFTTT

Clinical and Molecular Prognostic Factors for Long-Term Survival of Patients with Glioblastomas in Single-Institutional Consecutive Cohort

Publication date: October 2017
Source:World Neurosurgery, Volume 106
Author(s): Yu Nakagawa, Hikaru Sasaki, Kentaro Ohara, Taketo Ezaki, Masahiro Toda, Takayuki Ohira, Takeshi Kawase, Kazunari Yoshida
ObjectiveThe purpose of this study was to clarify the clinical and molecular characteristics associated with long-term survival in patients with glioblastoma.MethodsWe analyzed the characteristics of 96 glioblastoma patients. Long-term survivors (LTSs) were classified into moderate LTSs (mLTSs), who survived >3 years, and LTSs, who survived >5 years, and compared with short-term survivors (STSs). Clinical and molecular factors were investigated.ResultsYounger age, better recursive partitioning analysis class, lack of subventricular zone (SVZ) involvement, promoter methylation of the O6-methylguanine-DNA methyltransferase (MGMT) gene, and loss of 19q were associated with mLTSs as compared with STSs. After adjustment for these factors, younger age and MGMT methylation remained independently associated with mLTSs. Younger age, better recursive partitioning analysis class, lack of SVZ involvement, and loss of 19q were associated with LTSs as compared with STSs. After adjustment, younger age and better preoperative Karnofsky performance scale (KPS) score remained independently associated with LTSs. Kaplan-Meier analyses revealed that younger age (<50 years), better preoperative KPS score (≥70), lack of SVZ involvement, and loss of 19q were associated with longer overall survival. In the multivariate analysis, only age was significantly associated with overall survival.ConclusionsYounger age and better preoperative KPS score were the characteristics associated with LTSs as compared with STSs. MGMT promoter methylation was associated with mLTSs, but not with LTSs. In addition, lack of SVZ involvement and loss of 19q might be prognostic for longer survival.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2vDe72x
via IFTTT

A Simple Neuronal Mechanical Injury Methodology to Study Drosophila Motor Neuron Degeneration

Here we describe a simple and widely accessible method to injure segmental nerves in Drosophila larvae to visualize and quantify neurodegeneration of motor neurons at the neuromuscular junction (NMJ) of third instar larvae.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uDxJq0
via IFTTT

Membrane phase transition during heating and cooling: molecular insight into reversible melting

Abstract

With increasing temperature, lipid bilayers undergo a gel-fluid phase transition, which plays an essential role in many physiological phenomena. In the present work, this first-order phase transition was investigated for variable heating and cooling rates for a dipalmitoylphosphatidylcholine (DPPC) lipid bilayer by means of atomistic molecular dynamics simulations. Alternative methods to track the melting temperature \(T_m\) are compared. The resulting \(T_m\) is shown to be independent of the scan rate for small heating rates (0.05–0.3 K/ns) implying reversible melting, and increases for larger heating (0.3–4 K/ns) or cooling rates (2–0.1 K/ns). The reported dependency of the melting temperature on the heating rate is in perfect agreement with a two-state kinetic rate model as suggested previously. Expansion and shrinkage, as well as the dynamics of melting seeds is described. The simulations further exhibit a relative shift between melting seeds in opposing membrane leaflets as predicted from continuum elastic theory.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2traKPG
via IFTTT

The Relationship Between Cerebral Vasoreactivity and Post-Concussive Symptom Severity

Journal of Neurotrauma , Vol. 0, No. 0.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uAspnx
via IFTTT

Red Blood Cell Transfusion Guided by Near Infrared Spectroscopy in Neurocritically Ill Patients with Moderate or Severe Anemia: A Randomized, Controlled Trial

Journal of Neurotrauma , Vol. 0, No. 0.


from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tfTt7X
via IFTTT

Quiz: Capnography for kids: Unique considerations

Test your knowledge on the challenges of assessing and treating children with capnography

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uJMKHL
via IFTTT

Applying a new bilateral mammographic density segmentation method to improve accuracy of breast cancer risk prediction

Abstract

Purpose

How to optimally detect bilateral mammographic asymmetry and improve risk prediction accuracy remains a difficult and unsolved issue. Our aim was to find an effective mammographic density segmentation method to improve accuracy of breast cancer risk prediction.

Methods

A dataset including 168 negative mammography screening cases was used. We applied a mutual threshold to bilateral mammograms of left and right breasts to segment the dense breast regions. The mutual threshold was determined by the median grayscale value of all pixels in both left and right breast regions. For each case, we then computed three types of image features representing asymmetry, mean and the maximum of the image features, respectively. A two-stage classification scheme was developed to fuse the three types of features. The risk prediction performance was tested using a leave-one-case-out cross-validation method.

Results

By using the new density segmentation method, the computed area under the receiver operating characteristic curve was 0.830 ± 0.033 and overall prediction accuracy was 81.0%, significantly higher than those of 0.633 ± 0.043 and 57.1% achieved by using the previous density segmentation method ( \(p<0.01\) , t-test).

Conclusions

A new mammographic density segmentation method based on a bilateral mutual threshold can be used to more effectively detect bilateral mammographic density asymmetry and help significantly improve accuracy of near-term breast cancer risk prediction.

from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2uDmq10
via IFTTT