Corpus callosotomy outcomes in pediatric patients: A systematic review

Summary

Objective

Corpus callosotomy is a palliative neurosurgical treatment for patients with either generalized or multifocal refractory epilepsy and injurious drop attacks. This report aims to systematically review the pediatric literature.

Methods

Medline, Embase, Web of Knowledge, and Scopus were searched systematically for published articles on treatment outcomes of corpus callosotomy for refractory epilepsy. Studies were included if the patient population was younger than 18 at the time of surgery and median follow-up was >1 year. Studies were excluded if resective surgery was also performed.

Results

A total of 12 articles met inclusion criteria. All articles were retrospective case series, with the exception of one being a prospectively designed retrospective case series. There was very little agreement among authors on the definition of a good seizure outcome. Articles that used the Engel classification found that 88.2% of total corpus callosotomy patients had a worthwhile reduction in seizures compared with 58.6% of patients who underwent anterior corpus callosotomy (p < 0.05). Drop attacks improved from corpus callosotomy more than other generalized seizure types. Reported complications were minor in all but one patient, and one death was reported. Transient disconnection syndrome was significantly more likely in total corpus callosotomy than in anterior corpus callosotomy (12.5% vs. 0%; p < 0.05). Improvements in quality of life, behavior, and intelligence/development quotient, as well as parental satisfaction, were generally correlated with seizure outcome. There was no postcallosotomy change in the number of antiepileptic drugs.

Significance

Total corpus callosotomy was significantly more likely to result in a reduction in seizures. Anterior corpus callosotomy was unlikely to result in disconnection syndrome. Although all of the papers drew a similar conclusion, the quality of evidence was low. At best, the evidence raises the hypothesis that corpus callosotomy is a safe and effective treatment for refractory generalized epilepsy. It is clear that a case–control or randomized trial is warranted.

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Microarray study reveals a transforming growth factor-β-dependent mechanism of fibrosis in discoid lupus erythematosus

Summary

Background

Discoid lupus erythematosus (DLE) is characterized by scarring lesions that develop and perpetuate fibrotic lesions. These are not observed in subacute cutaneous lupus erythematosus (SCLE). The pathophysiological basis of this is currently unknown.

Objectives

To identify contradistinctive signalling pathways and cellular signatures between the two type of lupus, with a focus on the molecular mechanisms leading to fibrosis.

Methods

We conducted a gene expression microarray analysis in lesional and nonlesional skin biopsy specimens of patients with DLE (n = 10) and SCLE (n = 10). Confirmatory reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry were performed on selected transcripts in a new cohort of paraffin-embedded skin biopsies (n = 20). Changes over time of a group of selected inflammatory and fibrotic genes were also evaluated in a second biopsy taken 12 weeks later. In vitro functional studies were performed in primary isolated fibroblasts.

Results

Compared with nonlesional skin, DLE samples expressed a distinctive T-cell gene signature. DLE samples displayed a significant CD4 T-cell enrichment with an imbalance towards T helper 1 cytokine predominance and a relative increased forkhead box (FOX)P3 response. RT-qPCR and immunochemical analysis over time showed a progressive increment of fibrotic markers and persistent FOXP3 recruitment. Ex vivo upregulation of SERPINE1, MMP9, TGFBR1, phosphorylated SMAD3 and TGFB1 suggested a transforming growth factor (TGF)-β-dependent mechanism of fibrosis in DLE, also confirmed by the results observed following in vitro stimulation with TGF-β.

Conclusions

These results highlight major pathogenic pathways in DLE and provide novel molecular targets for the development of new therapies. The data suggest the existence of a TGF-β-dependent pathway inducing fibrosis in DLE.

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Ketoconazole does not decrease fungal amount in patients with seborrhoeic dermatitis

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Staphylococcus aureus and chronic folliculocentric pustuloses of the scalp – cause or association?

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Efficacy of Biofeedback and Precautenous Tibial Nerve Stimulation on Functional Faecal Incontinence in Children.

2016-05-29T20-30-29Z
Source: International Journal of Therapies and Rehabilitation Research
mohamed serag Mahgoub, Abdkader Mohamed.
studying the effect of precautenious tibial nerve stimulation and biofeedback on functional faecal defecation and comparing the result with traditional physical therapy program group.


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Can synaptophysin be used as a marker of breast cancer diagnosed by core-needle biopsy in epithelial proliferative diseases of the breast?

Abstract

The differential diagnosis of epithelial proliferative disease using core needle biopsy (CNB) is problematic because it is difficult to differentiate between intraductal papilloma, ductal hyperplasia, ductal carcinoma in situ, and invasive ductal carcinoma. Many studies have reported that breast cancer lesions are positive for neuroendocrine (NE) markers, whereas only a small number of studies have reported immunopositivity for NE markers in normal mammary tissues or benign lesions. We asked whether NE factors could be used as markers of breast cancer. We determined the immunopositivity rate of synaptophysin, an NE marker, in 204 lesions excised from the breast using CNB in patients who visited a university-affiliated comprehensive medical facility and examined whether synaptophysin is a marker of breast cancer. The specimens were classified as synaptophysin-negative cases (56 benign, 99 malignant); equivocal cases (<1 %: 2 benign, 15 malignant); and synaptophysin-positive cases (1 benign, 31 malignant). The sensitivity, specificity, positive predictive value, and negative predictive value for malignancy of the lesions classified as synaptophysin positive were 23.3 %, 98.2 %, 96.9 %, and 36.1 %, respectively. The respective values for lesions classified as equivocal were 11.6 %, 96.6 %, 88.2 %, and 36.1 %. Synaptophysin may provide a marker of breast cancer diagnosed by CNB.

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Ferric maltol therapy for iron deficiency anaemia in patients with inflammatory bowel disease: long-term extension data from a Phase 3 study

Summary

Background

Ferric maltol was effective and well-tolerated in iron deficiency anaemia patients with inflammatory bowel disease during a 12-week placebo-controlled trial.

Aim

To perform a Phase 3 extension study evaluating long-term efficacy and safety with ferric maltol in inflammatory bowel disease patients in whom oral ferrous therapies had failed to correct iron deficiency anaemia.

Methods

After 12 weeks of randomised, double-blind treatment, patients with iron deficiency anaemia and mild-to-moderate ulcerative colitis or Crohn's disease received open-label ferric maltol 30 mg b.d. for 52 weeks.

Results

111 patients completed randomised treatment and 97 entered the open-label ferric maltol extension. In patients randomised to ferric maltol ('continued'; n = 50), mean ± s.d. haemoglobin increased by 3.07 ± 1.46 g/dL between baseline and Week 64. In patients randomised to placebo ('switch'; n = 47), haemoglobin increased by 2.19 ± 1.61 g/dL. Normal haemoglobin was achieved in high proportions of both continued and switch patients (89% and 83% at Week 64, respectively). Serum ferritin increased from 8.9 μg/L (baseline) to 26.0 μg/L (Week 12) in ferric maltol-treated patients, and to 57.4 μg/L amongst all patients at Week 64. In total, 80% of patients reported ≥1 adverse event by Week 64. Adverse events considered related to ferric maltol were recorded in 27/111 (24%) patients: 8/18 discontinuations due to adverse events were treatment-related. One patient was withdrawn due to increased ulcerative colitis activity.

Conclusions

Normal haemoglobin was observed in ≥80% of patients from weeks 20–64 of long-term ferric maltol treatment, with concomitant increases in iron storage parameters. Ferric maltol was well-tolerated throughout this 64-week study.

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Intensive simulation versus control in the assessment of time to skill competency and confidence of medical students to assess and manage cardiovascular and respiratory conditions—a pseudo-randomised trial

Background: The Clinical Placement Enhancement Program (CPEP) is a simulation course for medical students learning the core topics of cardiovascular and respiratory medicine, incorporating patient safety and professionalism teaching and based on adult learning principles and proven educational theory. The aims of this study are to assess whether the CPEP delivered at the beginning of a clinical rotation would result in competency outcomes that are at least equivalent to those achieved through a standard 6-week programme and whether this programme would increase student confidence levels in assessing and managing patients with cardiovascular and respiratory conditions. Methods: This was a pseudo-randomised control trial between two groups of medical students from one clinical school. The intervention group participated in CPEP, a 4-day immersive simulation course, in the first week of their cardiac and respiratory medicine clinical rotation. The control group participants attended the normal programme of the 6-week cardiovascular and respiratory medicine clinical rotation. The programme and student competence was assessed using Observed Structured Clinical Examinations (OSCEs) and self-reported confidence surveys. Results: There was no significant difference in OSCE scoring between the intervention group (examined in week one of their clinical rotation following CPEP) and the control group (examined at the end of their full clinical rotation). Students exposed to CPEP started their clinical rotation with confidence levels similar to those reported by the control group at the end of their rotation. Confidence levels of CPEP students were higher at the end of the rotation compared to those of the control group. Conclusions: Based on OSCE results, immersion into a 4-day simulation-based teaching programme at the start of a clinical rotation resulted in skill competency levels that were equivalent to those obtained after a full clinical rotation of 6 weeks. CPEP improved students' confidence levels in the assessment and management of patients presenting with cardiovascular and respiratory conditions. Simulation utilised in courses such as CPEP has the potential to enhance the overall learning experience in medical school clinical rotations.

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Iodine in commercial edible iodized salts and assessment of iodine exposure in Sri Lanka

Background: Iodine is an essential micronutrient used by the thyroid gland in the production of thyroid hormones. Both excessive and insufficient iodine intakes can cause thyroid diseases thus harmful to the human body. Inadequate iodine intake by human body causes Iodine Deficiency Disorders (IDD) and hypothyroidism. Excessive iodine intake causes Iodine Induced Hyperthyroidism (IIH). Universal Salt Iodization (USI) is the most effective way of preventing IDD. This study determined the concentrations of iodine species in commercial edible salt products, the stability of iodine at different conditions and iodine exposure at the consumer level. Methods: The iodine contents of six commercial edible iodized salts were determined qualitatively and quantitatively for both iodide and iodate. Thereafter, the first three products of highest iodine contents, the stability of iodide at exposed to air and heat was measured after 24 hours. Risk assessment of exposure was done at four levels considering the WHO estimation. Results: Results revealed that all of the salt products have excess iodine that is above the fortification level of 15–30 mg kg −1 level in Sri Lanka. Iodide stability was reduced at the average percentages of 13.1, 10.7 and 11.3. The iodate loss percentages were 0, 5.7 and 0 at open air. The iodide loss percentages at the temperature of 50 °C were 4.6, 7.8 and 8.6 while at 100 °C, loss percentages were 11.1, 11.4 and 15.9 for the same salt products. The iodine exposure at lower consumption during cooking ranged 244.4–432.2 μg/day while 325.9–576.3 μg/day for medium consumption, 407.4–720.4 μg/day for moderate high salt consumptions and 488.8–864.4 μg/day for high salt consumptions. As a total 95.8 % cases can cause IIH and only 4.1 % of them can provide optimal iodine nutrition in a population. Iodine exposure without cooking ranged 305.5–540.3 μg/day for low salt consumption, 407.4–720.4 μg/day for medium consumption and 509.2–900.5 μg/day for moderate high consumption and 611.1–1080.6 μg/day for high salt consumptions. Conclusions: All of the incidents (100 %) of consumption without cooking at the household level can cause excessive iodine intake and IIH in a population.

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Clinical significance of T-bet, GATA-3, and Bcl-6 transcription factor expression in bladder carcinoma

Background: The aim of this study was to investigate the clinical significance of three immune cell-related transcription factors, T-bet, GATA-3 and Bcl-6 in bladder cancer in Tunisian patients. Methods: Expression of T-bet, GATA-3 and Bcl-6 genes was assessed using RT-qPCR in 65 bladder cancers from patients: 32 being diagnosed as low- and medium-grade, 31 as high-grade, 25 as muscle invasive stage and 39 as non-muscle invasive stage. Gene expression was statistically correlated according to the grade, the stage, tobacco consumption, the BCG response and disease severity. Results: T-bet levels in patients with high-grade bladder cancer were significantly elevated compared to patients with low- or medium-grade bladder cancer (p = 0.005). In invasive carcinoma (T2–T4), the T-bet levels were significantly higher than in superficial non-invasive bladder tumors (Tis, Ta, and T1) (p = 0.02). However, T-bet is predictive of the response to BCG. Its expression is high in good responders to BCG (p = 0.02). In contrast, the expression of GATA-3 and Bcl-6 in non-invasive carcinoma (p = 0.008 and p = 0.0003) and in patients with low- and medium-grade cancers (p = 0.001 and p < 0.0001) is significantly higher than in invasive bladder tumors and in patients with high-grade bladder carcinoma, respectively. In addition, heavy smokers, whose tumors express low levels of GATA-3 and Bcl-6, are poor responders to BCG (p = 0.01 and p = 0.03). Finally, better patient survival correlated with GATA-3 (p = 0.04) and Bcl-6 (p = 0.04) but not T-bet expression. Conclusions: Our results suggest that T-bet expression in bladder tumors could be a positive prognostic indicator of BCG therapy, even if high levels are found in high-grade and stage of the disease. However, GATA-3 and Bcl-6 expression could be considered as predictive factors for good patient survival.

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Acute neck pain caused by pseudogout attack of calcified cervical yellow ligament: a case report

Background: Calcification of the yellow ligament sometimes compresses the spinal cord and can induce myelopathy. Usually, the calcification does not induce acute neck pain. We report a case of a patient with acute neck pain caused by calcium pyrophosphate dihydrate in a calcified cervical yellow ligament.Case presentationA 70-year-old Japanese woman presented with acute neck pain. She had a moderately high fever (37.5 °C), and her neck pain was so severe that she could not move her neck in any direction. Computed tomography showed a high-density area between the C5 and C6 laminae suspicious for calcification of the yellow ligament. Magnetic resonance imaging showed intermediate-signal intensity on T1-weighted imaging and high-signal intensity on T2-weighted imaging surrounding a low-signal region on both T1- and T2-weighted imaging with cord compression. There was a turbid, yellow fluid collection in the yellow ligament at the time of operation. Histologically, calcium pyrophosphate dihydrate crystals were found in the fluid, and she was diagnosed as having a pseudogout attack of the yellow ligament. Conclusions: Pseudogout attack of the cervical yellow ligament is rare, but this clinical entity should be added to the differential diagnosis of acute neck pain, especially when calcification of the yellow ligament exists.

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Unilateral high division of brachial artery

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
T M Sucharitha, L Hema, S V Phanindra.



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Occipitalization of atlas - a case report

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Saranya Deb Barma, Gunamani Rabha, Kunjalal Talukdar.



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Abnormal formation of medial cord of brachial plexus - a case report

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Rupak Jyoti Baishya, Rubi Sakia, Shobhana Medhi.



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Bilateral bony bar bridging of the sigmoid sulcus: a case report

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Navneet Kumar, Rakesh Kumar verma, Arvind Kumar Pankaj, Archana Rani, Rakesh Kumar Diwan.



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A case of midline defect of posterior arch of atlas in a cadaver

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Leena AB.



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A study on maxillary simus by computed tomography in population of Tamil Nadu

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
N Muthukumaravel, K Y Manjunath.



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Divine social scientific way to serve mankind

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Jitendra patel, Sanjay Kanani.



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Norms for size and closure time of antrior fontanelle: a study on babies in Nagpur region

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Amit Tirpude, M P Fulpatil, Swapan Kole.



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Magnetic resonance evaluation with staging of biopsy cases of cancer cervix and to compare with FIGO staging

2016-05-29T17-46-01Z
Source: National Journal of Clinical Anatomy
Parul Dutta, Prabahita Barula, Aswin Padmanabhan, Karuna Hazarika.



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Onyx Embolization for Tentorial Dural Arteriovenous Fistula with Pial Arterial Supply: Case Series and Analysis of Complications

Publication date: August 2016
Source:World Neurosurgery, Volume 92
Author(s): Qi Wu, Xiang-sheng Zhang, Han-dong Wang, Qing-rong Zhang, Li-li Wen, Chun-hua Hang, Xin Zhang
ObjectiveWe describe treatment with Onyx embolization in a series of cases of tentorial dural arteriovenous fistula (DAVF) with pial arterial supply. The aim of this study was to analyze the cause of intraoperative hemorrhage and to explore therapeutic strategies.MethodsRetrospective review was performed of 53 consecutive patients with DAVF treated by Onyx embolization between February 2009 and December 2014. Tentorial DAVF with pial arterial supply was diagnosed in 6 patients (2 women and 4 men; mean age, 47.3 years ± 10.2), and transarterial Onyx embolization was performed in these patients. Fisher exact test was used to analyze differences of incidence of procedure-related complications.ResultsIntraoperative hemorrhage occurred in 2 of 6 patients with pial arterial supply. One patient died as a result of hemorrhage, and the other patient survived after craniotomy. The incidence of complications for these 6 patients (2 of 6; 33.3%) was significantly higher (P = 0.0309) compared with patients with DAVF without pial arterial supply (1 of 47; 2.1%).ConclusionsPial arterial supply may be a risk factor for intraoperative hemorrhage during transarterial embolization of DAVF through dural feeders. Identification of pial feeders and early superselective occlusion of such feeders are important for safe management.



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Risk Factors for Newly Developed Cerebral Infarction After Surgical Revascularization for Adults with Moyamoya Disease

Publication date: August 2016
Source:World Neurosurgery, Volume 92
Author(s): Wonhyoung Park, Jae Sung Ahn, Hye Sun Lee, Jung Cheol Park, Byung Duk Kwun
ObjectiveIt is important to recognize the incidence and risk factors for ischemic complications after surgical revascularization for moyamoya disease (MMD). However, most studies focus on pediatric MMD or pediatric and adult MMD. Our study identified the incidence and risk factors of newly developed cerebral infarction after surgical revascularization for adult MMD.MethodsIschemic complications were defined as newly developed cerebral infarction within 15 days after surgery, as identified by imaging studies. To identify the incidence and these risk factors for adult patients ≥18 years, we retrospectively reviewed our experience with 194 adult MMD patients with 241 surgical revascularizations.ResultsThe incidence of symptomatic infarction after surgical revascularization was 5.8% (14 cases); 30 cases (12.4%) experienced a silent infarction. In univariate analysis, initial presentation as infarction, initial presentation as hemorrhage, transient ischemic attacks (TIAs) >3 times/month, involvement of the posterior cerebral artery (PCA), combined bypass, and using muscle for revascularization were variables related to the newly developed cerebral infarction. Multivariate analysis revealed that the following factors were independently associated with newly developed cerebral infarction after surgery: cerebral infarction as initial presentation (odds ratio [OR] 1.150; 95% confidence interval [CI] 1.038–1.273; P = 0.0073), TIAs >3times/month (OR 1.188; 95% CI 1.058–1.335; P = 0.0035), and PCA involvement (OR 1.095; 95% CI 1.005–1.194; P = 0.039).ConclusionsOur findings demonstrate that newly developed, silent cerebral infarction developed more frequently than symptomatic cerebral infarction in adult patients. Cerebral infarction as initial presentation, frequent TIA before surgery, and PCA involvement were also independent risk factors for newly developed cerebral infarction after surgical revascularization for adult MMD.



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Predictors of Long-Term Outcome of Thoracic Sympathectomy in Patients with Complex Regional Pain Syndrome Type 2

Publication date: August 2016
Source:World Neurosurgery, Volume 92
Author(s): Hazem M. Alkosha, Yasser M. Elkiran
Background and ObjectiveLong-term results of sympathectomy in patients with complex regional pain syndrome (CRPS) type 2 varies widely among studies due to nonspecific or vague criteria of diagnosis and absence of outcome predictors that help good patient selection. The objective was to determine the predictors of long-term outcome of sympathectomy in patients with upper limb CRPS type 2.MethodsA retrospective cohort, in which those who underwent thoracic sympathectomy for upper limb CRPS type 2 from 2007 to 2014, were included. Demographic and clinical data of patients, in addition to stellate ganglion block (SGB) details and percent of pain relief at the end of follow-up, were collected and used for statistical analysis.ResultsOur study included 53 patients, with a mean age of 47 ± 7 years, and 60% females. Using bivariate correlations; age, sex, nerve injured, type of injury, and occupation were not significantly correlated to outcome. Multiple linear regression analysis of correlated variables revealed that duration of pain relief after SGB and degree of sympathetic overactivity were positive predictors (β = 0.286, P = 0.027, and β = 0.257, P = 0.003, respectively), whereas presence of allodynia was a negative predictor (β = −0.280, P = 0.041) of the final pain relief. Final pain relief was better in those patients who experienced extended relief of their pain >2 days after SGB (P = 0.001, Kruskal Wallis test).ConclusionsThoracic sympathectomy may prove more effective than reported in carefully selected CRPS patients with prominent sympathetic overactivity, no or early allodynia, and pain relief >2 days after SGB.



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Systematic use of isolated pancreatic anastomosis after pancreatoduodenectomy: five years of experience with zero mortality

Publication date: Available online 29 May 2016
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Marcel C.C. Machado, Marcel Autran C. Machado
ObjectiveThe aim of this study is to perform a comprehensive evaluation of 5 years of experience with the technique of isolated pancreatic anastomosis reconstruction after pancreatoduodenectomy from the perspective of safety and surgical efficacy using a prospective database.MethodsThe study included all consecutive patients undergoing pancreatoduodenectomy from April 2009 to April 2014 at a single referral center for hepato-pancreato-biliary diseases. The primary endpoint was the safety of the procedures, which was assessed as the occurrence of complications during hospitalization. Ninety-day mortality was also assessed. Postoperative pancreatic fistulas were classified as grade A, B, or C according to the International Study Group of Pancreatic Fistula classification.ResultsThe study group included 214 consecutive patients with a median age of 60 years who underwent pancreatoduodenectomy. Portal vein resection was performed on 41 patients. Indications for resection were 165 pancreatic head tumors, 33 ampullary tumors, 7 chronic pancreatitis, 3 distal bile duct tumors, and 6 duodenal tumors. There was no perioperative or 90-day mortality in this series. Complications occurred in 68 patients (32%), and 42 patients presented with pancreatic fistulas (19.6%). Grade A fistulas were present in 38 patients. Three patients presented persistent pancreatic fistula and were treated with percutaneous drainage. One patient developed combined pancreatic and biliary fistulas and was reoperated on for pancreatic abscess drainage.ConclusionsThe technique of isolated pancreatic anastomosis by diverting the pancreatic from biliary secretion may contribute to reducing the severity of pancreatic fistulas and therefore the severity of this complication.



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Bone tissue engineering using polyetherketoneketone scaffolds combined with autologous mesenchymal stem cells in a sheep calvarial defect model

In craniofacial surgery, bone defects are preferably reconstructed with autogenous bone, such as iliac crest, fibula, scapula or rib grafts. Autogenous bone is still regarded as the gold standard in reconstruction. The major drawbacks of bone transplantation include donor side morbidity and increased operation time. Therefore, bone implants made of natural or artificial biomaterials could be a promising alternative (Kolk et al., 2012; Rubin and Yaremchuk, 1997; Terella et al., 2010). The choice of implant relies on several individual factors such as defect size, shape and volume, as well as patient-associated complications (Brydone et al., 2010).

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Prevalence of Abdominal Aortic Aneurysm in Men Aged 65–74 Years in a Metropolitan Area in North-East Spain

Publication date: Available online 29 May 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): B. Salvador-González, M. Martín-Baranera, Á. Borque-Ortega, R.M. Sáez-Sáez, M. de Albert-Delas Vigo, E. Carreño-García, L. Tarín-Masriera, P. Badia-Millán, M. Martínez-Gil, J. Torrabadella-Fàbrega
BackgroundA declining prevalence of AAA and a shift in the distribution towards the older population have been observed during the last decade in Europe. The aim was to estimate the current screening prevalence of AAA in men aged 65–74 years in a metropolitan area in north-east Spain and to identify associated risk factors.MethodsA cross sectional prevalence study in men registered in L'Hospitalet Primary Healthcare Services (Barcelona, Spain) was performed. There were 619 randomly selected subjects (expected prevalence of aneurysm, 5%; accuracy of estimation, ±2%; loss to follow up, 30%). Exclusion criteria were life expectancy <1 year, limited quality of life, previous diagnosis of AAA, prior aorto-femoral surgery, and non-Caucasian. The following were measured: internal diameter of the infrarenal abdominal aorta using ultrasound, cardiovascular risk factors, personal (heart disease, stroke, peripheral vascular disease) and family history (AAA), physical examination, and blood tests. We estimated the prevalence and 95% confidence interval of AAA, and used logistic regression analysis to identify risk factors for AAA.ResultsAmong the 651 individuals included in the analysis the prevalence of aneurysm was 2.30% (95% CI, 1.30–3.77%). In the regression analysis, AAA was associated with smoking (0–10, 11–20, or >20 cigarettes/day), diagnosis of myocardial infarction, and being taller than the median (165 cm).ConclusionsThe current screening prevalence of AAA among men aged 65–74 years in a metropolitan area in north-east Spain is similar to that in northern Europe. Smoking, myocardial infarction, and height were associated with the presence of AAA.



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Examining daily variability in willingness to drink in relation to underage young adult alcohol use

Publication date: October 2016
Source:Addictive Behaviors, Volume 61
Author(s): Melissa Lewis, Kevin King, Dana Litt, Alex Swanson, Christine Lee
A key component of the Prototype Willingness Model is willingness, which reflects an openness to opportunity to perform a behavior in situations that are conducive to that behavior. Willingness has traditionally been tested using global, hypothetical assessments, and has not been examined at the daily level. We expected to find within-person variability in willingness to drink, such that on days with greater willingness, individuals would report greater drinking. A national sample (N=288) of young adults aged 18 to 20 (31.60% female) completed a Web-based survey that was comprised of measures of drinking and sexual behavior, including the Timeline Follow-Back (Sobell & Sobell, 1992). Findings show daily variability in willingness to drink (ICC=0.54), which suggests that there are substantial differences from day-to-day in this drinking-related cognition. Participants drank more on days when individuals also reported feeling more willing to drink than their own average level across the two weeks. Daily process level mechanisms allow greater insight into factors contributing to increased risk in-the-moment, which may point to targets for interventions aimed at improving adolescents' and young adults' abilities to make healthier choices in moments when they may be at greater risk for engaging in risky behaviors.



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The within-person association between alcohol use and sleep duration and quality in situ: An experience sampling study

Publication date: October 2016
Source:Addictive Behaviors, Volume 61
Author(s): David M. Lydon, Nilam Ram, David E. Conroy, Aaron L. Pincus, Charles F. Geier, Jennifer L. Maggs
ObjectiveDespite evidence for detrimental effects of alcohol on sleep quality in laboratory studies, alcohol is commonly used as a self-prescribed sleep aid. This study examined the within-person associations of alcohol use with sleep duration and quality in everyday life to gain insight into the ecological validity of laboratory findings on the association between sleep and alcohol.MethodA sample of 150 adults (age 19–89years) were followed for 60+days as part of an intensive experience sampling study wherein participants provided daily reports of their alcohol use, sleep duration, and sleep quality. Within-person and between-person associations of daily sleep duration and quality with alcohol use were examined using multilevel models.ResultsA significant, negative within-person association was observed between sleep quality and alcohol use. Sleep quality was lower on nights following alcohol use. Sleep duration did not vary as a function of within-person variation in alcohol use.ConclusionsIn line with laboratory assessments, alcohol use was associated with low sleep quality but was not associated with sleep duration, suggesting that laboratory findings generalize to everyday life. This examination of individuals' daily lives suggests that alcohol does not systematically improve sleep quality or duration in real life.



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Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China

Publication date: October 2016
Source:Addictive Behaviors, Volume 61
Author(s): Songli Mei, Yvonne H.C. Yau, Jingxin Chai, Jinhua Guo, Marc N. Potenza
Given the prevalence of Internet use among youth, there is concern that a subset of Internet-using youth may exhibit problematic or addictive patterns of Internet use. The present study examines the association between problematic Internet use (PIU), demographic variables, and health-related measures among Chinese adolescents. Survey data from 1552 adolescents (male=653, mean age=15.43years) from Jilin Province, China, were collected. According to the Young Diagnostic Questionnaire for Internet Addiction (YDQ), 77.8% (n=1207), 16.8% (n=260), and 5.5% (n=85) showed adaptive, maladaptive, and problematic Internet use, respectively. Multinomial logistic regression analysis revealed that gender and family income per month differed between youth showing problematic and adaptive patterns of Internet use. Well-being, self-esteem, and self-control were related to severity of problematic Internet use, with greater severity typically associated with poorer measures in each domain. The findings that severity of problematic Internet use is associated with specific socio-demographic features and temperamental and well-being measures suggest that specific groups of youth may be particularly vulnerable to developing problematic Internet use. Early prevention/intervention programs targeting at-risk groups may help improve public health.



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Ethical considerations and potential threats to validity for three methods commonly used to collect geographic information in studies among people who use drugs

Publication date: October 2016
Source:Addictive Behaviors, Volume 61
Author(s): Abby E. Rudolph, Angela Robertson Bazzi, Sue Fish
BackgroundAnalyses with geographic data can be used to identify "hot spots" and "health service deserts", examine associations between proximity to services and their use, and link contextual factors with individual-level data to better understand how environmental factors influence behaviors. Technological advancements in methods for collecting this information can improve the accuracy of contextually-relevant information; however, they have outpaced the development of ethical standards and guidance, particularly for research involving populations engaging in illicit/stigmatized behaviors. Thematic analysis identified ethical considerations for collecting geographic data using different methods and the extent to which these concerns could influence study compliance and data validity.MethodsIn-depth interviews with 15 Baltimore residents (6 recruited via flyers and 9 via peer-referral) reporting recent drug use explored comfort with and ethics of three methods for collecting geographic information: (1) surveys collecting self-reported addresses/cross-streets, (2) surveys using web-based maps to find/confirm locations, and (3) geographical momentary assessments (GMA), which collect spatiotemporally referenced behavioral data.ResultsSurvey methods for collecting geographic data (i.e., addresses/cross-streets and web-based maps) were generally acceptable; however, participants raised confidentiality concerns regarding exact addresses for illicit/stigmatized behaviors. Concerns specific to GMA included burden of carrying/safeguarding phones and responding to survey prompts, confidentiality, discomfort with being tracked, and noncompliance with study procedures. Overall, many felt that confidentiality concerns could influence the accuracy of location information collected for sensitive behaviors and study compliance.ConclusionsConcerns raised by participants could result in differential study participation and/or study compliance and questionable accuracy/validity of location data for sensitive behaviors.



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Minority stress is longitudinally associated with alcohol-related problems among sexual minority women

Publication date: October 2016
Source:Addictive Behaviors, Volume 61
Author(s): Sarah M. Wilson, Amanda K. Gilmore, Isaac C. Rhew, Kimberley A. Hodge, Debra L. Kaysen
Compared to sexual minority men and heterosexual women, sexual minority women report elevated alcohol use in young adulthood. Heavy alcohol use and alcohol use disorders disproportionately affect sexual minority women across the lifespan, yet there is limited research investigating reasons for such associations. The present study investigates longitudinal associations between minority stress and both alcohol use as well as self-rated drinking consequences. Participants (N=1057) were self-identified lesbian (40.5%) and bisexual (59.5%) women between the ages of 18 to 25 recruited from across the U.S. using online advertisements. Participants completed four annual surveys. Hurdle mixed effects models were used to assess associations between minority stress and typical weekly drinking and drinking consequences one year later. Minority stress was not significantly associated with subsequent typical drinking. However, minority stress was significantly associated with having any alcohol consequences as well as the count of alcohol consequences one year later after controlling for covariates. Consistent with extant literature, this study provides evidence for a prospective association between minority stress experienced by sexual minority women and drinking consequences. This study also provides support for the potential impact of efforts to reduce minority stress faced by sexual minority women.



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Comprehensive Solution for Transient Flow in Heterogeneous Porous Media

Abstract

Solutions of the hydraulic diffusivity equation are of utmost importance for many reservoir engineering problems. Despite all the efforts, there is still a need for the development of rigorous and comprehensive solutions for transient flow problems in heterogeneous oil reservoirs. This study demonstrates the use of an integral transform approach to obtain such a rigorous and comprehensive solution for the hydraulic diffusivity equation in heterogeneous porous domain. The reservoir heterogeneities can be approximated by any continuous differentiable function. The presented general solution and its derivation are valid for multi-dimensional problems in any orthogonal coordinate system. It has the advantage of rigorously solving the hydraulic diffusivity equation for transient, late-transient and steady-state (or pseudo-steady-state) flow regimes in a single formulation that allows the consideration of variable flowrates. In this work, applications of the general solution for one-dimensional problems in the Cartesian and radial coordinate systems are presented, showing comparisons of the results obtained with a finite difference numerical scheme. The solution presented can be used to analyze buildup, drawdown and interference test data, making it a useful tool for pressure transient analysis applied to reservoir engineering problems.

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Generation of Marked and Markerless Mutants in Model Cyanobacterial Species

Introducing multiple genomic alterations into cyanobacteria is an essential tool in the development of strains for industrial and basic research purposes. We describe a system for generating unmarked mutants in the model cyanobacterial species Synechocystis sp. PCC6803 and marked mutants in Synechococcus sp. PCC7002.

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Cognitive differences between Sprague-Dawley rats selectively bred for sensitivity or resistance to diet induced obesity

Publication date: 15 September 2016
Source:Behavioural Brain Research, Volume 311
Author(s): Sunam Gurung, Martin-Paul Agbaga, Dean A. Myers
Epidemiological studies have shown strong correlations between high fat diets, diet-induced obesity and cognitive impairment, primarily focusing on cognitive defects after the onset of obesity. A remaining question is whether cognitive impairment precedes obesity in individuals metabolically prone to diet-induced obesity. The inbred diet-induced obesity sensitive (DIO) and resistant (DR) strains of Sprague-Dawley rats serve as models for human polygenic obesity. DIO rats become overweight on a standard rat chow and have metabolic symptoms similar to overweight humans. We hypothesized that cognitive impairment pre-exists in adult male DIO rats prior to exposure to high fat diet. Male DIO and DR rats were fed a standard rat chow diet from 4 through 20 weeks of age and subjected to the Morris water maze at 12 weeks of age. At 5 and 20 weeks of age, brains of DIO and DR males were examined for indices of inflammation, lipid peroxidation and neuroproliferation. DIO rats showed significant memory impairment on water maze and increased indices of hippocampal inflammation at 20 weeks of age compared to DR rats. At 5 weeks of age, DIO rats exhibited significantly less neural progenitor cell (NPCs) proliferation in the dentate gyrus and increased hippocampal lipid peroxidation compared to DR rats. Therefore, we conclude that DIO rats exhibit early post-weaning indices of hippocampal inflammation, lipid peroxidation and decreased NPC proliferation, as well as impaired hippocampal dependent memory by early adulthood suggesting that inherent metabolic differences predispose the DIO strain to cognitive deficit prior to exposure to high fat diet and/or obesity.



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A Miniaturized Glycan Microarray Assay for Assessing Avidity and Specificity of Influenza A Virus Hemagglutinins

Using a printed glycan microarray strategy, a conventional 96-well plate assay was miniaturized for analysis of influenza A virus hemagglutinin avidity and specificity for sialic acid containing receptors.

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Minor salivary glands function is decreased in hyposalivation-related diseases

Publication date: September 2016
Source:Archives of Oral Biology, Volume 69
Author(s): Zhen Wang, Wei Li, Xia Hong, Jia-Zeng Su, Hong Hua, Xin Peng, Lan Lv, Guang-Yan Yu
ObjectivesThe aim of this cross-sectional study was to investigate the relationship between minor salivary gland (MSG) flow rates and oral dryness degrees in patients with xerostomia induced by primary Sjögren's syndrome (pSS), IgG4-related sialadenitis (IgG4-RS), radiation therapy-induced dry mouth (RTDM), or Steven–Johnson syndrome (SJS).Design160 patients with pSS, IgG4-RS, RTDM, or SJS and their age- and sex-matched healthy control subjects were enrolled. The whole saliva flow rates and MSG flow rates were measured in four locations, including the upper labial, lower labial, buccal, and palatal mucosae. The degree of oral dryness was assessed in patient groups using the summated xerostomia inventory (SXI).ResultsThe flow rates of whole saliva and most MSGs in patient groups were significantly lower than the flow rates in healthy control groups (P<0.05). The mean relative percentage of decrease in saliva flow rates was smaller in MSGs than in whole saliva in patient groups (P<0.05), indicating that these disorders have less impact on MSGs. Among the four MSG locations (the upper labial, lower labial, buccal, and palatal), buccal glands showed the highest flow rates in patient groups (P<0.05). SXI scores were significantly higher in pSS and RTDM patients than in IgG4-RS and SJS patients (P<0.05). The degree of xerostomia varied among different patient groups (P<0.05) and there was no clear correlation between MSG flow rates and SXI scores (P>0.05).ConclusionsMSG function is significantly reduced in pSS, RTDM, IgG4-RS, and SJS patients, but this reduction is more pronounced in the major salivary glands.



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Genistein as antioxidant and antibrowning agents in in vivo and in vitro: A review

Publication date: August 2016
Source:Biomedicine & Pharmacotherapy, Volume 82
Author(s): Md. Anisur Rahman Mazumder, Parichat Hongsprabhas
Genistein is a phytoestrogen with diverse biological activities. It is a potent antioxidant and antibrowning agent in in vivo and in vitro. Genistein acts as a preventative and therapeutic effects for cancers, postmenopausal syndrome, osteoporosis and cardiovascular diseases in animals and humans. Gensitein possesses cancer related enzyme-inhibitory effect and substantially inhibits skin carcinogenesis and cutaneous aging induced by ultraviolet (UV) light in mice and photodamage in humans. Two-stage skin carcinogenesis showed genistein exhibited a moderate inhibition of ornithine decarboxylase activity through blockage of DNA adducts formation. The anticancer, anti-inflammatory, cardio-protective and enzyme-inhibitory effects of genistein might be related to their antioxidant activities. Genistein also altered the Maillard reaction pathway by trapping the advanced glycation end products (AGEs) both in biological and protein-lactose suspensions. As a result, soy isoflavone can be used to enrich or fortify different types of food products.

Graphical abstract

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Eupatilin inhibits the apoptosis in H9c2 cardiomyocytes via the Akt/GSK-3β pathway following hypoxia/reoxygenation injury

Publication date: August 2016
Source:Biomedicine & Pharmacotherapy, Volume 82
Author(s): Zengyong Qiao, Ya-wei Xu, Jingyu Yang
Eupatilin, a pharmacologically active flavone derived from the Artemisia plant species, has been reported to have anti-oxidant, anti-inflammatory, anti-allergic, and neuroprotective activities against cerebral ischemia/reperfusion (I/R). However, the role of eupatilin in myocardial I/R injury remains unclear. In the present study, we aimed to investigate the potential molecular mechanisms against hypoxia/reoxygenation (H/R) induced cardiomyocytes apoptosis in vitro. Our results showed that eupatilin markedly improved the cell viability and decreased lactate dehydrogenase (LDH) release. Eupatilin also suppressed oxidative stress and apoptosis in H9c2 cells after myocardial I/R injury. Furthermore, eupatilin obviously increased the phosphorylation of Akt and GSK-3β in H9c2 cells. Our results suggested that eupatilin could provide significant cardioprotection against myocardial I/R injury, and the potential mechanisms might involve inhibition of cardiomyocyte apoptosis through activating the Akt/GSK-3β signaling pathway.



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Performance and Carcass Characteristics of Rabbits Fed Graded Levels of Balsam Apple (Mormodica balsamina)

2016-05-29T10-30-44Z
Source: International Journal of Livestock Research
Maryam Mainasara Mikailu, Khalifa Muhammad Aljameel, Shehu Ahmad Maigandi, Nasiru Muhammad, Ibrahim Abubakar Anka.
An experiment was conducted to evaluate the effect of graded levels of Mormodica balsamina on performance and carcass characteristics of rabbits. The animals were fed diets containing 0, 2.5, 5 and 7.5% inclusion levels of M. balsamina in a completely randomized experimental design replicated five times. Data were collected for 12 consecutive weeks on feed intake and live weight gain. At the end of the feeding trial, three (3) animals were selected for carcass evaluation. With the exception of feed conversion ratio and final weight gain, results indicated no significant difference between the treatments on all performance parameters (P>0.05), Carcass evaluation shows significant effect on weight of liver and lungs (P


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Ischemic Stroke in Confederation with Trivial Head Trauma

Minor head injuries in children are common, resulting in brain concussion, and these injuries mostly end up without complications. Usually head trauma results in hemorrhagic stroke. Here we present a case of ischemic stroke following a trivial head trauma. A 10-month-old girl presented with posttraumatic right sided hemiparesis with right sided facial palsy. MRI brain revealed an area of acute infarct in the left capsuloganglionic region. The child was initially managed conservatively, as the hematological parameters were normal, and was started on anticoagulant therapy. An improvement in the clinical condition was achieved in 12 hrs of treatment with gain in power and resolution of weakness in 10 days. The specific cause for hemiparesis in the child is not elicited; possibility of genetic and environmental factors can be attributable.

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Analysis of Nerve Agent Metabolites from Hair for Long-Term Verification of Nerve Agent Exposure

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b01274

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Lactate Dehydrogenase in Hepatocellular Carcinoma: Something Old, Something New

Hepatocellular carcinoma (HCC) is the most common primary liver tumour (80–90%) and represents more than 5.7% of all cancers. Although in recent years the therapeutic options for these patients have increased, clinical results are yet unsatisfactory and the prognosis remains dismal. Clinical or molecular criteria allowing a more accurate selection of patients are in fact largely lacking. Lactic dehydrogenase (LDH) is a glycolytic key enzyme in the conversion of pyruvate to lactate under anaerobic conditions. In preclinical models, upregulation of LDH has been suggested to ensure both an efficient anaerobic/glycolytic metabolism and a reduced dependence on oxygen under hypoxic conditions in tumour cells. Data from several analyses on different tumour types seem to suggest that LDH levels may be a significant prognostic factor. The role of LDH in HCC has been investigated by different authors in heterogeneous populations of patients. It has been tested as a potential biomarker in retrospective, small, and nonfocused studies in patients undergoing surgery, transarterial chemoembolization (TACE), and systemic therapy. In the major part of these studies, high LDH serum levels seem to predict a poorer outcome. We have reviewed literature in this setting trying to resume basis for future studies validating the role of LDH in this disease.

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Comparison of Neuroprotective Effect of Bevacizumab and Sildenafil following Induction of Stroke in a Mouse Model

To evaluate the effect of bevacizumab and sildenafil on stroke parameters in a mouse model, middle cerebral artery occlusion was induced in male C57Bl/6 mice using an intra-arterial filament method. The filament was removed after 60 minutes, and the mice were immediately given a single intraperitoneal injection of saline, bevacizumab, or sildenafil. An additional group of mice () received bevacizumab 6 h after MCAO induction. The mice were euthanized 24 hours later and evaluated for infarct area and brain edema using triphenyltetrazolium chloride staining and ImageJ. In the saline-treated mice (), total stroke volume was  mm3, mean penumbra area was  mm3, and hemispheric asymmetry was 106.5%. Corresponding values in the bevacizumab group () were  mm3,  mm3, and 108.6%; in the delayed (6 h) bevacizumab injected mice () they were  mm3,  mm3, and 98.2%; and in the sildenafil group () they were  mm3,  mm3, and 109.9%. The bevacizumab group had a significantly larger mean penumbra area when given immediately and smaller total stroke area in both groups than the saline- () and sildenafil-treated () groups. Only delayed bevacizumab group had reduced edema. Bevacizumab, injected immediately or delayed after injury, exerts a neuroprotective/salvage effect, whereas immediate treatment with sildenafil does not. Inflammation may play a role in the neuroprotective effect.

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Scientific evidence on the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in oral and maxillofacial surgery

Abstract

Purpose

This study aimed to identify the main indications for the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for bone repair and maintenance in the maxilla and mandible through a review of clinical trials evaluating the viability of using rhBMP-2 to delay the installation of dental implants, thus allowing satisfactory bone formation and long-term osseointegration.

Methods

Literature search of the PubMed/Medline databases was performed using the following MeSH index terms—"bone morphogenetic protein 2" and "dentistry". Only clinical trials necessarily published in English, related to dentistry, and focused on bone reconstruction in critical defects, post-extraction alveoli, increasing the atrophic alveolar ridge, or surgery for maxillary sinus elevation were included, regardless of the age, sex, ethnicity, associated morbidities, or period of publication.

Results

Of the 17 studies identified based on the search filters, 2 were excluded. Therefore, 15 studies were finally included in this review.

Conclusions

Based on the results of our review, we concluded that the use of rhBMP-2 for the preservation of the alveolar ridge after tooth extraction or for increasing the local defects is safe and viable. The use of rhBMP-2/Bio-Oss® for the elevation of the maxillary sinus membrane is unnecessary; however, it can improve and accelerate the maturation process in cases of guided bone regeneration in peri-implant defects. Compounds comprising rhBMP-2, allogenic bone, and plasma-rich platelet (PRP) can act as autograft substitutes in mandibular critical defects.

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Endoscopic Septoplasty—Two Handed Technique with Endoscope Holder: A Novel Approach

Abstract

The popularity of endoscopes has been expanding not only in diagnostics but also in therapeutics. The traditional septal surgery also has come under the purview of endoscopic surgery in the last few decades. Endoscopic septoplasty has definitely many advantages over the conventional procedure. But the only disadvantage of endoscopic surgery is that it is a single handed technique as the other hand is used for holding the endoscope which may compromise the overall surgical time as the hemostasis and suctioning of the surgical field off the blood cannot be done simultaneously, in addition to the surgeon fatigue associated with holding the endoscope in the left hand. Endoscope holder allows both hands of the surgeon to be free for surgical manipulation and also imitates more or less same actions of the left hand. To report the preliminary use of Khan's endoscope holder for endoscopic septoplasty. Prospective Non Randomized Clinical Study. Khan's Endoscope Holder, which was primarily designed for endoscopic ear surgery, has been used for two handed technique of endoscopic septoplasty. The design of the Endoscope holder is described in detail. A total of 49 endoholder assisted endoscopic septoplasties were operated from Nov 2014 to Jan 2015 in MIMER Medical College and Sushrut ENT Hospital, Talegaon D, Pune, India. Our Endoscope Holder is a good option for two handed technique in Endoscopic Septoplasty due to its advantages. The study reports the successful usage and applicability of the endo holder for endoscopic Septoplasty.

Level of evidence IV.

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A Case of Leukocytoclastic Vasculitis Caused by Listeria monocytogenes Bacteremia

Importance. Infections can cause leukocytoclastic vasculitis. Observations. We report the case of a patient with a left ventricular assist device who presented with acute kidney injury and biopsy proven leukocytoclastic vasculitis. Blood cultures grew Listeria monocytogenes. The patient's rash improved with treatment of the underlying Listeria infection. Conclusion. Clinicians should be aware that there are a number of broad categories of disease associated with the histologic finding of vasculitis, including infection. It is important to keep in mind the risk factors of a particular patient when formulating a differential diagnosis. This is the first reported case of Listeria bacteremia causing leukocytoclastic vasculitis.

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Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature

Syphilis is a sexually transmitted infection that remains fairly commonplace. The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV), syphilis is now on a resurgence with sometimes curious presentations. We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis. Skin lesions were reminiscent of "malignant" syphilis. CD4 count was 57 cells/μL. RPR was elevated with 1 : 64 titer and positive confirmatory TP-PA. Radiography of the limbs revealed polyostotic cortical irregularities corroborated on bone scintigraphy. The patient had an unknown penicillin allergy and was unwilling to conduct a trial of penicillin-based therapy. He was subsequently treated with doxycycline 100 mg twice daily for 6 weeks and commenced antiretroviral therapy, noting dramatic improvement in both the skin lesions and joint pains. Unfortunately, he defaulted on follow-up, precluding serial RPR and bone imaging. Penicillin allergies have proven to be quite a conundrum in such patients, without much recourse for alternative therapy. Doxycycline with/without azithromycin is other options worth considering.

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Tumour control and Quality of Life in children with rhabdomyosarcoma treated with pencil beam scanning proton therapy

Publication date: Available online 28 May 2016
Source:Radiotherapy and Oncology
Author(s): Dominic Leiser, Gabriele Calaminus, Robert Malyapa, Beat Bojaxhiu, Francesca Albertini, Ulrike Kliebsch, Lorentzos Mikroutsikos, Petra Morach, Alessandra Bolsi, Marc Walser, Beate Timmermann, Tony Lomax, Ralf Schneider, Damien C. Weber
PurposeTo assess clinical outcomes in children with rhabdomyosarcoma (RMS) treated with pencil beam scanning (PBS) proton therapy (PT).Methods and materialsEighty-three RMS (embryonal, n=74; 89%) patients treated between January 2000 and December 2014 were included. The median age was 4.5years (range, 0.8–15.5). All patients received systemic chemotherapy according to prospective protocols. Patients had low-, intermediate-, and high-risk disease in 24%, 63%, and 13% of cases, respectively. The median total dose delivered was 54Gy(RBE) (range, 41.4–64.8).ResultsAfter a median follow-up time of 55.5 months (range, 0.9–126.3), local failure occurred in 16 patients. The 5-year local-control survival rate was 78.5% [95% confidence interval (CI), 69.5–88.5%]. Significant predictors for local failure were group/stage, tumour location, and size. Fourteen patients (16%) died, all from tumour progression. The 5-year overall survival was 80.6% (95%CI, 71.8–90.0%). The 5-year incidence of grade 3 non-ocular late toxicity was 3.6% (95%CI, 1–12%). No grade 4–5 late toxicities were observed. One radiation-induced malignancy was observed (1.2%). The Quality of Life (QoL) scores increased significantly after PT compared to baseline values.ConclusionsPBS PT led to excellent outcome in children with RMS. Late non-ocular toxicity was minimal and QoL good.



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Tibolone protects astrocytic cells from glucose deprivation through a mechanism involving estrogen receptor beta and the upregulation of neuroglobin expression

Publication date: Available online 29 May 2016
Source:Molecular and Cellular Endocrinology
Author(s): Marco Avila-Rodriguez, Luis Miguel Garcia-Segura, Oscar Hidalgo-lanussa, Eliana Baez, Janneth Gonzalez, George E. Barreto
Tibolone, a synthetic steroid used for the prevention of osteoporosis and the treatment of climacteric symptoms in post-menopausal women, may exert tissue selective estrogenic actions acting on estrogen receptors (ERs). We previously showed that tibolone protects human T98G astroglial cells against glucose deprivation (GD). In this study we have explored whether the protective effect of tibolone on these cells is mediated by ERs. Experimental studies showed that both ERα and ERβ were involved in the protection by tibolone on GD cells, being ERβ preferentially involved on these actions over ERα. Tibolone increased viability of GD cells by a mechanism fully blocked by an ERβ antagonist and partially blocked by an ERα antagonist. Furthermore, ERβ inhibition prevented the effect of tibolone on nuclear fragmentation, ROS and mitochondrial membrane potential in GD cells. The protective effect of tibolone was mediated by neuroglobin. Tibolone upregulated neuroglobin in T98G cells and primary mouse astrocytes by a mechanism involving ERβ and neuroglobin silencing prevented the protective action of tibolone on GD cells. In summary, tibolone protects T98G cells by a mechanism involving ERβ and the upregulation of neuroglobin.



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APPL1-mediated activation of STAT3 contributes to inhibitory effect of adiponectin on hepatic gluconeogenesis

Publication date: Available online 28 May 2016
Source:Molecular and Cellular Endocrinology
Author(s): Youming Ding, Deling Zhang, Bin Wang, Yemin Zhang, Lei Wang, Xiaoyan Chen, Mingxin Li, Zhao Tang, Changhua Wang
Adiponectin has been shown to suppress hepatic gluconeogenesis. However, the signaling pathways underlying its action remain ill-defined. The purpose of this study was to examine the potential role of APPL1 in mediating anti-gluconeogenic ability of adiponectin. Primary hepatocytes were isolated from male C57BL/6 mice. Western blot and RT-PCR were performed to detect protein expression and mRNA level, respectively. The protein-protein association was determined by immunoprecipitation and GST pull-down assay. We found that APPL1 protein levels were negatively associated with expressions of proteins and mRNAs of gluconeogenesis enzymes under stimulation with adiponectin. In addition, adiponectin-stimulated STAT3 phosphorylation and acetylation were positively regulated by APPL1 and negative regulated by SirT1. Pharmacological and genetic inhibition of STAT3 mitigated impact of adiponectin on hepatic gluconeogenesis. Furthermore, adiponectin administration facilitated the binding of APPL1 to SirT1 and suppressed the association of SirT1 with STAT3. Taken together, our study showed that APPL1-SirT1-STAT3 pathway mediated adiponectin signaling in primary hepatocytes. This new finding provides a novel mechanism by which adiponectin suppresses hepatic gluconeogenesis.



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