Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Σάββατο 8 Απριλίου 2017
Hematopoietic stem cell transplantation in advanced cutaneous T-cell lymphoma
Abstract
We retrospectively reviewed data pertaining to five patients with cutaneous T-cell lymphoma (CTCL) who had received hematopoietic stem cell transplantation (HSCT) between 2004 and 2015 at Kurume University Hospital, along with their clinical data until March 2016. For patients with advanced CTCL eligible for HSCT, autologous HSCT was performed when they responded well to chemotherapy, and allogeneic HSCT was selected for patients with advanced mycosis fungoides (MF)/Sézary syndrome (SS) and CTCL other than MF/SS with poor chemosensitivity. Two patients (primary cutaneous anaplastic large cell lymphoma and primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma) who responded well to chemotherapy received autologous HSCT: one patient was alive in partial remission and the other died due to therapy-related acute myeloid leukemia without disease relapse. In the remaining three patients with MF or SS, allogeneic HSCT was performed. Although one patient with MF died due to disease progression, the remaining two patients were alive in complete remission. Although there were two deaths in this study, the outcomes were considered satisfactory.
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Identification of a heterozygous p.Gly568Val missense mutation in the TRPV3 gene in a Japanese patient with Olmsted syndrome: In silico analysis of TRPV3
Abstract
Olmsted syndrome is a very rare congenital disorder, characterized by palmoplantar keratoderma and periorificial keratotic lesions. Recently, TRPV3 was reported to be a causative gene of Olmsted syndrome. We identified a heterozygous missense mutation of TRPV3, c.1703G>T, p.Gly568Val, in a Japanese patient with Olmsted syndrome. To the best of our knowledge, this is the first report of a Japanese patient with Olmsted syndrome harboring a missense mutation in TRPV3. We conducted in silico analysis of TRPV3 to evaluate whether the p.Gly568Val leads to structural changes in the TRPV3 selectivity filter. The selectivity filter was shown to become dilated and hyperpermeable as a result of genetic mutation (p.Gly573Ser, p.Tr692Gly or p.Gly568Val) as well as after a change in temperature (300 K to 310 K). In silico analysis of TRPV3 could be a useful approach in predicting mutation-induced activated states of ion channels, and thus enrich our understanding of the pathogenesis of Olmsted syndrome.
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Apremilast, an oral phosphodiesterase 4 inhibitor, in the treatment of Japanese patients with moderate to severe plaque psoriasis: Efficacy, safety and tolerability results from a phase 2b randomized controlled trial
Abstract
Apremilast, an oral, small-molecule phosphodiesterase 4 inhibitor, works intracellularly within immune cells to regulate inflammatory mediators. This phase 2b randomized, placebo-controlled study evaluated efficacy and safety of apremilast among Japanese patients with moderate to severe plaque psoriasis. In total, 254 patients were randomized to placebo, apremilast 20 mg b.i.d. (apremilast 20) or apremilast 30 mg b.i.d. (apremilast 30) through week 16; thereafter, all placebo patients were re-randomized to apremilast 20 or 30 through week 68. Efficacy assessments included achievement of 75% or more reduction from baseline in Psoriasis Area and Severity Index score (PASI-75; primary) and achievement of static Physician Global Assessment (sPGA; secondary) score of 0 (clear) or 1 (minimal) at week 16. Safety was assessed through week 68. At week 16, PASI-75 response rates were 7.1% (placebo), 23.5% (apremilast 20; P = 0.0032 vs placebo) and 28.2% (apremilast 30; P = 0.0003 vs placebo); sPGA response rates (score of 0 or 1) were 8.8% (placebo), 23.9% (apremilast 20; P = 0.0165 vs placebo) and 29.6% (apremilast 30; P = 0.0020 vs placebo). Responses were maintained with apremilast through week 68. Most common adverse events (AEs) with placebo, apremilast 20 and apremilast 30 (0–16 weeks) were nasopharyngitis (8.3%, 11.8%, 11.8%), diarrhea (1.2%, 8.2%, 9.4%), and abdominal discomfort (1.2%, 1.2%, 7.1%), respectively. Exposure-adjusted incidence of these AEs did not increase with continued apremilast treatment (up to 68 weeks). Apremilast demonstrated efficacy and safety in Japanese patients with moderate to severe plaque psoriasis through 68 weeks that was generally consistent with prior studies.
http://ift.tt/2nPN3ZK
Hematopoietic stem cell transplantation in advanced cutaneous T-cell lymphoma
Abstract
We retrospectively reviewed data pertaining to five patients with cutaneous T-cell lymphoma (CTCL) who had received hematopoietic stem cell transplantation (HSCT) between 2004 and 2015 at Kurume University Hospital, along with their clinical data until March 2016. For patients with advanced CTCL eligible for HSCT, autologous HSCT was performed when they responded well to chemotherapy, and allogeneic HSCT was selected for patients with advanced mycosis fungoides (MF)/Sézary syndrome (SS) and CTCL other than MF/SS with poor chemosensitivity. Two patients (primary cutaneous anaplastic large cell lymphoma and primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma) who responded well to chemotherapy received autologous HSCT: one patient was alive in partial remission and the other died due to therapy-related acute myeloid leukemia without disease relapse. In the remaining three patients with MF or SS, allogeneic HSCT was performed. Although one patient with MF died due to disease progression, the remaining two patients were alive in complete remission. Although there were two deaths in this study, the outcomes were considered satisfactory.
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Identification of a heterozygous p.Gly568Val missense mutation in the TRPV3 gene in a Japanese patient with Olmsted syndrome: In silico analysis of TRPV3
Abstract
Olmsted syndrome is a very rare congenital disorder, characterized by palmoplantar keratoderma and periorificial keratotic lesions. Recently, TRPV3 was reported to be a causative gene of Olmsted syndrome. We identified a heterozygous missense mutation of TRPV3, c.1703G>T, p.Gly568Val, in a Japanese patient with Olmsted syndrome. To the best of our knowledge, this is the first report of a Japanese patient with Olmsted syndrome harboring a missense mutation in TRPV3. We conducted in silico analysis of TRPV3 to evaluate whether the p.Gly568Val leads to structural changes in the TRPV3 selectivity filter. The selectivity filter was shown to become dilated and hyperpermeable as a result of genetic mutation (p.Gly573Ser, p.Tr692Gly or p.Gly568Val) as well as after a change in temperature (300 K to 310 K). In silico analysis of TRPV3 could be a useful approach in predicting mutation-induced activated states of ion channels, and thus enrich our understanding of the pathogenesis of Olmsted syndrome.
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Apremilast, an oral phosphodiesterase 4 inhibitor, in the treatment of Japanese patients with moderate to severe plaque psoriasis: Efficacy, safety and tolerability results from a phase 2b randomized controlled trial
Abstract
Apremilast, an oral, small-molecule phosphodiesterase 4 inhibitor, works intracellularly within immune cells to regulate inflammatory mediators. This phase 2b randomized, placebo-controlled study evaluated efficacy and safety of apremilast among Japanese patients with moderate to severe plaque psoriasis. In total, 254 patients were randomized to placebo, apremilast 20 mg b.i.d. (apremilast 20) or apremilast 30 mg b.i.d. (apremilast 30) through week 16; thereafter, all placebo patients were re-randomized to apremilast 20 or 30 through week 68. Efficacy assessments included achievement of 75% or more reduction from baseline in Psoriasis Area and Severity Index score (PASI-75; primary) and achievement of static Physician Global Assessment (sPGA; secondary) score of 0 (clear) or 1 (minimal) at week 16. Safety was assessed through week 68. At week 16, PASI-75 response rates were 7.1% (placebo), 23.5% (apremilast 20; P = 0.0032 vs placebo) and 28.2% (apremilast 30; P = 0.0003 vs placebo); sPGA response rates (score of 0 or 1) were 8.8% (placebo), 23.9% (apremilast 20; P = 0.0165 vs placebo) and 29.6% (apremilast 30; P = 0.0020 vs placebo). Responses were maintained with apremilast through week 68. Most common adverse events (AEs) with placebo, apremilast 20 and apremilast 30 (0–16 weeks) were nasopharyngitis (8.3%, 11.8%, 11.8%), diarrhea (1.2%, 8.2%, 9.4%), and abdominal discomfort (1.2%, 1.2%, 7.1%), respectively. Exposure-adjusted incidence of these AEs did not increase with continued apremilast treatment (up to 68 weeks). Apremilast demonstrated efficacy and safety in Japanese patients with moderate to severe plaque psoriasis through 68 weeks that was generally consistent with prior studies.
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The Demographic Study of Otorhinolaryngological Trauma Among Patients with Head and Neck Trauma and Their Management in a Tertiary Care Centre
Abstract
The trauma has been increasing in frequency, especially in recent decades because of the higher number of automobile accidents and violence. The ear, nose and face region is the area in the body that is commonly involved in head and neck injury. Trauma to this region is often associated with mortality and varying degree of physical, functional and psychological damage. To study the demography, aetiology, clinical presentation, outcome of ENT trauma in our tertiary care centre and to compare our study with previous studies to see the changing trends with passage of time. A prospective study was conducted on 200 head and neck patients with ENT injuries during a period of 1 year from July 2014 to July 2015, who were admitted in ENT Department and Trauma Centre of Gajra Raja Medical College and J.A. Group of Hospital, Gwalior. Most of the patients were young adult males of age group 18–40 years (45, 22.5%) with a male:female ratio 1.78:1. Among them 53% patients were from rural area while 47% were from urban area. RTA is the most prevalent cause of ENT trauma (37%), followed by interpersonal violence (25%). 27% of the patients had facial injury and multiple region injury each. Among 200 patients 33% were managed conservatively on the other hand 66% patients required surgical interventions. Mortality rate was 8%. Among all 184 survivors 25.5% suffered from hearing loss, 14.5% had tympanic membrane perforation with hearing loss, 12% had pinna disfigurement, 10% had change in voice, 6.5% had permanent nasal deformity, 2% had facial nerve palsy. Young male adults were the most prevalent victims of ENT trauma, and Road traffic accidents were responsible for majority of the ENT injuries. Screening of all the patients with head and neck injuries for the presence of trauma in the ENT region should be introduced to enable early detection and therefore prevention of complications.
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The Demographic Study of Otorhinolaryngological Trauma Among Patients with Head and Neck Trauma and Their Management in a Tertiary Care Centre
Abstract
The trauma has been increasing in frequency, especially in recent decades because of the higher number of automobile accidents and violence. The ear, nose and face region is the area in the body that is commonly involved in head and neck injury. Trauma to this region is often associated with mortality and varying degree of physical, functional and psychological damage. To study the demography, aetiology, clinical presentation, outcome of ENT trauma in our tertiary care centre and to compare our study with previous studies to see the changing trends with passage of time. A prospective study was conducted on 200 head and neck patients with ENT injuries during a period of 1 year from July 2014 to July 2015, who were admitted in ENT Department and Trauma Centre of Gajra Raja Medical College and J.A. Group of Hospital, Gwalior. Most of the patients were young adult males of age group 18–40 years (45, 22.5%) with a male:female ratio 1.78:1. Among them 53% patients were from rural area while 47% were from urban area. RTA is the most prevalent cause of ENT trauma (37%), followed by interpersonal violence (25%). 27% of the patients had facial injury and multiple region injury each. Among 200 patients 33% were managed conservatively on the other hand 66% patients required surgical interventions. Mortality rate was 8%. Among all 184 survivors 25.5% suffered from hearing loss, 14.5% had tympanic membrane perforation with hearing loss, 12% had pinna disfigurement, 10% had change in voice, 6.5% had permanent nasal deformity, 2% had facial nerve palsy. Young male adults were the most prevalent victims of ENT trauma, and Road traffic accidents were responsible for majority of the ENT injuries. Screening of all the patients with head and neck injuries for the presence of trauma in the ENT region should be introduced to enable early detection and therefore prevention of complications.
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Thymus Transplantation for Complete Digeorge Syndrome: European Experience
Source:Journal of Allergy and Clinical Immunology
Author(s): E Graham Davies, Melissa Cheung, Kimberly Gilmour, Jesmeen Maimaris, Joe Curry, Anna Furmanski, Neil Sebire, Neil Halliday, Konstantinos Mengrelis, Stuart Adams, Jolanta Bernatoniene, Ronald Bremner, Michael Browning, Blythe Devlin, Hans Christian Erichsen, H Bobby Gaspar, Lizzie Hutchison, Winnie Ip, Marianne Ifversen, T Ronan Leahy, Elizabeth McCarthy, Despina Moshous, Kim Neuling, Malgorzata Pac, Alina Papadopol, Kathryn L. Parsley, Luigi Poliani, Ida Ricciardelli, David M. Sansom, Tiia Voor, Austen Worth, Tessa Crompton, M Louise Markert, Adrian J. Thrasher
BackgroundThymus transplantation is a promising strategy for the treatment of athymic complete DiGeorge syndrome (cDGS).MethodsTwelve patients with cDGS were transplanted with allogeneic cultured thymus.ObjectiveTo confirm and extend the results previously obtained in a single centre.ResultsTwo patients died of pre-existing viral infections without developing thymopoeisis and one late death occurred from autoimmune thrombocytopaenia. One infant suffered septic shock shortly after transplant resulting in graft loss and the need for a second transplant. Evidence of thymopoeisis developed from 5-6 months after transplantation in ten patients. The median (range) of circulating naïve CD4 counts (x106/L) were 44(11-440) and 200(5-310) at twelve and twenty-four months post-transplant and T-cell receptor excision circles were 2238 (320-8807) and 4184 (1582 -24596) per106 T-cells. Counts did not usually reach normal levels for age but patients were able to clear pre-existing and later-acquired infections. At a median of 49 months (22-80), eight have ceased prophylactic antimicrobials and five immunoglobulin replacement. Histological confirmation of thymopoeisis was seen in seven of eleven patients undergoing biopsy of transplanted tissue including five showing full maturation through to the terminal stage of Hassall body formation. Autoimmune regulator (AIRE) expression was also demonstrated. Autoimmune complications were seen in 7/12 patients. In two, early transient autoimmune haemolysis settled after treatment and did not recur. The other five suffered ongoing autoimmune problems including: thyroiditis (3); haemolysis (1), thrombocytopaenia (4) and neutropenia (1).ConclusionsThis study confirms the previous reports that thymus transplantation can reconstitute T cells in cDGS but with frequent autoimmune complications in survivors.
Teaser
In twelve patients with complete DiGeorge syndrome treated with thymus transplantation, there was a 75% survival with T-cell reconstitution. Autoimmunity, mostly manageable, was a frequent occurrence in survivors.http://ift.tt/2ocCamm
Autophagy – Nobel Prize 2016 and Allergy and Asthma Research
Source:Journal of Allergy and Clinical Immunology
Author(s): Harald Renz
http://ift.tt/2oRRJCS
Prevalence of proximal contact loss between implant-supported fixed prostheses and adjacent natural teeth and its associated factors: a 7-year prospective study
Abstract
Objectives
The aim was to analyze the prevalence rate of proximal contact loss (PCL) between implant-fixed prostheses (IFPs) and adjacent teeth and investigate the associated factors.
Material and methods
One hundred fifty participants were recruited for this prospective study from January 2009 to December 2014. Two hundred thirty-four IFPs supported by 384 implants for the posterior region were followed up until June 2016. The contact tightness had been recorded using aluminum strips of different thicknesses with a regular interval after delivery. Proximal contact was considered as lost if the contact tightness was over 50 μm, and statistical analyses were performed to estimate the prevalence rate of PCL and its influential factors.
Results
Among the total 299 proximal contacts of 234 IFPs, 179 were observed as a PCL (59.9%). Bone level and root configuration of the adjacent teeth, the proximal contact position and jaw position of the implant prostheses were statistically significant factors, when analyzed by the cumulative PCL rate using the log-rank test of the Kaplan–Meier method (P < 0.05) According to the Cox proportional hazard regression analysis, the proximal contact position, bone level of adjacent teeth and jaw position were revealed to be statistically significant (P < 0.05).
Conclusion
PCL should be considered an implant prosthesis complication to which various associated factors could be related. This study revealed that the lower alveolar bone support level of the adjacent teeth, maxillary position of IFPs and mesial site of IFPs were significantly associated with a higher incidence of PCL.
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Thymus Transplantation for Complete Digeorge Syndrome: European Experience
Source:Journal of Allergy and Clinical Immunology
Author(s): E Graham Davies, Melissa Cheung, Kimberly Gilmour, Jesmeen Maimaris, Joe Curry, Anna Furmanski, Neil Sebire, Neil Halliday, Konstantinos Mengrelis, Stuart Adams, Jolanta Bernatoniene, Ronald Bremner, Michael Browning, Blythe Devlin, Hans Christian Erichsen, H Bobby Gaspar, Lizzie Hutchison, Winnie Ip, Marianne Ifversen, T Ronan Leahy, Elizabeth McCarthy, Despina Moshous, Kim Neuling, Malgorzata Pac, Alina Papadopol, Kathryn L. Parsley, Luigi Poliani, Ida Ricciardelli, David M. Sansom, Tiia Voor, Austen Worth, Tessa Crompton, M Louise Markert, Adrian J. Thrasher
BackgroundThymus transplantation is a promising strategy for the treatment of athymic complete DiGeorge syndrome (cDGS).MethodsTwelve patients with cDGS were transplanted with allogeneic cultured thymus.ObjectiveTo confirm and extend the results previously obtained in a single centre.ResultsTwo patients died of pre-existing viral infections without developing thymopoeisis and one late death occurred from autoimmune thrombocytopaenia. One infant suffered septic shock shortly after transplant resulting in graft loss and the need for a second transplant. Evidence of thymopoeisis developed from 5-6 months after transplantation in ten patients. The median (range) of circulating naïve CD4 counts (x106/L) were 44(11-440) and 200(5-310) at twelve and twenty-four months post-transplant and T-cell receptor excision circles were 2238 (320-8807) and 4184 (1582 -24596) per106 T-cells. Counts did not usually reach normal levels for age but patients were able to clear pre-existing and later-acquired infections. At a median of 49 months (22-80), eight have ceased prophylactic antimicrobials and five immunoglobulin replacement. Histological confirmation of thymopoeisis was seen in seven of eleven patients undergoing biopsy of transplanted tissue including five showing full maturation through to the terminal stage of Hassall body formation. Autoimmune regulator (AIRE) expression was also demonstrated. Autoimmune complications were seen in 7/12 patients. In two, early transient autoimmune haemolysis settled after treatment and did not recur. The other five suffered ongoing autoimmune problems including: thyroiditis (3); haemolysis (1), thrombocytopaenia (4) and neutropenia (1).ConclusionsThis study confirms the previous reports that thymus transplantation can reconstitute T cells in cDGS but with frequent autoimmune complications in survivors.
Teaser
In twelve patients with complete DiGeorge syndrome treated with thymus transplantation, there was a 75% survival with T-cell reconstitution. Autoimmunity, mostly manageable, was a frequent occurrence in survivors.from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2ocCamm
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Autophagy – Nobel Prize 2016 and Allergy and Asthma Research
Source:Journal of Allergy and Clinical Immunology
Author(s): Harald Renz
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Incidental Findings in Reduction Mammoplasty Specimens in Patients with No Prior History of Breast Cancer. An Analysis of 783 Specimens
Abstract
Breast reduction surgery is a common procedure and the rate of incidental findings in the removed specimens varies between 0% and 4.6%. There are no guidelines about pathological evaluation of breast reduction surgery. We reviewed all pathology reports of patients undergoing breast reduction surgery in a single tertiary institution in Brazil from January 2008 to August 2014. Exclusion criteria were a personal history of breast cancer, unclear reason for mastectomy and incomplete data on the pathology report. We considered "relevant findings" flat epithelial atypia, atypical hyperplasia, carcinomas in situ and invasive carcinoma. Of 1672 specimens from breast reduction surgery, 783 met inclusion criteria. Median patient age was 40 (8–77), 91% underwent bilateral mastectomy and 57% of the specimens weighted less than 200 g. In 55% of cases, 4 or more paraffin blocks were sampled. There were 40 (5.1%) relevant findings and the most common was atypical lobular hyperplasia (16–2%). There were 3 invasive carcinomas (0.38%). In multivariate analysis, the only variables associated with a higher odds of relevant pathological findings were patient age ≥ 40 (OR 4.73 CI95% 1.98–11.3 p < 0.001) and sampling of ≥4 paraffin blocks from each specimen (OR 6.69 95% CI 2.25–19.9 p < 0.001). The incidence of pre-malignant and malignant lesions in specimens from breast reduction surgery is around 5%, but this risk is significantly higher for patients older than 40 years-old. Sampling at least 4 paraffin blocks from each specimen significantly increases detection rates.
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Ultrastructural localization of 5-methylcytosine on DNA and RNA
Abstract
DNA methylation is the major epigenetic modification and it is involved in the negative regulation of gene expression. Its alteration can lead to neoplastic transformation. Several biomolecular approaches are nowadays used to study this modification on DNA, but also on RNA molecules, which are known to play a role in different biological processes. RNA methylation is one of the most common RNA modifications and 5-methylcytosine presence has recently been suggested in mRNA. However, an analysis of nucleic acid methylation at electron microscope is still lacking. Therefore, we visualized DNA methylation status and RNA methylation sites in the interphase nucleus of HeLa cells and rat hepatocytes by ultrastructural immunocytochemistry and cytochemical staining. This approach represents an efficient alternative to study nucleic acid methylation. In particular, this ultrastructural method makes the visualization of this epigenetic modification on a single RNA molecule possible, thus overcoming the technical limitations for a (pre-)mRNA methylation analysis.
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One-Anastomosis Gastric Bypass: First 407 Patients in 1 year
Abstract
Background
One-anastomosis gastric bypass (OAGB) is a promising laparoscopic procedure with various benefits including shorter operating times and less operative complications. That said, it is yet to gain widespread acceptance. Here, we describe our first-year experience with OAGB in our department, in particular the safety and efficacy of this procedure.
Methods
This study is a retrospective analysis of all patients who underwent OAGB between March 2015 and March 2016 by our bariatric surgery unit. Patient demographics, comorbidities, operative and postoperative data were collected and analyzed as well as outcomes during the first year.
Results
Four hundred and seven patients underwent OAGB (254 females, average age 41.8 ± 12.05, BMI = 41.7 ± 5.77 kg/m2). Ninety-eight patients (24%) had prior bariatric surgery. Ninety-four patients (23%) had diabetes, 93 patients (22.8%) had hypertension, 123 (28.8%) had hyperlipidemia, and 35 patients (8.6%) suffered from obstructive sleep apnea. Eight patients (1.96%) had early minor complications (Clavien-Dindo 1–3a), and 10 patients (2.45%) suffered early major complications (Clavien-Dindo ≥3b). The average length of hospital stay was 2.2 ± 0.84 days (range 2–10 days). Twenty patients (4.8%) were readmitted, and 10 patients underwent reoperation. Patients who had had previous bariatric surgery had higher rates of complications, a prolonged hospital admission, higher rates of readmission, and early reoperations. The average excess weight loss (%EWL) 1 year following surgery was 88.9 ± 27.3 and 72.8 ± 43.5% in patients that underwent primary and revision OAGB, respectively.
Conclusions
OAGB is both safe and effective as a primary as well as a revision bariatric surgery.
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Influence of vitamin D levels on the cardiovascular profile of hypogonadal men
Abstract
Purpose
A large body of evidence suggests a role for vitamin D in conditioning cardiovascular risk. Therefore, it can be hypothesized that vitamin D might also play a role in influencing the metabolic profile of hypogonadal men. In this work, we aimed at evaluating if any relationship exists between vitamin D levels and cardiovascular parameters in male hypogonadism.
Methods
Hypogonadal patients attending our andrology unit were retrospectively reviewed. Clinical and biochemical parameters were evaluated.
Results
103 patients were studied (51 non-diabetic and 52 diabetic subjects). Mean age of the whole sample was 65 years (standard error of the mean: 0.62). Significant correlations of age, total testosterone, parathyroid hormone (PTH), calcemia, and 25-OH vitamin D with the metabolic profile were found. In logistic regression models including age, total testosterone, PTH, calcemia and 25-OH vitamin D as independent variables, lower levels of 25-OH vitamin D were associated with high values of body mass index (BMI) [odds ratio (OR) 0.910, p 0.019], insulin (OR 0.918, p 0.034), homeostatic model assessment (HOMA) index (OR 0.918, p 0.030), total cholesterol (OR 0.819, p < 0.001), triglycerides (OR 0.820, p < 0.001), and low-density lipoprotein cholesterol (OR 0.923, p 0.034). In non-diabetic subjects, lower levels of 25-OH vitamin D were associated with high values of BMI, insulin, HOMA, triglycerides, systolic, and diastolic blood pressure. On the other hand, in diabetic subjects, lower levels of 25-OH vitamin D were associated with high values of total cholesterol and triglycerides.
Conclusions
Our work shows the influence of vitamin D on cardiovascular profile in male hypogonadism. This effect seems to be more relevant in non-diabetic subjects. If these data were to be confirmed, vitamin D assessment might become mandatory in the clinical evaluation of cardiovascular profile in male hypogonadism.
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IJMS, Vol. 18, Pages 784: Lysozyme Associated Liposomal Gentamicin Inhibits Bacterial Biofilm
Bacteria on living or inert surfaces usually form biofilms which make them highly resistant to antibiotics and immune clearance. Herein, we develop a simple approach to overcome the above conundrum through lysozyme-associated liposomal gentamicin (LLG). The association of lysozyme to the surface of liposomes can effectively reduce the fusion of liposomes and undesirable payload release in regular storage or physiological environments. The LLG was more effective at damaging established biofilms and inhibiting biofilm formation of pathogens including Gram-positive and Gram-negative bacteria than gentamicin alone. This strategy may provide a novel approach to treat infections due to bacterial biofilm.
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Temporal properties of colour opponent receptive fields in the cat lateral geniculate nucleus
Abstract
The primordial form of mammalian colour vision relies on opponent interactions between inputs from just two cone types, "blue" (S-) and "green" (ML-) cones. We recently described the spatial receptive field structure of colour opponent blue-ON cells from the lateral geniculate nucleus of cats. Functional inputs from the opponent cone types were spatially coextensive and equally weighted, supporting their high chromatic and low achromatic sensitivity. Here, we studied relative cone weights, temporal frequency tuning and visual latency of cat blue-ON cells and non-opponent achromatic cells to temporally modulated cone-isolating and achromatic stimuli. We confirmed that blue-ON cells receive equally weighted antagonistic inputs from S- and ML-cones whereas achromatic cells receive exclusive ML-cone input. The temporal frequency tuning curves of S- and ML-cone inputs to blue-ON cells were tightly correlated between 1 Hz and 48 Hz. Optimal temporal frequencies of blue-ON cells were around 3 Hz, whereas the frequency optimum of achromatic cells was close to 10 Hz. Most blue-ON cells showed negligible response to achromatic flicker across all frequencies tested. Latency to visual stimulation was significantly greater in blue-ON than in achromatic cells. The S- and ML-cone responses of blue-ON cells had on average, similar latencies to each other. Altogether, cat blue-ON cells showed remarkable balance of opponent cone inputs. Our results also confirm similarities to primate blue-ON cells suggesting that colour vision in mammals evolved on the basis of a sluggish pathway that is optimised for chromatic sensitivity at a wide range of spatial and temporal frequencies.
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Probabilistic versus deterministic fiber tracking and the influence of different seed regions to delineate cerebellar-thalamic fibers in deep brain stimulation
Abstract
This study compared tractography approaches for identifying cerebellar-thalamic fiber bundles relevant for planning target sites for deep brain stimulation (DBS). In particular, probabilistic and deterministic tracking of the dentate-rubro-thalamic tract (DRTT) and differences between the spatial courses of the DRTT and the cerebello-thalamo-cortical (CTC) tract were compared.
Six patients with movement disorders were examined by magnetic resonance imaging (MRI) including two sets of diffusion-weighted images (12 and 64 directions). Probabilistic and deterministic tractography was applied on each diffusion-weighted dataset to delineate the DRTT. Results were compared with regard to their sensitivity in revealing the DRTT and additional fiber tracts and processing time. Two sets of regions-of-interests (ROIs) guided deterministic tractography of the DRTT or the CTC, respectively. Tract distances to an atlas-based reference target were compared.
Probabilistic fiber tracking with 64 orientations detected the DRTT in all twelve hemispheres. Deterministic tracking detected the DRTT in nine (12 directions) and in only two (64 directions) hemispheres. Probabilistic tracking was more sensitive in detecting additional fibers (e.g., ansa lenticularis and medial forebrain bundle) than deterministic tracking. Probabilistic tracking lasted substantially longer than deterministic. Deterministic tracking was more sensitive in detecting the CTC than the DRTT. CTC tracts were located adjacent but consistently more posterior to DRTT tracts.
These results suggest that probabilistic tracking is more sensitive and robust in detecting the DRTT but harder to implement than deterministic approaches. Although sensitivity of deterministic tracking is higher for the CTC than the DRTT, targets for DBS based on these tracts likely differ.
This article is protected by copyright. All rights reserved.
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Karolinska Institutet flags at half mast to honour victims of attack
Saturday 8 April the Swedish flag will fly at half mast at Karolinska Institutet, in honour of those killed and wounded in the attack at Drottninggatan, Stockholm, Sweden yesterday. Government Offices and others flags at half mast.
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Exercise on balance and function for knee osteoarthritis: A randomized controlled trial
Publication date: Available online 7 April 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Roberta de Matos Brunelli Braghin, Elisa Cavalheiro Libardi, Carina Junqueira, Marcello Henrique Nogueira – Barbosa, Daniela Cristina Carvalho de Abreu
ObjectivesTo assess balance and function of symptomatic and asymptomatic subjects with knee osteoarthritis (OA) and investigate the influence of physical exercise.DesignSubjects were divided into three groups: Group 1 (n = 15), symptomatic knee OA; Group 2 (n = 11), asymptomatic knee OA; and Group 3 (n = 16), knee OA and no intervention. History of falls, the WOMAC questionnaire, balance and functionality were assessed.ResultsAfter intervention, there was a significant difference in the total WOMAC score and in the pain and function domains only in Group 1. After intervention, Group 2 showed significant differences in decreased time on the Step Up/Over test and postural sway increased.ConclusionAfter the intervention, the symptomatic group reported improvement in pain and function on the WOMAC, while the asymptomatic group showed improvement in performance in the Step Up/Over test. There were no new episodes of falls in groups 1 and 2.
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Acute effects of self-myofascial release and stretching in overhead athletes with GIRD
Publication date: Available online 7 April 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Ryan R. Fairall, Lee Cabell, Richard J. Boergers, Fortunato Battaglia
Summary ObjectiveTo examine the acute effects of self-myofascial release (SMR), static stretching (SS), and the combination of self-myofascial release and static stretching (SMR+SS) on glenohumeral internal rotation range of motion (GH IR ROM) in overhead athletes with glenohumeral internal rotation deficit (GIRD).ParticipantsTwelve asymptomatic adult male amateur softball position players exhibiting GIRD.ResultsAll three methods significantly improved GH IR ROM. Post hoc testing revealed that SS alone and SMR+SS improved GH IR ROM significantly more than SMR alone. However, there were no significant differences in GH IR ROM between SS alone and SMR+SS.ConclusionsIf an athlete has a limited time to perform a warm-up (e.g., 3-4 minutes), SS alone is recommended to improve GH IR ROM. However, if the athlete has more time available to warm up (e.g., 7-8 minutes), combining SMR+SS may result in a greater increase in GH IR ROM.
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Effects of Percutaneous Coronary Intervention on Viable Myocardium and Heart Function of Diabetic Patients With Chronic Total Occlusion.
Objective: The aim of this study was to compare the effects of percutaneous coronary intervention (PCI) on coronary chronic total occlusion patients with (DM) or without (NDM) diabetes mellitus. Methods: A total of 78 patients were divided into DM group and NDM group according to whether the patient has DM. The results of PCI were analyzed using quantitative coronary analysis. In addition, all the patients underwent 99mTc-MIBI (methoxyisobutylisonitrile) single-photon emission computed tomography (SPECT) and ultrasonic cardiogram in the first week and the sixth month after PCI to evaluate PCI results. During the 6-month follow-up, major adverse cardiac event (MACE) was recorded and analyzed as well. Results: The first and second classes of collateral circulation between the 2 groups have significant differences (P
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StrataMR Adjustable Valves and Shunts by Medtronic: Recall - Potential for Under-Drainage of Cerebrospinal Fluid
Audience: Neurology, Surgery [Posted 04/08/2017] ISSUE: Medtronic announced that on February 22, 2017 it notified customers of a voluntary recall of all unused units of the StrataMR adjustable valves and shunts. Medtronic is conducting this...
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Inter-individual variability in discourse informativeness in elderly populations.
| Related Articles |
Inter-individual variability in discourse informativeness in elderly populations.
Clin Linguist Phon. 2017;31(5):391-408
Authors: Pistono A, Pariente J, Bézy C, Pastor J, Tran TM, Renard A, Fossard M, Nespoulous JL, Jucla M
Abstract
An increasing number of studies focus on discourse production in patients with neurodegenerative diseases and underline its clinical usefulness. However, if this is to be used as a clinical tool, one needs to consider how normal discourse varies within cognitively unimpaired elderly populations. In the current study, the aim has been to investigate discourse macrolinguistic variability. For this, 123 participants aged between 55 and 84 were recruited. A cluster analysis of their discourse macrolinguistic features was conducted. Then, cluster characterisation based on socio-demographic and linguistic performance was tested (fluency, naming, syntax and spelling). This method aims to identify various profiles of speaker and informativeness and then see if inter-individual variability may be related to socio-demographic and/or linguistic aspects. Four clusters of informativeness were found but no socio-demographic features appeared significant. The fourth cluster, defined as 'off topic', had lower performance during linguistic tasks than others and thus the boundary between normality and pathology should be questioned.
PMID: 28388219 [PubMed - in process]
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Surgical site infections following oral cavity cancer resection and reconstruction is a risk factor for plate exposure
Plate-related complications following head and neck cancer ablation and reconstruction remains a challenging problem often requiring further management and reconstructive surgeries. We aim to identify an assoc...
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Surgical site infections following oral cavity cancer resection and reconstruction is a risk factor for plate exposure
Plate-related complications following head and neck cancer ablation and reconstruction remains a challenging problem often requiring further management and reconstructive surgeries. We aim to identify an assoc...
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Intentional cannabis use to reduce crack cocaine use in a Canadian setting: A longitudinal analysis
Source:Addictive Behaviors, Volume 72
Author(s): M. Eugenia Socías, Thomas Kerr, Evan Wood, Huiru Dong, Stephanie Lake, Kanna Hayashi, Kora DeBeck, Didier Jutras-Aswad, Julio Montaner, M.-J. Milloy
BackgroundNo effective pharmacotherapies exist for the treatment of crack cocaine use disorders. Emerging data suggests that cannabinoids may play a role in reducing cocaine-related craving symptoms. This study investigated the intentional use of cannabis to reduce crack use among people who use illicit drugs (PWUD).MethodsData were drawn from three prospective cohorts of PWUD in Vancouver, Canada. Using data from participants reporting intentional cannabis use to control crack use, we used generalized linear mixed-effects modeling to estimate the independent effect of three pre-defined intentional cannabis use periods (i.e., before, during and after first reported intentional use to reduce crack use) on frequency of crack use.ResultsBetween 2012 and 2015, 122 participants reported using cannabis to reduce crack use, contributing a total of 620 observations. In adjusted analyses, compared to before periods, after periods were associated with reduced frequency of crack use (Adjusted Odds Ratio [AOR]=1.89, 95% Confidence Interval [CI]: 1.02–3.45), but not the intentional use periods (AOR=0.85, 95% CI: 0.51–1.41). Frequency of cannabis use in after periods was higher than in before periods (AOR=4.72, 95% CI: 2.47–8.99), and showed a tendency to lower frequency than in intentional cannabis use periods (AOR=0.56, 95% CI: 0.32–1.01).ConclusionsA period of intentional cannabis use to reduce crack use was associated with decreased frequency of crack use in subsequent periods among PWUD. Further clinical research to assess the potential of cannabinoids for the treatment of crack use disorders is warranted.
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Structural and functional insight into pan-endopeptidase inhibition by α2-macroglobulins
Authors: Goulas, Theodoros / Garcia-Ferrer, Irene / Marrero, Aniebrys / Marino-Puertas, Laura / Duquerroy, Stephane / Gomis-Rüth, F. Xavier
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The role of sirtuins in mitochondrial function and doxorubicin-induced cardiac dysfunction
Authors: Dolinsky, Vernon W.
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The Facial Platysma and Its Underappreciated Role in Lower Face Dynamics and Contour.
BACKGROUND: The platysma is a superficial muscle involved in important features of the aging neck. Vertical bands, horizontal lines, and loss of lower face contour are effectively treated with botulinum toxin A (BoNT-A). However, its pars facialis, mandibularis, and modiolaris have been underappreciated. OBJECTIVE: To demonstrate the role of BoNT-A treatment of the upper platysma and its impact on lower face dynamics and contour. MATERIAL AND METHODS: Retrospective analysis of cases treated by an injection pattern encompassing the facial platysma components, aiming to block the lower face as a whole complex. It consisted of 2 intramuscular injections into the mentalis muscle and 2 horizontal lines of BoNT-A injections superficially performed above and below the mandible (total dose, 16 onabotulinumtoxinA U/side). Photographs were taken at rest and during motion (frontal and oblique views), before and after treatment. RESULTS: A total of 161 patients have been treated in the last 2 years with the following results: frontal and lateral enhancement of lower facial contour, relaxation of high horizontal lines located just below the lateral mandibular border, and lower deep vertical smile lines present lateral to the oral commissures and melomental folds. CONCLUSION: The upper platysma muscle plays a relevant role in the functional anatomy of the lower face that can be modulated safely with neuromodulators. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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Repeatable Tie-Over Dressing Technique Using "3-Way Stop-Cock".
No abstract available
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Endocrine Mucin-Producing Sweat Gland Carcinoma Treated With Mohs Micrographic Surgery.
No abstract available
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Randomized, Controlled Trial of Fractional Carbon Dioxide Laser Resurfacing Followed by Ultrashort Incubation Aminolevulinic Acid Blue Light Photodynamic Therapy for Actinic Keratosis.
BACKGROUND: Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an established treatment option for actinic keratosis (AK), and recently fractional carbon dioxide (CO2) laser was shown to improve outcomes; but studies of short incubation photosensitizer are lacking. OBJECTIVE: Assess the efficacy of short incubation ALA followed by blue light PDT with and without previous fractional CO2 treatment for the treatment of AK. METHODS: Randomized, paired split-design, controlled trial of fractional CO2 followed by ultrashort 15-minute versus 30-minute incubation ALA and blue light PDT for the treatment of AK on the face. RESULTS: The complete clearance rates (CRs) at 8 weeks after ALA PDT with and without FxCO2 at 30- and 15-minute ALA incubation times were 89.78% (+FxCO2) versus 71.20% CR (-FxCO2) at 30', and 86.38% (+FxCO2) versus 69.23% (-FxCO2) at 15' ALA incubation. All lesion improvements were statistically significant. CONCLUSION: This randomized, comparative paired group controlled clinical study demonstrates that ultrashort 15- and 30-minute incubation ALA PDTs are of limited efficacy for the treatment of AK. Pretreatment with fractional ablative resurfacing yields statistically significant greater AK clearance with ALA-PDT at ultrashort ALA incubations followed by blue light. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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Modified V-Y Advancement Flap With "Directed" Granulation and Leveling Sutures for Defects of the Lid-Cheek Junction.
No abstract available
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Differences in Hyaluronic Acid Filler Persistence Depending Upon Facial Site: A Consideration of Anatomical Factors.
No abstract available
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Safety of Cochlear Implants in Electrosurgery: A Systematic Review of the Literature.
BACKGROUND: The implications of electrosurgical instrument use in patients with cochlear implants (CIs) are becoming increasingly relevant for dermatologic surgeons as the number of implanted CI devices continues to grow. The literature, however, fails to provide clear recommendations for appropriate treatment of these patients. OBJECTIVE: To systematically consolidate and critique the current literature regarding electrosurgical instrument use in patients with CI, to determine implications of various electrosurgical devices and settings on CI function and health of cochlear tissues, and to devise recommendations for appropriate use. MATERIALS AND METHODS: The manuscript was created based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A broad search of PubMed, Access Medicine, Clinical Key, Ovid, Scopus, the Cochrane Library, and Web of Science was performed using key words such as CI, electrosurgery, and/or electrosurgical device. Criteria for inclusion included being written in English language and institutional access to manuscript. All years were included. Additional references were obtained from personal communication with CI manufacturers. Study biases were assessed through evaluation of funding and/or sponsoring agencies for included studies. RESULTS: The authors' search yielded a total of 8 studies, 5 of which were a level of evidence 5, 2 of which were level of evidence 4, and 1 of which was a level of evidence 3. The remaining study was relegated only to device testing. These studies were complicated by inaccurate terminology and inconsistent recommendations. CONCLUSION: The body of evidence evaluating electrosurgical instrument use in patients with CI is severely limited in number and quality. Thus, vague and inconsistent recommendations have emerged that place patients at risk of serious and costly adverse effects. In light of this, the authors suggest use of the most conservative recommendations available for electrosurgical instrument use in patients with CI. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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Customized Assembly of Microneedling Device in the Clinic.
No abstract available
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Surgical Pearl: Adding Gentian Violet to Aluminum Chloride Aids in Differentiating Cotton-Tipped Applicators on Surgical Tray.
No abstract available
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Multiple Squamous Cell Carcinomas Arising in Hyperpigmented Patches: A Newly Recognized Feature of Incontinentia Pigmenti?.
No abstract available
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Disease Burden of Mild Asthma: Findings from a Cross-Sectional Real-World Survey
Abstract
Introduction
Most asthma patients have mild disease, although the burden of mild asthma is not well understood nor studied. Some evidence suggests that many patients with mild asthma experience suboptimal symptom control and exacerbations. This study characterizes the burden of illness and treatment patterns among patients with a confirmed diagnosis of mild asthma, defined as GINA Step 1 or Step 2, and residing in China, France, Germany, Italy, Japan, Spain, the United Kingdom, or the United States.
Methods
The Respiratory Disease-Specific Programme prospective cross-sectional survey was conducted with primary care and specialty physicians in each of the eight countries. Physician and patient surveys assessed demographic and clinical characteristics, frequency and timing of asthma symptoms, exacerbations, and rescue inhaler usage, the most recent FEV1% predicted, and healthcare utilization. GINA Step was determined by prescribed treatment regimen. GINA Step 1 patients were prescribed as-needed reliever medication and Step 2 required treatment with a low-dose inhaled corticosteroid, leukotriene receptor antagonist, or theophylline. Treatment adherence was assessed with the Morisky Medication Adherence scale, disease control with the Asthma Control Test, and work and activity impairments with the Work Productivity and Activity Impairment scale.
Results
The sample included 1115 GINA Step 1 and 2 patients, with 53% classified as Step 2. Overall asthma control was suboptimal, with reports of nocturnal symptoms (40.6%), symptom worsening (10.5%), and rescue inhaler usage in the last 4 weeks (33.6%). 25% of patients were uncontrolled. The overall mean number of exacerbations in the last 12 months was 0.4, with a higher frequency of exacerbations in Step 2 patients who also experienced more exacerbations requiring treatment intensification, an emergency department visit, or hospitalization.
Conclusion
Mild asthma imposes a substantial burden on patients, establishing the need for comprehensive management plans and ongoing support for treatment adherence.
Funding
AstraZeneca.
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Editorial Board
Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1
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Development of medial pterygoid muscle fibers in rabbits fed with a liquid diet
Source:Archives of Oral Biology, Volume 80
Author(s): Kozue Kuroki, Takumi Morita, Hiroki Takasu, Keisuke Saito, Takuya Fujiwara, Katsunari Hiraba, Shigemi Goto
ObjectiveThis study aimed to investigate the influence of decreased functional load on the medial pterygoid muscle during mastication in rabbits fed with a liquid-diet.Materials and MethodsMedial pterygoid muscles from 54 rabbits (solid- and liquid-diet groups, n=48; unweaned group, n=6) were histochemically examined at 4, 9, 12, 18, and 33 weeks after birth. Six fiber types (I, IC, IIC, IIA, IIAB, and IIB) were distinguished via mATPase staining.ResultsSignificant increases in the diameters of all fiber types were seen up to 33 weeks of age in the solid-diet group; however, no significant increase was noted in fiber types I and IC, from 4 to 33 weeks of age, in the liquid-diet group. The proportion of slow fibers increased up to 12 weeks followed by an increase in the number of fast fibers in the solid-diet group, whereas in the liquid-diet group, the number of slow fiber declined after weaning.ConclusionsLiquid-diet consumption caused muscle fiber atrophy and an increase in the number of fast fibers during early developmental stages after weaning. Furthermore, the growth pattern of the medial pterygoid muscle in the liquid-diet group was different from that in the solid-diet group.
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Research into the Health Benefits of Sprint Interval Training Should Focus on Protocols with Fewer and Shorter Sprints
Abstract
Over the past decade, it has been convincingly shown that regularly performing repeated brief supramaximal cycle sprints (sprint interval training [SIT]) is associated with aerobic adaptations and health benefits similar to or greater than with moderate-intensity continuous training (MICT). SIT is often promoted as a time-efficient exercise strategy, but the most commonly studied SIT protocol (4–6 repeated 30-s Wingate sprints with 4 min recovery, here referred to as 'classic' SIT) takes up to approximately 30 min per session. Combined with high associated perceived exertion, this makes classic SIT unsuitable as an alternative/adjunct to current exercise recommendations involving MICT. However, there are no indications that the design of the classic SIT protocol has been based on considerations regarding the lowest number or shortest duration of sprints to optimise time efficiency while retaining the associated health benefits. In recent years, studies have shown that novel SIT protocols with both fewer and shorter sprints are efficacious at improving important risk factors of noncommunicable diseases in sedentary individuals, and provide health benefits that are no worse than those associated with classic SIT. These shorter/easier protocols have the potential to remove many of the common barriers to exercise in the general population. Thus, based on the evidence summarised in this current opinion paper, we propose that there is a need for a fundamental change in focus in SIT research in order to move away from further characterising the classic SIT protocol and towards establishing acceptable and effective protocols that involve minimal sprint durations and repetitions.
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Table of Contents
Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1
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outside front cover
Publication date: February 2017
Source:Seminars in Oncology, Volume 44, Issue 1
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A Peutz–Jeghers syndrome family associated with sinonasal adenocarcinoma: 28 years follow up report
Abstract
Peutz–Jeghers syndrome (PJS) is a rare hereditary disorder characterized by hamartomatous polyps in both of the gastrointestinal tract and mucosal pigmentation. It could increase in risk of intestinal and extra-intestinal neoplasms. We here described three cases of sinonasal polyposis in a PJS family and two developed sinonasal type adenocarcinoma. Genetic study revealed a germline STK11/LKB1 mutation on codon 179 (c.C536G, p.P179R) of exon 4. LOH analysis of the LKB1 locus confirms this to be a deleterious mutation. Sinonasal polyposis with malignant transformation could be encountered in PJS patients. Regular follow-up was recommended for the risk of malignant changes in nasal polyps.
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Estimation of heavy metal-contaminated soils’ mechanical characteristics using electrical resistivity
Abstract
Under the process of urbanization in China, more and more attention has been paid to the reuse of heavy metal-contaminated sites. The shear characteristics of heavy metal-contaminated soils are investigated by electrical detection in this paper. Three metal ions (Zn2+, Cd2+, and Pb2+) were used, the metal concentrations of which are 50, 166.67, 500, 1666.67, and 5000 mg/kg, respectively. Direct shear tests were used to investigate the influence of heavy metal ions on the shear characters of soil samples. It is found that with the addition of heavy metal ions, the shear strength, cohesion, and friction angle of contaminated soils are higher than the control samples. The higher concentration of heavy metal ions penetrated in soils, the higher these engineering characteristics of contaminated soils observed. In addition, an electrical resistivity detection machine is used to evaluate the shear characteristics of contaminated soils. The electrical resistivity test results show that there is a decreasing tendency of resistivity with the increase of heavy metal ion concentrations in soils. Compared with the electrical resistivity and the shear characteristics of metal-contaminated soils, it is found that, under fixed compactness and saturation, shear strength of metal-contaminated soils decreased with the increase of resistivity. A basic linear relationship between C/log(N + 10) and resistivity can be observed, and there is a basic linear relationship between φ/log(N + 10) and resistivity. Besides, a comparison of the measured and predicted shear characteristics shows a high accuracy, indicating that the resistivity can be used to evaluate the shear characteristics of heavy metal contaminated soils.
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Fishing for contaminants: identification of three mechanism specific transcriptome signatures using Danio rerio embryos
Abstract
In ecotoxicology, transcriptomics is an effective way to detect gene expression changes in response to environmental pollutants. Such changes can be used to identify contaminants or contaminant classes and can be applied as early warning signals for pollution. To do so, it is important to distinguish contaminant-specific transcriptomic changes from genetic alterations due to general stress. Here we present a first step in the identification of contaminant class-specific transcriptome signatures. Embryos of zebrafish (Danio rerio) were exposed to three substances (methylmercury, chlorpyrifos and Aroclor 1254, each from 24 to 48 hpf exposed) representing sediment typical contaminant classes. We analyzed the altered transcriptome to detect discriminative genes significantly regulated in reaction to the three applied contaminants. By comparison of the results of the three contaminants, we identified transcriptome signatures and biologically important pathways (using Cytoscape/ClueGO software) that react significantly to the contaminant classes. This approach increases the chance of finding genes that play an important role in contaminant class-specific pathways rather than more general processes.
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Preparation, characterization, and dye removal study of activated carbon prepared from palm kernel shell
Abstract
Palm oil mill wastes (palm kernel shell (PKS)) were used to prepare activated carbons, which were tested in the removal of colorants from water. The adsorbents were prepared by 1-h impregnation of PKS with ZnCl2 as the activating agent (PKS:ZnCl2 mass ratios of 1:1 and 2:1), followed by carbonization in autogenous atmosphere at 500 and 550 °C during 1 h. The characterization of the activated carbons included textural properties (porosity), surface chemistry (functional groups), and surface morphology. The dye removal performance of the different activated carbons was investigated by means of the uptake of methylene blue (MB) in solutions with various initial concentrations (25–400 mg/L of MB) at 30 °C, using a 0.05-g carbon/50-mL solution relationship. The sample prepared with 1:1 PKS:ZnCl2 and carbonized at 550 °C showed the highest MB adsorption capacity (maximum uptake at the equilibrium, q max = 225.3 mg MB / g adsorbent), resulting from its elevated specific surface area (BET, 1058 m2/g) and microporosity (micropore surface area, 721 m2/g). The kinetic experiments showed that removals over 90% of the equilibrium adsorptions were achieved after 4-h contact time in all the cases. The study showed that palm oil mill waste biomass could be used in the preparation of adsorbents efficient in the removal of colorants in wastewaters.
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The significance of renewable energy use for economic output and environmental protection: evidence from the Next 11 developing economies
Abstract
Increasing economic activities in developing economies raise demand for energy mainly sourced from conventional sources. The consumption of more conventional energy will have a significant negative impact on the environment. Therefore, attention of policy makers has recently shifted towards the promotion of renewable energy generation and uses across economic activities to ensure low carbon economy. Given the recent scenario, in this paper, we aim to examine the role of renewable energy consumption on the economic output and CO2 emissions of the next fastest developing economies of the world. The study employs several robust panel econometric models by using annual data from 1990 to 2012. Empirical findings confirm the significant long-run association among the variables. Similarly, results show that renewable energy consumption positively contributes to economic output and has an adverse effect on CO2 emissions. Given our findings, we suggest policy makers of those economies to initiate further effective policies to promote more renewable energy generation and uses across economic activities to ensure sustainable economic development.
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Evaluation of the effect of tacrolimus on periodontitis induced in rats
Source:Archives of Oral Biology, Volume 80
Author(s): Luiz Alexandre Moura Penteado, Gilmara Medeiros Lucena, Marcílio Otávio Brandão Peixoto, Thiago Correia Barbosa, Ana Carolina de Souza Leitão Arruda, Renata Cimões
ObjectiveThis study was to investigate the effect of tacrolimus (FK506) on periodontitis induced in rats.DesignPeriodontal disease was induced in 30 Wistar rats which were then randomly divided into two groups: treatment with a daily injection of 0.9% saline (1mL/day) and treatment with a daily injection of FK506. After periods of 10, 15 and 30days the animals were killed and separate radiographs of the right and left hemimandibles were obtained. One calibrated examiner measured the periodontal bone support (PBS) in the images, after the following treatments: S, saline without ligature; SL, saline with ligature; T, FK506 without ligature; TL, FK506 with ligature. The data were subjected to analysis of variance (ANOVA) and the Tukey test (p<0.01).ResultsThe radiographic results were similar at all evaluation time points. The S treatment had a higher PBS averaging at 10, 15 and 30days, which was statistically significant different compared with the SL treatment and TL treatment, but not significantly different from the T treatment. The SL and TL treatments showed no statistically significant differences between them.ConclusionsTacrolimus used for up to 30days showed no protective or aggravating effects on alveolar bone loss.
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Cigarette smoke extract (CSE) induces RAGE-mediated inflammation in the Ca9-22 gingival carcinoma epithelial cell line
Source:Archives of Oral Biology, Volume 80
Author(s): Nolan T. Sanders, Derek J. Dutson, Justin W. Durrant, Joshua B. Lewis, Shalene H. Wilcox, Duane R. Winden, Juan A. Arroyo, Benjamin T. Bikman, Paul R. Reynolds
ObjectiveThe oral environment is anatomically positioned as a significant gateway for exposure to environmental toxicants. Cigarette smoke exposure compromises oral health by orchestrating inflammation. The receptor for advanced glycation end-products (RAGE) has been implicated in smoke-induced inflammatory effects; however, its role in the oral cavity is unknown. The purpose of this study was to determine RAGE expression by immortalized gingival carcinoma cells and the degree to which RAGE-mediated signaling influences inflammation.DesignGingival epithelia cells (Ca9-22) were exposed to 10% cigarette smoke extract (CSE) for six hours and screened for RAGE expression and inflammatory mediators.ResultsQuantitative PCR and immunoblotting revealed increased RAGE expression following exposure. Furthermore, exposure activated RAGE signaling intermediates including Ras and NF-κB. IL-6 and IL-1β were also elevated in cell culture medium from CSE-exposed cells when compared to controls. A family of anionic, partially lipophilic sulfated polysaccharide derivatives known as semi-synthetic glycosaminoglycan ethers (SAGEs) were used in an effort to block RAGE signaling. Co-treatment of CSE and SAGEs ameliorated inflammatory responses.ConclusionsThese results provide a new perspective on a mechanism of cigarette smoke induced oral inflammation. Further work may show RAGE signaling as a potential target in the treatment of diseases of the oral cavity exacerbated by tobacco smoke exposure.
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Development of medial pterygoid muscle fibers in rabbits fed with a liquid diet
Source:Archives of Oral Biology, Volume 80
Author(s): Kozue Kuroki, Takumi Morita, Hiroki Takasu, Keisuke Saito, Takuya Fujiwara, Katsunari Hiraba, Shigemi Goto
ObjectiveThis study aimed to investigate the influence of decreased functional load on the medial pterygoid muscle during mastication in rabbits fed with a liquid-diet.Materials and MethodsMedial pterygoid muscles from 54 rabbits (solid- and liquid-diet groups, n=48; unweaned group, n=6) were histochemically examined at 4, 9, 12, 18, and 33 weeks after birth. Six fiber types (I, IC, IIC, IIA, IIAB, and IIB) were distinguished via mATPase staining.ResultsSignificant increases in the diameters of all fiber types were seen up to 33 weeks of age in the solid-diet group; however, no significant increase was noted in fiber types I and IC, from 4 to 33 weeks of age, in the liquid-diet group. The proportion of slow fibers increased up to 12 weeks followed by an increase in the number of fast fibers in the solid-diet group, whereas in the liquid-diet group, the number of slow fiber declined after weaning.ConclusionsLiquid-diet consumption caused muscle fiber atrophy and an increase in the number of fast fibers during early developmental stages after weaning. Furthermore, the growth pattern of the medial pterygoid muscle in the liquid-diet group was different from that in the solid-diet group.
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Cigarette smoke extract (CSE) induces RAGE-mediated inflammation in the Ca9-22 gingival carcinoma epithelial cell line
Source:Archives of Oral Biology, Volume 80
Author(s): Nolan T. Sanders, Derek J. Dutson, Justin W. Durrant, Joshua B. Lewis, Shalene H. Wilcox, Duane R. Winden, Juan A. Arroyo, Benjamin T. Bikman, Paul R. Reynolds
ObjectiveThe oral environment is anatomically positioned as a significant gateway for exposure to environmental toxicants. Cigarette smoke exposure compromises oral health by orchestrating inflammation. The receptor for advanced glycation end-products (RAGE) has been implicated in smoke-induced inflammatory effects; however, its role in the oral cavity is unknown. The purpose of this study was to determine RAGE expression by immortalized gingival carcinoma cells and the degree to which RAGE-mediated signaling influences inflammation.DesignGingival epithelia cells (Ca9-22) were exposed to 10% cigarette smoke extract (CSE) for six hours and screened for RAGE expression and inflammatory mediators.ResultsQuantitative PCR and immunoblotting revealed increased RAGE expression following exposure. Furthermore, exposure activated RAGE signaling intermediates including Ras and NF-κB. IL-6 and IL-1β were also elevated in cell culture medium from CSE-exposed cells when compared to controls. A family of anionic, partially lipophilic sulfated polysaccharide derivatives known as semi-synthetic glycosaminoglycan ethers (SAGEs) were used in an effort to block RAGE signaling. Co-treatment of CSE and SAGEs ameliorated inflammatory responses.ConclusionsThese results provide a new perspective on a mechanism of cigarette smoke induced oral inflammation. Further work may show RAGE signaling as a potential target in the treatment of diseases of the oral cavity exacerbated by tobacco smoke exposure.
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Evaluation of the effect of tacrolimus on periodontitis induced in rats
Source:Archives of Oral Biology, Volume 80
Author(s): Luiz Alexandre Moura Penteado, Gilmara Medeiros Lucena, Marcílio Otávio Brandão Peixoto, Thiago Correia Barbosa, Ana Carolina de Souza Leitão Arruda, Renata Cimões
ObjectiveThis study was to investigate the effect of tacrolimus (FK506) on periodontitis induced in rats.DesignPeriodontal disease was induced in 30 Wistar rats which were then randomly divided into two groups: treatment with a daily injection of 0.9% saline (1mL/day) and treatment with a daily injection of FK506. After periods of 10, 15 and 30days the animals were killed and separate radiographs of the right and left hemimandibles were obtained. One calibrated examiner measured the periodontal bone support (PBS) in the images, after the following treatments: S, saline without ligature; SL, saline with ligature; T, FK506 without ligature; TL, FK506 with ligature. The data were subjected to analysis of variance (ANOVA) and the Tukey test (p<0.01).ResultsThe radiographic results were similar at all evaluation time points. The S treatment had a higher PBS averaging at 10, 15 and 30days, which was statistically significant different compared with the SL treatment and TL treatment, but not significantly different from the T treatment. The SL and TL treatments showed no statistically significant differences between them.ConclusionsTacrolimus used for up to 30days showed no protective or aggravating effects on alveolar bone loss.
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The genus Achyranthes: A review on traditional uses, phytochemistry, and pharmacological activities
Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Xirui He, Xiaoxiao Wang, Jiacheng Fang, Yu Chang, Ning Ning, Hao Guo, Linhong Huang, Xiaoqiang Huang
Ethnopharmacological relevanceAchyranthes L. (Amaranthaceae), also known as Chaff Flower and Niuxi/牛膝, mainly includes two famous medicinal species namely A. bidentata and A. aspera. A. bidentata has been widely used as blood-activating and stasis-resolving medicine for the treatment of various diseases including amenorrhea, dysmenorrhea, lumbago, gonalgia, paraplegia, edema, stranguria, headache, dizziness, odontalgia, oral ulcer, hematemesis, and epistaxis. A. aspera has been widely used to treat various diseases, including gynecological disorder, asthma, ophthalmia, odontalgia, haemorrhoids, and abdominal tumor, and has been applied to difficult labour, wound healing, insect and snake bites.Aim of this reviewThis review aims to provide systematically reorganized information on distributions, botanical characteristics, ethnopharmacology, chemical constituents, qualitative and quantitative analysis, pharmacological activities, and toxicity of Achyranthes species to support their therapeutic potential.Materials and methodsThe relevant information on Achyranthes species was gathered from worldwide accepted scientific databases via electronic search (Google Scholar, Web of Science, ScienceDirect, ACS Publications, PubMed, Wiley Online Library, SciFinder, CNKI). Information was also obtained from International Plant Names Index, Chinese Pharmacopoeia, Chinese herbal classic books, PhD and MSc dissertations, etc.ResultsA comprehensive analysis of literatures obtained through the above- mentioned sources confirms that the ethnomedicinal uses of Achyranthes species are mainly recorded in China, India, Korea, Pakistan, Ethiopia, Kenya, Sri Lanka, Bangladesh, Philippines, etc. Phytochemical investigations revealed that the major bioactive substances of Achyranthes plants are polysaccharides, polypeptides, triterpenoid saponins, and ketosteroids. Achyranthes plants have been shown to not only act on immune system, nervous system, bone metabolism, and reproduction, but also possess a wide range of biological activities, including blood-activating, anti-tumor, anti-inflammation, anti-arthritis, anti-oxidation, anti-aging, wound healing, etc. Toxicity studies indicated that A. bidentata and A. aspera seem non-toxic at the common therapeutic doses.ConclusionsA. bidentata and A. aspera are very promising to be fully utilized in the development of nutraceutical and pharmaceutical products. There are, however, needs for further in-depth studies to confirm some ethnomedicinal uses of Achyranthes plants and to elucidate the scientific connotation of the widely documented property of conducting drug downward of A. bidentata. In addition, other widespread Achyranthes species like A. japonica and A. rubrofusca ought to be studied. Likewise, systematic comparative studies of the chemical constituents of medicinal Achyranthes plants resources with the same local name are also needed. Furthermore, not only should the investigations on the structure-activity relationship of the main bioactive compounds triterpenoid saponins and ketosteroids be carried out, but the pathways of absorption, distribution, metabolism, and excretion ought to be clarified. Last but not least, there is also a need to evaluate the long-term chronic toxicity and acute toxicity in vivo of the main bioactive compounds.
Graphical abstract
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Abietic acid isolated from pine resin (Resina Pini) enhances angiogenesis in HUVECs and accelerates cutaneous wound healing in mice
Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Jun Yeon Park, Yun Kyung Lee, Dong-Soo Lee, Jeong-Eun Yoo, Myoung-Sook Shin, Noriko Yamabe, Su-Nam Kim, Seulah Lee, Ki Hyun Kim, Hae-Jeung Lee, Seok Sun Roh, Ki Sung Kang
Ethnopharmacological relevanceResin known as Resina Pini is listed in the Korean and Japanese pharmacopoeias and has been used for treating skin wounds and inflammation. Resin is composed of more than 50% abietic acid and 10% neutral substances.ObjectiveIn the present study, the wound-healing effects of abietic acid and the possible underlying mechanism of action were investigated in various in vitro and in vivo models.Materials and methodsThe effects of abietic acid on tube formation and migration were measured in human umbilical vein vascular endothelial cells (HUVECs). Protein expression of mitogen-activated protein kinase (MAPK) activation was evaluated via Western blotting analysis. The wound-healing effects of abietic acid were assessed using a mouse model of cutaneous wounds.ResultsThe results showed that abietic acid enhanced cell migration and tube formation in HUVECs. Abietic acid induced significant angiogenic potential, which is associated with upregulation of extracellular signal-regulated kinase (ERK) and p38 expression. Additionally, 0.8μM abietic acid-treated groups showed accelerated wound closure compared to the controls in a mouse model of cutaneous wounds.ConclusionThe current data indicate that abietic acid treatment elevated cell migration and tube formation in HUVECs by the activation of ERK and p38 MAPKs. We suggest that abietic acid can be developed as a wound-healing agent.
Graphical abstract
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Protective effect of a phenolic extract containing indoline amides from Portulaca oleracea against cognitive impairment in senescent mice induced by large dose of D-galactose /NaNO2
Publication date: 5 May 2017
Source:Journal of Ethnopharmacology, Volume 203
Author(s): Peipei Wang, Hongxiang Sun, Dianyu Liu, Zezhao Jiao, Su Yue, Xiuquan He, Wen Xia, Jianbo Ji, Lan Xiang
Ethnopharmacological relevance:Portulaca oleracea L. is a potherb and also a widely used traditional Chinese medicine. In accordance with its nickname "longevity vegetable", pharmacological study demonstrated that this plant possessed antioxidant, anti-aging, and cognition-improvement function. Active principles pertaining to these functions of P. oleracea need to be elucidated.Aim of the study:The present study evaluated the effect of a phenolic extract (PAAs) from P. oleracea which contained specific antioxidant indoline amides on cognitive impairment in senescent mice.Materials and methods:PAAs was prepared through AB-8 macroporous resin column chromatography. Total phenol content was determined using colorimetric method, and contents of indoline amides were determined using HPLC-UV method. Senescent Kunming mice with cognitive dysfunction were established by intraperitoneal injection of D-galactose (D-gal, 1250mg/kg/day) and NaNO2 (90mg/kg/day) for 8 weeks, L-PAAs (360mg/kg/day), H-PAAs (720mg/kg/day), and nootropic drug piracetam (PA, 400mg/kg/day) as the positive control were orally administered. Spatial learning and memory abilities were evaluated by Morris water maze experiment. Activities of AChE, SOD, CAT, and levels of GSH and MDA in the brain or plasma were measured. Hippocampal morphology was observed by HE staining.Results:Chronic treatment of large dose of D-gal/NaNO2 significantly reduced lifespan, elevated AChE activity, decreased CAT activity, compensatorily up-regulated SOD activity and GSH level, increased MDA level, induced neuronal damage in hippocampal CA1, CA3 and CA4 regions, and impaired cognitive function. Similar to PA, PAAs prolonged the lifespan and improved spatial memory ability. Moreover, PAAs improved learning ability. H-PAAs significantly reversed compensatory increase in SOD activity to the normal level, elevated serum CAT activity, and reduced MDA levels in brain and plasma, more potent than L-PAAs. Besides these, PAAs evidently inhibited hippocampal neuronal damage. However, it had no effect on brain AChE activity.Conclusion:PAAs as the bioactive principles of P. oleracea attenuated oxidative stress, improved survival rate, and enhanced cognitive function in D-gal/NaNO2-induced senile mice, similar to piracetam. This phenolic extract provides a promising candidate for prevention of aging and aging-related cognitive dysfunction in clinic.
Graphical abstract
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Improved Outcomes with Pedicled Nipple-sparing Mastectomies Using a New Surgical Delay: Mastectomy through Wise Incisions
Summary: Nipple-sparing mastectomy (NSM) is challenging in patients with significant ptosis and skin excess. We previously described the first use of a surgical delay (a supraareolar incision with undermining off the breast mound) to facilitate a second-stage pedicled NSM and reconstruction. Here, we present an improvement in our surgical delay technique—a total skin and NSM through Wise incisions. This technique obviates concerns regarding delays in cancer care and more aggressively delays the nipple, allowing for more reliable and extreme NAC transpositions. This strategy also delays the Wise pattern flaps resulting in better wound healing, which is critical in implant-based reconstructions.from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2o2FErm
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Psychoactive Drugs in Plastic Surgery
Background: Psychoactive drug use is on the rise in the United States, with plastic surgery patients a potentially susceptible group. This study aimed to determine the incidence of cosmetic and reconstructive patients in our practice taking psychoactive drugs and to compare those values with the national average. Furthermore, we discuss the patient safety concerns when patients withhold their medical history information over the course of their treatment. Methods: Urban private plastic practice patients who underwent surgery in a closed practice from 2009 to 2016 were divided into cosmetic and reconstructive cohorts. Review for drug use was medical scripts, history, and Surescripts drug reporting. Extracted information includes age, race, procedure, psychoactive medications, and whether or not they stated a mental health diagnosis on their medical history forms. Only patients with complete records were included. Results: A total of 830 patients were included in statistical analysis. Due to minimal cohort number, 70 men were excluded, as there were no comparative national data. Our analysis found that 33.6% cosmetic patients and 46.3% reconstructive patients used at least one psychoactive drug. Conclusion: There is a statistically significant difference between psychoactive drug use at our practice compared with the general population and a significantly larger percentage of reconstructive patients taking drugs compared with the cosmetic cohort.from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2nimQqY
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The Aesthetic Items Scale: A Tool for the Evaluation of Aesthetic Outcome after Breast Reconstruction
Background: Valid tools to assess aesthetic outcomes after breast reconstructive surgery are scarce. Previously a professional aesthetic assessment scale was introduced, the Aesthetic Items Scale (AIS). We aim to determine if this method is a valid and reliable tool to assess aesthetic outcome after breast reconstructive surgery. Methods: The study population was consenting women who underwent prophylactic mastectomy with subsequent implant-based breast reconstruction. The aesthetic outcome with regard to breast volume, shape, symmetry, scars, and nipple areola complex was rated on a 5-point scale using standardized photographs to give a summed total score. Photographs were evaluated by the patient, 5 plastic surgeons, and 3 mammography nurses. An overall rating of aesthetic outcome on a 1–10 scale was given separately. We determined the intraclass correlation coefficient and assessed interobserver agreement. To assess validity, we calculated the correlation between total score and overall rating of aesthetic outcome. Results: Interobserver reliability was highest between plastic surgeons for the subitem and overall scores and ranged between 0.56 and 0.82. The summed score of the AIS correlates strongly with the overall rating in professionals but not in patients. Conclusions: The AIS is a valid and reliable method for evaluating aesthetic outcome of breast reconstruction by plastic surgeons. The results indicate that patients judge aesthetic outcome differently, taking into account factors that are not represented in the AIS. Professionals can use this method to evaluate surgical results, but other measurements are needed to map satisfaction of the patient with her breasts.from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2o2HQzk
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Predicting posttraumatic hydrocephalus: derivation and validation of a risk scoring system based on clinical characteristics
Abstract
Posttraumatic hydrocephalus (PTH) is a disorder of disturbed cerebrospinal fluid (CSF) dynamics after traumatic brain injury (TBI). It can lead to brain metabolic impairment and dysfunction and has a high risk of clinical deterioration and worse outcomes. The incidence and risk factors for the development of PTH after decompressive craniectomy (DC) has been assessed in previous studies, but rare studies identify patients with higher risk for PTH among all TBI patients. This study aimed to develop and validate a risk scoring system to predict PTH after TBI. Demographics, injury severity, duration of coma, radiologic findings, and DC were evaluated to determine the independent predictors of PTH during hospitalization until 6 months following TBI through logistic regression analysis. A risk stratification system was created by assigning a number of points for each predictor and validated in an independent cohort. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC). Of 526 patients in the derivation cohort, 57 (10.84%) developed PTH during 6 months follow up. Age > 50 yrs (Odd ratio [OR] = 1.91, 95% confidence interval [CI] 1.09–3.75, 4 points), duration of coma ≥1 w (OR = 5.68, 95% CI 2.57–13.47, 9 points), Fisher grade III (OR = 2.19, 95% CI 1.24–4.36, 5 points) or IV (OR = 3.87, 95% CI 1.93–8.43, 7 points), bilateral DC (OR = 6.13, 95% CI 2.82–18.14, 9 points), and extra herniation after DC (OR = 2.36, 95% CI 1.46–4.92, 5 points) were independently associated with PTH. Rates of PTH for the low- (0–12 points), intermediate- (13–22 points) and high-risk (23–34 points) groups were 1.16%, 35.19% and 78.57% (p < 0.0001). The corresponding rates in the validation cohort, where 17/175 (9.71%) developed PTH, were 1.35%, 37.50% and 81.82% (p < 0.0001). The risk score model exhibited good-excellent discrimination in both cohorts, with AUC of 0.839 versus 0.894 (derivation versus validation) and good calibration (Hosmer-Lemshow p = 0.56 versus 0.68). This model will be useful to identify patients at high risk for PTH who may be candidates for preventive interventions, and to improve their outcomes.
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Inhibition of Voltage-Gated Na+ Channels by Bupivacaine Is Enhanced by the Adjuvants Buprenorphine, Ketamine, and Clonidine.
Background and Objectives: Regional anesthesia includes application of local anesthetics (LAs) into the vicinity of peripheral nerves. Prolongation or improvement of nerve blocks with LAs can be accomplished by coapplication with adjuvants, including buprenorphine, ketamine, and clonidine. While the mechanisms mediating prolonged or improved LA-induced effects by adjuvants are poorly understood, we hypothesized that they are likely to increase LA-induced block of voltage-gated Na+ channels. In this study, we investigated the inhibitory effects of the LA bupivacaine alone and in combination with the adjuvants on neuronal Na+ channels. Methods: Effects of bupivacaine, buprenorphine, ketamine, and clonidine on endogenous Na+ channels in ND7/23 neuroblastoma cells were investigated with whole-cell patch clamp. Results: Bupivacaine, buprenorphine, ketamine, and clonidine are concentration- and state-dependent inhibitors of Na+ currents in ND7/23 cells. Tonic block of resting channels revealed an order of potency of bupivacaine (half-maximal inhibitory concentration [IC50] 178 +/- 8 [mu]M) > buprenorphine (IC50 172 +/- 25) > clonidine (IC50 824 +/- 55 [mu]M) > ketamine (IC50 1377 +/- 92 [mu]M). Bupivacaine and buprenorphine, but not clonidine and ketamine, induced a strong use-dependent block at 10 Hz. Except for clonidine, all substances enhanced fast and slow inactivation. The combination of bupivacaine with one of the adjuvants resulted in a concentration-dependent potentiation bupivacaine-induced block. Conclusions: We demonstrate that buprenorphine, ketamine, and clonidine directly inhibit Na+ channels and that they potentiate the blocking efficacy of bupivacaine on Na+ channels. These data indicate that block of Na+ channels may account for the additive effects of adjuvants used for regional anesthesia. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.
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A New Step Toward Evidence of In Vivo Perineural Dexamethasone Safety: An Animal Study.
Background and Objectives: The aim of this study was to analyze histological nerve toxicity of perineural dexamethasone administration in combination with ropivacaine on mice. Efficacy of perineural dexamethasone in combination with regional anesthesia is clearly demonstrated. However, the safety of this procedure is still a matter of debate. Methods: A sciatic nerve block was performed on 90 mice. Five groups, each containing 18 mice assigned randomly, were used in these experiments: the sham group (isotonic saline solution), R group (perineural ropivacaine), D group (perineural dexamethasone), RDPN group (perineural ropivacaine and perineural dexamethasone), and the RDS group (perineural ropivacaine and systemic dexamethasone). Sensory and motor blocks were evaluated every 30 minutes for 14 hours. Fourteen and 28 days after this procedure, 9 mice in each group were killed for sciatic nerve histological assessment. Results: No statistical difference was observed between different groups for Wallerian degeneration (P = 0.28 at day 14 and P = 0.22 at day 28) and perineural inflammation (P = 0.9 at day 14). Motor and sensory block durations were tested for each group. A statistical difference was observed for motor block duration between the RDPN group (150 minutes [127-172 minutes]), the RDS group (120 minutes [90-120 minutes]), and the R group (60 minutes [60-90 minutes]). Sensory block duration was also statistically different: 660 minutes (660-720 minutes) in the RDPN group, 480 minutes (427-660 minutes) in RDS group, 330 minutes (240-410) in the R group. Conclusions: A combination of ropivacaine and perineural dexamethasone allows longer sensory block duration compared with ropivacaine alone or ropivacaine and systemic dexamethasone, without increased neural toxicity. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.
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Quality and Safety in Health Care, Part XXVI: The Adult Cardiac Surgery Database.
The Adult Cardiac Surgery Database of the Society of Thoracic Surgeons has provided highly useful information in quality and safety in general thoracic surgery, including ratings of the surgeons and institutions participating in this type of surgery. The Adult Cardiac Surgery Database information is very helpful for writing guidelines and determining optimal protocols and for many research projects. This article discusses the history and current status of this database. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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An Alternate, Egg-Free Radiolabeled Meal Formulation for Gastric-Emptying Scintigraphy.
99mTc-radiolabeled scrambled eggs (SEs) are most often used as the ingested solid phase for gastric-emptying scintigraphy, leading egg-reluctant patients to avoid the examination. We formulated and validated 2 egg-free alternate meals, in the absence of any commercialized formulation: chocolate mug cake (MC) and scrambled tofu (ST). Six healthy volunteers underwent gastric-emptying scintigraphy after ingesting 99mTc-radiolabeled MC, ST, or SE. Gastric retention indexes did not change significantly between formulations (% of overtime variation to SE: MC 7.75% +/- 7.1%, ST 7.17% +/- 5.8%; P = 0.6618, not statistically significant), suggesting MC and ST as interesting egg-free alternatives. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Struma Ovarii With Hyperthyroidism.
We report the case of a 61-year-old woman with persistent thyrotoxicosis for 7 years despite low thyroidal radioiodine uptake and methimazole treatment. Her initial 123I whole-body scan (WBS) was read as negative. Upon evaluation in our institution, she remained hyperthyroid after discontinuation of methimazole. Repeat WBS with SPECT/CT revealed low 24-hour thyroidal uptake (RAIU = 2%) and intensely focal radioiodine uptake in a large heterogeneous left pelvic mass, consistent with left adnexal struma ovarii. Resection of this mass confirmed benign struma ovarii. This case illustrates the advantage of fusion SPECT/CT imaging with planar 123I-WBS for diagnosis of extrathyroidal thyrotoxicosis. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Inhibition of Voltage-Gated Na+ Channels by Bupivacaine Is Enhanced by the Adjuvants Buprenorphine, Ketamine, and Clonidine.
Background and Objectives: Regional anesthesia includes application of local anesthetics (LAs) into the vicinity of peripheral nerves. Prolongation or improvement of nerve blocks with LAs can be accomplished by coapplication with adjuvants, including buprenorphine, ketamine, and clonidine. While the mechanisms mediating prolonged or improved LA-induced effects by adjuvants are poorly understood, we hypothesized that they are likely to increase LA-induced block of voltage-gated Na+ channels. In this study, we investigated the inhibitory effects of the LA bupivacaine alone and in combination with the adjuvants on neuronal Na+ channels. Methods: Effects of bupivacaine, buprenorphine, ketamine, and clonidine on endogenous Na+ channels in ND7/23 neuroblastoma cells were investigated with whole-cell patch clamp. Results: Bupivacaine, buprenorphine, ketamine, and clonidine are concentration- and state-dependent inhibitors of Na+ currents in ND7/23 cells. Tonic block of resting channels revealed an order of potency of bupivacaine (half-maximal inhibitory concentration [IC50] 178 +/- 8 [mu]M) > buprenorphine (IC50 172 +/- 25) > clonidine (IC50 824 +/- 55 [mu]M) > ketamine (IC50 1377 +/- 92 [mu]M). Bupivacaine and buprenorphine, but not clonidine and ketamine, induced a strong use-dependent block at 10 Hz. Except for clonidine, all substances enhanced fast and slow inactivation. The combination of bupivacaine with one of the adjuvants resulted in a concentration-dependent potentiation bupivacaine-induced block. Conclusions: We demonstrate that buprenorphine, ketamine, and clonidine directly inhibit Na+ channels and that they potentiate the blocking efficacy of bupivacaine on Na+ channels. These data indicate that block of Na+ channels may account for the additive effects of adjuvants used for regional anesthesia. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.
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A New Step Toward Evidence of In Vivo Perineural Dexamethasone Safety: An Animal Study.
Background and Objectives: The aim of this study was to analyze histological nerve toxicity of perineural dexamethasone administration in combination with ropivacaine on mice. Efficacy of perineural dexamethasone in combination with regional anesthesia is clearly demonstrated. However, the safety of this procedure is still a matter of debate. Methods: A sciatic nerve block was performed on 90 mice. Five groups, each containing 18 mice assigned randomly, were used in these experiments: the sham group (isotonic saline solution), R group (perineural ropivacaine), D group (perineural dexamethasone), RDPN group (perineural ropivacaine and perineural dexamethasone), and the RDS group (perineural ropivacaine and systemic dexamethasone). Sensory and motor blocks were evaluated every 30 minutes for 14 hours. Fourteen and 28 days after this procedure, 9 mice in each group were killed for sciatic nerve histological assessment. Results: No statistical difference was observed between different groups for Wallerian degeneration (P = 0.28 at day 14 and P = 0.22 at day 28) and perineural inflammation (P = 0.9 at day 14). Motor and sensory block durations were tested for each group. A statistical difference was observed for motor block duration between the RDPN group (150 minutes [127-172 minutes]), the RDS group (120 minutes [90-120 minutes]), and the R group (60 minutes [60-90 minutes]). Sensory block duration was also statistically different: 660 minutes (660-720 minutes) in the RDPN group, 480 minutes (427-660 minutes) in RDS group, 330 minutes (240-410) in the R group. Conclusions: A combination of ropivacaine and perineural dexamethasone allows longer sensory block duration compared with ropivacaine alone or ropivacaine and systemic dexamethasone, without increased neural toxicity. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.
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