Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τρίτη 18 Απριλίου 2017

The factor structure of dental fear

There is limited empirical information as to whether or how stimuli associated with dental fear can be classified into distinct subtypes. The purpose of the current study was to develop a descriptive framework for the classification of dental fear. Data were collected using a survey among Dutch twin families (n = 11,771). The sample was randomly divided into two subsamples of, respectively, 5,920 and 5,851 individuals. An exploratory factor analysis (EFA) was performed on the first subsample to delineate the multidimensional structure of a set of 28 dental-fear-provoking objects and situations. The second sample was used to confirm the newly derived model using confirmatory factor analysis (CFA). The EFA yielded a three-factor solution with 70.7% explained variance pertaining to: (i) invasive treatment or pain; (ii) losing control; and (iii) physical sensations. The CFA showed an acceptable fit to the data, thereby confirming the stability of the three-factor structure. There are at least three different subtypes of dental fear. As these subtypes require a different treatment approach in clinical practice, it could be important to assess the severity of patients' fear response along these three dimensions.



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Food protein induced enterocolitis syndrome in Australia: A population based study 2012-2014

Publication date: Available online 18 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Sam Mehr, Katie Frith, Elizabeth H. Barnes, Dianne E. Campbell
BackgroundFood protein induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal allergic disorder. Large population based FPIES studies are lacking.ObjectiveTo determine the incidence and clinical characteristics of FPIES in Australian infantsMethodsAn Australia wide survey (2012-2014) was undertaken via the Australian Paediatric Surveillance Unit, with monthly notification of new cases of acute FPIES in infants aged <24 months by 1400 participating Paediatricians.Results230 infants with FPIES were identified. The incidence of FPIES in Australian infants (<24 months) was 15.4/100,000/year. Median age of first episode, diagnosis and notification were 5, 7 and 10 months respectively. There was no gender predilection. 7% of infants had siblings with a history of FPIES and 5% reacted during exclusive breastfeeding. 68% had a single food trigger (20% two, 12% three or more food triggers). The most common FPIES triggers were rice (45%), cow's milk (33%) and egg (12%). 51% of infants reacted on their first known exposure. Infants with FPIES to multiple versus single food groups were younger at initial episode (4.6 vs. 5.8 months, P=0.001) and more frequently had fruit and/or vegetable FPIES (66% vs. 21%, p<0.0001). Infants exclusively breastfed for more than 4 months had a trend to lower rates of FPIES to multiple food groups (23% vs. 36%, P=0.06). 64% of infants with multiple FPIES which included cow's milk FPIES had co-associated solid food FPIES. 42% of infants with fish-FPIES had reacted to other food groups.ConclusionsFPIES is not rare, with an estimated incidence of 15.4/100,000/year. Rice is the most common food trigger in Australia. Factors associated with multiple-FPIES included early onset disease and FPIES to fruits and/or vegetables.



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Use of vegetable oils in dermatology: an overview

Summary

Vegetable oils have been used for a wide variety of purposes since time immemorial; however, their principle use remains as skin moisturizers, especially in neonates and children. Because of their considerable efficacy and a low side effect profile and bearable cost, these oils are hugely popular as moisturizers among the common people in countries such as India. A wide variety of oils have been used, and newer ones are coming up with each passing day. This article focuses on the different types of vegetable oils and their varied uses in dermatology.



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Preoperative versus Postoperative Radiotherapy in Localized Soft Tissue Sarcoma: Nationwide Patterns of Care and Trends in Utilization

Publication date: Available online 18 April 2017
Source:Practical Radiation Oncology
Author(s): Stanislav Lazarev, Heather McGee, Erin Moshier, Meng Ru, Elizabeth G. Demicco, Vishal Gupta
PurposeThe timing of perioperative radiotherapy (RT) in the treatment of soft tissue sarcoma (STS) varies among institutions. This study examines patterns of care, trends in utilization, and survival with preoperative (preop) versus postoperative (postop) RT for primary STS.MethodsUsing the National Cancer Data Base, we identified patients with stage I-III STS who underwent definitive surgery with either preop or postop RT between 2004 and 2012. Univariate, bivariate, and multivariate analyses were performed to identify factors predicting receipt of preop versus postop RT. Overall survival (OS) was analyzed using the log-rank test, Kaplan–Meier method, and Cox proportional-hazards model.ResultsThis study included 9604 patients: 7246 (75.4%) received postop and 2358 (24.6%) - preop RT. Chemotherapy was administered to 27.0% patients in the preop and 13.0% in the postop cohort. Use of preop RT increased over time, from 16.8% in 2004 to 29.7% in 2012. Multivariate analysis revealed that preop RT utilization increased with the following factors: higher educational attainment, treatment at an academic facility, further distance from facility (>60miles), receipt of chemotherapy, tumor originating in lower extremities, >10cm tumors, myxoid liposarcoma. OS analysis revealed no difference between the two treatment cohorts.ConclusionsPostop RT is utilized much more commonly than preop RT in localized STS. However, preop RT use has increased in recent years. Multiple demographic and clinicopathologic factors were predictive of preop RT use. Consistent with randomized phase 3 data, there was no difference in OS.



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Potential Abscopal Response to Dual Checkpoint Blockade in RCC After Re-Irradiation Using Dose Painting SBRT

Publication date: Available online 18 April 2017
Source:Practical Radiation Oncology
Author(s): Quincey LaPlant, Carl Deselm, Natalie A. Lockney, James Hsieh, Yoshiya Yamada




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Fully-automated, comprehensive knowledge-based planning for stereotactic radiosurgery – pre-clinical validation through blinded physician review

Publication date: Available online 19 April 2017
Source:Practical Radiation Oncology
Author(s): B.P. Ziemer, S. Shiraishi, J.A. Hattangadi-Gluth, P. Sanghvi, K.L. Moore
PurposeAs knowledge-based planning (KBP) attempts to augment and potentially supplant manual treatment planning, it is imperative to ensure any implementation maintains or improves overall plan quality in any disease site. The purpose of this study was to demonstrate the overall quality of KBP-driven automated stereotactic radiosurgery (SRS) treatment planning using blinded physician comparison and determine systematic factors predictive of physician plan preference to guide future KBP refinement.MethodsAutomated non-coplanar volume modulated arc therapy KBP routines were developed for 199 plans across three clinical SRS scenarios: isolated lesions (ISOLATED), lesions closely abutting (<3 cm) organs-at-risk (INVOLVED) and single-isocenter multiple metastases (MULTIMET). Overall plan quality and preference were assessed via blinded review of the plans by two SRS physicians. Quantitative quality metrics (QMs) were also compared to determine systematic differences in the treatment plans. Multiple parameters were investigated as predictors of KBP plan selection.ResultsFor the ISOLATED, INVOLVED and MULTIMET scenarios, the KBP plans were considered to be superior or equivalent to clinical plans 86.7%(91/105), 81.1%(43/53) and 78.1%(32/41) of the time, respectively. All investigated QMs were equivalent or indicated more sparing for all KBP plans. The only non-dosimetric predictor was PTV volume in the ISOLATED (p=0.02) and INVOLVED (p=0.05) groups. The dosimetric predictors for the ISOLATED group were gradient measure and heterogeneity index (both p<0.01). In the MULTIMET category, the only significant dosimetric predictor was inter-lesion dose (p=0.01).ConclusionsThe fully automated KBP SRS plans were equivalent or superior to previously treated plans in 83.4%(166/199) of cases. In clinical implementation, geometric features found to be predictive of KBP performance can be used to identify plans where KBP results might benefit from further refinement, while dosimetric predictive features could be used to further refine KBP optimization priorities.



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Lessons learned from twins in autoimmune and chronic inflammatory diseases

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Publication date: Available online 18 April 2017
Source:Journal of Autoimmunity
Author(s): Elena Generali, Angela Ceribelli, Maria Antonietta Stazi, Carlo Selmi
Autoimmunity and chronic inflammation recognize numerous shared factors and, as a result, the resulting diseases frequently coexist in the same patients or respond to the same treatments. Among the convenient truths of autoimmune and chronic inflammatory diseases, there is now agreement that these are complex conditions in which the individual genetic predisposition provides a rate of heritability. The concordance rates in monozygotic and dizygotic twins allows to estimate the weight of the environment in determining disease susceptibility, despite recent data supporting that only a minority of immune markers depend on hereditary factors. Concordance rates in monozygotic and dizygotic twins should be evaluated over an observation period to minimize the risk of false negatives and this is well represented by type I diabetes mellitus. Further, concordance rates in monozygotic twins should be compared to those in dizygotic twins, which share 50% of their genes, as in regular siblings, but also young-age environmental factors. Twin studies have been extensively performed in several autoimmune conditions and cumulatively suggest that some diseases, i.e. celiac disease and psoriasis, are highly genetically determined, while rheumatoid arthritis or systemic sclerosis have a limited role for genetics. These observations are necessary to interpret data gathered by genome-wide association studies of polymorphisms and DNA methylation in MZ twins. New high-throughput technological platforms are awaited to provide new insights into the mechanisms of disease discordance in twins beyond strong associations such as those with HLA alleles.



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Prospective cluster controlled crossover trial to compare the impact of an improved hydrogen peroxide disinfectant and a quaternary ammonium-based disinfectant on surface contamination and health care outcomes

Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): John M. Boyce, Kerri A. Guercia, Linda Sullivan, Nancy L. Havill, Renee Fekieta, Janet Kozakiewicz, David Goffman
BackgroundQuaternary ammonium–based (Quat) disinfectants are widely used, but they have disadvantages.MethodsThis was a 12-month prospective cluster controlled crossover trial. On 4 wards, housekeepers performed daily cleaning using a disinfectant containing either 0.5% improved hydrogen peroxide (IHP) or Quat. Each month, 5-8 high-touch surfaces in several patient rooms on each ward were tagged with a fluorescent marker and cultured before and after cleaning. Hand hygiene compliance rates and antimicrobial usage on study wards were obtained from hospital records. Outcomes included aerobic colony counts (ACCs), percent of wiped surfaces yielding no growth after cleaning, and a composite outcome of incidence densities of nosocomial acquisition and infection caused by vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus, and Clostridium difficile infection. Statistical analysis was performed using χ2 test, Fisher exact test, Welch test, and logistic regression methods.ResultsMean ACCs per surface after cleaning were significantly lower with IHP (14.0) than with Quat (22.2) (P = .003). The proportion of surfaces yielding no growth after cleaning was significantly greater with IHP (240/500; 48%) than with Quat (182/517; 35.2%) (P < .0001). Composite incidence density of nosocomial colonization or infection with IHP (8.0) was lower than with Quat (10.3) (incidence rate ratio, 0.77; P = .068; 95% confidence interval, 0.579-1.029).ConclusionsCompared with a Quat disinfectant, the IHP disinfectant significantly reduced surface contamination and reduced a composite colonization or infection outcome.



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Epidemiology of device-associated infections in an intensive care unit of a teaching hospital in Nepal: A prospective surveillance study from a developing country

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BackgroundDevice-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs.MethodsA prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal. DA-HAIs were identified using the Centers for Disease Control and Prevention definitions, and their rates were expressed as number of DA-HAIs per 1,000 device-days.ResultsOverall incidence rate of DA-HAIs was 27.3 per 1,000 patient-days occurring in 37.1% of patients. The device utilization ratio for mechanical ventilation, central line catheter, and urinary catheter was 0.83, 0.63, and 0.78, respectively. The rates of VAP, CLABSI, and CAUTI were 21.40, 8.64, and 5.11 per 1,000 device-days, respectively. Acinetobacter spp (32.7%), Klebsiella spp (23.6%), Burkholderia cepacia complex (12.7%), and Escherichia coli (10.9%) were the common bacterial pathogens. Most of the bacterial isolates associated with DA-HAIs were found to be multidrug-resistant.ConclusionsIncidence of DA-HAIs in the study intensive care unit was high compared with that of developed countries. Formulation and implementation of standard infection control protocols, active surveillance of DA-HAIs, and antimicrobial stewardship are urgently needed in our country.



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Klebsiella pneumoniae carbapenemase-producing Serratia marcescens outbreak in a university hospital

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Felipe Francisco Tuon, Kassia Cordova, Thayrine Mayara Dario, Luciana de Souza Nunes, Afonso Luís Barth, Andreza Francisco Martins




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Infection prevention and control and the refugee population: Experiences from the University of Louisville Global Health Center

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Ruth M. Carrico, Linda Goss, Timothy L. Wiemken, Rahel S. Bosson, Paula Peyrani, William A. Mattingly, Allison Pauly, Rebecca A. Ford, Stanley Kotey, Julio A. Ramirez
BackgroundDuring 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful acculturation. The objective of this report is to identify what is currently known about refugees and circumstances important to infection prevention and control with respect to their roles as new community members, employees, and consumers of health care.MethodsUsing data from the University of Louisville Global Health Center's Newly Arriving Refugee Surveillance System, health issues affecting refugees from the perspective of a community member, an employee, and a patient were explored.ResultsLack of immunity to vaccine-preventable diseases is the most widespread issue impacting almost every adult, adolescent, and child refugee resettled in Kentucky. Health issues of concern from an infection prevention and control perspective include latent tuberculosis infection, HIV, hepatitis B, hepatitis C, syphilis, and parasites. Other health conditions that may also be important include anemia, obesity, oral health, diabetes, and cardiovascular disease.ConclusionsRefugee resettlement provides motivation for collaborative work among those responsible for infection prevention and control in all settings, their public health partners, and those responsible for and interested in community workforce concerns.



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Implementation of daily chlorhexidine bathing to reduce colonization by multidrug-resistant organisms in a critical care unit

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Jackson S. Musuuza, Ajay K. Sethi, Tonya J. Roberts, Nasia Safdar
BackgroundColonized patients are a reservoir for transmission of multidrug-resistant organisms (MDROs). Not many studies have examined the effectiveness of daily chlorhexidine gluconate (CHG) bathing under routine care conditions. We present a descriptive analysis of the trends of MDRO colonization following implementation of daily CHG bathing under routine clinical conditions in an intensive care unit (ICU).MethodsFrom May 2010-January 2011, we screened patients admitted to a 24-bed ICU for and methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and fluoroquinolone-resistant gram-negative bacilli (FQRGNB). We calculated and plotted monthly incidence and prevalence of colonization of these MDROs.ResultsPrevalence decreased in the immediate aftermath of daily CHG bathing implementation and generally remained at that level throughout the observation period. We observed low rates of incidence of MDRO colonization with VRE>FQRGNB>MRSA. Monthly prevalence of colonization and incidence for the composite of MRSA, VRE, and/or FQRGNB was 1.9%-27.9% and 0-1.1/100 patient-days, respectively.ConclusionsFollowing the implementation of daily CHG bathing, the incidence of MDROs remained low and constant over time, whereas the prevalence decreased immediately after the implementation.



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Comparing knowledge and self-reported hand hygiene practices with direct observation among Iranian hospital nurses

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Seyed Sadeq Seyed Nematian, Charles John Palenik, Seyed Kousha Mirmasoudi, Nahid Hatam, Mehrdad Askarian
We compared knowledge and self-reported hand hygiene practices with direct observations among Shiraz Nemazee Hospital nurses. Overall hand hygiene compliance was low (39.6%). Use and appreciation for alcohol-based handrubs were suboptimal. Some reluctance was due to religious concerns. Most nurses self-reported performing proper hand hygiene more than 75% of the time, whereas direct observation indicated much lower levels of compliance. It appears that additional training and improved monitoring are needed.



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Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Lisa Pineles, Daniel J. Morgan, Alison Lydecker, J. Kristie Johnson, John D. Sorkin, Patricia Langenberg, Natalia Blanco, Alan Lesse, John Sellick, Kalpana Gupta, Luci Leykum, Jose Cadena, Nickie Lepcha, Mary-Claire Roghmann
BackgroundThis was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies.MethodsParticipants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present). HCWs wore gowns and gloves during usual care activities. After each activity, a research coordinator swabbed the HCW's gown and gloves. Swabs were cultured for MRSA.ResultsThere were 200 residents enrolled; 94 (46%) were MRSA colonized. Glove contamination was higher than gown contamination (20% vs 11%, respectively; P < .01). Transmission varied greatly by type of care from 0%-19% for gowns and 7%-37% for gloves. High-risk care activities (odds ratio [OR] > 1.0, P < .05) for gown contamination included changing dressings (eg, wound), dressing, providing hygiene (eg, brushing teeth), and bathing. Low-risk care activities (OR < 1.0, P < .05 or no transmission) for gown contamination included glucose monitoring, giving medications, and feeding.ConclusionsMRSA transmission from colonized residents to gloves was higher than transmission to gowns. Transmission to gloves varies by type of care, but all care had a risk of contamination, demonstrating the importance of hand hygiene after all care. Transmission to gowns was significantly higher with certain types of care. Optimizing gown and glove use by targeting high-risk care activities could improve resident-centered care for MRSA-colonized residents by promoting a home-like environment.



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Health care–associated infections studies project: An American Journal of Infection Control and National Healthcare Safety Network data quality collaboration

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Henrietta Smith, Janet E. Brooks, Denise Leaptrot, Katherine Allen-Bridson, Angela Anttila, Cindy Gross, Joan N. Hebden, Georganne Ryan, Eileen Scalise, Marc-Oliver Wright
This case study is part of a series centered on the Centers for Disease Control and Prevention's National Healthcare Safety Network's (NHSN) health care–associated infection (HAI) surveillance definitions. The intent of the case study series is to foster standardized application of the NHSN's HAI surveillance definitions among infection preventionists and accurate determination of HAI events. This specific case study focuses on the definitions found within the surgical site infection (SSI) protocol. It aims to reflect the real life and complex patient scenario surrounding a bloodstream infection that is secondary to an SSI and the application of the Present at the Time of Surgery event detail. An online survey link is provided where participants may confidentially answer questions related to the case study and receive immediate feedback in the form of correct answers and explanations and rationales. Details of the case study, answers, and explanations have been reviewed and approved by NHSN staff. We hope that participants take advantage of this educational offering and thereby gain a greater understanding of the NHSN's HAI surveillance definitions.



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Ultraviolet-C light as a means of disinfecting anesthesia workstations

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Matthew Nottingham, Gene Peterson, Christopher Doern, Michelle Doll, Nadia Masroor, Kakotan Sanogo, Michael Stevens, Gonzalo Bearman
BackgroundAnesthesia workstations (AWs) are a reservoir for pathogenic organisms potentially associated with surgical site infections. This study examined the effectiveness of the Tru-D SmartUVC device (Tru-D LLC, Nashville, TN) on bioburden reduction (BR) on AWs.MethodsStrips of tissue inoculated with a known concentration of either Staphylococcus aureus, Enterococcus faecalis, or Acinetobacter sp were placed on 22 high-touch surfaces of an AW. Half of the AW surfaces received direct ultraviolet (UV) light exposure and half received indirect exposure. Two inoculated strips, in sterile tubes outside of the room, represented the control. Trials were conducted on AWs in an operating room and a small room. Strips were placed in a saline solution, vortexed, and plated on blood agar to assess BR by the number of colony forming units.ResultsAll experimental trials, compared with controls, exhibited a BR >99%. There was a significantly greater reduction of E faecalis colony forming units in the operating room AW under direct exposure (P = .019) compared with indirect exposure. There was no significant difference in reduction when comparing AWs between rooms.ConclusionRegardless of room size and exposure type, automated UV-C treatment greatly influences BR on AW high-touch surfaces. Hospitals instituting an automated UV-C system as an infection prevention adjunct should consider utilizing it in operating rooms for BR as part of a horizontal infection prevention surgical site infection-reduction strategy.



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How well does transfer of bacterial pathogens by culture swabs correlate with transfer by hands?

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Anubhav Kanwar, Thriveen S.C. Mana, Jennifer L. Cadnum, Heba Alhmidi, Sreelatha Koganti, Curtis J. Donskey
In laboratory testing and in isolation rooms, pickup and transfer of health care-associated pathogens by premoistened rayon swabs correlated well with pickup and transfer by bare hands or moistened gloves. These results suggest that swab cultures provide a useful surrogate indicator of the risk for pathogen pickup and transfer by hands.



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Guideline compliance and clinical outcomes among patients with Staphylococcus aureus bacteremia with infectious diseases consultation in addition to antimicrobial stewardship-directed review

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Publication date: Available online 18 April 2017
Source:American Journal of Infection Control
Author(s): Kevin Buehrle, Jennifer Pisano, Zhe Han, Natasha N. Pettit
ObjectivePrevious studies have shown infectious diseases consultation (IDC) for Staphylococcus aureus bacteremia (SAB) improves management and outcomes. The influence of IDC on outcomes for SAB in addition to an antimicrobial stewardship program (ASP) review for adult inpatients with SAB has not been evaluated. The purpose of this study was to investigate the effect of IDC on SAB management with concomitant ASP review and resulting outcomes.MethodsAdult inpatients with SAB admitted December 2012-October 2014 were included. The primary end point compared adherence to Infectious Disease Society of America guideline recommendations between patients receiving an IDC versus those not receiving an IDC. We also evaluated adherence to the individual components of the primary end point and clinical outcomes, including time to microbiologic clearance, recurrence of bacteremia, mortality, and length of stay.ResultsThis study included 154 patients (115 IDC and 39 non-IDC). Guideline adherence was significantly greater in the IDC group 78% versus 46% in the non-IDC group (P < .001). Significantly more patients in the IDC group had echocardiography (91% vs 67%; P < .001) and follow-up blood cultures (92% vs 64%; P > .001). Mortality was also greater in the non-IDC group (23%) versus 5% for the IDC group (P = .001).ConclusionsPatients with SAB receiving an IDC were more likely to receive guideline-congruent management and had significantly reduced mortality. No improvements in antibiotic choice or dosing were observed, likely a result of ASP review.



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Evolutionary genetics: Fantastic beasts — cephalopod RNA recoding



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Persistence in Temporary Lung Niches: A Survival Strategy of Lung-Resident Memory CD8+ T Cells

Viral Immunology , Vol. 0, No. 0.


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Evaluation in Mice of the Immunogenicity of a Tetravalent Subunit Vaccine Candidate Against Dengue Virus Using Mucosal and Parenteral Immunization Routes

Viral Immunology , Vol. 0, No. 0.


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Response: Prevalence of BRAF(V600E) mutation in Asian patients with thyroid cancer.

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Response: Prevalence of BRAF(V600E) mutation in Asian patients with thyroid cancer.

Malays J Pathol. 2017 Apr;39(1):97

Authors: Navarro-Locsin CG

Abstract
No abstract available.

PMID: 28413213 [PubMed - in process]



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Prevalence of BRAF(V600E) mutation in Asian patients with thyroid cancer.

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Prevalence of BRAF(V600E) mutation in Asian patients with thyroid cancer.

Malays J Pathol. 2017 Apr;39(1):95-96

Authors: Bychkov A

Abstract
No abstract available.

PMID: 28413212 [PubMed - in process]



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Vaginal Brenner tumor with literature review: does this tumour originate from Walthard nests?

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Vaginal Brenner tumor with literature review: does this tumour originate from Walthard nests?

Malays J Pathol. 2017 Apr;39(1):89-93

Authors: Park S, Cho MS

Abstract
Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.

PMID: 28413211 [PubMed - in process]



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Acute pulmonary thromboembolism in a case of fatal child abuse.

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Acute pulmonary thromboembolism in a case of fatal child abuse.

Malays J Pathol. 2017 Apr;39(1):83-87

Authors: Rahimi R, Zulkifli ZF, Omar E, Ismail H, Md Noor S

Abstract
Child abuse is a worldwide problem. The four major types of abuse include physical abuse, child neglect, psychological maltreatment and sexual violence. We describe a fatal case of child abuse which presented with numerous old and recent soft tissue injuries all over the body. The injuries on the legs have immobilized the victim for quite some time, giving rise to deep vein thrombosis, leading to death as a result of acute pulmonary thromboembolism. This case demonstrates presence of both elements of abuse and neglect in one victim. As this category of crime involves a helpless child, we would also like to reiterate that the community has an obligation to prevent such tragedies and educating the public to recognize the signs and symptoms of abuse would be of utmost important. Ultimately, the community must also be responsible for reporting such offences and the act of silence is akin to condoning a crime witnessed.

PMID: 28413210 [PubMed - in process]



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Duplication 17p11.2 (Potocki-Lupski Syndrome) in a child with developmental delay.

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Duplication 17p11.2 (Potocki-Lupski Syndrome) in a child with developmental delay.

Malays J Pathol. 2017 Apr;39(1):77-81

Authors: Shuib S, Saaid NN, Zakaria Z, Ismail J, Abdul Latiff Z

Abstract
Potocki-Lupski syndrome (PTLS), also known as duplication 17p11.2 syndrome, trisomy 17p11.2 or dup(17)(p11.2p11.2) syndrome, is a developmental disorder and a rare contiguous gene syndrome affecting 1 in 20,000 live births. Among the key features of such patients are autism spectrum disorder, learning disabilities, developmental delay, attention-deficit disorder, infantile hypotonia and cardiovascular abnormalities. Previous studies using microarray identified variations in the size and extent of the duplicated region of chromosome 17p11.2. However, there are a few genes which are considered as candidates for PTLS which include RAI1, SREBF1, DRG2, LLGL1, SHMT1 and ZFP179. In this report, we investigated a case of a 3-year-old girl who has developmental delay. Her chromosome analysis showed a normal karyotype (46,XX). Analysis using array CGH (4X44 K, Agilent USA) identified an ~4.2 Mb de novo duplication in chromosome 17p11.2. The result was confirmed by fluorescence in situ hybridization (FISH) using probes in the critical PTLS region. This report demonstrates the importance of microarray and FISH in the diagnosis of PTLS.

PMID: 28413209 [PubMed - in process]



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Anti-M induced severe haemolytic disease of foetus and newborn in a Malay woman with recurrent pregnancy loss.

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Anti-M induced severe haemolytic disease of foetus and newborn in a Malay woman with recurrent pregnancy loss.

Malays J Pathol. 2017 Apr;39(1):73-76

Authors: Mohd Nazri H, Noor Haslina MN, Shafini MY, Noor Shaidatul Akmal AR, Rapiaah M, Wan Zaidah A

Abstract
Haemolytic disease of the foetus and newborn (HDFN) is caused by maternal red blood cells (RBC) alloimmunisation resulted from incompatibility of maternal and foetal RBCs. However, only a few HDFN attributed to anti-M were reported, varying from asymptomatic to severe anaemia with hydrops foetalis and even intrauterine death. A case of severe HDFN due to anti-M alloantibody from an alloimmunized grandmultiparous Malay woman with recurrent pregnancy loss is reported here. The newborn was delivered with severe and prolonged anaemia which required frequent RBC transfusions, intensive phototherapy and intravenous immunoglobulin administration. Although anti-M is rarely known to cause severe HDFN, a careful serological work-up and close assessment of foetal well-being is important, similar to the management of RhD HDFN. Alloimmunisation with anti-M type can lead to severe HDFN and even foetal loss.

PMID: 28413208 [PubMed - in process]



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Rate of active Helicobacter pylori infection among symptomatic patients of Pakistan.

Related Articles

Rate of active Helicobacter pylori infection among symptomatic patients of Pakistan.

Malays J Pathol. 2017 Apr;39(1):69-72

Authors: Rasheed F, Yameen A, Ahmad T, Bilal R

Abstract
Only few epidemiological studies have examined the rate of active H. pylori infection in the symptomatic population in Pakistan. This retrospective study presents the laboratory data collected during the past 13 years (2002 to 2015) from 2315 symptomatic patients referred to the BreathMAT Lab, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad for the diagnosis of active H. pylori infection using the (13)C Urea Breath Test. Rate of infection and its association with gender and age were evaluated. The overall rate of active H. pylori infection was 49.5% and there was no association of this rate of infection with gender. An increase in rate of infection was observed with increasing age with significant difference (p < 0.05). The patients that tested negative for this infection might be having symptoms due to stress and indiscriminate use of non-steroidal antiinflammatory drugs (NSAIDs) in this community. The fact that half of the symptomatic patients were negative needs to be highlighted and further suggests that symptomatic patients should be tested by the (13)C UBT before prescribing antibiotic treatment for H. pylori eradication. In addition, there is a need to educate this community about the harmful and side effects of self medication and overuse of NSAIDs.

PMID: 28413207 [PubMed - in process]



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Differential diagnostic significance of HBME-1, CK19 and S100 in various thyroid lesions.

Related Articles

Differential diagnostic significance of HBME-1, CK19 and S100 in various thyroid lesions.

Malays J Pathol. 2017 Apr;39(1):55-67

Authors: Palo S, Biligi DS

Abstract
OBJECTIVE: Due several overlapping histomorphological features and pitfalls in thyroid pathology, there is need to establish a panel of immunomarkers that would aid in proper diagnosis. This study was carried out to investigate the ability of HBME-1, CK19, and S100 in differentiating between hyperplastic, benign and malignant thyroid lesions.
MATERIALS AND METHODS: Immunohistochemical analysis of 60 thyroidectomy specimens (10 hyperplastic nodules, 14 follicular adenomas and 36 malignant thyroid neoplasms) was carried out. The extent and intensity of HBME-1, CK19, and S100 immunoreactivity was assessed in each case.
RESULTS: HBME-1 positivity was noted in 86.1% of malignant cases while the majority of the benign lesions were negative. Diffuse strong CK19 positivity was documented in 27/31 papillary carcinoma whereas all cases of follicular carcinoma and medullary carcinoma were negative. Most of the hyperplastic nodules and follicular adenomas were also CK19 negative, although focal weak staining was noted in a few cases. S100 was positive only in medullary carcinoma. HBME-1 was most sensitive (86.1%) and specific (87.5%) in distinguishing between benign and malignant thyroid lesions. The diagnostic accuracy was further increased when HBME-1 was used simultaneously with CK19/S100/CK19+S100. The sequential use of HBME-1 and CK19 also proved beneficial in discriminating between the various follicular-patterned thyroid lesions.
CONCLUSION: HBME-1 immunolabeling suggests malignancy, whereas strong diffuse CK19 positivity substantiates papillary differentiation. The utilization of these markers (alone or in combination) along with histomorphological evaluation is helpful in the differential diagnosis. S100 has minimal utility in this regard.

PMID: 28413206 [PubMed - in process]



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Oral ketamine induced pathological changes of the urinary tract in a rat model.

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Oral ketamine induced pathological changes of the urinary tract in a rat model.

Malays J Pathol. 2017 Apr;39(1):47-53

Authors: Rajandram R, Yap NY, Ong TA, Mun KS, Mohamad Wali HA, Hasan MS, Razack AHA, Ali Mohd M

Abstract
INTRODUCTION: In recent years, prolonged ketamine abuse has been reported to cause urinary tract damage. However, there is little information on the pathological effects of ketamine from oral administration. We aimed to study the effects of oral ketamine on the urinary tract and the reversibility of these changes after cessation of ketamine intake.
METHODS: Rats were fed with illicit (a concoction of street ketamine) ketamine in doses of 100 (N=12), or 300 mg/kg (N=12) for four weeks. Half of the rats were sacrificed after the 4-week feeding for necropsy. The remaining rats were taken off ketamine for 8 weeks to allow for any potential recovery of pathological changes before being sacrificed for necropsy. Histopathological examination was performed on the kidney and urinary bladder.
RESULTS: Submucosal bladder inflammation was seen in 67% of the rats fed with 300 mg/kg illicit ketamine. No bladder inflammation was observed in the control and 100 mg/kg illicit ketamine groups. Renal changes, such as interstitial nephritis and papillary necrosis, were observed in rats given illicit ketamine. After ketamine cessation, no inflammation was observed in the bladder of all rats. However, renal inflammation remained in 60% of the rats given illicit ketamine. No dose-effect relationship was established between oral ketamine and changes in the kidneys.
CONCLUSION: Oral ketamine caused pathological changes in the urinary tract, similar to that described in exposure to parenteral ketamine. The changes in the urinary bladder were reversible after short-term exposure.

PMID: 28413205 [PubMed - in process]



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The study of the circannual relationship between the activity of the epiphysis and gonads in rats of different sex and age.

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The study of the circannual relationship between the activity of the epiphysis and gonads in rats of different sex and age.

Malays J Pathol. 2017 Apr;39(1):39-45

Authors: Kononenko N, Hnatiuk V

Abstract
BACKGROUND: The relationship between the activity of the epiphysis and gonads in rats of different sex and age in different seasons of the year was determined by studying the levels of melatonin and testosterone in the blood plasma. Determination of the levels of melatonin and testosterone in the serum of rats was carried out by enzyme-linked immunosorbent assay. To assess the relationship between the levels of melatonin and testosterone the correlation coefficient was calculated. Based on the study of the levels of melatonin and testosterone in serum the circannual relationship between the activity of the pineal gland and gonads in males of reproductive age has been determined. In females, the relationship between the levels of melatonin and testosterone without the circannual dependence has been determined. The strongest correlation between melatonin and testosterone is present in males at the age of 9 months in autumn, and it corresponds to the human age of 29-30 years.

PMID: 28413204 [PubMed - in process]



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Nuclear morphometry and texture analysis on cytological smears of thyroid neoplasms: a study of 50 cases.

Related Articles

Nuclear morphometry and texture analysis on cytological smears of thyroid neoplasms: a study of 50 cases.

Malays J Pathol. 2017 Apr;39(1):33-37

Authors: Deka L, Gupta S, Gupta R, Gupta K, Kaur CJ, Singh S S

Abstract
BACKGROUND: Fine needle aspiration cytology (FNAC) is a reliable and reproducible diagnostic technique for thyroid lesions with certain limitations. Computed morphometric methods have been introduced with a view to improve the diagnostic yield of thyroid aspirates. However, a review of the existing literature revealed conflicting reports regarding morphometric parameters in thyroid neoplasms.
MATERIALS AND METHODS: This study included 50 cases of thyroid lesions (20 cases of colloid goitre, 15 of follicular adenoma, 5 of follicular carcinoma and 10 papillary carcinomas). Digital images of cytologic smears of these cases were captured using a dedicated photomicrography system and nuclear profiles traced manually. With self-designed image analysis software, nuclear morphometric measurements, including texture analysis, were performed. Discriminant analysis was performed including the morphometric parameters and percentage of correctly classified nuclei noted.
RESULTS: Nuclear morphometry parameters showed that papillary thyroid carcinoma had the highest perimeter, area, radius and elongation factor compared to other thyroid lesions. Discriminant analysis revealed that altogether 77.9% of cells could be correctly classified to their lesion category based on the nuclear morphometric and textural parameters. Of the neoplastic cases, 84.5% of cells of follicular neoplasms and 72.5% of papillary carcinoma were classified to the respective category.
CONCLUSION: Nuclear morphometry, including texture analysis, can assist in the cytologic diagnosis of thyroid lesions, considering the high degree of accuracy of classification. Further studies and methodological refinements can achieve higher accuracy.

PMID: 28413203 [PubMed - in process]



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Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic.

Related Articles

Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic.

Malays J Pathol. 2017 Apr;39(1):25-31

Authors: Situ SF, Ding CH, Nawi S, Johar A, Ramli R

Abstract
BACKGROUND: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria.
METHODS: Ninety five first-time male attendees of the Genito-urinary Medicine Clinic in Hospital Kuala Lumpur were included in this cross-sectional study. The detection of C. trachomatis was achieved through direct fluorescence antibody (DFA) staining of urethral swabs and real-time polymerase chain reaction testing (Xpert(®) CT/NG assay) on urine specimens. N. gonorrhoeae was detected through Gram staining and culture of urethral swabs and Xpert(®) CT/ NG assay on urine specimens.
RESULTS: From the Xpert(®) CT/NG results, 11 (11.6%) attendees had chlamydia, 23 (24.2%) had gonorrhoea and 8 (8.4%) had both STIs. The sensitivity and specificity of DFA in detecting chlamydia compared to Xpert(®) CT/NG were 5.3% (95% CI: 0-28) and 94.7% (95% CI: 86-98), respectively. For gonorrhoea, the sensitivity and specificity of Gram staining were 90.3% (95% CI: 73-98) and 95.3% (86-99), respectively, whereas the sensitivity and specificity of culture compared to Xpert(®) CT/NG were 32.2% (95% CI: 17-51) and 100% (95% CI: 93-100), respectively.
CONCLUSION: Although Gram-stained urethral swab smears are sensitive enough to be retained as a screening tool for gonorrhoea, culture as well as DFA lack sensitivity and are poorly suited to screen for gonorrhoea and chlamydia, respectively. However, owing to their high specificity, conventional detection methods are still suitable as confirmatory tests for gonorrhoea and chlamydia.

PMID: 28413202 [PubMed - in process]



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Detection of α-thalassaemia in neonates on cord blood and dried blood spot samples by capillary electrophoresis.

Related Articles

Detection of α-thalassaemia in neonates on cord blood and dried blood spot samples by capillary electrophoresis.

Malays J Pathol. 2017 Apr;39(1):17-23

Authors: Alauddin H, Langa M, Mohd Yusoff M, Raja Sabudin RZA, Ithnin A, Abdul Razak NF, Sardi NH, Hussin NH

Abstract
INTRODUCTION: Haemoglobin Bart's (Hb Bart's) level is associated with α-thalassaemia traits in neonates, enabling early diagnosis of α-thalassaemia. The study aimed to detect and quantify the Hb Bart's using Cord Blood (CB) and CE Neonat Fast Hb (NF) progammes on fresh and dried blood spot (DBS) specimen respectively by capillary electrophoresis (CE).
METHODS: Capillarys Hemoglobin (E) Kit (for CB) and Capillarys Neonat Hb Kit (for NF) were used to detect and quantify Hb Bart's by CE in fresh cord blood and dried blood spot (DBS) specimens respectively. High performance liquid chromatography (HPLC) using the β-Thal Short Programme was also performed concurrently with CE analysis. Confirmation was obtained by multiplex ARMS Gap PCR.
RESULTS: This study was performed on 600 neonates. 32/600 (5.3%) samples showed presence of Hb Bart's peak using the NF programme while 33/600 (5.5%) were positive with CB programme and HPLC methods. The range of Hb Bart's using NF programme and CB programme were (0.5-4.1%) and (0.5-7.1%), respectively. Molecular analysis confirmed all positive samples possessed α-thalassaemia genetic mutations, with 23/33 cases being αα/--(SEA), four -α(3.7)/-α(3.7), two αα/-α(3.7) and three αα/αα(CS). Fifty Hb Bart's negative samples were randomly tested for α-genotypes, three were also found to be positive for α-globin gene mutations. Thus, resulting in sensitivity of 91.7% and 88.9% and specificity of 100% for the Capillarys Cord Blood programme and Capillarys Neonat Fast programme respectively.
CONCLUSION: Both CE programmes using fresh or dried cord blood were useful as a screening tool for α-thalassaemia in newborns. All methods show the same specificity (100%) with variable, but acceptable sensitivities in the detection of Hb Bart.

PMID: 28413201 [PubMed - in process]



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The oral microbiome community variations associated with normal, potentially malignant disorders and malignant lesions of the oral cavity.

Related Articles

The oral microbiome community variations associated with normal, potentially malignant disorders and malignant lesions of the oral cavity.

Malays J Pathol. 2017 Apr;39(1):1-15

Authors: Mok SF, Karuthan C, Cheah YK, Ngeow WC, Rosnah Z, Yap SF, Ong HKA

Abstract
The human oral microbiome has been known to show strong association with various oral diseases including oral cancer. This study attempts to characterize the community variations between normal, oral potentially malignant disorders (OPMD) and cancer associated microbiota using 16S rDNA sequencing. Swab samples were collected from three groups (normal, OPMD and oral cancer) with nine subjects from each group. Bacteria genomic DNA was isolated in which full length 16S rDNA were amplified and used for cloned library sequencing. 16S rDNA sequences were processed and analysed with MOTHUR. A core oral microbiome was identified consisting of Firmicutes, Proteobacteria, Fusobacteria, Bacteroidetes and Actinobacteria at the phylum level while Streptococcus, Veillonella, Gemella, Granulicatella, Neisseria, Haemophilus, Selenomonas, Fusobacterium, Leptotrichia, Prevotella, Porphyromonas and Lachnoanaerobaculum were detected at the genus level. Firmicutes and Streptococcus were the predominant phylum and genus respectively. Potential oral microbiome memberships unique to normal, OPMD and oral cancer oral cavities were also identified. Analysis of Molecular Variance (AMOVA) showed a significant difference between the normal and the cancer associated oral microbiota but not between the OPMD and the other two groups. However, 2D NMDS showed an overlapping of the OPMD associated oral microbiome between the normal and cancer groups. These findings indicated that oral microbes could be potential biomarkers to distinguish between normal, OPMD and cancer subjects.

PMID: 28413200 [PubMed - in process]



http://ift.tt/2olJA63

Oral intake of Boesenbergia pandurata extract improves skin hydration, gloss, and wrinkling: A randomized, double-blind, and placebo-controlled study

Summary

Background

Photoaging is a severe skin damage that occurs as a result of exposure to external elements, primarily ultraviolet (UV) irradiation. Chronically, UV-irradiated skin exhibits the signs of sunburn and hyperpigmentation with the destruction of connective tissues. Previously, Boesenbergia pandurata (B. pandurata) and its active compound panduratin A showed antiphotoaging activities in vitro and in vivo.

Objective

The aim of this study was to investigate the clinical efficacy of B. pandurata intake on skin hydration, gloss, wrinkling, and elasticity.

Methods

A double-blind, placebo-controlled trial was conducted to clinically evaluate the effect of B. pandurata ethanol extract (BPE) containing 8% of panduratin A on human skin hydration, gloss, wrinkling, and elasticity. Ninety-two subjects were randomly assigned to receive tablets containing either BPE or placebo for 12 weeks.

Results

The test group had significantly increased skin hydration and gloss and decreased wrinkling compared to the placebo group at 12 weeks. There was no significant difference in skin elasticity between the two groups; however, the increment rate in the test group was higher than that in the placebo group at 12 weeks. None of the subjects developed adverse symptoms during the study period.

Conclusion

These results suggest that BPE can be used as a nutraceutical or nutricosmetic material for improving human skin hydration, gloss, and wrinkling.



http://ift.tt/2oMePIC

Oral intake of Boesenbergia pandurata extract improves skin hydration, gloss, and wrinkling: A randomized, double-blind, and placebo-controlled study

Summary

Background

Photoaging is a severe skin damage that occurs as a result of exposure to external elements, primarily ultraviolet (UV) irradiation. Chronically, UV-irradiated skin exhibits the signs of sunburn and hyperpigmentation with the destruction of connective tissues. Previously, Boesenbergia pandurata (B. pandurata) and its active compound panduratin A showed antiphotoaging activities in vitro and in vivo.

Objective

The aim of this study was to investigate the clinical efficacy of B. pandurata intake on skin hydration, gloss, wrinkling, and elasticity.

Methods

A double-blind, placebo-controlled trial was conducted to clinically evaluate the effect of B. pandurata ethanol extract (BPE) containing 8% of panduratin A on human skin hydration, gloss, wrinkling, and elasticity. Ninety-two subjects were randomly assigned to receive tablets containing either BPE or placebo for 12 weeks.

Results

The test group had significantly increased skin hydration and gloss and decreased wrinkling compared to the placebo group at 12 weeks. There was no significant difference in skin elasticity between the two groups; however, the increment rate in the test group was higher than that in the placebo group at 12 weeks. None of the subjects developed adverse symptoms during the study period.

Conclusion

These results suggest that BPE can be used as a nutraceutical or nutricosmetic material for improving human skin hydration, gloss, and wrinkling.



http://ift.tt/2oMePIC

Non-linear enhancement of mRNA delivery efficiencies by influenza A derived NS1 protein engendering host gene inhibition property

Publication date: July 2017
Source:Biomaterials, Volume 133
Author(s): Kyle K.L. Phua, Yi Liu, Shun Hui Sim
Nucleic acid induced immunogenicity remains a significant impediment in biomedical therapeutics because the innate immune system is a complex network overlaid with functional redundancies. Herein we report that non-structural protein 1 (NS1), an immune evasion protein derived from influenza A virus, when co-delivered in mRNA format is a potent mRNA transfection enhancer without toxicity. Transfection enhancement is mediated by NS1's effector domain through inhibition of IRF3 and PKR, activators of early anti-viral responses as well as CPSF30, a non immunostimulating protein. Importantly, host gene inhibition mediated via CPSF30 inhibition is a highly effective immune evasion mechanism because it blocks de novo gene expression non-specifically and inhibits global anti-viral responses during mRNA transfection. We show that only NS1 with CPSF30 inhibition property can enhance modified mRNA transfections. Furthermore, transfection efficiency of unmodified mRNA, if co-delivered with NS1-TX91 mRNA, can exceed that of modified mRNA in HepG2, RAW 264.7 and HeLa cells. The novel impact of NS1-TX91 lays the foundation of a virus inspired immune evasion genes co-delivery approach that can address problems arising from RNA immunogenicity for non-vaccine mRNA therapeutics in an affordable and scalable way. It is also transferable to applications that benefits from active inhibition of material-induced immunogenicity.

Graphical abstract

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Cell-borne 2D nanomaterials for efficient cancer targeting and photothermal therapy

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Publication date: July 2017
Source:Biomaterials, Volume 133
Author(s): Zhibin Li, Jundong Shao, Qian Luo, Xue-Feng Yu, Hanhan Xie, Haidi Fu, Siying Tang, Huaiyu Wang, Guangli Han, Paul K. Chu
Two of the challenges for clinical implementation of nano-therapeutic strategies are optimization of tumor targeting and clearance of the nanoagents in vivo. Herein, a cell-mediated therapy by transporting 2D Bi2Se3 nanosheets within macrophage vehicles is described. The Bi2Se3 nanosheets with excellent near-infrared photothermal performance exhibit high macrophage uptake and negligible cytotoxicity thus facilitating the fabrication of Bi2Se3-laden-macrophages. Compared with bare Bi2Se3, the Bi2Se3-laden-macrophages after intravenous injection show prolonged blood circulation and can overcome the hypoxia-associated drug delivery barrier to target the tumor efficiently and dramatically enhance the efficiency of photothermal cancer therapy. The Bi2Se3-laden-macrophages possess good biocompatibility as demonstrated by the biochemical and histological analyses and furthermore, most of the materials are excreted from the body within 25 days. Our findings reveal a desirable system for highly efficient near-infrared photothermal cancer therapy.



http://ift.tt/2pOZNRD

Allogenic bone grafts in post-traumatic juxta-articular defects: Need for allogenic bone banking

Publication date: Available online 18 April 2017
Source:Medical Journal Armed Forces India
Author(s): Anil Kumar Mishra, Rohit Vikas, H.S. Agrawal
Allogenic bone banking provide both structural and granular bone grafts for various orthopaedic, spinal, oncological and dental surgeries. However allogenic bones, presently, are not readily available. This article discusses the clinical applications of the allogenic grafts, the screening criteria and procedure for maintenance of such a bone banking facility. This article demonstrates the effective role of allogenic bone in a case of post-traumatic bone loss situation and discusses the growing need and present situation of bone banking in our country.



http://ift.tt/2pyLFzB

Panendoscopic characterization of Cronkhite–Canada syndrome

Publication date: Available online 18 April 2017
Source:Medical Journal Armed Forces India
Author(s): Ashish Kumar Jha, Amarendra Kumar, Sanjeet Kumar Singh, Richa Madhawi




http://ift.tt/2oM8Wee

Risk factors for degenerative aortic valve disease in India: A case control study

Publication date: Available online 18 April 2017
Source:Medical Journal Armed Forces India
Author(s): D.S. Chadha, S.K. Malani, P. Bharadwaj, G. Karthikeyan, P.K. Hasija
BackgroundDegenerative aortic valve disease often co-exists with coronary artery disease (CAD) and studies done in western populations have shown that it shares the same risk factors which cause CAD. However little is known in this context among Asian Indians. The current study looks into the risk factors of degenerative aortic valve disease in Asian Indian population.MethodsNinety-one consecutive patients with severe aortic stenosis (AS) reporting for left heart catheterization prior to valve replacement surgery at a tertiary care centre were recruited for the study. They were compared with age and sex matched controls selected from a database of 3200 patients referred for elective diagnostic left heart catheterization for suspected CAD. Following traditional cardiovascular risk factors were assessed in all patients: age, gender, family history of CAD, smoking history, presence of diabetes, hypertension and dyslipidemia.ResultsThe mean age of the study population was 57.8±8.2 years (range, 40–80 years). Smoking, family history of CAD and hypercholesterolemia were significantly more prevalent in patients with degenerative AS compared to those with normal valves. No significant difference was noted in the presence of diabetes mellitus. On multivariate logistic regression, family history of premature CAD (OR 3.68; CI 1.38–9.78) smoking history (OR, 2.56; CI, 1.21–5.39), and raised LDL levels (OR, 5.55; CI, 2.63–11.69) were independently associated with the aortic stenosis patient cohort.ConclusionsThe study showed a significant association of cardiovascular risk factors with aortic stenosis independent of age and gender in Asian Indian patients.



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Genetics of thyroid function

Publication date: Available online 18 April 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Marco Medici, Theo J. Visser, Robin P. Peeters
Recent studies show that subtle variations in thyroid function, including subclinical thyroid dysfunction, and even variation in thyroid function within the normal range, are associated with morbidity and mortality. It is estimated that 40-65% of the inter-individual variation in serum TSH and FT4 levels is determined by genetic factors. To identify these factors, various linkage and candidate gene studies have been performed in the past, which have identified only a few genes. In the last decade, genome-wide association studies identified many new genes, while recent whole-genome sequencing efforts have also been proven to be effective. In the current review, we provide a systematic overview of these studies, including strengths and limitations. We discuss new techniques which will further clarify the genetic basis of thyroid function in the near future, as well as the potential use of these genetic markers in personalizing the management of thyroid disease patients.



http://ift.tt/2pA96FJ

Non-Invasive Tracking of Hydrogel Degradation Using Upconversion Nanoparticles

Publication date: Available online 17 April 2017
Source:Acta Biomaterialia
Author(s): Yuqing Dong, Guorui Jin, Changchun Ji, Rongyan He, Min Lin, Xin Zhao, Ang Li, Tian Jian Lu, Feng Xu
Tracking the distribution and degradation of hydrogels in vivo is important for various applications including tissue engineering and drug delivery. Among various imaging modalities, fluorescence imaging has attracted intensive attention due to their high sensitivity, low cost and easy operation. Particularly, upconversion nanoparticles (UCNPs) that emit visible lights upon near-infrared (NIR) light excitation as tracking probes are promising in deciphering the fate of hydrogels after transplantation. Herein, we reported a facile and non-invasive in vivo hydrogel tracking method using UCNPs, where the degradation of hydrogels was determined using the decrease in fluorescence intensity from the UCNPs encapsulated in the hydrogels. We found that the change in the fluorescence intensity from the UCNPs was well consistent with that of the fluorescein isothiocyanate (FITC) covalently conjugated to hydrogels and also with the weight change of the hydrogels, suggesting the accuracy of the UCNPs in tracking the degradation of hydrogels. Furthermore, the in vivo fluorescence signals were only observed from the UCNPs instead of FITC after implantation for 7 days due to the deep tissue penetration of UCNPs, demonstrating the capability of UCNPs in longitudinal, consecutive and non-invasive monitoring the in vivo degradation of hydrogels without causing any damage to the major organs (heart, lung, liver and kidney) of model rats. This study thus paves the way for monitoring the in vivo behaviors of biomimetic materials via deep tissue imaging with great clinical translation potentials.Statement of SignificanceLong-term noninvasive in vivo tracking of the distribution and degradation of biodegradable hydrogels using fluorescent probes is important in tissue regeneration and drug delivery. Unlike the widely used fluorescent dyes and quantum dots (QDs) that suffer from photobleaching and undesired toxicity, upconversion nanoparticles (UCNPs) with high stability, deep tissue penetration as tracking probes are promising in deciphering the fate of hydrogels after transplantation. Herein, we reported a noninvasive in vivo hydrogel tracking method using UCNPs and found that the fluorescence intensity change from the UCNPs was well consistent with the weight change of the hydrogels, suggesting the accuracy of UCNPs in tracking hydrogel degradation. This study provides inspirations on developing advanced NIR light regulated probes with great clinical translation potentials.

Graphical abstract

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Sec71 functions as a GEF for the small GTPase Arf1 to govern dendrite pruning of Drosophila sensory neurons [RESEARCH ARTICLE]

Yan Wang, Heng Zhang, Meng Shi, Yih-Cherng Liou, Lei Lu, and Fengwei Yu

Pruning, whereby neurons eliminate their exuberant neurites, is central for the maturation of the nervous system. In Drosophila, sensory neurons, ddaCs, selectively prune their larval dendrites without affecting their axons during metamorphosis. However, it is unknown whether the secretory pathway plays a role in dendrite pruning. Here, we show that the small GTPase Arf1, an important regulator of secretory pathway, is specifically required for dendrite pruning of ddaC/D/E sensory neurons but dispensable for apoptosis of ddaF neurons. Analyses of the GTP and GDP-locked forms of Arf1 indicate that the cycling of Arf1 between GDP-bound and GTP-bound forms is essential for dendrite pruning. We further identified Sec71 as a guanine nucleotide exchange factor for Arf1 that preferentially interacts with its GDP-bound form. Like Arf1, Sec71 is also important for dendrite pruning, but not apoptosis, of sensory neurons. Arf1 and Sec71 are interdependent for their localizations on Golgi. Finally, we show that Sec71/Arf1-mediated trafficking process is a prerequisite for Rab5-dependent endocytosis to facilitate endocytosis and degradation of the cell adhesion molecule Neuroglian (Nrg).



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Excitatory neurons sculpt GABAergic neuronal connectivity in the C. elegans motor circuit [RESEARCH ARTICLE]

Belinda Barbagallo, Alison Philbrook, Denis Touroutine, Navonil Banerjee, Devyn Oliver, Christopher M. Lambert, and Michael M. Francis

Establishing and maintaining the appropriate number of GABA synapses is key for balancing excitation and inhibition in the nervous system, though we have only a limited understanding of the mechanisms controlling GABA circuit connectivity. Here, we show that disrupting cholinergic innervation of GABAergic neurons in the C. elegans motor circuit alters GABAergic neuron synaptic connectivity. These changes are accompanied by a reduced frequency and increased amplitude of GABAergic synaptic events. Acute genetic disruption in early development–during the integration of post-embryonic born GABAergic neurons into the circuit–produces irreversible effects on GABAergic synaptic connectivity that mimic those produced by chronic manipulations. In contrast, acute genetic disruption of cholinergic signaling in the adult circuit does not reproduce these effects. Our findings reveal that GABAergic signaling is regulated by cholinergic neuronal activity, likely through distinct mechanisms in the developing and mature nervous system.



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Reciprocal proteasome-mediated degradation of PIFs and HFR1 underlying photomorphogenic development in Arabidopsis [RESEARCH ARTICLE]

Xiaosa Xu, Praveen Kumar Kathare, Vinh Ngoc Pham, Qingyun Bu, Andrew Nguyen, and Enamul Huq

The phytochrome-mediated regulation of photomorphogenesis under red and far-red light conditions involves both positive and negatively acting factors. The positively acting factors (e.g., HY5/HFR1/LAF1 and others) are degraded in the dark to prevent photomorphogenesis. By contrast, the negatively acting factors (e.g., PIFs) are degraded in response to light to promote photomorphogenesis. Here we show that the negatively acting factor, PIF1 is also degraded in the dark by direct heterodimerization with the positively acting factor, HFR1. Conversely, PIF1 also promotes the degradation of HFR1 in darkness. PIF1 enhances the poly-ubiquitination of HFR1 by COP1 in vivo and in vitro. In addition, the reciprocal co-degradation of PIF1 and HFR1 is dependent on the 26S-proteasome pathway in vivo. Genetic evidence shows that the hfr1 mutant partially suppresses the constitutive photomorphogenic phenotypes of the cop1-6 pif1 and pifq both in the dark and far-red light conditions. Taken together, these data uncover a co-degradation mechanism between PIFs and HFR1 underlying photomorphogenic development in Arabidopsis thaliana.



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Revisiting Mechanisms of Extraterritorial Allodynia



http://ift.tt/2oRvX1E

Revisiting Mechanisms of Extraterritorial Allodynia



http://ift.tt/2oRvX1E

Thermal imprinting modifies adult stress and innate immune responsiveness in the teleost sea bream

The impact of thermal imprinting during development on the plasticity of the hypothalamic-pituitary-interrenal (HPI) axis and stress response in an adult ectotherm, the gilthead sea bream (Sparus aurata, L.), was assessed. Fish were reared under 4 thermal regimes and the resulting adults exposed to acute confinement stress and plasma cortisol levels and genes of the HPI axis monitored. Changes in immune function, a common result of stress, was also evaluated using histomorphometric measurements of melano-macrophages centres (MMCs) in the head kidney and by monitoring macrophage related transcripts. Thermal history significantly modified HPI responsiveness in adult sea bream when eggs and larvae were reared at a higher than optimal temperature (HT, 22 ºC) and they had a reduced amplitude in their cortisol response and significantly up-regulated pituitary pomc and head kidney star transcripts. Additionally, after an acute stress challenge immune function was modified and the head kidney of adult fish reared during development at high temperatures (HT and LHT, 18-22 ºC) had a decreased number of MMCs and a significant down-regulation of dopachrome tautomerase. The impact of thermal imprinting during development on the physiology of adult sea bream was evident even in the absence of acute stress and eggs and larvae reared at 22 ºC and 18 ºC, respectively (high-low thermal regime, HLT) had increased plasma glucose, sodium and potassium relative to adults from eggs and larvae maintained at a constant temperature (22 ºC or 18 ºC). Overall the results demonstrate that temperature during early development impacts on the adult HPI axis and immune function in a teleost fish.



http://ift.tt/2pyIfg3

Activation of the P2Y2 receptor regulates bone cell function by enhancing ATP release

Bone cells constitutively release ATP into the extracellular environment where it acts locally via P2 receptors to regulate bone cell function. Whilst P2Y2 receptor stimulation regulates bone mineralisation the functional effects of this receptor in osteoclasts remain unknown. This investigation used the P2Y2 receptor knockout (P2Y2R-/-) mouse model to investigate the role of this receptor in bone. MicroCT analysis of P2Y2R-/- mice demonstrated age-related increases in trabecular bone volume (≤48%), number (≤30%) and thickness (≤17%). In vitro P2Y2R-/- osteoblasts displayed a 3-fold increase in bone formation and alkaline phosphatase activity whilst P2Y2R-/- osteoclasts exhibited a 65% reduction in resorptive activity. Serum cross-linked c-telopeptide levels (CTX, bone resorption marker) were also decreased (≤35%). The resorption defect in P2Y2R-/- osteoclasts was rescued by the addition of exogenous ATP, suggesting that an ATP deficit could be a key factor in the reduced function of these cells. In agreement, we found that basal ATP release was reduced up to 53% in P2Y2R-/- osteoclasts. The P2Y2 receptor agonists, UTP and 2-thioUTP, increased osteoclast activity and ATP release in wildtype but not P2Y2R-/-cells. This indicates that the P2Y2 receptor may regulate osteoclast function indirectly by promoting ATP release. UTP and 2-thioUTP also stimulate ATP release from osteoblasts suggesting that the P2Y2 receptor exerts a similar function in these cells. Taken together, our findings are consistent with the notion that the primary action of P2Y2 receptor signalling in bone is to regulate extracellular ATP levels.



http://ift.tt/2oLV5F0

Role of the fatty acid binding protein 4 in heart failure and cardiovascular disease

Obesity and ectopic fat accumulation in non-adipose tissues are major contributors to heart failure (HF) and cardiovascular disease (CVD). Adipocytes act as endocrine organs by releasing a large number of bioactive molecules into the bloodstream, which participate in a communication network between white adipose tissue and other organs, including the heart. Among these molecules, fatty acid binding protein 4 (FABP4) has been recently shown to increase cardiometabolic risk. Both clinical and experimental evidence have identified FABP4 as a relevant player in atherosclerosis and coronary artery disease, and it has been directly related to cardiac alterations such as left ventricular hypertrophy (LVH) or both systolic and diastolic cardiac dysfunction. The available interventional studies preclude the establishment of a direct causal role of this molecule in CVD and HF and propose FABP4 as a biomarker rather than as an aetiological factor. However, several experimental reports have suggested that FABP4 may act as a direct contributor in cardiac metabolism and physiopathology, and pharmacological targeting of FABP4 may restore some of the metabolic alterations that are conducive to CVD and HF. Here, we review the current knowledge of FABP4 with regard to HF and CVD as well as the molecular basis of how this protein participates in the regulation of cardiac function.



http://ift.tt/2pyK24K

Executive and Perceptual Distraction in Visual Working Memory.

Author: Allen, Richard J.; Baddeley, Alan D.; Hitch, Graham J.
DOI: 10.1037/xhp0000413
Publication Date: POST AUTHOR CORRECTIONS, 17 April 2017


http://ift.tt/2pA9J2e

Location-Coding Account Versus Affordance-Activation Account in Handle-to-Hand Correspondence Effects: Evidence of Simon-Like Effects Based on the Coding of Action Direction.

Author: Pellicano, Antonello; Koch, Iring; Binkofski, Ferdinand
DOI: 10.1037/xhp0000414
Publication Date: POST AUTHOR CORRECTIONS, 17 April 2017


http://ift.tt/2oTJRAv

Neighing, Barking, and Drumming Horses-Object Related Sounds Help and Hinder Picture Naming.

Author: Madebach, Andreas; Wohner, Stefan; Kieseler, Marie-Luise; Jescheniak, Jorg D.
DOI: 10.1037/xhp0000415
Publication Date: POST AUTHOR CORRECTIONS, 17 April 2017


http://ift.tt/2pzXQZT

Spelling Ability Selectively Predicts the Magnitude of Disruption in Unspaced Text Reading.

Author: Veldre, Aaron; Drieghe, Denis; Andrews, Sally
DOI: 10.1037/xhp0000425
Publication Date: POST AUTHOR CORRECTIONS, 17 April 2017


http://ift.tt/2oTytnQ

Glechoma hederacea extracts attenuate cholestatic liver injury in a bile duct-ligated rat model

Publication date: 23 May 2017
Source:Journal of Ethnopharmacology, Volume 204
Author(s): Ya-Yu Wang, Shih-Yi Lin, Wen-Ying Chen, Su-Lan Liao, Chih-Cheng Wu, Pin-Ho Pan, Su-Tze Chou, Chun-Jung Chen
Ethnopharmacological relevanceIn traditional Chinese medicine, Glechoma hederacea is frequently prescribed to patients with cholelithiasis, dropsy, abscess, diabetes, inflammation, and jaundice. Polyphenolic compounds are main bioactive components of Glechoma hederacea.Aim of the studyThis study was aimed to investigate the hepatoprotective potential of hot water extract of Glechoma hederacea against cholestatic liver injury in rats.Materials and methodsCholestatic liver injury was produced by ligating common bile ducts in Sprague-Dawley rats. Saline and hot water extract of Glechoma hederacea were orally administrated using gastric gavages. Liver tissues and bloods were collected and subjected to evaluation using histological, molecular, and biochemical approaches.ResultsUsing a rat model of cholestasis caused by bile duct ligation (BDL), daily oral administration of Glechoma hederacea hot water extracts showed protective effects against cholestatic liver injury, as evidenced by the improvement of serum biochemicals, ductular reaction, oxidative stress, inflammation, and fibrosis. Glechoma hederacea extracts alleviated BDL-induced transforming growth factor beta-1 (TGF-β1), connective tissue growth factor, and collagen expression, and the anti-fibrotic effects were accompanied by reductions in α-smooth muscle actin-positive matrix-producing cells and Smad2/3 activity. Glechoma hederacea extracts attenuated BDL-induced inflammatory cell infiltration/accumulation, NF-κB and AP-1 activation, and inflammatory cytokine production. Further studies demonstrated an inhibitory effect of Glechoma hederacea extracts on the axis of high mobility group box-1 (HMGB1)/toll-like receptor-4 (TLR4) intracellular signaling pathways.ConclusionsThe hepatoprotective, anti-oxidative, anti-inflammatory, and anti-fibrotic effects of Glechoma hederacea extracts seem to be multifactorial. The beneficial effects of daily Glechoma hederacea extracts supplementation were associated with anti-oxidative, anti-inflammatory, and anti-fibrotic potential, as well as down-regulation of NF-κB, AP-1, and TGF-β/Smad signaling, probably via interference with the HMGB1/TLR4 axis.

Graphical abstract

image


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Trinucleotide-repeat expanded and normal DMPK transcripts contain unusually long poly(A) tails despite differential nuclear residence

Publication date: Available online 18 April 2017
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Anke E.E.G. Gudde, Ingeborg D.G. van Kessel, Laurène M. André, Bé Wieringa, Derick G. Wansink
In yeast and higher eukaryotes nuclear retention of transcripts may serve in control over RNA decay, nucleocytoplasmic transport and premature cytoplasmic appearance of mRNAs. Hyperadenylation of RNA is known to be associated with nuclear retention, but the cause-consequence relationship between hyperadenylation and regulation of RNA nuclear export is still unclear. We compared polyadenylation status between normal and expanded DMPK transcripts in muscle cells and tissues derived from unaffected individuals and patients with myotonic dystrophy type 1 (DM1). DM1 is an autosomal dominant disorder caused by (CTG)n repeat expansion in the DMPK gene. DM1 etiology is characterized by an almost complete block of nuclear export of DMPK transcripts carrying a long (CUG)n repeat, including aberrant sequestration of RNA-binding proteins. We show here by use of cell fractionation, RNA size separation and analysis of poly(A) tail length that a considerable fraction of transcripts from the normal DMPK allele is also retained in the nucleus (~30%). They carry poly(A) tails with an unusually broad length distribution, ranging between a few dozen to >500 adenosine residues. Remarkably, expanded DMPK (CUG)n transcripts from the mutant allele, almost exclusively nuclear, carry equally long poly(A) tails. Our findings thus suggest that nuclear retention may be a common feature of regulation of DMPK RNA expression. The typical forced nuclear residence of expanded DMPK transcripts affects this regulation in tissues of DM1 patients, but not through hyperadenylation.



http://ift.tt/2pzUqq1

[Pre- and Intra-Operative Supporting Technology for Brain Tumors(6)Cerebellomedullary Fissure Approach for Fourth Ventricle Tumors].

Related Articles

[Pre- and Intra-Operative Supporting Technology for Brain Tumors(6)Cerebellomedullary Fissure Approach for Fourth Ventricle Tumors].

No Shinkei Geka. 2017 Apr;45(4):361-369

Authors: Shibahara I, Kumabe T

PMID: 28415062 [PubMed - in process]



http://ift.tt/2pPTcGw

[A Case of Subarachnoid Hemorrhage with Multiple Cerebral Aneurysms with a Difficult-to-Identify Rupture Site].

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[A Case of Subarachnoid Hemorrhage with Multiple Cerebral Aneurysms with a Difficult-to-Identify Rupture Site].

No Shinkei Geka. 2017 Apr;45(4):351-354

Authors: Watanabe D, Yanaka K, Nakamura K, Yamamoto T, Matsumura A

PMID: 28415061 [PubMed - in process]



http://ift.tt/2pQ5bUn

[A Case of Foramen Magnum Meningioma Manifesting as Hypoglossal Nerve Palsy].

Related Articles

[A Case of Foramen Magnum Meningioma Manifesting as Hypoglossal Nerve Palsy].

No Shinkei Geka. 2017 Apr;45(4):345-350

Authors: Inaka Y, Otani N, Nishida S, Ueno H, Tomiyama A, Tomura S, Toyooka T, Wada K, Mori K

Abstract
We report a case of foramen magnum meningioma manifesting as hypoglossal nerve palsy. A 72-year-old woman presented with progressive hypoglossal nerve palsy and lingual atrophy on the left side. Gadolinium-enhanced T1-weighted magnetic resonance imaging revealed a heterogeneously enhanced mass lesion with dural tail sign partially extending into the hypoglossal canal. The transcondylar approach was performed to expose the hypoglossal canal and resect the tumor completely. Histological examination revealed a transitional meningioma. The postoperative course was uneventful. Hypoglossal nerve palsy improved gradually after the operation.

PMID: 28415060 [PubMed - in process]



http://ift.tt/2pQdtM4

[A Case of Slowly Progressive Brain Metastasis with Minor Bleeding after Removal of and Chemotherapy for Non-Small Cell Lung Cancer].

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[A Case of Slowly Progressive Brain Metastasis with Minor Bleeding after Removal of and Chemotherapy for Non-Small Cell Lung Cancer].

No Shinkei Geka. 2017 Apr;45(4):339-344

Authors: Matsufuji H, Shiozaki E, Nakatake Y, Yoshida K, Kamada K, Matsuo T

Abstract
Of all brain metastases, the most common primary lesion is derived from the lung. These types of metastases enlarge aggressively with unfavorable prognoses. We report the case of a 75-year-old male patient who had a history of pulmonary resection for Stage IA non-small cell lung cancer(NSCLC), and received chemotherapy. One year after NSCLC surgery, he experienced a cardiogenic cerebral infarction, and anticoagulant therapy was initiated. Mass lesions with hemorrhage were detected bilaterally in the frontal lobes through magnetic resonance imaging three years after the NSCLC surgery. The lesions slowly enlarged during follow-up. However, there were no clinical symptoms. There was no finding indicating a local recurrence or metastasis through positron emission tomography(PET). Two and a half years after the detection of the lesion, left hemiplegia was observed. Massive hemorrhage from the right frontal lobe lesion was observed on computed tomography(CT). Craniotomy and evacuation of the hematoma were performed. The histopathological findings showed adenocarcinoma and the diagnosis was brain metastasis of the lung cancer. This case reveals brain metastasis of lung cancer that progressed without extracranial metastases for three years. The brain tumor enlarged, accompanied by hemorrhage, extremely slowly without any symptoms. It was difficult to differentiate between metastasis and cavernous hemangioma, considering the extremely slow progress and image analyses. Of the reported prognostic factors associated with postoperative brain metastasis from surgically resected NSCLC, three factors were applicable to this case:adenocarcinoma, a small number of brain metastases, and the absence of extracranial metastases at the diagnosis of brain metastasis. We should consider the possibility of a metastatic brain tumor secondary to lung cancer even long after thoracic surgery.

PMID: 28415059 [PubMed - in process]



http://ift.tt/2pPTn4O

[A Case of Arteriovenous Malformation of the Parotid Gland Associated with Cowden Disease].

Related Articles

[A Case of Arteriovenous Malformation of the Parotid Gland Associated with Cowden Disease].

No Shinkei Geka. 2017 Apr;45(4):333-338

Authors: Nishi K, Murai S, Itami H, Otsuka S, Kusaka N, Nishiura T, Kimura N, Ogihara K

Abstract
We report a rare case of arteriovenous malformation(AVM)of the parotid gland associated with Cowden disease successfully treated with preoperative embolization followed by surgical removal. A 39-year-old man with a history of Cowden disease presented with a pulsating and growing mass on his left lower jaw. Contrast-enhanced computed tomography(CT)and angiography revealed a high-flow AVM in the deep lobe of the left parotid gland. After intravascular embolization of the feeding arteries, surgery was performed using the NIM-response<sup>®</sup>3.0, facial nerve monitoring system. The AVM was almost completely removed and the facial nerves were morphologically preserved. Interestingly, the intraoperative findings revealed that the enlarged vasa nervorum of the facial nerve also fed the AVM. Although left facial nerve palsy appeared after the surgery, the nerve function gradually improved over one year. No recurrence of the AVM has been observed for one year.

PMID: 28415058 [PubMed - in process]



http://ift.tt/2pQ5caT

[De Novo Cavernous Angioma Secondary to a Developmental Venous Anomaly:A Case Report and Review of the Literature].

Related Articles

[De Novo Cavernous Angioma Secondary to a Developmental Venous Anomaly:A Case Report and Review of the Literature].

No Shinkei Geka. 2017 Apr;45(4):325-331

Authors: Sakakibara Y, Taguchi Y, Nakamura H, Onodera H, Uchida M, Kawaguchi K, Aida Y

Abstract
OBJECTIVE: Previously, cavernous angiomas(CAs)have been thought to be only congenital in origin. Recently, however, a few cases of de novo CAs have been reported in the literature. We present a case of a de novo CA and discuss the etiology of the newly appeared CA.
CASE REPORT: A 29-year-old man was presented to a local clinic because of hypersomnia. MRI demonstrated a heterogeneous mass peripherally located, which was in contact with a developmental venous anomaly(DVA)at the left thalamus. Six years before the presentation, he visited the same clinic because of faintness, and MRI results indicated no abnormality except for the DVA. Three weeks later, he suddenly experienced difficulty in speech, and the MRI revealed an increase in the size of the mass. Subsequently, he was admitted at our institution, and neurological examination revealed aphasia and right hemiparesis. A left carotid angiogram on venous phase showed a narrowing of the DVA, which was seen as it entered the internal cerebral vein. The diagnosis of a de novo CA was made. The mass was completely resected through the transcallosal transventricular approach to avoid injuring the DVA. The DVA could not be found during surgery. The pathological diagnosis was in line with the findings of CA. Postoperatively, the patient continued having difficulty in speech and was transferred to another institution for speech rehabilitation.
CONCLUSIONS: Although the association of CA and DVA has been described with increasing frequencies recently, the etiology of de novo CA in the case of this association has been a matter of debate. In the present case, it was speculated that a narrowing of the DVA resulted in increased venous pressure and caused the development of de novo CA.

PMID: 28415057 [PubMed - in process]



http://ift.tt/2pPRRzJ

[Pulsatile Tinnitus due to an Aberrant Internal Carotid Artery in the Middle Ear:A Case Report].

Related Articles

[Pulsatile Tinnitus due to an Aberrant Internal Carotid Artery in the Middle Ear:A Case Report].

No Shinkei Geka. 2017 Apr;45(4):321-324

Authors: Kuwayama K, Satomi J, Yamaguchi T, Yamaguchi I, Sogabe S, Yoshioka S, Nagahiro S

Abstract
We report a rare case of aberrant internal carotid artery in the middle ear. The patient was a 30-year-old man with pulsatile tinnitus. MRA and 3D-CTA revealed an aberrant course of the internal carotid artery in the middle ear. 3D-CTA proved useful for radiographic diagnosis, leading to the observation of an aberrant internal carotid artery passing the foramen. We discuss the diagnosis and management of such patients.

PMID: 28415056 [PubMed - in process]



http://ift.tt/2ojQPLH

[Risk Factors for Predicting the Need for Additional Surgery for Symptomatic Adjacent Segment Disease after Minimally Invasive Surgery-Transforaminal Lumbar Interbody Fusion].

Related Articles

[Risk Factors for Predicting the Need for Additional Surgery for Symptomatic Adjacent Segment Disease after Minimally Invasive Surgery-Transforaminal Lumbar Interbody Fusion].

No Shinkei Geka. 2017 Apr;45(4):311-319

Authors: Fukaya K, Hasegawa M, Shirato M, Teshima T

Abstract
PURPOSE: To determine the incidence of and risk factors for symptomatic adjacent segment disease(SASD)requiring additional surgery in patients previously treated with minimally invasive surgery-transforaminal lumbar interbody fusion(MIS-TLIF)for degenerative lumbar disease.
MATERIALS AND METHODS: A series of 467 consecutive patients who had undergone MIS-TLIF of one or two segments to treat degenerative lumbar disease was identified. The mean age of the patients at the time of the index operation was 67.7 years and the mean follow-up period was 33.2 months(range, 6.0-110.1 months). The incidence rate of SASD surgeries was calculated using the Kaplan-Meier method. The log-rank test and Cox regression analysis were used for risk factor analysis based on age, sex, number of fused segments, presence of laminectomy adjacent to index fusion, and L1 plumb line.
RESULTS: The overall incidence rate of SASD requiring additional surgery was 2.8%. Kaplan-Meier analysis predicted a disease-free rate of adjacent segments in 94.3% of the patients at 4 years and in 90.8% of the patients at 8 years after the index operation. In the analysis of risk factors, a negative L1 plumb line was associated with a 5.6 times higher incidence of SASD requiring additional surgery than that associated with a positive L1 plumb line(p=0.0096). There was no significant difference in the survival rates based on age, sex, number of fused segments, and concomitant laminectomy to adjacent segment.
CONCLUSION: Approximately 9.2% of the patients were predicted to undergo additional surgery for treating SASD within 8 years of MIS-TLIF. In this study, presence of a negative L1 plumb line indicated higher incidence of additional SASD associated surgeries than that shown by a positive L1 plumb line. Therefore, surgeons should carefully consider this factor while performing MIS-TLIF.

PMID: 28415055 [PubMed - in process]



http://ift.tt/2pPTmhg

[Hemodialysis Increases the Incidence of Post-Traumatic Seizure in Hemodialysis Patients with Traumatic Intracranial Hemorrhage].

Related Articles

[Hemodialysis Increases the Incidence of Post-Traumatic Seizure in Hemodialysis Patients with Traumatic Intracranial Hemorrhage].

No Shinkei Geka. 2017 Apr;45(4):303-309

Authors: Oishi T, Takehara S, Yamamura Y, Tomida M, Ikegaya N, Seki G, Ohta N

Abstract
BACKGROUND: In Japan, the number of hemodialysis patients increases every year, along with the average age of this patient population. Further, certain complications of hemodialysis make the care of traumatic head injury(THI)patients particularly difficult.
OBJECTIVE: This study was aimed at investigating the occurrence of and risk factors for post-traumatic seizures in hemodialysis patients with a history of THI, and determining patient outcomes.
METHODS: Subjects were selected from patients who were admitted to Yaizu Municipal Hospital in Shizuoka, Japan for traumatic intracranial hemorrhage(TICH). Retrospective medical histories of TICH patients who were and were not receiving hemodialysis were reviewed to investigate the risk factors for seizures and to determine patient outcomes.
RESULTS: We identified 18 THI patients on hemodialysis and 86 THI patients not on hemodialysis treatment. We determined that predictive factors of post-traumatic seizure include:current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma. Moreover, 66.7% of seizures in our dialysis patients occurred during hemodialysis. Our data also suggest that Glasgow Coma Scale(GCS)scores on admission are a predictive factor for patient outcomes following discharge.
CONCLUSION: Current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma are predictive factors of seizure occurrence in THI patients. As post-traumatic seizures triggered unfavorable outcomes in some dialysis patients, it is important to create appropriate plans for preventing dialysis disequilibrium syndrome that may lead to seizures in TICH/TIH patients on hemodialysis. We also determined that a low GCS score upon admission is a significant predictor of unfavorable outcomes.

PMID: 28415054 [PubMed - in process]



http://ift.tt/2pQaL9u

[Treatment Types and Optimal Age for Craniosynostosis].

Related Articles

[Treatment Types and Optimal Age for Craniosynostosis].

No Shinkei Geka. 2017 Apr;45(4):293-300

Authors: Sakamoto Y, Miwa T

PMID: 28415053 [PubMed - in process]



http://ift.tt/2o1jMQw

Intralabyrinthäre Schwannome

Zusammenfassung

Intralabyrinthäre Schwannome (ILS) sind eine seltene Differenzialdiagnose des Hörsturzes und von Schwindelbeschwerden. In einer eigenen Fallserie von 12 Patienten fanden sich die Tumoren 6‑mal intracochleär und 3‑mal intravestibulär sowie je 1‑mal transmodiolär und im Kleinhirn-Brücken-Winkel (KHBW), 1‑mal transotisch und im KHBW und 1‑mal multilokulär. Von 9 Fällen mit chirurgischer Tumorentfernung erfolgte bei 3 Patienten die Tumorentfernung über eine Labyrinthektomie mit gleichzeitiger Cochleaimplantat(CI)-Operation, in einem Fall über eine erweiterte Cochleostomie mit gleichzeitiger Cochleaimplantation, in 3 Fällen über eine partielle oder subtotale Cochleoektomie mit partieller Cochlearekonstruktion sowie Cochleaimplantation (1-mal) oder Einlage eines CI-Elektroden-Dummies für eine evtl. spätere Cochleaimplantation nach wiederholten MRT-Kontrollen (2-mal). In 2 Fällen erfolgte die kombinierte translabyrinthär-transotische Tumorentfernung aus dem inneren Gehörgang und dem Kleinhirnbrückenwinkel bei transmodiolärem und transmakulärem bzw. transotischem Tumorwachstum. Drei Patienten entschieden sich für ein „Wait-and-test-and-scan-Vorgehen". Bei den intracochleären Tumoren konnte die Gleichgewichtsfunktion postoperativ weitgehend erhalten werden. In allen Fällen mit Cochleaimplantation war die Hörrehabilitation mittels CI erfolgreich, auch in dem Fall mit subtotaler Cochleoektomie, wenn auch hier mit eingeschränktem Sprachverstehen. Eine operative Entfernung intracochleär wachsender Schwannome durch eine partielle oder subtotale Cochleoektomie ist auch mit Erhalt der Funktion des Gleichgewichtsorgans prinzipiell möglich. Die Indikation zur Radiotherapie von ILS ist aus unserer Sicht nur in Einzelfällen gegeben. Die CI-Versorgung nach operativer Entfernung eines ILS ist prinzipiell eine Option zur auditorischen Rehabilitation. Sie stellt bei rechtzeitiger Indikationsstellung im Gegensatz zum abwartenden Verhalten („Wait-and-test-and-scan-Strategie") einen therapeutischen Ansatz dar.



http://ift.tt/2oqKg9v

Intralabyrinthäre Schwannome

Zusammenfassung

Intralabyrinthäre Schwannome (ILS) sind eine seltene Differenzialdiagnose des Hörsturzes und von Schwindelbeschwerden. In einer eigenen Fallserie von 12 Patienten fanden sich die Tumoren 6‑mal intracochleär und 3‑mal intravestibulär sowie je 1‑mal transmodiolär und im Kleinhirn-Brücken-Winkel (KHBW), 1‑mal transotisch und im KHBW und 1‑mal multilokulär. Von 9 Fällen mit chirurgischer Tumorentfernung erfolgte bei 3 Patienten die Tumorentfernung über eine Labyrinthektomie mit gleichzeitiger Cochleaimplantat(CI)-Operation, in einem Fall über eine erweiterte Cochleostomie mit gleichzeitiger Cochleaimplantation, in 3 Fällen über eine partielle oder subtotale Cochleoektomie mit partieller Cochlearekonstruktion sowie Cochleaimplantation (1-mal) oder Einlage eines CI-Elektroden-Dummies für eine evtl. spätere Cochleaimplantation nach wiederholten MRT-Kontrollen (2-mal). In 2 Fällen erfolgte die kombinierte translabyrinthär-transotische Tumorentfernung aus dem inneren Gehörgang und dem Kleinhirnbrückenwinkel bei transmodiolärem und transmakulärem bzw. transotischem Tumorwachstum. Drei Patienten entschieden sich für ein „Wait-and-test-and-scan-Vorgehen". Bei den intracochleären Tumoren konnte die Gleichgewichtsfunktion postoperativ weitgehend erhalten werden. In allen Fällen mit Cochleaimplantation war die Hörrehabilitation mittels CI erfolgreich, auch in dem Fall mit subtotaler Cochleoektomie, wenn auch hier mit eingeschränktem Sprachverstehen. Eine operative Entfernung intracochleär wachsender Schwannome durch eine partielle oder subtotale Cochleoektomie ist auch mit Erhalt der Funktion des Gleichgewichtsorgans prinzipiell möglich. Die Indikation zur Radiotherapie von ILS ist aus unserer Sicht nur in Einzelfällen gegeben. Die CI-Versorgung nach operativer Entfernung eines ILS ist prinzipiell eine Option zur auditorischen Rehabilitation. Sie stellt bei rechtzeitiger Indikationsstellung im Gegensatz zum abwartenden Verhalten („Wait-and-test-and-scan-Strategie") einen therapeutischen Ansatz dar.



http://ift.tt/2oqKg9v

Population pharmacokinetic modelling of rupatadine solution in 6–11 year olds and optimisation of the experimental design in younger children

by Eva Santamaría, Javier Alejandro Estévez, Jordi Riba, Iñaki Izquierdo, Marta Valle

Aims

To optimise a pharmacokinetic (PK) study design of rupatadine for 2–5 year olds by using a population PK model developed with data from a study in 6–11 year olds. The design optimisation was driven by the need to avoid children's discomfort in the study.

Methods

PK data from 6–11 year olds with allergic rhinitis available from a previous study were used to construct a population PK model which we used in simulations to assess the dose to administer in a study in 2–5 year olds. In addition, an optimal design approach was used to determine the most appropriate number of sampling groups, sampling days, total samples and sampling times.

Results

A two-compartmental model with first-order absorption and elimination, with clearance dependent on weight adequately described the PK of rupatadine for 6–11 year olds. The dose selected for a trial in 2–5 year olds was 2.5 mg, as it provided a Cmax below the 3 ng/ml threshold. The optimal study design consisted of four groups of children (10 children each), a maximum sampling window of 2 hours in two clinic visits for drawing three samples on day 14 and one on day 28 coinciding with the final examination of the study.

Conclusions

A PK study design was optimised in order to prioritise avoidance of discomfort for enrolled 2–5 year olds by taking only four blood samples from each child and minimising the length of hospital stays.



http://ift.tt/2pe8gRW

Comparison of the mechanical properties of different skin sites for auricular and nasal reconstruction

Abstract

Background

Autologous and synthetic nasal and auricular frameworks require skin coverage. The surgeon's decides on the appropriate skin coverage for reconstruction based on colour matching, subcutaneous tissue thickness, expertise and experience. One of the major complications of placing subcutaneous implants is the risk of extrusion (migration through the skin) and infection. However, knowledge of lessening the differential between the soft tissue and the framework can have important implications for extrusion. This study compared the mechanical properties of the skin commonly used as skin sites for the coverage in auricular and nasal reconstruction.

Methods

Using ten fresh human cadavers, the tensile Young's Modulus of the skin from the forehead, forearm, temporoparietal, post-auricular and submandibular neck was assessed. The relaxation rate and absolute relaxation level was also assessed after 90 min of relaxation.

Results

The submandibular skin showed the greatest Young's elastic modulus in tension of all regions (1.28 MPa ±0.06) and forearm showed the lowest (1.03 MPa ±0.06). The forehead demonstrated greater relaxation rates among the different skin regions (7.8 MPa−07 ± 0.1). The forearm showed the lowest rate of relaxation (4.74 MPa−07 ± 0.1). The forearm (0.04 MPa ±0.004) and submandibular neck skin (0.04 MPa ±0.005) showed similar absolute levels of relaxation, which were significantly greater than the other skin regions (p < 0.05).

Conclusions

This study provides an understanding into the biomechanical properties of the skin of different sites allowing surgeons to consider this parameter when trying to identify the optimal skin coverage in nasal and auricular reconstruction.



http://ift.tt/2oLpuDb

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