Publication date: Available online 9 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): T Mark Campbell, Bahareh Bahram Ghaedi, Elizabeth Tanjong Ghogomu, Vivian Welch
ObjectiveTo determine whether shoe lifts effectively treat leg length discrepancy (LLD)-associated morbidities in adults with common painful musculoskeletal conditions.Data SourcesTRIP, CENTRAL, PubMed, PEDro and National Guideline Clearinghouse databases. The search was performed in September 2017, limited to English-only, and had no time constraints.Study SelectionTwo reviewers independently determined study eligibility. Inclusion criteria were: (1) participants ≥18 years-old with musculoskeletal-related complaints and LLD, (2) a shoe lift intervention was used, and (3) the study reported on pain, function, range of motion, patient satisfaction, quality of life, or adverse events. Randomized controlled trials (RCTs), controlled intervention, cohort, before-and-after, case-series and case report studies were included. Three-hundred-and-nineteen articles were screened and nine guidelines reviewed.Data ExtractionWe extracted data pertaining to participant demographic characteristics, study setting, recruitment, randomization, method of LLD measurement, shoe lift characteristics, treatment duration, and outcome measures. We included ten studies, including one RCT.Data SynthesisLLD was associated with low back pain, scoliosis, and osteoarthritis of the hip and knee. Description of LLD correction strategy was often inadequate. Study quality was very low or poor. In non-RCT studies reporting on the proportion of participants who improved with a shoe lift, 88±3% of 349 participants treated had partial or complete pain relief (effect size range 66.7-100%). All 22 RCT participants receiving treatment experienced pain relief (mean pain reduction 27±9mm on a 150mm visual analogue scale). Two of nine guidelines recommended shoe lift use based on consensus, and were of moderate-to-high quality.ConclusionsThere is low-quality evidence that shoe lifts reduce pain and improve function in patients with LLD and common painful musculoskeletal conditions. High quality research evaluating a threshold LLD to correct and a strategy to do so is necessary. Developing an appropriate comparison group to test clinically-relevant outcome measures would make a valuable contribution in this regard.
http://ift.tt/2B10oJ3
Παρασκευή 8 Δεκεμβρίου 2017
Shoe Lifts for Leg Length Discrepancy in Adults with Common Painful Musculoskeletal Conditions: A Systematic Review of the Literature
Post procedural complications of cardiac implants done in a resource limited setting under ‘C’ arm: A single centre experience
Source:Medical Journal Armed Forces India
Author(s): A. Jayachandra, Vivek Aggarwal, Sandeep Kumar, I.V. Nagesh
BackgroundCardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm.MethodsThis study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities. Consecutive patients reporting to cardiology center, between Jan 2015 and Oct 2016, with a definite indication for cardiac device implant were included in the study. All the procedure of implantation was done in the operation theatre under 'C' arm under local anesthesia with continuous cardiac monitoring and critical care back up.ResultsTotal 58 device implantations were done from Jan 2015 to Oct 2016. The mean age of the patients was 67.15±10.85 years. Males constituted almost two third (68.9%) of patients. The commonest indication for device implantation was sinus node dysfunction in 60.34% followed by complete heart block in 25.86% and ventricular tachycardia in 12.06%. No post procedure infection was observed in our study.ConclusionDevice implantation constitute a major group of life saving interventions in cardiology practice. Our study has emphasised that when appropriate aseptic measures are taken during device implantation at peripheral centres, the complications rate are comparable to interventions done at advance cardiac centres.
http://ift.tt/2AGIwk3
Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC): A Review
Publication date: January 2018
Source:Neoplasia, Volume 20, Issue 1
Author(s): Bryan Oronsky, Patrick Ma, Tony R. Reid, Pedro Cabrales, Michelle Lybeck, Arnold Oronsky, Neil Oronsky, Corey A. Carter
As the leading cause of cancer-related mortality, lung cancer is a worldwide health issue that is overwhelmingly caused by smoking. However, a substantial minority (~25%) of patients with non–small cell lung cancer (NSCLC) has never smoked. In these patients, activating mutations of the epidermal growth factor receptor (EGFR) are more likely, which render their tumors susceptible for a finite period to treatment with EGFR tyrosine kinase inhibitors (TKIs) and confer a better prognosis than EGFR wild-type NSCLC. On progression, due to the inevitable insurgence of resistance, TKIs are generally followed by second- or third-line salvage chemotherapy until treatment failure, after which no standard treatment options are available, resulting in a poor prognosis and a high risk of death. With the focus of clinical attention on treatment with TKIs, few studies on optimal salvage therapies, including cytotoxic chemotherapy, after failure of EGFR TKIs have been reported. Despite a paucity of available data, the aim of this review is to summarize the "no-man's land" of TKI-failed EGFR-mutated NSCLC and expand on alternative strategies as well as potential future directions.
http://ift.tt/2y9vqt2
Health-related quality of life in elderly hearing aid users vs. non-users
Publication date: Available online 8 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Eman A. Said
Background and aimPresbycusis, is usually a harbinger of aging. The negative consequences are not limited to an auditory impairment but influences a range of psychosocial and physical health concerns. The cornerstone of audiologic intervention is the use hearing aids. Optimal management should include an evaluation of quality of life (QoL) status and its assessment. Aim of this work: To quantify the quality of life of hearing impaired elderly individuals (HIEI) and to assess hearing aids impact on QoL.SubjectsElderly patients (1 2 7) above 60 years had sensorineural hearing loss ranged from mild to severe degree of hearing loss, only 24 of them (21.1%) were fitted with monaural hearing aid.MethodsEach subject of this study underwent basic audiologic evaluation, speech perception in noise, aided tonal sound field threshold and aided speech tests. Generic WHOQOL-BREF and hearing handicap inventory for the elderly (HHIE).ResultsThere were significant lower aided tonal sound field thresholds (ATSFTs) at 0.5, 1, 2 and 4 kHz of hearing aid users when compared with values of non-users at all tested frequencies. Hearing aid users perform better in all domains of WHO QOL-BREF with significant reductions in emotional, social and total scores of HHIE in users group compared with non-users indicated improvement in their QOL. There were no significant differences between scores of males and scores of females. The severity of the hearing loss had statistically significant effects on these scores for non-users but not in users group.
http://ift.tt/2kI8Iqx
Health-related quality of life in elderly hearing aid users vs. non-users
Publication date: Available online 8 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Eman A. Said
Background and aimPresbycusis, is usually a harbinger of aging. The negative consequences are not limited to an auditory impairment but influences a range of psychosocial and physical health concerns. The cornerstone of audiologic intervention is the use hearing aids. Optimal management should include an evaluation of quality of life (QoL) status and its assessment. Aim of this work: To quantify the quality of life of hearing impaired elderly individuals (HIEI) and to assess hearing aids impact on QoL.SubjectsElderly patients (1 2 7) above 60 years had sensorineural hearing loss ranged from mild to severe degree of hearing loss, only 24 of them (21.1%) were fitted with monaural hearing aid.MethodsEach subject of this study underwent basic audiologic evaluation, speech perception in noise, aided tonal sound field threshold and aided speech tests. Generic WHOQOL-BREF and hearing handicap inventory for the elderly (HHIE).ResultsThere were significant lower aided tonal sound field thresholds (ATSFTs) at 0.5, 1, 2 and 4 kHz of hearing aid users when compared with values of non-users at all tested frequencies. Hearing aid users perform better in all domains of WHO QOL-BREF with significant reductions in emotional, social and total scores of HHIE in users group compared with non-users indicated improvement in their QOL. There were no significant differences between scores of males and scores of females. The severity of the hearing loss had statistically significant effects on these scores for non-users but not in users group.
http://ift.tt/2kI8Iqx
Differential distribution patterns of Fonsecaea agents of chromoblastomycosis, exemplified by the first case due to F. monophora from Argentina
Publication date: Available online 8 December 2017
Source:Medical Mycology Case Reports
Author(s): Marcelo Label, Luciana C. Karayan, Sybren De Hoog, Javier Afeltra, Togo Bustamante, Roxana G. Vitale
Chromoblastomycosis is a mutilating infection of the skin and subcutaneous tissues caused by melanized fungi belonging to the order Chaetothyriales. Proven cases of the main agent, Fonsecaea pedrosoi are mainly limited to (sub)tropical, humid climates of Latin and Central America and the Caribbean. Fonsecaea monophora has a global distribution along the equator. Cases outside the (sub)tropics have thus far mostly been considered to have been imported, but here we report the first endemic case by F. monophora from Argentina. Patient was a 82-year-old rural female worker from Corrientes, a province with a dry continental climate.
http://ift.tt/2A6zMTo
Unusual pathological fracture of the clavicle revealing primary hyperparathyroidism: a case report
Primary hyperparathyroidism revealed by a pathological fracture is very uncommon; in the majority of cases the discovery of lytic bone lesions on imaging examinations evokes in the clinician first a neoplastic...
http://ift.tt/2yR3Owe
Dosimetric effects of saline- versus water-filled balloon applicators for IORT using the model S700 electronic brachytherapy source
Source:Brachytherapy
Author(s): Gage Redler, Alistair Templeton, Heming Zhen, Julius Turian, Damian Bernard, James C.H. Chu, Katherine L. Griem, Yixiang Liao
PurposeThe Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT. However, Xoft recommends saline for balloon applicator filling. This study investigates dosimetric differences due to increased effective atomic number (Zeff) for saline (Zeff = 7.56) versus water (Zeff = 7.42).MethodsBalloon applicator diameters range from 3 to 6 cm. Monte Carlo N-Particle software is used to calculate dose at the surface (Ds) of and 1 cm away (D1cm) from the water-/saline-filled balloon applicator using a single dwell at the applicator center as a simple estimation of the dosimetry and multiple dwells simulating the clinical dose distributions for the atlas plans.ResultsSingle-dwell plans show a 4.4–6.1% decrease in Ds for the 3- to 6-cm diameter applicators due to the saline. Multidwell plans show similar results: 4.9% and 6.4% Ds decrease, for 4-cm and 6-cm diameter applicators, respectively. For the single-dwell plans, D1cm decreases 3.6–5.2% for the 3- to 6-cm diameter applicators. For the multidwell plans, D1cm decreases 3.3% and 5.3% for the 4-cm and 6-cm applicators, respectively.ConclusionsThe dosimetric effect introduced by saline versus water filling for Xoft balloon applicator–based IORT treatments is ∼5%. Users should be aware of this in the context of both treatment planning and patient outcome studies.
http://ift.tt/2iL1Y73
Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use
Publication date: Available online 8 December 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Hyangkyoung Kim, Hojong Park, Sang Jun Park, Bong Won Park, Jae Chol Hwang, Young Woo Seo, Hong Rae Cho
ObjectivesThis study aimed to show the intention to treat results of treatment for spontaneous isolated superior mesenteric artery dissection (SISMAD) without anticoagulation or antiplatelet agents and the follow-up results of SISMAD according to the configuration on computed tomography (CT) scans.DesignRetrospective, observational single centre studyMethodsAll cases of SISMAD were enrolled consecutively from 2006 onwards. There were 25 symptomatic and four asymptomatic patients in whom SISMAD was found incidentally. The SISMAD patients were treated using a consistent therapeutic strategy without antithrombotics. SISMAD was categorized into four types based on the configuration on CT scans by Yun's classification. Follow-up CT was performed at 3 months, 6 months, and yearly thereafter.ResultsThe median follow-up duration was 57 months (13–129 months). Improvement or complete resolution on CT scans, with no symptom recurrence, was seen in 27 patients. The non-invasive approach failed in three cases and two patients underwent further intervention. No patient died during the follow-up.ConclusionsWeighing the risks versus benefits of antithrombotics and considering the benign nature of SISMAD, conservative treatment without antithrombotics might be sufficient in patients without evidence of bowel ischaemia or infarction on initial CT scan.
http://ift.tt/2A84cEY
Association of HLA-DQB1*03:03 with pityriasis rosea in Chinese patients
Summary
Background
The association of human leucocyte antigen (HLA) with a variety of diseases has been described, especially with various autoimmune diseases. However, there are few studies on the association between HLA and pityriasis rosea (PR).
Aim
To investigate the relevance of HLA II alleles with the development of PR.
Methods
Typing for HLA-DRB1, HLA-DQA1 and HLA-DQB1 typing was performed in 55 patients with PR and 90 healthy controls (HCs), using sequence-based typing (SBT) and PCR with sequence-specific primers (PCR-SSP), respectively.
Results
We found that the frequency of HLA-DQB1*03:03 was significantly higher in the PR compared with the HC group [P = 0.001; relative risk (RR) = 2.24; 95% CI 1.38–3.6], while suggestive evidence for a protective effect of HLA-DQB1*06:06 was observed in the study cohort (P < 0.02; RR = 0.40; 95% CI 0.17–0.90).
Conclusions
The HLA-DQB1*03:03 allele may be a susceptible factor in patients with PR. In addition, the association of HLA-DQB1*03:03 with PR suggests participation of immunity in the pathogenesis of PR.
http://ift.tt/2yQM43S
Association of HLA-DQB1*03:03 with pityriasis rosea in Chinese patients
Summary
Background
The association of human leucocyte antigen (HLA) with a variety of diseases has been described, especially with various autoimmune diseases. However, there are few studies on the association between HLA and pityriasis rosea (PR).
Aim
To investigate the relevance of HLA II alleles with the development of PR.
Methods
Typing for HLA-DRB1, HLA-DQA1 and HLA-DQB1 typing was performed in 55 patients with PR and 90 healthy controls (HCs), using sequence-based typing (SBT) and PCR with sequence-specific primers (PCR-SSP), respectively.
Results
We found that the frequency of HLA-DQB1*03:03 was significantly higher in the PR compared with the HC group [P = 0.001; relative risk (RR) = 2.24; 95% CI 1.38–3.6], while suggestive evidence for a protective effect of HLA-DQB1*06:06 was observed in the study cohort (P < 0.02; RR = 0.40; 95% CI 0.17–0.90).
Conclusions
The HLA-DQB1*03:03 allele may be a susceptible factor in patients with PR. In addition, the association of HLA-DQB1*03:03 with PR suggests participation of immunity in the pathogenesis of PR.
http://ift.tt/2yQM43S
Effect of age and body mass index on the yield of stromal vascular fraction
Summary
Objective
The aim of this study was to determine the influence of age, body mass index, and site of liposuction on the cell yield of SVF.
Methods
A prospective study was performed on 58 patients. The average age was 39 years old, with BMI ≤ 25 or BMI ≥ 25. Fat tissue was harvested from the abdominal region, flanks, or thighs and SVF was isolated.
Results
The yield of viable SVF was evaluated by trypan blue, and the markers of stem cells were evaluated by flow cytometry. The cells were positive for stem cells markers, the age, sex of the patient had no impact on SVF cell yield with an average of 1.17 × 10^8. However, the BMI > 25 had resulted in higher cell numbers, and the harvest site had a significant impact on cell yield with abdomen being the site of interest.
Conclusion
These data demonstrate that the age of the person does not affect the cell yield of SVF; nevertheless, the donor site and BMI might be important factors in affecting cell number.
http://ift.tt/2BlBnsJ
Effect of age and body mass index on the yield of stromal vascular fraction
Summary
Objective
The aim of this study was to determine the influence of age, body mass index, and site of liposuction on the cell yield of SVF.
Methods
A prospective study was performed on 58 patients. The average age was 39 years old, with BMI ≤ 25 or BMI ≥ 25. Fat tissue was harvested from the abdominal region, flanks, or thighs and SVF was isolated.
Results
The yield of viable SVF was evaluated by trypan blue, and the markers of stem cells were evaluated by flow cytometry. The cells were positive for stem cells markers, the age, sex of the patient had no impact on SVF cell yield with an average of 1.17 × 10^8. However, the BMI > 25 had resulted in higher cell numbers, and the harvest site had a significant impact on cell yield with abdomen being the site of interest.
Conclusion
These data demonstrate that the age of the person does not affect the cell yield of SVF; nevertheless, the donor site and BMI might be important factors in affecting cell number.
http://ift.tt/2BlBnsJ
Cardiovascular risk and severity factors in patients admitted to hospital for spontaneous epistaxis
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): N. André, N. Klopp-Dutote, A. Biet-Hornstein, V. Strunski, C. Page
ObjectivesTo assess the role of cardiovascular risk factors, intake of drugs altering hemostasis and severity signs in patients admitted with spontaneous epistaxis.Material and methodsA single-center retrospective study covering a 7-year period in a university hospital center included 205 patients admitted with spontaneous epistaxis. Study variables comprised: cardiovascular risk factors (cardiovascular disease or history of cardiovascular disease with hemorrhagic or thromboembolic risk, high blood pressure, type-2 diabetes, dyslipidemia), intake of drugs altering hemostasis, blood pressure and minimum hemoglobin level during hospital stay. Groups of serious and non-serious epistaxis were distinguished.ResultsThere were no significant inter-group differences for mean age, sex ratio, history of high blood pressure or number of cardiovascular risk factors. Serious epistaxis was associated with significantly lower blood pressure and hemoglobinemia. Number of cardiovascular risk factors correlated with probability of blood transfusion.ConclusionThe real influence of the various study factors, including severity factors, on onset of spontaneous epistaxis remains to be elucidated.
http://ift.tt/2BluCqR
Impact of allergy on phenotypic and endotypic profiles of nasal polyposis
Publication date: Available online 8 December 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): G. Mortuaire, I. Gengler, M. Balden, M. Capron, G. Lefèvre
ObjectivesTo assess the impact of allergy on clinical presentations (phenotypes) and inflammatory patterns (endotypes) of chronic rhinosinusitis with nasal polyps (CRSwNP).MethodsA single-center prospective study was conducted over an 18-month period. Fifty-seven patients with refractory CRSwNP were included. The diagnosis of allergy was based on concordant skin prick tests and symptoms. Phenotypes were determined on symptom severity score, polyp size classification and Lund-Mackay CT staging. Inflammatory endotypes were determined on biomarker analysis (IgE, IgA, IL-5, IL-9, ECP, EDN) in blood and nasal secretions. Eosinophil counts were obtained in blood, nasal secretions and polyps.ResultsPhenotype and endotype profiles were comparable in patients with (n=15) or without (n=42) allergy. Only asthma with high total IgE blood concentration showed association with allergy.ConclusionsThe present results suggest that allergy is not directly involved in the clinical expression and specific inflammatory pathways of CRSwNP. New therapies target inflammation signaling pathways, and identifying accurate blood and tissue biomarkers will be the line of research most likely to improve treatment of CRSwNP.
http://ift.tt/2ALc0PR
RELN signaling modulates glioblastoma growth and substrate-dependent migration
Abstract
Glioblastoma (GBM) represents the most common and most malignant type of primary brain tumor and significantly contributes to cancer morbidity and mortality. Invasion into the healthy brain parenchyma is a major feature of glioblastoma aggressiveness. Reelin (RELN) is a large secreted extracellular matrix glycoprotein that regulates neuronal migration and positioning in the developing brain and sustains functionality in the adult brain. We here show that both RELN and its main downstream effector DAB1 are silenced in glioblastoma as compared to non-neoplastic tissue and mRNA expression is inversely correlated with malignancy grade. Furthermore, RELN expression is positively correlated with patient survival in two large, independent clinically annotated datasets. RELN silencing occurs via promoter hypermethylation as shown by both database mining and bisulfite sequencing of the RELN promoter. Consequently, treatment with 5'-Azacytidine and trichostatin A induced RELN expression in vitro. On the functional level, we found RELN to regulate glioblastoma cell migration both in a DAB1 (tyrosine phosphorylation)-dependent and -independent fashion, depending on the substrate provided. Moreover, stimulation of RELN signaling strongly reduced proliferation in glioblastoma cells. This phenotype depends on DAB1 stimulation by RELN, as a mutant that lacks all RELN induced tyrosine phosphorylation sites (DAB1-5F) failed to induce a growth arrest. Proteomic analyzes revealed that these effects are mediated by a reduction in E2F targets and dephosphorylation of ERK1/2. Taken together, our data establish a relevance of RELN signaling in glioblastoma pathology and thereby might unearth novel, yet unrecognized treatment options. This article is protected by copyright. All rights reserved.
http://ift.tt/2BMI2bF
Dominant role of microglial and macrophage innate immune responses in human ischemic infarcts
Abstract
Inflammatory mechanisms, involving granulocytes, T-cells, B-cells, macrophages and activated microglia, have been suggested to play a pathogenic role in experimental models of stroke and may be targets for therapeutic intervention. However, knowledge on the inflammatory response in human stroke lesions is limited. Here, we performed a quantitative study on the inflammatory reaction in human ischemic infarct lesions. We found increased numbers of T-lymphocytes, mainly CD8+ cells, but not of B-lymphocytes. Their number was very low in comparison to that seen in inflammatory diseases of the central nervous system and they did not show signs of activation. Polymorphonuclear leukocytes were present in meninges and less prominently in the perivascular space in early lesions, but their infiltration into the lesioned tissue was sparse with the exception of a single case. Microglia were lost in the necrotic core of fresh lesions, their number was increased in the surrounding penumbra, apparently due to proliferation. Using TMEM119 as a marker for the resident microglia pool, macrophages in lesions were in part derived from the original microglia pool, depending upon the lesion stage. Most microglia and macrophages revealed a pro-inflammatory activation pattern, expressing molecules involved in phagocytosis, oxidative injury, antigen presentation and iron metabolism and had partially lost the expression of P2RY12, an antigen expressed on homeostatic ("resting") microglia in rodents. At later lesion stages, the majority of macrophages showed intermediate activation patterns, expressing pro-inflammatory and anti-inflammatory markers. Microglia in the normal white matter of controls and stroke patients were already partly activated towards a pro-inflammatory phenotype. Our data suggest that the direct contribution of lymphocytes and granulocytes to active tissue injury in human ischemic infarct lesions is limited and that stroke therapy that targets pro-inflammatory microglia and macrophage activation may be effective. This article is protected by copyright. All rights reserved.
http://ift.tt/2BUq1c9
Effects of acrylamide on oxidant/antioxidant parameters and CYP2E1 expression in rat pancreatic endocrine cells
Source:Acta Histochemica
Author(s): Jelena Marković, Milena Stošić, Danijela Kojić, Milica Matavulj
Oxidative stress is one of the principle mechanism of acrylamide-induced toxicity. Acrylamide is metabolized by cytochrome P450 2E1 (CYP2E1) to glycidamide or by direct conjugation with glutathione. Bearing in mind that up to now the effects of acrylamide on oxidative stress status and CYP2E1 level in endocrine pancreas have not been studied we performed qualitative and quantitative immunohistochemical evaluation of inducible nitric oxide synthase (iNOS), superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), catalase (CAT) and CYP2E1 expression in islets of Langerhans of rats subchronically treated with 25 or 50mg/kg bw of acrylamide. Since the majority of cells (>80%) in rodent islets are beta cells, in parallel studies, we employed the Rin-5F beta cell line to examine effects of acrylamide on redox status and the activity of CAT, SOD and glutathione-S-transferase (GST), their gene expression, and CYP2E1, NF-E2 p45-related factor 2 (Nrf2) and iNOS expression. Immunohistochemically stained pancreatic sections revealed that acrylamide induced increase of iNOS and decrease of CYP2E1 protein expression, while expression of antioxidant enzymes was not significantly affected by acrylamide in islets of Langerhans. Analysis of Mallory-Azan stained pancreatic sections revealed increased diameter of blood vessels lumen in pancreatic islets of acrylamide-treated rats. Increase in the GST activity, lipid peroxidation and nitrite level, and decrease in GSH content, CAT and SOD activities was observed in acrylamide-exposed Rin-5F cells. Level of mRNA was increased for iNOS, SOD1 and SOD2, and decreased for GSTP1, Nrf2 and CYP2E1 in acrylamide-treated Rin-5F cells. This is the first report of the effects of acrylamide on oxidant/antioxidant parameters and CYP2E1 expression in pancreatic endocrine cells.
http://ift.tt/2AqQvos
Neurons and satellite glial cells in adult rat lumbar dorsal root ganglia express connexin 36
Source:Acta Histochemica
Author(s): E. Martha Pérez Armendariz, Monica Norcini, Beatriz Hernández-Tellez, Andrés Castell-Rodríguez, Cristina Coronel-Cruz, Raquel Guerrero Alquicira, Alexandra Sideris, Esperanza Recio-Pinto
Previous studies have shown that following peripheral nerve injury there was a downregulation of the gap junction protein connexin 36 (Cx36) in the spinal cord; however, it is not known whether Cx36 protein is expressed in the dorsal root ganglia (DRGs), nor if its levels are altered following peripheral nerve injuries. Here we address these aspects in the adult rat lumbar DRG. Cx36 mRNA was detected using qRT-PCR, and Cx36 protein was identified in DRG sections using immunohistochemistry (IHC) and immunofluorescence (IF). Double staining revealed that Cx36 co-localizes with both anti-β-III tubulin, a neuronal marker, and anti-glutamine synthetase, a satellite glial cell (SGC) marker. In neurons, Cx36 staining was mostly uniform in somata and fibers of all sizes and its intensity increased at the cell membranes. This labeling pattern was in contrast with Cx36 IF dots mainly found at junctional membranes in islet beta cells used as a control tissue. Co-staining with anti-Cx43 and anti-Cx36 showed that whereas mostly uniform staining of Cx36 was found throughout neurons and SGCs, Cx43 IF puncta were localized to SGCs. Cx36 mRNA was expressed in normal lumbar DRG, and it was significantly down-regulated in L4 DRG of rats that underwent sciatic nerve injury resulting in persistent hypersensitivity. Collectively, these findings demonstrated that neurons and SGCs express Cx36 protein in normal DRG, and suggested that perturbation of Cx36 levels may contribute to chronic neuropathic pain resulting from a peripheral nerve injury.
http://ift.tt/2jyNwA1
Circulating allergen-specific Th2 lymphocytes: CCR4+ rather than CLA+ is the predominant phenotype in peanut allergic subjects
Source:Journal of Allergy and Clinical Immunology
Author(s): Lars H. Blom, Nanna Juel-Berg, Lau Fabricius Larsen, Kirsten S. Hansen, Lars K. Poulsen
Teaser
The skin and airway homing chemokine CCR4, but not CLA, emerged as the primary discriminating homing factor, of Th2 lymphocytes, suggesting that peanut sensitization occurs both via the skin and airways.http://ift.tt/2yQMyaz
Neutrophil-lymphocyte ratio kinetics in patients with advanced solid tumours on phase I trials of PD-1/PD-L1 inhibitors
Source:European Journal of Cancer, Volume 89
Author(s): Malaka Ameratunga, Maxime Chénard-Poirier, Irene Moreno Candilejo, Manuel Pedregal, Andrew Lui, David Dolling, Caterina Aversa, Alvaro Ingles Garces, Joo Ern Ang, Udai Banerji, Stan Kaye, Hui Gan, Bernard Doger, Victor Moreno, Johann de Bono, Juanita Lopez
BackgroundAlthough the neutrophil-lymphocyte ratio (NLR) is prognostic in many oncological settings, its significance in the immunotherapy era is unknown. Mechanistically, PD-1/PD-L1 inhibitors may alter NLR. We sought to characterise NLR kinetics in patients with advanced solid tumours treated with PD-1/PD-L1 inhibitors.MethodsElectronic records of patients treated with PD-1/PD-L1 inhibitors on phase I trials across three sites were reviewed. A high NLR (hNLR) was predefined as >5. Univariate logistic regression models were used for toxicity, response analyses and Cox models for overall survival (OS) and progression-free survival analyses. Landmark analyses were performed (cycle two, three). Longitudinal analysis of NLR was performed utilising a mixed effect regression model.ResultsThe median OS for patients with hNLR was 8.5 months and 19.4 for patients with low NLR, (hazard ratio [HR] = 1.85, 95% confidence interval [CI] 1.15–2.96, p = 0.01). On landmark analysis, hNLR was significantly associated with inferior OS at all time points with a similar magnitude of effect over time (p < 0.05). On multivariate analysis, NLR was associated with OS (HR 1.06, 95% CI 1.01–1.11, p = 0.01). NLR did not correlate with increased immune toxicity. Longitudinally, NLR correlated with response: NLR decreased by 0.09 (95% CI: −0.15 to −0.02; p = 0.01) per month in responders compared with non-responders.ConclusionshNLR at baseline and during treatment is adversely prognostic in patients with advanced malignancies receiving PD-1/PD-L1 blockade. Importantly, NLR reduced over time in responders to immunotherapy. Taken together, these data suggest that baseline and longitudinal NLR may have utility as a unique biomarker to aid clinical decision-making in patients receiving immunotherapy.
http://ift.tt/2kf8Zh8
The use of breast imaging for predicting response to neoadjuvant lapatinib, trastuzumab and their combination in HER2-positive breast cancer: Results from Neo-ALTTO
Source:European Journal of Cancer, Volume 89
Author(s): S. Di Cosimo, C. Campbell, H.A. Azim, G. Galli, G. Bregni, G. Curigliano, C. Criscitiello, M. Izquierdo, L. de la Pena, D. Fumagalli, L. Fein, J. Vinholes, W.M.J. Ng, M. Colleoni, A. Ferro, B.J. Naume, A. Patel, J. Huober, M.J. Piccart-Gebhart, J. Baselga, E. de Azambuja
AimTo determine the value of mammography and breast ultrasound (US) in predicting outcomes in HER2 positive breast cancer patients (pts) within Neo-ALTTO trial.Patients and methodsMammography and US were required at baseline, week 6 and surgery. Two independent blinded investigators reviewed the measurements and assigned the corresponding response category. Pts showing complete or partial response according to RECIST (v1.1) were classified as responders. The association between imaging response at week 6 or prior to surgery was evaluated with respect to pathological complete response (pCR) and event-free Survival (EFS).ResultsOf the 455 pts enrolled in the trial, 267 (61%) and 340 (77%) had evaluable mammography and US at week 6; 248 (56%) and 309 (70%) pts had evaluable mammography and US prior to surgery. At week 6, 32% and 43% of pts were classified as responders by mammography and US, respectively. pCR rates were twice as high for responders than non-responders (week 6: 46% versus 23% by US, p < 0.0001; 41% versus 24% by mammography, p = 0.007). Positive and negative predictive values of mammography and US prior to surgery were 37% and 35%, and 82% and 70%, respectively. No significant correlation was found between response by mammography and/or US at week 6/surgery and EFS.ConclusionsMammography and US were underused in Neo-ALTTO although US had the potential to assess early response whereas mammography to detect residual disease prior to surgery. Our data still emphasise the need for further imaging studies on pts treated with neoadjuvant HER2-targeted therapy.
http://ift.tt/2BkyfNU
Comparing granulocyte colony–stimulating factor filgrastim and pegfilgrastim to its biosimilars in terms of efficacy and safety: A meta-analysis of randomised clinical trials in breast cancer patients
Source:European Journal of Cancer, Volume 89
Author(s): Edoardo Botteri, Andriy Krendyukov, Giuseppe Curigliano
BackgroundGranulocyte colony–stimulating factors (G-CSFs) are widely used to prevent neutropenia in cancer patients undergoing myelosuppressive chemotherapy. Several biosimilar medicines of G-CSF are now available, with their development involving a step-wise series of comparisons to demonstrate similarity to reference biologics. Randomised clinical trials (RCTs) are considered confirmatory, and for G-CSF biosimilars, patients with breast cancer (BC) undergoing myelosuppressive chemotherapy are the most sensitive population in which to confirm similarity. This meta-analysis aimed to compare the clinical efficacy and safety of approved or proposed G-CSF biosimilars (filgrastim or pegfilgrastim) with reference G-CSF in patients with BC.MethodsA Medline literature search up to March 2017 identified RCTs comparing biosimilar G-CSF to reference in BC patients. The primary efficacy end-point was mean difference in duration of severe neutropenia (DSN). Secondary efficacy end-points were differences in depth of absolute neutrophil count (ANC) nadir, time to ANC recovery and incidence of febrile neutropenia. Safety analyses included calculation of risk ratios for bone pain events, myalgia events and serious adverse events. Random effect models were fitted to obtain the pooled estimates of the mean difference for continuous outcomes and the risk ratio for dichotomous outcomes and their corresponding 95% confidence intervals (CIs).FindingsEight eligible RCTs were included in this meta-analysis. Overall difference in DSN between reference and biosimilar medicines was not statistically significant (0·06 d [95% CI −0·05, 0·17]). The analysis of secondary efficacy end-points showed no significant differences between reference biologics and biosimilar medicines, as well as the analysis of bone pain events, myalgia events and serious adverse events.
http://ift.tt/2kbKeCo
Positron emission tomography/computed tomography evaluation of oncolytic virus therapy efficacy in melanoma
Source:European Journal of Cancer
Author(s): Viola Franke, Bernies van der Hiel, Bart A. van de Wiel, Willem M.C. Klop, Sylvia ter Meulen, Alexander C.J. van Akkooi
http://ift.tt/2BmmW7N
In response to Letter to the Editor entitled ‘Is an endoscopic or a microscopic approach optimal for management of attic cholesteatoma?’
Source:American Journal of Otolaryngology
Author(s): Giuseppe Magliulo, Giannicola Iannella
http://ift.tt/2y8XCMD
The G-protein-coupled receptor Gpr161 regulates forelimb formation, limb patterning and skeletal morphogenesis in a primary cilium-dependent manner [RESEARCH ARTICLE]
The role of basal suppression of Sonic hedgehog (Shh) pathway and its interaction with Indian hedgehog (Ihh) signaling during limb/skeletal morphogenesis is not well understood. The orphan G-protein-coupled receptor, Gpr161 localizes to primary cilia, and functions as a negative regulator of Shh signaling by promoting Gli transcriptional repressor versus activator formation. Here, we show that forelimb buds are not formed in Gpr161 knockout mice embryos despite establishment of prospective limb fields. Limb-specific deletion of Gpr161 resulted in prematurely expanded Shh signaling and ectopic Shh-dependent patterning defects to cause polysyndactyly. In addition, endochondral bone formation in forearms, including formation of both trabecular bone and bone collar was prevented. Endochondral bone formation defects resulted from accumulation of proliferating round/periarticular-like chondrocytes, lack of differentiation into columnar chondrocytes, and corresponding absence of Ihh signaling. Gpr161 deficiency in craniofacial mesenchyme also prevented intramembranous bone formation in calvarium. Defects in limb patterning, endochondral and intramembranous skeletal morphogenesis were suppressed in the absence of cilia. Overall, Gpr161 promotes forelimb formation, regulates limb patterning, prevents periarticular chondrocyte proliferation, and drives osteoblastogenesis in intramembranous bones in a cilium-dependent manner.
http://ift.tt/2y9eBhA
Anti-mumps IgM antibody positive rate with sudden sensorineural hearing loss using second-generation enzyme immunoassay: A retrospective, multi-institutional investigation in Hokkaido, Japan
Source:Auris Nasus Larynx
Author(s): Atsushi Fukuda, Shinya Morita, Yuji Nakamaru, Kimiko Hoshino, Keishi Fujiwara, Shigeru Akazawa, Tomohiro Sakashita, Nobuyuki Obara, Akihiro Homma
ObjectiveAlthough elevated anti-mumps IgM antibody levels were reported in 5.7%–7.2% of Japanese patients with sudden sensorineural hearing loss (SSNHL), there were several reports of false-positive cases, such as the continually IgM positive case and the IgM positive case in normal adults. To improve specificity, the new enzyme immuno assay (EIA) anti-mumps IgM antibody measurement kit was introduced in December 2009. This study re-examined the frequency of anti-mumps IgM antibody test positivity with SSNHL using the new measurement kit and compared the results with those from a previous report that used old kit.MethodsThis is a retrospective multi-institutional study involving patients diagnosed with SSNHL who exhibited the anti-mumps IgM antibody. We compared the positive rate of anti-mumps IgM antibody and the annual average number of mumps cases per sentinel in Hokkaido between the patients in the present study and patients previously evaluated.ResultsOverall, 100 patients with SSNHL were enrolled. One case (1.0%) was positive for anti-mumps IgM antibody. Of the 69 patients evaluated in the previous study, 5 cases (7.2%) were positive for anti-mumps IgM antibody. The positive rate of the anti-mumps IgM antibody in the present cases was significantly lower than that previously reported (p=0.042). The annual average number of mumps cases per sentinel in Hokkaido of the present and previous surveillance period was 34.47 and 42.77, respectively; no significant difference was seen in these data (p=0.4519).ConclusionThe present study revealed that 1.0% of SSNHL was positive for the anti-mumps IgM antibody using the new EIA-IgM measurement kit. After the introduction of the new EIA-IgM measurement kit, anti-mumps IgM antibody positive rate with SSNHL significantly decreased, indicating that the proportion of asymptomatic mumps among etiology of SSNHL may be lower than those previously reported.
http://ift.tt/2yQiwni
Genetic Hearing Loss: A Comprehensive Review
http://ift.tt/2yPX4yL
Ménière's Disease: Current and Potential New Objective Measures Using Electrocochleography
http://ift.tt/2y8Sl7v
A Review of Human Immunodeficiency Virus on the Auditory System
http://ift.tt/2y99aiD
SIG 6 Perspectives Vol. 19, No. 2, November 2015: Earn 0.15 CEUs
http://ift.tt/2yQnJvr
Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitian Nutritionists
Publication date: Available online 22 November 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Denise Andersen, Shari Baird, Tracey Bates, Denise L. Chapel, Alana D. Cline, Shyamala N. Ganesh, Margaret Garner, Barbara L. Grant, Kathryn K. Hamilton, Krista Jablonski, Sherri L. Jones, Alexandra G. Kazaks, Susan H. Konek, Kelly K. Leonard, Kimi G. McAdam, Beth N. Ogata, Egondu M. Onuoha, Gretchen Y. Robinson, Darrin W. Schmidt, Nancy G. Walters, Pauline Williams, Pamela Wu, Karen Hui, Carol Gilmore, Mujahed Khan, Dana Buelsing, Sharon M. McCauley
Registered dietitian nutritionists (RDNs) face complex situations every day. Competently addressing the unique needs of each situation and applying standards appropriately are essential to providing safe, timely, patient-/client-/customer-centered, quality nutrition and dietetics care and services. The Academy of Nutrition and Dietetics (Academy) leads the profession by developing standards that can be used by RDNs (who are credentialed by the Commission on Dietetic Registration) for self-evaluation to assess quality of practice and performance. The Standards of Practice reflect the Nutrition Care Process and workflow elements as a method to manage nutrition care activities with patients/clients/populations that include nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention/plan of care, nutrition monitoring and evaluation, and discharge planning and transitions of care. The Standards of Professional Performance consist of six domains of professional performance: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The Academy's Revised 2017 Standards of Practice and Standards of Professional Performance for RDNs, along with the Academy's Code of Ethics and the Revised 2017 Scope of Practice for the RDN, provide minimum standards and tools for demonstrating competence and safe practice and are used collectively to gauge and guide an RDN's performance in nutrition and dietetics practice.
http://ift.tt/2Bj6m8R
Food Insecurity and the Nutrition Care Process: Practical Applications for Dietetics Practitioners
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Marianna S. Wetherill, Kayla Castleberry White, Christine Rivera
http://ift.tt/2kanliC
How Do I Know Whether It Is an Ethical Issue? Helping Registered Dietitian Nutritionists Identify Ethical Issues in Practice
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Mindy Beth Nelkin
http://ift.tt/2Bj655P
December 2017 Classified Advertisements
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2kbxqfl
Table of Contents
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2Bj5P6R
What's New Online
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2kcGwYY
Consider Making Public Policy a Part of Your New Year
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Donna S. Martin
http://ift.tt/2Bj9Hox
Pediatric Weight Management Evidence-Based Practice Guidelines: Components and Contexts of Interventions
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Beverly W. Henry, Jane Ziegler, James Scott Parrott, Deepa Handu
http://ift.tt/2kdMOIb
Prevalence of and Differences in Salad Bar Implementation in Rural Versus Urban Arizona Schools
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Michelle Blumenschine, Marc Adams, Meg Bruening
BackgroundRural children consume more calories per day on average than urban children, and they are less likely to consume fruit. Self-service salad bars have been proposed as an effective approach to better meet the National School Lunch Program's fruit and vegetable recommendations. No studies have examined how rural and urban schools differ in the implementation of school salad bars.ObjectiveTo compare the prevalence of school-lunch salad bars and differences in implementation between urban and rural Arizona schools.DesignSecondary analysis of a cross-sectional web-based survey.Participants/settingSchool nutrition managers (N=596) in the state of Arizona.Main outcomes measuredNational Center for Education Statistics locale codes defined rural and urban classifications. Barriers to salad bar implementation were examined among schools that have never had, once had, and currently have a school salad bar. Promotional practices were examined among schools that once had and currently have a school salad bar.Statistical analyses performedGeneralized estimating equation models were used to compare urban and rural differences in presence and implementation of salad bars, adjusting for school-level demographics and the clustering of schools within districts.ResultsAfter adjustment, the prevalence of salad bars did not differ between urban and rural schools (46.9%±4.3% vs 46.8%±8.5%, respectively). Rural schools without salad bars more often reported perceived food waste and cost of produce as barriers to implementing salad bars, and funding was a necessary resource for offering a salad bar in the future, as compared with urban schools (P<0.05). No other geographic differences were observed in reported salad bar promotion, challenges, or resources among schools that currently have or once had a salad bar.ConclusionsAfter adjustment, salad bar prevalence, implementation practices, and concerns are similar across geographic settings. Future research is needed to investigate methods to address cost and food waste concerns in rural areas.
http://ift.tt/2Bj1H6I
VegPlate: A Mediterranean-Based Food Guide for Italian Adult, Pregnant, and Lactating Vegetarians
Publication date: Available online 21 November 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Luciana Baroni, Silvia Goggi, Maurizio Battino
http://ift.tt/2keYYAy
Prepare for a New Year with Real Solutions You Can Use
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Barbara Jirka, Corey Holland
http://ift.tt/2Bk22WK
From Neighborhood to Genome: Three Decades of Nutrition-Related Research from the Atherosclerosis Risk in Communities Study
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Margaret R. Savoca, Lyn M. Steffen, Alain G. Bertoni, Lynne E. Wagenknecht
http://ift.tt/2kbqO0s
Dietary Energy Density in the Australian Adult Population from National Nutrition Surveys 1995 to 2012
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Amanda Lee Grech, Anna Rangan, Margaret Allman-Farinelli
BackgroundIt is hypothesized that the observed proliferation of energy-dense, nutrient-poor foods globally is an important contributing factor to the development of the obesity epidemic. However, evidence that the population's dietary energy density has increased is sparse. The World Cancer Research Fund recommends that dietary energy density be <1.25 kcal/g to prevent weight gain.ObjectiveThe aim of this research was to determine whether the dietary energy density of the Australian population has changed between 1995 and 2012.DesignA secondary analysis of two cross-sectional Australian national nutrition surveys from 1995 and 2011/2012 was conducted.Participants/settingParticipants of the surveys included adults aged 18 years and older (1995 n=10,986 and 2011/2012 n=9,435) completing 24-hour dietary recalls, including a second recall for a subset of the population (10.4% in 1995 and 64.6% in 2011/2012).Main outcome measuresOutcome measures included the change in dietary energy density (calculated as energy/weight of food [kcal/g] for food only) between surveys.Statistical analysisThe National Cancer Institute method for "estimating ratios of two dietary components that are consumed nearly every day" was used to determine the usual distribution and the percentage of participants reporting energy density <1.25 kcal/g.ResultsThe mean (standard deviation) dietary energy density was 1.59 (0.26) kcal/g and 1.64 (0.32) kcal/g (P<0.0001) in 1995 and 2011/2012, respectively, with 13% and 5% (P<0.0001) of the population meeting dietary energy-density recommendations. For those aged 70 years and older, the percentage with energy density <1.25 kcal/g decreased from 22% to 6% (P<0.0001) for men and from 33% to 11% (P<0.0001) for women in 1995 and 2011/2012, respectively. Among those aged 18 to 29 years, 1% of men in both surveys (P=0.8) and 4% of women in 1995 and 2% in 2011/2012 (P=0.01) reported energy density <1.25 kcal/g.ConclusionsDietary energy density has increased between the two surveys and few people consumed low energy-dense diets in line with recommendations. The change was largely due to increased energy density of older adult's diets, while young adults had high dietary energy density at both time points. These data suggest efforts now focus on the evaluation of the role of modifying energy density of the diet to reduce the risk of weight gain in adults.
http://ift.tt/2BlmzKT
Use of Added Sugars Instead of Total Sugars May Improve the Capacity of the Health Star Rating System to Discriminate between Core and Discretionary Foods
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Hannah Menday, Bruce Neal, Jason H.Y. Wu, Michelle Crino, Surinder Baines, Kristina S. Petersen
BackgroundThe Australian Government has introduced a voluntary front-of-package labeling system that includes total sugar in the calculation.ObjectiveOur aim was to determine the effect of substituting added sugars for total sugars when calculating Health Star Ratings (HSR) and identify whether use of added sugars improves the capacity to distinguish between core and discretionary food products.DesignThis study included packaged food and beverage products available in Australian supermarkets (n=3,610). The product categories included in the analyses were breakfast cereals (n=513), fruit (n=571), milk (n=309), non-alcoholic beverages (n=1,040), vegetables (n=787), and yogurt (n=390). Added sugar values were estimated for each product using a validated method. HSRs were then estimated for every product according to the established method using total sugar, and then by substituting added sugar for total sugar. The scoring system was not modified when added sugar was used in place of total sugar in the HSR calculation. Products were classified as core or discretionary based on the Australian Dietary Guidelines. To investigate whether use of added sugar in the HSR algorithm improved the distinction between core and discretionary products as defined by the Australian Dietary Guidelines, the proportion of core products that received an HSR of ≥3.5 stars and the proportion of discretionary products that received an HSR of <3.5 stars, for algorithms based upon total vs added sugars were determined.ResultsThere were 2,263 core and 1,347 discretionary foods; 1,684 of 3,610 (47%) products contained added sugar (median 8.4 g/100 g, interquartile range=5.0 to 12.2 g). When the HSR was calculated with added sugar instead of total sugar, an additional 166 (7.3%) core products received an HSR of ≥3.5 stars and 103 (7.6%) discretionary products received a rating of ≥3.5 stars. The odds of correctly identifying a product as core vs discretionary were increased by 61% (odds ratio 1.61, 95% CI 1.26 to 2.06; P<0.001) when the algorithm was based on added compared to total sugars.ConclusionsIn the six product categories examined, substitution of added sugars for total sugars better aligned the HSR with the Australian Dietary Guidelines. Future work is required to investigate the impact in other product categories.
http://ift.tt/2kbPmGt
December 2017 Sites in Review
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2BkcldE
Attitude and Behavior Factors Associated with Front-of-Package Label Use with Label Users Making Accurate Product Nutrition Assessments
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Mary G. Roseman, Hyun-Woo Joung, Emily I. Littlejohn
BackgroundFront-of-package (FOP) labels are increasing in popularity on retail products. Reductive FOP labels provide nutrient-specific information, whereas evaluative FOP labels summarize nutrient information through icons. Better understanding of consumer behavior regarding FOP labels is beneficial to increasing consumer use of nutrition labeling when making grocery purchasing decisions.ObjectiveWe aimed to determine FOP label format effectiveness in aiding consumers at assessing nutrient density of food products. In addition, we sought to determine relationships between FOP label use and attitude toward healthy eating, diet self-assessment, self-reported health and nutrition knowledge, and label and shopping behaviors.DesignA between-subjects experimental design was employed. Participants were randomly assigned to one of four label conditions: Facts Up Front, Facts Up Front Extended, a binary symbol, and no-label control.Participants/settingOne hundred sixty-one US primary grocery shoppers, aged 18 to 69 years. Participants were randomly invited to the online study.InterventionParticipants in one of four label condition groups viewed three product categories (cereal, dairy, and snacks) with corresponding questions.Main outcome measuresAdults' nutrition assessment of food products based on different FOP label formats, along with label use and attitude toward healthy eating, diet self-assessment, self-reported health and nutrition knowledge, and label and shopping behaviors.Statistical analyses performedData analyses included descriptive statistics, χ2 tests, and logistical regression. Significant outcomes were set to α=.05.ResultsParticipants selected the more nutrient-dense product in the snack food category when it contained an FOP label. Subjective health and nutrition knowledge and frequency of selecting food for healthful reasons were associated with FOP label use (P<0.01 and P<0.05, respectively).ConclusionsBoth Facts Up Front (reductive) and binary (evaluative) FOP labels appear effective for nutrition assessment of snack products compared with no label. Specific attitude and behavior factors were associated with label use.
http://ift.tt/2kbPmpX
Gardening Experience Is Associated with Increased Fruit and Vegetable Intake among First-Year College Students: A Cross-Sectional Examination
Publication date: Available online 1 December 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jennifer Loso, Daniel Staub, Sarah E. Colby, Melissa D. Olfert, Kendra Kattelmann, Melissa Vilaro, James Colee, Wenjun Zhou, Lisa Franzen-Castle, Anne E. Mathews
BackgroundGardening interventions have been shown to increase fruit and vegetable (F/V) intake among school-aged children. It is unknown whether these effects persist into later adolescence or adulthood, and little is known about whether gardening in later adolescence is related to F/V intake.ObjectiveTo identify the relationship between both childhood and recent (within the past 12 months) gardening experiences and current F/V intake among college students.Design/participantsA cross-sectional evaluation of 1,121 college freshmen with suboptimal F/V consumption from eight US universities.Main outcome measuresParticipants completed the National Cancer Institute Fruit and Vegetable Screener and questions about gardening experiences. Respondents were grouped as having gardened or not gardened during childhood and recently.Statistical analyses performedA linear mixed model was used to evaluate the relationship between childhood and recent gardening and current F/V intake.ResultsOf the student participants, 11% reported gardening only during childhood, 19% reported gardening only recently, 20% reported gardening both as a child and recently, and 49% of students reported never having gardened. Students who gardened both during childhood and recently had a significantly higher mean current intake of F/V compared with students who never gardened (2.5±0.6 vs 1.9±0.5 cup equivalents [CE], respectively; P<0.001). In addition, F/V intake increased with frequency of recent gardening engagement when comparing students who did not garden with those who gardened monthly or weekly (2.1±0.5 CE, 2.4±0.6 CE, and 2.8±0.7 CE, respectively; P<0.001).ConclusionsThis analysis suggests that the combination of childhood and recent gardening experience is associated with greater current F/V intake among first-year college students not currently meeting national F/V recommendations. In addition, a greater frequency of gardening experience may further enhance this effect.
http://ift.tt/2kdTB4u
Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers’ Perspectives
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Dipti A. Dev, Virginia Carraway-Stage, Daniel J. Schober, Brent A. McBride, Car Mun Kok, Samantha Ramsay
BackgroundNational childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited.ObjectiveUsing the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years).DesignUsing a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached.Participants/settingThe study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois.Main outcome measureChild-care providers' perspectives regarding implementation of NE.Statistical analyses performedThematic analysis to derive themes using NVivo software.ResultsThree overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods.ConclusionsPresent study findings offer insights regarding providers' perspectives on implementing NE in child care. Drawing from these perspectives, registered dietitian nutritionists can train providers about the importance of NE for encouraging healthy eating in children, integrating NE with mealtime conversations, and practicing low-cost, hands-on NE activities that meet the food safety standards for state licensing. Such strategies may improve providers' ability to deliver NE in child-care settings.
http://ift.tt/2BlIyRO
Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Denise Andersen, Shari Baird, Tracey Bates, Denise L. Chapel, Alana D. Cline, Shyamala N. Ganesh, Margaret Garner, Barbara L. Grant, Kathryn K. Hamilton, Krista Jablonski, Sherri L. Jones, Alexandra G. Kazaks, Susan H. Konek, Kelly K. Leonard, Kimi G. McAdam, Beth N. Ogata, Egondu M. Onuoha, Gretchen Y. Robinson, Darrin W. Schmidt, Nancy G. Walters, Pauline Williams, Pamela Wu, Karen Hui, Carol Gilmore, Mujahed Khan, Dana Buelsing, Sharon M. McCauley
The Academy of Nutrition and Dietetics (Academy) is the world's largest organization of food and nutrition professionals and the association that represents credentialed nutrition and dietetics practitioners—registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs). RDNs integrate research, professional development, and practice to stimulate innovation and discovery; collaborate to solve the greatest food and nutrition challenges now and in the future; focus on systemswide impact across the food, wellness, and health sectors; have a global impact in eliminating all forms of malnutrition; and amplify the contribution of nutrition and dietetics practitioners and expand workforce capacity and capability. The Revised 2017 Scope of Practice for the RDN reflects the position of the Academy on the essential role of the RDN in the direction and delivery of food and nutrition services. The scope of practice for the RDN is composed of education and credentialing, practice resources, Academy Standards of Practice and Professional Performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, and organizational policy and procedures. The Revised 2017 Scope of Practice for the RDN is used in conjunction with the Revised 2017 Standards of Practice (SOP) in Nutrition Care and the Standards of Professional Performance (SOPP) for RDNs. The SOP address activities related to direct patient and client care. The SOPP address behaviors related to the professional role of RDNs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for RDNs. A companion document addresses the scope of practice for the NDTR.
http://ift.tt/2ke6oUn
Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): David H. Holben, Michelle Berger Marshall
It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.
http://ift.tt/2Bjql7t
Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class
Abstract
Objective
Key for successful jugulotympanic paraganglioma management is a personalized approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control- and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification.
Design
A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided.
Main outcome measures
local control, cranial nerve damage, complications, function recovery.
Results
Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post surgery for class A and B tumours and risk of cranial nerve damage was <1%. For class C1-4 tumours, local control was 80-95% post surgery (84% post radiotherapy) and, cranial nerve damage was found in 71-76% (none post radiotherapy; p < 0.05). There was no difference in treatment outcomes between tumours of different C class. For class C1-4De/Di tumours, local control was 38-86% (98% post radiotherapy; p < 0.05), cranial nerve damage/complication rates were 67-100% (3% post radiotherapy; p < 0.05). C1-4DeDi tumours showed lesser local control and cranial nerve damage rates when compared to C1-4De tumours.
Conclusions
An individual risk is constituted for surgery and radiotherapy, stratified per Fisch class. For class A and B tumours surgery is a suitable treatment option. For class C and D tumours radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group.
This article is protected by copyright. All rights reserved.
http://ift.tt/2BPqvzq
Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class
Abstract
Objective
Key for successful jugulotympanic paraganglioma management is a personalized approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control- and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification.
Design
A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided.
Main outcome measures
local control, cranial nerve damage, complications, function recovery.
Results
Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post surgery for class A and B tumours and risk of cranial nerve damage was <1%. For class C1-4 tumours, local control was 80-95% post surgery (84% post radiotherapy) and, cranial nerve damage was found in 71-76% (none post radiotherapy; p < 0.05). There was no difference in treatment outcomes between tumours of different C class. For class C1-4De/Di tumours, local control was 38-86% (98% post radiotherapy; p < 0.05), cranial nerve damage/complication rates were 67-100% (3% post radiotherapy; p < 0.05). C1-4DeDi tumours showed lesser local control and cranial nerve damage rates when compared to C1-4De tumours.
Conclusions
An individual risk is constituted for surgery and radiotherapy, stratified per Fisch class. For class A and B tumours surgery is a suitable treatment option. For class C and D tumours radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group.
This article is protected by copyright. All rights reserved.
http://ift.tt/2BPqvzq
Intelligibility of Synthetic Speech for Normal-Hearing and Hearing-Impaired Listeners
http://ift.tt/2kHhANh
Who shall be Called Language Disordered? Some Reflections and One Perspective
http://ift.tt/2iFLH3n
Effects of Repair Strategies on Visual Identification of Sentences
http://ift.tt/2iJrSs8
The Iowa Articulation Norms Project and its Nebraska Replication
http://ift.tt/2kGDeBs
Spoken and Written English Errors of Postsecondary Students with Severe Hearing Impairment
http://ift.tt/2iKnQPX
Taxonomies in Biology, Phonetics, Phonology, and Speech Motor Control
http://ift.tt/2kGXfrx
Tabletop Versus Microcomputer-Assisted Speech Management: Response Evocation Phase
http://ift.tt/2iFIHUD
Fast Mapping of Words in Event Contexts by Children with Down Syndrome
http://ift.tt/2kHbCMs
The Relationship between Communication Problems and Psychological Difficulties in Persons with Profound Acquired Hearing Loss
http://ift.tt/2iHdU9S
Generalized Learning of Receptive and Expressive Action-Object Responses by Language-Delayed Preschoolers
http://ift.tt/2iFndY2
Partner Sensitivity to Communication Behavior of Young Children with Developmental Disabilities
http://ift.tt/2iHIwZ7
Patient Compliance with Cleft Palate Team Regimens
http://ift.tt/2kHmFoE
Generalization to Conversational Speech
http://ift.tt/2iJrw4M
A Sindscal Analysis of Perceptual Features for Consonants Produced by Esophageal and Tracheoesophageal Talkers
http://ift.tt/2kDtFmz
Comprehension Monitoring in Language-Disordered Children: A Preliminary Investigation of Cognitive and Linguistic Factors
http://ift.tt/2iFndau
Normative Data in Quiet, Broadband Noise, and Competing Message for Northwestern University Auditory Test No. 6 by a Female Speaker
http://ift.tt/2kDtt6P
Verbal Behaviors of Preschool Stutterers and Conversational Partners: Observing Reciprocal Relationships
http://ift.tt/2iHIn81
Elevated levels of the antimicrobial peptide LL-37 in hidradenitis suppurativa are associated with a Th1/Th17 immune response
Summary
Hidradenitis suppurativa (HS) is an inflammatory skin disease with poorly understood immunopathogenic mechanisms. LL-37 is an antimicrobial peptide, which is transcribed from the CAMP (cathelicidin antimicrobial peptide) gene. Previous reports showed upregulated levels of CAMP and LL-37 in HS lesions and therefore the aim of this study was to compare levels of LL-37 in HS to other inflammatory skin diseases and to establish immunomodulatory functions of LL-37 in HS. We confirm an upregulation of the LL-37 peptide in lesional HS skin with comparable levels as in psoriasis patients and are able to positively correlate the presence of LL-37 in HS with the presence of T cells, macrophages, neutrophils, IFNγ, IL-17, IL-23, TNFα, IL-32 and IL-1β. Mechanistically, LL-37 boosts the proliferation of unspecifically activated CD4+ T cells via an increased calcium signalling independent of antigen presenting cells. Targeting LL-37 may therefore represent a new therapeutic option for the treatment of this recalcitrant disease, but it has to be kept in mind that LL-37 also has an antimicrobial function.
This article is protected by copyright. All rights reserved.
http://ift.tt/2nHsNPa
Monocytes enhance neutrophil-induced blister formation in an ex vivo model of bullous pemphigoid
Abstract
Background
Lesions of bullous pemphigoid (BP), an autoimmune subepidermal blistering disease characterized by the presence of tissue-bound and circulating autoantibodies to hemidesmosomal antigens, harbour a mixed inflammatory cellular infiltrate. In various models, neutrophils, eosinophils, mast cells, monocytes as well as B and T cells have been shown to be involved in the pathogenesis of BP. However, their interactions with and effective role in blister formation remains uncertain. This study was aimed at investigating the effect of monocyte/neutrophil interaction on blister formation in an ex vivo BP model.
Methods
Skin cryosections were incubated with purified human neutrophils and monocytes, in the presence or absence of BP autoantibodies. Production of reactive oxygen species (ROS), degranulation, mediator release (neutrophil elastase (NE), myeloperoxidase (MPO), matrix metalloproteinase-9 (MMP-9)), binding of Fcγ receptor (CD16, CD32, CD64), and cell adhesion (CD18, ICAM-1) were investigated using appropriate inhibitors. Dermal-epidermal separation (DES) was assessed by light microscopy and quantified by Fiji software.
Results
Monocytes and neutrophils synergistically interact resulting in a significantly higher DES compared to either monocytes or neutrophils separately (P < 0.0001). Monocyte/neutrophil-induced DES was associated with increased ROS production and was dependent on adhesion and FcγRIII binding. Upon stimulation by the granule-poor fraction of monocyte supernatants, neutrophils increased their release of MMP-9, thereby also DES at the dermal-epidermal junction of skin cryosections.
Conclusion
Our observations suggest that the interaction of cells, as shown here for monocytes and neutrophils, enhances mediator release resulting in an increased subepidermal blister formation. Thus, blocking intercellular cross-talk promises a new therapeutic approach for blocking tissue damage in BP.
This article is protected by copyright. All rights reserved.
http://ift.tt/2BPR7At
Monocytes enhance neutrophil-induced blister formation in an ex vivo model of bullous pemphigoid
Abstract
Background
Lesions of bullous pemphigoid (BP), an autoimmune subepidermal blistering disease characterized by the presence of tissue-bound and circulating autoantibodies to hemidesmosomal antigens, harbour a mixed inflammatory cellular infiltrate. In various models, neutrophils, eosinophils, mast cells, monocytes as well as B and T cells have been shown to be involved in the pathogenesis of BP. However, their interactions with and effective role in blister formation remains uncertain. This study was aimed at investigating the effect of monocyte/neutrophil interaction on blister formation in an ex vivo BP model.
Methods
Skin cryosections were incubated with purified human neutrophils and monocytes, in the presence or absence of BP autoantibodies. Production of reactive oxygen species (ROS), degranulation, mediator release (neutrophil elastase (NE), myeloperoxidase (MPO), matrix metalloproteinase-9 (MMP-9)), binding of Fcγ receptor (CD16, CD32, CD64), and cell adhesion (CD18, ICAM-1) were investigated using appropriate inhibitors. Dermal-epidermal separation (DES) was assessed by light microscopy and quantified by Fiji software.
Results
Monocytes and neutrophils synergistically interact resulting in a significantly higher DES compared to either monocytes or neutrophils separately (P < 0.0001). Monocyte/neutrophil-induced DES was associated with increased ROS production and was dependent on adhesion and FcγRIII binding. Upon stimulation by the granule-poor fraction of monocyte supernatants, neutrophils increased their release of MMP-9, thereby also DES at the dermal-epidermal junction of skin cryosections.
Conclusion
Our observations suggest that the interaction of cells, as shown here for monocytes and neutrophils, enhances mediator release resulting in an increased subepidermal blister formation. Thus, blocking intercellular cross-talk promises a new therapeutic approach for blocking tissue damage in BP.
This article is protected by copyright. All rights reserved.
http://ift.tt/2BPR7At