Detoxification of U(VI) by Paecilomyces catenlannulatus investigated by batch, XANES and EXAFS techniques

Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Fengbo Li, Xiaoyu Li, Pu Cui
Paecilomyces catenlannulatus (P. catenlannulatus) as a genus of entomogenous fungus presented a variety of surface reactive groups by batch characterizations. The detoxification of U(VI) by P. catenlannulatus was investigated under different water chemistry (pH, incubation time, foreign anions and U(VI) concentration) by batch techniques. Approximately 75% of U(VI) was reduced to U(IV) (i.e., U^(IV)O2(s)) by P. catenlannulatus at pH 5.5 and 7 days under glovebox conditions, therefore the formation of precipitates decreased the toxicity of U(VI) for P. catenlannulatus. In addition, phosphate facilitate the U(VI) reduction, whereas carbonate and sulfate inhibited the U(VI) reduction. The activities of catalase (CAT), superoxide dismutase (SOD) and glutathione (GSH) level were stimulated exposure to 1-30 mg/L U(VI), indicating that CAT, SOD and GSH were antagonized for the oxidant stress derived from U(VI) at low concentrations. According to XPS and XANES analysis, the occurrence of U(IV) revealed the reduction of adsorbed U(VI) to U(IV) by P. catenlannulatus. The results of EXAFS analysis indicated that the fitting of U-O and U-U shell for U-loaded P. catenlannulatus was similar to that of U^(IV)O2(s)). The formation of U-bearing precipitates decreased the toxicity of U(VI) for P. catenlannulatus. These findings indicated that P. catenlannulatus is capable to detoxify U(VI) by extracellar/intracellar defense systems. Therefore, P. catenlannulatus can be utilized as a promising bioadsorbents for remediation of uranium-contaminated wastewater in environmental cleanup.



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Functional film by trigger-free self-assembly of adhesive soft microgels at skin temperature

Publication date: 5 June 2018
Source:Materials & Design, Volume 147
Author(s): Mohamed Boularas, Sadia Radji, Emilie Gombart, Jean-François Tranchant, Valérie Alard, Laurent Billon
Trigger-free self-assembly of oligo(ethylene glycol) OEG-based responsive microgels is for the first time described via simple solvent evaporation process at skin temperature and ambient pressure. This unique behaviour is attributed to the intrensic OEG microgel structure and properties due to a negative glass transition temperature, a high adhesion energy, an elastic mechanical property and a high interpenetration of microgels, combined in an all-in-one building block. Furthermore, the encapsulation of magnetic nanoparticles (NPs) into the OEG-based microgels introduced interferential photonic and magnetic properties to the films. These microgels exhibiting simultaneously spontaneous film-forming and colored photonic properties open up the development of a unique easy-to-handle material for cosmetic applications, but also smart patches for healthcare or medicine.

Graphical abstract

http://ift.tt/2FVM0kJ

Preparation of thermochromic liquid crystal microcapsules for intelligent functional fiber

Publication date: 5 June 2018
Source:Materials & Design, Volume 147
Author(s): Yu Guan, Liping Zhang, Dong Wang, John L. West, Shaohai Fu
Cholesteric liquid crystals microcapsules (CLCM) were prepared via complex coacervation method, which were further used as thermochromic materials in an intelligent functional fiber. The morphology of CLCM with core-shell structure was confirmed by SEM and TEM images. According to the TG results, CLC core took 52wt% of the microcapsules. Thermochromic property of the CLCM was closely related to its particle size, and CLCM in the range of 3–30μm had excellent thermochromic property producing color progressively moving from red to blue as the temperature was raised. The CLCM were added to polyvinyl pyrrolidone (PVP) solution and CLCM/PVP fibers were prepared by electrospinning method. The thermochromic performance of CLCM/PVP fibers was in accordance with CLCM, and the optimal particle size of CLCM for preparing CLCM/PVP fibers was 3–10μm.

Graphical abstract

http://ift.tt/2G1OMbt

Outcome Analysis of Microlaryngeal Surgery for Benign Lesions of Vocal Cord Using Videostroboscopy and Voice Handicap Index

Abstract

Benign vocal cord mass lesions are common causes of dysphonia which are often surgically correctable. They include lesions like vocal polyps, vocal cysts, vocal nodules and Reinke's edema. A prospective study of 30 patients was carried out at SMS medical college and hospital between April 2014 to November 2015 after institutional ethical committee clearance. The purpose of our study was to evaluate outcome of microlaryngeal surgery for benign lesions of vocal cord using videostroboscopy and voice handicap index. All cases between the age group 15–60 years with clinical evidence of benign lesions of vocal cord were included in study. Preoperative amplitude, mucosal wave, glottic closure was seen by videostroboscopy and subjective assessment of severity of handicap in voice was assessed by set of questionnaire using voice handicap index (Jacobson et al. in Am J Speech Lang Pathol 6: 66–70, 1997). Postoperative follow up was done at 3rd week and 10th week, and outcome of microlaryngeal surgery was assessed using videostroboscope and voice handicap index. At the end of study data was compiled systemically and analysed using paired 't' test and Chi square test. Our study observed statistically significant improvement in amplitude and mucosal wave and glottic closure. Subjective improvement in perception of severity of handicap in voice was analysed by voice handicap index which shows statistically significant data. Overall our study conclude microlaryngeal surgery as an effective way for improvement in speech parameters, that can be assessed by use of videostroboscopy and voice handicap index.

http://ift.tt/2FWtzMw

Outcome Analysis of Microlaryngeal Surgery for Benign Lesions of Vocal Cord Using Videostroboscopy and Voice Handicap Index

Abstract

Benign vocal cord mass lesions are common causes of dysphonia which are often surgically correctable. They include lesions like vocal polyps, vocal cysts, vocal nodules and Reinke's edema. A prospective study of 30 patients was carried out at SMS medical college and hospital between April 2014 to November 2015 after institutional ethical committee clearance. The purpose of our study was to evaluate outcome of microlaryngeal surgery for benign lesions of vocal cord using videostroboscopy and voice handicap index. All cases between the age group 15–60 years with clinical evidence of benign lesions of vocal cord were included in study. Preoperative amplitude, mucosal wave, glottic closure was seen by videostroboscopy and subjective assessment of severity of handicap in voice was assessed by set of questionnaire using voice handicap index (Jacobson et al. in Am J Speech Lang Pathol 6: 66–70, 1997). Postoperative follow up was done at 3rd week and 10th week, and outcome of microlaryngeal surgery was assessed using videostroboscope and voice handicap index. At the end of study data was compiled systemically and analysed using paired 't' test and Chi square test. Our study observed statistically significant improvement in amplitude and mucosal wave and glottic closure. Subjective improvement in perception of severity of handicap in voice was analysed by voice handicap index which shows statistically significant data. Overall our study conclude microlaryngeal surgery as an effective way for improvement in speech parameters, that can be assessed by use of videostroboscopy and voice handicap index.

http://ift.tt/2FWtzMw

Aortic stent graft injury over active blood flow: over the fence

Description

A 72-year-old woman was admitted to our hospital complaining of chest pain at rest. She underwent thoracic endovascular repair (TER) using three stent grafts (GORE TAG 34x150, 34x200 and 26x200 mm; W. L. Gore & Associates, Flagstaff, Arizona, USA) with type B aortic dissection 5 years earlier (figure 1A). Coronary CT angiography (CTA) findings were inconclusive because of remarkable massive calcification in all coronary arteries. As a low-density area suspected of mural thrombus inside the second stent graft was detected (figure 1B), non-obstructive angioscopy was performed to evaluate graft failure besides invasive coronary angiography.1 No significant stenosis was found using invasive coronary angiography; however, suspicious blood flow through the graft was observed at the aneurysmal descending aorta in the middle of the second graft (figure 2 and video 1). Being uninfluenced by aortic blood flow, it was thought to exist...

http://ift.tt/2G81BRt

Impact of economic growth, nonrenewable and renewable energy consumption, and urbanization on carbon emissions in Sub-Saharan Africa

Abstract

The present study explores the impact of economic growth; urban expansion; and consumption of fossil fuels, solid fuels, and renewable energy on environmental degradation in developing economies of Sub-Saharan Africa. To demonstrate its findings in detail, the study adopts a system generalized method of moment (GMM) on a panel of 34 emerging economies for the period from 1995 to 2015. The results describe that the consumption of fossil and solid fuels for cooking and expansion of urban areas are significantly contributing to carbon dioxide emissions, on one end, and stimulating air pollution, on the other. The results also exhibit an inverted U-shape relationship between per capita economic growth and carbon emissions. This relation confirms the existence of an environmental Kuznets curve (EKC) in middle- and low-income economies of Sub-Saharan Africa. Furthermore, the findings reveal that the use of renewable energy alternatives improves air quality by controlling carbon emissions and lowering the direct interaction of households with toxic gases. Thus, the use of renewable energy alternatives helps the economies to achieve sustainable development targets.

http://ift.tt/2FQUHfX

Investigating the role of urban development in the conventional environmental Kuznets curve: evidence from the globe

Abstract

We investigated the role of urbanization in the conventional environmental Kuznets curve (EKC) of the globe. The overall population and rural population were also considered for control purposes. Based on our findings, we suggest that the conventional EKC of the globe is not an inverted U-shape but becomes downward sloping when urban development is added and inverted U-shapes when the overall population and rural population volumes are added.

http://ift.tt/2G29dVE

Risk assessment by percolation leaching tests of extensive green roofs with fine fraction of mixed recycled aggregates from construction and demolition waste

Abstract

Extensive green roofs are urban construction systems that provide thermal regulation and sound proofing for the buildings involved, in addition to providing an urban heat island mitigation or water retention. On the other hand, policies towards reduction of energy consumption, a circular economy and sustainability are core in the European Union. Motivated by this, an experimental study was carried out to evaluate the environmental risk assessment according to release levels of polluting elements on leachates of different green roof substrate mixtures based on recycled aggregates from construction and demolition waste through (i) the performance in laboratory of two procedures: compliance and percolation tests and (ii) an upscaled experimental leaching test for long-term on-site prediction. Four plots were built on a building roof and covered with autochthonous Mediterranean plants in Córdoba, South of Spain. As growing substrate, four mixtures were used of a commercial growing substrate with different proportions of a fine mixed recycled aggregate ranging from 0 to 75% by volume. The results show that these mixtures were classified as non-hazardous materials according to legal limits of the Landfill Directive 2003/33/CE. The release levels registered in extensive green roofs were lower compared to the laboratory test data. This shows how laboratory conditions can overestimate the potential pollutant effect of these materials compared to actual conditions.

http://ift.tt/2HGg58j

Heavy metal bioaccessibility and health risks in the contaminated soil of an abandoned, small-scale lead and zinc mine

Abstract

The lack of management in small-scale mining operations has the potential for negative repercussions, e.g., mine collapses, compared with well-regulated large-scale mines. Here, we used an in vitro model to investigate heavy metal soil pollution characteristics and their attendant health risks in an abandoned, small-scale lead (Pb) and zinc (Zn) mine located in southwestern China that had suffered from collapse. Our results showed the following: (1) Even the mine had been closed for many years, the soil was still heavily polluted by Pb, cadmium (Cd), and Zn, and there is a risk of secondary pollution. Pb, Zn, and Cd concentrations in the mining areas were all approximately 22–42 times higher than the background soil levels of Guangxi Province. (2) Cd had the largest bioaccessibility, and mining areas tend to have soils containing more bioaccessible metals (78 ± 14%, 27 ± 4%, and 38 ± 12% for Cd, Pb, and Zn in gastric phase and 40 ± 12%, 10 ± 5%, and 19 ± 8% in intestinal phase correspondingly). (3) Results of a stepwise, multiple regression analysis revealed that the total soil content of the three metals (Pb, Zn, and Cd), TOC (total organic carbon), soil composition, and Mn content were the main impact factors for the Pb, Cd, and Zn soil bioaccessibility in study area (R² = 0.37~0.93). (4) A health risk assessment based on Pb, Cd, and Zn bioaccessibility indicated that the health risk for people in mine area is not high (HI is 1.07 at most and CR 2.40E−6 at most for children).

http://ift.tt/2G28RhM

Contribution of root uptake to cadmium accumulation in two peanut cultivars: evidence from a split-column soil experiment

Abstract

Cadmium (Cd) accumulation and internal Cd translocation in the peanut (Arachis hypogaea L.) are highly related to root uptake, which may largely depend on the cultivar variation and the depth of the Cd-contaminated soil. A split-column soil experiment was conducted using two common Chinese peanut cultivars (Huayu-20 and Huayu-23) known to relocate Cd to different tissues. The growth medium was separated into four layers and Cd solution was solely applied to one layer to determine the key depth affecting the Cd accumulation in a plant via root uptakes. The results showed that the biomass of Huayu-23 was significantly higher biomass (3.28–94.0%) than that of Huayu-20, especially in the aerial parts (stems and leaves) and kernels, implying the dilution of Cd. Following the addition of Cd to the soil, the Cd concentrations in peanut tissues increased on average by 28.9–172 and 28.3–111% in Huayu-20 and Huayu-23, respectively. The largest presence of Cd in a peanut plant was observed in the aerial parts, followed by the kernels. Huayu-20 accumulated more Cd in plant tissues than did Huayu-23 due to the former's high Cd translocation. These findings imply that peanut cultivars vary widely in biomass, Cd accumulation, and the percentage distribution of Cd among various plant tissues, especially kernels. Different Cd treatments in the full depth of the root zone induced significant alterations in Cd accumulation of peanut tissues, especially kernels, for both cultivars. The percentage distribution of Cd accumulation by kernels was significantly higher in the deeper layer than in the top layer of the root zone for both peanut cultivars. This study suggests that soil modifications performed during agronomic activities should take into account the full depth of root exploration as well as the peanut cultivars to manage plant Cd uptake.

http://ift.tt/2FWgDGs

Book Review—Diagnostic Pathology: Lymph Nodes and Extranodal Lymphomas, 2nd Edition

http://ift.tt/2G2fvV9

Clinical Thyroidology®for the Public – Highlighted Article

From Clinical Thyroidology^® for the Public:  In 1–2% of PET scans performed for the diagnosis or staging of non-thyroid cancers, incidental uptake of a thyroid lesion is detected. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

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http://ift.tt/2DCnh2Z

Clinical Thyroidology®for the Public – Highlighted Article

From Clinical Thyroidology^® for the Public:  In 1–2% of PET scans performed for the diagnosis or staging of non-thyroid cancers, incidental uptake of a thyroid lesion is detected. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

Feedback & Suggestions

The post Clinical Thyroidology^®for the Public – Highlighted Article appeared first on American Thyroid Association.

http://ift.tt/2DCnh2Z

Neurocognitive Basis of Racial Ingroup Bias in Empathy

Publication date: Available online 18 March 2018
Source:Trends in Cognitive Sciences
Author(s): Shihui Han
Racial discrimination in social behavior, although disapproved of by many contemporary cultures, has been widely reported. Because empathy plays a key functional role in social behavior, brain imaging researchers have extensively investigated the neurocognitive underpinnings of racial ingroup bias in empathy. This research has revealed consistent evidence for increased neural responses to the perceived pain of same-race compared with other-race individuals in multiple brain regions and across multiple time-windows. Researchers have also examined neurocognitive, sociocultural, and environmental influences on racial ingroup bias in empathic neural responses, as well as explored possible interventions to reduce racial ingroup bias in empathic brain activity. These findings have important implications for understanding racial ingroup favoritism in social behavior and for improving interracial communication.



http://ift.tt/2GEmUb1

Durable response of early-stage breast cancer to bilateral definitive SBRT in a medically inoperable patient

Publication date: Available online 18 March 2018
Source:Practical Radiation Oncology
Author(s): Robert W. Gao, Sean S. Park, James W. Jakub, Tina J. Hieken, Amy L. Conners, Lonzetta Neal, Sandhya Pruthi, Kimberly S. Corbin, Elizabeth S. Yan, Robert W. Mutter, Bradley J. Stish




http://ift.tt/2pm9OrI

In vivo response to a low-modulus PMMA bone cement in an ovine model

Publication date: Available online 17 March 2018
Source:Acta Biomaterialia
Author(s): C. Robo, G. Hulsart-Billström, M. Nilsson, C. Persson
Poly(methyl methacrylate) (PMMA) is the most commonly used material for the treatment of osteoporosis-induced vertebral compression fractures. However, its high stiffness may introduce an increased risk of adjacent vertebral fractures post-surgery. One alternative in overcoming this concern is the use of additives. This presents its own challenge in maintaining an adequate biocompatibility when modifying the base cement. The aim of this study was to evaluate the in vivo biocompatibility of linoleic acid (LA)-modified acrylic bone cement using a large animal model for the first time, in order to further advance towards clinical use. A worst-case approach was used, choosing a slow-setting base cement. The in vitro monomer release from the cements was also assessed. Additional material characterization, including mechanical tests, are summarized in Appendix A. Unmodified and LA-modified cements were injected into a total of 56 bone defects created in the femur and humerus of sheep. Histopathologic and histomorphometric analysis indicated that LA-modified cement showed a harmless tissue response similar to that of the unmodified cement. Adjacent bone remodeling was observed microscopically 4 weeks after implantation, suggesting a normal healing process of the bone tissues surrounding the implant. LA-modified cement exhibited lower mechanical properties, with a reduction in the elastic modulus of up to 65%. The handling properties were slightly modified without negatively affecting the injectability of the base cement. LA-modified bone cement showed good biocompatibility as well as bone compliant mechanical properties and may therefore be a promising material for the treatment of osteoporotic vertebral fractures.

Graphical abstract

http://ift.tt/2pmi5Lk

Neuroprotective effect of Phosphocreatine on oxidative stress and mitochondrial dysfunction induced apoptosis in vitro and in vivo: Involvement of dual PI3K/Akt and Nrf2/HO-1 pathways

Publication date: Available online 17 March 2018
Source:Free Radical Biology and Medicine
Author(s): Hailong Li, Zhongyuan Tang, Peng Chu, Yanlin Song, Ying Yang, Bin Sun, Mengyue Niu, Eskandar Qaed, Abdullah Shopit, Guozhu Han, Xiaodong Ma, Jinyong Peng, Min Hu, Zeyao Tang
Methylglyoxal (MGO), an active metabolite of glucose, is observed in high levels in the tissues and blood of diabetic patients. Phosphocreatine (PCr), a high-energy phosphate compound, exhibits a range of pharmacological actions but little is well known of its neuroprotective action. The aim of the present study was to investigate the neuroprotective effects and the possible mechanisms of PCr. Diabetes is closely associated with neurodegenerative diseases, leading not only to the peripheral nervous system (PNS) and but also to central nervous system (CNS) damage. Therefore, we established two rat models of diabetes in vivo induced by MGO and streptozocin (STZ) respectively, while utilized differentiated PC-12 cells in vitro. Treatment of PC-12 cells with PCr markedly attenuated MGO-induced change of viability, apoptosis, accompanied by decreased levels of caspase-3, casapse-9 and Bcl-2/Bax protein ratio. Determination of cellular respiratory function was performed with intact PC-12 cells and homogenized hippocampal neuron tissue of rat. Reactive oxygen species (ROS) generation was assessed by membrane permeable fluorescent probe DCFH-DA. The expressions of Akt, Nrf2 and HO-1 were examined by Western blot. PCr pretreatment significantly reduced oxidative stress-induced high LDH, MDA level, and ROS production of PC-12 cells. PCr pretreatment also significantly decreased mitochondrial dysfunction in vitro and in vivo. In addition, PCr pretreatment increased the expression of p-Akt, Nrf2 and HO-1, and reduced the apoptosis. Moreover, the expression of Cleaved caspase3 was partially increased and the p-Akt, Nrf2 and HO-1 was partially reduced by a PI3K inhibitor (LY294002). While, compared with LY294002 groups, pre-treatment with PCr at the concentrations of 20mM significantly reduced the expression of Cleaved caspase3 and increased the expression of p-Akt, Nrf2 and HO-1. Molecular docking assay showed that PCr possessed powerful affinity towards to Akt with lower binding energy. In conclusion, the neuroprotective effects of PCr in vitro and in vivo rely on normalizing mitochondrial function and reducing oxidative stress via Akt mediated Nrf2/HO-1 pathway, suggesting that PCr may be a novel therapeutic candidate for the treatment of diabetes-associated neurodegenerative diseases.

Graphical abstract

http://ift.tt/2HLwRD3

Cochlear implants in developing countries: practical and ethical considerations

No abstract available

http://ift.tt/2IwTPyU

Overcoming developing-world challenges in cochlear implantation: a South American perspective

Purpose of review Effective hearing rehabilitation with cochlear implantation is challenging in developing countries, and this review focuses on strategies for childhood profound sensorineural hearing loss care in South America. Recent findings Most global hearing loss exists in developing countries; optimal cost-effective management strategies are essential in these environments. This review aims to assess and discuss the challenges of cochlear implantation effectiveness in South America. The authors searched electronic databases, bibliographies, and references for published and unpublished studies. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and failure rate. Costs were obtained from experts in South America using known costs and estimations whenever necessary. Recent studies reported several challenges in unilateral or bilateral cochlear implants: cochlear implant costs, deaf education costs, increasing need for cochlear implant capacity, and training and increasing longevity. Summary Cochlear implantation was very cost-effective in all South American countries. Despite inconsistencies in the quality of available evidence, the robustness of systematic review methods substantiates the positive findings of the included studies, demonstrating that unilateral cochlear implantation is clinically effective and likely to be cost-effective in developing countries. Correspondence to Sady S. Da Costa, MD, PhD, Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - Bairro Santa Cecília Porto Alegre, Rio Grande do Sul 90035-903, Brazil. E-mail: selaimen@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2pqBqv8

A comparison of neuromuscular electrical stimulation and traditional therapy, versus traditional therapy in patients with longstanding dysphagia

Purpose of review Dysphagia in adults arises from a range of causes including acquired neurological disorders and some cancers. Previous research has suggested that treatment using neuromuscular electrical stimulation (NMES) when used in conjunction with conventional therapy is effective. This review describes the recent literature and a small prospective case series carried out in the United Kingdom. This study contributed to support National Institute of Clinical Excellence (NICE) guidance for clinicians who wish to include NMES in a rehabilitation programme for dysphagic patients, specifically with reference to safety and the impact on swallowing function of this intervention. Recent findings In 2014, the UK NICE issued guidelines enabling UK therapists to trial the use of NMES, but the guidelines also sought additional evidence on the impact on swallowing function of NMES and the incidence of side effects. This small prospective case series investigated both of these aspects with a group of patients with dysphagia of neurological origin who had not achieved adequate swallowing function with traditional therapy alone. This study recruited 10 adult patients with dysphagia of neurological origin. All had previously received traditional swallowing therapy for at least 6 months but only achieved a Functional Oral Intake Scale of 4 or less (a scale for amounts and types of oral intake). The total study period was 10 weeks for each subject comprising 5 weeks of traditional therapy delivered three times a week followed by 5 weeks of NMES concurrent with traditional therapy (NMES + traditional therapy) delivered three times a week using the VitalStim stimulator (VitalStim Therapy, UK). In addition, the Quality of Life in Swallowing and Eating Assessment Tool 10 (quality of life scales) were determined to allow comparison between studies. Nine subjects achieved an improvement in swallowing function after NMES + traditional therapy was measured using the Functional Oral Intake Scale, giving a statistically significant improvement (P 

http://ift.tt/2Iv1JJ3

Cochlear implants in developing countries: practical and ethical considerations

No abstract available

http://ift.tt/2IwTPyU

Overcoming developing-world challenges in cochlear implantation: a South American perspective

Purpose of review Effective hearing rehabilitation with cochlear implantation is challenging in developing countries, and this review focuses on strategies for childhood profound sensorineural hearing loss care in South America. Recent findings Most global hearing loss exists in developing countries; optimal cost-effective management strategies are essential in these environments. This review aims to assess and discuss the challenges of cochlear implantation effectiveness in South America. The authors searched electronic databases, bibliographies, and references for published and unpublished studies. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and failure rate. Costs were obtained from experts in South America using known costs and estimations whenever necessary. Recent studies reported several challenges in unilateral or bilateral cochlear implants: cochlear implant costs, deaf education costs, increasing need for cochlear implant capacity, and training and increasing longevity. Summary Cochlear implantation was very cost-effective in all South American countries. Despite inconsistencies in the quality of available evidence, the robustness of systematic review methods substantiates the positive findings of the included studies, demonstrating that unilateral cochlear implantation is clinically effective and likely to be cost-effective in developing countries. Correspondence to Sady S. Da Costa, MD, PhD, Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - Bairro Santa Cecília Porto Alegre, Rio Grande do Sul 90035-903, Brazil. E-mail: selaimen@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2pqBqv8

A comparison of neuromuscular electrical stimulation and traditional therapy, versus traditional therapy in patients with longstanding dysphagia

Purpose of review Dysphagia in adults arises from a range of causes including acquired neurological disorders and some cancers. Previous research has suggested that treatment using neuromuscular electrical stimulation (NMES) when used in conjunction with conventional therapy is effective. This review describes the recent literature and a small prospective case series carried out in the United Kingdom. This study contributed to support National Institute of Clinical Excellence (NICE) guidance for clinicians who wish to include NMES in a rehabilitation programme for dysphagic patients, specifically with reference to safety and the impact on swallowing function of this intervention. Recent findings In 2014, the UK NICE issued guidelines enabling UK therapists to trial the use of NMES, but the guidelines also sought additional evidence on the impact on swallowing function of NMES and the incidence of side effects. This small prospective case series investigated both of these aspects with a group of patients with dysphagia of neurological origin who had not achieved adequate swallowing function with traditional therapy alone. This study recruited 10 adult patients with dysphagia of neurological origin. All had previously received traditional swallowing therapy for at least 6 months but only achieved a Functional Oral Intake Scale of 4 or less (a scale for amounts and types of oral intake). The total study period was 10 weeks for each subject comprising 5 weeks of traditional therapy delivered three times a week followed by 5 weeks of NMES concurrent with traditional therapy (NMES + traditional therapy) delivered three times a week using the VitalStim stimulator (VitalStim Therapy, UK). In addition, the Quality of Life in Swallowing and Eating Assessment Tool 10 (quality of life scales) were determined to allow comparison between studies. Nine subjects achieved an improvement in swallowing function after NMES + traditional therapy was measured using the Functional Oral Intake Scale, giving a statistically significant improvement (P 

http://ift.tt/2Iv1JJ3

An atypical autistic phenotype associated with a 2q13 microdeletion: a case report

Autism spectrum disorders are serious neurodevelopmental disorders that affect approximately 1% of the population. These disorders are substantially influenced by genetics. Several recent linkage analyses have...

http://ift.tt/2GEP7yv

Severe abdominal pain and diarrhea – unusual multiple myeloma presentation with a severe prognosis: a case report

Multiple myeloma is a hematologic disease with high mortality rates all over the world. The diagnosis has always been challenging since the first case was reported in 1844. For that reason the diagnostic crite...

http://ift.tt/2tWwMKR

Visual Outcomes and Clinical Manifestations of Pediatric Optic Neuritis in Indian Population: An Institutional Study

Background: Optic neuritis in children is an uncommon disorder which usually occurs after a viral illness or vaccination and, less frequently, occurs as a manifestation of a demyelinating disorder. Pediatric optic neuritis usually is bilateral and presents with optic disc edema, recovers rapidly with steroid therapy, and generally has low conversion rate to multiple sclerosis or neuromyelitis optica spectrum disorder. We report the clinical features and treatment outcomes of pediatric optic neuritis in Indian population, for which little data are available. Methods: We reviewed the medical case records of patients with optic neuritis who were younger than 18 years, from 1999 to 2016. All patients were assessed and managed in the Neuro-Ophthalmology Department of Sankara Nethralaya, a unit of Medical Research Foundation and Pediatric Neurology Department of Kanchi Kamakoti—Childs Trust Hospital, Chennai, India. Results: One hundred seventeen eyes of 78 children with mean age of 11.84 (±4.58) years were identified. Forty-two (53.8%) were females and 36 (46.2%) were males. Thirty-nine patients (50%) had bilateral involvement and a similar number had unilateral involvement. Fifty-nine eyes (50.4%) had optic disc edema, 20 eyes (17.1%) had disc pallor, and 38 eyes (32.4%) had normal discs. Of 63 patients who had neuroimaging, 36 had MRI, and 27 underwent computed tomography. Eighty-four eyes (of 59 patients) received steroid therapy according to the protocol of the Optic Neuritis Treatment Trial (ONTT). Thirty-three eyes that were treated with other steroid protocols were excluded from the final visual outcome analyses. Sixty of the 84 eyes (72.3%) recovered visual acuity of 20/40 or better. Visual acuity improvement was statistically significant between initial and final visual acuity (logMAR) in our patients treated with the ONTT protocol (P ≤ 0.001). Conclusions: Our Indian pediatric population had good visual recovery after steroid treatment for optic neuritis. Profound loss of visual acuity on presentation and bilateral involvement were significantly associated with poor visual outcome. Address correspondence to Selvakumar Ambika, DO, DNB, Department of Neuro Ophthalmology, Sankara Nethralaya, A Unit of Medical Research Foundation, 18 College Road, Nungambakkam, Chennai 600 006, India; E-mail: drsa@snmail.org The authors report no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society

http://ift.tt/2DCRte2

Cerebrospinal Fluid Pressure Reduction Results in Dynamic Changes in Optic Nerve Angle on Magnetic Resonance Imaging

Background: Optic nerve sheath tortuosity is a previously reported, but incompletely characterized, finding in idiopathic intracranial hypertension (IIH). We hypothesized that optic nerve angle (ONA), as a quantitative measure of tortuosity, would change dynamically with cerebrospinal fluid (CSF) pressure status of patients with IIH immediately before and after lumbar puncture (LP). Methods: Consecutive patients with suspected IIH referred for MRI and diagnostic LP were prospectively enrolled in this single institution, institutional review board–approved study. Each patient underwent a pre-LP MRI, diagnostic LP with opening pressure (OP) and closing pressure (CP), and then post-LP MRI all within 1 session. Sagittal and axial ONAs were measured on multiplanar T2 SPACE images by 2 neuroradiologists on pre- and post-LP MRI. Effects of measured pressure and CSF volume removal on changes in ONA were analyzed as was interrater reliability for ONA measurement. Results: Ten patients with IIH were included {all female, median age 29 (interquartile range [IQR] 25–32)}. All patients had elevated OP (median 37, IQR 34–41 cm H2O), and significantly reduced CP (median 18, IQR 16–19 cm H2O, P

http://ift.tt/2pl4l4k

Neuro-Ophthalmology in Turkey

No abstract available

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Evaluation of Vision-Related Quality of Life in Chinese Patients With Leber Hereditary Optic Neuropathy and the G11778A Mutation

Objective: To assess quality of life (QoL) measures in Chinese Leber hereditary optic neuropathy (LHON) patients with the G11778A mutation. Methods: Chinese LHON patients with the G11778A mutation were prospectively evaluated using the Visual Function Index (VF-14) at 6 months, 1 year, and 3 years after the involvement of the second eye. Patients who completed the VF-14 at all 3 follow-up time designations were included in the analysis. Results: Fifty-five patients met the inclusion criteria. The median age of patients when their vision was bilaterally affected was 16.3 years old (interquartile range: 13.9–18.3 years). In our patient cohort, 89.1% (n = 49) were male, and the ratio of males to females was 8.2:1. The median logMAR visual acuity was 2.0 (interquartile range: 1.0–2.6). The mean VF-14 scores of patients with LHON at 6-month, 1-year, and 3-year follow-ups were 18.0 ± 19.2 (range 0–85.4), 19.9 ± 20.0 (range 0–85.4), and 20.7 ± 20.2 (range 0–85.4), and the differences were statistically significant (P

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Comparing Simultaneous Liver-Kidney Transplant Strategies: A Modified Cost-Effectiveness Analysis

Background The proportion of patients with kidney failure at time of liver transplantation is at an historic high in the United States. The optimal timing of kidney transplantation with respect to the liver transplant is unknown. Methods We used a modified cost-effectiveness analysis to compare four strategies: the old system ("pre-OPTN"), the new Organ Procurement Transplant Network (OPTN) system since August 10, 2017 ("OPTN"), and two strategies which restrict simultaneous liver-kidney transplants ("safety net" and "stringent"). We measured "cost" by deployment of deceased donor kidneys (DDKs) to liver transplant recipients and effectiveness by life years (LYs) and quality-adjusted life years (QALYs) in liver transplant recipients. We validated our model against Scientific Registry for Transplant Recipients data. Results The OPTN, safety net and stringent strategies were on the efficient frontier. By rank order, OPTN > safety net > stringent strategy in terms of LY, QALY and DDK deployment. The pre-OPTN system was dominated, or outperformed, by all alternative strategies. The incremental LY per DDK between the strategies ranged from 1.30 to 1.85. The incremental QALY per DDK ranged from 1.11 to 2.03. Conclusion These estimates quantify the "organ"-effectiveness of various kidney allocation strategies for liver transplant candidates. The OPTN system will likely deliver better liver transplant outcomes at the expense of more frequent deployment of DDKs to liver transplant recipients. Corresponding Authors: Jane C. Tan, 750 Welch Rd, Suite 200, MC 5785, Palo Alto CA 94304, 650-725-9891. janetan@stanford.edu; W. Ray Kim, 300 Pasteur Drive, Always M211, Stanford CA 94305, 650-725-6511. wrkim@stanford.edu Authorship: X.S.C.: Research design, data acquisition, data analysis, results interpretation, paper writing. W.R.K.: Research design, results interpretation, paper writing. J.C.T.: Research design, data acquisition, results interpretation, paper writing. G.M.C.: Research design, results interpretation, paper writing. J.G.: Research design, data analysis, results interpretation, paper writing. The authors declare no conflict of interest. Research reported here was supported by the John M. Sobrato Gift Fund (J.C.T.) and National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number K24DK092336 (W.R.K.) and K24 DK085446 (G.M.C.). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Real-Time Ultrasound-Assisted Thoracic Epidural Placement: A Feasibility Study of a Novel Technique

The placement of thoracic epidural catheters is complicated by the layering of the vertebral lamina. Therefore, traditional blind palpation techniques require insertion of an epidural needle with likely contact of lamina with redirections into the epidural space. We discuss a safe and consistent technique using true real-time ultrasound visualization of the needle with a paramedian sagittal oblique view to improve the consistency of placing an epidural in the thoracic spine for postoperative analgesia. Successful epidural placement was achieved in every patient. All catheters were found to be effective for use in the postoperative phase. Accepted for publication November 20, 2017. Address correspondence to: Amitabh Gulati, MD, Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (e-mail: gulatia@mskcc.org). The authors have no sources of funding to declare for this article. This work was presented in part as an abstract at the American Society of Regional Anesthesia and Pain Medicine's 42nd Annual Regional Anesthesiology and Acute Pain Medicine Meeting; April 6 to 8, 2017; San Francisco, CA. The authors declare no conflict of interest. Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.

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