Head and Neck Diseases by Alexandros G.Sfakianakis: 05/09/18

Τετάρτη 9 Μαΐου 2018

A Case-Based Guide to Eye Pain: Perspectives From Ophthalmology and Neurology

No abstract available

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Literature Commentary

In this issue of Journal of Neuro-Ophthalmology, M. Tariq Bhatti, MD and Mark L. Moster, MD will discuss the following 6 articles: Nazarian S, Hansford R, Rahsepar AA, Weltin V, McVeigh D, Gucuk Ipek E, Kwan A, Berger RD, Calkins H, Lardo AC, Kraut MA, Kamel IR, Zimmerman SL, Halperin HR. Safety of magnetic resonance imaging in patients with cardiac devices. N Engl J Med. 2017;377:2555–2564.Martin DR, Kalb B, Mittal A, Salman K, Vedantham S, Mittal PK. No incidence of nephrogenic systemic fibrosis after gadobenate dimeglumine administration in patients undergoing dialysis or those with severe chronic kidney disease. Radiology. 2018;286:113–119.Howard JF Jr, Utsugisawa K, Benatar M, Murai H, Barohn RJ, Illa I, Jacob S, Vissing J, Burns TM, Kissel JT, Muppidi S, Nowak RJ, O'Brien F, Wang JJ, Mantegazza R; REGAIN Study Group. Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalized myasthenia gravis (REGAIN): a phase 3, randomized, double-blind, placebo-controlled, multicenter study. Lancet Neurol. 2017;16:976–986. Erratum in: Lancet Neurol. 2017;16:954.Dosunmu EO, Hatt SR, Leske DA, Hodge DO, Holmes JM. Incidence and etiology of presumed fourth cranial nerve palsy: a population-based study. Am J Ophthalmol. 2018;185:110–114.Eade EL, Hardy TG, McKelvie PA, McNab AA. Review of extraocular muscle biopsies and utility of biopsy in extraocular muscle enlargement. Br J Ophthalmol. 2018 Jan 19 (epub ahead of print).Nath S, Badhiwala JH, Alhazzani W, et al. Atraumatic versus traumatic lumbar puncture needles: a systematic review and meta-analysis. Lancet. 2018;391:1197–1204. © 2018 by North American Neuro-Ophthalmology Society

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Restoration of an academic historical gross pathology collection—refreshed impact on current medical teaching?

Abstract

The declaration of Leiden pronounces the demand to conserve pathological-anatomical collections as cultural heritage. Likewise, the Institute of Pathology of the Friedrich-Alexander-University Erlangen-Nuremberg owns macroscopic pathological-anatomical specimens reaching back over 150 years. The purpose of this work is to examine the impact, meaning, and perception of such historical preparations during the current medical curriculum. Additionally, the experiences from the renovation process can be used as a template for other institutes. All preparations were documented, photographed, and catalogued in an electronic database. During a restoration period, a series of didactically suitable specimens were professionally restored. Hereby, the help of a special course of interested students was admitted. In a second step, the specimens were integrated into the regular teaching of students in macroscopic pathology. An evaluation was carried out on two student cohorts with and without historical specimens by means of a questionnaire with 23 items and two free text fields. In total, 1261 specimens were registered covering diseases from almost the complete human body with a strong representation of the cardiovascular, urinary, gastrointestinal, and central nervous systems. Hereby, exceptional rare and untreated cases with medical relevance could be found and stepwise implemented into the curriculum. The student evaluation positively addressed that the courses became livelier and interactive. Furthermore, a more comprehensive overview and a better understanding of the macroscopic pathology were appreciated. However, more self-study time with the specimen was demanded. The authenticity of historical specimens contrasts with the tendency to carry out virtual "online" didactic methods. The stereoscopic view on often untreated and, therefore, unbiased cases enhances a skill-oriented deeper understanding of diseases. In conclusion, historical specimens regain interest and even didactic value, especially in an era of declining autopsy rates.

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The use of a honeycomb technique combined with ultrasonic aspirators and indocyanine green fluorescence angiography for a superthin anterolateral thigh flap: a pilot study

Background: Harvesting an optimally thinned anterolateral thigh flaps (ALTFs) is a challenge in overweight individuals and in the Western population. Here, we describe a novel honeycomb technique to achieve a superthin ALTF in overweight patients. Methods: Forty patients with a body mass index(BMI) >25 kg/m2 who required a thinned ALTF for reconstruction were randomly assigned to a honeycomb technique (HCT) group or a microdissection technique (MDT) group. Patients in the HCT group received cavitron ultrasonic surgical aspiration (CUSA) to thin the flaps, and flap thinning was performed with a conventional MDT in the MDT group. The perfusion of all flaps was measured by indocyanine green fluorescence (ICG) angiography before and after thinning. Hypoperfusion was defined as 30 percent. Results: The mean BMI was 28.6±2.0 and 27.3±1.9 in the HCT group and the MDT group, respectively. The flap size, perforator, type of dissection and the initial perfusion were comparable between the two groups. However, significantly more patients (9/21) experienced final hypoperfusion in the MDT group than in the HCT group (2/19) (p=0.034). In addition, blood loss and final flap thickness were significantly lower in the HCT group (p

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Letter to the Editor on “Transversus Abdominis Plane Blocks With Single-Dose Liposomal Bupivacaine in Conjunction With a Nonnarcotic Pain Regimen Help Reduce Length of Stay Following Abdominally Based Microsurgical Breast Reconstruction”

No abstract available

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An innovative approach to attached cultivation of Chlorella vulgaris using different materials

Abstract

This article investigates the innovative attached cultivation of Chlorella vulgaris (C. vulgaris) using different materials as an alternative to high capital techniques of harvesting such as centrifugation, flocculation, and filtration. A simple attached algal cultivation system was proposed that was equipped by 10 submerged supporting materials which can harvest algal cells, efficiently. The effect of operational parameters such as light intensity, the rate of aeration, and auto-harvesting time was investigated. A chip, durable, and abundant cellulosic material (Kaldnes carriers covered by kenafs, KCCKs) was proposed for auto-harvesting C. vulgaris cells. The results revealed that optimum aeration rate, light intensity, and auto-harvesting of microalgal cells were 3.6 vvm, 10,548 W/m², and 12 days, respectively. Six of these KCCKs had the highest biofilm formation percent up to 33%. In this condition, the rate of cell growth increased to 0.6 mg/cm². Therefore, this system can be used for appropriate auto-harvesting of microalgae in the attached growth systems. C. vulgaris biomass composition is valuable for biodiesel, bioethanol, and animal protein production.

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Metal contamination in quail meat: residues, sources, molecular biomarkers, and human health risk assessment

Abstract

Quail meat is an emerging source of high-quality animal protein. Quails are exposed to a wide range of xenobiotics such as heavy metals. In this study, residual concentrations of four toxic metals, of significant public health importance, including cadmium (Cd), lead (Pb), arsenic (As), and nickel (Ni), were determined in edible tissues of quails. In addition, metal loads were measured in water, feed, and litter samples collected from same quail farms as possible sources for quail exposure to heavy metals. The possible use of metallothionein (MT) and heat shock protein 70 (Hsp70) as molecular biomarkers of exposure to heavy metals was further investigated. Furthermore, the dietary intake and the potential risk assessment of the examined heavy metals among children and adults were calculated. The edible tissues of quails contained high concentrations of four heavy metals (contents (ppm/ww) ranging from 0.02 to 0.32 in Cd, 0.05 to 1.96 in Pb, 0.002 to 0.32 in As, and 1.17 to 3.94 in Ni), which corresponded to the high contents of these metals in the feeds, water, and litter. MT and Hsp70 mRNA expressions showed positive correlations with the concentrations of heavy metals in tissues indicating the possibility to use these proteins as biomarkers for quail's exposure to toxic metals. Dietary intake of quail meat and risk assessment revealed potential risks especially for children after prolonged exposure to the examined metals. Thus, legislations should be established and continuous screening of metal residues should be adopted in order to reduce the toxic metal concentrations in feeds and drinking water for quails. Reduction of exposure to heavy metals subsequently would lead to minimization of exposure of such toxicants through consumption of quail meat.

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Bond strength of adhesive systems to sound and demineralized dentin treated with bioactive glass ceramic suspension

Abstract

Objective

The objective of this study was to evaluate the effect of a Biosilicate®, associated with dentin adhesive system, on microtensile bond strength (μTBS) to sound and demineralized dentin.

Materials and methods

Eighty sound-extracted molars had their middle occlusal dentin exposed. In forty teeth, dentin was artificially demineralized (pH cycling). Sound and demineralized dentin teeth were separated into four groups (n = 10), according to the substrate treatment before restoration: Group 1—total-etching adhesive Adper TM Single bond 2 (ASB) + Biosilicate®, Group 2—ASB (without Biosilicate®), Group 3—AdheSE self-etching adhesive system (AdSE) + Biosilicate®, and Group 4—AdSE (without Biosilicate®). Each tooth was restored with a hybrid composite and stored in water at 37 °C for 6 months. After water aging, teeth were cut in sticks (≈ 1 mm² cross-sectional area) and all samples were submitted to μTBS test. The fracture modes of the samples were analyzed by stereomicroscopy. The representatively fractured samples were observed by scanning electron microscopy. Representative samples of each group were analyzed on energy dispersive X-ray spectrometry (EDX). The μTBS and Ca-P ratio values were analyzed by 2-way ANOVA, Bonferroni, and Tukey test, respectively, p < .05.

Results

ASB + Biosilicate® presented the highest μTBS values (p < .05), and lowest μTBS values (p < .05) were found in AdSE Group. There was no statistical difference (p < .05) on μTBS when substrates were compared, except for Group 2. The fracture pattern analysis showed prevalence of adhesive fractures in all groups.

Conclusion

Biosilicate® enhanced bond strength of self-etching and etch-and-rinse adhesives to sound and demineralized dentin.

Clinical relevance

Bioactive glass ceramic suspension could be recommended to be used to improve the dentin bond strengths of the total-etching and self-etching adhesives after acid-etching and priming.

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Gingival crevicular fluid levels of human beta-defensin-1 in type 2 diabetes mellitus and periodontitis

Abstract

Objectives

Human β-defensin (hBD)-1 is an important gatekeeper of the gingiva against constant bacterial challenge, and glucose levels are involved in its optimal expression. The aims of the study were to investigate hBD-1 levels in gingival crevicular fluid (GCF) and to compare these levels between type 2 diabetics with or without periodontitis and healthy individuals.

Materials and methods

Altogether, 81 subjects were included in the study: 21 subjects with type 2 diabetes mellitus (T2DM) suffering from generalized periodontitis (T2DM + GP), 18 systemically healthy generalized periodontitis patients (GP), 18 periodontally healthy T2DM subjects (T2DM + H), and 24 systemically and periodontally healthy subjects (control). Plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded, and GCF samples were collected. hBD-1 levels in GCF were measured using ELISA.

Results

hBD-1 levels were significantly reduced in the T2DM + GP and GP groups. Although PI and GI scores were similar in both periodontally healthy groups, hBD-1 levels were lower in the T2DM + H group. In the whole population, hBD-1 levels correlated negatively with all periodontal parameters.

Conclusions

Both diabetes and periodontitis affect hBD-1 levels in GCF.

Clinical relevance

The altered levels of hBD-1 in GCF of diabetics might be associated with the susceptibility of diabetics to periodontitis.

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Cost assessment of a new oral care program in the intensive care unit to prevent ventilator-associated pneumonia

Abstract

Objectives

Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP.

Materials and methods

In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration. Budgetary effect of the new program from the hospital's point of view was analyzed for both periods. The costs avoided were calculated from the incidence density of VAP (cases per 1000 days of intubation). The cost study included device cost, benefit lost, and ICU cost (medication, employer and employee contributions, blood sample analysis…).

Results

A total of 2030 intubated patients admitted to the ICUs benefited from oral care. The cost of implementing the study protocol was estimated to be €11,500 per year. VAP rates decreased significantly between the two periods (p1 = 12.8% and p2 = 8.5%, p = 0.002). The VAP revenue was ranged from €28,000 to €45,000 and the average cost from €39,906 to €42,332. The total cost assessment calculated was thus around €1.9 million in favor of the new oral care program.

Conclusion and clinical relevance

Our study showed that the implementation of a simple strategy improved the quality of patient care is economically viable.

Trial registration

NCT02400294

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Evaluation of implant screw loosening by resonance frequency analysis with triaxial piezoelectric pick-up: in vitro model and in vivo animal study

Abstract

Objective

The aim of this study was to evaluate implant screw loosening using resonance frequency (RF) analysis with triaxial piezoelectric pick-up in vitro and in vivo.

Methods

For the in vitro experiment, a titanium implant was inserted into a mandibular model. The abutment screws were tightened to 10 N torque and loosened from 0 to 90° for RF measurement using 13 different screw conditions. In the in vivo experiment, three titanium implants were installed in each tibia of a New Zealand white rabbit, and the RF values were recorded after 8 weeks. For the RF analyses, a small 3D accelerometer was mounted rigidly onto the implant abutment, and impulsive vibration was directly applied to the abutment to vibrate the implant in a direction perpendicular to the tibia and implant (x-axis). The y-axis was defined as parallel to the tibia. The RF values of the x- and y-axis directions (RF-X and RF-Y) were used for evaluation.

Results

The RF values significantly decreased according to the degree of screw loosening (p < 0.05, ANOVA). In the in vitro model, RF-Y with x- and y-axis vibrations (RF-Yx and RF-Yy) significantly differed from the initial value at 10 and 15°, respectively (p < 0.05, Dunnett's test). In the in vivo experiment, the RF-Yy significantly differed from the initial value between 5 and 20° (p < 0.05).

Conclusion

The results suggest that RF analysis with triaxial piezoelectric pick-up can be used to detect implant screw loosening.

Clinical relevance

RF analysis with the triaxial piezoelectric pick-up can be used to detect screw loosening after mounting the superstructure.

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Placement of an antibiotic oral pack on the hard palate after primary cleft palatoplasty: a randomized controlled trial into the effect on fistula rates

Abstract

Objective

The objective of this study is to determine whether placement of an antibiotic oral pack on the hard palate reduces fistula rates after primary cleft palatoplasty.

Subjects and methods

This study was a parallel blocked randomized controlled trial. The study consisted of two groups of 100 patients each with non-syndromic unilateral complete cleft lip, alveolus, and hard and soft palate that underwent primary palatoplasty. Group A had an oral pack placed on the hard palate for 5 days postoperatively while group B did not. Occurrence of fistulae between both groups was tested using odds ratios (OR).

Results

In 2% of the patients in group A, a fistula was found 6 months after palatal surgery. In contrast, in 21% of the patients in group B, a palatal fistula could be confirmed. The fistula occurrence in group A was statistically significantly lower than that in group B (OR = 0.0768, CI = [0.02 … 0.34], p < 0.001).

Conclusion

The findings of this study provide evidence that the rate of fistula formation after primary palatoplasty is significantly reduced if a pack soaked with antibiotic cream is placed on the palate postoperatively for 5 days.

Clinical relevance

The use of an antibiotic pack after cleft palate repair can be recommended to prevent occurrence of oronasal fistulae.

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Micro-CT evaluation of voids using two root filling techniques in the placement of MTA in mesial root canals of Vertucci type II configuration

Abstract

Objective

The present study aims to compare two mineral trioxide aggregate (MTA) placement techniques, manual compaction and ultrasonic activation of manually compacted MTA, with warm vertical compaction (WVC) for orthograde obturation of mesial root canals of mandibular first molars showing Vertucci type II root canal configuration.

Materials and methods

Thirty roots were selected according to their micro-CT scanned images. Root canals were chemomechanically prepared using Reciproc R25 and NaOCl using EndoVac. The specimens were divided into three groups according to the root canal filling technique, as manual compaction of MTA, ultrasonic activation of manually compacted MTA and WVC using gutta-percha and AH Plus (Denstply Sirona, Ballaigues, Switzerland). Percentages of voids located in apical 3 mm and remaining coronal half until the level where separate root canals re-join within filling were calculated. Data were analyzed using the Kruskal-Wallis and Dunn's tests, and significance was set at 5%.

Results

No significant difference was found among the filling techniques regarding the percentage volume of voids at apical 3 mm (P > 0.05). At the coronal half of the isthmus, WVC produced significantly less percentage volume of voids than manual compaction of MTA (P < 0.05) and similar to ultrasonic activation group did (P > 0.05). There was no significant difference between two MTA placement techniques at the coronal half of the isthmus (P > 0.05).

Conclusions

No filling technique produced void-free fillings. The percentage of void volume was similar among groups at apical 3 mm but was different at the coronal half of the isthmus.

Clinical relevance

Warm vertical compaction and ultrasonically activated MTA fillings revealed similar quality at the isthmus area, which was superior to manually compacted MTA.

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Orofacial manifestations in outpatients with anorexia nervosa and bulimia nervosa focusing on the vomiting behavior

Abstract

Objective

This case-control study aims to evaluate the oral health status and orofacial problems in a group of outpatients with eating disorders (ED)—either anorexia nervosa (AN) or bulimia nervosa (BN)—further focusing on the influence of vomit.

Materials and methods

Fifty-five women outpatients with AN or BN diagnosis were invited to participate, of which 33 agreed. ED outpatients and matched controls were submitted to a questionnaire and clinical oral examination.

Results

Multivariate analysis identified a significantly higher incidence of teeth-related complications (i.e., tooth decay, dental erosion, and self-reported dentin hypersensitivity), periodontal disease, salivary alterations (i.e., hyposalivation and xerostomia), and oral mucosa-related complications in ED outpatients. Dental erosion, self-reported dentin hypersensitivity, hyposalivation, xerostomia, and angular cheilitis were found to be highly correlated with the vomiting behavior.

Conclusions

ED outpatients were found to present a higher incidence of oral-related complications and an inferior oral health status, compared to gender- and age-matched controls. Alterations verified within outpatients were acknowledged to be quite similar to those previously reported within inpatients, in both of nature and severity, thus sustaining that the cranio-maxillofacial region is significantly affected by ED, even in the early/milder forms of the condition, as expectedly verified within outpatients.

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Bisphosphonates hinder osteoblastic/osteoclastic differentiation in the maxillary sinus mucosa-derived stem cells

Abstract

Objectives

Although bisphosphonates (BPs) are known to be associated with osteonecrosis of the maxilla, the precise effects of BPs on bone metabolism in human maxillary sinus mucosal cells (HMSMCs) are not yet known. The purposes of this study were to examine the effects of the BPs zoledronate (ZOL) and alendronate (ALN) on osteoblastic and osteoclastic differentiation in HMSMCs and to investigate the signaling pathways involved.

Materials and methods

The effects of ZOL and ALN were assessed for osteoblast differentiation by alkaline phosphatase (ALP) activity, alizarin red staining, and RT-PCR for genes encoding Runx2 and osterix. Receptor activator of nuclear factor-κB ligand (RANKL)-mediated osteoclast differentiation in bone marrow macrophages (BMMs) was also examined.

Results

ZOL and ALN both suppressed osteoblastic differentiation, as evidenced by their effects on ALP activity, mineralization nodule formation, and the mRNA expression levels of osteoblastic transcript factors. The RANKL/osteoprotegerin ratio in HMSMCs was increased by ALN, whereas ZOL had the opposite effect. Conditioned medium obtained from ALN-treated HMSMCs stimulated osteoclast formation and upregulated NFATc1 expression, whereas conditioned medium from ZOL-treated cells did not. ALN was more cytotoxic and stimulated apoptosis more strongly than ZOL. BPs decreased the protein levels of the non-canonical Wnt signaling protein Wnt5a and calmodulin-dependent kinase II. Moreover, recombinant human Wnt5a reversed the effects of BPs on osteoblastic and osteoclastic differentiation.

Conclusion

This study is the first demonstration that BPs exert negative effects on osteoblastic and osteoclastic processes via the non-canonical Wnt pathway in HMSMSCs.

Clinical relevance

It suggests that patients taking BPs during the period of maxillary sinus lifting and amentation should be given special attention.

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Adsorption of platinum ion from “aged” aqueous solution: application and comparative study between purified MWCNTs and triphenylphosphine MWCNTs

Abstract

This study entails adsorption attempt of platinum ion from "aged" aqueous solution with purified multiwalled carbon nanotubes and tryphenylphosphine-linked multiwalled carbon nanotubes (1) and (2) (Tpp-MWCNTs (1) and Tpp-MWCNTs (2)). The aims were to produce and use purified MWCNTs, Tpp-MWCNTs (1) and (2) and compare their adsorption capacity. These adsorbents were characterised with SEM, FTIR, XPS, BET and zeta potential. Tpp-MWCNTs (1) and (2) differ by their atomic percentage content of phosphorus which is 0.7 and 2.6%, respectively. A commercial stock solution (1000 mg/L) of platinum was used for the batch adsorption experiments. The data revealed that the adsorption was dependent on the following parameters: pH, contact time and initial concentration. The adsorbents attained higher adsorption capacity at pH 2 with an initial concentration of 7.9 mg/L, adsorbent dose of 0.8 g/L, contact time of 60 min at room temperature (RT), whereas 48.25, 40.06 and 41.31 mg/g were adsorbed from 20 mg/L by purified MWCNTs, Tpp-MWCNTs (1) and (2), respectively. The results are quite interesting and show that purified MWCNTs are better than Tpp-MWCNTs under the experimental conditions. The data was best described by the Langmuir model and the adsorption process occurs on the surface monolayer of the adsorbents. The isotherm studies confirmed that the adsorption of platinum ion is favourable. The findings indicate that the practical adsorption of platinum ion using the adsorbents investigated is useful.

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Role of lncRNAs as prognostic markers of hepatic cancer and potential therapeutic targeting by S-adenosylmethionine via inhibiting PI3K/Akt signaling pathways

Abstract

Hepatic cancer (HCC) is a well-identified dilemma throughout the world, and hence, the molecular mechanisms and strategy for preventive protection against this malignancy are critical. S-adenosylmethionine (SAM) is a unique methyl granter in vast reactions, including DNA methylation, and secures the genome against hypomethylation, which is a hallmark of tumors. Consequently, SAM may control the rate of gene expression. The objective of this investigation was to evaluate the expression of long noncoding RNAs (lncRNAs) transcript involved in hepatic tumorigenesis, including additional coding CEBPA (ecCEBPA) and urothelial carcinoma related 1 (UCA1), antioxidant enzymes transcripts, and relevant signaling pathway in diethylnitrosamine (DEN)-prompted HCC along with their conceivable targeting by SAM at different stages of HCC in rats. Our outcomes revealed that SAM particularly when given at the starting phase downregulates ecCEBPA and UCA1 gene transcripts and ameliorate histopathological alterations in DEN-initiated HCC. Interestingly, SAM attenuates DEN-induced upregulation of PI3K/Akt protein expression. However, SAM upregulates the antioxidant enzymes mRNA transcripts and effectively diminishing DNA oxidation. The results of a DNA fragmentation assay further support the capacity of SAM to ameliorate DEN-induced hepatic malignancy. These results revealed the role of ecCEBPA and UCA1 in HCC and suggest that these lncRNAs may be helpful as prognostic and analytical biomarkers of HCC. Curiously, SAM readily targets the studied genes via inhibiting PI3K/Akt signaling pathway, which should make SAM an appealing agent for both chemoprevention and treatment of HCC.

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Effect of sulfonated graphene on uptake, translocation, and metabolism of 2,4,4′-trichlorobiphenyl in maize seedlings

Abstract

Graphene may affect fate of organic contaminants due to its strong adsorption properties, which is very crucial for accurately assessing ecological risk of graphene and concurrent contaminants, while the current information remains largely unknown. Here, we firstly explored the adsorption characteristics of sulfonated graphene (SG) for a widespread polychlorinated biphenyl 2,4,4′-trichlorobiphenyl (PCB28) (0.5–100 μg L⁻¹). Subsequently, the influence of SG on the uptake, translocation, and metabolism of PCB28 in maize seedlings was investigated through hydroponic exposure experiment. Adsorption isotherm of PCB28 to SG fitted best with the Langmuir model and the Polanyi-Dubinin-Manes (PDM) model, with the maximum adsorption capacity (Q_max) calculated as around 530 mg kg⁻¹. The presence of SG significantly promoted the maximum accumulation amount of PCB28 in roots by 112%, whereas reduced that in stems and leaves by 32 and 39%, respectively. The translocation factor (TFs) of PCB28 from roots to stems was 26–70% lower for SG exposed seedlings than nonexposed seedlings when the exposure time was longer than 24 h, demonstrating an obvious suppression of SG in the transportation of PCB28 from roots to stems. PCB28 could be metabolized to PCB8 and PCB18 through dechlorination and rearrangement in different parts of maize seedlings. SG significantly increased the accumulation of PCB8 and PCB18 in roots, but decreased that in stems and leaves. These findings might provide new implications for the risk assessment of SG and PCBs in the environment.

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Electrochemical treatment of humic acid using particle electrodes ensembled by ordered mesoporous carbon

Abstract

In order to degrade the macromolecular pollutant of humic acid, the powder ordered mesoporous carbon (POMC, average pore diameter 4.29 nm) was first applied for preparing the granular OMC (GOMC, Φ × H = 4 × 3–6 mm) as electrodes in a continuous three-dimensional (3D) electrochemical system. The POMC was synthesized by hard-templating method and characterized using scanning electron microscopy (SEM), transmission electron microscopy (TEM), particle size distribution, N₂ adsorption/desorption technology, and Fourier-transform infrared (FT-IR). The effects of electrochemical degradation parameters, such as current and hydraulic retention time (HRT), were investigated, and the degradation mechanism of HA was explored as well. The results indicated that the degradation efficiency of HA, chemical oxygen demand (COD), and total organic carbon (TOC) reached 95.3, 86.2, and 62.7%, respectively, under initial HA of 100 mg/L, current of 0.2 A, and HRT of 130 min. The detection of electron paramagnetic resonance (EPR) showed that plenty of ˙OH was generated on GOMC electrodes, which made the 3D system more effective than the conventional two-dimensional (2D) system. The cyclic voltammetry curves indicated that the reactions of HA on the OMC materials surface included both direct oxidation and direct reduction.

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Controlling factors of soil selenium distribution in a watershed in Se-enriched and longevity region of South China

Abstract

Selenium (Se) is an essential nutritional element for human beings. Many studies have been conducted on concentration and distribution patterns of soil Se in low Se, Se-enriched, and selenosis areas; however, soil Se has not been systematically studied in a watershed, especially in Se-enriched longevity region and karst area in South China. This study is carried out to explore the controlling factors of Se-enriched soils in Baishou river tributary watershed, where soils are Se-enriched, and local people have the phenomenon of longevity. The area-weighted average rock Se concentration in the watershed is 0.054 mg/kg, and there are no significant differences in rock Se concentration between different strata and between different lithological rocks. The area-weighted average concentration of Se in soils (0–20 cm) is 0.80 mg/kg, and the soil Se concentration is of high level in the watershed. Soil Se concentration decreases from upstream to downstream in the watershed, and significantly correlated with elevation. Climate is the main factor causing high content of soil Se in the watershed which lacks black rock series. The difference of clastic and carbonate parent materials in soil forming process and the physical and chemical properties (pH, OM, etc.) are the main reasons for the spatial variation of Se distribution in the watershed. The research will be beneficial to the development and utilization of Se-enriched soil in Se-enriched area.

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23-valent pneumococcal polysaccharide vaccine elicits hierarchical antibody and cellular responses in healthy and tuberculosis-cured elderly, and HIV-1-infected subjects

Publication date: Available online 9 May 2018
Source:Clinical Immunology
Author(s): Huichang Huang, Xiaohua Qian, Rong Pan, Ling Shen, Shanshan Liang, Feifei Wang, Peng Zhang, Hongbo Shen, Zheng W. Chen
The PPV23 immunizes healthy elderly and other high-risk populations against pneumococcal disease. Immune mechanisms whereby these populations differently mount antibody(Ab) and cellular responses to PPV23 vaccination remain unknown. Here, healthy elderly, those elderly with prior tuberculosis-cured history (TB-cured), and HIV-infected humans were vaccinated with PPV23, and assessed for opsonophagocytic Ab responses and potential cellular mechanisms. PPV23 vaccination elicited hierarchical responses of opsonophagocytic Ab. PPV23-elicited Ab titers were highest in healthy elderly, significantly lower in TB-cured elderly and lowest in HIV-infected subjects. Mechanistically, high PPV23-elicited Ab titers in healthy elderly were associated with increases in CD19 + CD69+ cells and CD19 + CD138 + plasma cells. Surprisingly, TB-cured elderly failed to show PPV23-induced increases in these cells. While HIV-infected subjects showed a depressed CD19 + CD69+ cellular response, PPV23 vaccination uncovered HIV-related over-reactive increases in CD19 + CD138 + cells. For the first time, we demonstrate that PPV23-elicted opsonophagocytic Ab titers correlate with different cellular responses in healthy, TB-cured and HIV statuses.

https://ift.tt/2KSGxOe

23-valent pneumococcal polysaccharide vaccine elicits hierarchical antibody and cellular responses in healthy and tuberculosis-cured elderly, and HIV-1-infected subjects

Accumulation degree and source apportionment of trace metals in smaller than 63 μm road dust from the areas with different land uses: A case study of Xi'an, China

Publication date: 15 September 2018
Source:Science of The Total Environment, Volume 636
Author(s): Dongqi Shi, Xinwei Lu
Finer urban dusts have more serious environmental detriment and health risk than coarser urban dusts. The trace metals Pb, Cu, Zn, Cr, Co, Ba, Mn, Ni, V, Y, Rb, Ga, Hf, and Zr were analyzed using X-ray fluorescence spectrometry in smaller than 63 μm road dust collected from the areas with different land use types and human activities in Xi'an city. The purposes of this study were to reveal the impact of human activities on the environment through element enrichment factor, and to determine the sources of trace metals measured by multivariate statistical analysis and multiple liner regression of absolute principal component scores. The results indicated that the smaller than 63 μm road dust in Xi'an, in comparison to the element background value of local soil, had higher Cu, Pb, Zn, Cr, Y, Hf and Zr concentrations. Trace metals had different variations in the dusts, while the anthropogenic trace metals had no significant difference in the four areas owing to the wide existing of human activities. The accumulation level of Pb was the highest, followed by Cr, Cu and Zn, and then was Hf and Zr, while the other trace metals were deficient or deficient to minimal enrichment in the finer road dust. Source analysis results indicated that Co, Ga, Mn, Ni, V, Rb and Y mainly originated from natural source, which accounted about 57%–87% for these metals' concentration. Ba, Cr, Pb, Cu and Zn primarily derived from traffic source, which contributed approximately 59%–79% to these metals' content. Hf and Zr were mainly from construction source, which contributed 74.6% to Hf concentration and 78.2% to Zr concentration. The study indicated that traffic and construction activities had a predominant influence on local environment.

Graphical abstract

https://ift.tt/2G0NHwx

Native crustacean species as a bioindicator of freshwater ecosystem pollution: A multivariate and integrative study of multi-biomarker response in active river monitoring

Publication date: September 2018
Source:Chemosphere, Volume 206
Author(s): Lidwina Bertrand, Magdalena Victoria Monferrán, Catherine Mouneyrac, María Valeria Amé
The aim of this study was to evaluate the ability of Palaemonetes argentinus to evidence the environmental degradation due to pollutants mixture in a freshwater aquatic ecosystem. For this purpose, an active monitoring (96 h exposure) was carried out in seven sites along the Ctalamochita River basin (Córdoba, Argentina), as a case of study.Our results evidenced sewage discharges impact in the water quality index, as well as metal pollution in water (Ag, Al, B, Pb, Hg) and sediments (Hg) with a potential effect on aquatic biota. The accumulation of total metals measured in exposed P. argentinus showed significant correlation with metals in water. Also, metallothioneins in cephalothorax showed significant changes along the basin, correlating with soluble concentrations of Cr, Zn, Cd, Hg, and V measured in shrimp tissues, which would be reflecting their bioavailability in the environment. In addition, the increase in antioxidant and detoxifying enzymes suggests the occurrence of oxidative stress in exposed shrimps. The integrative biomarker response index (IBR) pointed out the effect of metals on P. argentinus but also the occurrence of others pollutants.Finally, a high consensus was observed for water, sediments, and shrimps through the multivariate analysis (90%), indicating that P. argentinus can reflect changes in the abiotic matrixes. Moreover, studied sites were grouped according to their environmental quality.The use of active biomonitoring and the integration of biological responses through an IBR confirm that native biota could be a useful monitoring tool for bioavailable pollutants in aquatic ecosystems constituting a highly valuable approach.

Graphical abstract

https://ift.tt/2KOpWLK

To Compute Lightness, Illumination is Not Estimated, It is Held Constant.

Author: Gilchrist, Alan L.

DOI: 10.1037/xhp0000487

Publication Date: POST AUTHOR CORRECTIONS, 3 May 2018

https://ift.tt/2jJce0m

The Least Costs Hypothesis: A Rational Analysis Approach to the Voluntary Symbolic Control of Attention.

Author: Pauszek, Joseph R.; Gibson, Bradley S.

DOI: 10.1037/xhp0000527

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2I2TkQF

Do We Know What We Need? Preference for Feedback About Accurate Performances Does Not Benefit Sensorimotor Learning.

Author: Bastos, Flavio Henrique; Tani, Go; Drews, Ricardo; Riek, Stephan; Marinovic, Welber

DOI: 10.1037/xhp0000529

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2IaIt3d

The Affordance of Catchability in Running to Intercept Fly Balls.

Author: Postma, Dees B. W.; Lemmink, Koen A. P. M.; Zaal, Frank T. J. M.

DOI: 10.1037/xhp0000531

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2jKqEx9

A Note by Any Other Name: Intonation Context Rapidly Changes Absolute Note Judgments.

Author: Van Hedger, Stephen C.; Heald, Shannon L. M.; Uddin, Sophia; Nusbaum, Howard C.

DOI: 10.1037/xhp0000536

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2IcdovM

Can Vigilance Tasks Be Administered Online? A Replication and Discussion.

Author: Claypoole, Victoria L.; Neigel, Alexis R.; Fraulini, Nicholas W.; Hancock, Gabriella M.; Szalma, James L.

DOI: 10.1037/xhp0000538

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2I2TcAF

A Physiologically Based Nonhomogeneous Poisson Counter Model of Visual Identification.

Author: Christensen, Jeppe H.; Markussen, Bo; Bundesen, Claus; Kyllingsbaek, Soren

DOI: 10.1037/xhp0000539

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2IctmWH

Surface Filling-In and Contour Interpolation Contribute Independently to Kanizsa Figure Formation.

Author: Chen, Siyi; Glasauer, Stefan; Muller, Hermann J.; Conci, Markus

DOI: 10.1037/xhp0000540

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2I3ekqp

Object-Based Target Templates Guide Attention During Visual Search.

Author: Berggren, Nick; Eimer, Martin

DOI: 10.1037/xhp0000541

Publication Date: POST AUTHOR CORRECTIONS, 3 May 2018

https://ift.tt/2Icdh3k

Regularity and Dimensional Salience in Temporal Grouping.

Author: Prince, Jon B.; Rice, Tim

DOI: 10.1037/xhp0000542

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2I3Tfw9

Familiar Size Effects on Reaction Time: When Congruent is Better.

Author: Fisher, Carmen; Sperandio, Irene

DOI: 10.1037/xhp0000543

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2Icd7ce

Audiovisual Semantic Interactions Between Linguistic and Nonlinguistic Stimuli: The Time-Courses and Categorical Specificity.

Author: Chen, Yi-Chuan; Spence, Charles

DOI: 10.1037/xhp0000545

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2I409l5

Reconceptualizing Perceptual Load as a Rate Problem: The Role of Time in the Allocation of Selective Attention.

Author: Li, Zhi; Xin, Keyun; Li, Wei; Li, Yanzhe

DOI: 10.1037/xhp0000547

Publication Date: POST AUTHOR CORRECTIONS, 30 April 2018

https://ift.tt/2I6RY39

From human antibody structure and function towards the design of a novel Plasmodium falciparum circumsporozoite protein malaria vaccine

Hedda Wardemann | Rajagopal Murugan

https://ift.tt/2K6CU6m

Sustainable vaccine development: a vaccine manufacturer's perspective

Rino Rappuoli | Emmanuel Hanon

https://ift.tt/2wsQDCj

Chronic stress and temporalis muscle activity in TMD patients and controls during sleep: a pilot study in females

Abstract

Objectives

The aim of this study was to assess the correlation between chronic stress and temporalis muscle activity during four nights.

Material and methods

Forty-four female subjects were recruited in five dental practices located in different areas of the federal state of Saarland, Germany (dental practice network in Saarland). The following inclusion criteria were used: female, aged between 18 and 65, no somatization or depression, and no pain medication, graded chronic pain status < 3. Both subjects reporting about sleep bruxism and subjects negating sleep bruxism during anamnesis were included. Anamnestic issues, sleep bruxism, anxiety, and chronic stress were assessed using validated questionnaires. Temporalis muscle activity was measured for four nights using a portable electromyographic device. Correlation coefficient was used to assess the correlation (Spearman-correlation) between chronic stress and number of temporalis muscle episodes/hour and between anxiety and the number of episodes/hour.

Results

The analysis showed that the factors "work overload" (adulthood chronic stress because of too many demands at work) and "pressure to perform" (necessity to be successful at work) were significantly correlated with the number of temporalis muscle episodes per hour. In contrast, anxiety was not correlated with temporalis muscle episodes per hour.

Conclusions

Work-related chronic stress seems to be associated with an increased level of temporalis muscle activity during sleep.

Clinical relevance

During anamnesis, work-related aspects should be assessed in females presenting with sleep-bruxism.

https://ift.tt/2KKvSFz

Comparative evaluation of three obturation techniques in primary incisors using digital intra-oral receptor and C.B.C.T—an in vitro study

Abstract

Objectives

Successful pulpectomy in primary teeth depends on quality of obturation. It can be evaluated using digital intra-oral receptor (D.I.O.R) and cone beam computed tomography (C.B.C.T). The purposes of this study were to compare 3 different obturation techniques such as lentulospiral, insulin syringe, and endodontic plugger in primary incisors and to evaluate its quality of obturation using D.I.O.R and C.B.C.T technique.

Materials and methods

Thirty-three extracted primary incisors were biomechanically prepared and obturated with zinc oxide eugenol cement by 3 different obturation techniques. The obturation was evaluated for length of obturation and voids using D.I.O.R and C.B.C.T methods.

Results

There was a statistically significant difference between all the groups in length of obturation (P = 0.02) in both D.I.O.R and C.B.C.T. Significant differences (P = 0.03) were present in number of voids among 3 obturation techniques in C.B.C.T. Statistically more voids were observed with D.I.O.R in lentulospiral (P = 0.04) group and in insulin syringe (P = 0.02) group.

Conclusions

Acceptable result was obtained with lentulospiral in length of obturation compared to insulin syringe and endodontic plugger technique. Insulin syringe technique resulted in increased underfilling with least number of voids. More number of voids were seen in middle one-third and least number of voids were observed at apical one third of the root among all the 3 techniques of obturation. The study concluded that void identification is improved with D.I.O.R compared to C.B.C.T.

Clinical relevance

Lentulospiral reported effective length of obturation, while insulin syringe with least number of voids. D.I.O.R (2-Dimensional) is efficient in detecting voids compared to C.B.C.T (3-Dimensional) in obturated primary teeth.

https://ift.tt/2KMEUlk

Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars

Abstract

Objectives

This study aimed to compare four final irrigation protocols (passive ultrasonic irrigation [PUI], EndoVac, Self-Adjusting File [SAF] and EasyClean) on the removal of accumulated hard-tissue debris (AHTD) from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis.

Materials and methods

Forty mesial roots of mandibular molars presenting isthmuses type I or III were scanned in a micro-CT device and instrumented up to Reciproc R40 instrument. After the completion of canal preparations, root canals of each group were submitted to a final rinse using 20 mL of solution (16 mL of 5.25% NaOCl and 4 mL of 17% EDTA) in a total time of 5 min according to one of the four final irrigation protocols (n = 10): PUI, EndoVac, SAF and EasyClean operated at reciprocating motion. The sample was scanned again after canal preparation and after the use of the final irrigation protocols, and the registered data sets were examined to evaluate the percentage of AHTD. Data were statistically compared using the Tukey test with a significance level set at 5%.

Results

All groups presented a decrease on the accumulation of hard-tissue debris after the use of the final irrigation protocols (P < 0.05). No significant differences in the removal of AHTD were observed among the final irrigation protocols (P > 0.05).

Conclusions

All final irrigation protocols showed the same effectiveness in the removal of AHTD. None of them was able to render mesial canals of mandibular molars completely free from packed debris.

Clinical relevance

This study highlighted that all final irrigation protocols (PUI, EndoVac, SAF, and EasyClean) promoted a similar removal of AHTD. However, none of the final irrigation protocols was able to render mesial canals of mandibular molars completely free from packed debris.

https://ift.tt/2G0bLQ0

Less is more: similar efficacy in three sessions and seven sessions of pulsed dye laser treatment in infantile port-wine stain patients

Abstract

Port-wine stains (PWS) affect 0.3 to 0.5% of newborns and pulsed dye laser (PDL) remains the treatment of choice. However, no reliable study regarding the benefits of more frequent has been conducted. We designed the present study to evaluate whether more frequent PDL treatments in infantile patients would achieve further lightening of erythema. We prospectively investigated 20 infants with PWS. Two adjacent sites were both treated for a 12-week duration and randomly allocated to be treated for seven sessions at 2-week intervals or three sessions at 6-week intervals. The efficacy outcome 2 months after the final treatment was determined by visual and chromameter evaluation. Sixteen patients completed the study with a total of 54 treatment sites. Similar results were observed in the two groups. The average blanching rates were 42.93% (SD = 27.92%) and 43.81% (SD = 32.80%) for PDL treatments with seven and three sessions, respectively (p = 0.374). Partial recovery from the laser treatment was more frequently observed and side effects were significantly higher at 2-week follow-ups (p < 0.001), resulting in a total of 3–13 weeks for skin recovery. More frequent PDL treatments do not necessarily increase efficacy in infantile PWS patients. Considering the potential risks and added costs, this practice may not be of benefit. (Clinical trial registration number: ChiCTR-ONC-17010857)

https://ift.tt/2K6MOET

CONTRA: Postoperative Epiduralanalgesie – der Goldstandard?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 246-251
DOI: 10.1055/s-0043-104667

Die Epiduralanalgesie (EDA) kann nicht für alle Eingriffe mit mittelstarkem bis starkem Schmerzniveau der Goldstandard der Therapie sein. Die EDA ist der PCA (patientenkontrollierte Analgesie) und den oralen Analgetika in Bezug auf Reduktion der postoperativen Schmerzintensität überlegen [1]. Mögliche schwerwiegende Komplikationen sowie die höheren Kosten der EDA erfordern aber eine sorgfältige, evidenzbasierte operationsspezifische Abwägung.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Intensivmedizin: Dysphagie nach Intensivbeatmung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 231-232
DOI: 10.1055/a-0589-4882

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2ryFoUb

Patientenkontrollierte Analgesie: Methoden, Handhabung und Ausbaufähigkeit

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 270-280
DOI: 10.1055/s-0043-104665

Eine nebenwirkungsarme und patientenadaptierte Schmerztherapie ist integraler Bestandteil aller multimodalen Behandlungskonzepte, die eine schnelle und komplikationsfreie Erholung nach operativen Eingriffen ermöglichen sollen. Die patientenkontrollierte Analgesie (PCA) bietet dabei eine etablierte und sichere Option für eine individuell angepasste Schmerztherapie, die – richtig genutzt – ein hohes Maß an Patientenzufriedenheit garantiert.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Opioid-Missbrauch bei chronischen Schmerzen: Messinstrumente zur Risikoeinschätzung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 232-234
DOI: 10.1055/a-0588-2062

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2K945NW

Neurologisches Defizit nach intraoperativem anaphylaktischen Schock

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 314-316
DOI: 10.1055/a-0592-8364

Schlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle" stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2wsIpKr

Intraoperative Anaphylaxie: Nach Behandlung kann die OP meist weitergehen

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 234-234
DOI: 10.1055/a-0588-2034

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2rwjzob

Periphere Regionalanästhesie ohne Komplikationen – Ein Traum wird wahr?!

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 252-268
DOI: 10.1055/s-0043-104664

Periphere Regionalanästhesieverfahren sind relativ sichere Verfahren der klinischen Anästhesie – dennoch können typische, meist transiente und selten sogar persistierende Komplikationen auftreten. Neben allgemeinen Komplikationen und Strategien zur Risikoreduktion widmet sich dieser Artikel akzidentellen Mitblockaden anderer nervaler Strukturen am Beispiel des Plexus brachialis. Ein Ausblick in die Zukunft informiert über selektivere Blockaden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2rwfArS

Organisation der perioperativen Schmerztherapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 282-294
DOI: 10.1055/s-0043-104671

Organisatorische Aspekte der postoperativen Schmerztherapie werden oft vernachlässigt – dabei sind sie ebenso wichtig wie Details zu pharmakologischen oder regionalanalgetischen Verfahren. Anhand virtueller Fragen und Erfahrungen eines Assistenzarztes beleuchten wir in diesem Artikel die „Organisation der perioperativen Schmerztherapie": Schmerzerfassung und Dokumentation, Patienteninformation und -edukation, Aufgaben eines Akutschmerzdienstes.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2rvmAVE

PRO: Epiduralanalgesie – Goldstandard bei abdominalen und thorakalen Eingriffen

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 237-244
DOI: 10.1055/s-0043-104668

Die Kombination aus thorakaler Epiduralanalgesie (TEA) und Allgemeinanästhesie hat sich bei großen abdominellen und thorakalen Operationen aufgrund der ausgezeichneten Analgesiequalität bewährt 1. Komplikationen sind selten, aber potenziell schwerwiegend – sie müssen rasch erkannt und therapiert werden. Daher sollte die TEA in ein den gesamten perioperativen Verlauf umfassendes Konzept integriert sein, wie es in diesem Beitrag vorgestellt wird.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2rx1nee

Transfusion in der Herzchirurgie: liberal oder restriktiv?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 229-230
DOI: 10.1055/a-0589-4915

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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https://ift.tt/2ru9Kr4

Kasuistik: Opioidtherapie bei chronischem Rückenschmerz

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 306-313
DOI: 10.1055/s-0043-115205

Ein 76-jähriger stellt sich mit chronischen lumbalen Rückenschmerzen vor, die trotz hochdosierter Opioidtherapie nicht suffizient behandelt sind. Nach Ausschluss spezifischer Ursachen konnte im Rahmen eines multimodalen tagesklinischen Behandlungsprogramms für Senioren die Opioidtagesdosis von 480 mg auf 28 mg Morphinäquivalent und die initiale hohe Schmerzintensität von 7 auf 4 Punkte auf einer numerischen Rangskala erfolgreich reduziert werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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An interoperable clinical decision-support system for early detection of SIRS in pediatric intensive care using openEHR

Publication date: Available online 9 May 2018
Source:Artificial Intelligence in Medicine
Author(s): Antje Wulff, Birger Haarbrandt, Erik Tute, Michael Marschollek, Philipp Beerbaum, Thomas Jack
BackgroundClinical decision-support systems (CDSS) are designed to solve knowledge-intensive tasks for supporting decision-making processes. Although many approaches for designing CDSS have been proposed, due to high implementation costs, as well as the lack of interoperability features, current solutions are not well-established across different institutions. Recently, the use of standardized formalisms for knowledge representation as terminologies as well as the integration of semantically enriched clinical information models, as openEHR Archetypes, and their reuse within CDSS are theoretically considered as key factors for reusable CDSS.ObjectiveWe aim at developing and evaluating an openEHR based approach to achieve interoperability in CDSS by designing and implementing an exemplary system for automated systemic inflammatory response syndrome (SIRS) detection in pediatric intensive care.MethodsWe designed an interoperable concept, which enables an easy integration of the CDSS across different institutions, by using openEHR Archetypes, terminology bindings and the Archetype Query Language (AQL). The practicability of the approach was tested by (1) implementing a prototype, which is based on an openEHR based data repository of the Hannover Medical School (HaMSTR), and (2) conducting a first pilot study.ResultsWe successfully designed and implemented a CDSS with interoperable knowledge bases and interfaces by reusing internationally agreed-upon Archetypes, incorporating LOINC terminology and creating AQL queries, which allowed retrieving dynamic facts in a standardized and unambiguous form. The technical capabilities of the system were evaluated by testing the prototype on 16 randomly selected patients with 129 days of stay, and comparing the results with the assessment of clinical experts (leading to a sensitivity of 1.00, a specificity of 0.94 and a Cohen's kappa of 0.92).ConclusionsWe found the use of openEHR Archetypes and AQL a feasible approach to bridge the interoperability gap between local infrastructures and CDSS. The designed concept was successfully transferred into a clinically evaluated openEHR based CDSS. To the authors' knowledge, this is the first openEHR based CDSS, which is technically reliable and capable in a real context, and facilitates clinical decision-support for a complex task. Further activities will comprise enrichments of the knowledge base, the reasoning processes and cross-institutional evaluations.

Graphical abstract

https://ift.tt/2I6TQsK

Tyrosine kinase inhibitors for brain metastases in HER2-positive breast cancer

Publication date: Available online 9 May 2018
Source:Cancer Treatment Reviews
Author(s): Renata Duchnowska, Sibylle Loibl, Jacek Jassem
Approximately 30–50% of advanced HER2-positive breast cancer patients will develop central nervous system (CNS) metastases, with an annual risk of around 10%, and a half of them will die from brain progression. An increased risk of brain metastases is also seen in patients with early HER2-positive breast cancer administered curative therapy. Brain metastases in HER2-positive breast cancer patients usually constitute the first site of recurrence. The administration of anti-HER2 monoclonal antibodies, trastuzumab and pertuzumab, considerably delays the onset of symptomatic brain disease: however, the limited penetration of these compounds into the CNS hinders their efficacy. The small-molecule tyrosine kinase inhibitors of epidermal growth factor receptors family have established activity in HER2-positive breast cancer in both advanced disease and neoadjuvant setting. Favorable physico-chemical properties of these compounds allow them for a more efficient penetration through the blood-brain barrier, and hold the promise for more effective prevention and treatment of brain metastases. In this article we review the role of currently available or investigational HER2 tyrosine kinase inhibitors: lapatinib, neratinib, afatinib and tucatinib in the treatment of brain metastases in HER2-positive breast cancer patients.

https://ift.tt/2FZlDtm

Chromosome instability: From molecular mechanisms to disease

Publication date: June–July 2018
Source:DNA Repair, Volumes 66–67
Author(s): Guillermo de Cárcer, Pablo Huertas, Andres J. López-Contreras
The International University of Andalusian (UNIA) held on the 13th to 15th of November 2017 was a meeting oriented to the concept of Chromosomal Instability and related diseases. The meeting was part of the renowned UNIA workshops programme "Current Trends in Biomedicine", held in the UNESCO World Heritage awarded city Baeza, located in the south of Spain.The goal of this Workshop was to bring together experts in DNA repair and chromosome segregation in order to address the phenomenon of Chromosomal Instability as a whole, facilitating the communication between scientists from different fields to foster cross-disciplinary approaches.This report summarizes a selection of the many interesting results and data presented during the meeting.

https://ift.tt/2KQ2aPA

Ausgedehnte Raumforderung des Parapharyngealraums

Laryngo-Rhino-Otol
DOI: 10.1055/a-0601-6954

Article in Thieme eJournals:
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Verification of Bioanalytical Method for Quantification of Exogenous Insulin (Insulin Aspart) by the Analyser Advia Centaur® XP.

https:--www.clin-lab-publications.com-as

Verification of Bioanalytical Method for Quantification of Exogenous Insulin (Insulin Aspart) by the Analyser Advia Centaur® XP.

Clin Lab. 2018 Mar 01;64(3):399-403

Authors: Mihailov R, Stoeva D, Pencheva B, Pentchev E

Abstract
BACKGROUND: In a number of cases the monitoring of patients with type I diabetes mellitus requires measurement of the exogenous insulin levels. For the purpose of a clinical investigation of the efficacy of a medical device for application of exogenous insulin aspart, a verification of the method for measurement of this synthetic analogue of the hormone was needed. The information in the available medical literature for the measurement of the different exogenous insulin analogs is insufficient. Thus, verification was required to be in compliance with the active standards in Republic of Bulgaria. A manufactured method developed for ADVIA Centaur XP Immunoassay, Siemens Healthcare, was used which we verified using standard solutions and a patient serum pool by adding the appropriate quantity exogenous insulin aspart.
METHODS: The method was verified in accordance with the bioanalytical method verification criteria and regulatory requirements for using a standard method: CLIA chemiluminescence immunoassay ADVIA Centaur® XP.
RESULTS: The following parameters are determined and monitored: intra-day precision and accuracy, inter-day precision and accuracy, limit of detection and lower limit of quantification, linearity, analytical recovery.
CONCLUSIONS: The routine application of the method for measurement of immunoreactive insulin using the analyzer ADVIA Centaur® XP is directed to the measurement of endogenous insulin. The method is applicable for measuring different types of exogenous insulin, including insulin aspart.

PMID: 29739124 [PubMed - in process]

https://ift.tt/2G0vAH3

Erythropoietin Protects Erythrocytes Against Oxidative Stress-Induced Eryptosis In Vitro.

Erythropoietin Protects Erythrocytes Against Oxidative Stress-Induced Eryptosis In Vitro.

Clin Lab. 2018 Mar 01;64(3):365-369

Authors: Sun Y, Liu G, Jiang Y, Wang H, Xiao H, Guan G

Abstract
BACKGROUND: Excessive eryptosis has been found in maintained hemodialysis or peritoneal dialysis patients. Signaling of triggering eryptosis includes oxidative stress, increased cytosolic Ca2+-activity, and ceramide. Erythropoietin (EPO) possesses the property of an antioxidant. The aim of this study was to investigate the ability of hydrogen peroxide (H2O2) on erythrocytes in vitro, and to assess the possible effects of recombinant human erythropoietin (rhEPO) on eryptosis.
METHODS: One percent erythrocyte suspension was cultured in vitro in three kinds of media: Control group (Group C), H2O2 group (Group H), and EPO group (Group E). Erythrocytes were sampled at 24 hours and 60 hours. Phosphatidylserine (PS) was estimated with annexin-V, reactive oxygen species (ROS) with 2',7'-dichlorodihydrofuorescein diacetate (DCFDA) and cytosolic Ca2+ activity ([Ca2+]i) with Fluo3.
RESULTS: Eryptosis in Group C increased as the incubating time extended (2.05 ± 0.06 at 24 hours, and 10.00 ± 0.08 at 60 hours). Eryptosis increased in Group H compared with Group C (10.86 ± 0.06 at 24 hours, p < 0.01; 12.46 ± 0.14 at 60 hours, p < 0.01, respectively), while it decreased in Group E compared with Group H (8.80 ± 0.08 at 24 hours, p < 0.01; 11.29 ± 0.04 at 60 hours, p < 0.01, respectively). Meanwhile, ROS increased in Group H compared with Group C (9.37 ± 0.04 versus 5.49 ± 0.09 at 24 hours, p < 0.01;19.82 ± 0.05 versus 13.51 ± 0.10 at 60 hours, p < 0.01). [Ca2+]i increased in Group H compared with Group C (10.91 ± 0.12 versus 2.53 ± 0.06 at 24 hours, p < 0.01;14.55 ± 0.05 versus 4.63 ± 0.08 at 60 hours, p < 0.01). ROS decreased in Group E compared with Group H (6.80 ± 0.05 at 24 hours, p < 0.01; 16.82 ± 0.06 at 60 hours, p < 0.01). [Ca2+]i decreased in Group E compared with Group H (7.63 ± 0.14 at 24 hours, p < 0.01; 10.72 ± 0.07 at 60 hours, p < 0.01).
CONCLUSIONS: Our research showed eryptosis was triggered by H2O2 and paralleled by increased ROS and [Ca2+]i which was partially reversed by EPO. It indicated that EPO could protect erythrocytes against oxidative stress-induced eryptosis.

PMID: 29739123 [PubMed - in process]

https://ift.tt/2jJkblY

Serum CEA and CA19-9 Levels are Associated with the Presence and Severity of Colorectal Neoplasia.

Serum CEA and CA19-9 Levels are Associated with the Presence and Severity of Colorectal Neoplasia.

Clin Lab. 2018 Mar 01;64(3):351-356

Authors: Zhai H, Huang J, Yang C, Fu Y, Yang B

Abstract
BACKGROUND: High concentrations of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were found in the serum of patients with colon cancer. We performed the present work to investigate the association between elevated levels of serum biomarkers (CEA and CA19-9) and shortened survival in patients with colon cancer.
METHODS: We examined patients who underwent colonoscopies between 2001 and 2014 and measured and analyzed the serum CEA and CA19-9 levels of 362 participants.
RESULTS: Elevated CEA concentrations were found to be associated with advanced invasion, lymph node metastasis, and short survival. Elevated CA19-9 concentrations also were associated with lymph node metastasis and short survival.
CONCLUSIONS: Elevated serum CEA or CA19-9 levels were found to be associated with shortened survival.

PMID: 29739122 [PubMed - in process]

https://ift.tt/2G0RjP8

Performance Verification of Alternative Quality Control Materials for Urine Albumin Assessment.

Performance Verification of Alternative Quality Control Materials for Urine Albumin Assessment.

Clin Lab. 2018 Mar 01;64(3):345-349

Authors: Wang HB, Hu Y, Shan XY

Abstract
BACKGROUND: Accurate detection of urine albumin is important for evaluating the progression of diabetic kidney disease. However, two levels of daily quality control may not be practically feasible in some small clinical laboratories owing to a small number of patient samples and high costs. We aimed to prepare homemade quality control material (HQM) to measure urine albumin and then verify its performance.
METHODS: Normal saline solution and fresh mixed urine samples from five donors with serious kidney disease were used to prepare two levels of HQM (HQM1 and HQM2). Anhydrous ethylene glycol and sodium azide were used as antifreeze and as a preservative, respectively.
RESULTS: Before being separated into Eppendorf tubes, 20 tests for HQM1 and HQM2 were performed, resulting in mean ± SD of 19.52 ± 0.91 mg/L and 105.28 ± 3.71 mg/L, respectively. After having been divided, the vial-to-vial variations of HQM1 and HQM2 were small (4.93% and 3.70%, respectively). The stability of HQM1 and HQM2 stored at 2 - 8°C was about 2 months and 80 days, respectively, and when stored at -20°C, remained stable for more than 8 months. After 1 - 8 months of cryopreservation at -20°C, once opened, the HQM in every Eppendorf tube could be kept for at least five days (CV < 6.1%).
CONCLUSIONS: Our HQM stored at -20°C remained stable for a long time, and so could be considered as an alternative to standard QMs in the clinical laboratory.

PMID: 29739121 [PubMed - in process]

https://ift.tt/2jMg8pj

Concordance of Capillary Electrophoresis and Conventional Gel Electrophoresis in Two Different Groups of Patients with.

Concordance of Capillary Electrophoresis and Conventional Gel Electrophoresis in Two Different Groups of Patients with.

Clin Lab. 2018 Mar 01;64(3):339-344

Authors: Kim S, Yang HS, Lee A, Cho SY

Abstract
BACKGROUND: Serum and urinary protein electrophoresis play an important role in the identification of monoclonal gammopathy. Recently, capillary electrophoresis (CE) has been adapted in many clinical laboratories because of several advantages such as short turnaround time, automation, and high reproducibility. However, there have been unsolved concerns for the concordance between conventional gel and automated capillary electrophoresis methods for protein separation in clinical specimens. In this study, we investigated the diagnostic performance of both methods for detecting monoclonal (M) protein.
METHODS: From February 2012 to August 2015, a total of 3,013 CE tests were performed in our hospital. Among these cases, we reconfirmed results of CE (Capillary 2, Sebia, Lysse, France) with those of conventional agarose gel electrophoresis (GE) (Hydragel 4IF, Sebia, Lisses, France) in 28 specimens from 24 patients with newly diagnosed monoclonal gammopathy (group 1). In addition, 22 cases from 15 patients with previously diagnosed monoclonal gammopathy presenting indeterminate or suspicious results on CE (group 2) were also reconfirmed with GE.
RESULTS: We compared the results between the two electrophoresis methods in two different groups of patients with newly diagnosed discrete monoclonal peaks vs. pre-existing monoclonal gammopathy with obscure results in follow-up courses. In group 1, agreement rate was 100% (28/28) and there was no discrepant result between these two electrophoresis methods. In contrast, group 2 showed 86.4% (19/22) agreement rate and 0.67 Cohen's kappa value (95% confidence interval, 0.51 - 1.02).
CONCLUSIONS: According to our results, both electrophoresis methods can be used with the same level of assurance at the time of initial diagnosis for monoclonal gammopathy. However, in patients with previously diagnosed monoclonal gammopathy in follow-up course after appropriate treatments, discordant results can be observed due to the reduced amount of M proteins. Therefore, we suggest that some ambiguous cases with very small amounts of M components require a combination of both CE and GE methods for accurate interpretation to confirm the presence of M proteins.

PMID: 29739120 [PubMed - in process]

https://ift.tt/2FZjwWs

Investigation of Iron Metabolism for Regulating Megakaryopoiesis and Platelet Count According to the Mechanisms of Anemia.

Investigation of Iron Metabolism for Regulating Megakaryopoiesis and Platelet Count According to the Mechanisms of Anemia.

Clin Lab. 2018 Mar 01;64(3):329-332

Authors: Kim S, Cho SY

Abstract
BACKGROUND: Iron deficiency anemia (IDA) is characterized by depletion of total body iron stores or a poor supply of plasma iron. By contrast, chronic inflammation makes iron unavailable for hematopoiesis through a cytokinemediated cascade and leads to a condition known as anemia of chronic disease (AOC). However, the laboratory data regarding the regulatory role of iron metabolism on platelet count has not been fully discussed yet. In this study, we investigated the relationship between iron status and platelet production according to different anemic mechanisms representing different iron metabolisms.
METHODS: The study included a total of 759 specimens. Blood samples were obtained through venipuncture. The complete blood count was measured using an Advia 2120 (Siemens Healthcare Diagnostics Inc., USA). Biochemical indices including iron level were estimated using a Toshiba chemical analyzer (Toshiba, Japan).
RESULTS: In the AOC group, we found a significant relationship between platelet count and serum iron level (p < 0.27), whereas there was no correlation in the IDA group. Moreover, when the AOC patient group was subdivided by serum iron level, a remarkable difference was observed as follows. The platelet count was significantly correlated with serum iron level only in the AOC group with decreased serum iron levels (serum iron < 50 µg/dL) (p < 0.0001), while there was no correlation in the AOC group with normal serum iron levels (serum iron 50 - 100 µg/dL).
CONCLUSIONS: Iron deficiency in AOC involves upregulated hepcidin production induced by elevated inflammatory cytokines. This can cause increased iron sequestration in macrophages and decreased iron absorption for bone marrow. The condition of decreased megakaryocytic iron supply makes megakaryocytes with higher ploidy which can release more platelets than lower ploidy. Moreover, reactive thrombocytosis in inflammatory states occurs by cytokine cascades involving interleukin 6 and thrombopoietin in AOC. These two features may enhance thrombocytosis in patients of AOC with decreased iron level. In the future, further study should be performed to elucidate regulating mechanism of iron metabolism for megakaryopoiesis in AOC patients, and guide proper supplemental therapy of iron to decrease thrombotic risk due to reactive thrombocytosis in various kinds of anemia.

PMID: 29739118 [PubMed - in process]

https://ift.tt/2K2xtoX

Low Serum Levels of Pre-Surgical Total Cholesterol are Associated with Unfavorable Overall Survival in Patients with Operable Non-Small Cell Lung Cancer.

Low Serum Levels of Pre-Surgical Total Cholesterol are Associated with Unfavorable Overall Survival in Patients with Operable Non-Small Cell Lung Cancer.

Clin Lab. 2018 Mar 01;64(3):321-327

Authors: Zhang G, Zhang D, Wu J, Zhang F, Zhu Z, Chen K, Zhang N, Jin J, Feng J, Lin N, Zhang Y, Yu H, Su D, Ying L

Abstract
BACKGROUND: Cholesterol is an essential building block of the cell membrane and an important molecule for cell signaling and function. The dysregulation of cholesterol metabolism has been linked to several diseases, including cancer. The aim of this study is to investigate whether serum cholesterol is associated with the survival outcomes of patients with non-small cell lung cancer (NSCLC).
METHODS: The concentration of total cholesterol (TC) was measured in pre-operative serum samples of 637 NSCLC patients. The associations of TC with recurrence and overall survival were analyzed using a Cox proportional hazard regression model. Kaplan-Meier survival curves were calculated for overall survival analysis.
RESULTS: Our analyses showed that low serum levels of TC were associated with an increased risk of death. The association between TC and overall survival remained significant after patient age at diagnosis, gender, disease stage, histotype, tumor grade, body mass index (BMI), and smoking status were adjusted in the analysis. The patients with low serum TC had a 61% (95% confidence interval: 1.18 - 2.19) higher risk of death compared to those with normal TC. A Kaplan-Meier survival analysis showed similar results. No association was found between TC and recurrence in NSCLC.
CONCLUSIONS: Our study suggests that the pre-surgical serum level of TC may be an independent prognostic indicator for NSCLC overall survival.

PMID: 29739117 [PubMed - in process]

https://ift.tt/2jJtOkH

Evaluation of Samples with DFS Staining Pattern Detected by Indirect Immunofluorescence Assay.

Evaluation of Samples with DFS Staining Pattern Detected by Indirect Immunofluorescence Assay.

Clin Lab. 2018 Mar 01;64(3):393-397

Authors: Togay A, Mutlu E, Ongut G, Mutlu D, Colak D, Gultekin M

Abstract
BACKGROUND: In this study, we aimed to determine the presence of anti DFS70 antibody by a specific IB method in samples showing the DFS pattern and to determine the distribution of DFS pattern in different patient groups.
METHODS: 2,401 serum samples, which were received for ANA screening, were tested by IIF method at Akdeniz University Hospital Diagnostic Laboratory. Out of 139 samples with DFS pattern, 75 samples were tested for the presence of anti DFS70 antibody by IB and were included in the study. Patients' clinical diagnoses were obtained retrospectively from medical records.
RESULTS: 63 (84%) of 75 samples, which showed DFS patern by IIF, were found to have anti DFS70 antibody by IB. Five of these patients were diagnosed with SARD while the rest (58) had diseases other than SARD.
CONCLUSIONS: DFS pattern detected by IIF and isolated anti DFS70 antibody positivity detected by IB show high concordance. However IIF results should be confirmed because of the patterns that can be misidentified as DFS pattern. The presence of anti-DFS70 antibodies, which help to exclude SARD, prevent further unnecessary referral demands.

PMID: 29739116 [PubMed - in process]

https://ift.tt/2G2hl4d

Upregulation of Breast Cancer Resistance Protein Expression was Decreased in Plasma Membrane of Colon Cancer with Metastasis of Lymphatic Node.

Upregulation of Breast Cancer Resistance Protein Expression was Decreased in Plasma Membrane of Colon Cancer with Metastasis of Lymphatic Node.

Clin Lab. 2018 Mar 01;64(3):311-319

Authors: Wu A, Zhang J, Zeng L, Li F, Dong Z, Feng Y, Jia X, Jin JO, Zhang L

Abstract
BACKGROUND: ATP-binding cassette sub-family G member 2 (ABCG2), an ABC transport protein involved in the efflux of anticancer compounds, has been reported to have altered expression levels in several cancers including breast, colon, and gastric cancer, etc. However, its expression change (up- or down-regulated in cancer) is still contradictory.
METHODS: We performed immunohistochemistry to examine ABCG2 expression in the microarray with 90 pairs of colon cancer and their adjacent normal tissues. To find the expression of ABCG2 in lymphatic node metastasis (N1) and N0, we performed immunofluorescence, analyzed by Confocal technology.
RESULTS: Compared to adjacent normal tissues, the percentage and density of positive cells expressing ABCG2 in colon cancer were significantly increased. In addition, ABCG2 expression in plasma membrane was related to lymph node metastasis in colon cancer, which was further verified to be downregulated by 2.7-fold in N1 to N0 through immunofluorescent analysis.
CONCLUSIONS: ABCG2 expression in colon cancer was up-regulated, and its expression was decreased in the plasma membrane of colon cancer with lymphatic node metastasis (N metastasis).

PMID: 29739115 [PubMed - in process]

https://ift.tt/2KND1ok

Mutations in Core Gene Region of Hepatitis B Virus in Patients with Chronic Hepatitis B.

Mutations in Core Gene Region of Hepatitis B Virus in Patients with Chronic Hepatitis B.

Clin Lab. 2018 Mar 01;64(3):303-310

Authors: Ciftci S, Keskin F, Abaci N, Akyuz F, Cakiris A, Badur S, Kaymakoglu S, Ustek D

Abstract
BACKGROUND: The HBV core protein plays a major role in host immune response. Mutations occurring in the HBV core gene may cause alterations in the major epitopes being effective in the host immune response. Until now, the persistent effects of core gene mutations on HBV infections have not been fully understood. The aim of this study is to analyze the core gene mutations for epitopes in the T lymphocytes [T helper (Th) and cytotoxic (CTL)] and B cell and C terminal region in patients with chronic hepatitis using ultra-deep pyrosequencing (UDPS) method.
METHODS: Eleven patients with chronic hepatitis B infection were included in the study. Amplification of the core gene was performed by a conventional PCR method. Mutations in the epitopes for T lymphocytes (Th and CTL) and B cell and in the C terminal region of HBV core gene were screened by UDPS. These mutations were analyzed in HBeAg positive and negative patients.
RESULTS: The minimum percentages of amino acid substitutions were found with 0.9% in HBeAg positive patients and 1.2% in negative patients. The number of missense mutation was higher in patients with HBeAg positive than negative patients (p < 0.005). The number of amino acid substitutions in the region of aa49 - 69 in the Th epitopes was found to be the highest in both HBeAg positive and negative patients. The mutation frequency was higher in the C-terminal region of the core protein compared to the Th, CTL, and B cell regions and these were more common in subjects with high-grade fibrosis. Some types of mutations (V27I, R47H, Y132I, R174STOP, S181P, Q182K) were only detected in subjects with liver cirrhosis.
CONCLUSIONS: Unlike literature, our results show that there is no significant increase in number of mutations in the core gene of the virus during the anti-HBe positive period. The role of low abundance variants and mutations in the immune system can be understood using methods such as UDPS in the near future.

PMID: 29739114 [PubMed - in process]

https://ift.tt/2G1biNm

Combination of MicroRNAs and Cytokines: a Method for Better Evaluation of Acute-on-Chronic Liver Failure.

Combination of MicroRNAs and Cytokines: a Method for Better Evaluation of Acute-on-Chronic Liver Failure.

Clin Lab. 2018 Mar 01;64(3):247-256

Authors: Pu C, Jiang C, Lang L, Hui H, Wang Z, Ma D, Zhang Y

Abstract
BACKGROUND: The aim was to establish expression profiles of microRNAs (miRNAs) in Peripheral Blood Mononuclear Cells (PBMC) and of plasma cytokines from the patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) and high-risk of acute-on-chronic liver failure (ACLF) patients as well as healthy people and to examine the relationships between these profiles and clinical features.
METHODS: Herein, we collected PBMCs and plasma from peripheral blood of HBV-ACLF and ACLF patients as well as healthy people. Microarray, real-time qPCR, and ELISA assays were used.
RESULTS: In this study, we found 39 miRNAs including miR-146a, miR-150, and miR-29a downregulated and 5 miRNAs elevated in PBMCs from HBV-ACLF patients compared to healthy controls. However, elevated plasma levels of cytokines such as TNF-α, IFN-α, and TGF-β were found in PBMCs from HBV-ACLF patients compared with the controls, but no significant difference was found between the high-risk and control groups. MiR-146a, miR-150, miR-29a, PTA, and anti-HBc were positively correlated with the survival of ACLF patients, while TNFα, IFN-α, INR, and TBiL were negatively correlated with the survival of these patients.
CONCLUSIONS: Combined examination of miRNAs in PBMCs and cytokines in plasma together is a better method for monitoring and evaluating HBV-ACLF patients.

PMID: 29739113 [PubMed - in process]

https://ift.tt/2jJk6ia

Identification of a Novel Nonsense Mutation in a Patient with Transfusion-Dependent Hb H Disease.

Identification of a Novel Nonsense Mutation in a Patient with Transfusion-Dependent Hb H Disease.

Clin Lab. 2018 Mar 01;64(3):371-374

Authors: Holtkamp N, Pistioli A, Rasenack T, Kiesewetter H, Heinze KG

Abstract
BACKGROUND: Hb H disease is a form of α-thalassemia. The high clinical variability is influenced by the exact combination of mutations. Here we report on a 29-year-old female patient from Afghanistan who received regular blood transfusions since her childhood.
METHODS: For diagnosis we employed Sanger sequencing, multiplex ligation-dependent probe amplification, hemoglobin-electrophoresis, and hematological analysis.
RESULTS: Molecular genetic analysis revealed a non-deletional Hb H genotype with two in cis point mutations in HBA1 (c.183G>T;p.Lys61Asn and c.184A>T;p.Lys62*) in addition to the common deletions α4.2 and α3.7 in HBA2. The nonsense-mutation p.Lys62* has not been described before. Hematological data were in accordance with the genetic findings.
CONCLUSIONS: We describe here a novel mutation in the HBA1 gene and support evidence for non-deletional type of Hb H leading to transfusion-dependent anemia.

PMID: 29739111 [PubMed - in process]

https://ift.tt/2KNYg9O

Comparison of New Liquid Chromatography-Mass Spectrometry Method and Enzyme-Multiplied Immunoassay Technique for Routine Therapeutic Drug Monitoring of.

Comparison of New Liquid Chromatography-Mass Spectrometry Method and Enzyme-Multiplied Immunoassay Technique for Routine Therapeutic Drug Monitoring of.

Clin Lab. 2018 Mar 01;64(3):277-285

Authors: Yuan G, Liu H, Shaikh AS, Zhang R, Li P, Wang B, Guo R

Abstract
BACKGROUND: Therapeutic drug monitoring of vancomycin is very valuable due to the good correlation between trough levels and clinical outcome. Therefore, it is important to accurately determine the concentration of vancomycin in patient plasma for adequate dose-adjustment. The objective of this study was to develop a new liquid chromatography-mass spectrometry (LC-MS) method for determination of vancomycin in patient plasma and compare the results with those obtained from enzyme-multiplied immunoassay technique (EMIT).
METHODS: After extraction by simple protein precipitation, vancomycin and bergenin (internal standard) were separated on a C18 column (150×4.6 mm, 5 µm) at 40°C by gradient elution with 0.1% formic acid and acetonitrile as the mobile phase and measured by electrospray ionization source in positive selective ion monitoring mode. Seventy-nine plasma samples from patients with severe infection were analyzed by enzyme-multiplied immunoassay technique and LC-MS method. MedCalc 15.2 software with Bland-Altman analysis and Passing-Bablok regression analysis was used for statistical analysis.
RESULTS: The weighted (1/x2) calibration curve of the validated LC-MS was linear within the concentration range of 0.25 - 40 µg/mL. The inter- and intra-day precisions (%RSD) were less than 10.0%. No significant matrix effect was observed in the relevant time ranges. Comparison of the two methods indicated that results of the LC-MS were close to that of EMIT with a correlation coefficient of 0.957. Upon Bland-Altman analysis, the bias amounted to 2.9 µg/mL (95% confidence intervals of -3.4 - 9.2 µg/mL).
CONCLUSIONS: The established LC-MS method and EMIT were both suitable for routine TDM of vancomycin.

PMID: 29739110 [PubMed - in process]

https://ift.tt/2G1rUoj

A Proposed Kinetic Model for the Diagnostic and Prognostic Value of WT1 and p53 in Acute Myeloid Leukemia.

A Proposed Kinetic Model for the Diagnostic and Prognostic Value of WT1 and p53 in Acute Myeloid Leukemia.

Clin Lab. 2018 Mar 01;64(3):357-363

Authors: Bani-Ahmad MA, Al-Sweedan SA, Al-Asseiri MA, Alkhatib AJ

Abstract
BACKGROUND: Wilms tumor (WT1) and p53 proteins were identified in the pathogenesis of several malignancies, including hematological malignancies. As a result of their interaction and diverse context-specific functions, this study aimed to emphasize the diagnostic and prognostic impacts of WT1 and p53 expression in acute myeloid leukemia (AML).
METHODS: Twelve bone marrow (BM) biopsies were obtained from AML patients who were diagnosed in accordance with the French-American-British diagnostic criteria. For comparative purposes, nine normal BM biopsies were included. The expression rate of WT1 and p53 were determined by an immunohistochemistry assay.
RESULTS: A significantly higher (p < 0.005) and strongly correlated ( = 0.855, p = 0.001) expression rates of WT1 and p53 were observed in the BM of AML patients in comparison to control BM. Furthermore, relapsed AML patients had significantly higher expression of WT1, but not p53, when compared to newly diagnosed patients. In regard of patient's responsiveness to chemotherapy, no significant difference was reported between good and poor responders. However, the relative ratio of p53 to WT1 expression was evidently correlated to the responsiveness groups (p < 0.05), where the ratio was observed to be significantly higher among poor responders. Poor responders were characterized by a statistically significant and dominant p53 expression (p53/WT1 > 1.0) while both good responding patients and control subjects had a dominant WT1 expression (p53/WT1 < 1.0).
CONCLUSIONS: The enhanced expression levels of WT1 and p53 proteins in the BM of AML patients is supportive of their intermediate role in the pathogenesis of the disease. WT1 expression rate may encompass a negative prognostic value of the disease. Furthermore, the ratio of p53/WT expression may serve as a hallmark of the patient's responsiveness to chemotherapy, where a dominant WT1 expression may reveal good responsiveness to chemotherapy. Herein, we are proposing a kinetic model where the p53/WT1 ratio might be useful as a laboratory approach to evaluate the prognostic value of AML including the patient's responsiveness to chemotherapeutic regimen.

PMID: 29739109 [PubMed - in process]

https://ift.tt/2IojkVY

Using Blood and Plasma MicroRNAs as a Non-Invasive Biomarker in Patients with Colorectal Cancer.

Using Blood and Plasma MicroRNAs as a Non-Invasive Biomarker in Patients with Colorectal Cancer.

Clin Lab. 2018 Mar 01;64(3):257-262

Authors: Stefanescu H, Muntean D, Pilut C, Diaconu M, Popescu R, Hutanu D, Moise M, Diana L, Nitu R, Cherecheanu AP, Negoita S, Iovan CV, Ungureanu E, Calu V, Ciuca I

Abstract
BACKGROUND: A high percentage of oncological patients die yearly because of colorectal cancer (CRC). Worldwide, CRC represents the fourth leading cause of death among oncological patients. Numerous studies have been conducted in order to identify new biomarkers for the early diagnosis of patients with CRC. From this point of view, an ideal biomarker is represented by the expression of microRNAs. In this paper, we wish to summarize the expressions of microRNAs in CRC and to present the pathophysiological and genetic interactions that microRNAs have with protein systems in these patients.
METHODS: For this paper, we looked into the studies available in scientific databases such as PubMed. For the search the following keywords have been used: "miRNAs expression", "colorectal cancer", "genetic polymorphisms in CRC", and "genetic biomarkers in CRC".
RESULTS: Modifying the expression of microRNAs can be used successfully both in diagnosing patients with CRC and in following their response to chemotherapy. Numerous studies have shown high specificity for certain microRNA species in the case of CRC. An extraordinary advantage of these biomarkers is represented by their non-invasive sampling from urine and blood. Moreover, a series of connections of microRNAs in some mechanisms involved in the appearance and development of CRC have been shown. Therefore, microRNAs can be named as the biomarker of the future, as well as the epigenetic targeted treatment for patients with CRC.
CONCLUSIONS: The expression of microRNAs can be successfully used in the evaluation and non-invasive monitoring of patients with CRC. However, further studies are needed regarding the expression of microRNAs and the connections these species have in the pathological mechanisms specific for CRC.

PMID: 29739108 [PubMed - in process]

https://ift.tt/2rziVW2

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 9 Μαΐου 2018

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