Statine nicht um jeden Preis in Palliativsituation absetzen

Multiples Myelom
Die Medikation auf das Notwendige zu reduzieren ist ein wichtiges Prinzip der Palliativmedizin in der letzten Lebensphase. Deshalb fallen Statine als primär präventiv eingesetzte Medikamente oft am Lebensende weg. Anders zu bewerten sind Statine aber bei Patienten mit Multiplem Myelom.

from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/1RMcIyF
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1mHHw7a
via IFTTT

Multiple analyses of factors related to complications in endoscopic sinus surgery.

Multiple analyses of factors related to complications in endoscopic sinus surgery.

J Chin Med Assoc. 2015 Dec 16;

Authors: Chou TW, Chen PS, Lin HC, Lee KS, Tsai HT, Lee JC, Leu YS, Wang YP

Abstract
BACKGROUND: This study was undertaken to evaluate whether endoscopic sinus surgery (ESS) with a microdebrider had an impact on complication rates, and to facilitate the determination of factors associated with complications in patients who underwent ESS at a tertiary referral center in Taiwan.
METHODS: This investigation was a retrospective study and literature review. We analyzed 997 consecutive patients who underwent ESS at Mackay Memorial Hospital in Taipei, Taiwan from January 2006 through February 2010. All data including those of patient medical information, and peri- and postoperative complications were provided by the surgeons involved in patient medical care. We analyzed the complication rates using the following 10 variables by univariate analysis and multivariate logistic regression: gender, age, Lund-Mackay score, polyp grading, previous sinonasal surgery, surgeon skill, adjunctive sinonasal surgery, mesenteric type of anterior ethmoid artery, Keros skull base type, and the use of a microdebrider.
RESULTS: Of the 997 patients in our study, 78 (7.8%) had complications. Major complications occurred in five patients (0.5%): two with cerebrospinal fluid rhinorrhea, one with medial rectus muscle damage, and two with retrobulbar hematoma. Minor complications were found in 73 patients (7.3%), which included 32 patients with perioperative estimated blood loss > 15% of the total estimated blood volume, 26 with lamina papyracea damage, two with orbital cellulitis, and 13 with postoperative bleeding. Univariate analysis showed that risk factors related to complication rate were advanced Lund-Mackay scores (scores 19-24), advanced polyp grading (Grades 2 and 3), inexperienced surgeon (resident), and microdebrider usage. However, multivariate analysis revealed that complication rate was linked to advanced Lund-Mackay scores (Scores 19-24), mesenteric type of anterior ethmoid artery, and inexperienced surgeon.
CONCLUSION: Overall, the results of our study showed that the ESS complication rate was 7.8%, with risk factors including advanced Lund-Mackay scores (19-24, odds ratio 10.4) and inexperienced surgeon. It was also noted that ESS with a microdebrider had no impact on complication rates, although the presence of a mesenteric type of anterior ethmoid artery proved to be a protective factor.

PMID: 26706826 [PubMed - as supplied by publisher]

from Head and Neck on PubMed via xlomafota13 on Inoreader http://ift.tt/1R2aRV0
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1QTQJ8T
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed - as supplied by publisher]

from Head and Neck on PubMed via xlomafota13 on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1QTQKcZ
via IFTTT

Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects and thrombotic microangiopathies. Marked increase of lactate dehydrogenase and hemosiderinuria are typical of intravascular hemolysis, as observed in paroxysmal nocturnal hemoglobinuria, and hyperferritinemia is associated with chronic hemolysis. Prosthetic valve replacement and stenting are also associated with intravascular and chronic hemolysis. Compensatory reticulocytosis may be inadequate/absent in case of marrow involvement, iron/vitamin deficiency, infections, or autoimmune reaction against bone marrow-precursors. Reticulocytopenia occurs in 20–40% of autoimmune hemolytic anemia cases and is a poor prognostic factor. Increased reticulocytes, lactate dehydrogenase, and bilirubin, as well as reduced haptoglobin, are observed in conditions other than hemolysis that may confound the clinical picture. Hemoglobin defines the clinical severity of hemolysis, and thrombocytopenia suggests a possible thrombotic microangiopathy or Evans' syndrome. A comprehensive clinical and laboratory evaluation is advisable for a correct diagnostic and therapeutic workup of the different hemolytic conditions.

from #Medicine via ola Kala on Inoreader http://ift.tt/1mHwOxr
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1YJZku2
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1NRmNoa
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1mHGbNJ
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1QTQISs
via IFTTT

Statine nicht um jeden Preis in Palliativsituation absetzen

Multiples Myelom
Die Medikation auf das Notwendige zu reduzieren ist ein wichtiges Prinzip der Palliativmedizin in der letzten Lebensphase. Deshalb fallen Statine als primär präventiv eingesetzte Medikamente oft am Lebensende weg. Anders zu bewerten sind Statine aber bei Patienten mit Multiplem Myelom.

from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/1RMcIyF
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1YJZkdF
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1NRmPwl
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed – as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UbeVS5
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1QTQJWu
via IFTTT

Irradiation of localized squamous cell carcinoma of the nasal vestibule.

Irradiation of localized squamous cell carcinoma of the nasal vestibule.

Head Neck. 2015 Dec 26;

Authors: Vanneste BG, Lopez-Yurda M, Tan IB, Balm AJ, Borst GR, Rasch CR

Abstract
BACKGROUND: The purpose of this study was to evaluate the long-term results of primary radiotherapy treatment for squamous cell carcinoma (SCC) of the nasal vestibule.
METHODS: Eighty-one patients were treated with external beam radiotherapy (EBRT) and/or interstitial radiotherapy (IRT) for a primary, localized, Wang classified SCC of the nasal vestibule.
RESULTS: Median follow-up was 38 months. T1 tumors were treated with IRT: we observed 1 local failure (at 13 months) among 48 patients (5-year local control rate of 97%). Most T2 tumors (20 of 26) were treated with EBRT. There were 8 local recurrences among 26 patients (5-year local control rate of 68%). For the T3 tumors (n = 7; all treated with EBRT), we observed local recurrence in 2 patients (5-year local control rate of 53%). The late-term side effects were relatively mild.
CONCLUSION: Local primary radiotherapy (either IRT for T1 or EBRT for T2/3) is an adequate treatment for SCC of the nasal vestibule with little late sequelae. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26706779 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaF8L
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cFT
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1NRmNnY
via IFTTT

Current and future biomarkers in allergic asthma.

Current and future biomarkers in allergic asthma.

Allergy. 2015 Dec 25;

Authors: Zissler UM, Bieren JE, Jakwerth CA, Chaker AM, Schmidt-Weber CB

Abstract
Diagnosis early in life, sensitization, asthma endotypes, monitoring of disease and treatment progression are key motivations for the exploration of biomarkers for allergic rhinitis and allergic asthma. The number of genes related to allergic rhinitis and allergic asthma increases steadily, however prognostic genes have not yet entered clinical application. We hypothesize that the combination of multiple genes may generate biomarkers with prognostic potential. The current review attempts to group more than 161 different potential biomarkers involved in respiratory inflammation to pave the way for future classifiers. The potential biomarkers are categorized into either epithelial or infiltrate-derived or mixed origin, epithelial biomarkers. Furthermore surface markers were grouped into cell-type specific categories. The current literature provides multiple biomarkers for potential asthma endotypes that are related to T cell phenotypes such as Th1, Th2, Th9, Th17, Th22 and Tregs and their lead cytokines. Eosinophilic and neutrophilic asthma endotypes are also classified by epithelium-derived CCL-26 and osteopontin, respectively. There are currently about 20 epithelium-derived biomarkers exclusively derived from epithelium, which are likely to innovate biomarker panels as they are easy to sample. This article systematically reviews and categorizes genes and collects current evidence that may promote these biomarkers to become part of allergic rhinitis or allergic asthma classifiers with high prognostic value. This article is protected by copyright. All rights reserved.

PMID: 26706728 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1ORnE80
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOndF
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1NRmPwf
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed – as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1ShE2nM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1NRmN7C
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4axY
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1QTQJFZ
via IFTTT

TPX2 promotes migration and invasion of human breast cancer cells.

TPX2 promotes migration and invasion of human breast cancer cells.

Asian Pac J Trop Med. 2015 Dec;8(12):1064-70

Authors: Yang Y, Li DP, Shen N, Yu XC, Li JB, Song Q, Zhang JH

Abstract
OBJECTIVE: To investigate the expression of targeting protein for Xenopus kinesin-like protein 2 (TPX2) in breast cancer tissue and to explore its role in proliferation, migration and invasion of breast cancer cells.
METHODS: The mRNA and protein expressions of TPX2 in breast cancer tissue and cell lines were assessed by quantitative RT-PCR and Western blot. The effect of TPX2 with RNA interference on proliferation, invasion and migration of breast cancer cells was observed by MTT and Transwell assays.
RESULTS: Both mRNA and protein expressions of TPX2 were upregulated in breast cancer tissues compared to tumor-adjacent tissue. TPX2 expression was also upregulated in breast cancer cell lines, and the TPX2 interfered by small interfering RNA could inhibit the proliferation, invasion and migration of breast cancer cells by inhibiting matrix metalloproteinase-2 and matrix metalloproteinase-9.
CONCLUSIONS: Significantly upregulated TPX2 expression is observed in breast cancer tissue and cells, and contributes to promote the proliferation, migration and invasion of breast cancer cells.

PMID: 26706681 [PubMed]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaDxq
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOkOQ
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1NRmPfL
via IFTTT

Small Cell Neuroendocrine Carcinomas Arising in the Head and Neck Region.

Small Cell Neuroendocrine Carcinomas Arising in the Head and Neck Region.

J Oral Maxillofac Surg. 2015 Nov 22;

Authors: Hosokawa S, Takahashi G, Baba S, Mineta H

Abstract
PURPOSE: This study evaluated the clinical factors associated with outcomes of head and neck small cell neuroendocrine carcinoma (SCNEC-HN).
MATERIALS AND METHODS: A retrospective review of clinical data was performed for 11 patients with SCNEC-HN treated at the Hamamatsu University Hospital (Hamamatsu, Japan). Clinical features, treatment methods, and outcomes were evaluated. The main outcome measurements were disease stage, patient age, primary tumor site, treatment procedures, and estimated survival rates. Survival rates were calculated using the Kaplan-Meier method.
RESULTS: Patients were followed for a mean of 40.0 months (range, 8 to 191 months). The 1-, 2-, and 5-year overall survival rates were 52.0, 20.8, and 10.4%, respectively. Rates did not differ significantly between the N2 and N0/1 groups, although the latter had a slightly better prognosis (P = .08).
CONCLUSION: Chemoradiotherapy was a reasonable treatment for patients with SCNEC-HN. Those with N0/1 or maxillary sinus SCNEC-HN had a better prognosis than those with N2 disease or cancers at other sites, respectively. However, more aggressive treatment might not be warranted even for patients with limited disease. The outcomes continue to be suboptimal, and more effective therapies are needed because most patients had local or distant failure.

PMID: 26706487 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGdVw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cFP
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1QTQGKq
via IFTTT

Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects and thrombotic microangiopathies. Marked increase of lactate dehydrogenase and hemosiderinuria are typical of intravascular hemolysis, as observed in paroxysmal nocturnal hemoglobinuria, and hyperferritinemia is associated with chronic hemolysis. Prosthetic valve replacement and stenting are also associated with intravascular and chronic hemolysis. Compensatory reticulocytosis may be inadequate/absent in case of marrow involvement, iron/vitamin deficiency, infections, or autoimmune reaction against bone marrow-precursors. Reticulocytopenia occurs in 20–40% of autoimmune hemolytic anemia cases and is a poor prognostic factor. Increased reticulocytes, lactate dehydrogenase, and bilirubin, as well as reduced haptoglobin, are observed in conditions other than hemolysis that may confound the clinical picture. Hemoglobin defines the clinical severity of hemolysis, and thrombocytopenia suggests a possible thrombotic microangiopathy or Evans' syndrome. A comprehensive clinical and laboratory evaluation is advisable for a correct diagnostic and therapeutic workup of the different hemolytic conditions.

from #Medicine via ola Kala on Inoreader http://ift.tt/1mHwOxr
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1YJZku2
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1mHGbNJ
via IFTTT

Statine nicht um jeden Preis in Palliativsituation absetzen

Multiples Myelom
Die Medikation auf das Notwendige zu reduzieren ist ein wichtiges Prinzip der Palliativmedizin in der letzten Lebensphase. Deshalb fallen Statine als primär präventiv eingesetzte Medikamente oft am Lebensende weg. Anders zu bewerten sind Statine aber bei Patienten mit Multiplem Myelom.

from #Medicine-SfakianakisAlexandros via o.lakala70 on Inoreader http://ift.tt/1RMcIyF
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1YJZkdF
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed – as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UbeVS5
via IFTTT

Irradiation of localized squamous cell carcinoma of the nasal vestibule.

Irradiation of localized squamous cell carcinoma of the nasal vestibule.

Head Neck. 2015 Dec 26;

Authors: Vanneste BG, Lopez-Yurda M, Tan IB, Balm AJ, Borst GR, Rasch CR

Abstract
BACKGROUND: The purpose of this study was to evaluate the long-term results of primary radiotherapy treatment for squamous cell carcinoma (SCC) of the nasal vestibule.
METHODS: Eighty-one patients were treated with external beam radiotherapy (EBRT) and/or interstitial radiotherapy (IRT) for a primary, localized, Wang classified SCC of the nasal vestibule.
RESULTS: Median follow-up was 38 months. T1 tumors were treated with IRT: we observed 1 local failure (at 13 months) among 48 patients (5-year local control rate of 97%). Most T2 tumors (20 of 26) were treated with EBRT. There were 8 local recurrences among 26 patients (5-year local control rate of 68%). For the T3 tumors (n = 7; all treated with EBRT), we observed local recurrence in 2 patients (5-year local control rate of 53%). The late-term side effects were relatively mild.
CONCLUSION: Local primary radiotherapy (either IRT for T1 or EBRT for T2/3) is an adequate treatment for SCC of the nasal vestibule with little late sequelae. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26706779 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaF8L
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cFT
via IFTTT

Current and future biomarkers in allergic asthma.

Current and future biomarkers in allergic asthma.

Allergy. 2015 Dec 25;

Authors: Zissler UM, Bieren JE, Jakwerth CA, Chaker AM, Schmidt-Weber CB

Abstract
Diagnosis early in life, sensitization, asthma endotypes, monitoring of disease and treatment progression are key motivations for the exploration of biomarkers for allergic rhinitis and allergic asthma. The number of genes related to allergic rhinitis and allergic asthma increases steadily, however prognostic genes have not yet entered clinical application. We hypothesize that the combination of multiple genes may generate biomarkers with prognostic potential. The current review attempts to group more than 161 different potential biomarkers involved in respiratory inflammation to pave the way for future classifiers. The potential biomarkers are categorized into either epithelial or infiltrate-derived or mixed origin, epithelial biomarkers. Furthermore surface markers were grouped into cell-type specific categories. The current literature provides multiple biomarkers for potential asthma endotypes that are related to T cell phenotypes such as Th1, Th2, Th9, Th17, Th22 and Tregs and their lead cytokines. Eosinophilic and neutrophilic asthma endotypes are also classified by epithelium-derived CCL-26 and osteopontin, respectively. There are currently about 20 epithelium-derived biomarkers exclusively derived from epithelium, which are likely to innovate biomarker panels as they are easy to sample. This article systematically reviews and categorizes genes and collects current evidence that may promote these biomarkers to become part of allergic rhinitis or allergic asthma classifiers with high prognostic value. This article is protected by copyright. All rights reserved.

PMID: 26706728 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1ORnE80
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOndF
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed – as supplied by publisher]

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1ShE2nM
via IFTTT

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.

Hear Res. 2015 Dec 16;

Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E

Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.

PMID: 26706707 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGeIM
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4axY
via IFTTT

TPX2 promotes migration and invasion of human breast cancer cells.

TPX2 promotes migration and invasion of human breast cancer cells.

Asian Pac J Trop Med. 2015 Dec;8(12):1064-70

Authors: Yang Y, Li DP, Shen N, Yu XC, Li JB, Song Q, Zhang JH

Abstract
OBJECTIVE: To investigate the expression of targeting protein for Xenopus kinesin-like protein 2 (TPX2) in breast cancer tissue and to explore its role in proliferation, migration and invasion of breast cancer cells.
METHODS: The mRNA and protein expressions of TPX2 in breast cancer tissue and cell lines were assessed by quantitative RT-PCR and Western blot. The effect of TPX2 with RNA interference on proliferation, invasion and migration of breast cancer cells was observed by MTT and Transwell assays.
RESULTS: Both mRNA and protein expressions of TPX2 were upregulated in breast cancer tissues compared to tumor-adjacent tissue. TPX2 expression was also upregulated in breast cancer cell lines, and the TPX2 interfered by small interfering RNA could inhibit the proliferation, invasion and migration of breast cancer cells by inhibiting matrix metalloproteinase-2 and matrix metalloproteinase-9.
CONCLUSIONS: Significantly upregulated TPX2 expression is observed in breast cancer tissue and cells, and contributes to promote the proliferation, migration and invasion of breast cancer cells.

PMID: 26706681 [PubMed]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaDxq
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOkOQ
via IFTTT

Small Cell Neuroendocrine Carcinomas Arising in the Head and Neck Region.

Small Cell Neuroendocrine Carcinomas Arising in the Head and Neck Region.

J Oral Maxillofac Surg. 2015 Nov 22;

Authors: Hosokawa S, Takahashi G, Baba S, Mineta H

Abstract
PURPOSE: This study evaluated the clinical factors associated with outcomes of head and neck small cell neuroendocrine carcinoma (SCNEC-HN).
MATERIALS AND METHODS: A retrospective review of clinical data was performed for 11 patients with SCNEC-HN treated at the Hamamatsu University Hospital (Hamamatsu, Japan). Clinical features, treatment methods, and outcomes were evaluated. The main outcome measurements were disease stage, patient age, primary tumor site, treatment procedures, and estimated survival rates. Survival rates were calculated using the Kaplan-Meier method.
RESULTS: Patients were followed for a mean of 40.0 months (range, 8 to 191 months). The 1-, 2-, and 5-year overall survival rates were 52.0, 20.8, and 10.4%, respectively. Rates did not differ significantly between the N2 and N0/1 groups, although the latter had a slightly better prognosis (P = .08).
CONCLUSION: Chemoradiotherapy was a reasonable treatment for patients with SCNEC-HN. Those with N0/1 or maxillary sinus SCNEC-HN had a better prognosis than those with N2 disease or cancers at other sites, respectively. However, more aggressive treatment might not be warranted even for patients with limited disease. The outcomes continue to be suboptimal, and more effective therapies are needed because most patients had local or distant failure.

PMID: 26706487 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGdVw
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cFP
via IFTTT

ICBM-NY - a highly detailed volume conductor model for EEG source localization and TCS targeting.

ICBM-NY - a highly detailed volume conductor model for EEG source localization and TCS targeting.

Neuroimage. 2015 Dec 16;

Authors: Huang Y, Parra LC, Haufe S

Abstract
In source localization of electroencephalograpic (EEG) signals, as well as in targeted transcranial current stimulation (TCS), a volume conductor model is required to describe the flow of electric currents in the head. Boundary element models (BEM) can be readily computed to represent major tissue compartments, but cannot encode detailed anatomical information within compartments. Finite element models (FEM) can capture more tissue types and intricate anatomical structures, but with the higher precision also comes the need for semi-automated segmentation, and a higher computational cost. In either case, adjusting to the individual human anatomy requires costly magnetic resonance imaging (MRI), and thus head modeling is often based on the anatomy of an 'arbitrary' individual (e.g. Colin27). Additionally, existing reference models for the human head often do not include the cerebro-spinal fluid (CSF), and their field of view excludes portions of the head and neck - two factors that demonstrably affect current-flow patterns. Here we present a highly detailed FEM, which we call ICBM-NY. It is based on the ICBM152 anatomical template (a non-linear average of the MRI of 152 adult human brains), for which we extended the field of view to the neck, and performed a detailed segmentation of six tissue types (scalp, skull, CSF, gray matter, white matter, air cavities) at 0.5mm(3) resolution. The model was solved for 231 electrode locations. To evaluate its performance, additional FEMs and BEMs were constructed for four individual subjects. Each of the four individual FEMs (regarded as the 'ground truth') is compared to its BEM counterpart, the ICBM-NY, a BEM of the ICBM anatomy, an 'individualized' BEM of the ICBM anatomy warped to the individual head surface, and FEMs of the other individuals. Performance is measured in terms of EEG source localization and TCS targeting errors. Results show that the ICBM-NY outperforms FEMs of mismatched individual anatomies as well as the BEM of the ICBM anatomy according to both criteria. We therefore propose the ICBM-NY as a new standard head model to be used in future EEG and TCS studies whenever an individual MRI is not available. We release all model data online to facilitate broad adoption.

PMID: 26706450 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaDh5
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOndD
via IFTTT

Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada.

Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada.

Cancer Epidemiol. 2015 Dec 16;40:102-112

Authors: Chu KP, Habbous S, Kuang Q, Boyd K, Mirshams M, Liu FF, Espin-Garcia O, Xu W, Goldstein D, Waldron J, O'Sullivan B, Huang SH, Liu G

Abstract
BACKGROUND: Despite universal healthcare in some countries, lower socioeconomic status (SES) has been associated with worse cancer survival. The influence of SES on head and neck cancer (HNC) survival is of immense interest, since SES is associated with the risk and prognostic factors associated with this disease.
PATIENTS AND METHODS: Newly diagnosed HNC patients from 2003 to 2010 (n=2124) were identified at Toronto's Princess Margaret Cancer Centre. Principal component analysis was used to calculate a composite score using neighbourhood-level SES variables obtained from the 2006 Canada Census. Associations of SES with overall survival were evaluated in HNC subsets and by p16 status (surrogate for human papillomavirus).
RESULTS: SES score was higher for oral cavity (n=423) and p16-positive oropharyngeal cancer (OPC, n=404) patients compared with other disease sites. Lower SES was associated with worse survival [HR 1.14 (1.06-1.22), p=0.0002], larger tumor staging (p<0.001), current smoking (p<0.0001), heavier alcohol consumption (p<0.0001), and greater comorbidity (p<0.0002), but not with treatment regimen (p>0.20). After adjusting for age, sex, and stage, the lowest SES quintile was associated with the worst survival only for OPC patients [HR 1.66 (1.09-2.53), n=832], primarily in the p16-negative subset [HR 1.63 (0.96-2.79)]. The predictive ability of the prognostic models improved when smoking/alcohol was added to the model (c-index 0.71 vs. 0.69), but addition of SES did not (c-index 0.69).
CONCLUSION: SES was associated with survival, but this effect was lost after accounting for other factors (age, sex, TNM stage, smoking/alcohol). Lower SES was associated with greater smoking, alcohol consumption, comorbidity, and stage.

PMID: 26706365 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGebU
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cpz
via IFTTT

In Vitro Capture of Small Ferrous Particles with a Magnetic Filtration Device Designed for Intravascular Use with Intraarterial Chemotherapy: Proof-of-Concept Study.

In Vitro Capture of Small Ferrous Particles with a Magnetic Filtration Device Designed for Intravascular Use with Intraarterial Chemotherapy: Proof-of-Concept Study.

J Vasc Interv Radiol. 2015 Dec 16;

Authors: Mabray MC, Lillaney P, Sze CH, Losey AD, Yang J, Kondapavulur S, Liu D, Saeed M, Patel A, Cooke D, Jun YW, El-Sayed I, Wilson M, Hetts SW

Abstract
PURPOSE: To establish that a magnetic device designed for intravascular use can bind small iron particles in physiologic flow models.
MATERIALS AND METHODS: Uncoated iron oxide particles 50-100 nm and 1-5 µm in size were tested in a water flow chamber over a period of 10 minutes without a magnet (ie, control) and with large and small prototype magnets. These same particles and 1-µm carboxylic acid-coated iron oxide beads were likewise tested in a serum flow chamber model without a magnet (ie, control) and with the small prototype magnet.
RESULTS: Particles were successfully captured from solution. Particle concentrations in solution decreased in all experiments (P < .05 vs matched control runs). At 10 minutes, concentrations were 98% (50-100-nm particles in water with a large magnet), 97% (50-100-nm particles in water with a small magnet), 99% (1-5-µm particles in water with a large magnet), 99% (1-5-µm particles in water with a small magnet), 95% (50-100-nm particles in serum with a small magnet), 92% (1-5-µm particles in serum with a small magnet), and 75% (1-µm coated beads in serum with a small magnet) lower compared with matched control runs.
CONCLUSIONS: This study demonstrates the concept of magnetic capture of small iron oxide particles in physiologic flow models by using a small wire-mounted magnetic filter designed for intravascular use.

PMID: 26706187 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaF8x
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOndB
via IFTTT

Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma.

Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma.

Head Neck. 2015 Dec 26;

Authors: Wong BY, Stafford ND, Green VL, Greenman J

Abstract
BACKGROUND: The neutrophil/lymphocyte ratio (NLR) has been found to be predictive of survival outcome in a range of tumors. The purpose of this study was to investigate the prognostic value of pretreatment (NLR) in patients with laryngeal squamous cell carcinoma (SCC).
METHODS: A retrospective analysis of 140 patients with laryngeal SCC treated between 2005 and 2010 in the Hull and East Yorkshire Hospitals NHS Trust was carried out. Patient records were evaluated and both pretreatment neutrophil and lymphocyte counts were documented together with survival data, sex, smoking status, nodal classification, and disease staging.
RESULTS: An elevated NLR was significantly associated with advanced disease stage (eg, node-positive and tumors stage III and IV). In addition, a high NLR was significantly associated with poor overall survival (OS) but not disease-free survival (DFS) on multivariate analysis, with the greatest significance seen in patients with the highest NLR.
CONCLUSION: Pretreatment NLR may serve as a useful prognostic marker in laryngeal SCC; however, a large prospective study is required to determine an optimal NLR cutoff value. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26706179 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGdon
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cpx
via IFTTT

Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes.

Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes.

Head Neck. 2015 Dec 26;

Authors: Lewis GD, Holliday EB, Kocak-Uzel E, Hernandez M, Garden AS, Rosenthal DI, Frank SJ

Abstract
BACKGROUND: Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes.
METHODS: Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records.
RESULTS: There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%.
CONCLUSION: We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26705956 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1ShCQkm
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOkOM
via IFTTT

What Do We Know About Education in Colorectal Cancer Prevention?-Survey Among 1130 Medical Students.

What Do We Know About Education in Colorectal Cancer Prevention?-Survey Among 1130 Medical Students.

J Cancer Educ. 2015 Dec 26;

Authors: Pietrzyk Ł, Torres A, Denisow-Pietrzyk M, Torres K

Abstract
Colorectal cancer (CRC) is a global public health problem. The degree of knowledge on CRC among medical students, future physicians, brings essential implications for their patients. Therefore, to acquire information about students' knowledge on CRC, a questionnaire survey was conducted in Medical University of Lublin, Poland, with a representative sample of 1130 medical students (basic vs. clinical 552 vs. 578; male vs. female 442 vs. 688). The questionnaire was anonymous and designed in a four-section scheme (CRC risk factors, CRC prevention, CRC symptoms, CRC screening methods). There was a significant difference in the percentage of correct answers between basic and clinical level groups (P = 0.034). In general, clinical students had higher scores for their knowledge regarding CRC. Gender impacted the students' CRC knowledge to a lesser degree; however, if the difference was revealed, female students were more aware about CRC issues (P = 0.045). We found several important deficits in students' knowledge on CRC. These findings should motivate the oncology education coordinator as well as our teachers to introduce innovations in education methods and training environments to enable students to gain necessary knowledge and acquire the skills and competencies that would help them to function as physicians.

PMID: 26706466 [PubMed - as supplied by publisher]

from #PubMed 3 via ola Kala on Inoreader http://ift.tt/1OmP3y9
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cpt
via IFTTT

Molecular epidemiology of nonencapsulated Streptococcus pneumoniae among Japanese children with acute otitis media.

Molecular epidemiology of nonencapsulated Streptococcus pneumoniae among Japanese children with acute otitis media.

J Infect Chemother. 2015 Dec 16;

Authors: Hotomi M, Nakajima K, Hiraoka M, Nahm MH, Yamanaka N

Abstract
The introduction of pneumococcal conjugate vaccine may change the epidemiology of Streptococcus pneumoniae. The increased prevalence of non-vaccine serotypes as the cause of pneumococcal diseases has already reported in the United States and Europe. However, little attention has been focused on the S. pneumoniae. In this study, nonencapsulated S. pneumoniae were identified in 15 isolates (6.4%) out of 236 pneumococcal strains obtained from the nasopharynges of children with acute otitis media (AOM), in 3 isolates (14.3%) out of 21 strains from acute rhinosinusitis, and in 2 isolates (12.5%) out of 16 nasopharyngeal carriage strains obtained from normal healthy children. Among the 20 nonencapsulated S. pneumoniae isolates, 15 (75.0%) isolates had the pspK gene. Seven sequence types (STs) were identified: ST7502 (5 strains), ST1106 (2 strains), ST7803 (2 strains), ST7786 (1 strain), ST6741 (1 strain), ST7496 (1 strain), and ST8642 (1 strain). Because nonencapsulated S. pneumoniae strains are not targeted by the current available pneumococcal vaccines, these strains will gradually become more common in nasopharyngeal carriage. The increase in colonization and dissemination of these strains would increase the risk of AOM and other systemic pneumococcal diseases against which current vaccines cannot provide protection. Nonencapsulated S. pneumoniae may thus become more prevalent as human pathogen.

PMID: 26705748 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGd7L
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOndv
via IFTTT

Intensity-modulated radiotherapy for head and neck surgeons.

Intensity-modulated radiotherapy for head and neck surgeons.

Head Neck. 2015 Dec 26;

Authors: Gutiontov SI, Shin EJ, Lok B, Lee NY, Cabanillas R

Abstract
The development of intensity-modulated radiotherapy (IMRT) has played a major role in improving outcomes and decreasing morbidity in patients with head and neck cancer. This review addresses this vital modality with a focus on the important role of the head and neck surgeon. The technique as well as its benefits and points of caution are outlined, the definitions of tumor and treatment volumes are discussed, and the dose and fractionation are detailed. Following this are several sections dedicated to the role of the head and neck surgeon in the planning of both definitive and postoperative radiotherapy to the primary site and neck. There is a focus throughout on anatomic and surgical considerations; commonly encountered situations are illustrated. With a deeper understanding of this technique and their own pivotal contribution to target delineation, head and neck surgeons will be poised to expand their role and improve cancer care for their patients. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26705685 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1JCaESd
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4axU
via IFTTT

Sturge-Weber Syndrome: Brain Magnetic Resonance Imaging and Neuropathology Findings.

Sturge-Weber Syndrome: Brain Magnetic Resonance Imaging and Neuropathology Findings.

Pediatr Neurol. 2015 Nov 26;

Authors: Pinto AL, Chen L, Friedman R, Grant PE, Poduri A, Takeoka M, Prabhu SP, Sahin M

Abstract
BACKGROUND: We describe the brain magnetic resonance imaging (MRI) abnormalities and neuropathologic findings in patients with Sturge-Weber syndrome and medically refractory epilepsy.
METHODS: We retrospectively reviewed the clinical features, preoperative MRI studies, and pathologic findings of all patients with Sturge-Weber syndrome who underwent excisional surgery for intractable epilepsy at Boston Children's Hospital between 1993 and 2011.
RESULTS: Eleven patients (male/female = 4/7) with Sturge-Weber syndrome were identified who underwent surgery for intractable epilepsy (mean age 13 ± 6.2 months), including hemispherectomy (n = 10) and focal cortical resection (n = 1). Mean age at seizure onset was 15 ± 11 weeks. Fifty-five percent (n = 6) of patients exhibited two different types of seizures, and 18% (n = 2) had three types of seizures. Focal clonic seizures were the most common type, occurring in nine patients; apnea was the second most common, occurring in four patients. Brain MRIs were reviewed in five patients. Histopathologic examination revealed signs of varied degrees of cortical morphologic anomaly in seven of 11 patients. Overall, there were no abnormalities in the MRIs that corresponded directly with the pathologic findings except in one patient with polymicrogyria.
CONCLUSIONS: In spite of pathologic findings of cortical anomalies in varied degrees, these findings could not be readily detected on brain MRIs. The failure to detect focal cortical dysplasia on MRIs may be attributable to the subtle microscopic nature of the abnormalities; in some of the older individuals, the imaging studies available for review were done during an advanced stage of the disease.

PMID: 26706049 [PubMed - as supplied by publisher]

from #PubMed 3 via ola Kala on Inoreader http://ift.tt/1mcw7MB
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1IwOndr
via IFTTT

Carotid intima-medial thickness as a marker of radiation-induced carotid atherosclerosis.

Carotid intima-medial thickness as a marker of radiation-induced carotid atherosclerosis.

Radiother Oncol. 2015 Dec 16;

Authors: Gujral DM, Shah BN, Chahal NS, Bhattacharyya S, Hooper J, Senior R, Harrington KJ, Nutting CM

Abstract
PURPOSE: Arterial thickening is a precursor to atherosclerosis. Carotid intima-medial thickness (CIMT), a measure of arterial thickening, is a validated surrogate for prediction of cerebrovascular events. This study investigates CIMT as an early marker of radiation-induced carotid artery damage.
MATERIALS/METHODS: Head and neck cancer patients treated with radiotherapy (RT) (minimum dose of 50Gy) to one side of the neck (unirradiated side as control) at least 2years previously were included. CIMT was measured in 4 arterial segments: proximal, mid, distal common carotid artery (CCA), and bifurcation and were compared to corresponding unirradiated segments. CIMT measurements >75th percentile of a reference population were considered abnormal and at increased cerebrovascular risk.
RESULTS: 50 patients (34 males) with a median age of 58 years (interquartile range (IQR) 50-62) were included. The mean maximum dose to the irradiated and unirradiated artery was 53Gy (standard deviation (SD) 13Gy) and 1.9Gy (SD 3.7Gy), respectively. Mean CIMT was significantly greater in irradiated versus unirradiated arteries: proximal CCA (0.76mm ±0.15 vs 0.68mm ±0.14 (p<0.0001), mid CCA (0.74mm ±0.2 vs 0.68mm ±0.16 (p=0.01), distal CCA (0.77mm ±0.2 vs 0.68mm ±0.15 (p=0.004), and bifurcation (0.85mm ±0.25 vs 0.72mm ±0.17 (p=0.001). For all arterial segments, a significantly greater number of CIMT measurements were abnormal on the irradiated side (proximal: p=0.004, mid: p=0.05, distal: p=0.005, bifurcation: p=0.03). There was no effect of time from RT, age, smoking status, surgery and chemotherapy on CIMT difference (irradiated-unirradiated) in all segments.
CONCLUSIONS: CIMT is increased after RT and may be a useful marker of radiation-induced carotid atherosclerosis. There appears to be no additional effect of other atherosclerotic risk factors on CIMT following RT.

PMID: 26705683 [PubMed - as supplied by publisher]

from #PubMed 1 via ola Kala on Inoreader http://ift.tt/1PqGcRp
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Vl4cpp
via IFTTT

What Do We Know About Education in Colorectal Cancer Prevention?-Survey Among 1130 Medical Students.

What Do We Know About Education in Colorectal Cancer Prevention?-Survey Among 1130 Medical Students.

J Cancer Educ. 2015 Dec 26;

Authors: Pietrzyk Ł, Torres A, Denisow-Pietrzyk M, Torres K

Abstract
Colorectal cancer (CRC) is a global public health problem. The degree of knowledge on CRC among medical students, future physicians, brings essential implications for their patients. Therefore, to acquire information about students' knowledge on CRC, a questionnaire survey was conducted in Medical University of Lublin, Poland, with a representative sample of 1130 medical students (basic vs. clinical 552 vs. 578; male vs. female 442 vs. 688). The questionnaire was anonymous and designed in a four-section scheme (CRC risk factors, CRC prevention, CRC symptoms, CRC screening methods). There was a significant difference in the percentage of correct answers between basic and clinical level groups (P = 0.034). In general, clinical students had higher scores for their knowledge regarding CRC. Gender impacted the students' CRC knowledge to a lesser degree; however, if the difference was revealed, female students were more aware about CRC issues (P = 0.045). We found several important deficits in students' knowledge on CRC. These findings should motivate the oncology education coordinator as well as our teachers to introduce innovations in education methods and training environments to enable students to gain necessary knowledge and acquire the skills and competencies that would help them to function as physicians.

PMID: 26706466 [PubMed - as supplied by publisher]

from #PubMed 3 via ola Kala on Inoreader http://ift.tt/1OmP3y9
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1mHEmAl
via IFTTT

Sodium salicylate reduces the level of GABAB receptors in the rat's inferior colliculus.

Sodium salicylate reduces the level of GABAB receptors in the rat's inferior colliculus.

Neuroscience. 2015 Dec 16;

Authors: Butt S, Ashraf F, Porter L, Zhang H

Abstract
Previous studies have indicated that sodium salicylate can cause hearing abnormalities through affecting the central auditory system. In order to understand central effects of the drug, we examined how a single intraperitoneal injection of the drug changed the level of subunits of the type-B γ-aminobutyric acid receptor (GABAB receptor) in the rat's inferior colliculus. Immunohistochemical and western blotting experiments were conducted three hours following a drug injection, as previous studies indicated that a tinnitus-like behavior could be reliably induced in rats within this time period. Results revealed that both subunits of the receptor, GABABR1 and GABABR2, reduced their level over the entire area of the inferior colliculus. Such a reduction was observed in both cell body and neuropil regions. In contrast, no changes were observed in other brain structures such as the cerebellum. Thus, a coincidence existed between a structure-specific reduction in the level of GABAB receptor subunits in the inferior colliculus and the presence of a tinnitus-like behavior. This coincidence likely suggests that a reduction in the level of GABAB receptor subunits was involved in the generation of a tinnitus-like behavior and/or used by the nervous system to restore normal hearing following application of sodium salicylate.

PMID: 26705739 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OmP4Cd
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1mHEmAn
via IFTTT

Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.

Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.

Neuroscience. 2015 Dec 16;

Authors: Heeringa AN, Stefanescu RA, Raphael Y, Shore SE

Abstract
Vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) have distinct distributions in the cochlear nucleus that correspond to the sources of the labeled terminals. VGLUT1 is mainly associated with terminals of auditory nerve fibers, whereas VGLUT2 is mainly associated with glutamatergic terminals deriving from other sources that project to the cochlear nucleus (CN), including somatosensory and vestibular terminals. Previous studies in guinea pig have shown that cochlear damage results in a decrease of VGLUT1-labeled puncta and an increase in VGLUT2-labeled puncta. This indicates cross-modal compensation that is of potential importance in somatic tinnitus. To examine whether this effect is consistent across species and to provide a background for future studies, using transgenesis, the current study examines VGLUT expression profiles upon cochlear insult by intracochlear kanamycin injections in the mouse. Intracochlear kanamycin injections abolished ipsilateral ABR responses in all animals and reduced ipsilateral spiral ganglion neuron densities in animals that were sacrificed after four weeks, but not in animals that were sacrificed after three weeks. In all unilaterally deafened animals, VGLUT1 density was decreased in CN regions that receive auditory nerve fiber terminals, i.e. in the deep layer of the dorsal cochlear nucleus (DCN), in the interstitial region where the auditory nerve enters the CN, and in the magnocellular region of the antero- and posteroventral CN. In contrast, density of VGLUT2 expression was upregulated in the fusiform cell layer of the DCN and in the granule cell lamina, which are known to receive somatosensory and vestibular terminals. These results show that a cochlear insult induces cross-modal compensation in the cochlear nucleus of the mouse, confirming previous findings in guinea pig, and that these changes are not dependent on the occurrence of spiral ganglion neuron degeneration.

PMID: 26705736 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1mkwLqN
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UbehUR
via IFTTT

Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects and thrombotic microangiopathies. Marked increase of lactate dehydrogenase and hemosiderinuria are typical of intravascular hemolysis, as observed in paroxysmal nocturnal hemoglobinuria, and hyperferritinemia is associated with chronic hemolysis. Prosthetic valve replacement and stenting are also associated with intravascular and chronic hemolysis. Compensatory reticulocytosis may be inadequate/absent in case of marrow involvement, iron/vitamin deficiency, infections, or autoimmune reaction against bone marrow-precursors. Reticulocytopenia occurs in 20–40% of autoimmune hemolytic anemia cases and is a poor prognostic factor. Increased reticulocytes, lactate dehydrogenase, and bilirubin, as well as reduced haptoglobin, are observed in conditions other than hemolysis that may confound the clinical picture. Hemoglobin defines the clinical severity of hemolysis, and thrombocytopenia suggests a possible thrombotic microangiopathy or Evans' syndrome. A comprehensive clinical and laboratory evaluation is advisable for a correct diagnostic and therapeutic workup of the different hemolytic conditions.

from #Medicine via ola Kala on Inoreader http://ift.tt/1mHwOxr
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1mHEoIy
via IFTTT

How effective is postoperative packing in FESS patients? A critical analysis of published interventional studies

Abstract

The present study aimed to assess the clinical effectiveness of absorbable packing alone, non-absorbable packing alone, and absorbable versus non-absorbable packing in the postoperative care of FESS patients, regarding bleeding control, adhesion formation, wound healing, and overall patient comfort. Systematic literature review in Medline and other database sources until July 2013, and critical analysis of pooled data were conducted. Blinded prospective randomized control trials, prospective, and retrospective comparative studies were included in study selection. The total number of analyzed studies was 19. Placing packs in the middle meatus after endoscopic procedures does not seem to be harmful for postoperative patient care. Regarding the postoperative bleeding rate, absorbable packing is not superior to no postoperative packing (strength of recommendation A). Comparing absorbable to non-absorbable packing, the former one seems slightly more effective than the latter in the aforementioned domain (strength of recommendation C). Absorbable packing was also found more effective than non-absorbable packing as a means of reducing the postoperative adhesion rate (strength of recommendation B), and more effective in comparison with not placing any packing material at all (strength of recommendation C). Non-absorbable packing also proves more effective than no postoperative packing in preventing the appearance of such adhesions (strength of recommendation A). Absorbable packing is also more comfortable compared to non-absorbable materials (strength of recommendation A), or no postoperative packing in FESS patients (strength of recommendation B). The comparative analysis between the different packing modalities performed in the present study may help surgeons design a more individualized postoperative patient care.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/1ShonFa
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0yb
via IFTTT

Prescription of antibacterial agents for acute upper respiratory tract infections in Beijing, 2010-2012.

Prescription of antibacterial agents for acute upper respiratory tract infections in Beijing, 2010-2012.

Eur J Clin Pharmacol. 2015 Dec 26;

Authors: Wu Y, Yang C, Xi H, Zhang Y, Zhou Z, Hu Y

Abstract
PURPOSE: The purpose of this study was to describe the prescription of antibacterial agents for acute upper respiratory tract infections (URIs) in Beijing.
METHODS: A total of 8,588,699 outpatient cases in tertiary hospitals with acute upper respiratory tract infections (URIs) were selected from the Beijing Medical Claim Data for Employees (BMCDE) from Oct 2010 to Sep 2012. Second-generation cephalosporins, third-generation cephalosporins, fourth-generation cephalosporins, fluoroquinolones, macrolides (except for erythromycin), combinations of penicillins (including β-lactamase inhibitors), and streptomycins were classified as broad-spectrum antibacterial agents. The rates for antibiotic prescriptions and broad-spectrum antibiotic use were calculated in all cases as well as in various URI diagnosis subgroups and age (18-44, 45-64, and ≥65 years) subgroups. The most frequently prescribed antibiotic classes were identified by calculating the proportions of the different agents in all prescribed antibiotic agents.
RESULTS: Overall, the rate of antibiotic prescription is 39.0 %, and cases diagnosed with acute tonsillitis, sinusitis, and epiglottitis have the highest prescription rate (73.6 %), followed by acute laryngitis and bronchitis (52.3 %), acute pharyngitis (40.1 %), and acute nasopharyngitis (37.2 %). Broad-spectrum agents were chosen in 82.4 % of the cases that were prescribed antibiotics, ranging from 81.9 % of cases with naspharyngitis to 87.1 % of the cases with tonsillitis, sinusitis, and epiglottitis. Second-generation cephalosporins, macrolides, fluoroquinolones, third-generation cephalosporins, and combinations of penicillins were most frequently prescribed, accounting for more than 80 % of all prescribed antibacterials.
CONCLUSIONS: Antibacterial drug prescription for outpatients with acute URIs is common in tertiary hospitals in Beijing, and the prescribed antibacterials are usually broad-spectrum agents.

PMID: 26706249 [PubMed - as supplied by publisher]

from #PubMed 2 via ola Kala on Inoreader http://ift.tt/1OmP3OJ
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UbehUL
via IFTTT

How effective is postoperative packing in FESS patients? A critical analysis of published interventional studies

Abstract

The present study aimed to assess the clinical effectiveness of absorbable packing alone, non-absorbable packing alone, and absorbable versus non-absorbable packing in the postoperative care of FESS patients, regarding bleeding control, adhesion formation, wound healing, and overall patient comfort. Systematic literature review in Medline and other database sources until July 2013, and critical analysis of pooled data were conducted. Blinded prospective randomized control trials, prospective, and retrospective comparative studies were included in study selection. The total number of analyzed studies was 19. Placing packs in the middle meatus after endoscopic procedures does not seem to be harmful for postoperative patient care. Regarding the postoperative bleeding rate, absorbable packing is not superior to no postoperative packing (strength of recommendation A). Comparing absorbable to non-absorbable packing, the former one seems slightly more effective than the latter in the aforementioned domain (strength of recommendation C). Absorbable packing was also found more effective than non-absorbable packing as a means of reducing the postoperative adhesion rate (strength of recommendation B), and more effective in comparison with not placing any packing material at all (strength of recommendation C). Non-absorbable packing also proves more effective than no postoperative packing in preventing the appearance of such adhesions (strength of recommendation A). Absorbable packing is also more comfortable compared to non-absorbable materials (strength of recommendation A), or no postoperative packing in FESS patients (strength of recommendation B). The comparative analysis between the different packing modalities performed in the present study may help surgeons design a more individualized postoperative patient care.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/1ShonFa
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1OmPMiY
via IFTTT

Impact of Perioperative Blood Transfusion on Postoperative Complications and Prognosis of Gastric Adenocarcinoma Patients with Different Preoperative Hemoglobin Value

Background. The impact of perioperative blood transfusion on the prognosis of gastric adenocarcinoma patients is still controversial. The aim of this study was to elucidate the impact of perioperative blood transfusion on postoperative complications and prognosis of patients who underwent gastrectomy for gastric adenocarcinoma with different levels of preoperative hemoglobin value (POHb). Method. From 2003 to 2011, 1199 patients who underwent curative gastrectomy were retrospectively enrolled and followed up to December 2014. Clinicopathological features and survival outcomes were compared between transfused and nontransfused patients. Results. In this study, transfused patients had more postoperative complications than nontransfused ones (). In survival analysis, the difference was not significant between transfused and nontransfused patients with POHb between 70 and 100 g/L (). However, in patients with POHb >100 g/L, transfused patients had significantly worse prognosis (), especially in TNM III stage patients (). And intraoperative blood transfusion predicted poor prognosis (). Conclusion. Perioperative blood transfusion might lead to poor survival in gastric adenocarcinoma patients with POHb >100 g/L and transfused patients had more postoperative complications; thus it is better to refrain from unnecessary perioperative blood transfusion especially intraoperative transfusion.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1UbaDub
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0y9
via IFTTT

On the Existence and Stability of Standing Waves for 2-Coupled Nonlinear Fractional Schrödinger System

We study a system of 2-coupled nonlinear fractional Schrödinger equations. Firstly, we construct constrained minimization problem to the system. Next, we prove the existence of standing waves for the system by using the concentration-compactness and commutator estimates method. Lastly, we also consider the set of minimizers of the constrained minimization problem. We prove that it is a stable set for initial value of the problem; that is, a solution to the system with initial value which is near the set will remain near it for all time.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1UbaDu9
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote2pU
via IFTTT

Temporal Trends and Predictors of Modern Contraceptive Use in Lusaka, Zambia, 2004–2011

Introduction. Although increasing access to family planning has been an important part of the global development agenda, millions of women continue to face unmet need for contraception. Materials and Methods. We analyzed data from a repeated cross-sectional community survey conducted in Lusaka, Zambia, over an eight-year period. We described prevalence of modern contraceptive use, including long-acting reversible contraception (LARC), among female heads of household aged 16–50 years. We also identified predictors of LARC versus short-term contraceptive use among women using modern methods. Results and Discussion. Twelve survey rounds were completed between November 2004 and September 2011. Among 29,476 eligible respondents, 17,605 (60%) reported using modern contraception. Oral contraceptive pills remained the most popular method over time, but use of LARC increased significantly, from less than 1% in 2004 to 9% by 2011 (). Younger women (OR: 0.46, 95% CI: 0.34, 0.61) and women with lower levels of education (OR: 0.70, 95% CI: 0.56, 0.89) were less likely to report LARC use compared to women using short-term modern methods. Conclusions. Population-based assessments of contraceptive use over time can guide programs and policies. To achieve reproductive health equity and reduce unmet contraceptive need, future efforts to increase LARC use should focus on young women and those with less education.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1ShAnqg
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0hR
via IFTTT

Effect of Kinetin on Physiological and Biochemical Properties of Maize Seedlings under Arsenic Stress

The effects of different levels of kinetin (KT) application on the growth, biomass, contents of chlorophyll (Chl a, Chl b, and carotenoid), arsenic uptake, and activities of antioxidant enzymes in maize seedlings under arsenic (As) stress were investigated by a hydroponic experiment. The results showed that KT supplementation increased the biomass in terms of root length, root number, fresh weight, and seedling length, and KT treatments also improved the contents of Chl a, As uptake, and Chl a : b ratio compared to cases with As treatment alone. However, no significant changes were observed in carotenoid content, and a reduction was found in Chl b content of seedlings. KT also increased the activities of catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD) in the leaves of maize seedlings when 0.1 mg/L KT and As were applied, which decreased the content of malondialdehyde (MDA). These results suggested that KT could alleviate the toxicity of As to maize seedlings by keeping the stability of chlorophyll, enhancing the activities of antioxidant enzymes, and inhibiting the lipid peroxidation. In conclusion, the alleviation effect of KT in maize seedlings exposed to As stress was clearly observed in the present study.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1UbaDu7
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0hP
via IFTTT

Musculoskeletal Simulation for Assessment of Effect of Movement-Based Structure-Modifying Treatment Strategies

The better understanding of the complex mechanism between neural motor control and its resulting joint kinematics and muscle forces allows a better elucidation of the mechanisms behind body growth, aging progression, and disease development. This study aimed at investigating the impact of movement-based structure-modifying treatment strategies on joint kinematics, muscle forces, and muscle synergies of the gait with instrumented implant. A patient-specific musculoskeletal model was used to quantitatively assess the deviations of joint and muscle behaviors between the normal gait and 4 gait modifications (bouncy, medial thrust, midcrouch, and mtp (i.e., gait with forefoot strike)). Moreover, muscle synergy analysis was performed using EMG-based nonnegative matrix factorization. Large variation of 19 degrees and 190 N was found for knee flexion/extension and lower limb muscle forces, respectively. EMG-based muscle synergy analysis revealed that the activation levels of the vastus lateralis and tibialis anterior are dominant for the midcrouch gait. In addition, an important contribution of semimembranosus to the medial thrust and midcrouch gaits was also observed. In fact, such useful information could allow a better understanding of the joint function and muscle synergy strategies leading to deeper knowledge of joint and muscle mechanisms related to neural voluntary motor commands.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1UbaDtZ
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0hL
via IFTTT

Ketogenic diet – the practical details

← Older revision		Revision as of 10:40, 21 December 2015
Line 583:		Line 583:
|style=»height:30px; width:100px; text-align:center;» | Sauerkraut	|style=»height:30px; width:100px; text-align:center;» | Sauerkraut
|style=»height:30px; width:100px; text-align:center;» | 19	|style=»height:30px; width:100px; text-align:center;» | 19
−	|style=»height:30px; width:100px; text-align:center;» | 5.0	+	|style=»height:30px; width:100px; text-align:center;» | 1.4
|style=»height:30px; width:100px; text-align:center;» | 0.0	|style=»height:30px; width:100px; text-align:center;» | 0.0
|style=»height:30px; width:100px; text-align:center;» | 2.8	|style=»height:30px; width:100px; text-align:center;» | 2.8

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1ShAnq1
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0hH
via IFTTT

Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects and thrombotic microangiopathies. Marked increase of lactate dehydrogenase and hemosiderinuria are typical of intravascular hemolysis, as observed in paroxysmal nocturnal hemoglobinuria, and hyperferritinemia is associated with chronic hemolysis. Prosthetic valve replacement and stenting are also associated with intravascular and chronic hemolysis. Compensatory reticulocytosis may be inadequate/absent in case of marrow involvement, iron/vitamin deficiency, infections, or autoimmune reaction against bone marrow-precursors. Reticulocytopenia occurs in 20–40% of autoimmune hemolytic anemia cases and is a poor prognostic factor. Increased reticulocytes, lactate dehydrogenase, and bilirubin, as well as reduced haptoglobin, are observed in conditions other than hemolysis that may confound the clinical picture. Hemoglobin defines the clinical severity of hemolysis, and thrombocytopenia suggests a possible thrombotic microangiopathy or Evans' syndrome. A comprehensive clinical and laboratory evaluation is advisable for a correct diagnostic and therapeutic workup of the different hemolytic conditions.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1mHwOxr
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1OmJKPd
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1ShA26L
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote2pO
via IFTTT

Complimentary Imaging Modalities for Investigating Obscure Gastrointestinal Bleeding: Capsule Endoscopy, Double-Balloon Enteroscopy, and Computed Tomographic Enterography

Objectives. The complimentary value of computed tomographic enterography (CTE) and double-balloon enteroscopy (DBE) combined with capsule endoscopy (CE) was evaluated in the diagnosis of obscure gastrointestinal bleeding (OGIB). Methods. Patients who received CE examinations at Ruijin Hospital between July 2007 and July 2014 with the indication of OGIB were identified, and those who also underwent DBE and/or CTE were included. Their clinical information was retrieved, and results from each test were compared with findings from the other two examinations. Results. The overall diagnostic yield of CE was comparable with DBE (73.9% versus 60.9%) but was significantly higher than the yield of CTE (87% versus 25%, ). The diagnostic yield of angiodysplasia at CE was significantly higher than CTE (73% versus 8%, ) and DBE (39.1% versus 17.4%, ), while no significant difference was found between the three approaches for small bowel tumors. DBE and CTE identified small bowel diseases undetected or undetermined by CE. Conversely, CE improved diagnosis in the cases with negative CTE and DBE, and findings at initial CE directed further diagnosis made by DBE. Conclusions. Combination of the three diagnostic platforms provides complementary value in the diagnosis of OGIB.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1MBDZfn
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1PqAqPz
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ubakzp
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote0hD
via IFTTT

Capsule Endoscopy for Portal Hypertensive Enteropathy

Portal hypertensive enteropathy (PHE) is a mucosal abnormality of the small bowel that is observed in patients with portal hypertension (PH) and can lead to gastrointestinal bleeding and anemia. The pathogenesis is still not completely understood. The introduction of new endoscopic methods, including capsule endoscopy (CE) or balloon-assisted enteroscopy, has increased the detection of these abnormalities. CE can also serve as a road map for deciding subsequent interventions and evaluating the treatment effect. The prevalence of PHE is reportedly 40–70% in patients with PH. Endoscopic findings can be roughly divided into vascular and nonvascular lesions such as inflammatory-like lesions. Traditionally, PHE-associated factors include large esophageal varices, portal hypertensive gastropathy or colopathy, Child-Turcotte-Pugh class B or C, a history of variceal treatment, and acute gastrointestinal bleeding. More recently, on using scoring systems, a high computed tomography or transient elastography score was reportedly PHE-related factors. However, the prevalence of PHE and its related associated factors remain controversial. The management of PHE has not yet been standardized. It should be individualized according to each patient's situation, the availability of therapy, and each institutional expertise.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1mHwOh2
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1PqApeq
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1UbamqY
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote01n
via IFTTT

A Design of Double Broadband MIMO Antenna

The MIMO antenna applied to LTE mobile system should be miniaturization and can work in the current communication frequency band; isolation between each antenna unit also should be good so as to reduce loss of radio wave energy and improve the antenna performance of the MIMO system. This paper puts forward the design scheme of a broadband MIMO double antenna. And the design of antenna unit and debugging and related technical measures, such as bending antenna bracket, are both presented; the integration design of high isolation of ultra broadband MIMO antenna is realized on the plate with the volume of 100 × 52 × 0.8 mm3; antenna working bands are 698 MHz~960 MHz and 1710 MHz~2700 MHz; in the whole spectrum, the 10 dB of port isolation can be basically achieved; in low frequency band, the isolation degree of antenna port can reach 12 dB.

from #Medicine-Sfakianakis via simeraentaxei on Inoreader http://ift.tt/1MBDYZ1
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1PqApeo
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ubakzl
via IFTTT

from #Med Blogs by Alexandros G.Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/1Ote2pK
via IFTTT