Head and Neck Diseases by Alexandros G.Sfakianakis: 02/28/16

Κυριακή 28 Φεβρουαρίου 2016

Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis

OBJECTIVE: Determining the severity of sarcoidosis is based on the clinical and radiological findings of the disease and the changes in pulmonary function test results. On the other hand; studies are ongoing for objective and easy markers in this respect. Neutrophil/lymphocyte ratio (NLR) is shown as a good prognostic marker for inflammation due to tissue damage in recent clinical trials. In this study, we aimed to identify the possible relationship between NLR and radiological extent of sarcoidosis.

PATIENTS AND METHODS: Data of 122 patients included in the study were evaluated retrospectively in terms of age, gender, complete blood count parameters, erythrocyte sedimentation rate (ESR) and radiological findings at the time of diagnosis.

RESULTS: Mean NLR and ESR were significantly different between radiological stages according to chest radiography and also total HRCT score (THS) groups according to parenchymal involvement in thorax tomography (p <0.05). Mean NLR was found to be 1.28 in stage 0, 1.65 in stage 1, 2.88 in stage 2,5.47 in stage 3 and 8.48 in stage 4; 1.63 in THS group 1, 2.01 in group 2, 3.47 in group 3 and 5.46 in group 4. There were statistically significant positive correlations between NLR and WBC, NLR and THS, NLR and ESR, THS and ESR, ESR and platelet, WBC and #neutrophil, WBC and #lymphocyte.

CONCLUSIONS: Our findings suggest that NLR might be used as a prognostic marker in pulmonary sarcoidosis.

L'articolo Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis sembra essere il primo su European Review.

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Job burnout is associated with dysfunctions in brain mechanisms of voluntary and involuntary attention

Publication date: Available online 27 February 2016
Source:Biological Psychology
Author(s): Laura Sokka, Marianne Leinikka, Jussi Korpela, Andreas Henelius, Lauri Ahonen, Claude Alain, Kimmo Alho, Minna Huotilainen
Individuals with job burnout symptoms often report having cognitive difficulties, but related electrophysiological studies are scarce. We assessed the impact of burnout on performing a visual task with varying memory loads, and on involuntary attention switch to distractor sounds using scalp recordings of event-related potentials (ERPs). Task performance was comparable between burnout and control groups. The distractor sounds elicited a P3a response, which was reduced in the burnout group. This suggests burnout-related deficits in processing novel and potentially important events during task performance. In the burnout group, we also observed a decrease in working-memory related P3b responses over posterior scalp and increase over frontal areas. These results suggest that burnout is associated with deficits in cognitive control needed to monitor and update information in working memory. Successful task performance in burnout might require additional recruitment of anterior regions to compensate the decrement in posterior activity.

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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174

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Irisin/FNDC5 – An updated review

OBJECTIVE: The irisin, recently identified novel molecule, has been shown to be secreted from fibronectin type III domain containing 5 (FNDC5) of skeletal muscle by an unknown protease. It has been proposed that this molecule plays an important role in converting the white adipose tissue to brown adipose tissue and regulating the energy expenditure. Apart from this, its expression and role in various other conditions such as inflammation, hippocampal neurogenesis, aging and other metabolic conditions have been reported. However, due to conflicting results, several issues have been raised regarding its expression, cleavage, circulating levels, detection, excretion, designation, etc.

MATERIALS AND METHODS: Complete literature survey was performed using PubMed database search to gather available information regarding FNDC5/irisin.

RESULTS AND CONCLUSIONS: The present review discussed on the discovery of irisin, its possible role in physiological and pathological conditions and controversies. It also discussed the current challenges and future perspectives.

L'articolo Irisin/FNDC5 – An updated review sembra essere il primo su European Review.

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Psychosoziale Aspekte bei seltenen Krebserkrankungen

Psychoonkologie
Viele hämatologische und onkologische Erkrankungen zählen zu den „orphan diseases". Gleichzeitig werden einige dieser Erkrankungen durch optimierte und teilweise zielgerichtete Therapien „chronifizierbar". Welchen besonderen psychosozialen Belastungen sind betroffene Patienten ausgesetzt?

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Getting Better, but not Well: A 1.5 Year Follow-up of Cognitive Performance and Cortisol Levels in Clinical and Non-Clinical Burnout

Publication date: Available online 27 February 2016
Source:Biological Psychology
Author(s): Bart G. Oosterholt, Joseph H.R. Maes, Dimitri Van der Linden, Marc J.P.M. Verbraak, Michiel A.J. Kompier
The purpose was to reexamine cognitive performance and cortisol levels of initial clinical burnout patients, non-clinical burnout individuals, and healthy controls. After 1.5-years of the initial measurement, clinical burnout patients showed a reduction of burnout symptoms and general physical and psychological complaints, but these were still elevated compared with controls. Nonetheless, they continued to report cognitive problems and still showed a minor impaired cognitive test performance. However, they no longer reported larger subjective costs associated with cognitive test performance and their cortisol awakening response (CAR) returned to a normal level. Compared with controls, non-clinical burnout individuals still reported the same, elevated, level of burnout symptoms, general physical and psychological complaints, and cognitive problems. Their cognitive test performance and associated subjective costs remained normal. However, they seemed to continue to display a lowered CAR. To conclude, after 1.5-years, clinical burnout patients got better, but not 'well', and non-clinical burnout individuals remained not 'well'.

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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174

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Mycobacterial disease in patients with chronic granulomatous disease: A retrospective analysis of 71 cases

Publication date: Available online 28 February 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Francesca Conti, Saul Oswaldo Lugo-Reyes, Lizbeth Blancas Galicia, Jianxin He, Güzide Aksu, Edgar Borges de Oliveira, Caroline Deswarte, Marjorie Hubeau, Neslihan Karaca, Maylis de Suremain, Antoine Guérin, Laila Ait Baba, Carolina Prando, Gloria G. Guerrero, Melike Emiroglu, Fatma Nur Öz, Marco Antonio Yamazaki Nakashimada, Edith Gonzalez Serrano, Sara Espinosa, Isil Barlan, Nestor Pérez, Lorena Regairaz, Héctor Eduardo Guidos Morales, Liliana Bezrodnik, Daniela Di Giovanni, Ghassan Dbaibo, Fatima Ailal, Miguel Galicchio, Matias Oleastro, Jalel Chemli, Silvia Danielian, Laura Perez, Maria Claudia Ortega, Susana Soto Lavin, Joseph Hertecant, Ozden Anal, Nadia Kechout, Eman Al-Idrissi, Gehad ElGhazali, Anastasia Bondarenko, Liudmyla Chernyshova, Peter Ciznar, Rose-Marie Herbigneaux, Aminata Diabate, Stéphanie Ndaga, Barik Konte, Ambre Czarna, Mélanie Migaud, Sigifredo Pedraza-Sánchez, Mussaret Bano Zaidi, Guillaume Vogt, Stéphane Blanche, Imen Benmustapha, Davood Mansouri, Laurent Abel, Stéphanie Boisson-Dupuis, Nizar Mahlaoui, Ahmed Aziz Bousfiha, Capucine Picard, Ridha Barbouche, Saleh Al-Muhsen, Francisco J. Espinosa-Rosales, Necil Kütükçüler, Antonio Condino-Neto, Jean-Laurent Casanova, Jacinta Bustamante
BackgroundChronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by inborn errors of the phagocyte nicotinamide adenine dinucleotide phosphate oxidase complex. From the first year of life onward, most affected patients display multiple, severe, and recurrent infections caused by bacteria and fungi. Mycobacterial infections have also been reported in some patients.ObjectiveOur objective was to assess the effect of mycobacterial disease in patients with CGD.MethodsWe analyzed retrospectively the clinical features of mycobacterial disease in 71 patients with CGD. Tuberculosis and BCG disease were diagnosed on the basis of microbiological, pathological, and/or clinical criteria.ResultsThirty-one (44%) patients had tuberculosis, and 53 (75%) presented with adverse effects of BCG vaccination; 13 (18%) had both tuberculosis and BCG infections. None of these patients displayed clinical disease caused by environmental mycobacteria, Mycobacterium leprae, or Mycobacterium ulcerans. Most patients (76%) also had other pyogenic and fungal infections, but 24% presented solely with mycobacterial disease. Most patients presented a single localized episode of mycobacterial disease (37%), but recurrence (18%), disseminated disease (27%), and even death (18%) were also observed. One common feature in these patients was an early age at presentation for BCG disease. Mycobacterial disease was the first clinical manifestation of CGD in 60% of these patients.ConclusionMycobacterial disease is relatively common in patients with CGD living in countries in which tuberculosis is endemic, BCG vaccine is mandatory, or both. Adverse reactions to BCG and severe forms of tuberculosis should lead to a suspicion of CGD. BCG vaccine is contraindicated in patients with CGD.

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An inflammation-independent contraction mechanophenotype of airway smooth muscle in asthma

Publication date: Available online 28 February 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Steven S. An, Wayne Mitzner, Wan-Yee Tang, Kwangmi Ahn, A-Rum Yoon, Jessie Huang, Onur Kilic, Hwan Mee Yong, Jed W. Fahey, Sarvesh Kumar, Shyam Biswal, Stephen T. Holgate, Reynold A. Panettieri, Julian Solway, Stephen B. Liggett

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Reverse inference of memory retrieval processes underlying metacognitive monitoring of learning using multivariate pattern analysis

Publication date: 15 May 2016
Source:NeuroImage, Volume 132
Author(s): Peter Stiers, Luciana Falbo, Alexandros Goulas, Tamara van Gog, Anique de Bruin
Monitoring of learning is only accurate at some time after learning. It is thought that immediate monitoring is based on working memory, whereas later monitoring requires re-activation of stored items, yielding accurate judgements. Such interpretations are difficult to test because they require reverse inference, which presupposes specificity of brain activity for the hidden cognitive processes. We investigated whether multivariate pattern classification can provide this specificity. We used a word recall task to create single trial examples of immediate and long term retrieval and trained a learning algorithm to discriminate them. Next, participants performed a similar task involving monitoring instead of recall. The recall-trained classifier recognized the retrieval patterns underlying immediate and long term monitoring and classified delayed monitoring examples as long-term retrieval. This result demonstrates the feasibility of decoding cognitive processes, instead of their content.

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The utility of a multidomain assessment of steroid response for predicting clinical response to omalizumab

Publication date: Available online 28 February 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Louise Fleming, Maria Koo, Cara J. Bossley, Prasad Nagakumar, Andrew Bush, Sejal Saglani

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Electrophysiological evidence for flexible goal-directed cue processing during episodic retrieval

Publication date: 15 May 2016
Source:NeuroImage, Volume 132
Author(s): Jane E. Herron, Lisa H. Evans, Edward L. Wilding
A widely held assumption is that memory retrieval is aided by cognitive control processes that are engaged flexibly in service of memory retrieval and memory decisions. While there is some empirical support for this view, a notable exception is the absence of evidence for the flexible use of retrieval control in functional neuroimaging experiments requiring frequent switches between tasks with different cognitive demands. This absence is troublesome in so far as frequent switches between tasks mimic some of the challenges that are typically placed on memory outside the laboratory. In this experiment we instructed participants to alternate frequently between three episodic memory tasks requiring item recognition or retrieval of one of two different kinds of contextual information encoded in a prior study phase (screen location or encoding task). Event-related potentials (ERPs) elicited by unstudied items in the two tasks requiring retrieval of study context were reliably different, demonstrating for the first time that ERPs index task-specific processing of retrieval cues when retrieval goals change frequently. The inclusion of the item recognition task was a novel and important addition in this study, because only the ERPs elicited by unstudied items in one of the two context conditions diverged from those in the item recognition condition. This outcome constrains functional interpretations of the differences that emerged between the two context conditions and emphasises the utility of this baseline in functional imaging studies of retrieval processing operations.

Graphical abstract

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The Effect of Two Different Cognitive Tests on Gait Parameters during Dual Tasks in Healthy Postmenopausal Women

Introduction. The paper aims to evaluate the influence of two different demanding cognitive tasks on gait parameters using BTS SMART system analysis. Patients and Methods. The study comprised 53 postmenopausal women aged 64.5 ± 6.7 years (range: 47–79). For every subject, gait analysis using a BTS SMART system was performed in a dual-task study design under three conditions: (I) while walking only (single task), (II) walking while performing a simultaneous simple cognitive task (SCT) (dual task), and (III) walking while performing a simultaneous complex cognitive task (CCT) (dual task). Time-space parameters of gait pertaining to the length of a single support phase, double support phase, gait speed, step length, step width, and leg swing speed were analyzed. Results. Performance of cognitive tests during gait resulted in a statistically significant prolongation of the left (by 7%) and right (by 7%) foot gait cycle, shortening of the length of steps made with the right extremity (by 4%), reduction of speed of swings made with the left (by 11%) and right (by 8%) extremity, and reduction in gait speed (by 6%). Conclusions. Performance of cognitive tests during gait changes its individual pattern in relation to the level of the difficulty of the task.

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A Study of Using Massage Therapy Accompanied with Stretching Exercise for Rehabilitation of Mammary Gland Hyperplasia

Purpose. To apply massage therapy accompanied with stretching exercises for treatment of mammary gland hyperplasia, evaluate the clinical outcome in patients, and estimate the therapy as a novel treatment method for mammary hyperplasia. Methods. 28 adult female patients were selected and treated with massage therapy and stretching exercises focusing on skeleton muscles of chest, abdomen, and axilla. The mammary gland oxyhemoglobin (OxyHb) and deoxyhemoglobin (DeoxyHb) levels were detected before and after treatment after 15, 30, and 45 days. Results. In this cohort, pretreatment OxyHb (mean ± SD) is (medium-high), and DeoxyHb is (normal). All patients were clinically diagnosed with benign mammary gland hyperplasia and mastitis. The posttreatment OxyHb levels are (normal-medium, 15-day), (normal, 30-day), and (normal, 45-day), and DeoxyHb levels are (normal, 15-day), (normal, 30-day), and (normal, 45-day). Patients were diagnosed with decreased hyperplasia 15 and 30 days after treatment and with no symptom of hyperplasia in mammary gland 45 days after treatment. Conclusion. Mammary gland hyperplasia is closely correlated with pathological changes of skeletal muscles and could be significantly improved by massage therapy and stretching exercises targeting neighboring skeletal muscles.

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Mathematical Model for an Effective Management of HIV Infection

Human immunodeficiency virus infection destroys the body immune system, increases the risk of certain pathologies, damages body organs such as the brain, kidney, and heart, and causes death. Unfortunately, this infectious disease currently has no cure; however, there are effective retroviral drugs for improving the patients' health conditions but excessive use of these drugs is not without harmful side effects. This study presents a mathematical model with two control variables, where the uninfected CD4+T cells follow the logistic growth function and the incidence term is saturated with free virions. We use the efficacy of drug therapies to block the infection of new cells and prevent the production of new free virions. Our aim is to apply optimal control approach to maximize the concentration of uninfected CD4+T cells in the body by using minimum drug therapies. We establish the existence of an optimal control pair and use Pontryagin's principle to characterize the optimal levels of the two controls. The resulting optimality system is solved numerically to obtain the optimal control pair. Finally, we discuss the numerical simulation results which confirm the effectiveness of the model.

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Proanthocyanidins affects the neurotoxicity of Aβ25-35 on C57/bl6 mice

OBJECTIVE: To investigate the influence of procyanidins on the impairment of memory.

MATERIALS AND METHODS: Thirty male C57bl/6 mice were divided into five groups: low, middle, and high concentration, model, and control groups. Intracerebroventricular injection of β-amyloid25-35 in C57bl/6 mice caused an impairment of learning and memory. Next day, intragastric administration of procyanidins in the treatment group mice: (lower, middle and high concentration). Hoechst staining observed apoptosis of neuronal nuclei in the hippocampus. Immunohistochemistry determined synaptic remodeling reaction and the expression level of glial inflammatory response.

RESULTS: Compared with the model group, the proportion of neuronal apoptosis decreased in the hippocampal CA1 region of the treatment group. The Synaptic (SYN) density was increased, and the level of activated astrocytes and microglia expression in the hippocampus was decreased.

CONCLUSIONS: Procyanidins have a protective influence on Aβ25-35 mice hippocampus neuron, reducing nerve cell damage and eases learning and memory deficit.

L'articolo Proanthocyanidins affects the neurotoxicity of Aβ25-35 on C57/bl6 mice sembra essere il primo su European Review.

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Disseminated intravascular coagulation in secondary glioblastoma due to excessive intraoperative bleeding - case report and review of the literature.

Disseminated intravascular coagulation in secondary glioblastoma due to excessive intraoperative bleeding - case report and review of the literature.

World Neurosurg. 2016 Feb 24;

Authors: Pinggera D, Kerschbaumer J, Innerhofer N, Woehrer A, Freyschlag CF, Thomé C

Abstract
BACKGROUND: Disseminated intravascular coagulation (DIC) describes a pathological activation of coagulation mechanisms, leading to thrombi in various organs with contribution to multiple organ failure. In clinical practice, diagnosis of DIC can often be made by laboratory values, including prolonged coagulation times, thrombocytopenia or high levels of fibrin degradation products. DIC is frequently observed after neurotrauma, but rarely occurs in patients with primary brain tumors. There are only few case reports of DIC in patients with primary brain tumors, all sharing the highly elevated mortality. We report the case of a young patient presenting with secondary glioblastoma, who developed multi-organ failure induced by DIC following extensive intraoperative bleeding.
CASE DESCRIPTION: A 30-year-old patient was admitted in poor general condition with insomnia, severe headache and vomiting. She had undergone surgery for secondary glioblastoma twice. MRI revealed a left temporoparietal mass lesion with indication for resection. Surgery then was complicated by diffuse intraoperative bleeding due to a high content of microvascular proliferation as shown in the histopathological workup. Subsequently, an uncontrollable multi-organ failure developed, causing the patient`s death four days after surgery.
CONCLUSIONS: Although a rare complication, in excessive intraoperative bleeding, especially in surgery for brain tumors located next to the ventricular system, disseminated intravascular coagulation should be kept in mind as a possible diagnosis.

PMID: 26921703 [PubMed - as supplied by publisher]

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Radiological surveillance of untreated unruptured intracranial aneurysms: A single surgeon's experience.

Radiological surveillance of untreated unruptured intracranial aneurysms: A single surgeon's experience.

World Neurosurg. 2016 Feb 24;

Authors: Teo M, St George EJ

Abstract
BACKGROUND: The management of untreated unruptured intracranial aneurysms remains controversial, the natural history is still not well understood and many patients are not routinely followed up. We present a single surgeon's data on radiological surveillance of these lesions.
METHODS: 94 patients with 152 unruptured intracranial aneurysms, with a mean follow up time of 3.4years from the time of diagnosis, underwent surveillance using CTA, MRA or DSA. Aneurysm growth was defined as an increase in one or more dimensions above the measurement error. Statistical analysis was performed.
RESULTS: Of 152 aneurysms, 126 (83%) were less than 7mm, 25 (16%) were 7-12mm and 1 aneurysm was 13-24mm. 18 of 152 (12%) cerebral aneurysms in 17 patients grew larger. 7% (9/126) of aneurysm <7mm, and 36% (9/25) of aneurysm 7-12mm enlarged. Spontaneous aneurysmal rupture occurred in 4 of 152 (2.6%) of aneurysms, ie 4/94 patients (4%), with an average initial aneurysm size of 5.7mm. The risk of aneurysm rupture per patient-year was 5% with growth, 0.2% without growth and there was a 24-fold increase in aneurysmal rupture risk for growing aneurysm (p=0.005). 15% (16/109) of aneurysms in group 1(no previous SAH), compared to 5% (2/43) of group 2 (previous SAH) aneurysms showed evidence of growth during the study period (p=0.0424).
CONCLUSIONS: These results support imaging follow up of patients with untreated unruptured intracranial aneurysms, including those with aneurysms smaller than the current treatment threshold of 7mm. Apart from the initial size, aneurysm growth is also associated with an increased risk of SAH and therefore growing aneurysms warrant treatment. The data also demonstrated that incidental aneurysms, in patients without previous SAH, do not behave less aggressively, contrary to current opinion.

PMID: 26921702 [PubMed - as supplied by publisher]

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Postoperative stereotactic radiosurgery (SRS) utilizing 5 Gy X 5 sessions in the management of brain metastases.

Postoperative stereotactic radiosurgery (SRS) utilizing 5 Gy X 5 sessions in the management of brain metastases.

World Neurosurg. 2016 Feb 24;

Authors: Abuodeh Y, Ahmed KA, Naghavi AO, Venkat PS, Sarangkasiri S, Johnstone PA, Etame AB, Yu HM

Abstract
BACKGROUND: Multiple regimens for stereotactic radiosurgery to the post-operative bed have shown a high local control rate and a low toxicity profile with no decrease in overall survival with the omission of whole brain radiation therapy.
METHODS: In this retrospective analysis, we evaluate our experience with post-operative SRS using a uniform regimen of 25 Gy in 5 sessions.
RESULTS: Between April 2011 to May 2014, a total of 75 patients treated to 77 metastatic brain lesions with post-operative stereotactic radiosurgery in 5 sessions. The median PTV was 13.8 cm3 (1.93-128.43 cm3) with a median follow up for all lesions of 9.5 months (range 1.2-38.2 months). Kaplan-Meier estimates of local control at 1 and 2 years were 88.8% and 83.9%, respectively. On univariate analysis, a trend in decreased survival with multiple brain lesions was noted (HR=2 (95% CI 0.87-4.53), p=0.10). There was a trend towards decreased local control with radioresistant tumors (HR=3.23 (0.7-22.6), p=0.14) and PTV volume ≥ 17 cm3 (HR= 3.07 (0.73-15.23), p=0.12). Two (3%) patients developed radionecrosis, one of them required craniotomy.
CONCLUSION: SRS with a dose of 25 Gy in 5 sessions is associated with excellent local control at the resection site with minimal toxicity in the postoperative settings in our patient population. Further investigation is required to determine if dose escalation to the post-operative cavity of radioresistant tumors improves outcomes.

PMID: 26921701 [PubMed - as supplied by publisher]

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Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Expandable Technology: A Clinical and Radiographic Analysis of 50 Patients.

Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Expandable Technology: A Clinical and Radiographic Analysis of 50 Patients.

World Neurosurg. 2016 Feb 24;

Authors: Kim CW, Doerr TM, Luna IY, Joshua G, Shen SR, Fu X, Wu AM

Abstract
OBJECTIVE: Interbody cage implantation during minimally invasive surgery for transforaminal lumbar interbody fusion (MIS TLIF) presents challenges. Expandable cages when collapsed facilitate insertion; subsequent expansion in situ optimizes endplate contact. This report describes clinical and radiographic outcomes of MIS TLIF with an expandable cage.
METHODS: Researchers retrospectively analyzed prospective data from 50 patients (62 operative levels) when an expandable interbody spacer was combined with transpedicular posterior stabilization. Clinical outcomes, fusion rates, incidence of reoperation, and device-related complications were obtained from clinical and radiographic records.
RESULTS: Mean patient age was 58.1 years (56.2% female). In all, 76% (38/50) underwent single-level fusion, and 24% (12/50) two-level fusion. Average operative time was 239 ± 87 minutes for single-level and 350 ± 75 minutes for two-level procedures; average hospital stay overall was 2.5 ± 1.7 days, with no intraoperative complications reported. Mean visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores decreased significantly from preoperative to all postoperative assessment times (6, 12, and 24 months) (P < 0.05). Intervertebral disc height (8 ± 3 vs 11 ± 2 mm) increased significantly, with increases sustained over 24 months (P < 0.05). Postoperative radiographs showed no evidence of cage migration, subsidence, or collapse and suggested fusion at all operative levels by 12 months and 24 months (93%, 54/58; 97%, 28/29), respectively.
CONCLUSIONS: An expandable interbody cage led to significant improvement in clinical and radiographic outcomes following MIS TLIF, including intervertebral disc height restoration and high fusion rates, with no evidence of device-related complications.

PMID: 26921700 [PubMed - as supplied by publisher]

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The Efficacy of Antibacterial Prophylaxis against the Development of Meningitis after Craniotomy: a Meta-analysis.

The Efficacy of Antibacterial Prophylaxis against the Development of Meningitis after Craniotomy: a Meta-analysis.

World Neurosurg. 2016 Feb 24;

Authors: Alotaibi AF, Hulou MM, Vestal M, Alkholifi F, Asgarzadeh M, Cote DJ, Bi WL, Dunn IF, Mekary RA, Smith TR

Abstract
BACKGROUND: Prophylactic antibiotics are widely used before craniotomy to prevent postoperative infections.
OBJECTIVE: A systematic review and meta-analysis was conducted to examine the effect of prophylactic antibiotics on post-craniotomy meningitis.
METHODS: PubMed, EMBASE, and Cochrane databases were searched through October 2014 for randomized controlled trials (RCTs) that evaluated the effect of prophylactic antibiotics on post-craniotomy meningitis. Pooled effect estimates were calculated using fixed- and random-effects models.
RESULTS: Seven studies with 2365 patients were included in the final analysis. All studies were randomized controlled trials with different antibiotic regimens. Prophylactic antibiotic use reduced the rate of post-neurosurgical meningitis, with a pooled Peto Odds ratio of 0.34 (95% CI: 0.18; 0.63). Cochran's Q test indicated no significant heterogeneity among studies (I(2) =0%; P-for heterogeneity =0.44). Subgroup analysis based on gram-negative coverage, blinding design, and study quality demonstrated no statistically significant difference among these groups (P > 0.05 for all). A meta-regression on surgery duration (P=0.52) and on antibiotics duration (P=0.59) did not show significant differences in the results among studies.
CONCLUSION: This meta-analysis shows that prophylactic antibiotic use significantly decreases post-craniotomy meningitis infections.

PMID: 26921699 [PubMed - as supplied by publisher]

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The Negative Impact of Anemia on Outcome from Traumatic Brain Injury.

The Negative Impact of Anemia on Outcome from Traumatic Brain Injury.

World Neurosurg. 2016 Feb 24;

Authors: Litofsky NS, Martin S, Diaz J, Ge B, Petroski G, Miller DC, Barnes SL

PMID: 26921698 [PubMed - as supplied by publisher]

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Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience.

Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience.

BMC Cancer. 2016;16(1):162

Authors: Besic N, Schwarzbartl-Pevec A, Vidergar-Kralj B, Crnic T, Gazic B, Marolt Music M

Abstract
BACKGROUND: It is generally believed that patients with Hürthle cell thyroid carcinoma (HCTC) have a poor prognosis. Furthermore, distant metastases represent the most frequent cause of thyroid cancer-related death of patients with HCTC. The aim of this study was to report the treatment and outcomes of patients with distant metastases.
METHODS: Altogether 108 patients were treated for HCTC from 1972 to 2011 in our tertiary center and 32 patients (19 females, 13 males; median age 64.5 years) had either initially proven metastatic disease (N = 12) or distant progression of HCTC after initial treatment (N = 20). Patients with metastases were followed for 1-226 (median 77) months. Data were collected on the patients' gender and age, extent of their disease, morphologic characteristics, therapy, outcome, and survival rate. Statistical correlation between possible prognostic factors and cause-specific survival from time of detection of metastases was analyzed by univariate analysis and log-rank test.
RESULTS: The most common were lung metastases, followed by bone, mediastinum, kidney, and liver in 24, 8, 2, 1, and 1 case, respectively. Total thyroidectomy, lobectomy, subtotal thyroidectomy and neck dissection were performed in 19, 10, 3, and 7 patients, respectively. Radioiodine (RAI) ablation of thyroid remnant was performed in 30 patients, while 20 of them had RAI therapy (median 4 times). RAI uptake in metastases was present in 16 patients and ranged from 0.05 % to 12 %. Chemotherapy was used in 13 patients and external beam radiotherapy in 19 patients. Locoregional control of disease was achieved in 19/21 (90 %) cases who succumbed due to HCTC. Estimated 10-year disease-specific survival for all patients was 60 %. 10-year disease-specific survival for patients with pulmonary metastases and other sites metastases was 60 % and 62 %, respectively. 10-year disease-specific survival for patients with single organ and multiple organ metastases was 52 %, and 100 %, respectively. Estimated median disease-specific survival after the diagnosis of metastatic disease for all patients was 77 months. The median disease-specific survival after the diagnosis of metastatic disease for patients with pulmonary metastases and other sites metastases was 72 and 138 months, respectively.
CONCLUSIONS: Ten-year disease-specific survival for all patients with metastatic Hürthle cell thyroid carcinoma, patients with pulmonary metastases and bone metastases was 60 %, 60 % and 68 %, respectively.

PMID: 26921186 [PubMed – as supplied by publisher]

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Editorial Board/Aims and Scope

Publication date: 14 March 2016
Source:Vaccine, Volume 34, Issue 12

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Visible Light Induced Enhanced Photocatalytic Degradation of Industrial Effluents (Rhodamine B) in Aqueous Media Using TiO2 Nanoparticles

In recent years, new textile materials have been developed through the use of nanotechnology-based tools. The development of textile surfaces with self-cleaning properties has a large combined potential to reduce the environmental impact related to pollution. In this research work, three types of textiles substrates (cotton, Entretela, and polylactic acid (PLA)) were functionalized with titanium dioxide nanoparticles (TiO2) using chemical and mechanical processes (padding). During the functionalization process, two different methods were used, both of which allowed a good fixation of nanoparticles of TiO2 on textile substrates. The samples were examined for morphology and for photocatalytic properties under visible light irradiation. A study aimed at evaluating the effect of pH of the aqueous solution of TiO2 nanoparticles was performed in order to promote interaction between TiO2 and the dye solution rhodamine B (Rh-B). The TiO2 nanoparticles were characterized by X-ray diffraction (XRD). The measurement of the zeta potential of the TiO2 nanoparticle solution proved to be always positive and have low colloidal stability. Chromatography (HPLC and GC-MS) analyses confirm that oxalic acid is the intermediate compound formed during the photodegradation process.

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The Correlation of Serum Myeloid-Related Protein-8/14 and Eosinophil Cationic Protein in Patients with Coronary Artery Disease

Objective. To investigate the changes in serum Myeloid-Related Protein 8/14 (MRP8/14) and Eosinophil Cationic Protein (ECP) levels in patients with different types of coronary artery diseases (CAD) and assess the value of MRP8/14 and ECP detection in predicting CAD. Methods. 178 patients were divided into CAD group including unstable angina pectoris (UAP), acute myocardial infarction (AMI), and stable angina pectoris (SAP). Thirty-six individuals with normal coronary artery served as the control group. Serum MRP8/14 and ECP were measured by ELISA. The severity of coronary artery stenosis was assessed by the numbers of involved coronary artery branches and the sum of Gensini scores. Results. The MRP8/14 levels were significantly higher in AMI and UAP group than SAP and control group (). The levels of MRP8/14 in AMI group were also obviously higher than UAP group (). The ECP levels were obviously increased in AMI group, but there was no difference between SAP and UAP group (). The ECP was significantly increased in three impaired coronary arteries and obviously correlated with Gensini score (), whereas the MRP8/14 was obviously positively correlated with CRP (). Conclusions. Increased MRP8/14 levels suggest the instability of the atherosclerotic plaque. ECP reflects the severity of coronary arteries stenosis, predicting atherosclerosis burden. They may become the new biomarkers of CAD.

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Maternal Health-Related Quality of Life and Its Predicting Factors in the Postpartum Period in Iran

Background/Purpose. Postpartum period is accompanied by many physical, emotional, and social changes in women's health. The aim of this study was to examine the mothers' quality of life in postpartum period. In addition, it also sought to recognize the variables that predict their quality of life. Methods. This cross-sectional, descriptive study was undertaken among 380 women in 10 urban health centers in Ilam province in west of Iran. They were selected using proportional random sampling method. The SF-36 questionnaire was used to identify women's health-related quality of life (HRQoL). Data were analyzed using SPSS version 15. Results. Women who were employed, aged less than 30 years, had college degree, have no history of disease in pregnancy, and had given birth more than 3 months ago had higher quality of life scores. Independent predictors for lower physical HRQoL were being with history of disease in pregnancy; being with high school diploma or lower education; and giving birth less than 3 months ago. Also, independent predictor for lower mental HRQoL was being housewife. Conclusion. According to study findings, greater attention must be paid to providing postpartum healthcare for housewife and less educated women as well as those with history of disease in pregnancy.

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Fracture Propagation Characteristic and Micromechanism of Rock-Like Specimens under Uniaxial and Biaxial Compression

This paper presents a set of uniaxial and biaxial compression tests on the rock-like material specimens with different fracture geometries through a rock mechanics servo-controlled testing system (RMT-150C). On the basis of experimental results, the characteristics of fracture propagation under different fracture geometries and loading conditions are firstly obtained. The newly formed fractures are observed propagating from or near the preexisting crack tips for different specimens, while the propagation paths are affected by the loading condition obviously. Then, by adopting acoustic emission (AE) location technique, AE event localization characteristics in the process of loading are investigated. The locations of AE events are in good agreement with the macroscopic fracture propagation path. Finally, the micromechanism of macroscopic fracture propagation under uniaxial and biaxial compression conditions is analyzed, and the fracture propagation can be concluded as a result of microdamage accumulation inside the material. The results of this paper are helpful for theory and engineering design of the fractured rock mass.

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Effect of NSAIDs on the aminopeptidase activity of cultured human osteoblasts

Publication date: Available online 27 February 2016
Source:Molecular and Cellular Endocrinology
Author(s): G. Lucena, C. Reyes-Botella, O. García-Martínez, J. Ramos-Torrecillas, E. De Luna Bertos, C. Ruiz
Aminopeptidases (APs) are involved in various physiological and pathological processes. In tumor tissues the expression of APs, cyclooxygenase-2 and its metabolites are increased. The objective was to determine the effect of certain NSAIDs on the AP activity of osteoblasts. Primary cultures of osteoblast were treated with different concentrations of indomethacin, meloxicam, naproxen, nimesulide, and piroxicam. The AP activity was fluorimetrically determined using aminoacyl-β-naphthylamides (aa-βNAs) as substrates: Ala-βNA, Arg-βNA, Gly-βNA, Leu-βNA, Lys-βNA, Met-βNA, and Phe-βNA.The five NSAIDs showed an inhibitory effect of AP activity against the study substrates depending on the dose tested. Meloxicam and piroxicam had the highest inhibitory effect on enzymatic activity, with an IC50 of around 70 μM. Our results suggest that the physiological alteration of osteoblasts in the presence of NSAIDs may be a consequence of AP inhibition, suggesting a potential clinical role for these drugs against cancer in combination with chemotherapeutic agents.

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A 4D-Role Based Access Control Model for Multitenancy Cloud Platform

Since more and more applications and services have been transferred from servers in the B/S architecture to cloud, user access control has become a significant part in a multitenancy cloud platform. Role based access control model makes users participate in an enterprise system as particular identities. However, in a multitenancy cloud environment, it has a high probability that the information of tenants has been leaked by using existing role based access control (RBAC) model. Moreover, management problems may emerge in the multitenancy platform with the increment of the number of tenants. In this paper, a novel concept of 4D-role is presented. With a detailed definition on the concept of 4D-role, a 4D-role based multitenancy model is proposed for running various applications and services in the multitenancy cloud platform. A theoretical analysis indicates that the model has the characters of tenant isolation, role hierarchy, and administration independence. The three characters are also verified by experimental evaluation. Moreover, the evaluation results indicate that the model has a good performance in using cloud resources when large-scale users are operating in the cloud platform simultaneously.

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Vertical Handover Decision Algorithm Using Ants’ Colonies for 4G Heterogeneous Wireless Networks

With the development of 4G mobile telecommunication systems, providing users with the convenience of a seamless continuous connection is not enough anymore. Users want to be connected through the best available network with the best quality of service. It is necessary to have a good decision-making algorithm which decides whether it is necessary to perform handoff to another network, the best network to vertically perform handoff to, and the right time to initiate the handover. This paper proposes a new approach in which mobile terminals (MTs) continuously analyze the network and keep a database of the best available networks. The concept is based on QoS aware ant colony built on the vertical handoff mechanism that uses an updated version of ants' colony optimization decision algorithm (), the dynamic and static factors such as RSS, the cost of service, bandwidth, the velocity of MT, the power consumption and security, and the module for predicting the traveling distance within an IEEE 802.11 WLAN cell. Simulation results show that we can not only meet the individual needs of users in terms of QoS, but also improve the whole system performance by reducing the number of handover failures and unnecessary handover instances by up to 95%.

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Effect of a Balanced Concentration of Hydrogen on Graphene CVD Growth

The extraordinary properties of graphene make it one of the most interesting materials for future applications. Chemical vapor deposition (CVD) is the synthetic method that permits obtaining large areas of monolayer graphene. To achieve this, it is important to find the appropriate conditions for each experimental system. In our CVD reactor working at low pressure, important factors appear to be the pretreatment of the copper substrate, considering both its cleaning and its annealing before the growing process. The carbon precursor/hydrogen flow ratio and its modification during the growth are significant in order to obtain large area graphene crystals with few defects. In this work, we have focused on the study of the methane and the hydrogen flows to control the production of single layer graphene (SLG) and its growth time. In particular, we observe that hydrogen concentration increases during a usual growing process (keeping stable the methane/hydrogen flow ratio) resulting in etched domains. In order to balance this increase, a modification of the hydrogen flow results in the growth of smooth hexagonal SLG domains. This is a result of the etching effect that hydrogen performs on the growing graphene. It is essential, therefore, to study the moderated presence of hydrogen.

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Evaluating the case-positive, control test-negative study design for influenza vaccine effectiveness for the frailty bias

Publication date: Available online 28 February 2016
Source:Vaccine
Author(s): H. Keipp Talbot, Hui Nian, Qingxia Chen, Yuwei Zhu, Kathryn M. Edwards, Marie R. Griffin
IntroductionPrevious influenza vaccine effectiveness studies were criticized for their failure to control for frailty. This study was designed to see if the test-negative study design overcomes this bias.MethodsAdults≥50 years of age with respiratory symptoms were enrolled from November 2006 through May 2012 during the influenza season (excluding the 2009–2010 H1N1 pandemic season) to perform yearly test-negative control influenza vaccine effectiveness studies in Nashville, TN. At enrollment, both a nasal and throat swab sample were obtained and tested for influenza by RT-PCR. Frailty was calculated using a modified Rockwood Index that included 60 variables ascertained in a retrospective chart review giving a score of 0 to 1. Subjects were divided into three strata: non frail (≤0.08), pre-frail (>0.08 to <0.25), and frail (≥0.25). Vaccine effectiveness was calculated using the formula [1-adjusted odds ratio (OR)]×100%. Adjusted ORs for individual years and all years combined were estimated by penalized multivariable logistic regression.ResultsOf 1023 hospitalized adults enrolled, 866 (84.7%) participants had complete immunization status, molecular influenza testing and covariates to calculate frailty. There were 83 influenza-positive cases and 783 test-negative controls overall, who were 74% white, 25% black, and 59% female. The median frailty index was 0.167 (Interquartile: 0.117, 0.267). The frailty index was 0.167 (0.100, 0.233) for the influenza positive cases compared to 0.183 (0.133, 0.267) for influenza negative controls (p=0.07). Vaccine effectiveness estimates were 55.2% (95%CI: 30.5, 74.2), 60.4% (95%CI: 29.5, 74.4), and 54.3% (95%CI: 28.8, 74.0) without the frailty variable, including frailty as a continuous variable, and including frailty as a categorical variable, respectively.ConclusionsUsing the case positive test negative study design to assess vaccine effectiveness, our measure of frailty was not a significant confounder as inclusion of this measure did not significantly change vaccine effectiveness estimates.

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Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study

Publication date: Available online 27 February 2016
Source:Vaccine
Author(s): Hayley A. Hutchings, Annette Evans, Peter Barnes, Melanie A. Healy, Michelle James-Ellison, Ronan A. Lyons, Alison Maddocks, Shantini Paranjothy, Sarah E. Rodgers, Frank Dunstan
BackgroundThere are conflicting findings regarding the impact of residential mobility on immunisation status. Our aim was to determine whether there was any association between residential mobility and take up of immunisations and whether they were delayed in administration.MethodsWe carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisation were collected electronically. We defined frequent movers as those who had moved: 2 or more times in the period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or more times in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal and meningitis C vaccinations. We defined immunisations due at 2–4 months delayed if they had not been given by age 1; and those due at 12–13 months as delayed if they had not been given by age 2.ResultsUptake rates of routine immunisations and whether they were given within the specified timeframe were high for both groups. There was no increased risk (odds ratios (95% confidence intervals) between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88–1.32); booster Meningitis C 1.65 (0.93–2.92); booster pneumococcal 1.60 (0.59–4.31); primary 5 in 1 1.28 (0.92–1.78); and timeliness: primary MMR 0.92 (0.79–1.07); booster Meningitis C 1.26 (0.77–2.07); booster pneumococcal 1.69 (0.23–12.14); and primary 5 in 1 1.04 (0.88–1.23).DiscussionFindings suggest that children who move home frequently are not adversely affected in terms of the uptake of immunisations and whether they were given within a specified timeframe. Both were high and may reflect proactive behaviour in the primary healthcare setting to meet Government coverage rates for immunisation.

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Immune response to second vaccination series of hepatitis B virus among booster dose non-responders

Publication date: Available online 28 February 2016
Source:Vaccine
Author(s): Iman I. Salama, Samia M. Sami, Somaia I. Salama, Thanaa Mahmoud Rabah, Lobna Ahmed El Etreby, Amany T. Abdel Hamid, Dalia Elmosalami, Hazem El Hariri, Zeinab N. Said
ObjectiveTo evaluate the response to second vaccination series among post-booster sero-negative children who had previously received compulsory HBV vaccination.Subjects and methodsAfter given a booster dose to 1070 children, 103 of them failed to generate anamnestic response (anti-HBs <10IU/L). Only 91/103 children received additional two doses of recombinant HBV vaccine (i.e. 2nd vaccination series) after 1 and 6 months post-booster. Blood sample was withdrawn aseptically one month later for quantitative assessment of anti-HBs to detect development of protective immune response (≥10IU/L). Immunological vaccination failure was assigned to children who did not develop protective immune response after 2nd vaccination series.ResultsProtective immune response was detected among 84/91 children (92.3%). While 7/91 (7.7%) whose age were ≥10 years did not respond and had post-booster undetectable anti-HBs. About 80% of children with post-booster detectable anti-HBs showed significant protective immune response (anti-HBs ≥100IU/L) and higher GMT (299.1±3.6IU/L) compared to those with undetectable 60% and 106.2±12.9IU/L respectively (P<0.05). No significant difference was detected as regards gender or residence, P>0.05. All children with history of rheumatic fever (7 children) or diabetes mellitus (1 child) developed immune response after 2nd vaccination series.ConclusionA booster dose of HB vaccine may be unable to induce sufficient immunological response in children who had undetectable anti-HBs titers. Revaccination for non-responders is an important procedure to increase HBV protection rate.

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Editorial Board/Aims and Scope

Publication date: 14 March 2016
Source:Vaccine, Volume 34, Issue 12

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A phase 3, randomized, active-controlled study to assess the safety and tolerability of meningococcal serogroup B vaccine bivalent rLP2086 in healthy adolescents and young adults

Publication date: 14 March 2016
Source:Vaccine, Volume 34, Issue 12
Author(s): Lars Ostergaard, Gregg H. Lucksinger, Judith Absalon, Johannes Beeslaar, Joseph Eiden, Kathrin U. Jansen, Laura J. York, Angela Quinn, Mette E. Graversen, John L. Perez
BackgroundNeisseria meningitidis serogroup B (MnB) is an important cause of invasive meningococcal disease (IMD). A MnB vaccine (bivalent rLP2086, Trumenba^®) consisting of 2 factor H binding protein variants received accelerated approval in the United States for the prevention of IMD caused by MnB in individuals 10–25 years of age. This randomized, active-controlled, observer-blind study further assessed the safety and tolerability of bivalent rLP2086.MethodsEligible subjects ≥10 to <26 years were randomized (2:1) to receive bivalent rLP2086 at months 0, 2, and 6, or hepatitis A virus vaccine (HAV, Havrix^®) at months 0 and 6, and saline at month 2. The primary endpoints were serious adverse events (SAEs) throughout the study and medically-attended adverse events (MAEs) within 30 days after vaccination. Additional safety assessments included SAEs at other study intervals and adverse events (AEs) during the vaccination phase.ResultsOf 5712 subjects randomized, 84.6% (n=3219) of bivalent rLP2086 recipients and 87.2% (n=1663) of HAV/saline recipients completed the study. Throughout the study, SAEs were reported for 1.6% and 2.5% of bivalent rLP2086 and HAV/saline recipients, respectively. SAEs related to either vaccine were rare. MAEs occurred in 7.0% and 6.1% of subjects after vaccination 1; 5.5% and 6.1% after vaccination 2; and 5.3% and 5.5% after vaccination 3 in the bivalent rLP2086 and HAV/saline groups, respectively. A greater proportion of subjects reported AEs during the vaccination phase after bivalent rLP2086 compared with HAV/saline recipients; however, when reactogenicity events were excluded, the proportion between groups was similar.ConclusionThis safety study, the largest randomized, active-controlled trial evaluating a recombinant MnB vaccine, demonstrated that bivalent rLP2086 is safe and tolerable in healthy individuals ≥10 to <26 years of age.

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Knowledge and attitudes about Ebola vaccine among the general population in Sierra Leone

Publication date: Available online 28 February 2016
Source:Vaccine
Author(s): Xiang Huo, Guoqing Shi, Xinxu Li, Xuehui Lai, Liquan Deng, Feng Xu, Mingquan Chen, Qiang Wei, Thomas Samba, Xiaofeng Liang
BackgroundClinical trials of Ebola vaccine are ongoing. Before it becomes commercially available, understanding the Ebola vaccine-related knowledge and attitude of the general population is imperative to developing an effective vaccine coverage strategy.MethodsWe conducted a survey including 400 participants from general communities of the West Area Rural District, Sierra Leone. Knowledge and attitudes about Ebola vaccine were investigated, and the determinants of having knowledge and a positive attitude toward accepting vaccination were identified.ResultsOver half (55.8%) of the participants were aware of Ebola vaccine. About 60% of the participants were willing to be study subjects if the Ebola vaccine clinical trial were conducted in their communities. Most of the participants (72.5%) were willing to take Ebola vaccination if it was free of charge. Given that the vaccination was not free, the proportion willing to pay a fee to take the vaccination declined dramatically to 26.6%. Using a forward step-wise logistic model, monthly salary was identified as the single determinant (OR for every 100,000 Leones increase: 1.17, 95%CI: 1.04–1.31) for awareness of Ebola vaccine, which was identified as the determinant (OR: 1.88, 95%CI: 1.17–3.02) for free vaccination uptake willingness. The combination of monthly salary, monthly average income of family members and their interaction was found to be associated with charged vaccination uptake willingness.DiscussionMeasures are still needed to promote the Ebola vaccine awareness and knowledge updating. Free or low-priced vaccine could increase the vaccination acceptability of the general community population significantly.

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Generation and immunogenicity of porcine circovirus type 2 chimeric virus-like particles displaying porcine reproductive and respiratory syndrome virus GP5 epitope B

Publication date: Available online 28 February 2016
Source:Vaccine
Author(s): Gaowei Hu, Naidong Wang, Wanting Yu, Zhanfeng Wang, Yawen Zou, Yan Zhang, Aibing Wang, Zhibang Deng, Yi Yang
Virus-like particles (VLPs) can be used as transfer vehicles carrying foreign proteins or antigen epitopes to produce chimeric VLPs for bivalent or multivalent vaccines. Based on the crystal structure of porcine circovirus type 2 (PCV2) capsid protein (Cap), in addition to alignment of the Cap sequences collected from various isolates of PCV2 and PCV1, we predicted that Loop CD of the PCV2 Cap should tolerate insertion of foreign epitopes, and furthermore that such an insertion could be presented on the surface of PCV2 VLPs. To validate this, the GP5 epitope B of porcine reproductive and respiratory syndrome virus (PRRSV) was inserted into Loop CD of the PCV2 Cap. The 3D structure of the recombinant PCV2 Cap (rCap) was simulated by homology modeling; it appeared that the GP5 epitope B was folded as a relatively independent unit, separated from the PCV2 Cap backbone. Furthermore, based on transmission electron microscopy, the purified PCV2 rCap self-assembled into chimeric VLPs which entered PK-15 cells. In addition, PCV2 chimeric VLPs induced strong humoral (neutralizing antibodies against PCV2 and PRRSV) and cellular immune responses in mice. We concluded that the identified insertion site in the PCV2 Cap had great potential to develop PCV2 VLPs-based bivalent or multivalent vaccines; furthermore, it would also facilitate development of a nano-device to present a functional peptide on the surface of the VLPs that could be used for therapeutic purposes.

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LGBT health and vaccinations: Findings from a community health survey of Lexington-Fayette County, Kentucky, USA

Publication date: Available online 28 February 2016
Source:Vaccine
Author(s): Jeff Jones, Asheley Poole, Vivian Lasley-Bibbs, Mark Johnson
Data on adult immunization coverage at the state level and for LGBT Americans in particular are sparse. This study reports the results of a 2012 Lexington-Fayette County, Kentucky, community health assessment's results asking about eight adult vaccinations among 218 lesbian, gay, bisexual, and transgendered (LGBT) respondents. Researchers collected data using an online survey distributed through LGBT social media, posters, and LGBT print media. The LGBT sample largely matches the demographics of the county as a whole except this group reports higher level of education and fewer uninsured individuals. Among LGBT respondents, immunization prevalence reaches 68.0% (annual Influenza), 65.7% (Hepatitis B), 58.8% (Chickenpox/Varicella), 55.9% (Hepatitis A), 41.2% (Smallpox), and 25.8% (Pneumonia). Among respondents who are currently within the recommended 19–26 years age range for the Human Papillomavirus (HPV) vaccine, the LGBT females are less likely to report receiving the vaccine (15.4%) compared to the national coverage percentage of 34.5%. Males, however, are more likely to have received the vaccine (10.3%) than the national percentage of 2.3%. The small number of LGBT seniors in the study report a much higher prevalence of the Shingles (Herpes Zoster) vaccines than for U.S. seniors 60 and older (71.4% compared to 20.1% nationally). LGBT respondents report higher percentages of adult vaccination.

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A potential clinical usefulness of measuring serum bilirubin levels in patients with polymyositis

OBJECTIVE: Accumulated data have indicated that bilirubin has antiinflammatory, antioxidative, and immunosuppressive properties. Polymyositis (PM) belongs to an autoimmune disease characterized by chronic inflammation in skeletal muscle. Until now, to the best of our knowledge, there are no literature investigating bilirubin levels in patients with PM. Therefore, the aim of this investigation was to assess a relationship between bilirubin and PM.

PATIENTS AND METHODS: Our study included newly diagnosed 77 patients with PM who were admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities (Guangxi, China) and 108 healthy subjects as controls. Clinical characteristics and laboratory parameters of patients were analyzed, retrospectively.

RESULTS: The serum concentrations of total bilirubin (TB), conjugate bilirubin (CB), unconjugated bilirubin (UCB) were significantly lower in patients with PM than healthy controls. Serum concentrations of TB were negatively correlated with erythrocyte sedimentation rate (ESR), creatine kinase (CK) and lactic dehydrogenase (LDH) in patients with PM (r=-0.494, p＜0.001; r=-0.274, p=0.017; r=-0.282, p=0.014), and serum concentrations of UCB were negatively correlated with ESR and CK in PM patients (r=-0.424, p＜0.001; r=-0.234, p=0.041). Both serum TB and UBC concentrations were positively correlated with manual muscle test (MMT) score in patients with PM (r=0.328, p=0.004; r=0.333, p=0.004). In multiple linear regression analysis, serum UBC levels were independently associated with MMT score (r=0.239, p=0.003).

CONCLUSIONS: We observed significantly lower serum concentrations of TB, CB and UCB in patients with PM, and suggested a potential association between serum concentrations of UBC and disease activity in PM patients.

L'articolo A potential clinical usefulness of measuring serum bilirubin levels in patients with polymyositis sembra essere il primo su European Review.

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Evaluating the case-positive, control test-negative study design for influenza vaccine effectiveness for the frailty bias

Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study

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Study on the relationship between miR-520g and the development of breast cancer

OBJECTIVE: Breast cancer (BC) is one of the most common malignant tumors occurred in women. There is no sensitive and specific marker for early diagnosis, treatment and prognosis of breast cancer. It is suggested that miRNA may be a potential tumor marker for breast cancer. Mir-520g is considered to be associated with many tumors. This study aims to test the expression of mir-520g in peripheral blood of BC patients and healthy control. We also explored the relationship between mir-520g and several prognostic factors in breast cancer patients.

PATIENTS AND METHODS: The peripheral blood of 86 cases with breast cancer (including 18 cases with stage 0, 24 cases of phase I, 20 cases of stage II, 24 cases of stage III) and 26 cases of healthy subjects were collected. The miR-520g level was measured by real-time quantitative PCR (RT qPCR) method. The correlation between plasma miR-520g level and the clinical stage, molecular subtype, receptors' expression and other factors related to the prognosis of the patients were examined.

RESULTS: Plasma mir-520g expression levels were significantly higher in BC patients with lymph node metastatic and low differentiation degree grade (p = 0.033 and 0.016), and plasma miR-520g expression was significantly higher in breast cancer patients with mammary gland invasion (p < 0.01) and low expressed p53 (p = 0.0039).

CONCLUSIONS: Highly expressed mir-520g is associated with lymph node metastasis and low differentiation of breast cancer, and also is associated with mammary gland invasion in breast cancer. This study suggests that mir-520g may be associated with some important prognostic factors in breast cancer patients, and may have a potential value for breast cancer marker.

L'articolo Study on the relationship between miR-520g and the development of breast cancer sembra essere il primo su European Review.

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Preoperative neutrophil-to-lymphocyte ratio (NLR) may be predictive of pathologic stage in patients with bladder cancer larger than 3 cm

OBJECTIVE: Bladder cancer (BCa) is the most common malignancy of the urinary tract. In this study, we aimed to evaluate the ability of preoperative neutrophil-to-lymphocyte ratio (NLR) to predict pathologic stage of at the time of first transurethral resection of bladder tumor (TUR-BT) in patients with BCa larger than 3 cm.

PATIENTS AND METHODS: Records of consecutive patients undergoing TUR-BT for BCa with a diameter >3 cm were reviewed. A total of 222 patients were eligible for analysis, and were divided into two groups: 162 patients in non-muscle-invasive BCa (NMIBC) group and 60 patients in muscle-invasive BCa (MIBC) group. Differences in preoperative blood parameters and NLR were evaluated between groups with an unequal variance t-test.

RESULTS: In the NMIBC group, 59 patients had low-grade and 103 high-grade papillary urothelial carcinomas. 60 patients had T2 stage carcinoma. The mean age of the patients was 71.8 and 75.7 years, and mean NLR was 3.44 ± 2.03 and 4.6 ± 2.8 in NMIBC and MIBC groups, respectively. In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.005).

CONCLUSIONS: Our results showed that NLR might act as a significant predictive biomarker on the staging of BCa. Also, NLR could be used as a cost-effective, simple, common usable biomarker in urology clinic practice.

L'articolo Preoperative neutrophil-to-lymphocyte ratio (NLR) may be predictive of pathologic stage in patients with bladder cancer larger than 3 cm sembra essere il primo su European Review.

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Expression of CD27, CD28 and IL-17A in peripheral blood from patients with colorectal carcinoma

OBJECTIVE: To compare the different expressions of CD27, CD28, IL-17A, IFN-γ and TNF-α in the peripheral blood sampled from patients with colorectal carcinoma and healthy volunteers.

PATIENTS AND METHODS: Vδ2 T cells were isolated from the peripheral blood mononuclear cells (PBMCs) of patients with the colorectal carcinoma (CRC, n = 30) and healthy controls (HC, n = 21). The proportion of CD27, CD28, IL-17A, IFN-γ and TNF-α of Vδ2 T cells was detected by the flow cytometry.

RESULTS: We found that the proportion of IL-17A of Vδ2 T cells in PBMCs was higher in the CRC vs. the HC group (p < 0.05). A significant positive correlation was observed between the expression of IFN-γ and TNF-α of Vδ2 T cells. In the CRC patients, the proportions of IL-17A of CD27- Vδ2 T cells and CD28+ Vδ2 T cells were higher than those of CD27+ Vδ2 T cells and CD28- Vδ2 T cells, whereas the expression of IFN-γ and TNF-α of CD27-Vδ2 T cells was lower than that of CD27+ Vδ2 T cells.

CONCLUSIONS: Vδ2 T cells from PBMCs had higher expression of IL-17A in CRC patients than that in the HC group. The expression of IFN-γ and TNF-α of Vδ2 T cells from PBMCs was positively correlated. The cytokine profiles of peripheral Vδ2 T cells were likely determined by a CD27 and CD28 involving mechanism.

L'articolo Expression of CD27, CD28 and IL-17A in peripheral blood from patients with colorectal carcinoma sembra essere il primo su European Review.

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Relationship between leptin and regulatory T cells in systemic lupus erythematosus: preliminary results

OBJECTIVE: Crescent literature data demonstrated a role of adipokines in immune responses, particularly leptin is involved in wide spectrum of pro-inflammatory functions. Several evidences suggested that leptin is able to inhibit T regulatory cells proliferation and function in vitro models. In the present study, we investigate the relationship between leptin and circulating T regulatory cells (Tregs) in patients affected by systemic lupus erythematosus (SLE).

PATIENTS AND METHODS: 13 SLE patients and 11 healthy controls were enrolled. Metabolic syndrome and cardiovascular parameters were evaluated. Serum leptin levels were detected by commercial ELISA kit and circulating regulatory T cells were determined by FACS analysis as CD4+CD25highFOP3+ lymphocytes.

RESULTS: Metabolic syndrome, defined by ATPIII criteria, was more prevalent in SLE compared to controls (38.4% vs. 0%, p = 0.04), as well as arterial hypertension (38.4% vs. 0%, p = 0.04). We did not find significant differences in mean leptin levels among SLE and controls (13.13±1.51 ng/ml vs. 9.48±8.67 ng/ml, p = 0.6). Mean Tregs percentage of total CD4 were 1.27±0.9 in SLE vs. 2.8±1.2 in healthy controls (p = 0.001). We found a negative correlation between leptin levels and Tregs percentage of total CD4 in SLE patients (r = 0.4, p = 0.01).

CONCLUSIONS: Our results, suggest a role of leptin in the regulation of circulating T regulatory cells amount in human SLE.

L'articolo Relationship between leptin and regulatory T cells in systemic lupus erythematosus: preliminary results sembra essere il primo su European Review.

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The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma: an experimental study in swines

OBJECTIVE: Optimal hemodynamic resuscitation strategy of the trauma patient with uncontrolled hemorrhage and severe head injury in the pre-hospital setting remains a special challenge. Permissive hypotension prior to definite surgical haemostasis promotes coagulation, decreases blood loss and favors survival. However, hypotension is associated with poor outcome in severe head injury. The purpose of this experimental animal study was to assess the impact of permissive hypotension on survival, hemodynamic profile and brain oxygenation parameters before and/or after definite surgical haemostasis.

PATIENTS AND METHODS: Six-week-old pigs (n=12) underwent general anesthesia and brain injury was produced by the fluid percussion model. Animals were instrumented to measure hemodynamic parameters and cerebral blood flow. All animals (n=12) were subjected to laparotomy and a surgical knot was placed through the abdominal aorta wall. Uncontrolled hemorrhage was simulated by pulling out the intentionally left protruding free ends of the suture (goal MAP=30 mmHg). Animals were randomly divided into two groups; group A (n=6) was subjected to aggressive fluid resuscitation (goal SAP >80 mmHg) and group B (n=6) was left hypotensive (permissive hypotension). Animals who survived one hour of hypotensive shock underwent definite surgical haemostasis and were resuscitated for one hour. We measured survival, hemodynamic and brain oxygenation parameters at different time points before and after surgical haemostasis.

RESULTS: All animals from Group A and 50% from Group B died before surgical haemostasis. In surviving animals (Group B, 50%, p=0.033), MAP, CO, rCBF, SjO2 and AVDO2 were restored to pre-procedural levels.

CONCLUSIONS: Permissive hypotension by delaying fluid resuscitation up to definite surgical haemostasis improves survival, hemodynamics and allows restoration of cerebral oxygenation in severe head injury.

L'articolo The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma: an experimental study in swines sembra essere il primo su European Review.

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A new cyclic RGD peptide dimer for integrin αvβ3 imaging

OBJECTIVE: To design a new Arg-Gly-Asp (RGD) peptide that can specifically bind integrin αvβ3 and evaluate the possibility of using 131I-labeled peptide for imaging αvβ3-positive tumors.

MATERIALS AND METHODS: The structure of the RGD monomer was selected using V-life software. Based on the RGD monomer, a dimer of cyclic RGD [c(RGD)2] linked by Tyr-(D)Ser-Lys-(D)Ser-Ser with a Gly-Gly-(D)Ala-Gly side chain on the lysine residue was synthesized. 131I-c(RGD)2 was synthesized using the chloramine-T (ChT) method, and the octanol-water partition coefficient was experimentally measured. To evaluate its binding affinity and selectivity, its equilibrium dissociation constant (Kd) with U87 MG glioma cells was measured in vitro, while whole body imaging and biodistribution were assessed in vivo in mice bearing U87 MG xenografts.

RESULTS: The optimal structure of the monomer was cyclic [-Cys-Arg-Gly-Asp-(D)Ser-Cys-]. The 131I-c(RGD)2 molecule exhibited good stability and was highly hydrophilic. The Kd value was (3.87 ± 0.05) × 10-9 M, suggesting a high αvβ3-binding affinity and specificity. The tumors were clearly visualized at 3 and 6 h post-injection. Biodistribution data of the 131I-c(RGD)2 molecule showed rapid clearance from the blood and predominant accumulation in the tumor and kidney. The tumor-to-normal tissue (T/NT) ratio increased over time. At 24 h post-injection, the tumor-to-liver, tumor-to-muscle, and tumor-to-blood ratios were 4.92, 4.29, and 5.00, respectively.

CONCLUSIONS: These results suggest that the 131I-c(RGD)2 molecule may serve as a promising tracer for the detection of αvβ3-positive tumors.

L'articolo A new cyclic RGD peptide dimer for integrin αvβ3 imaging sembra essere il primo su European Review.

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Impression cytological study for ocular surface disorders of late stage eye burns

OBJECTIVE: This study aims to explore the ocular surface of late stage eye burns by impression cytology (IC) and analyze the cytological changes and their relationship to ocular surface abnormalities.

PATIENTS AND METHODS: 68 eyes with late stage eye burns (thermal burn: 28 eyes; alkali burn: 26 eyes; acid burn: 14 eyes), procured from 68 patients (aged ranges from 17 to 70 years old). Ocular surface abnormalities were assessed under slit lamp and graded. These were broadly classified as eyelid, corneal, conjunctival, and tear film abnormalities. Impression cytological examination was taken by cellulose acetate filter paper for all eyes. Samples were analyzed and scored under light microscope, including the status of epithelial cells, goblet cells, mucus and inflammatory cells. All the results and data were compared and analyzed by SPSS software (version 16.0).

RESULTS: According to the IC results, loosed cell-to-cell density and nuclear abnormality, keratinization, reduced goblet cell amount, disorder of mucus, and existing of inflammatory cells were observed in almost all the cases. The IC results were significantly correlated to the ocular surface injury severity (r=0.458, p<0.01). The ocular surface injury severity mostly contains three aspects: the corneal neovascularization scales, the present or absent of recurrent epithelial erosion and the tear film break-up time. Eyes with the foreword three symptoms were inclined to have higher IC scores. The epithelial cell-to-cell density, goblet cell and mucus amount were all correlated to tear film break-up time. However, inflammatory cell density showed no significant correlation to the conjunctival hyperemia grade. But inflammatory cell density correlated to the corneal opacity grade and epithelial stability status.

CONCLUSIONS: IC examinations could reflect the cytological disorders and relative injury severity of the ocular surface in late stage eye burns. It provides further information which will be useful in surgery and therapy.

L'articolo Impression cytological study for ocular surface disorders of late stage eye burns sembra essere il primo su European Review.

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A correlation between selenium and carnitine levels with Hypo-osmotic swelling test for sperm membrane in low-grade varicocele patients

OBJECTIVE: The hypo-osmotic swelling (HOS) test predicts membrane integrity by determining the ability of the sperm membrane to maintain equilibrium between the sperm cell and its environment. The aim of our study was to determine the correlation between selenium and carnitine levels in the seminal fluid with HOS test for sperm membrane in low-grade varicocele patients.

PATIENTS AND METHODS: Study numbered 64 examinees who suffered from low-grade varicocele and were divided into two groups, according to fertility potential and HOS test outcome. The study also included a control group of 64 healthy subjects, with no varicocele.

RESULTS: From the Shapiro-Wilk's test, it is clear that carnitine distribution differs significantly from normal (0.938, p = 0.03). In distribution of selenium, Kolmogorov-Smirnov test clearly shows statistically significant deviation from the normal curve (z = 0.225, p < 0.000), likewise Shapiro-Wilk's statistic (0.787, p < 0.000). According to the results, the second group had significantly higher levels of carnitine and selenium than the first group of examinees (p < 0.05); therefore, when we compared epididymal markers with HOS tests outcomes, we found significant differences between the two groups. There were no significant differences between second group and healthy subjects (p > 0.05).

CONCLUSIONS: HOS test outcome in varicocele patients is directly proportional to the carnitine and selenium levels, which could play a major role in both determining fertility parameters and in the treatment of its impairment. This result is especially important for sub-clinical varicocele in infertile patients with normal semen analysis, since there is no evidence of benefit from any treatment so far.

L'articolo A correlation between selenium and carnitine levels with Hypo-osmotic swelling test for sperm membrane in low-grade varicocele patients sembra essere il primo su European Review.

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Effect of complete hilar versus only renal artery clamping on renal histomorphology following ischemia/reperfusion injury in an experimental model

OBJECTIVE: To evaluate the effect of temporary complete hilar versus only renal artery clamping with different duration of warm ischemia on renal functions, and possibly identify a "safe" clamping type and duration of renal ischemia.

MATERIALS AND METHODS: Fifty male rabbits have been incorporated to study. Rabbits were subjected to ischemia/reperfusion injury by temporary vascular clamping. Reagents were randomized to 3 experimental groups (only renal artery clamping, complete hilar clamping, sham surgery) and sub-groups were determined according to different clamping times (30 and 60 minutes). Median laparotomy and left renal hilus dissection were performed to sham group. Only artery or complete hilar clamping was performed for 30 or 60 minutes by microvascular bulldog clamps to other reagents. Rabbits were sacrificed 10 days after primary surgery and left nephrectomy performed. Nephrectomy materials were evaluated for the level of nitric-oxide synthase (NOS) immunoreactivity, malondialdehyde (MDA) level and superoxide dismutase (SOD) activity and an electron microscopic examination was performed.

RESULTS: NOS immunoreactivity was correlated with the temporary clamping time. We also observed that complete hilar vascular clamping entails an increase on NOS immunoreactivity. MDA levels were similar for all experimental surgery groups (p = 0.42). The SOD activity was decreased among all subgroups compared with sham surgery. But the significant decrease occurred in 30 minutes only artery and 30 minutes complete hilar clamping groups in proportion to sham surgery (p = 0.026 and p = 0.019, respectively).

CONCLUSIONS: This current study suggested that only renal artery clamping under 30 minutes is more appropriate during renal surgical procedures requiring temporary vascular clamping.

L'articolo Effect of complete hilar versus only renal artery clamping on renal histomorphology following ischemia/reperfusion injury in an experimental model sembra essere il primo su European Review.

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Αρχειοθήκη ιστολογίου

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Κυριακή 28 Φεβρουαρίου 2016

Graphical abstract

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