Multimodal therapy approaches that combine interventions aimed at different aspects of disease are emerging as potential—and perhaps essential—ways to enhance clinical outcomes for patients with psychiatric and neurological disorders. In order to examine the general principles underlying multimodal therapies and to explore challenges, potential barriers, and opportunities for their development, the National Academies of Sciences, Engineering, and Medicine convened a workshop in June 2016. Participants explored scientific, clinical, regulatory, and reimbursement issues related to multimodal approaches and potential opportunities to enhance clinical outcomes for individuals with nervous system disorders. This publication summarizes the presentations and discussions from the workshop.
http://ift.tt/2flNFlv
Τρίτη 22 Νοεμβρίου 2016
Developing Multimodal Therapies for Brain Disorders: Proceedings of a Workshop [Prepublication Draft].
WHO Guidelines for the Treatment of Genital Herpes Simplex Virus.
Since the publication of the World Health Organization (WHO) Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. These guidelines provide updated treatment recommendations for genital HSV infection based on the most recent evidence; they form one of several modules of guidelines for specific STIs. Other modules will focus on treatments for Neisseria gonorrhoeae (gonorrhoea), C. trachomatis (chlamydial infection) and Treponema pallidum (syphilis). In addition, future work will provide guidance for syphilis screening and treatment of pregnant women, STI syndromic approach, clinical management, STI prevention, and treatments of other STIs. It is strongly recommended that countries take updated global guidance into account as they establish standardized national protocols, adapting this guidance to the local epidemiological situation and antimicrobial susceptibility data.
http://ift.tt/2flWNXc
The Academy’s Millennial Generation
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
Author(s): Lucille Beseler
http://ift.tt/2gipMx2
Science—The Cornerstone of Nutrition Policy, Promotion, and Practice
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
Author(s): Angie Tagtow
http://ift.tt/2gGYTqq
Table of Contents
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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Position of the Academy of Nutrition and Dietetics: Vegetarian Diets
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
Author(s): Vesanto Melina, Winston Craig, Susan Levin
It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage. Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity. Low intake of saturated fat and high intakes of vegetables, fruits, whole grains, legumes, soy products, nuts, and seeds (all rich in fiber and phytochemicals) are characteristics of vegetarian and vegan diets that produce lower total and low-density lipoprotein cholesterol levels and better serum glucose control. These factors contribute to reduction of chronic disease. Vegans need reliable sources of vitamin B-12, such as fortified foods or supplements.
http://ift.tt/2gGQX8E
The Commission on Dietetic Registration: Ahead of the Trends for a Competent 21st Century Workforce
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
Author(s): Karen Stein, Mickie Rops
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2016 Academy of Nutrition and Dietetics Foundation Award and Grant Recipients
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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2017 Call for Abstracts: Posters and Innovations in Practice and Education
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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Thanks to Our Reviewers
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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December 2016 People & Events
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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Erratum
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
http://ift.tt/2girZIS
December 2016 New in Review
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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December 2016 Classified Advertisements
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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December 2016 New Products and Services
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
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What Strategies do Registered Dietitian Nutritionists Use to Assess a Patient’s/Client’s Weight Loss Readiness?
Source:Journal of the Academy of Nutrition and Dietetics, Volume 116, Issue 12
Author(s): Eleese Cunningham
http://ift.tt/2gipVki
Using the OASES-A to illustrate how network analysis can be applied to understand the experience of stuttering
Source:Journal of Communication Disorders
Author(s): Cynthia S.Q. Siew, Kristin M. Pelczarski, J. Scott Yaruss, Michael S. Vitevitch
PurposeNetwork science uses mathematical and computational techniques to examine how individual entities in a system, represented by nodes, interact, as represented by connections between nodes. This approach has been used by Cramer et al. (2010) to make "symptom networks" to examine various psychological disorders. In the present analysis we examined a network created from the items in the Overall Assessment of the Speaker's Experience of Stuttering-Adult (OASES-A), a commonly used measure for evaluating adverse impact in the lives of people who stutter.MethodThe items of the OASES-A were represented as nodes in the network. Connections between nodes were placed if responses to those two items in the OASES-A had a correlation coefficient greater than ±.5. Several network analyses revealed which nodes were "important" in the network.ResultsSeveral centrally located nodes and "key players" in the network were identified. A community detection analysis found groupings of nodes that differed slightly from the subheadings of the OASES-A.ConclusionsCentrally located nodes and "key players" in the network may help clinicians prioritize treatment. The different community structure found for people who stutter suggests that the way people who stutter view stuttering may differ from the way that scientists and clinicians view stuttering. Finally, the present analyses illustrate how the network approach might be applied to other speech, language, and hearing disorders to better understand how those disorders are experienced and to provide insights for their treatment.
http://ift.tt/2gilmq6
Unusual cause of profound weight loss in a young woman
A 27-year-old woman presented with anorexia, weight loss and psychiatric symptoms for the past 4 years. She did not have history of headache, visual disturbances or symptoms of raised intracranial pressure. She was sarcopenic with body mass index of 10.16 kg/m2.Her systemic examination was normal except for temporal hemianopia suggesting a sellar/suprasellar lesion. Hormonal evaluation revealed pan-hypopituitarism with central diabetes insipidus. Subsequent neuroimaging revealed sellar-suprasellar mass lesion with intense contrast enhancement and leptomeningeal metastases. Cerebrospinal fluid analysis showed elevated β human chorionic gonadotropin and the presence of syncytiotrophoblast germ cells. Histopathology from the mass lesion confirmed the diagnosis of germinoma. Immunohistochemistry of the tumour tissue was positive for c-kit and placental alkaline phosphatise. She received a combination of chemotherapy with craniospinal irradiation. Significant weight loss in a young woman may not always be an eating disorder like anorexia nervosa albeit more common than germ cell tumour.
http://ift.tt/2gcGwEI
Primary lymphoma of the uterine cervix: a rare constellation of symptoms
Description
A 40-year-old woman, multiparous, presented to the emergency room with insidious on-setting of pain and swelling of the right lower extremity. The initial workup diagnosed deep venous thrombosis of the affected limb caused by a pelvic tumorous mass originating from the uterine cervix. Anticoagulation therapy was initiated and she was transferred to our gynaecology department for subsequent investigation. On physical examination there were no abnormal findings, namely palpable masses or lymphadenopathies. However, on pelvic examination we detected a bulky cervical mass and carried out an incisional biopsy. The histology report revealed a non-Hodgkin's follicular, large B-cell lymphoma (figure 1). The immunohistochemical study was positive for CD20, CD10, bcl2 and bcl6 and negative for CD5, CD3, CD23 and cyclin D. The pelvic MRI (figure 2) showed a heterogeneous cervical mass, measuring 7.9x7.6x6.9 cm3, with stromal disruption and apparent involvement of the bladder, but not of...
http://ift.tt/2gyjrRt
Ascites and adnexal masses: not always ovarian or tubal carcinoma
Description
A 32-year-old Mozambican woman presented to the hospital with progressive abdominal distension, pelvic pain and low-grade fever (38°C). Her family history was significant for one sister with breast cancer at the age of 40 years. In the diagnostic assessment, cancer antigen 125 (CA-125) was highly elevated (950 U/L) and the pelvic MRI showed bilateral tubal enlargement, right suspicious ovarian cyst and diffuse mesenteric thickening, A diagnosis of ovarian/tubal carcinoma with peritoneal carcinomatosis was suspected. Diagnostic laparoscopy revealed high volume ascites, bilateral tubal enlargement and peritoneal oedema, as well as multiple whitish nodules affecting uterine, adnexal and intestinal serosas and omentum thickening (video 1, figure 1), suggestive of peritoneal tuberculosis. Visual diagnosis during laparoscopy can be diagnostic in up to 95% of cases of this disease,1 but in developed countries where tuberculosis is no longer an endemic disease, these laparoscopic findings are no longer...
http://ift.tt/2gylDbn
Neonatal osteomyelitis of the first rib causing lung abscess
Rib osteomyelitis (OM) is a rare disease that occurs in ~1% or less of all haematogenous OM. Acute OM of the rib has rarely been reported and its treatment is difficult. Prompt recognition and aggressive treatment will reduce mortality and morbidity in a new born.
http://ift.tt/2gcKfCp
Brief episodes of non-specific psychosis later diagnosed as periodic catatonia
A 73-year-old woman was known to have discrete episodes of psychosis not otherwise specified that would require a brief admission to hospital and total remission following a short course of benzodiazepine or antipsychotic treatment. She had no underlying schizophrenic or affective disorder and was completely unimpaired in between episodes, which could last several years. She presented to us with psychotic symptoms but also noted to have many catatonic features, which were also present on previous presentations. Following failure with antipsychotic trials on this index presentation, she completely remitted with a short course of electroconvulsive therapy. We discuss the importance of identifying and treating catatonia and the lesser-known variant of periodic catatonia. Current presentations should always take into account the lifetime context of psychiatric illness. Rarely do patients with primary psychotic disorders not have any impairment or treatment in between episodes.
http://ift.tt/2gyhgNI
Smooth muscle tumour of uncertain malignant potential (SMTUMP) in the nasal cavity: an incidental finding
Sino-nasal smooth muscle tumours of uncertain malignant potential (SMTUMP) are very rare neoplasms of mesenchymal origin with features in between a benign leiomyoma and a leiomyosarcoma. We report a rare case of SMTUMP in a 44-year-old woman, who presented with vague symptoms of pharyngitis. Nasal endoscopy revealed a smooth mass in left nasal cavity. Contrast-enhanced CT and MRI scans showed features likely to be inverted papilloma or olfactory neuroblastoma or meningioma. Excision was planned and intraoperatively, frozen section revealed a probable spindle cell lesion. Final histopathological report following immunohistochemistry (IHC) & immunofluoresence (IF) confirmed it to be a SMTUMP. This patient underwent complete resection via endoscopic KTP laser assisted, anterior skull base surgery with no recurrence on follow-up.
http://ift.tt/2gcGBs3
Bladder explosion, a rare complication following transurethral resection of the prostate
We present a man aged 69 years who suffered from bladder explosion during transurethral resection of the prostate. Exploratory laparotomy was performed and the bladder was primarily repaired with running sutures. This patient was discharged without symptoms of urinary dysfunction on day 8 after operation. We provide prevention methods that can decrease the risk of this important complication.
http://ift.tt/2gydnID
Aortic valve fibroelastoma: a rare cause of stroke
The prevalence of primary cardiac tumours varies from 0.02% to 0.45%. Cardiac papillary fibroelastoma (CPF) is a rare tumour diagnosed incidentally on imaging. The clinical manifestations result from thromboembolisation and include transient ischaemic attack, stroke and sudden cardiac death. We present a patient aged 57 years with CPF arising from the aortic valve. The patient presented with right hemiparesis due to acute stroke. He received tissue plasminogen activator with complete resolution of neurological symptoms. Echocardiography revealed a broad-based, gelatinous, non-mobile mass on the left aortic cusp. The tumour was excised sparing the aortic valve. The patient recovered rapidly without any complications. The histopathological examination confirmed the diagnosis of CPF. A review of the literature suggests that CPF is a rare but treatable cause of stroke. The course is not clear and there are no tumours or patient-related characteristics which could predict the risk of thromboembolisation. Surgical treatment is definite and is relatively safe.
http://ift.tt/2gcEzZ6
Rare cause of arterial hypertension
Description
We report the case of a man aged 55 years who was referred to our department for investigation of arterial hypertension. He had only a previous diagnosis of situs inversus. At presentation, his blood pressure was 190/100 mm Hg in both arms, but significantly lower in lower limbs. The pulses were equal over both upper extremities, but lower limbs pulses were also weakly palpable. On cardiac auscultation, a grade II/VI systolic murmur was heard on the right scapular region.
Chest radiography showed dextrocardia and bilateral rib notching (figure 1).
Figure 1
Chest radiogram showing bilateral rib notching (arrow).
The transthoracic echocardiography showed mild concentric hypertrophy and mild dilation of the ascending thoracic aorta; due to a poor suprasternal view, the aortic arch could not be adequately assessed.
Multislice CT angiography revealed a complete interruption of the aortic arch distal to the origin of...
http://ift.tt/2gypJAs
Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain
We describe the case of a man aged 43 years who presented with a 2-week history of a palpable lump in the right proximal penile shaft. This was preceded by a 6-month history of perineal pain, accompanied by erectile dysfunction. An urgent MRI scan of his penis identified a thrombus within the right crus and corpus of the penis. His thrombophilia screen was normal. The patient was started on oral anticoagulation and a phosphodiesterase inhibitor (PDE-5i) to prevent thrombus progression and maintain erectile function. At 5 months, the patients' symptoms had resolved and an MRI showed a reduction in the thrombus size. MRI is a useful imaging modality to diagnose a thrombus within the corpus cavernosum in patients presenting with a history of penile and perineal pain together with a palpable lump. The non-enhancement of the lesion helps to differentiate this from alternative rare lesions within the penis and perineum.
http://ift.tt/2gcHe5d
Large thymoma mass invading cardiac structures
Description
We report a retired, Afro-Caribbean man aged 69 years who presented to his local hospital with several weeks of dyspnoea and cough. Physical examination was unremarkable apart from an elevated jugular venous pressure and a bilateral pedal oedema. His medical history included asthma and controlled hypertension. Urgent transthoracic echocardiography showed a large soft tissue mass in the pericardial space compressing the right ventricle (RV), and the right atrium (RA).
A CT of the thorax showed a mass measuring 16 cm in width by 8 cm in depth with infiltration and compression of RV and RA with distortion of atrioventricular groove anatomy between RV and RA (figure 1).
Figure 1
Contrast CT scan of the chest (left) showing thymoma mass invading the right ventricle (RV) (arrow A), invading the right coronary artery origin (arrow B) and invading the right atrium (arrow C). Three-dimensional reconstruction of thymic mass...
http://ift.tt/2gylZ1B
Symmetrical digital gangrene after a high dose intravenous infusion of epinephrine and dopamine following resuscitation from cardiac arrest
Description
Symmetrical digital gangrene (SDG) is mostly due to low cardiac output and disseminated intravascular coagulation (DIC) (table 1).1 We describe a 36-year-old right-handed man with SDG requiring amputation of 14 digits. He had received continuous intravenous infusion of epinephrine and dopamine given for a cardiac arrest that developed 1 hour after resection of a meningioma (table 2). In cardiogenic shock, he had decreased responsiveness, sinus tachycardia (135 bpm) and arterial hypotension (50/45 mm Hg). Advanced cardiac life support with mechanical ventilatory support was instituted. The administration of inotropic agents stabilised blood pressure to around 110/65, heart rate at 98 and mean arterial pressure (MAP) at 70 mm Hg. The patient's responsiveness improved gradually, but cardiovascular instability made him inotropic dependant.
Table 1
Causes of symmetrical digital gangrene
Hypercoagulable statePrimary: Antithrombin III deficiency, protein C and protein S deficiency, abnormalities of the...http://ift.tt/2gcHcdB
Distortion-Product Otoacoustic Emission Measured Below 300 Hz in Normal-Hearing Human Subjects
Abstract
Physiological noise levels in the human ear canal often exceed naturally low levels of otoacoustic emissions (OAEs) near the threshold of hearing. Low-frequency noise, and electronic filtering to cope with it, has effectively limited the study of OAE to frequencies above about 500 Hz. Presently, a custom-built low-frequency acoustic probe was put to use in 21 normal-hearing human subjects (of 34 recruited). Distortion-product otoacoustic emission (DPOAE) was measured in the enclosed ear canal volume as the response to two simultaneously presented tones with frequencies f 1 and f 2. The stimulus–frequency ratio f 2/f 1 was varied systematically to find the "optimal" ratio evoking the largest level at 2 f 1−f 2 frequencies 87.9, 176, and 264 Hz. No reference data exist in this frequency region. Results show that DPOAE exists down to at least 87.9 Hz, maintaining the bell-shaped dependence on the f 2/f 1 ratio known from higher frequencies. Toward low frequencies, however, the bell broadens and the optimal ratio increases proportionally to the bandwidth of an auditory filter as defined by the equivalent rectangular bandwidth. The DPOAE phase rotates monotonously as a function of the stimulus ratio, and its slope trend supports the notion of a lack of scaling symmetry in the apex of the cochlea.
http://ift.tt/2gbNudb
Ph1b Study of Oraxol in Comb. w. Ramucirumab in Patients w. Gastric, Gastro-esophageal, or Esophageal Cancers
Interventions: Drug: Oraxol; Drug: Ramucirumab
Sponsor: Kinex Pharmaceuticals Inc
Not yet recruiting - verified November 2016
http://ift.tt/2fnBZlu
Distortion-Product Otoacoustic Emission Measured Below 300 Hz in Normal-Hearing Human Subjects
Abstract
Physiological noise levels in the human ear canal often exceed naturally low levels of otoacoustic emissions (OAEs) near the threshold of hearing. Low-frequency noise, and electronic filtering to cope with it, has effectively limited the study of OAE to frequencies above about 500 Hz. Presently, a custom-built low-frequency acoustic probe was put to use in 21 normal-hearing human subjects (of 34 recruited). Distortion-product otoacoustic emission (DPOAE) was measured in the enclosed ear canal volume as the response to two simultaneously presented tones with frequencies f 1 and f 2. The stimulus–frequency ratio f 2/f 1 was varied systematically to find the "optimal" ratio evoking the largest level at 2 f 1−f 2 frequencies 87.9, 176, and 264 Hz. No reference data exist in this frequency region. Results show that DPOAE exists down to at least 87.9 Hz, maintaining the bell-shaped dependence on the f 2/f 1 ratio known from higher frequencies. Toward low frequencies, however, the bell broadens and the optimal ratio increases proportionally to the bandwidth of an auditory filter as defined by the equivalent rectangular bandwidth. The DPOAE phase rotates monotonously as a function of the stimulus ratio, and its slope trend supports the notion of a lack of scaling symmetry in the apex of the cochlea.
http://ift.tt/2gbNudb
Ph1b Study of Oraxol in Comb. w. Ramucirumab in Patients w. Gastric, Gastro-esophageal, or Esophageal Cancers
Interventions: Drug: Oraxol; Drug: Ramucirumab
Sponsor: Kinex Pharmaceuticals Inc
Not yet recruiting - verified November 2016
http://ift.tt/2fnBZlu
Congenital Hypothyroidism: An Unusual Combination of Biochemical Abnormalities
A forty-five-day-old female infant presented with prolonged jaundice with clinical features suggestive of congenital hypothyroidism (CHT). On investigations, the infant was noted to have indirect hyperbilirubinemia (13.8 mg/dl) with increased levels of AST (298 IU/dl) and ALT (174 IU/dl) in the serum. The child had low levels of free T3 (500 microIU/ml) in the serum. The combination of indirect hyperbilirubinemia and raised levels of hepatic transaminases has not been reported in babies with CHT. Following institution of oral thyroxin therapy, the serum bilirubin levels ameliorated (2.9 mg/dl) considerably by 15 days of therapy and the serum levels of AST (40 IU/dl) and ALT (20 IU/dl) got normalized. The case demonstrates that raised levels of hepatic transaminases can occur in infants with CHT and these can resolve just with thyroxin therapy, obviating the need for extensive investigative laboratory work-up.
http://ift.tt/2gybhrU
Dilated Cardiomyopathy Induced by Chronic Starvation and Selenium Deficiency
Protein energy malnutrition (PEM) has been rarely documented as a cause of cardiovascular abnormalities, including dilated cardiomyopathy. Selenium is responsible for antioxidant defense mechanisms in cardiomyocytes, and its deficiency in the setting of PEM and disease related malnutrition (DRM) may lead to exacerbation of the dilated cardiomyopathy. We report a rare case of a fourteen-year-old boy who presented with symptoms of congestive heart failure due to DRM and PEM (secondary to chronic starvation) along with severe selenium deficiency. An initial echocardiogram showed severely depressed systolic function consistent with dilated cardiomyopathy. Aggressive nutritional support and replacement of selenium and congestive heart failure medications that included diuretics and ACE inhibitors with the addition of carvedilol led to normalization of the cardiac function within four weeks. He continues to have significant weight gain and is currently completely asymptomatic from a cardiovascular standpoint.
http://ift.tt/2gcv6km
Sumoylation Stabilizes Smoothened to Promote Hedgehog Signaling
Publication date: 21 November 2016
Source:Developmental Cell, Volume 39, Issue 4
Author(s): Yun Qi, Han Liu, Xinhua Lin
The conserved Hedgehog signaling pathway is essential for embryonic development and tissue homeostasis and is tightly regulated. In this issue of Developmental Cell, Ma et al. (2016) demonstrate that sumoylation works in parallel with phosphorylation to stabilize Smoothened, antagonizing its ubiquitination and subsequent degradation, thus activating Hh target gene transcription.
Teaser
The conserved Hedgehog signaling pathway is essential for embryonic development and tissue homeostasis and is tightly regulated. In this issue of Developmental Cell, Ma et al. (2016) demonstrate that sumoylation works in parallel with phosphorylation to stabilize Smoothened, antagonizing its ubiquitination and subsequent degradation, thus activating Hh target gene transcription.http://ift.tt/2gcAunz
Subdistal Appendages Stabilize the Ups and Downs of Ciliary Life
Publication date: 21 November 2016
Source:Developmental Cell, Volume 39, Issue 4
Author(s): Domenico F. Galati, Brian J. Mitchell, Chad G. Pearson
Centrioles acquire subdistal appendages (sDAPs) during primary cilium formation. In this issue of Developmental Cell, Mazo et al. (2016) demonstrate that sDAPs keep cilia submerged within deep membrane invaginations. When sDAPs and centrosome cohesion are disrupted, cilia surface to the plasma membrane, which may alter mechanical and chemical signal transduction.
Teaser
Centrioles acquire subdistal appendages (sDAPs) during primary cilium formation. In this issue of Developmental Cell, Mazo et al. (2016) demonstrate that sDAPs keep cilia submerged within deep membrane invaginations. When sDAPs and centrosome cohesion are disrupted, cilia surface to the plasma membrane, which may alter mechanical and chemical signal transduction.http://ift.tt/2gcx44u
Aging Hematopoietic Stem Cells Make Their History
Publication date: 21 November 2016
Source:Developmental Cell, Volume 39, Issue 4
Author(s): Eva Maria Fast, Leonard Ira Zon
A major hallmark of aging is a decline in tissue regeneration. In a recent issue of Cell, Bernitz and colleagues (2016) determine the divisional history of hematopoietic stem cells (HSCs) to be a key player of regenerative potential in the aging mouse.
Teaser
A major hallmark of aging is a decline in tissue regeneration. In a recent issue of Cell, Bernitz and colleagues (2016) determine the divisional history of hematopoietic stem cells (HSCs) to be a key player of regenerative potential in the aging mouse.http://ift.tt/2gyaXtn
Redox Paradox: Can Hypoxia Heal Ischemic Hearts?
Publication date: 21 November 2016
Source:Developmental Cell, Volume 39, Issue 4
Author(s): Nuno Guimarães-Camboa, Sylvia M. Evans
Adult cardiomyocytes are largely thought to lack proliferative and therefore regenerative potential. Reporting in Nature, Nakada et al. (2016) find that a hypoxic regime reduces mitochondrial metabolism and promotes proliferation in adult mouse cardiomyocytes, resulting in increased regeneration following myocardial infarction. These findings suggest the potential to transform post-MI care.
Teaser
Adult cardiomyocytes are largely thought to lack proliferative and therefore regenerative potential. Reporting in Nature, Nakada et al. (2016) find that a hypoxic regime reduces mitochondrial metabolism and promotes proliferation in adult mouse cardiomyocytes, resulting in increased regeneration following myocardial infarction. These findings suggest the potential to transform post-MI care.http://ift.tt/2gczJv4
A Tether Is a Tether Is a Tether: Tethering at Membrane Contact Sites
Publication date: 21 November 2016
Source:Developmental Cell, Volume 39, Issue 4
Author(s): Michal Eisenberg-Bord, Nadav Shai, Maya Schuldiner, Maria Bohnert
Membrane contact sites enable interorganelle communication by positioning organelles in close proximity using molecular "tethers." With a growing understanding of the importance of contact sites, the hunt for new contact sites and their tethers is in full swing. Determining just what is a tether has proven challenging. Here, we aim to delineate guidelines that define the prerequisites for categorizing a protein as a tether. Setting this gold standard now, while groups from different disciplines are beginning to explore membrane contact sites, will enable efficient cooperation in the growing field and help to realize a great collaborative opportunity to boost its development.
Teaser
Membrane contact sites enable interorganellar communication by positioning two organelles in proximity through molecular "tethers." Determining just what is a tether has been challenging. Eisenberg-Bord, Shai et al. review known tether machineries and aim to delineate a gold-standard definition for categorizing a protein as a tether.http://ift.tt/2gyhSTe
One Gene, Many Proteins: Mapping Cell-Specific Alternative Splicing in Plants
Publication date: 21 November 2016
Source:Developmental Cell, Volume 39, Issue 4
Author(s): Ranjan Swarup, Martin Crespi, Malcolm J. Bennett
Pre-mRNA alternative splicing (AS) generates protein variants from a single gene that can create novel regulatory opportunities. In this issue of Developmental Cell, Li et al. (2016) present a high-resolution expression map of AS events in Arabidopsis root tissues, giving insight into cell-type- and stage-specific AS mechanisms in plants.
Teaser
Pre-mRNA alternative splicing (AS) generates protein variants from a single gene that can create novel regulatory opportunities. In this issue of Developmental Cell, Li et al. (2016) present a high-resolution expression map of AS events in Arabidopsis root tissues, giving insight into cell-type- and stage-specific AS mechanisms in plants.http://ift.tt/2gcymMz
Somatostatin agonist pasireotide inhibits exercise stimulated growth in the male Siberian hamster (Phodopus sungorus)
Abstract
The Siberian hamster (Phodopus sungorus) is a seasonal mammal, exhibiting a suite of physiologically and behaviourally distinct traits dependent on the time of year and governed by changes in perceived day length (photoperiod). These attributes include significant weight loss, reduced food intake, gonadal atrophy, and pelage change with short day photoperiod as in winter. The central mechanisms driving seasonal phenotype change during winter are mediated by a reduced availability of hypothalamic tri-iodothyronine (T3), but downstream mechanisms responsible for physiological and behavioural changes are yet to be fully elucidated. With access to a running wheel (RW) in short photoperiod, Siberian hamsters which have undergone photoperiod mediated weight loss override photoperiod-drive for reduced body weight and regain weight similar to a hamster held in long days. These changes occur despite retaining the majority of hypothalamic gene expression profiles appropriate for short day hamsters. Utilising the somatostatin agonist pasireotide, we have recently provided evidence for an involvement of the growth hormone axis (GH axis) in the seasonal regulation of bodyweight. In the present study we employed pasireotide to test for the possible involvement of the GH axis in running wheel induced body weight regulation. Pasireotide successfully inhibited exercise stimulated growth in short day hamsters and this was accompanied by altered hypothalamic gene expression of key GH axis components. Our data provides support for an involvement of the GH axis in the RW response in Siberian hamsters.
This article is protected by copyright. All rights reserved.
http://ift.tt/2gcsSS2
Performance of the irregular surface compensator compared with four-field box and intensity modulated radiation therapy for gynecologic cancer.
| Related Articles |
Performance of the irregular surface compensator compared with four-field box and intensity modulated radiation therapy for gynecologic cancer.
Phys Med. 2016 Nov 17;:
Authors: Sung W, Kim JI, Kim HS, Kim HJ, Lee YH, Ye SJ
Abstract
PURPOSE: A retrospective planning study was undertaken to evaluate the dosimetric advantages of the irregular surface compensator (ISC) technique, a forward planning technique with electronic compensation algorithm available on Varian Eclipse treatment planning system. This was extensively compared to the conventional four-field box (4FB) and intensity modulated radiation therapy using 5 fields (IMRT5F) on gynecologic cancer patients.
METHODS: Twenty-two patients were enrolled. The prescribed dose was 50.4Gy in 28 fractions to the primary target including pelvic lymph nodes. 4FB treatment plans were generated, then fluence of anterior and posterior fields were modified to generate ISC plans. IMRT5F were inversely optimized with equally spaced five coplanar fields. Dose-volume parameters were evaluated for the comparison of three planning techniques. The MU and delivery time were also estimated.
RESULTS: In terms of target coverage, the conformity and homogeneity index of ISC (1.67 and 1.03, respectively) were superior to those of 4FB (2.43 and 1.06, respectively) but slightly inferior to those of IMRT5F (1.10 and 1.02, respectively). ISC also illustrated an overall improvement in normal organ saving. Compared to 4FB, the mean dose of the rectum was reduced by about 4.0-5.0Gy with ISC and IMRT5F. The volume receiving large doses was reduced for bladder with statistical significance with ISC and more with IMRT5F relative to 4FB. The mean number of MU per fraction were 200.86 (4FB), 446.09 (ISC) and 895.59 (IMRT5F).
CONCLUSION: The ISC technique has the superior target coverage and healthy tissue sparing in comparison with conventional 4FB and comparable normal organ saving compared to IMRT5F. The ISC can be an available option for gynecologic radiotherapy.
PMID: 27866896 [PubMed - as supplied by publisher]
http://ift.tt/2gi1Yts
Testing continuum models of psychosis: No reduction in source monitoring ability in healthy individuals prone to auditory hallucinations
Publication date: Available online 22 November 2016
Source:Cortex
Author(s): Jane R. Garrison, Peter Moseley, Ben Alderson-Day, David Smailes, Charles Fernyhough, Jon S. Simons
People with schizophrenia who hallucinate show impairments in reality monitoring (the ability to distinguish internally generated information from information obtained from external sources) compared to non-hallucinating patients and healthy individuals. While this may be explained at least in part by an increased externalizing bias, it remains unclear whether this impairment is specific to reality monitoring, or whether it also reflects a general deficit in the monitoring of self-generated information (internal source monitoring). Much interest has focused recently on continuum models of psychosis which argue that hallucination-proneness is distributed in clinical and non-clinical groups, but few studies have directly investigated reality monitoring and internal source monitoring abilities in healthy individuals with a proneness to hallucinations. Two experiments are presented here: the first (N = 47, with participants selected for hallucination-proneness from a larger sample of 677 adults) found no evidence of an impairment or externalizing bias on a reality monitoring task in hallucination-prone individuals; the second (N = 124) found no evidence of atypical performance on an internal source monitoring task in hallucination-prone individuals. The significance of these findings is reviewed in light of the clinical evidence and the implications for models of hallucination generation discussed.
http://ift.tt/2fBqxAi
Crossing the Chasm(s): Demonstrating the Clinical Value of Hyperpolarized Gas MRI
Source:Academic Radiology
Author(s): Bastiaan Driehuys
http://ift.tt/2fnbZa0
Estimating the Area Under ROC Curve When the Fitted Binormal Curves Demonstrate Improper Shape
Source:Academic Radiology
Author(s): Andriy I. Bandos, Ben Guo, David Gur
Rationale and ObjectivesThe "binormal" model is the most frequently used tool for parametric receiver operating characteristic (ROC) analysis. The binormal ROC curves can have "improper" (non-concave) shapes that are unrealistic in many practical applications, and several tools (eg, PROPROC) have been developed to address this problem. However, due to the general robustness of binormal ROCs, the improperness of the fitted curves might carry little consequence for inferences about global summary indices, such as the area under the ROC curve (AUC). In this work, we investigate the effect of severe improperness of fitted binormal ROC curves on the reliability of AUC estimates when the data arise from an actually proper curve.Materials and MethodsWe designed theoretically proper ROC scenarios that induce severely improper shape of fitted binormal curves in the presence of well-distributed empirical ROC points. The binormal curves were fitted using maximum likelihood approach. Using simulations, we estimated the frequency of severely improper fitted curves, bias of the estimated AUC, and coverage of 95% confidence intervals (CIs). In Appendix S1, we provide additional information on percentiles of the distribution of AUC estimates and bias when estimating partial AUCs. We also compared the results to a reference standard provided by empirical estimates obtained from continuous data.ResultsWe observed up to 96% of severely improper curves depending on the scenario in question. The bias in the binormal AUC estimates was very small and the coverage of the CIs was close to nominal, whereas the estimates of partial AUC were biased upward in the high specificity range and downward in the low specificity range. Compared to a non-parametric approach, the binormal model led to slightly more variable AUC estimates, but at the same time to CIs with more appropriate coverage.ConclusionsThe improper shape of the fitted binormal curve, by itself, ie, in the presence of a sufficient number of well-distributed points, does not imply unreliable AUC-based inferences.
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Handgrip Strength Is Positively Associated with Mildly Elevated Serum Bilirubin Levels among Community-Dwelling Adults.
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Handgrip Strength Is Positively Associated with Mildly Elevated Serum Bilirubin Levels among Community-Dwelling Adults.
Tohoku J Exp Med. 2016;240(3):221-226
Authors: Kawamoto R, Ninomiya D, Kumagi T
Abstract
Handgrip strength (HGS) is a useful measure of health-related quality of life and general muscle strength. Serum total bilirubin (T-B) may present potential beneficial effects in preventing oxidative changes which are associated with a risk of metabolic syndrome and the development of cardiovascular disease. Limited information is available regarding whether HGS is an independent confounding factor for serum T-B. The study participants were 214 men aged 71 ± 8 (mean ± standard deviation) years and 302 women aged 71 ± 7 years that were enrolled consecutively from among paticipants aged ≥ 50 years through an annual check-up process. We evaluated the relationship between serum T-B and confounding factors within each sex. HGS related significantly with serum T-B in both men (r = 0.156, p = 0.023) and women (r = 0.173, p = 0.003). Multiple linear regression analysis showed that in men, HGS (β = 0.173) as well as smoking status (β = -0.147), exercise habit (β = 0.138), low-density lipoprotein cholesterol (β = 0.146), and hemoglobin A1c (HbA1c) (β = -0.198) were significantly and independently associated with serum T-B. In women, HGS (β = 0.159) as well as smoking status (β = -0.116), high-density lipoprotein cholesterol (β = 0.159), and HbA1c (β = -0.161) were significantly and independently associated with serum T-B. Multivariate-adjusted serum T-B levels were significantly lower in subjects with the lowest HGS level in both sexes. Increased HGS is strongly associated with increased serum T-B, independent of confounding factors in both sexes.
PMID: 27867155 [PubMed - in process]
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Bronchial Foreign Body Alerting of a Bronchial Tumor: The Need of a Follow-Up Radiography
Lung tumors are extremely rare in the pediatric population, comprising only 0.2% of all malignancies in children. Among them, mucoepidermoid carcinoma (MEC) is even rarer with a reported frequency of 0.1% to 0.2%. MEC is defined by the World Health Organization as a tumor characterized by a combination of mucus-secreting, squamous, and intermediate cell types. We describe the case of a 4-year-old girl who presented with a history of intermittent fever and nonproductive cough of 1-month duration after foreign body aspiration. The chest X-ray showed complete collapse of the left lung. After removal of the foreign body, the lung expanded well after. However, the control chest X-ray done after 5 days showed again complete collapse of the left lung. The biopsy specimen taken during bronchoscopy confirmed the diagnosis of low-grade MEC. Fluorescence in situ hybridization (FISH) confirmed the presence of MAML2 rearrangement. Complete surgical resection with preservation of lung parenchyma was performed. No adjuvant therapy was needed. Repeat bronchoscopy was performed 2 months after surgery and showed no recurrence of the tumor. In conclusion, a remote chest X-ray after removal of a foreign body is necessary to avoid missing a rare serious underlying disease such as MEC. According to the size and the location of the tumor, complete surgical removal is sufficient without additional treatment in case of low-grade tumor. The presence of MAML2 rearrangement confers a favorable outcome and may have long-term implications for the clinical management.
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Application of genetically engineered Salmonella typhimurium for interferon-gamma–induced therapy against melanoma
Source:European Journal of Cancer, Volume 70
Author(s): Wonsuck Yoon, Yoo Chang Park, Jinseok Kim, Yang Seok Chae, Jung Hye Byeon, Sang-Hyun Min, Sungha Park, Young Yoo, Yong Keun Park, Byeong Mo Kim
Salmonella have been experimentally used as anti-cancer agents, because they show selective growth in tumours. In this study, we genetically modified attenuated Salmonella typhimurium to express and secrete interferon-gamma (IFN-γ) as a tumouricidal agent to enhance the therapeutic efficacy of Salmonella. IFN-γ was fused to the N-terminal region (residues 1–160) of SipB (SipB160) for secretion from bacterial cells. Attenuated S. typhimurium expressing recombinant IFN-γ (S. typhimurium (IFN-γ)) invaded the melanoma cells and induced cytotoxicity. Subcutaneous administration of S. typhimurium (IFN-γ) also efficiently inhibited tumour growth and prolonged the survival of C57BL/6 mice bearing B16F10 melanoma compared with administration of phosphate-buffered saline (PBS), unmodified S. typhimurium or S. typhimurium expressing empty vector (S. typhimurium [Vec]) in a natural killer (NK) cell-dependent manner. Moreover, genetically modified Salmonella, including S. typhimurium (IFN-γ), showed little toxicity to normal tissues with no observable adverse effects. However, S. typhimurium (IFN-γ)-mediated tumour suppression was attributed to direct killing of tumour cells rather than to stable anti-tumour immunity. Collectively, these results suggest that tumour-targeted therapy using S. typhimurium (IFN-γ) has potential for melanoma treatment.
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Growth of a progesterone receptor-positive meningioma in a female patient with congenital adrenal hyperplasia
Summary
Meningioma growth has been previously described in patients receiving oestrogen/progestogen therapy. We describe the clinical, radiological, biochemical and pathologic findings in a 45-year-old woman with congenital adrenal hyperplasia secondary to a defect in the 21-hydroxylase enzyme who had chronic poor adherence to glucocorticoid therapy with consequent virilisation. The patient presented with a frontal headache and marked right-sided proptosis. Laboratory findings demonstrated androgen excess with a testosterone of 18.1 nmol/L (0–1.5 nmol) and 17-Hydroxyprogesterone >180 nmol/L (<6.5 nmol/L). CT abdomen was performed as the patient complained of rapid-onset increasing abdominal girth and revealed bilateral large adrenal myelolipomata. MRI brain revealed a large meningioma involving the right sphenoid wing with anterior displacement of the right eye and associated bony destruction. Surgical debulking of the meningioma was performed and histology demonstrated a meningioma, which stained positive for the progesterone receptor. Growth of meningioma has been described in postmenopausal women receiving hormone replacement therapy, in women receiving contraceptive therapy and in transsexual patients undergoing therapy with high-dose oestrogen and progestogens. Progesterone receptor positivity has been described previously in meningiomas. 17-Hydroxyprogesterone is elevated in CAH and has affinity and biological activity at the progesterone receptor. Therefore, we hypothesise that patients who have long-standing increased adrenal androgen precursor concentrations may be at risk of meningioma growth.
Learning points:Patients with long-standing CAH (particularly if not optimally controlled) may present with other complications, which may be related to long-standing elevated androgen or decreased glucocorticoid levels.
Chronic poor control of CAH is associated with adrenal myelolipoma and adrenal rest tissue tumours.
Meningiomas are sensitive to endocrine stimuli including progesterone, oestrogen and androgens as they express the relevant receptors.
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