Costs of perennial allergic rhinitis and allergic asthma increase with severity and poor disease control

Abstract

Background

Perennial allergic rhinitis (PAR) represents a global and public health problem, due to its prevalence, morbidity, and impact on the quality of life. PAR is frequently associated to allergic asthma (AA). Costs of PAR with or without AA are poorly documented.

Objective

Our study aimed to detail medical resource utilization (MRU) and related direct cost for PAR, with or without concomitant AA, in France.

Methods

Using Electronic Health Records (EHRs), we identified in 2010 two cohorts of PAR patients, based on General Practitioners' diagnoses and prescribing data, with and without concomitant AA. For each patient, the EHRs were linked to corresponding claims data with MRU and costs during years 2011 to 2013. Predefined sub-group analyses were performed according to severity of PAR and level of AA control.

Results

The median annual cost reimbursed by social security system for a patient with PAR and no AA was 159€ in 2013. This varied from 111€ to 188€ depending on PAR severity. For patients with PAR and concomitant AA, the median annual cost varied between 266€ and 375€, and drug treatment accounted for 42%-55% of the costs, depending on asthma control.

Conclusion

This study linking diagnoses from EHRs to claims data collected valid information on PAR management, with or without concomitant AA, and on related costs. There was a clear increase of costs with severity of PAR and control of AA.

This article is protected by copyright. All rights reserved.

http://ift.tt/2fzmK98

Wpływ spożywania orzeszków ziemnych w badaniu LEAP: wykonalność, rozwój fizyczny i stan odżywienia

Publication date: Available online 25 November 2016
Source:Alergologia Polska - Polish Journal of Allergology
Author(s): Mary Feeney, George Du Toit, Graham Roberts, Peter H. Sayre, Kaitie Lawson, Henry T. Bahnson, Michelle L. Sever, Suzana Radulovic, Marshall Plaut, Gideon Lack

Graphical abstract

http://ift.tt/2fgLBju

An isothermal, label-free, and rapid one-step RNA amplification/detection assay for diagnosis of respiratory viral infections

Publication date: 15 April 2017
Source:Biosensors and Bioelectronics, Volume 90
Author(s): Bonhan Koo, Choong Eun Jin, Tae Yoon Lee, Jeong Hoon Lee, Mi Kyoung Park, Heungsup Sung, Se Yoon Park, Hyun Jung Lee, Sun Mi Kim, Ji Yeun Kim, Sung-Han Kim, Yong Shin
Recently, RNA viral infections caused by respiratory viruses, such as influenza, parainfluenza, respiratory syncytial virus, coronavirus, and Middle East respiratory syndrome-coronavirus (MERS-CoV), and Zika virus, are a major public health threats in the world. Although myriads of diagnostic methods based on RNA amplification have been developed in the last decades, they continue to lack speed, sensitivity, and specificity for clinical use. A rapid and accurate diagnostic method is needed for appropriate control, including isolation and treatment of the patients. Here, we report an isothermal, label-free, one-step RNA amplification and detection system, termed as iROAD, for the diagnosis of respiratory diseases. It couples a one-step isothermal RNA amplification method and a bio-optical sensor for simultaneous viral RNA amplification/detection in a label-free and real-time manner. The iROAD assay offers a one-step viral RNA amplification/detection example to rapid analysis (<20min). The detection limit of iROAD assay was found to be 10-times more sensitive than that of real-time reverse transcription-PCR method. We confirmed the clinical utility of the iROAD assay by detecting viral RNAs obtained from 63 human respiratory samples. We envision that the iROAD assay will be useful and potentially adaptable for better diagnosis of emerging infectious diseases including respiratory diseases.



http://ift.tt/2fzrifx

Cortical interneuron specification: the juncture of genes, time and geometry

Publication date: February 2017
Source:Current Opinion in Neurobiology, Volume 42
Author(s): Rachel C Bandler, Christian Mayer, Gord Fishell
A fundamental question in developmental neuroscience is how hundreds of diverse cell types are generated to form specialized brain regions. The ganglionic eminences (GEs) are embryonic brain structures located in the ventral telencephalon that produce many inhibitory GABA (γ-Aminobutyric acid)-ergic cell types, including long-range projection neurons and local interneurons (INs), which disperse widely throughout the brain. While much has been discovered about the origin and wiring of these cells, a major question remains: how do neurons originating in the GEs become specified during development as one differentiated subtype versus another? This review will cover recent work that has advanced our knowledge of the mechanisms governing cortical interneuron subtype specification, particularly progenitors' spatial origin, birthdates, lineage, and mode of division.

Graphical abstract

http://ift.tt/2g09zid

Disease-modifying polymorphisms and C609Y mutation of RET associated with high penetrance of phaeochromocytoma and low rate of MTC in MEN2A

Mutations of the rearranged during transfection (RET) proto-oncogene, located on chromosome 10q11.2, cause multiple endocrine neoplasia type 2A (MEN2A). Patients with mutations at the codon 609 usually exhibit a high penetrance of medullary thyroid cancer (MTC), but a sufficiently low penetrance of phaeochromocytoma that screening for this latter complication has been called to question. Patients with other RET mutations are at higher risk of younger age onset phaeochromocytoma if they also possess other RET polymorphisms (L769L, S836S, G691S and S904S), but there are no similar data for patients with 609 mutations. We investigated the unusual phenotypic presentation in a family with MEN2A due to a C609Y mutation in RET. Sanger sequencing of the entire RET-coding region and exon–intron boundaries was performed. Five family members were C609Y mutation positive: 3/5 initially presented with phaeochromocytoma, but only 1/5 had MTC. The index case aged 73 years had no evidence of MTC, but presented with phaeochromocytoma. Family members also possessed the G691S and S904S RET polymorphisms. We illustrate a high penetrance of phaeochromocytoma and low penetrance of MTC in patients with a RET C609Y mutation and polymorphisms G691S and S904S. These data highlight the need for life-long screening for the complications of MEN2A in these patients and support the role for the screening of RET polymorphisms for the purposes of risk stratification.

Learning points:

C609Y RET mutations may be associated with a life-long risk of phaeochromocytoma indicating the importance of life-long screening for this condition in patients with MEN2A.

C609Y RET mutations may be associated with a lower risk of MTC than often quoted, questioning the need for early prophylactic thyroid surgery discussion at the age of 5 years.

There may be a role for the routine screening of RET polymorphisms, and this is greatly facilitated by the increasing ease of access to next-generation sequencing.

http://ift.tt/2gcIwh2

Internal and external generalizability of temporal dose–response relationships for xerostomia following IMRT for head and neck cancer

Publication date: Available online 24 November 2016
Source:Radiotherapy and Oncology
Author(s): Maria Thor, Adepitan A. Owosho, Haley D. Clark, Jung Hun Oh, Nadeem Riaz, Allan Hovan, Jillian Tsai, Steven D. Thomas, Sae Hee K. Yom, Jonn S. Wu, Joseph M. Huryn, Vitali Moiseenko, Nancy Y. Lee, Cherry L. Estilo, Joseph O. Deasy
Background and purposeTo study internal and external generalizability of temporal dose–response relationships for xerostomia after intensity-modulated radiotherapy (IMRT) for head and neck cancer, and to investigate potential amendments of the QUANTEC guidelines.Material and methodsObjective xerostomia was assessed in 121 patients (nCohort1=55; nCohort2=66) treated to 70Gy@2Gy in 2006–2015. Univariate and multivariate analyses (UVA, MVA with 1000 bootstrap populations) were conducted in Cohort1, and generalizability of the best-performing MVA model was investigated in Cohort2 (performance: AUC, p-values, and Hosmer–Lemeshow p-values (pHL)). Ultimately and for clinical guidance, minimum mean dose thresholds to the contralateral and the ipsilateral parotid glands (Dmeancontra, Dmeanipsi) were estimated from the generated dose–response curves.ResultsThe observed xerostomia rate was 38%/47% (3months) and 19%/23% (11–12months) in Cohort1/Cohort2. Risk of xerostomia at 3months increased for higher Dmeancontra and Dmeanipsi (Cohort1: 0.17·Dmeancontra+0.11·Dmeanipsi-8.13; AUC=0.90±0.05; p=0.0002±0.002; pHL=0.22±0.23; Cohort2: AUC=0.81; p<0.0001; pHL=0.27). The identified minimum Dmeancontra thresholds were lower than in the QUANTEC guidelines (Cohort1/Cohort2: Dmeancontra=12/19Gy; Dmeancontra, Dmeanipsi=16, 25/20, 26Gy).ConclusionsIncreased Dmeancontra and Dmeanipsi explain short-term xerostomia following IMRT. Our results also suggest decreasing Dmeancontra to below 20Gy, while keeping Dmeanipsi to around 25Gy. Long-term xerostomia was less frequent, and no dose–response relationship was established for this follow-up time.



http://ift.tt/2gcDjWx

The changing landscape in radiotherapy for breast cancer: Lessons from long term follow-up in some European breast cancer trials

Publication date: Available online 24 November 2016
Source:Radiotherapy and Oncology
Author(s): Harry Bartelink
This review describes the developments in the radiation treatment of breast cancer based on some randomized European trials during the past decades. It will focus on the relevance of long term follow-up in breast cancer patients, starting with the surprising and important change in treatment results during follow-up shown in a locally advanced breast cancer trial. Breast conserving therapy (BCT) in stage I and II breast cancer was explored and tested in a randomized trial to prove equivalence between BCT and mastectomy. The positive outcome led to trials in breast conserving therapy with lower doses and partial breast irradiation. Finally the need for finding genetic profiles for predicting treatment response will be addressed in a trial with preoperative partial breast irradiation.



http://ift.tt/2fyXLTo

Patient-reported quality of life after stereotactic body radiation therapy versus moderate hypofractionation for clinically localized prostate cancer

Publication date: Available online 24 November 2016
Source:Radiotherapy and Oncology
Author(s): Skyler Bryce Johnson, Pamela R. Soulos, Timothy D. Shafman, Constantine A. Mantz, Arie P. Dosoretz, Rudi Ross, Steven E. Finkelstein, Sean P. Collins, Simeng Suy, Jeffrey V. Brower, Mark A. Ritter, Christopher R. King, Patrick A. Kupelian, Eric M. Horwitz, Alan Pollack, Matthew C. Abramowitz, Mark A. Hallman, Sergio Faria, Cary P. Gross, James B. Yu
Background and purposeEvaluate changes in bowel, urinary and sexual patient-reported quality of life following treatment with moderately hypofractionated radiotherapy (<5Gray/fraction) or stereotactic body radiation therapy (SBRT;5–10Gray/fraction) for prostate cancer.Materials and methodsIn a pooled multi-institutional analysis of men treated with moderate hypofractionation or SBRT, we compared minimally detectable difference in bowel, urinary and sexual quality of life at 1 and 2years using chi-squared analysis and logistic regression.Results378 men received moderate hypofractionation compared to 534 men who received SBRT. After 1year, patients receiving moderate hypofractionation were more likely to experience worsening in bowel symptoms (39.5%) compared to SBRT (32.5%; p=.06), with a larger difference at 2years (37.4% versus 25.3%, p=.002). Similarly, patients receiving moderate fractionation had worsening urinary symptom score compared to patients who underwent SBRT at 1 and 2years (34.7% versus 23.1%, p<.001; and 32.8% versus 14.0%, p<.001). There was no difference in sexual symptom score at 1 or 2years. After adjusting for age and cancer characteristics, patients receiving SBRT were less likely to experience worsening urinary symptom scores at 2years (odds ratio: 0.24[95%CI: 0.07–0.79]).ConclusionsPatients who received SBRT or moderate hypofractionation have similar patient-reported change in bowel and sexual symptoms, although there was worse change in urinary symptoms for patients receiving moderate hypofractionation.



http://ift.tt/2fyTZcH

The Bench Press: The most misunderstood lift in Strength & Conditioning

Publication date: Available online 25 November 2016
Source:Journal of Bodywork and Movement Therapies
Author(s): Brian Carroll, D.C. Craig Liebenson




http://ift.tt/2gpdE01

Disease-modifying polymorphisms and C609Y mutation of RET associated with high penetrance of phaeochromocytoma and low rate of MTC in MEN2A

Mutations of the rearranged during transfection (RET) proto-oncogene, located on chromosome 10q11.2, cause multiple endocrine neoplasia type 2A (MEN2A). Patients with mutations at the codon 609 usually exhibit a high penetrance of medullary thyroid cancer (MTC), but a sufficiently low penetrance of phaeochromocytoma that screening for this latter complication has been called to question. Patients with other RET mutations are at higher risk of younger age onset phaeochromocytoma if they also possess other RET polymorphisms (L769L, S836S, G691S and S904S), but there are no similar data for patients with 609 mutations. We investigated the unusual phenotypic presentation in a family with MEN2A due to a C609Y mutation in RET. Sanger sequencing of the entire RET-coding region and exon–intron boundaries was performed. Five family members were C609Y mutation positive: 3/5 initially presented with phaeochromocytoma, but only 1/5 had MTC. The index case aged 73 years had no evidence of MTC, but presented with phaeochromocytoma. Family members also possessed the G691S and S904S RET polymorphisms. We illustrate a high penetrance of phaeochromocytoma and low penetrance of MTC in patients with a RET C609Y mutation and polymorphisms G691S and S904S. These data highlight the need for life-long screening for the complications of MEN2A in these patients and support the role for the screening of RET polymorphisms for the purposes of risk stratification.

Learning points:

C609Y RET mutations may be associated with a life-long risk of phaeochromocytoma indicating the importance of life-long screening for this condition in patients with MEN2A.

C609Y RET mutations may be associated with a lower risk of MTC than often quoted, questioning the need for early prophylactic thyroid surgery discussion at the age of 5 years.

There may be a role for the routine screening of RET polymorphisms, and this is greatly facilitated by the increasing ease of access to next-generation sequencing.

http://ift.tt/2gcIwh2

Pin-on-disc study of brake friction materials with ball-milled nanostructured components

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Cinzia Menapace, Mara Leonardi, Guido Perricone, Mauro Bortolotti, Giovanni Straffelini, Stefano Gialanella
Copper is an ingredient of the automotive disc brake pads with important functional role. On the other hand, copper is regarded as one of the most hazardous component of the particulate matter released by the brake linings. Legislation in several countries is progressively reducing the tolerated amount of copper in friction materials. In this work, a possible approach to the reduction of copper in brake friction materials is presented. Starting from a commercial, state-of-the art, non-asbestos organic friction material, different formulations have been prepared, changing the microstructure of some of the ingredients, namely copper and zirconia using high energy ball-milling. The wear behavior of the newly developed materials has been tested and validated using pin-on-disc wear tests. One interesting aspect observed is that the wearing out of copper fibres produces fine copper particles entering the friction layer, thus contributing to its compaction. This observation implies that copper powder is not strictly required as a component in the starting friction material to achieve anyway a satisfactory tribological behavior associated with a stable friction layer. Furthermore, the addition of milled components provided interesting indications to be explored further in view of the replacement of copper in brake friction materials.

Graphical abstract

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Development of a new high entropy alloy for wear resistance: FeCoCrNiW0.3 and FeCoCrNiW0.3+5at.% of C

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Marco Gabriele Poletti, Gianluca Fiore, Flavia Gili, Davide Mangherini, Livio Battezzati
A new high entropy alloy (HEA) has been synthesized using a predictive method recently developed. The alloy performance is compared to that of a benchmark commercial alloys (Stellite®6) as wear resistance material for coating automotive engine valves.Using step by step predictive parameters the occurrence of an fcc solid solution with entropy of mixing higher than the conventional limit of 1.5 R (with R the gas constant) was singled out and verified in the FeCoCrNiW0.3 composition. The as-cast ingot displays W segregation within the fcc grains as revealed by Scanning Electron Microscopy and X-ray Diffraction (XRD) patterns which were fitted by assuming the arc melted alloy contains two solid solutions. The segregation is eliminated by annealing at 1200°C for 3h. In these sample a (Co-Fe)7W6-type phase is found embedded in the solid solution matrix. Slip bands around indentation marks suggest low stacking fault energy of FeCoCrNiW0.3. The high entropy alloy (HEA) has been hardened by adding 5at.% C to form carbides inside the fcc matrix. Conventional hardness, scratch and oxidation resistance tests show that the alloy compares well with Co-based Stellite®6 being the content of the expensive and strategical elements halved with respect to it.

Graphical abstract

http://ift.tt/2fySafK

Self-organized sol-gel TiO2 structures: Particles, rectangle tubes, and flower-like slabs

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Shih-Jung Ho, Chang-Wei Yeh, Ramachandran Vasant Kumar, Hsueh-Shih Chen
Effects of alcohols on the growth and morphology of TiO2 from two different self-organization methods, i.e., water-vapor hydrolysis and ultraslow water-diffusion hydrolysis, were investigated. In the first method, Ti alkoxide was hydrolyzed by water vapor to generate TiO2 particles in a solution, which exhibited that the alcohols not only reduced the anatase crystal size, but also influenced the packing density of secondary particles and the subsequent sintering outcome, which are attributable to involvement of the alcohols in both self-organization and crystallization processes. In the other method based on the ultra-slow water-diffusion hydrolysis, ethanol led to very compact spherical secondary particles that resulted in a lower sintering temperature, while methanol caused the anisotropic growth of particles that produced two novel 1D structures, i.e., rectangle tubes and flower-like slabs due to incorporation of a structurally different alcohol in the sol-gel process.

Graphical abstract

http://ift.tt/2fyXtf9

Hot deformation characteristics and processing map of a phosphorous modified super austenitic stainless steel

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): K. Arun Babu, S. Mandal, C.N. Athreya, B. Shakthipriya, V. Subramanya Sarma
Hot deformation behavior of a phosphorous-modified super austenitic stainless steel was studied in the temperature range of 1173–1423K and strain rate range of 0.001–10s⁻¹ employing thermomechanical simulator. The apparent activation energy for deformation in the above processing regime was estimated to be 482kJmol⁻¹. The deformation parameters were modeled using Arrhenius equation and Zener–Hollomon parameter (Z). Peak stress, critical stress for dynamic recrystallization, stress at which flow softening is maximum as well as steady state stress was found to exhibit a linear relationship with ln(Z/A). Strains corresponding to these stresses were also found to exhibit the relation ε=CZAp. Processing maps were developed at different plastic strains employing dynamic materials modeling. Microstructures corresponding to the different processing conditions were characterized employing electron back scatter diffraction. Based on the analysis of microstructure and processing map, the optimum processing domain for hot deformation is identified as strain rate range of 0.01–0.1s⁻¹ and temperature range of 1300–1350K. Although a significant recrystallization was observed following hot deformation in the strain rate ranges of 1–10s⁻¹ and temperature ranges 1373–1423K, this domain was marked as unstable in the processing map.

Graphical abstract

http://ift.tt/2fyRuah

Synthesis and characterization of multilayered nanobiohybrid magnetic particles for biomedical applications

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): S.A. Maboudi, S.A. Shojaosadati, A. Arpanaei
In this study, new magnetic nanobiohybrid particles with a multilayered structure were prepared. 7±1nm oleic acid modified magnetite nanoparticles (MNP) were synthesized via the chemical coprecipitation method. Then, magnetite nanoparticles clusters were coated with a thin silica shell (MS) by the sol-gel approach. The as-synthesized MS particles have a spherical shape and an average size of 147±20nm according to SEM images. Then, bovine serum albumin was conjugated 9–10wt% to aminated particles through glutaraldehyde activation (BSA-MS). BSA-MS particles were then compared with MS particles as a platform for precipitation of subsequent protein shell which was imprinted by desolvation method (BSA shell-BSA-MS & BSA shell-MS particles, respectively). TGA data revealed that an albumin shell of about 17 and 31wt% has been formed on MS and BSA-MS particles, respectively. VSM analysis results indicated the superparamagnetic behavior for magnetite, MS, and BSA shell-BSA-MS particles. Cellular toxicity of MS and BSA shell-BSA-MS particles was also investigated on HepG2 cells. The presence of albumin as a biomolecule coating on the surface of MS particles showed an improving effect to reduce the cytotoxicity. The properties of the designed particles propose the multilayered nanobiohybrid magnetic particles as a promising candidate for multifunctional biomedical applications.

Graphical abstract

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Prediction of mechanical and fracture properties of rubber composites by microstructural modeling of polymer-filler interfacial effects

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Mohammad Alimardani, Mehdi Razzaghi-Kashani, Mir Hamid Reza Ghoreishy
In nano-dispersed filler containing rubbers, mechanical properties of composites are dictated by the characteristics of surface layers in the interphase as well as the manner in which rubber interacts with filler at the interface. In the present contribution, surface-related and volume-related effects of filler on the reinforcement were distinctively considered in the finite element prediction of mechanical and fracture properties. A unit-cell containing three phases of a single particle, an interphase perfectly bonded to the particle, and the rubber matrix was built. The particle represents the total volume fraction of the filler, and the interphase symbolizes all surface related phenomena of the filler including filler surface area, filler structure, filler-filler interaction and filler-polymer interaction. The J-integral was evaluated to approximate the energy release rate of a crack interacting with the interphase layers having hyper-elastic or hyper-viscoelastic properties. It was shown that the interphase layers are capable of lowering the crack driving force by reducing the level of local strain fields or inducing viscoelastic dissipations. Substitution of the "perfect bonding" interface with a "freely moving" one greatly affected the energy release rate, confirming the experimental evidence that a perfect bonding is not desirable for crack growth resistance.

Graphical abstract

http://ift.tt/2fyOV88

Formation mechanisms and functionality of boundary films derived from water lubricated polyoxymethylene/hexagonal boron nitride nanocomposites

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Chuanping Gao, Guofan Guo, Ga Zhang, Qihua Wang, Tingmei Wang, Honggang Wang
Development of high-performance polymer composites exposed to water lubrication conditions is of increasing interests for numerous applications, where high durability and reliability are demanded. However, formation of a protective boundary reaction layer on the rubbing surfaces can be problematic with the presence of water. The roles of hexagonal boron nitride (h-BN) nanoparticles on the tribological performance of polyoxymethylene (POM) and POM composite reinforced with short carbon fibers were investigated. It is identified that the addition of low loading h-BN greatly improves the tribological performance, e.g. wear resistance of POM is enhanced by one order of magnitude. Moreover, h-BN and carbon fibers play a synergetic role in enhancing the wear resistance. Tribo-chemistry and nanostructures of the boundary film were comprehensively investigated. It is revealed that H3BO3 and B2O3 generated as products of tribo-chemical reactions are arrayed in a closely packed outmost layer of the boundary film and exert an important influence on the tribological performance. Our work gives the evidence that the basal planes of H3BO3 and B2O3 are aligned parallel to the sliding direction, leading to low friction and wear.

Graphical abstract

http://ift.tt/2fyTJu5

Numerical study of inter-yarn friction on the failure of fabrics upon ballistic impacts

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Yanyan Chu, Shengnan Min, Xiaogang Chen
This paper investigates the influence of inter-yarn friction in fabrics on the ballistic performances of the target including failure. Finite element (FE) method was adopted for the study, where FE models were established for two types of fabrics based on the yarn properties of Twaron® and Dyneema®, respectively. Numerical analyses on the responses of the primary and secondary yarns in the fabrics subjected to ballistic impact were carried out based on these fabric models. The results show that larger inter-yarn friction leads to less slippage of primary yarns at impact centre. In addition, higher inter-yarn friction make more involvement of the secondary yarns join in loading the impact energy, so as to alleviate the loads in primary yarns and prolong the failure of primary yarns. However, if the inter-yarn friction is too high, beyond coefficient of static friction (CSF) of 0.8 and coefficient of kinetic friction (CKF) of 0.75, the action would be counterproductive. The reason is that the stress at those inter-yarn friction levels would be more concentrated on the primary yarns, resulting in an earlier failure of a fabric.

Graphical abstract

http://ift.tt/2fyWbki

Enhanced thermoelectric performance via the solid solution formation: The case of pseudobinary alloy (Cu2Te)(Ga2Te3)3 upon Sb substitution for Cu

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Jiaolin Cui, Xianglian Liu, Zhengliang Du, Yimin Chao
In this work we have observed the beneficial effect from the solid solution formation on the thermoelectric performance of (Cu2(1−x)Sb2xTe)(Ga2Te3)3 upon Sb substitution for Cu. This substitution allows the different occupations of Sb in the crystal lattice, i.e. Sb at Cu sites with x≤0.05 and at Ga sides with x≥0.05, which has resulted in the Pisarenko relation does not exactly capture the measured Seebeck coefficient under assumed effective masses m*. The reduction of the lattice thermal conductivity (κL) has been quantified within the temperature range from room temperature to 723K. Over the entire composition range, the κL value is reduced by 33% and 25% at temperature 723K and 580K, respectively. This observation is in a good agreement with the theoretical calculation based on the Callaway model used in the solid solutions. Along with the increasing of the mobility and electrical conductivity, the thermoelectric performance has been improved with the highest ZT value of 0.58 at 723K, which is about double the value of intrinsic (Cu2Te)(Ga2Te3)3.

Graphical abstract

http://ift.tt/2fyVgR3

Experimental investigation and thermodynamic calculation of the Al-rich corner in the ternary Al-Ti-V system

Publication date: 5 February 2017
Source:Materials & Design, Volume 115
Author(s): Qian Li, Zi-Wei Chen, Qun Luo, Bao-Wei Li
Vanadium was added into Al-Ti based alloys to improve the intermediate temperature ductility and refine the grains. However, the change of phase relations and phase transitions resulted from the V addition has not been fully understood. In this study, the phase equilibria in the Al-rich corner of Al-Ti-V system were investigated using X-ray diffraction, scanning electron microscopy, energy dispersive spectrometer and differential scanning calorimeter. To validate the phase relations, five Al-rich key alloys were prepared and annealed at 600°C and 700°C for 360h respectively. The results indicated that two three-phase regions and three two-phase regions exist in the Al-rich corner at 600°C. And one three-phase region and four two-phase regions are stable at 700°C. The EDS results showed that the solubility of V in TiAl3 can vary from 2.8at.% to 27.0at.%, which results in a solid solution phase (Ti, V)Al3. Based on the isothermal phase equilibria at 600°C and 700°C and the invariant reactions determined in this work, the model parameters of (Ti, V)Al3 were optimized and a new thermodynamic description of Al-Ti-V system was obtained. Comparing the calculated results with the experimental data, a good agreement was reached.

Graphical abstract

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Erratum to: Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

http://ift.tt/2gu1JeR

Rapid-onset obesity, hypoventilation, hypothalamic dysfunction, autonomic dysregulation and neuroendocrine tumor syndrome with a homogenous enlargement of the pituitary gland: a case report

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome is a rare pediatric disorder with a variable sequence of clinical presentations, undefined etiology, and...

http://ift.tt/2gHrwmQ

Association between recovery from Bell's palsy and body mass index

Abstract

Background

Although many factors have been found to be involved in recovery from Bell's palsy, no study has investigated the association between recovery from Bell's palsy and obesity. This study therefore evaluated the association between recovery from Bell's palsy and body mass index (BMI).

Methods

Subjects were classified into five groups based on BMI (kg/m2). Demographic and clinical characteristics were compared among these groups. Assessed factors included sex, age, time from paralysis to visiting a hospital, presence of comorbidities such as diabetes mellitus and hypertension, degree of initial facial nerve paralysis by House-Brackmann (H-B) grade and neurophysiological testing, and final recovery rate.

Results

Based on BMI, 37 subjects were classified as underweight, 169 as normal weight, 140 as overweight, 155 as obese, and 42 as severely obese. Classification of the degree of initial facial nerve paralysis as moderate or severe, according to H-B Grade and electroneurography, showed no difference in severity of initial facial paralysis among the five groups (p>0.05). However, the final recovery rate was significantly higher in the normal weight than in the underweight or obese group (p<0.05).

Conclusions

Obesity or underweight had no effect on the severity of initial facial paralysis, but the final recovery rate was lower in the obese and underweight groups than in the normal group

This article is protected by copyright. All rights reserved.

http://ift.tt/2fyMbYl

Association between recovery from Bell's palsy and body mass index

Abstract

Background

Although many factors have been found to be involved in recovery from Bell's palsy, no study has investigated the association between recovery from Bell's palsy and obesity. This study therefore evaluated the association between recovery from Bell's palsy and body mass index (BMI).

Methods

Subjects were classified into five groups based on BMI (kg/m2). Demographic and clinical characteristics were compared among these groups. Assessed factors included sex, age, time from paralysis to visiting a hospital, presence of comorbidities such as diabetes mellitus and hypertension, degree of initial facial nerve paralysis by House-Brackmann (H-B) grade and neurophysiological testing, and final recovery rate.

Results

Based on BMI, 37 subjects were classified as underweight, 169 as normal weight, 140 as overweight, 155 as obese, and 42 as severely obese. Classification of the degree of initial facial nerve paralysis as moderate or severe, according to H-B Grade and electroneurography, showed no difference in severity of initial facial paralysis among the five groups (p>0.05). However, the final recovery rate was significantly higher in the normal weight than in the underweight or obese group (p<0.05).

Conclusions

Obesity or underweight had no effect on the severity of initial facial paralysis, but the final recovery rate was lower in the obese and underweight groups than in the normal group

This article is protected by copyright. All rights reserved.

http://ift.tt/2fyMbYl

Classical and Non-Classical Causes of GH Deficiency in the Paediatric Age

Publication date: Available online 24 November 2016
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Natascia Di Iorgi, Giovanni Morana, Anna Elsa Maria Allegri, Flavia Napoli, Roberto Gastaldi, Annalisa Calcagno, Giuseppina Patty, Sandro Loche, Mohamad Maghnie
Growth hormone deficiency (GHD) may result from a failure of hypothalamic GHRH production or release, from congenital disorders of pituitary development, or from central nervous system insults including tumors, surgery, trauma, radiation or infiltration from inflammatory diseases. Idiopathic, isolated GHD is the most common sporadic form of hypopituitarism. GHD may also occur in combination with other pituitary hormone deficiencies, and is often referred to as hypopituitarism, combined pituitary hormone deficiency (CPHD), multiple pituitary hormone deficiency (MPHD) or panhypopituitarism. Children without any identifiable cause of their GHD are commonly labelled as having idiopathic hypopituitarism.MRI imaging is the technique of choice in the diagnosis of children with hypopituitarism. Marked differences in MRI pituitary gland morphology suggest different etiologies of GHD and different prognoses. Pituitary stalk agenesis and ectopic posterior pituitary (EPP) are specific markers of permanent GHD, and patients with these MRI findings show a different clinical and endocrine outcome compared to those with normal pituitary anatomy or hypoplastic pituitary alone. Furthermore,the classic triad of ectopic posterior pituitary gland, pituitary stalk hypoplasia/agenesis, and anterior pituitary gland hypoplasia is generally associated with permanent GHD. T2 DRIVE images aid in the identification of pituitary stalk without the use of contrast medium administration. Future developments in imaging techniques will undoubtedly reveal additional insights. Mutations in a number of genes encoding transcription factors - such as HESX1, SOX2, SOX3, LHX3, LHX4, PROP1, POU1F1, PITX, GLI3, GLI2, OTX2, ARNT2, IGSF1, FGF8, FGFR1, PROKR2, PROK2, CHD7, WDR11, TCF7L1, NFKB2, PAX6, IFT72, GPR161 and CDON - have been associated with pituitary dysfunction and abnormal pituitary gland development; the correlation of genetic mutations to endocrine and MRI phenotypes has improved our knowledge of pituitary development and management of patients with hypopituitarism, both in terms of possible genetic counseling, and of early diagnosis of evolving anterior pituitary hormone deficiencies.



http://ift.tt/2gHcpK2

Muscle and skeletal health in children and adolescents with GH deficiency

Publication date: Available online 25 November 2016
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Improda Nicola, Capalbo Donatella, Esposito Andrea, Salerno Mariacarolina
In addition to promoting linear growth, GH plays a key role in the regulation of bone and muscle development and metabolism. Although GH deficiency is frequently listed among the causes of secondary osteoporosis in children, its impact on bone and muscle health and on fracture risk is still not completely established. Current data suggest that childhood-onset GH deficiency can affect bone and muscle mass and strength, with GH replacement therapy exerting beneficial effects. Moreover, GH withdrawal at final height can result in reduced peak bone and muscle mass, potentially leading to increased fracture risk in adulthood.Thus, the muscle-bone unit in GH deficient subjects should be monitored during childhood and adolescence in order to prevent osteoporosis and increased fracture risk and GH replacement should be tailored to ensure an optimal bone and muscle health.



http://ift.tt/2fvOHv5

Could ethanol-induced alterations in the expression of glutamate transporters in testes contribute to the effect of paternal drinking on the risk of abnormalities in the offspring?

Publication date: Available online 24 November 2016
Source:Medical Hypotheses
Author(s): Mohammed Abul Kashem, Aven Lee, David V. Pow, Omar Šerý, Vladimir J. Balcar
It has been known that a preconception paternal alcoholism impacts adversely on the offspring but the mechanism of the effect is uncertain. Several findings suggest that there are signalling systems in testis that are analogous to those known to be altered by alcoholism in brain. We propose that chronic alcohol affects these systems in a manner similar to that in brain. Specifically, we hypothesise that excessive alcohol may disturb glutamatergic-like signalling in testis by increasing expression of the glutamate transporter GLAST (EAAT1). We discuss ways how to test the hypothesis as well as potential significance of some of the tests as tools in the diagnostics of chronic alcoholism.



http://ift.tt/2gnWOe8

Paying the price for body evolution

Publication date: Available online 24 November 2016
Source:Medical Hypotheses
Author(s): Francesca G. Magnani, Anna Sedda
Since its beginning, research about cognitive representation of our bodies has debated over multiple representations models. Furthermore, recent years have seen a rise in the study of body representation disorders and related impairments. However, why human beings manifest so many deficits is still a mystery. Considering human evolution, frontal brain regions are well known for their changes in dimensions and connections. Less known is that parietal and temporal lobes encountered similar changes. These areas, especially in the right hemisphere, are crucial for body representation. Our hypothesis is that evolution of these areas determined a more varied and widespread cross wiring between the temporal and parietal lobes, increasing their communication pathways and their reciprocal influence. As such, these connections could lead to an increased probability of interconnected body and emotional disorders in humans. The prediction of this hypothesis is that all body representation disorders have an associated emotional component and vice versa. Evidence supporting the interconnection between emotional and body representation disorders derives from psychiatric diseases such as eating disorders. This hypothesis opens up new directions to understand body representation and points towards innovative solutions for the clinical treatments of body representation/emotional impairments.



http://ift.tt/2fg763P

Heart rate variability regression and risk of sudden unexpected death in epilepsy

Publication date: Available online 25 November 2016
Source:Medical Hypotheses
Author(s): Alessio Galli, Federico Lombardi
The exact mechanisms of sudden unexpected death in epilepsy remain elusive, despite there is consensus that SUDEP is associated with severe derangements in the autonomic control to vital functions as breathing and heart rate regulation. Heart rate variability (HRV) has been advocated as biomarker of autonomic control to the heart. Cardiac dysautonomia has been found in diseases where other branches of the autonomous nervous system are damaged, as Parkinson disease and multiple system atrophy. In this perspective, an impaired HRV not only is a risk factor for sudden cardiac death mediated by arrhythmias, but also a potential biomarker for monitoring a progressive decline of the autonomous nervous system. This slope may lead to an acute imbalance of the regulatory pathways of vital functions after seizure and then to SUDEP.SUDEP: sudden unexpected death in epilepsy; HRV: heart rate variability.



http://ift.tt/2gnUJPt

Hydrogen donors and acceptors and basic amino acids jointly contribute to carcinogenesis

Publication date: Available online 24 November 2016
Source:Medical Hypotheses
Author(s): Man Tang, Yanchao Zhou, Yiqi Li, Juntong Zou, Beicheng Yang, Li Cai, Xuelan Zhang, Qiuyun Liu
A hypothesis is postulated that high content of hydrogen donors and acceptors, and basic amino acids cause the intracellular trapping of the H⁺ and Cl^- ions, which increases cancer risks as local formation of HCl is mutagenic to DNA. Other cations such as Ca²⁺, and weak acids such as short-chain organic acids may attenuate the intracellular gathering of the H⁺ and Cl^-, two of the most abundant ions in the cells. Current data on increased cancer risks on diabetic and obese patients are consistent with the assumption that hydrogen bonding propensity on glucose, triglycerides and other molecules is among the causative factors.



http://ift.tt/2fg77Vr

The gut-blood barrier permeability - a new marker in cardiovascular and metabolic diseases?

Publication date: Available online 24 November 2016
Source:Medical Hypotheses
Author(s): Marcin Ufnal, Kinga Pham
Recent studies suggest that blood-borne metabolites of gut microbiota, such as trimethylamine N-oxide (TMAO) are involved in the aetiology of cardiovascular diseases and may serve as markers of cardiovascular risk. To enter the bloodstream the microbiota-derived molecules need to pass the gut-blood barrier (GBB). The GBB plays an important role in maintaining organism homeostasis. It is a complex multi-layer system which determines the absorption of nutrients, water and many other substances. The integrity and permeability of the GBB may be impaired in numerous diseases including gastrointestinal, metabolic and cardiovascular diseases. Here, we propose that the evaluation of the GBB permeability may have a significant diagnostic potential in cardiovascular and metabolic diseases. Second, we suggest that the GBB permeability is a variable that confounds diagnostic value of new gut microbiota-derived biomarkers such as TMAO. Therefore, cardiovascular risk assessment requires the evaluation of both TMAO and the GBB permeability.



http://ift.tt/2gnQLGn

The synthesis and biological evaluation of alkyl and benzyl naphthyridinium analogs of eupolauridine as potential antimicrobial and cytotoxic agents

Publication date: 1 December 2016
Source:Bioorganic & Medicinal Chemistry, Volume 24, Issue 23
Author(s): Shahriyar Taghavi-Moghadam, Cecil D. Kwong, John A. Secrist, Shabana I. Khan, Alice M. Clark
Eupolauridine, an indenonaphthyridine alkaloid, has been previously reported by us to exhibit antifungal activity. This study describes the synthesis of new alkyl and benzyl naphthyridinium/pyridinium analogs of eupolauridine as potential antifungal agents. A majority of the analogs exhibited antifungal activity against opportunistic pathogens such as Candida albicans and Cryptococcus neoformans. Several of them were also effective against bacteria (Staphylococcus aureus, MRS, Pseudomonas and Mycobacterium) and the malaria parasite (Plasmodium falciparum) to variable extents. A number of analogs were also cytotoxic to human cancer cell lines.

Graphical abstract

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Synthesis and antimalarial activity of N-benzylated (N-arylcarbamoyl)alkylphosphonic acid derivatives

Publication date: 1 December 2016
Source:Bioorganic & Medicinal Chemistry, Volume 24, Issue 23
Author(s): Christiana M. Adeyemi, Faridoon, Michelle Isaacs, Dumisani Mnkandhla, Heinrich C. Hoppe, Rui W.M. Krause, Perry T. Kaye
A series of novel and readily accessible N-benzylated (N-arylcarbamoyl)alkylphosphonate esters and related compounds have been prepared as potential antimalarial agents. Bioassays reveal that some of these compounds exhibit promising activity against Plasmodium falciparum, and exhibit no significant growth inhibition of HeLa cells.

Graphical abstract

http://ift.tt/2fg42Vu

Design, synthesis, and biological activity of novel, potent, and highly selective fused pyrimidine-2-carboxamide-4-one-based matrix metalloproteinase (MMP)-13 zinc-binding inhibitors

Publication date: 1 December 2016
Source:Bioorganic & Medicinal Chemistry, Volume 24, Issue 23
Author(s): Hiroshi Nara, Kenjiro Sato, Akira Kaieda, Hideyuki Oki, Haruhiko Kuno, Takashi Santou, Naoyuki Kanzaki, Jun Terauchi, Osamu Uchikawa, Masakuni Kori
Matrix metalloproteinase-13 (MMP-13), a member of the collagenase family of enzymes, has been implicated to play a key role in the pathology of osteoarthritis. Recently, we have reported the discovery of a series of quinazoline-2-carboxamide based non-zinc-binding MMP-13 selective inhibitors, as exemplified by compound 1. We then continued our research of a novel class of zinc-binding inhibitors to obtain follow-up compounds with different physicochemical, pharmacokinetic, and biological activity profiles. In order to design selective MMP-13 inhibitors, we adopted a strategy of connecting a zinc-binding group with the quinazoline-2-carboxamide system, a unique S1′ binder, by an appropriate linker. Among synthesized compounds, a triazolone inhibitor 35 exhibited excellent potency (IC50=0.071nM) and selectivity (greater than 170-fold) over other MMPs (MMP-1, 2, 3, 7, 8, 9, 10, 12, and 14) and tumor necrosis factor-α converting enzyme (TACE). In this article, the design, synthesis, and biological activity of novel zinc-binding MMP-13 inhibitors are described.

Graphical abstract

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Synthesis, activity and docking studies of phenylpyrimidine–carboxamide Sorafenib derivatives

Publication date: 1 December 2016
Source:Bioorganic & Medicinal Chemistry, Volume 24, Issue 23
Author(s): Wenhui Wang, Chunjiang Wu, Jianqiang Wang, Rong Luo, Caolin Wang, Xiaobo Liu, Jiqing Li, Wufu Zhu, Pengwu Zheng
Two series of Sorafenib derivatives bearing phenylpyrimidine–carboxamide moiety (16a–g and 17a–p) were designed, synthesized and evaluated for the IC50 values against three cancer cell lines (A549, MCF-7 and PC-3). Two selected compounds (17f and 17n) were further evaluated for the activity against VEGFR2/KDR kinase. More than half of the synthesized compounds showed moderate to excellent activity against three cancer cell lines. Compound 17f showed equal activity to Sorafenib against MCF-7 cell line, with the IC50 values of 6.35±0.43μM. Meanwhile, compound 17n revealed more active than Sorafenib against A549 cell line, with the IC50 values of 3.39±0.37μM. Structure–activity relationships (SARs) and docking studies indicated that the second series (17a–p) showed more active than the first series (16a–g). What's more, the introduction of fluoro atom to the phenoxy part played no significant impact on activity. In addition, the presence of electron-donating on aryl group was benefit for the activity.

Graphical abstract

http://ift.tt/2fg6awo

Editorial board

Publication date: 1 December 2016
Source:Bioorganic & Medicinal Chemistry, Volume 24, Issue 23





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Anaphylaxis in a health maintenance organization: International Classification of Diseases coding and epinephrine auto-injector prescribing

Publication date: Available online 24 November 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Deena Pourang, Michael Batech, Javed Sheikh, Shefali Samant, Michael Kaplan
BackgroundAccurate estimates of the incidence of anaphylaxis are limited. Current International Classification of Diseases, Ninth Revision (ICD-9) codes complicate accurate diagnosis of anaphylaxis and assessment of appropriate epinephrine prescribing.ObjectiveTo quantify the incidence and demographic character of patients with anaphylaxis-related ICD-9 codes in a large health maintenance organization and analyze epinephrine prescribing and dispensing rates.MethodsAll patients included had at least 12 months of continuous membership over a 4-year period from January 1, 2008 to December 31, 2012 and were selected based on anaphylaxis-related ICD-9 codes (N = 159,172). This algorithm was extrapolated from a previous study that used expanded ICD-9 codes to identify more cases of anaphylaxis. Individual chart reviews found that many expanded ICD-9 codes represented unconfirmed cases of anaphylaxis and therefore were excluded, resulting in analysis of 52,405 patients.ResultsIncidence of anaphylaxis over 4 years was 2.07%, with female predominance (56.5%) over male predominance (43.5%). Epinephrine was prescribed in 16.2% of total cases. Highest rates of epinephrine prescription were for traditional ICD-9 codes 995.0 (other anaphylactic shock) and 995.60 to 995.69 (anaphylactic shock caused by food) at 49.3% and 58.6%, respectively. Of the cases in which an epinephrine auto-injector was prescribed, it was dispensed 95.9% of the time, independent of copayment amount.ConclusionLow epinephrine auto-injector prescribing rates in cases of anaphylaxis suggest the continued difficulty in the diagnosis of anaphylaxis and could result in suboptimal treatment of potential future episodes.



http://ift.tt/2fvHCuQ

Concurrent Chemoradiotherapy With or Without Adjuvant Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma Patients at High Risk of Distant Metastasis

Condition:   Local Advanced High Risk Nasopharyngeal Carcinoma
Interventions:   Drug: IMRT combine with cisplatin concurrent chemotherapy;   Drug: IMRT combine with cisplatin concurrent chemotherapy plus capecitabine adjuvant chemotherapy
Sponsor:   Zhao Chong
Not yet recruiting - verified November 2016

http://ift.tt/2gcdMNe

Early Detection of Esophageal Cancer

Conditions:   Esophageal Neoplasms;   Stomach Neoplasms;   Endoscopy, Gastrointestinal;   Digestive System Endoscopic Surgical Procedures;   Cytology
Intervention:  
Sponsor:   National Cancer Institute (NCI)
Recruiting - verified December 2015

http://ift.tt/2fyAOjc

Concurrent Chemoradiotherapy With or Without Adjuvant Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma Patients at High Risk of Distant Metastasis

Condition:   Local Advanced High Risk Nasopharyngeal Carcinoma
Interventions:   Drug: IMRT combine with cisplatin concurrent chemotherapy;   Drug: IMRT combine with cisplatin concurrent chemotherapy plus capecitabine adjuvant chemotherapy
Sponsor:   Zhao Chong
Not yet recruiting - verified November 2016

http://ift.tt/2gcdMNe

Early Detection of Esophageal Cancer

Conditions:   Esophageal Neoplasms;   Stomach Neoplasms;   Endoscopy, Gastrointestinal;   Digestive System Endoscopic Surgical Procedures;   Cytology
Intervention:  
Sponsor:   National Cancer Institute (NCI)
Recruiting - verified December 2015

http://ift.tt/2fyAOjc

Supine position and REM dependence in obstructive sleep apnea

Abstract

Background

When considering supine position and REM dependence, many studies refer to the traditional definition in which obstructive sleep apnea (OSA) severity is at least doubled in the corresponding position/sleep stage (Cartwright index). The lack of consideration of the time spent in that particular sleep situation can lead to clinical bias.

Patients and methods

Two cohorts of patients with at least moderate OSA were analyzed retrospectively for anthropometric associations and correlations with OSA severity. One group consisted of 48 patients diagnosed using a polygraph, and the other group of 222 patients underwent polysomnography. First, the conventional Cartwright index was used, and a modified index was later applied to integrate the relative time component for REM sleep and the supine position.

Results

Less than a fifth of the patients fulfilled the classic conditions for supine position or REM sleep dependency. There were no definitive cut-offs in the classic or modified Cartwright index with regard to daytime sleepiness. Both indices show there was a correlation between OSA severity and being overweight.

Conclusion

The modified Cartwright index allowed us to identify borderline cases that were characterized by a very low or high amount of time spent in the supine position or REM sleep situation. Therapy effects that could have been biased only by varying amounts of time spent in the supine position could be better controlled for. Future studies will possibly include various other ratios besides the previously accepted 2:1 ratio when different statistical parameters are considered, such as the reduction of OSA severity or therapy adherence.

http://ift.tt/2gc8ul8

Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia: A Systematic Review

Abstract

The Frazier Free Water Protocol was developed with the aim of providing patients with dysphagia an option to consume thin (i.e. unthickened) water in-between mealtimes. A systematic review was conducted of research published in peer-reviewed journals. An electronic search of the EMBASE, CINAHL and MEDLINE databases was completed up to July 2016. A total of 8 studies were identified for inclusion: 5 randomised controlled trials, 2 cohort studies with matched cases and 1 single group pre-post intervention prospective study. A total of 215 rehabilitation inpatients and 30 acute patients with oropharyngeal dysphagia who required thickened fluids or were to remain 'nil by mouth', as determined by bedside swallow assessment and/or videofluoroscopy/fiberoptic endoscopic evaluation of swallowing, were included. Meta-analyses of the data from the rehabilitation studies revealed (1) low-quality evidence that implementing the protocol did not result in increased odds of having lung complications and (2) low-quality evidence that fluid intake may increase. Patients' perceptions of swallow-related quality of life appeared to improve. This review has found that when the protocol is closely adhered to and patients are carefully selected using strict exclusion criteria, including an evaluation of their cognition and mobility, adult rehabilitation inpatients with dysphagia to thin fluids can be offered the choice of implementing the Free Water Protocol. Further research is required to determine if the Free Water Protocol can be implemented in settings other than inpatient rehabilitation.

http://ift.tt/2gGZW98

Supine position and REM dependence in obstructive sleep apnea

Abstract

Background

When considering supine position and REM dependence, many studies refer to the traditional definition in which obstructive sleep apnea (OSA) severity is at least doubled in the corresponding position/sleep stage (Cartwright index). The lack of consideration of the time spent in that particular sleep situation can lead to clinical bias.

Patients and methods

Two cohorts of patients with at least moderate OSA were analyzed retrospectively for anthropometric associations and correlations with OSA severity. One group consisted of 48 patients diagnosed using a polygraph, and the other group of 222 patients underwent polysomnography. First, the conventional Cartwright index was used, and a modified index was later applied to integrate the relative time component for REM sleep and the supine position.

Results

Less than a fifth of the patients fulfilled the classic conditions for supine position or REM sleep dependency. There were no definitive cut-offs in the classic or modified Cartwright index with regard to daytime sleepiness. Both indices show there was a correlation between OSA severity and being overweight.

Conclusion

The modified Cartwright index allowed us to identify borderline cases that were characterized by a very low or high amount of time spent in the supine position or REM sleep situation. Therapy effects that could have been biased only by varying amounts of time spent in the supine position could be better controlled for. Future studies will possibly include various other ratios besides the previously accepted 2:1 ratio when different statistical parameters are considered, such as the reduction of OSA severity or therapy adherence.

http://ift.tt/2gc8ul8

Interaction of language, auditory and memory brain networks in auditory verbal hallucinations

Publication date: Available online 24 November 2016
Source:Progress in Neurobiology
Author(s): Branislava Ćurčić-Blake, Judith Ford, Daniela Hubl, Natasza D. Orlov, Iris E. Sommer, Flavie Waters, Paul Allen, Renaud Jardri, Peter W. Woodruff, David Olivier, Christoph Mulert, Todd S. Woodward, André Aleman
Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses.



http://ift.tt/2gtL4bk

Oxidative Stress Induced Damage to Paternal Genome and Impact of Meditation and Yoga - Can it Reduce Incidence of Childhood Cancer?

Oxidative Stress Induced Damage to Paternal Genome and Impact of Meditation and Yoga - Can it Reduce Incidence of Childhood Cancer?

Asian Pac J Cancer Prev. 2016 Jan 9;17(9):4517-4525

Authors: Rima D, Shiv BK, Bhavna Ch, Shilpa B, Saima Kh

Abstract
Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG , and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

PMID: 27880996 [PubMed - as supplied by publisher]

http://ift.tt/2fZcUOh

Frequency of K-RAS and N-RAS Gene Mutations in Colorectal Cancers in Southeastern Iran

Frequency of K-RAS and N-RAS Gene Mutations in Colorectal Cancers in Southeastern Iran

Asian Pac J Cancer Prev. 2016 Jan 9;17(9):4511-4515

Authors: Mohsen N, Ahmadreza S, Fatemeh H, Fatemeh H, Fariba ER

Abstract
Background: K-RAS and N-RAS gene mutations cause resistance to treatment in patients with colorectal cancer. Based on this, awareness of mutation of these genes is considered a clinically important step towards better diagnosis and appropriate treatment. Materials and Methods: Fifty paraffin-embedded blocks of colorectal cancer were obtained from Imam Reza Hospital of Birjand, Iran. Following DNA extraction, the samples were analyzed for common mutations of exons 2, 3 and 4 of KRAS and NRAS genes using real time PCR and pyrosequencing. Results: According to this study, the prevalence of mutations was respectively 28% (14 out of 50) and 2% (1 out of 50) in KRAS and NRAS genes. All the mutations were observed in patients >50 years old. Conclusions: Mutations were found in both KRAS and NRAS genes in colorectal cancers in Iranian patients. Determining the frequency of these mutations in each geographical region may be necessary to benefit from targeted cancer therapy.

PMID: 27880995 [PubMed - as supplied by publisher]

http://ift.tt/2ffPqp6

Isothiocyanates in Brassica: Potential Anti Cancer Agents

Isothiocyanates in Brassica: Potential Anti Cancer Agents

Asian Pac J Cancer Prev. 2016 Jan 9;17(9):4507-4510

Authors: Anubhuti Sh, Ashok Sh, Prashant Y, Dhiraj S

Abstract
Isothiocyanates are naturally occurring small molecules that are formed from glucosinolate precursors of cruciferous vegetables. Many isothiocyanates, both natural and synthetic, display anti-carcinogenic activity because they reduce activation of carcinogens and increase their detoxification. This minireview summarizes the current knowledge on isothiocyanates and focuses on their role as potential anti-cancer agents.

PMID: 27880994 [PubMed - as supplied by publisher]

http://ift.tt/2gnFcPo

Clinical Factors Predictive of Metastases from Renal Cell Carcinomas

Clinical Factors Predictive of Metastases from Renal Cell Carcinomas

Asian Pac J Cancer Prev. 2016 Jan 9;17(9):4503-4506

Authors: Fina W, Agus Rizal AH, Chaidir A M, Rainy U

Abstract
Background: Lymph node and distant metastases are known as the prognostic factor in renal cell carcinoma (RCC). Clinical parameters are needed to predict metastases preoperatively. The aim of this study was to assess clinical predictive factors for lymph node and distant metastases. Materials and Methods: We collected RCC data from January 1995 until December 2015 at Cipto Mangunkusumo hospital in Jakarta. We only reviewed data that had renal cell carcinoma histopathology by operation or biopsy. Clinical information such as patient age, gender, hemoglobin (Hb), erythrocyte sedimentation rate (ESR), and tumor size (clinical T stage) were reviewed and analyzed by Chi-squre and logistic regression to establish clinical predictive value. Results: A total of 102 patients were reviewed. There were 32 (31.4%) with lymph node metastases and 27 (26.5%) with distant metastases. Age, Hb and clinical T staging were associated with nodal metastases. However, only Hb and clinical T staging were found to be associated with distant metastases. By logistic regression, we found T3-4 in clinical T-stage to be the only predictor of nodal metastases (OR 5.14; 1.87 - 14.09) and distant metastases (OR 3.42; 1.27 - .9.23). Conclusions: Clinical T-stages of T3 and T4 according to The AJCC TNM classification could be used as independent clinical predictive factors for lymph node or distant metastases in patients with RCC.

PMID: 27880993 [PubMed - as supplied by publisher]

http://ift.tt/2ffSf9y

European Journal of Cancer’s Biennial report on soft tissue and visceral sarcomas or the rapid evolution of treatment concepts in sarcomas

Publication date: January 2017
Source:European Journal of Cancer, Volume 70
Author(s): Jean-Yves Blay, Mehdi Brahmi, Isabelle Ray-Coquard
Soft tissue and visceral sarcoma gather a large group of rare to very rare cancers and locally aggressive connective tissue tumours. Novel concepts on histological and molecular classification, optimal management of patients, systemic adjuvant and neoadjuvant treatment have been emerging in the last 5 years. In the present publication, we review and summarise significant changes which impact on disease management in this group of rare cancers.



http://ift.tt/2gHaTHG