OnabotulinumtoxinA injections in detrusor facilitate self-catheterisation in a patient with paraplegia and bladder outlet dyssynergia

This case report describes the case of improvement of clean intermittent catheterisation procedures after each intradetrusor administration of onabotulinumtoxinA in a 45-year-old man with L1 paraplegia with neurogenic detrusor overactivity and bladder outlet dyssynergia.On three occasions, improvement on clean intermittent catheterisation procedures appeared 10 to 14 days after intradetrusor injections of onabotulinumtoxinA and lasted for 9 months. We hypothesise a possible influence of intravesical injections of onabotulinumtoxinA on the storage reflex. We also discuss the possibility of a dispersion of onabotulinumtoxinA towards contiguous structures such as the urethral sphincter.

http://ift.tt/2njuXng

Idiopathic subglottic stenosis: an epidemiological single-center study

Abstract

A retrospective epidemiological study of patients treated for idiopathic subglottic stenosis (ISS) during 2003–2013 at Oslo University Hospital, Rikshospitalet, was undertaken to assess its incidence, management and treatment outcomes. Out of a total of 123 patients with subglottic stenosis (84 female, 39 men), 38 patients were diagnosed with ISS, all of whom were female. Of these, 23 lived in the South-Eastern Norway Regional Health Authority, representing an incidence of 0.2 per 100,000 (95% CI 0.13–0.3) in this region of 2.9 million inhabitants. Mean age at diagnosis was 54 years (range 20–85 years), and the mean interval between symptom onset and diagnosis was 3.1 years. The 38 patients with ISS underwent a total of 132 operations between 2003 and 2013. All patients were managed endoscopically using laser surgery, with or without corticosteroids and Mitomycin C, with dilatation by balloon or bougie. Eight patients (21.1%) required only one procedure, while 30 patients (78.9%) had multiple operations. The median follow-up for all patients from the first operation was 5.3 years. The mean interval between procedures was 1 year for patients aged 20–48 years, 1.3 years for patients aged 49–61 years and 3.0 years for patients aged 62–85 years. No clinically significant complications were observed. In conclusion, the symptoms of ISS can be treated effectively with laser surgery and dilatation but the recurrence rate remains high and the time interval between operations does not increase with time, making ISS a continuing challenge.

http://ift.tt/2nQZRQc

Preferred nasolabial angle in Middle Eastern population

Abstract

To define the preferred nasolabial angle measurement in Middle Eastern population. An observational study was conducted from January 2012 to January 2016 at the Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. A total of 1027 raters, 506 males, and 521 females were asked to choose the most ideal nasolabial angle for 5 males and 5 females lateral photographs whose nasolabial angle were modified with Photoshop into the following angles (85°, 90°, 95°, 100°, 105°, and 110°). Male raters preferred the angle of 89.5° ± 3.5° (mean ± SD) for males and 90.8° ± 5.6° for females. While female raters preferred the angle of 89.3° ± 3.8° for males and 90.5° ± 4.8° for females. ANOVA test compare means among groups: p: 0.342, and there is no statistically significant difference between groups. The results of our study showed an even more acute angles than degrees found in the literature. It shows that what young generation in our region prefers and clearly reflects that what could be explained as under rotation of the nasal tip in other cultures is just the ideal for some Middle Eastern population.

http://ift.tt/2nR0ut7

Reply to the letter to the editor concerning: ‘Relationship between increased carotid artery stiffness and idiopathic subjective tinnitus’

http://ift.tt/2nj7UJm

Effect of hyaluronic acid with or without scaffold material on the regeneration of tympanic membrane perforations

http://ift.tt/2nQY91d

Relationship between increased carotid artery stiffness and idiopathic subjective tinnitus: methodological issues

http://ift.tt/2njgtnt

Repetitive transcranial magnetic stimulation and drugs for tinnitus

http://ift.tt/2njgsjp

Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia

Abstract

Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

http://ift.tt/2nQNJ1I

Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines

Abstract

The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others' practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.

http://ift.tt/2njgQhO

Primary unclassified sarcoma of the parotid gland: a case of diagnostic and therapeutic challenge

Abstract

Malignant salivary gland sarcomas represent a clinically and histologically diagnostic challenge. Primary unclassified sarcomas of the parotid gland consist a rare salivary gland tumor. We report an unusual case of such a tumor, which occurred in the right parotid gland of a 54-year-old male and presented as an asymptomatic painless mass. The pathologoanatomical examination revealed a rhabdoid large-cell unclassified sarcoma. The patient was treated with superficial parotidectomy and adjuvant radiotherapy. No recurrence was noted in a 10-year follow-up period. Due to the rare occurrence of primary unclassified sarcomas, there is no evidence-based treatment of choice. An optimal approach is best planned in a multidisciplinary setting, taking into consideration the resectability of the tumor, individual patient characteristics, presence of local or distant metastatic activity, local infiltrative behavior and tumor stage. A close follow-up of the patient is strongly recommended.

http://ift.tt/2nR2gu0

The variants of the retro- and hypotympanum: an endoscopic anatomical study

Abstract

The retro- and hypotympanum are hidden areas of the middle ear, only poorly recognized. Nevertheless, this region is of relevant clinical significance, since it is regularly affected by disease such as cholesteatoma. The aim of this study is to explore and describe the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy. We hypothesize a significant variability of this hidden region of the middle ear. Moreover, we believe that the minimal invasive, endoscopic access is suitable since angled scopes may be used to explore the region. To this end a total of 125 middle ears (83 cadaveric dissections, 42 surgical cases) were explored by the means of 3 mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge-shaped only in 8% of the cases, the finiculus in 17%. The sinus tympani had a normal configuration in 66%. A subcochlear canaliculus was detectable in 50%. The retro- and hypotympanum were classified, respectively, to the present bony crests and sinus in a novel classification type I–IV. In conclusion, we found abundant variability of the bony structures in the retro- and hypotympanum. The endoscopic access is suitable and offers thorough understanding and panoramic views of these hidden areas.

http://ift.tt/2nR2MIy

Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study

Abstract

Objective

To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection).

Methods

Sixty patients aged 7–40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0–10) at awakening and the worst pain level of the day in the postoperative period. All intake of pain medication was also recorded.

Results

No statistically significant differences were found between the two groups regarding postoperative pain levels or consumption of pain medication.

Conclusion

Usage of the harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with usage of the bipolar diathermy scissors.

http://ift.tt/2njcN5c

Application of a computer-assisted flexible endoscope system for transoral surgery of the hypopharynx and upper esophagus

Abstract

Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity. Here, we present the potential utilization of a flexible, single port, robot-assisted, and physician-controlled endoscope system to facilitate transoral surgical access to the hypopharynx and upper esophagus. Transoral surgery of the hypopharynx and upper esophagus was performed in human cadavers (n = 5) using the Flex System (Medrobotics, Raynham, USA). Anatomical landmarks were identified, and posterior cricothyroid myotomy was performed with compatible flexible instruments in all cases. The approach to the hypopharynx and upper esophagus using the Flex system is feasible in a cadaveric model. Myotomy with a flexible tool and needle knife (from the perspective of treatment of Zenker´s diverticulum) was successful in all cases. Visualization of the surgical site with the system's HD camera is suitable and the flexible instruments meet the special needs of a micro-invasive transoral approach. Zenker´s diverticulum can be potentially treated with a transoral minimally invasive approach using a computer-assisted flexible endoscope system. This setup could be of advantage in patients with reduced mobility of the cervical spine to prevent open transcervical surgery. In our study, the Flex system enabled advanced visualization of the surgical site and extended intervention options, compared to standard flexible endoscopic treatment. However, general anesthesia is mandatory for the presented approach. Application in live patients with actual pathologies of the hypopharynx and upper esophagus will have to prove suitability for the treatment of Zenker's diverticulum. Further development of the system could include improved instrumentation and an adoption by other disciplines with challenging anatomy such as colorectal surgery.

http://ift.tt/2nQNdAG

Preferred nasolabial angle in Middle Eastern population

Abstract

To define the preferred nasolabial angle measurement in Middle Eastern population. An observational study was conducted from January 2012 to January 2016 at the Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. A total of 1027 raters, 506 males, and 521 females were asked to choose the most ideal nasolabial angle for 5 males and 5 females lateral photographs whose nasolabial angle were modified with Photoshop into the following angles (85°, 90°, 95°, 100°, 105°, and 110°). Male raters preferred the angle of 89.5° ± 3.5° (mean ± SD) for males and 90.8° ± 5.6° for females. While female raters preferred the angle of 89.3° ± 3.8° for males and 90.5° ± 4.8° for females. ANOVA test compare means among groups: p: 0.342, and there is no statistically significant difference between groups. The results of our study showed an even more acute angles than degrees found in the literature. It shows that what young generation in our region prefers and clearly reflects that what could be explained as under rotation of the nasal tip in other cultures is just the ideal for some Middle Eastern population.

http://ift.tt/2nR0ut7

Reply to the letter to the editor concerning: ‘Relationship between increased carotid artery stiffness and idiopathic subjective tinnitus’

http://ift.tt/2nj7UJm

Idiopathic subglottic stenosis: an epidemiological single-center study

Abstract

A retrospective epidemiological study of patients treated for idiopathic subglottic stenosis (ISS) during 2003–2013 at Oslo University Hospital, Rikshospitalet, was undertaken to assess its incidence, management and treatment outcomes. Out of a total of 123 patients with subglottic stenosis (84 female, 39 men), 38 patients were diagnosed with ISS, all of whom were female. Of these, 23 lived in the South-Eastern Norway Regional Health Authority, representing an incidence of 0.2 per 100,000 (95% CI 0.13–0.3) in this region of 2.9 million inhabitants. Mean age at diagnosis was 54 years (range 20–85 years), and the mean interval between symptom onset and diagnosis was 3.1 years. The 38 patients with ISS underwent a total of 132 operations between 2003 and 2013. All patients were managed endoscopically using laser surgery, with or without corticosteroids and Mitomycin C, with dilatation by balloon or bougie. Eight patients (21.1%) required only one procedure, while 30 patients (78.9%) had multiple operations. The median follow-up for all patients from the first operation was 5.3 years. The mean interval between procedures was 1 year for patients aged 20–48 years, 1.3 years for patients aged 49–61 years and 3.0 years for patients aged 62–85 years. No clinically significant complications were observed. In conclusion, the symptoms of ISS can be treated effectively with laser surgery and dilatation but the recurrence rate remains high and the time interval between operations does not increase with time, making ISS a continuing challenge.

http://ift.tt/2nQZRQc

Relationship between increased carotid artery stiffness and idiopathic subjective tinnitus: methodological issues

http://ift.tt/2njgtnt

Primary unclassified sarcoma of the parotid gland: a case of diagnostic and therapeutic challenge

Abstract

Malignant salivary gland sarcomas represent a clinically and histologically diagnostic challenge. Primary unclassified sarcomas of the parotid gland consist a rare salivary gland tumor. We report an unusual case of such a tumor, which occurred in the right parotid gland of a 54-year-old male and presented as an asymptomatic painless mass. The pathologoanatomical examination revealed a rhabdoid large-cell unclassified sarcoma. The patient was treated with superficial parotidectomy and adjuvant radiotherapy. No recurrence was noted in a 10-year follow-up period. Due to the rare occurrence of primary unclassified sarcomas, there is no evidence-based treatment of choice. An optimal approach is best planned in a multidisciplinary setting, taking into consideration the resectability of the tumor, individual patient characteristics, presence of local or distant metastatic activity, local infiltrative behavior and tumor stage. A close follow-up of the patient is strongly recommended.

http://ift.tt/2nR2gu0

Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines

Abstract

The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others' practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.

http://ift.tt/2njgQhO

Effect of hyaluronic acid with or without scaffold material on the regeneration of tympanic membrane perforations

http://ift.tt/2nQY91d

Repetitive transcranial magnetic stimulation and drugs for tinnitus

http://ift.tt/2njgsjp

Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia

Abstract

Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

http://ift.tt/2nQNJ1I

The variants of the retro- and hypotympanum: an endoscopic anatomical study

Abstract

The retro- and hypotympanum are hidden areas of the middle ear, only poorly recognized. Nevertheless, this region is of relevant clinical significance, since it is regularly affected by disease such as cholesteatoma. The aim of this study is to explore and describe the anatomical variants of the hypo- and retrotympanum by the means of transcanal endoscopy. We hypothesize a significant variability of this hidden region of the middle ear. Moreover, we believe that the minimal invasive, endoscopic access is suitable since angled scopes may be used to explore the region. To this end a total of 125 middle ears (83 cadaveric dissections, 42 surgical cases) were explored by the means of 3 mm straight and angled scopes. The variants were documented photographically and tabularized. The bony crests ponticulus, subiculum and finiculus were most frequently represented as ridges. The ponticulus showed the highest variability with 38% ridge, 35% bridge and 27% incomplete presentation. The subiculum was bridge-shaped only in 8% of the cases, the finiculus in 17%. The sinus tympani had a normal configuration in 66%. A subcochlear canaliculus was detectable in 50%. The retro- and hypotympanum were classified, respectively, to the present bony crests and sinus in a novel classification type I–IV. In conclusion, we found abundant variability of the bony structures in the retro- and hypotympanum. The endoscopic access is suitable and offers thorough understanding and panoramic views of these hidden areas.

http://ift.tt/2nR2MIy

Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study

Abstract

Objective

To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection).

Methods

Sixty patients aged 7–40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0–10) at awakening and the worst pain level of the day in the postoperative period. All intake of pain medication was also recorded.

Results

No statistically significant differences were found between the two groups regarding postoperative pain levels or consumption of pain medication.

Conclusion

Usage of the harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with usage of the bipolar diathermy scissors.

http://ift.tt/2njcN5c

Application of a computer-assisted flexible endoscope system for transoral surgery of the hypopharynx and upper esophagus

Abstract

Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity. Here, we present the potential utilization of a flexible, single port, robot-assisted, and physician-controlled endoscope system to facilitate transoral surgical access to the hypopharynx and upper esophagus. Transoral surgery of the hypopharynx and upper esophagus was performed in human cadavers (n = 5) using the Flex System (Medrobotics, Raynham, USA). Anatomical landmarks were identified, and posterior cricothyroid myotomy was performed with compatible flexible instruments in all cases. The approach to the hypopharynx and upper esophagus using the Flex system is feasible in a cadaveric model. Myotomy with a flexible tool and needle knife (from the perspective of treatment of Zenker´s diverticulum) was successful in all cases. Visualization of the surgical site with the system's HD camera is suitable and the flexible instruments meet the special needs of a micro-invasive transoral approach. Zenker´s diverticulum can be potentially treated with a transoral minimally invasive approach using a computer-assisted flexible endoscope system. This setup could be of advantage in patients with reduced mobility of the cervical spine to prevent open transcervical surgery. In our study, the Flex system enabled advanced visualization of the surgical site and extended intervention options, compared to standard flexible endoscopic treatment. However, general anesthesia is mandatory for the presented approach. Application in live patients with actual pathologies of the hypopharynx and upper esophagus will have to prove suitability for the treatment of Zenker's diverticulum. Further development of the system could include improved instrumentation and an adoption by other disciplines with challenging anatomy such as colorectal surgery.

http://ift.tt/2nQNdAG

Creating a Great Patient Experience: Improving Care with Food and Nutrition Services

Publication date: Available online 6 April 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Christina Rollins, Stephanie Dobak




http://ift.tt/2oLuYjX

Differences in Mothers’ and Children’s Dietary Intake during Physical and Sedentary Activities: An Ecological Momentary Assessment Study

Publication date: Available online 6 April 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Sydney G. O'Connor, Carol Koprowski, Eldin Dzubur, Adam M. Leventhal, Jimi Huh, Genevieve Fridlund Dunton
BackgroundPhysical activity and diet are major modifiable health behaviors contributing to obesity risk. Although patterns of these behaviors tend to cluster within individuals and within family units, it is unknown to what extent healthy and unhealthy dietary intake might differentially accompany sedentary and physical activities in mothers compared with their children.ObjectiveOur goal was to examine differences in co-occurrence of activities and dietary intake between mothers and children, as measured in real time using ecological momentary assessment.Participants/settingThis study examined cross-sectional data from 175 mothers and their children aged 8 to 12 years.Main outcome measuresParticipants completed 8 days of ecological momentary assessment surveys, reporting on whether the following activities had occurred during the past 2 hours: sedentary screen activity, physical activity, and intake of healthy (ie, fruits and vegetables) and unhealthy (ie, fast food, chips/fries, pastries/sweets, and soda/energy drinks) foods.Statistical analyses performedMultilevel logistic regression models estimated the adjusted odds of consuming healthy and unhealthy dietary intake for mothers and children during time periods reporting physical activity (vs no physical activity) or sedentary screen activity (vs no sedentary screen activity). Post hoc tests compared estimates for mothers vs children.ResultsChildren were significantly more likely than their mothers to consume unhealthy foods during 2-hour windows that included physical activity (odds ratio [children] 1.85, 95% CI 1.47 to 2.31; odds ratio [mothers] 0.83, 95% CI 0.58 to 1.20; Pdiff <0.05), but not sedentary screen activity (Pdiff=0.067). In addition, children and their mothers did not differ in their likelihood of consuming healthy foods during 2-hour windows with sedentary screen activity (Pdiff =0.497) or physical activity (Pdiff =0.170).ConclusionsResults indicate that the consumption of unhealthy foods may be more likely to co-occur within a 2-hour window including physical activity in children as compared to their mothers. Future research should examine reasons for this difference, and potential areas for intervention.



http://ift.tt/2o3Rrps

Influence of negative dental experiences in childhood on the development of dental fear in adulthood: a case-control study

Abstract

Objective

The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood.

Methods

This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n=65) and controls (n=260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%.

Results

The multivariate model showed that students who reported negative dental experiences in childhood (OR=2.97; 95% CI:1.44–6.14), toothache in the last 12 months (OR 11.31; 95% CI:4.79–26.68), discomfort during dental treatment (OR=5.36; 95% CI:2.53–11.36) and poor self-evaluation of oral health (OR=3.82; 95% CI:1.61–8.11) were more likely to have high dental fear.

Conclusions

Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear.

This article is protected by copyright. All rights reserved.

http://ift.tt/2nR6VMQ

Self-report of TMJ clicking and psychological factors: is there an association?

Abstract

The objectives of the current study were to test the hypothesis that self-reported TMJ clicking sounds in adolescents are positively associated with non-specific somatic symptoms, self-perception of body image, and care-seeking behaviour.

A cross-sectional study was carried out in 353 young adolescents (48.4% females) recruited from community (N=272) and orthodontic clinic (N=81) settings. Assessments included self-reported TMJ clicking, non-specific physical symptoms, body image concerns, and for the clinic sample only, the source of motivation for treatment.

TMJ sounds were self-reported by 19% of the sample, and were associated with higher scores for non-specific physical symptoms and body image concerns (p<0.001). Adolescents who were self-motivated to seek orthodontic treatment had greater scores for non-specific physical symptoms, more body image concerns, and tended to report TMJ sounds more often (26.3% and 7.7% respectively; p=0.41) than those who were solely parent/family-motivated to seek treatment.

Self-reported TMJ sounds in adolescents were associated with a propensity to somatisation and concerns with body image. Care-seeking adolescents have greater non-specific physical symptoms and body image concerns, and tend to report more frequent TMJ sounds.

This article is protected by copyright. All rights reserved.

http://ift.tt/2njgCaw

Soil physicochemical factors as environmental filters for spontaneous plant colonization of abandoned tailing dumps

Abstract

Abandoned tailing dumps (ATDs) offer an opportunity to identify the main physicochemical filters that determine colonization of vegetation in solid mine wastes. The current study determined the soil physicochemical factors that explain the compositional variation of pioneer vegetal species on ATDs from surrounding areas in semiarid Mediterranean-climate type ecosystems of north-central Chile (Coquimbo Region). Geobotanical surveys—including physicochemical parameters of substrates (0–20 cm depth), plant richness, and coverage of plant species—were performed on 73 ATDs and surrounding areas. A total of 112 plant species were identified from which endemic/native species (67%) were more abundant than exotic species (33%) on ATDs. The distribution of sampling sites and plant species in canonical correspondence analysis (CCA) ordination diagrams indicated a gradual and progressive variation in species composition and abundance from surrounding areas to ATDs because of variations in total Cu concentration (1.3%) and the percentage of soil particles <2 μm (1.8%). According to the CCA, there were 10 plant species with greater abundance on sites with high total Cu concentrations and fine-textured substrates, which could be useful for developing plant-based stabilization programs of ATDs in semiarid Mediterranean-climate type ecosystems of north-central Chile.

http://ift.tt/2o8NrFM

Long-term simulated nitrogen deposition alters the plant cover dynamics of a Mediterranean rosemary shrubland in Central Spain through defoliation

Abstract

Nitrogen (N) deposition due to anthropogenic pollution is a major driver of the global biodiversity loss. We studied the effect of experimental N and phosphorus (P) fertilization (0, 10, 20, and 50 kg N ha⁻¹ year⁻¹ and 14 kg P ha⁻¹ year⁻¹ over the background deposition levels) on plant cover dynamics of a rosemary (Rosmarinus officinalis L.) shrubland after 8 years of nutrient addition in a semiarid Mediterranean ecosystem from Central Spain. We specifically aimed at testing whether N deposition has the potential to influence the observed expanding trend of woody vegetation into areas dominated by grassland, biological soil crusts, and bare soil. Our results show that N addition loads above 10 kg N ha⁻¹ year⁻¹ reverted the cover dynamics of shrubs. Under N addition conditions, N was no longer a limiting nutrient and other elements, especially P and calcium, determined the seasonal growth of young twigs. Interestingly, N fertilization did not inhibit the growth of young shoots; our estimates point to a reduced rosemary leaf lifespan that is driving individuals to death. This may be triggered by long-term accumulation of N compounds in leaves, suggesting the need to consider the old organs and tissues in long-lived perennial plants, where N toxicity effects could be more mediated by accumulation processes. Shrublands are a widely distributed ecosystem type in biodiverse Mediterranean landscapes, where shrubs play a key role as nurse plants. Therefore, the disappearance of shrublands may accelerate the biodiversity loss associated with other global change drivers, hamper the recruitment of seedlings of woody species, and, as a consequence, accelerate desertification.

http://ift.tt/2o3DzMc

Long-term broiler litter amendments can alter the soil’s capacity to sorb monensin

Abstract

Monensin is a common antiparasitic drug given to poultry that contaminates poultry manure and bedding material (broiler litter). As broiler litter is commonly applied to agricultural fields as fertilizer, monensin could be released beyond the farm if it is not retained or degraded in the soil. This study aimed to assess the impact of long-term surface application of broiler litter (i.e., 17 years) on the capacity of pasture soil to sorb monensin. The soils were exposed to a range of monensin concentrations (0.18 to 1.81 μmol L⁻¹), solution pH (pH 4–9), and temperatures (15, 25, and 35 °C) and monensin was measured as loss from solution (i.e., sorption). Soils receiving long-term litter applications were hypothesized to retain more monensin than unamended soils because they have higher organic matter concentrations. However, soils from broiler litter-amended fields sorbed 46% less monensin than soils from unamended fields, likely because broiler litter also increased soil pH. The sorption of monensin to soil was strongly influenced by pH, with an order of magnitude greater sorption at pH 4 than at pH 9. Both soils had similar capacity to sorb monensin under similar solution pH, despite differences in organic carbon content (with the broiler litter-amended having 25% greater relative to the unamended soil). Temperature did not significantly impact monensin sorption for either soil. Our findings suggest increasing soil pH, for instance through liming, could enhance mobility of monensin.

http://ift.tt/2o8Um1P

Environmental analysis of a potential district heating network powered by a large-scale cogeneration plant

Abstract

Among the solutions for the achievement of environmental sustainability in the energy sector, district heating (DH) with combined heat and power (CHP) systems is increasingly being used. The Italian city of Turin is in a leading position in this field, having one of the largest DH networks in Europe. The aim of this work is the analysis of a further development of the network, addressed to reduce the presence of pollutants in a city that has long been subject to high concentration levels. The environmental compatibility of this intervention, especially in terms of nitrogen oxides (NO_x) and particulate matter (PM) emissions, is evaluated. The pollutants dispersion is estimated using the CALPUFF model. The forecasting scenario is created firstly by simulating the energy production of the main generation plants in response to the estimated heat demand, and secondly by investigating the amount and the dispersion of pollutants removed due to the elimination of the centralized residential heaters. The results show a future reduction in ground level average NO_x concentration ranging between 0.2 and 4 μg/m³. The concentration of PM remains almost unchanged. Measures are then taken to lower the uncertainty in the simulation scenarios. This study provides important information on the effects of a change of the energy configuration on air quality in an urban area. The proposed methodological approach is comprehensive and repeatable.

http://ift.tt/2o3NpO7

Effect of earthworms on growth, photosynthetic efficiency and metal uptake in Brassica juncea L. plants grown in cadmium-polluted soils

Abstract

The present study has been carried out to examine the role of earthworms in phytoremediation of Cd and its effect on growth, pigment content, expression of genes coding key enzymes of pigments, photosynthetic efficiency and osmoprotectants in Brassica juncea L. plants grown under cadmium (Cd) metal stress. The effect of different Cd concentrations (0.50, 0.75, 1.0, 1.25 mM) was studied in 30 and 60-day-old plants grown in soils containing earthworms. It was observed that earthworm inoculation showed stimulatory effect on phytoremediation capacity and Cd uptake has increased by 49% (in 30-day-old plants) and 35% (in 60-day-old plants) in shoots and 13.3% (in 30-day-old plants) and 10% (in 60-day-old plants) in roots in 30 and 60-day-old plants in Cd (1.25 mM) treatments. Plant growth parameters such as root and shoot length, relative water content and tolerance index were found to increase in the presence of earthworms. Recovery in photosynthetic pigments (chlorophyll and carotenoid) and gas exchange parameters, i.e. net photosynthetic rate (P _n ), stomatal conductance (G _s ), intercellular CO₂ concentration (C _i ) and transpiration rate (E _t ), was observed after earthworm's supplementation. Modulation in expression of key enzymes for pigment synthesis, i.e. chlorophyllase, phytoene synthase, chalcone synthase and phenylalanine ammonia lyase, was also observed. The results of our study revealed that earthworms help to mitigate the toxic effects produced by Cd on plant growth and photosynthetic efficiency along with enhanced phytoremediation capacity when co-inoculated with Cd in soil.

http://ift.tt/2o9gt8r

Estrogen receptor beta mediates hepatotoxicity induced by perfluorooctane sulfonate in mouse

Abstract

Perfluorooctane sulfonate (PFOS), an artificial fluorosurfactant and global contaminant, is used widely in various consumer products. In this study, we investigated the function of estrogen receptor β (ERβ) in PFOS-induced bile acid and cholesterol metabolism disorders and gut microbiome using ERβ knockout mice that were exposed to PFOS by gavage. Our results showed that a daily dose of 5 mg PFOS/kg significantly induced hydropic degeneration and vacuolation in hepatic cells, reduced bile acid, and cholesterol levels in liver tissue, and influenced the abundance and composition of gut microbiota. Notably, ERβ deficiency not only ameliorated morphological alterations of hepatocytes but also relieved disorders in bile acids and cholesterol metabolism caused by PFOS. Furthermore, the changes in the gut microbiome by PFOS were also modulated. The relative transcript abundance of key genes involved in bile acid and cholesterol metabolism exhibited similar changes. In HepG2 cells, PFOS increased ERβ expression, which could be blocked by adding PHTPP (a selective antagonist of ERβ). Our study thus provides new evidence that ERβ mediates PFOS-induced hepatotoxicity.

http://ift.tt/2o3QwVW

Effect of salinity stress on growth, lipid productivity, fatty acid composition, and biodiesel properties in Acutodesmus obliquus and Chlorella vulgaris

Abstract

Two microalgae strains including Chlorella vulgaris and Acutodesmus obliquus were grown on BG11 medium with salinity stress ranging from 0.06 to 0.4 M NaCl. Highest lipid content in C. vulgaris and A. obliquus was 49 and 43% in BG11 amended with 0.4 M NaCl. The microalgal strains C. vulgaris and A. obliquus grow better at 0.06 M NaCl concentration than control condition. At 0.06 M NaCl, improved dry biomass content in C. vulgaris and A. obliquus was 0.92 and 0.68 gL⁻¹, respectively. Stress biomarkers like reactive oxygen species, antioxidant enzyme catalase, and ascorbate peroxidase were also lowest at 0.06 M NaCl concentration revealing that both the microalgal strains are well acclimatized at 0.06 M NaCl concentration. The fatty acid composition of the investigated microalgal strains was also improved by increased NaCl concentration. At 0.4 M NaCl, palmitic acid (37%), oleic acid (15.5%), and linoleic acid (20%) were the dominant fatty acids in C. vulgaris while palmitic acid (54%) and stearic acid (26.6%) were major fatty acids found in A. obliquus. Fatty acid profiling of C. vulgaris and A. obliquus significantly varied with salinity concentration. Therefore, the study showed that salt stress is an effective stress that could increase not only the lipid content but also improved the fatty acid composition which could make C. vulgaris and A. obliquus potential strains for biodiesel production.

http://ift.tt/2o46ShC

Interaction of TiO 2 nanoparticles with proteins from aquatic organisms: the case of gill mucus from blue mussel

Abstract

To better understand the mechanisms of TiO₂ nanoparticle (NP) uptake and toxicity in aquatic organisms, we investigated the interaction of NPs with the proteins found in gill mucus from blue mussels. Mucus is secreted by many aquatic organisms and is often their first line of defense against pathogens, xenobiotics, and other sources of environmental stress. Here, five TiO₂ NPs and one SiO₂ NP were incubated with gill mucus and run out on a one-dimensional polyacrylamide gel for a comparative qualitative analysis of the free proteins in the mucosal solution and the proteins bound to NPs. We then used nanoscale liquid chromatography coupled with tandem mass spectrometry to identify proteins of interest. Our data demonstrated dissimilar protein profiles between the crude mucosal solution and proteins adsorbed on NPs. In particular, extrapallial protein (EP), one of the most abundant mucus proteins, was absent from the adsorbed proteins. After thermal denaturation experiments, this absence was attributed to the EP content in aromatic amino acids that prevents protein unfolding and thus adsorption on the NP. Moreover, although the majority of the protein corona was qualitatively similar across the NPs tested here (SiO₂ and TiO₂), a few proteins in the corona showed a specific recruitment pattern according to the NP oxide (TiO₂ vs SiO₂) or crystal structure (anatase TiO₂ vs rutile TiO₂). Therefore, protein adsorption may vary with the type of NP.

Graphical abstract

Proteins with adsorption selectivity as identified from isolated bands

http://ift.tt/2o8Nq4G

Alleviative effect of selenium on inflammatory damage caused by lead via inhibiting inflammatory factors and heat shock proteins in chicken testes

Abstract

The aim of this study was to investigate ameliorative effect of selenium (Se) on lead (Pb)-induced inflammatory damage in chicken testes. One hundred eighty 7-day-old male chickens were randomly assigned into the control group, the Se group, the Pb group, and the Pb/Se group. Lead acetate was added in drinking water (350 mg/L Pb). Sodium selenite was added in the standard commercial diet (1 mg/kg Se). On the 30th, 60th, and 90th days of the experiment, 15 chickens of each group were euthanized. Inductively coupled plasma mass spectrometry, hematoxylin and eosin staining, real-time quantitative PCR, and Western blot were used. The results indicated that excess Pb increased nitric oxide content; inducible nitric oxide synthase (iNOS) activity; nuclear factor-kappa B (NF-κB), tumor necrosis factor-α, cyclooxygenase-2, prostaglandin E synthases, and iNOS mRNA levels in a time-dependent manner; NF-κB, iNOS, heat shock protein (HSP) 60, HSP70, and HSP90 protein levels; and Pb concentration. Excess Pb decreased Se concentration and induced histological changes. Se-alleviated Pb caused all of the above changes. Se improved Pb-caused inflammatory damage by decreasing the expression of inflammatory factors and heat shock proteins in the chicken testes. Our results provided theoretical basis of an alleviative effect of Se on Pb-induced bird testis damage.

http://ift.tt/2o8LKZc

Contrasting effects of nitrogen addition on soil respiration in two Mediterranean ecosystems

Abstract

Increased atmospheric nitrogen (N) deposition is known to alter ecosystem carbon source-sink dynamics through changes in soil CO₂ fluxes. However, a limited number of experiments have been conducted to assess the effects of realistic N deposition in the Mediterranean Basin, and none of them have explored the effects of N addition on soil respiration (R _s ). To fill this gap, we assessed the effects of N supply on R _s dynamics in the following two Mediterranean sites: Capo Caccia (Italy), where 30 kg ha⁻¹ year⁻¹ was supplied for 3 years, and El Regajal (Spain), where plots were treated with 10, 20, or 50 kg N ha⁻¹ year⁻¹ for 8 years. Results show a complex, non-linear response of soil respiration (R _s ) to N additions with R _s overall increasing at Capo Caccia and decreasing at El Regajal. This suggests that the response of R _s to N addition depends on dose and duration of N supply, and the existence of a threshold above which the N introduced in the ecosystem can affect the ecosystem's functioning. Soil cover and seasonality of precipitations also play a key role in determining the effects of N on R _s as shown by the different responses observed across seasons and in bare soil vs. the soil under canopy of the dominant species. These results show how increasing rates of N addition may influence soil C dynamics in semiarid ecosystems in the Mediterranean Basin and represent a valuable contribution for the understanding and the protection of Mediterranean ecosystems.

http://ift.tt/2o3NvVF

Photosynthetic pigments and peroxidase activity of Lepidium sativum L. during assisted Hg phytoextraction

Abstract

The study was conducted to evaluate metabolic answer of Lepidium sativum L. on Hg, compost, and citric acid during assisted phytoextraction. The chlorophyll a and b contents, total carotenoids, and activity of peroxidase were determined in plants exposed to Hg and soil amendments. Hg accumulation in plant shoots was also investigated. The pot experiments were provided in soil artificially contaminated by Hg and/or supplemented with compost and citric acid. Hg concentration in plant shoots and soil substrates was determined by cold vapor atomic absorption spectroscopy (CV-AAS) method after acid mineralization. The plant photosynthetic pigments and peroxidase activity were measured by standard spectrophotometric methods. The study shows that L. sativum L. accumulated Hg in its aerial tissues. An increase in Hg accumulation was noticed when soil was supplemented with compost and citric acid. Increasing Hg concentration in plant shoots was correlated with enhanced activation of peroxidase activity and changes in total carotenoid concentration. Combined use of compost and citric acid also decreased the chlorophyll a and b contents in plant leaves. Presented study reveals that L. sativum L. is capable of tolerating Hg and its use during phytoextraction assisted by combined use of compost and citric acid lead to decreasing soil contamination by Hg.

http://ift.tt/2o8U4bq

Antimicrobial activity of aqueous extracts from four plants on bacterial isolates from periodontitis patients

Abstract

Four aqueous extracts of different plant organs are the following: Artemisia herba-alba, Opuntia ficus-indica, Camellia sinensis and Phlomis crinita were evaluated against two bacterial strains: Porphyromonas gingivalis and Prevotella intermedia, which are implicated in periodontal diseases. By using a disc method, these plant extracts demonstrated powerful bacterial activity against these Gram-negative strains. The minimum inhibitory concentration values of the four plant extracts varied between 0.03 and 590.82 mg/ml for the microbes. Another assay using commercial antibiotics and antibacterials as positive controls was also conducted. Values obtained after statistical analysis of inhibition diameters of all plant extracts demonstrated that for P. gingivalis, the aqueous extracts of A. herba-alba and O. ficus-indica were most effective, followed by those of C. sinensis and P. crinita. For P. intermedia, aqueous extracts of O. ficus-indica and C. sinensis appeared to be more efficient with significantly different (P > 0.05) inhibition diameters, followed by those of O. ficus-indica and P. crinita. In summary, the statistical results reveal that these plant extracts exert stronger antibacterial activity on P. intermedia germ as compared to P. gingivalis.

http://ift.tt/2o3UvCa

Cheap non-toxic non-corrosive method of glass cleaning evaluated by contact angle, AFM, and SEM-EDX measurements

Abstract

Glass surface cleaning is the very first step in advanced coating deposition and it also finds use in conserving museum objects. However, most of the wet chemical methods of glass cleaning use toxic and corrosive chemicals like concentrated sulfuric acid (H₂SO₄), piranha (a mixture of concentrated sulfuric acid and 30% hydrogen peroxide), and hydrogen fluoride (HF). On the other hand, most of the dry cleaning techniques like UV-ozone, plasma, and laser treatment require costly instruments. In this report, five eco-friendly wet chemical methods of glass cleaning were evaluated in terms of contact angle (measured by optical tensiometer), nano-scale surface roughness (measured by atomic force microscopy or AFM), and elemental composition (measured by energy dispersive x-ray spectroscopy or SEM-EDX). These glass cleaning methods are devoid of harsh chemicals and costly equipment, hence can be applied in situ in close proximity with plantation such as greenhouse or upon subtle objects such as museum artifacts. Out of these five methods, three methods are based on the chemical principle of chelation. It was found that the citric acid cleaning method gave the greatest change in contact angle within the hydrophilic regime (14.25° for new glass) indicating effective cleansing and the least surface roughness (0.178 nm for new glass) indicating no corrosive effect. One of the glass sample showed unique features which were traced backed to the history of the glass usage.

http://ift.tt/2o91taz

Mantle Cell Lymphoma: Contemporary Diagnostic and Treatment Perspectives in the Age of Personalized Medicine

Publication date: Available online 6 April 2017
Source:Hematology/Oncology and Stem Cell Therapy
Author(s): Jose Sandoval-Sus, Eduardo M. Sotomayor, Bijal D. Shah
Mantle cell lymphoma is a clinically heterogeneous disease occurring within a heterogeneous patient population, highlighting a need for personalized therapy to ensure optimal outcomes. It is therefore critical to understand the benefits and risks associated with both intensive and deintensified approaches. In the following review we provide a therapeutic roadmap to strategically guide treatment for newly diagnosed and relapsed/refractory patients highlighting pivotal and recently published results involving known and novel therapies.



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Busulfan Drug Monitoring is Needed in Patients Undergoing Allogeneic Stem Cell Transplantation

Publication date: Available online 6 April 2017
Source:Hematology/Oncology and Stem Cell Therapy
Author(s): Bushra Salman, Mohammed Al-Zaabi, Mohammed Al-Huneini, David Dennison, Abdulhakeem Al-Rawas, Salam Al-Kindi, Khalil Al-Farsi, Melanie Tauro, Murtadha Al-Khabori
Busulfan (Bu)-based preparative regimens in hematopoietic stem cell transplantation are commonly used. Previous studies have shown that Bu at a fixed dose of 3.2 mg/kg/day (FBD) given intravenously decreases variability in drug pharmacokinetics and this decreases the dependency on therapeutic drug monitoring (TDM) of Bu. We compared the Bu dose given using TDM with the FBD of 3.2 mg/kg/day. Seventy-three patients with acute leukemia, myelodysplasia, chronic myeloid leukemia, thalassemia major, and sickle cell disease were included. The mean age at transplant was 15 years (range 2–55 years) with 57% adults. Indication for transplantation was leukemia/myelodysplastic syndrome in 46% of the patients, while the remaining 54% were transplanted for inherited blood disorders. We found that the median FBD was lower than the median TDM dose by 39 mg/day with a statistically significant difference (p < .001) even after adjusting for the weight (median total FBD of 349 mg, median TDM dose of 494 mg, p < .0001). Age and underlying condition (malignant vs. nonmalignant) were the main factors affecting Bu clearance (p < .001 and p < .07, respectively). TDM remains an important tool for the appropriate dosing of Bu in preparative regimens of hematopoietic stem cell transplantation, especially in populations with genetic admixture.



http://ift.tt/2oL7Hyt

Hydroxyurea For Non-Transfusion Dependent β-Thalassemia: A Systematic Review and Meta-Analysis

Publication date: Available online 6 April 2017
Source:Hematology/Oncology and Stem Cell Therapy
Author(s): Ali H. Algiraigri, Nicola A.M. Wright, Elizabeth Oddone Paolucci, Aliya Kassam
Nontransfusion-dependent β-thalassemia (NTDβT) syndromes consist of β-thalassemia intermedia and moderate hemoglobin E/β thalassemias. They are characterized by varying degrees of chronic anemia and a wide spectrum of complications due to ineffective erythropoiesis and iron overload from chronic transfusions. Hydroxyurea (HU), an oral chemotherapeutic drug, is anticipated to decrease disease severity. We performed a meta-analysis to evaluate the clinical efficacy and safety of HU in NTDβT patients of any age. MEDLINE, EMBASE, Cochrane databases, and major conference proceedings for studies that assessed HU in NTDβT patients were searched. Qualities of eligible studies were assessed by National Institutes of Health tools. Seventeen studies, collectively involving 709 patients, fulfilled the eligibility criteria. HU was associated with a significant decrease in transfusion need in severe NTDβT with complete and overall (≥ 50%) response rates of 42% and 79%, respectively. For mild NTDβT, HU was effective in raising hemoglobin by 1 g/L in 64% of patients. HU appears to be effective, well tolerated, and associated with mild and transient adverse events. NTDβT patients may benefit from a trial of HU, although large randomized clinical trials assessing its efficacy should be conducted to confirm the findings of this meta-analysis and to assess its long-term toxicity and response sustainability.



http://ift.tt/2o3I894

“Metabolic and cardiovascular response to exercise in patients with type 1 diabetes”

Abstract

Purpose

Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population.

Methods

This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer. Blood samples were collected for evaluation of glycemia and lactate levels.

Results

Mean oxygen uptake at peak exercise (VʹO_2,peak) was significantly lower in T1DM subjects (V′O_2,peak T1DM 2200 ± 132ml/min vs VʹO_2,peak Healthy subjects of 2659 ± 120 ml/min p = 0.035). Cardiovascular response analysis did not show statistically significant differences. Respiratory exchange ratio (RER) was significantly higher in healthy subjects at peak exercise and at the first minute of recovery (p = 0.022, p = 0.024). Peak exercise lactate levels were significantly higher in healthy subjects. There was no statistical correlation between CPET results and diabetes-related parameters.

Conclusions

Patients affected by T1DM have a worse exercise tolerance than normal subjects. The two groups differed by RER which can be greatly influenced by the substrate type utilized to produce energy. Because of the impaired carbohydrate utilization, T1DM subjects may use a larger amount of lipid substrates, such hypothesis could be strengthened by the lower lactate levels found in T1DM group at peak exercise. The lack of correlation between exercise tolerance and disease-related variables suggests that the alterations found could be independent from the glycemic levels.

http://ift.tt/2p7KW4o

High blood tacrolimus and hyperkalemia in a heart transplant patient

Manoj Kumar Sahu, Sarvesh Pal Singh, Anupam Das, Atul Abraham, Balram Airan, Intekhab Alam, Ramesh Menon, V Devagourou, Anish Gupta

Annals of Cardiac Anaesthesia 2017 20(2):270-271



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Anger: An enemy of heart, raj yoga meditation is heart friendly

Usha Kiran, Suruchi Ladha

Annals of Cardiac Anaesthesia 2017 20(2):127-128



http://ift.tt/2niSAfS

Inverted left atrial appendage masquerading as a left atrial mass

Suresh Kumaran, Gladdy George, AV Varsha, Raj Sahajanandan

Annals of Cardiac Anaesthesia 2017 20(2):248-249

An inverted left atrial appendage after cardiac surgery is a rare finding and can be misinterpreted as a thrombus, mass, or vegetation. We report a case where intraoperative transesophageal echocardiography assisted in making an accurate diagnosis.

http://ift.tt/2o3I0X5

Serial semi-invasive hemodynamic assessment following pericardiectomy for chronic constrictive pericarditis

Ujjwal Kumar Chowdhury, Poonam Malhotra Kapoor, Adil Rizvi, Vishwas Malik, Sandeep Seth, Rajiv Narang, Mani Kalaivani, Sarvesh Pal Singh, Sathiya Selvam

Annals of Cardiac Anaesthesia 2017 20(2):169-177

Objectives: This study was designed to prospectively investigate the effects of pericardiectomy via median sternotomy on intra- and postoperative hemodynamics by a new semi-invasive device (Flotrac/VigileoTM monitor) using arterial pressure waveform analysis. Patients and Methods: Thirty consecutive patients aged 15 to 55 years (mean+SD, 31.73 + 13.53 years), who had undergone total pericardiectomy via median sternotomy underwent serial hemodynamic evaluation. FlotracTM Sensor – derived stroke volume, stroke volume variation, systemic vascular resistance index (SVRI), cardiac index and right atrial pressure were measured just before and after pericardiectomy, at 12 hours, 24 hours, 48 hours, 72 hours and at discharge postoperatively. Results: Majority of patients (73.33%) exhibited statistically significant reduction of right atrial pressure and SVRI along with improvement in cardiac index and oxygen delivery in the immediate and late postoperative period. However, the stroke volume and stroke volume variation did not increase proportionately on completion of surgery. Patients with low cardiac output syndrome exhibited persistently high central venous pressure with reduced cardiac index and echocardiographically abnormal diastolic filling characteristics. Conclusions: We conclude that there is early normalization of hemodynamics following pericardiectomy via median sternotomy and the adequacy of pericardiectomy can be accurately assessed by the new semi-invasive arterial pressure waveform analysis device. Stroke volume variation is a non-predictor of fluid requirement during and after pericardiectomy.

http://ift.tt/2o3jOEw

Methylene blue for postcardiopulmonary bypass vasoplegic syndrome: A cohort study

Michael Mazzeffi, Benjamin Hammer, Edward Chen, Mark Caridi-Scheible, James Ramsay, Christopher Paciullo

Annals of Cardiac Anaesthesia 2017 20(2):178-181

Background: Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. Aims: We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine variables that predicted response to MB. Setting and Design: This was conducted in a tertiary care medical center; this study was a retrospective cohort study. Materials and Methods: Adult cardiac surgery patients who received MB for post-CPB VS over a 2-year period were studied. Mean arterial blood pressure (MAP) and vasopressor doses were compared before and after MB, and logistic regression was used to model which variables predicted response. Results: Eighty-eight patients received MB for post-CPB VS during the study period. MB administration was associated with an 8 mmHg increase in MAP (P = 0.004), and peak response occurred at 2 h. Variables that were associated with a positive drug response were deep hypothermic circulatory arrest during surgery and higher MAP at the time of drug administration (P = 0.006 and 0.02). A positive response had no correlation with in-hospital mortality (P = 0.09). Conclusions: MB modestly increases MAP in cardiac surgery patients with VS. Higher MAP at the time of drug administration and surgery with deep hypothermic circulatory arrest predict a greater drug response.

http://ift.tt/2niXfhW

Artificial intelligence in mitral valve analysis

Jelliffe Jeganathan, Ziyad Knio, Yannis Amador, Ting Hai, Arash Khamooshian, Robina Matyal, Kamal R Khabbaz, Feroze Mahmood

Annals of Cardiac Anaesthesia 2017 20(2):129-134

Background: Echocardiographic analysis of mitral valve (MV) has become essential for diagnosis and management of patients with MV disease. Currently, the various software used for MV analysis require manual input and are prone to interobserver variability in the measurements. Aim: The aim of this study is to determine the interobserver variability in an automated software that uses artificial intelligence for MV analysis. Settings and Design: Retrospective analysis of intraoperative three-dimensional transesophageal echocardiography data acquired from four patients with normal MV undergoing coronary artery bypass graft surgery in a tertiary hospital. Materials and Methods: Echocardiographic data were analyzed using the eSie Valve Software (Siemens Healthcare, Mountain View, CA, USA). Three examiners analyzed three end-systolic (ES) frames from each of the four patients. A total of 36 ES frames were analyzed and included in the study. Statistical Analysis: A multiple mixed-effects ANOVA model was constructed to determine if the examiner, the patient, and the loop had a significant effect on the average value of each parameter. A Bonferroni correction was used to correct for multiple comparisons, and P = 0.0083 was considered to be significant. Results: Examiners did not have an effect on any of the six parameters tested. Patient and loop had an effect on the average parameter value for each of the six parameters as expected (P < 0.0083 for both). Conclusion: We were able to conclude that using automated analysis, it is possible to obtain results with good reproducibility, which only requires minimal user intervention.

http://ift.tt/2nj0iqg

Erratum: Percutaneous tracheostomy in patients on anticoagulants

Annals of Cardiac Anaesthesia 2017 20(2):282-282



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Forbidden word entropy of cerebral oximetric values predicts postoperative neurocognitive decline in patients undergoing aortic arch surgery under deep hypothermic circulatory arrest

Anna Dubovoy, Peter Chang, Carol Persad, Wei Lau, Elizabeth Jewell, Daniel Cox, Milo Engoren

Annals of Cardiac Anaesthesia 2017 20(2):135-140

Purpose: Up to 53% of cardiac surgery patients experience postoperative neurocognitive decline. Cerebral oximetry is designed to detect changes in cerebral tissue saturation and therefore may be useful to predict which patients are at risk of developing neurocognitive decline. Methods: This is a retrospective analysis of a prospective study originally designed to determine if treatment of cerebral oximetry desaturation is associated with improvement in postoperative cognitive dysfunction in patients undergoing aortic reconstruction under deep hypothermic circulatory arrest. Cognitive function was measured, preoperatively and 3 months postoperatively, with 15 neuropsychologic tests administered by a psychologist; the individual test scores were summed and normalized. Bilateral cerebral oximetry data were stored and analyzed using measures of entropy. Cognitive decline was defined as any decrease in the summed normalized score from baseline to 3 months. Results: Seven of 17 (41%) patients suffered cognitive decline. There was no association between baseline cerebral oximetry and postoperative cognitive dysfunction. Nor were changes in oximetry values associated with cognitive decline. However, cognitive decline was associated with loss of forbidden word entropy (FwEn) (correlation: Rho ρ = 0.51, P = 0.037 for left cerebral oximetry FwEn and ρ = 0.54, P = 0.025 for right cerebral oximetry FwEn). Conclusion: Postoperative cognitive decline was associated with loss of complexity of the time series as shown by a decrease in FwEn from beginning to end of the case. This suggests that regulation of cerebral oximetry is different between those who do and those who do not develop cognitive decline.

http://ift.tt/2o3Cioh

Partial anomalous pulmonary venous return: Scimitar vein

Timothy Heinke, Scott R Stewart, Toby Steinberg, William R Hand, James H Abernathy

Annals of Cardiac Anaesthesia 2017 20(2):259-261

Scimitar syndrome is a rare association of congenital cardiopulmonary anomalies characterized by partial anomalous pulmonary venous return, in which an abnormal right pulmonary vein drains into the inferior vena cava. This case exemplifies the role of transesophageal echocardiography in perioperative management and surgical decision-making.

http://ift.tt/2nj8C9t

An analysis of the factors producing multiple ventricular arrhythmias during pulmonary artery catheterization

Hajime Satoh, Yuka Miyata, Tomohiko Hayasaka, Tsutomu Wada, Yukio Hayashi

Annals of Cardiac Anaesthesia 2017 20(2):141-144

Background: The development of arrhythmias during placement of a pulmonary artery catheter (PAC) is common. Aims: This study was designed to examine factors influencing development of ventricular arrhythmias in adult patients undergoing cardiovascular operations during the catheter placement. Settings and Designs: Prospective, observational, cohort study. Methods: We prospectively studied 174 patients undergoing cardiovascular operations. A PAC was inserted through the right internal jugular vein by staff anesthesiologists. Electrocardiography tracings were recorded as the catheter was advanced from the right atrium to the pulmonary artery. Arrhythmias were classified as absent, single, or multiple (two or more consecutive) ventricular arrhythmias. We examined risk factors to produce ventricular arrhythmias during the placement. Statistical Analysis: The data were analyzed using logistic regression analysis to assess factors for the occurrence of ventricular arrhythmias after univariate analyses. Results: Ventricular arrhythmias (single and multiple) occurred in 149 patients (85.6%) and multiple arrhythmias were observed in 78 patients (44.8%). There were no factors to facilitate the ventricular arrhythmias (single and multiple), whereas it showed that valvular diseases (P = 0.049) and the placement time (P < 0.001) are significant factors to produce multiple arrhythmias. Conclusion: Both valvular diseases and long placement time were significant risk factors to produce multiple ventricular arrhythmias during placement of a PAC.

http://ift.tt/2o3CgwF

Importance of 3D real time perioperative tee in ASD device embolisation

MS Sarvana Babu, Neelam Aggarwal, A Asha, Digraje Sunita Ashok, Thomas Koshy

Annals of Cardiac Anaesthesia 2017 20(2):278-278



http://ift.tt/2nj1Gt3

Carotid artery disease and periprocedural stroke risk after transcatheter aortic valve implantation

Parthasarathy D Thirumala, Sruthi Muluk, Reshmi Udesh, Amol Mehta, John Schindler, Suresh Mulukutla, Vinodh Jeevanantham, Lawrence Wechsler, Thomas Gleason

Annals of Cardiac Anaesthesia 2017 20(2):145-151

Objective/Background: To examine the role of carotid stenosis (CS) and other independent risk factors of perioperative stroke, following transcatheter aortic valve implantation (TAVI). Materials and Methods: Using data from the National Inpatient Sample database for analysis, patients who underwent TAVI were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Various preoperative and perioperative risk factors and their association with perioperative strokes were studied. Results: Data on 7566 patients who underwent a TAVI procedure from 2012 to 2013 were extracted. The average age of the patient population was 81.2 ± 0.32 years. The overall perioperative stroke rate in our patient cohort was 2.79%. Majority (94.6%) of the strokes were ischemic. Multivariate analysis showed the following independent risk factors for perioperative strokes after TAVI: female gender odds ratio (OR) = 2.25 (95% confidence interval [CI], 1.42–3.57), higher van Walraven score OR = 6.6 (95% CI = 3.71–11.73), bilateral CS OR = 4.46 (95% CI = 2.03–9.82), and TAVI with a cardiac procedure done under cardiopulmonary bypass OR = 2.84 (95% CI = 1.57–5.14). Conclusion: Bilateral carotid disease is a significant risk factor for perioperative strokes following TAVI. Preoperative screening with carotid Doppler to identify high-risk patients appears to be warranted. In addition, patients of female gender were found to have an increased risk for carotid disease.

http://ift.tt/2o3EWKN

Transthoracic echocardiography versus transesophageal echocardiography for rupture sinus of Valsalva aneurysm

Ira Dhawan, Vishwas Malik, Kamal Prakash Sharma, Neeti Makhija, Neha Pangasa

Annals of Cardiac Anaesthesia 2017 20(2):245-246

We report a rare case of sinus of Valsalva aneurysm of both right and left coronary sinus (LCS), with perforation of the LCS opening into the left ventricle. The LCS aneurysm with its perforation was undiagnosed on transthoracic echocardiography emphasizing the role of transesophageal echocardiography in delineating the anatomy.

http://ift.tt/2niSZ1D

Impact of dexmedetomidine on hemodynamic changes during and after coronary artery bypass grafting

Morteza Hashemian, Mehdi Ahmadinejad, Seyed Amir Mohajerani, Alireza Mirkheshti

Annals of Cardiac Anaesthesia 2017 20(2):152-157

Objective: To determine the effect of dexmedetomidine (Dex) on hemodynamic changes during cardiopulmonary pump and postoperative period in coronary artery bypass grafting (CABG). Methods and Design: This study is designed as a double-blinded, randomized clinical trial. Setting: University hospital and single center. Participants: patients candidate for elective CABG. Intervention: Dex 0.5 μg/kg/h or placebo was infused from the initiation of anesthesia up to extubation in Intensive Care Unit (ICU). Measurements: Heart rate (HR) and blood pressure (BP), pain score, and total morphine dose requirement were monitored and compared during cardiac pump up to 12 h postoperative in ICU. Results: Mean arterial pressure was significantly higher in Dex group in postoperation period at 1 (P = 0.010) and 2 h (P = 0.002) compared to control group. HR was significantly lower in Dex group in postcardiopulmonary bypass (CPB) time at 0 h (P = 0.001), 1 h (P = 0.0016), and 2 h (P = 0.001), and then in postoperative period in ICU at 1 h (P = 0.025), 2 h (P = 0.0012), and 4 h (P = 0.0025) compared to control group. Postoperative pain score was significantly lower during 12 h after surgery. Conclusion: Dex could effectively blunt hemodynamic response to surgical stress, particularly during CPB pump and afterward. Infusion of Dex maintains BP at higher range and HR at lower range compared to placebo.

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Mechanical cause for acute left lung atelectasis after neonatal aortic arch repair with arterial switch operation: Conservative management

Madan Mohan Maddali, Pranav Subbaraya Kandachar, Said Al-Hanshi, Mohammed Al Ghafri, John Valliattu

Annals of Cardiac Anaesthesia 2017 20(2):252-255

Respiratory complications due to mechanical obstruction of the airways can occur following pediatric cardiac surgery. Clinically significant intrathoracic vascular compression of the airway can occur when extensive dissection and mobilization of arch and neck vessels is involved as in repair of interrupted aortic arch. This case report describes a neonate who underwent interrupted aortic arch repair along with an arterial switch operation and developed a left lung collapse immediately after tracheal extubation. Fiber-optic bronchoscopy revealed vascular compression as the real culprit. The child was successfully managed conservatively.

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The role of Rajyoga meditation for modulation of anxiety and serum cortisol in patients undergoing coronary artery bypass surgery: A prospective randomized control study

Usha Kiran, Suruchi Ladha, Neeti Makhija, Poonam Malhotra Kapoor, Minati Choudhury, Sambhunath Das, Parag Gharde, Vishwas Malik, Balram Airan

Annals of Cardiac Anaesthesia 2017 20(2):158-162

Introduction: Rajyoga meditation is a form of mind body intervention that is promoted by the Brahma Kumaris World Spiritual University. This form of meditation can be easily performed without rituals or mantras and can be practiced anywhere at any time. The practice of Rajyoga meditation can have beneficial effects on modulating anxiety and cortisol level in patients undergoing major cardiac surgery. Materials and Methods: A prospective randomized control study was carried out in a single tertiary care center. One hundred and fifty patients undergoing elective coronary artery bypass surgery were enrolled in the study. The patients were randomized in two groups namely, Group 1 (Rajyoga group) and Group 2 (Control Group). Anxiety was measured on a visual analog scale 1–10 before the start of Rajyoga training or patient counseling (T1), on the morning of the day of surgery (T2), on the 2nd postoperative day (T3), and on the 5th postoperative day (T4). The serum cortisol level was measured in the morning of the day of surgery (T1), on the 2nd postoperative day (T2) and on the 5th postoperative day (T3), respectively. Results: In the study, it was seen that the anxiety level of the patients before the surgery (T1) and on the day of surgery (T2) were comparable between the two groups. However on the 2nd postoperative day (T3), the patients who underwent Rajyoga training had lower anxiety level in comparison to the control group (3.12 ± 1.45 vs. 6.12 ± 0.14, P < 0.05) and on the 5th postoperative day (T4) it was seen that Rajyoga practice had resulted in significant decline in anxiety level (0.69 ± 1.1 vs. 5.6 ± 1.38, P < 0.05). The serum cortisol level was also favorably modulated by the practice of Rajyoga meditation. Conclusion: Mindbody intervention is found to effective in reducing the anxiety of the patients and modulating the cortisol level in patients undergoing wellknown stressful surgery like coronary artery bypass surgery.

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Modified blalock-taussig shunt and levosimendan for left ventricular preparation in a child with transposition of great arteries and regressed ventricle undergoing rapid 2 stage arterial switch operation

Manoj Kumar Sahu, Anish Gupta, Intekhab Alam, Sarvesh Pal Singh, Ramesh Menon, V Devagouru

Annals of Cardiac Anaesthesia 2017 20(2):265-267

Rapid two-stage arterial switch operation (ASO) is very relevant as many patients of transposition of great arteries (TGA) present late to the hospital when primary switch either is not possible or carries a high risk of morbidity and mortality. Hence, other means apart from the traditional methods of left ventricle preparedness should be tried to help this category of patients, who are to undergo rapid two-stage ASO. We successfully used levosimendan and continuous positive airway pressure after 1st stage operation in a patient with dTGA and regressed ventricle, which helped in left ventricular preparedness, and the child underwent rapid two-stage ASO uneventfully.

http://ift.tt/2nj1wSp

Conscious sedation for balloon mitral valvotomy: A comparison of fentanyl versus sufentanil

Shailendra Deochandra Modak, Deepa G Kane

Annals of Cardiac Anaesthesia 2017 20(2):163-168

Context: Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy. Aims: In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl. Settings and Design: Single-centered, prospective single-blind study of sixty patients. Materials and Methods: Patients between 15 and 45 years of rheumatic mitral stenosis with valve area of 0.8–1 cm2 undergoing elective balloon mitral valvotomy, randomly divided to receive bolus injection fentanyl 1 mcg/kg (Group 1, n = 30) followed by infusion at 1 mcg/kg/h or bolus of injection sufentanil 0.1 mcg/kg (Group 2, n = 30) followed by continuous infusion at 0.1 mcg/h. Both the groups received injection midazolam bolus 0.02 mg/kg followed by infusion at 15 mcg/kg/h. Pain intensity (by visual analog score [VAS]), level of sedation (by Ramsay sedation scale), overall patient and operator's satisfaction, effect on cardiorespiratory parameters, and discharge score (by modified Aldrete score) were assessed. Statistical Analysis Used: Statistical analysis used Student's unpaired t-test and Chi-square test. P < 0.05 was considered statistically significant. Results: Mean number of bolus doses in fentanyl group was 0.9 versus 0.13 in sufentanil group (P < 0.01). The mean value of mean blood pressure in fentanyl group was 83.52 mmHg versus 88 mmHg in sufentanil group (P < 0.05), but the value was within normal range in both the groups. The mean VAS – patient's opinion in fentanyl group was 8.97 versus 9.53 in sufentanil group (P < 0.05). Mean discharge score in fentanyl group was 17.87 versus 18.23 in sufentanil group (P < 0.05). No statistically significant difference was found with respect to heart rate, respiratory rate, oxygen saturation, PaCO2values, and anxiety scores. Conclusion: Sufentanil was found to be better with respect to analgesia, patient satisfaction, and recovery however not cost-effective for continuous infusion technique.

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Role of MicroRNA in cardiac anesthesia: An innovative consequences and new possibility

Mayadhar Barik, Abhay Kumar, Pravash Ranjan Mishra, Poonam Malhotra Kapoor

Annals of Cardiac Anaesthesia 2017 20(2):274-275



http://ift.tt/2njaCib

Erratum: Annals of Cardiac Anesthesia: Beacon journey toward excellence: 2015–2017

Annals of Cardiac Anaesthesia 2017 20(2):280-280



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Wnt5a and CCL25 promote adult T-cell acute lymphoblastic leukemia cell migration, invasion and metastasis.

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Wnt5a and CCL25 promote adult T-cell acute lymphoblastic leukemia cell migration, invasion and metastasis.

Oncotarget. 2017 Mar 25;:

Authors: Deng X, Tu Z, Xiong M, Tembo K, Zhou L, Liu P, Pan S, Xiong J, Yang X, Leng J, Zhang Q, Xiao R, Zhang Q

Abstract
Adult T-cell acute lymphoblastic leukemia (T-ALL) is a refractory leukemia. We previously showed that CCL25/CCR9 promotes T-ALL metastasis. In the present study, we assessed the effects of CCL25 on Wnt expression and the effects of Wnt5a and CCL25 on PI3K/Akt and RhoA activation. Transwell assays and mouse xenograft experiments were utilized to assess the effects of Wnt5a and CCL25 on MOLT4 cell invasion, migration and metastasis. The effects of Wnt5a on MOLT4 cell actin polarization and pseudopodium formation were examined using laser scanning confocal microscopy and scanning electron microscopy. CCL25 induced Wnt5a expression in MOLT4 cells by promoting protein kinase C (PKC) expression and activation. Wnt5a promoted MOLT4 cell migration, invasion, actin polarization, and lamellipodium and filopodia formation via PI3K/Akt-RhoA pathway activation. These effects were rescued by PI3K/Akt or RhoA knockdown or inhibition. Additionally, Wnt5a in cooperation with CCL25 promoted MOLT4 cell mouse liver metastasis and stimulated RhoA activation. These results show that CCL25/CCR9 upregulates Wnt5a by promoting PKC expression and activation in MOLT4 cells. This in turn promotes cell migration and invasion via PI3K/Akt-RhoA signaling, enhancing cell polarization and pseudopodium formation. These findings indicate that the PI3K/Akt-RhoA pathway is likely responsible for Wnt5a-induced adult T-ALL cell migration and invasion.

PMID: 28380463 [PubMed - as supplied by publisher]

http://ift.tt/2nj7mDl

Impact of interaction between the G870A and EFEMP1 gene polymorphism on glioma risk in Chinese Han population.

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Impact of interaction between the G870A and EFEMP1 gene polymorphism on glioma risk in Chinese Han population.

Oncotarget. 2017 Mar 27;:

Authors: Libin Y, Bo Q, Xun X, Yongqin K, Jian L, Kexia F, Heng G, Hui Z, Yuan M

Abstract
AIMS: To investigate the impact of CCND1 and EFEMP1 gene polymorphism, and additional their gene-gene interactions and haplotype within EFEMP1 gene on glioma risk based on Chinese population.
METHODS: Logistic regression was performed to investigate association between single-nucleotide polymorphisms (SNP) and glioma risk and generalized multifactor dimensionality reduction (GMDR) was used to analyze the gene-gene interaction.
RESULTS: Glioma risks were higher in carriers of homozygous mutant of rs603965 within CCND1 gene, rs1346787 and rs3791679 in EFEMP1 gene than those with wild-type homozygotes, OR (95%CI) were 1.67 (1.23-2.02), 1.59 (1.25-2.01) and 1.42 (1.15-1.82), respectively. GMDR analysis indicated a significant two-locus model (p=0.0010) involving rs603965 within CCND1 gene and rs1346787 within EFEMP1 gene. Overall, the cross-validation consistency of the two- locus models was 10\ 10, and the testing accuracy is 60.17%. Participants with rs603965 - GA or AA and rs1346787- AG or GG genotype have the highest glioma risk, compared to participants with rs603965 - GG and rs1346787- AA genotype, OR (95%CI) was 3.65 (1.81-5.22). We conducted haplotype analysis for rs1346787 and rs3791679, because D' value between rs1346787 and rs3791679 was more than 0.8. The most common haplotype was rs1346787 - A and rs3791679- G haplotype, the frequency of which was 0.4905 and 0.4428 in case and control group.
CONCLUSIONS: Polymorphism in rs603965 within CCND1 gene and rs1346787 within EFEMP1 gene and its gene- gene interaction were associated with increased glioma risk.

PMID: 28380465 [PubMed - as supplied by publisher]

http://ift.tt/2nj6FKd

Heat stress induces intestinal injury through lysosome- and mitochondria-dependent pathway in vivo and in vitro.

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Heat stress induces intestinal injury through lysosome- and mitochondria-dependent pathway in vivo and in vitro.

Oncotarget. 2017 Mar 28;:

Authors: Yi G, Li L, Luo M, He X, Zou Z, Gu Z, Su L

Abstract
Damage to the small intestine secondary to heat stroke is a major factor in heat stroke-related morbidity and mortality. However, the underlying mechanisms by which heat stroke causes small intestinal lesions and dysfunction remain unclear. To explore the pathogenesis of small intestinal tissue and epithelial cell injury, the SW480 cell heat stress model and the mice heat stroke model were established to mimic heat stroke. Morphologic changes in intestinal tissue and increased TUNEL-positive index were induced by heat stress in vivo. Heat stress activated the lysosomal-mitochondrial apoptotic pathway in SW480 cells, increasing intracellular reactive oxygen species and causing lysosomal membrane permeabilization with subsequent release of cathepsin B to the cytosol, mitochondrial depolarization, and cytochrome C release to cytosol. An increase in the Bax/Bcl2 ratio, caspase-9 and caspase-3 were observed. N-Acetyl-L-Cysteine was shown to inhibit ROS generation, suppress permeabilization of lysosomal membranes, decrease levels of cathepsin B and cytochrome C in the cytosol, and inhibit Bax/Bcl2 ratio, caspase-9 and caspase-3 activity both in vitro and in vivo. Mitochondrial damage was alleviated when the models were pre-treated with CA-074 Me both in vitro and in vivo, decreasing cathepsin B and cytochrome C levels in the cytosol, Bax/Bcl2 ratio, caspase-9 and caspase-3 activity. In our models, heat stress-induced apoptosis of small intestinal tissue and epithelial cells through accumulation of ROS and activation of the lysosomal-mitochondrial apoptotic pathway involved the release of cathepsin B. These findings may offer potentially pharmaceutical targets and strategies to repair intestinal injury caused by heat stroke.

PMID: 28380464 [PubMed - as supplied by publisher]

http://ift.tt/2niXyJy

Metformin inhibits proliferation and growth hormone secretion of GH3 pituitary adenoma cells.

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Metformin inhibits proliferation and growth hormone secretion of GH3 pituitary adenoma cells.

Oncotarget. 2017 Mar 25;:

Authors: An J, Pei X, Zang Z, Zhou Z, Hu J, Zheng X, Zhang Y, He J, Duan L, Shen R, Zhang W, Zhu F, Li S, Yang H

Abstract
Metformin is an anti-hyperglycemic agent used to treat diabetes, and recent evidence suggests it has antitumor efficacy. Because growth hormone-secreting pituitary adenoma (GH-PA) patients have a high incidence of diabetes frequently treated with metformin, we assessed the antitumor effect of metformin on GH-PA. We found that metformin effectively inhibited proliferation and induced apoptosis in the GH-PA cell line GH3. We detected a decrease in mitochondrial membrane potential (MMP), an increase in expression of pro-apoptotic proteins, and a decrease in expression of an anti-apoptotic protein in metformin-treated GH3 cells, which suggests involvement of the mitochondrial-mediated apoptosis pathway. Inhibition of AMPK, which is activated by metformin, failed to reverse the antiproliferative effect. ATF3 was upregulated by metformin, and its knockdown significantly reduced metformin-induced apoptosis. In addition, GH secretion was inhibited by metformin through suppression of STAT3 activity independently of AMPK. Metformin also significantly suppressed cellular proliferation and GH secretion in primary human GH-PA cells. Metformin also significantly inhibited GH3 cell proliferation and GH secretion in vivo. ATF3 upregulation and p-STAT3 downregulation were confirmed in xenografts. These findings suggest metformin is a potentially promising therapeutic agent for the treatment of GH-PA, particularly in patients with diabetes.

PMID: 28380462 [PubMed - as supplied by publisher]

http://ift.tt/2niVlxE

Are pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer?

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Are pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer?

Oncotarget. 2017 Mar 24;:

Authors: Deng M, Ma X, Liang X, Zhu C, Wang M

Abstract
OBJECTIVES: The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) have been proved to affect the prognosis of various types of cancers. However, the prognostic role of NLR and PLR in patients with small-cell lung cancer (SCLC) remains controversial. The objective of this study is to assess the prognostic values of NLR, PLR and other potential prognostic indexes in SCLC patients.
RESULTS: The optimal cutoff levels were 2.65 for NLR, 125 for PLR and 210 for LDH by ROC curves analysis. Patients in the NLR ≥ 2.65 and LDH ≥ 210 groups were significantly correlated with worse PFS and OS. However, patients in the PLR < 125 group presented longer PFS time than patients in the PLR ≥ 125 group. Multivariate analysis showed that NLR ≥ 2.65 was an independent risk factor for both PFS (HR = 1.38; 95% CI 1.04-1.83; P = 0.027) and OS (HR = 1.35; 95% CI 1.02-1.79; P = 0.039). LDH and the clinical stage were independent prognostic factors for PFS in SCLC patients. LDH, surgery history, thoracic RT and PCI were independent prognostic factors for OS.
MATERIALS AND METHODS: 320 patients with SCLC were enrolled in this research from 2007 to 2014. Data was acquired through patients' medical records and follow-ups. Receiver operating curve (ROC) was used to determine the optimal cut-off levels of NLR, PLR and lactate dehydrogenase (LDH). The Kaplan-Meier univariate analysis and multivariate Cox regression analysis were used to evaluate the impact of the NLR, PLR and other potential prognostic factors on overall survival (OS) and progressive-free survival (PFS).
CONCLUSIONS: Pretreatment elevated NLR and LDH were independent factors for poor prognosis in SCLC patients. High PLR was associated with poor PFS, but it was not an independent prognostic factor for PFS and OS.

PMID: 28380461 [PubMed - as supplied by publisher]

http://ift.tt/2nj2gHn

CD47 promotes ovarian cancer progression by inhibiting macrophage phagocytosis.

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CD47 promotes ovarian cancer progression by inhibiting macrophage phagocytosis.

Oncotarget. 2017 Mar 24;:

Authors: Liu R, Wei H, Gao P, Yu H, Wang K, Fu Z, Ju B, Zhao M, Dong S, Li Z, He Y, Huang Y, Yao Z

Abstract
Targeting CD47 efficiently enhances macrophage phagocytosis in both physiological and pathological conditions. Anti-CD47 antibodies have been shown to inhibit the progression of several types of cancer. However, the mechanism of anti-CD47 monoclonal antibody (mAb) treatment remains controversial. In this study, we confirmed that CD47 protein is highly expressed in ovarian cancer, and is correlated with poor clinical characteristics and prognosis. CD47 knockdown in the ovarian cancer cell line, SK-OV-3, promoted phagocytosis by macrophages in vitro and inhibited tumor growth in vivo. These data combined suggest that CD47 inhibition is a potential strategy for cancer treatment. Using an anti-CD47 mAb, we found that CD47 inhibition in both SK-OV-3 cells and primary cancer cells was able to recapitulate our knockdown results and led to an increase in the number of infiltrating macrophages. In addition, the CD133+ tumor initiating cells expressed a high level of CD47, and anti-CD47 mAb treatment was able to trigger the phagocytosis of this cell population. In conclusion, our results indicate that CD47 inhibits macrophage phagocytosis of ovarian cancer cells, and down-regulation of CD47 or inhibiting CD47 by mAb was able to reverse the negative effect. Thus, CD47 antibody therapy may be a promising strategy to treat ovarian cancer.

PMID: 28380460 [PubMed - as supplied by publisher]

http://ift.tt/2nj7nqJ

Abce1 orchestrates M-phase entry and cytoskeleton architecture in mouse oocyte.

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Abce1 orchestrates M-phase entry and cytoskeleton architecture in mouse oocyte.

Oncotarget. 2017 Mar 24;:

Authors: Jiao XF, Huang CJ, Wu D, Zhang JY, Long YT, Chen F, Li X, Huo LJ

Abstract
ATP-binding cassette E1 (ABCE1) is a member of the ATP-binding cassette transporters and essential for diverse biological events regulating abroad range of biological functions including viral infection, cell proliferation, anti-apoptosis, translation initiation and ribosome biogenesis. Here, we discovered that Abce1 also plays indispensable roles in mouse oocyte meiotic progression. In the present study, we examined the expression, localization, and function of Abce1 during mouse oocyte meiotic maturation. Immunostaining and confocal microscopy identified that Abce1 localized as small dots in nucleus in germinal vesicle stage. After germinal vesicle breakdown, it dispersedly localized around the whole spindle apparatus. During the anaphase and telophase stages, Abce1 was just like a cap to localize around the two pole region of spindle but not the midbody and chromosome. Knockdown of Abce1 by specific siRNA injection delayed the resumption of meiosis (GVBD) and affected the extrusion of first polar body. Moreover, the process of spindle assembly and chromosome alignment were severely impaired. Abce1-RNAi led to the dissociation of γ-tubulin and p-MAPK from spindle poles, thus caused mounts of spindle morphology abnormities and chromosome alignment defects, leading to high incidence of aneuploidy. Our findings refresh the knowledge of Abce1 function by exploring its role in oocyte meiotic resumption, spindle assembly and chromosome alignment.

PMID: 28380459 [PubMed - as supplied by publisher]

http://ift.tt/2oEHlyB

Co-expression of AFAP1-AS1 and PD-1 predicts poor prognosis in nasopharyngeal carcinoma.

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Co-expression of AFAP1-AS1 and PD-1 predicts poor prognosis in nasopharyngeal carcinoma.

Oncotarget. 2017 Mar 24;:

Authors: Tang Y, He Y, Shi L, Yang L, Wang J, Lian Y, Fan C, Zhang P, Guo C, Zhang S, Gong Z, Li X, Xiong F, Li X, Li Y, Li G, Xiong W, Zeng Z

Abstract
Nasopharyngeal carcinoma (NPC) carries a high potential for metastasis and immune escape, with a great risk of relapse after primary treatment. Through analysis of whole genome expression profiling data in NPC samples, we found that the expression of a long non-coding RNA (lncRNA), actin filament-associated protein 1 antisense RNA 1 (AFAP1-AS1), is significantly correlated with the immune escape marker programmed death 1 (PD-1). We therefore assessed the expression of AFAP1-AS1 and PD-1 in a cohort of 96 paraffin-embedded NPC samples and confirmed that AFAP1-AS1 and PD-1 are co-expressed in infiltrating lymphocytes in NPC tissue. Moreover, patients with high expression of AFAP1-AS1 or PD-1 in infiltrating lymphocytes were more prone to distant metastasis, and NPC patients with positive expression of both AFAP1-AS1 and PD-1 had the poorest prognosis. This study suggests that AFAP1-AS1 and PD-1 may be potential therapeutic targets in NPC and that patients with co-expression of AFAP1-AS1 and PD-1 may be ideal candidates for future clinical trials of anti-PD-1 immune therapy.

PMID: 28380458 [PubMed - as supplied by publisher]

http://ift.tt/2o0GJAj

The integrative metabolomic-transcriptomic landscape of glioblastome multiforme.

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The integrative metabolomic-transcriptomic landscape of glioblastome multiforme.

Oncotarget. 2017 Mar 24;:

Authors: Heiland DH, Wörner J, Haaker JG, Delev D, Pompe N, Mercas B, Franco P, Gäbelein A, Heynckes S, Pfeifer D, Weber S, Mader I, Schnell O

Abstract
The purpose of this study was to map the landscape of metabolic-transcriptional alterations in glioblastoma multiforme. Omic-datasets were acquired by metabolic profiling (1D-NMR spectroscopy n=33 Patient) and transcriptomic profiling (n=48 Patients). Both datasets were analyzed by integrative network modeling. The computed model concluded in four different metabolic-transcriptomic signatures containing: oligodendrocytic differentiation, cell-cycle functions, immune response and hypoxia. These clusters were found being distinguished by individual metabolism and distinct transcriptional programs. The study highlighted the association between metabolism and hallmarks of oncogenic signaling such as cell-cycle alterations, immune escape mechanism and other cancer pathway alterations. In conclusion, this study showed the strong influence of metabolic alterations in the wide scope of oncogenic transcriptional alterations.

PMID: 28380457 [PubMed - as supplied by publisher]

http://ift.tt/2oPrg5Q

Circulating asymmetric dimethylarginine and the risk of preeclampsia: a meta-analysis based on 1338 participants.

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Circulating asymmetric dimethylarginine and the risk of preeclampsia: a meta-analysis based on 1338 participants.

Oncotarget. 2017 Mar 24;:

Authors: Yuan J, Wang X, Xie Y, Wang Y, Dong L, Li H, Zhu T

Abstract
BACKGROUND: Patients with preeclampsia have higher circulating asymmetric dimethylarginine (ADMA). However, whether circulating ADMA is elevated before the diagnosis of preeclampsia has not been determined.
METHODS: A meta-analysis of observational studies that reported circulating ADMA level before the onset of preeclampsia was performed. Pubmed and Embase were searched. Standardized mean differences (SMD) with 95% confidence intervals (CI) were used to estimate the differences in circulating ADMA. A random effect model or a fixed effect model was applied depending on the heterogeneity. The predictive efficacy of circulating ADMA for the incidence of preeclampsia was also explored.
RESULTS: Eleven comparisons with 1338 pregnant women were included. The pooled results showed that the circulating ADMA was significantly higher in women who subsequently developed preeclampsia as compared with those did not (SMD: 0.71, p < 0.001) with a moderate heterogeneity (I2 = 43%). Stratified analyses suggested elevation of circulating ADMA is more remarkable in studies with GA of ADMA sampling ≥ 20 weeks (SMD: 0.89, p < 0.01) as compared those with GA of ADMA sampling < 20 weeks (SMD: 0.56, p < 0.01; p for subgroup interaction = 0.03). Differences of maternal age, study design, and ADMA measurement methods did not significantly affect the results. Only two studies evaluated the potential predicting ability of circulating ADMA for subsequent preeclampsia, and retrieved moderate predictive efficacy.
CONCLUSIONS: Circulating ADMA is elevated before the development of preeclampsia. Studies are needed to evaluate the predictive efficacy of ADMA for the incidence of preeclampsia.

PMID: 28380456 [PubMed - as supplied by publisher]

http://ift.tt/2oPCt6B

Targeted next generation sequencing of mucosal melanomas identifies frequent NF1 and RAS mutations.

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Targeted next generation sequencing of mucosal melanomas identifies frequent NF1 and RAS mutations.

Oncotarget. 2017 Mar 24;:

Authors: Cosgarea I, Ugurel S, Sucker A, Livingstone E, Zimmer L, Ziemer M, Utikal J, Mohr P, Pfeiffer C, Pföhler C, Hillen U, Horn S, Schadendorf D, Griewank KG, Roesch A

Abstract
PURPOSE: Mucosal melanoma represents ~1% of all melanomas, frequently having a poor prognosis due to diagnosis at a late stage of disease. Mucosal melanoma differs from cutaneous melanoma not only in terms of poorer clinical outcome but also on the molecular level having e.g. less BRAF and more frequent KIT mutations than cutaneous melanomas. For the majority of mucosal melanomas oncogenic driver mutations remain unknown.
EXPERIMENTAL DESIGN AND RESULTS: In our study, 75 tumor tissues from patients diagnosed with mucosal melanoma were analyzed, applying a targeted next generation sequencing panel covering 29 known recurrently mutated genes in melanoma. NF1 and RAS mutations were identified as the most frequently mutated genes occurring in 18.3% and 16.9% of samples, respectively. Mutations in BRAF were identified in 8.4% and KIT in 7.0% of tumor samples.
CONCLUSIONS: Our study identifies NF1 as the most frequently occurring driver mutation in mucosal melanoma. RAS alterations, consisting of NRAS and KRAS mutations, were the second most frequent mutation type. BRAF and KIT mutations were rare with frequencies below 10% each. Our data indicate that in mucosal melanomas RAS/NF1 alterations are frequent, implying a significant pathogenetic role for MAPK and potentially PI3K pathway activation in these tumors.

PMID: 28380455 [PubMed - as supplied by publisher]

http://ift.tt/2oHjlKS