No abstract availablehttp://ift.tt/2pqBufg
Δευτέρα 1 Μαΐου 2017
Do Concussions Leave a Lasting Imprint on the Hearing Brain?
No abstract availablehttp://ift.tt/2pqGpgd
Evidence-Based Audiology Focus on Hearing Loss Prevention
No abstract availablehttp://ift.tt/2pqIybT
Noise-Induced Hearing Loss: What Your Patients Don't Know Can Hurt Them
No abstract availablehttp://ift.tt/2pqHKDY
Auditory Biomarker Identified for Early Cognitive Impairment
No abstract availablehttp://ift.tt/2pqFI6X
Reconstruction of skin and soft tissue defects of the outer ear in patients with severe burn injuries: analysis of three different operative techniques
Abstract
Background
An early soft tissue reconstruction is mandatory after burns of the outer ear to avoid cartilage loss. Although different procedures for covering soft tissue defects of the outer ear have been described in the past, the biomechanical properties and cosmetic outcome of reconstructed burned tissue are yet to be investigated more thoroughly.
Methods
Using photographs and the Cutometer, a device for measuring biomechanical skin properties such as firmness and elasticity, the 12 ears in six healthy volunteers and the 12 mainly deep partial-thickness injured ears in six patients who suffered burn injuries were examined. Three of the burned ears were covered with temporoparietal fascial flaps with split skin grafts based on the superficial temporal artery, four with retroauricular random pattern flaps, and five with full thickness skin graft.
Results
The median values of the firmness and elasticity of skin were approximately equal in the control group compared to the random pattern flap group. The median values of firmness and elasticity differ between the control group and the temporoparietal fascial flap and skin graft group (p = 0.05). Cosmetic outcome in terms of anatomical structures revealed full thickness grafts as the superior method.
Conclusions
Considering burn depth, the results of cosmetic outcome support the clinical principle of the reconstructive ladder, suggesting full thickness skin grafts as first choice. If high biomechanical skin quality is necessary, random pattern skin flaps from the lateral head region were the favorable procedure for burn reconstructions in the outer ear.
Level of Evidence: Level III, therapeutic study.
http://ift.tt/2qyQrtB
Modalities for prevention of adhesion formation after tendon surgery: a review of the literature
Abstract
Creation of adhesions in digital flexor tendons after repairing remains a major problem in hand surgery. The adhesions are part of the healing process and produce almost inevitably functional disability following the biological response after tendon injury. To achieve better gliding function of the digital tendons by reducing peritendinous adhesions without adversely affecting the healing process itself, several options, both surgical and pharmacological have been explored. Attempts at reducing postoperative adhesion formation have included early postoperative rehabilitation, low-friction surgical repair techniques, pharmacological antiadhesive reagents, and the use of physical barriers to adhesion formation.
Level of Evidence: Not ratable.
http://ift.tt/2pRXYY0
Vision Loss and Symmetric Basal Ganglia Lesions in Leber Hereditary Optic Neuropathy.
A 30-year-old woman with progressive vision loss was found to have asymptomatic, bilateral, and symmetric basal ganglia lesions on MRI and was later diagnosed with Leber hereditary optic neuropathy (LHON). The rare occurrence of basal ganglia changes on MRI in patients with LHON is discussed. (C) 2017 by North American Neuro-Ophthalmology Society
http://ift.tt/2p0dZXb
http://ift.tt/2p0dZXb
Advanced MRI of the Optic Nerve.
Background: Clinical orbital MRI protocols are routinely used to study the optic nerves and exclude compressive lesions, infarctions, or inflammation. However, the small caliber and divergent oblique orientations of the optic nerves make it challenging to characterize them well with conventional MRI, especially since adjacent air-filled bony structures distort the MRI signal and motion is a problem even in cooperative, healthy volunteers. Evidence Acquisition: Over the past 3 years we have experimented with multiple novel MRI approaches and sequences to better characterize the optic nerves. The perfect MRI protocol would be quantitative and sensitive to subtle optic nerve pathologic changes, provide high spatial resolution, be rapidly acquired, and resistant to motion degradation. Results: This review provides an update of recent MRI sequence innovations for the optic nerves being currently translated into clinical practice. Methods discussed include rapid MRI with compressed sensing or simultaneous multislice approaches, postprocessing techniques for quantitative T2 mapping or track density imaging, and multiple MRI sequences for measuring diffusion in the optic nerves. Conclusions: Recently-developed orbit-specific MRI coils, quantitative sequences, and rapid acquisition techniques can improve our future ability to study optic nerve pathologies noninvasively. As advanced MRI becomes more proficient at characterizing the optic nerves, its role in the clinical management of patients should increase. (C) 2017 by North American Neuro-Ophthalmology Society
http://ift.tt/2pCiwD0
http://ift.tt/2pCiwD0
p38γ and p38δ: From Spectators to Key Physiological Players
Publication date: Available online 1 May 2017
Source:Trends in Biochemical Sciences
Author(s): Ana Cuenda, Juan José Sanz-Ezquerro
Although the physiological roles of p38γ and p38δ signalling pathways are largely unknown, new genetic and pharmacological tools are providing groundbreaking information on the function of these two stress-activated protein kinases. Recent studies show the importance of p38γ and p38δ in the regulation of processes as diverse as cytokine production, protein synthesis, exocytosis, cell migration, gene expression, and neuron activity, which have an acute impact on the development of pathologies related to inflammation, diabetes, neurodegeneration, and cancer. These recent breakthroughs are resolving some of the questions that have long been asked regarding the function of p38γ and p38δ in biology and pathology.
http://ift.tt/2pqLNAb
Infantile Osteopetrosis in a Kazakh Boy.
| Related Articles |
Infantile Osteopetrosis in a Kazakh Boy.
Isr Med Assoc J. 2017 Jan;19(1):65-66
Authors: Cainelli F, Tastanbekova V, Nurgaliev D, Lim N, Vento S
PMID: 28457121 [PubMed - in process]
http://ift.tt/2oS50fo
Fertility Treatments and Psychiatric Disorders: Ethical Considerations Regarding a Patient's Desire to Become a Mother.
| Related Articles |
Fertility Treatments and Psychiatric Disorders: Ethical Considerations Regarding a Patient's Desire to Become a Mother.
Isr Med Assoc J. 2017 Jan;19(1):63-64
Authors: Stolovy T, Linder M, Zipris P, Doron A, Dafna Y, Melamed Y
PMID: 28457120 [PubMed - in process]
http://ift.tt/2oS5gep
The Importance of Trans-Thoracic Echocardiographic Suprasternal View in the Diagnosis and Treatment Follow-Up of Pulmonary Emboli.
| Related Articles |
The Importance of Trans-Thoracic Echocardiographic Suprasternal View in the Diagnosis and Treatment Follow-Up of Pulmonary Emboli.
Isr Med Assoc J. 2017 Jan;19(1):61-62
Authors: Rav Acha M, Medina A, Rosenmann D, Md N, Klutstein MW, Butnaru A, Weisz G
PMID: 28457119 [PubMed - in process]
http://ift.tt/2oSaerr
Kounis Syndrome: Acute ST segment Elevation Myocardial Infarction following Allergic Reaction to Amoxicillin.
| Related Articles |
Kounis Syndrome: Acute ST segment Elevation Myocardial Infarction following Allergic Reaction to Amoxicillin.
Isr Med Assoc J. 2017 Jan;19(1):59-60
Authors: Antonelli D, Rozner E, Turgeman Y
PMID: 28457118 [PubMed - in process]
http://ift.tt/2oScA9O
Is Syncope Always a Predictor of Unfavorable Outcome?
| Related Articles |
Is Syncope Always a Predictor of Unfavorable Outcome?
Isr Med Assoc J. 2017 Jan;19(1):57-58
Authors: Rosenheck S
PMID: 28457117 [PubMed - in process]
http://ift.tt/2oS4YEi
Second-Trimester Ultrasound for Adjusting Patient's Risk for Down Syndrome.
| Related Articles |
Second-Trimester Ultrasound for Adjusting Patient's Risk for Down Syndrome.
Isr Med Assoc J. 2017 Jan;19(1):55-56
Authors: Gilboa Y
PMID: 28457116 [PubMed - in process]
http://ift.tt/2oSccIA
Pseudoexfoliation: An Ocular Finding with Possible Systemic Implications.
| Related Articles |
Pseudoexfoliation: An Ocular Finding with Possible Systemic Implications.
Isr Med Assoc J. 2017 Jan;19(1):49-54
Authors: Aviv U, Ben Ner D, Sharif N, Gur Z, Achiron A
Abstract
BACKGROUND: Pseudoexfoliation syndrome (PES) is a common age-related disorder affecting 60-70 million people worldwide. Patients with PES have abnormal production and deposition of fibrillar material in the anterior chamber of the eye. These exfoliated fibrils, easily detected by ocular slit-lamp examination, have also been found to exist systematically in the skin, heart, lungs, liver and kidneys. Recently, myriad studies have associated PES with systemic conditions such as increased vascular risk, risk of dementia and inflammatory state. We review here the most current literature on the systemic implications of PES. Our aim is to encourage further studies on this important clinical entity.
PMID: 28457115 [PubMed - in process]
http://ift.tt/2oScyyI
Anti-BLyS Treatment of 36 Israeli Systemic Lupus Erythematosus Patients.
| Related Articles |
Anti-BLyS Treatment of 36 Israeli Systemic Lupus Erythematosus Patients.
Isr Med Assoc J. 2017 Jan;19(1):44-48
Authors: Sthoeger Z, Lorber M, Tal Y, Toubi E, Amital H, Kivity S, Langevitz P, Asher I, Elbirt D, Agmon Levin N
Abstract
BACKGROUND: Anti-BLyS treatment with the human belimumab monoclonal antibody was shown to be a safe and effective therapeutic modality in lupus patients with active disease (i.e., without significant neurological/renal involvement) despite standard treatment.
OBJECTIVES: To evaluate the "real-life" safety and efficacy of belimumab added to standard therapy in patents with active lupus in five Israeli medical centers.
METHODS: We conducted a retrospective open-labeled study of 36 lupus patients who received belimumab monthly for at least 1 year in addition to standard treatment. Laboratory tests (C3/C4, anti dsDNA autoantibodies, chemistry, urinalysis and complete blood count) were done every 3-4 months. Adverse events were obtained from patients' medical records. Efficacy assessment by the treating physicians was defined as excellent, good/partial, or no response.
RESULTS: The study group comprised 36 lupus patients (8 males, 28 females) with a mean age of 41.6 } 12.2 years. Belimumab was given for a mean period of 2.3 } 1.7 years (range 1-7). None of the patients discontinued belimumab due to adverse events. Four patients (11.1%) had an infection related to belimumab. Only 5 patients (13.9%) stopped taking belimumab due to lack of efficacy. The response was excellent in 25 patients (69.5%) and good/partial in the other 6 (16.6%). Concomitantly, serological response (reduction of C3/C4 and anti-dsDNA autoantibodies) was also observed. Moreover, following belimumab treatment, there was a significant reduction in the usage of corticosteroids (from 100% to 27.7%) and immunosuppressive agents (from 83.3% to 8.3%).
CONCLUSIONS: Belimumab, in addition to standard therapy, is a safe and effective treatment for active lupus patients.
PMID: 28457114 [PubMed - in process]
http://ift.tt/2oScxLa
Stereotactic Ablative Body Radiation for Stage I Lung Cancer in Israel: A Retrospective Single-Center Report.
| Related Articles |
Stereotactic Ablative Body Radiation for Stage I Lung Cancer in Israel: A Retrospective Single-Center Report.
Isr Med Assoc J. 2017 Jan;19(1):39-43
Authors: Appel S, Lawrence YR, Goldstein J, Pfeffer RM, Weiss I, Rabin T, Felder S, Ben-Ayun M, Tzvang L, Alezra D, Simansky D, Ben-Nun A, Bar J, Symon Z
Abstract
BACKGROUND: Stereotactic ablative radiation therapy (SABR) is the application of a very high radiation dose to a small treatment volume. It is the new standard of care in medically inoperable early-stage lung cancer.
OBJECTIVES: To report the outcomes of SABR in stage I lung cancer at Sheba Medical Center since its introduction in 2009.
METHODS: We conducted a retrospective chart review of patients with stage I lung cancer treated during the period 2009-2015. Survival status was retrieved from the electronic medical records and confirmed with the national registry. Local failure was defined as increased FDG uptake on PETCT scan within a 2 cm radius of the treated region. Toxicity was estimated from medical records and graded according to common toxicity criteria for adverse events (CTCAE) version 4.03. Overall survival and local control were estimated by the Kaplan-Meier method.
RESULTS: During the study period 114 patients were treated for 122 stage I lung cancer lesions. Median follow-up time was 27 months (range 8.2-69.5 months), median age was 76 years. Eighty-two percent of the tumors were stage IA (size ≤ 3 cm). Median survival was 46 months; estimated 3 year overall survival was 59% (95%CI 47-69%) and local control was 88% (95%CI 78-94%). Toxicity included chest wall pain in 8.4% of patients, rib fracture in 0.9%, grade 1-2 pneumonitis in 12%, grade 3 in 12% and grade 5 (death) in 0.9%.
CONCLUSIONS: SABR has been successfully implemented at Sheba Medical Center for the treatment of stage I lung cancer in inoperable patients. It is associated with excellent local control, minor toxicity and an acceptable overall survival.
PMID: 28457113 [PubMed - in process]
http://ift.tt/2oS8sqq
Iatrogenic Horner Syndrome: Etiology, Diagnosis and Outcomes.
| Related Articles |
Iatrogenic Horner Syndrome: Etiology, Diagnosis and Outcomes.
Isr Med Assoc J. 2017 Jan;19(1):34-38
Authors: Knyazer B, Smolar J, Lazar I, Rosenberg E, Tsumi E, Lifshitz T, Levy J
Abstract
BACKGROUND: The identification and prompt diagnosis of Horner syndrome (HS) is essential for preventing permanent damage. HS may arise when a lesion presents anywhere along the three-neuron oculosympathetic pathway that begins at the posterior-lateral nuclei of the hypothalamus all the way through to the orbit. We present four cases and review the literature to familiarize the reader with the identification, diagnosis and treatment of Horner syndrome. The four patients, three adults and one child, were followed for at least 6 months following the initial diagnosis (range 6-18 months). There was partial resolution in three of the four cases, while the fourth resolved completely. There are numerous causes of HS, some of them iatrogenic. While iatrogenic cases of HR are rare in both adults and children, HS is seen more often following surgical procedures. Prompt recognition of the syndrome and correction of the offending agent may prevent permanent damage to the neuronal pathway. It is therefore recommended that practitioners be aware of the risks for development of iatrogenic HS and the signs for early detection.
PMID: 28457112 [PubMed - in process]
http://ift.tt/2oSa977
Serum Tumor Necrosis Factor-Alpha Levels in Children with Nephrotic Syndrome: A Pilot Study.
| Related Articles |
Serum Tumor Necrosis Factor-Alpha Levels in Children with Nephrotic Syndrome: A Pilot Study.
Isr Med Assoc J. 2017 Jan;19(1):30-33
Authors: Weissbach A, Garty BZ, Lagovsky I, Krause I, Davidovits M
Abstract
BACKGROUND: Several studies link the pathogenesis of nephrotic syndrome to tumor necrosis factor-alpha (TNFα). However, data on the serum TNFα level in children with nephrotic syndrome are sparse.
OBJECTIVES: To investigate serum TNFα levels and the effect of steroid therapy in children with nephrotic syndrome.
METHODS: A prospective cohort pilot study of children with nephrotic syndrome and controls was conducted during a 1 year period. Serum TNFα levels were measured at presentation and at remission, or after a minimum of 80 days if remission was not achieved.
RESULTS: Thirteen patients aged 2-16 years with nephrotic syndrome were compared with 12 control subjects. Seven patients had steroid-sensitive and six had steroid-resistant nephrotic syndrome. Mean baseline serum TNFα level was significantly higher in the steroid-resistant nephrotic syndrome patients than the controls (6.13 pg/ml vs. 4.36 pg/ml, P = 0.0483). Mean post-treatment TNFα level was significantly higher in the steroid-resistant than in the steroid-sensitive nephrotic syndrome patients (5.67 pg/ml vs. 2.14 pg/ml, P = 0.001). In the steroid-resistant nephrotic syndrome patients, mean serum TNFα levels were similar before and after treatment.
CONCLUSIONS: Elevated serum TNFα levels are associated with a lack of response to corticosteroids. Further studies are needed to investigate the role of TNFα in the pathogenesis of nephrotic syndrome.
PMID: 28457111 [PubMed - in process]
http://ift.tt/2oSkgsO
Nicotine Addiction and Withdrawal among Orthodox Jews: the Effect of Sabbath Abstinence.
| Related Articles |
Nicotine Addiction and Withdrawal among Orthodox Jews: the Effect of Sabbath Abstinence.
Isr Med Assoc J. 2017 Jan;19(1):25-29
Authors: Munter G, Brivik Y, Freier-Dror Y, Zevin S
Abstract
BACKGROUND: Cigarette smoking is a widespread problem around the world. In Israel, the prevalence of smoking is 23%. Smokers who are Orthodox abstain from smoking during the Sabbath, i.e., from sundown Friday to sundown Saturday, due to a religious prohibition. The prevalence of smoking among Orthodox men is 13%. However, there are no data on patterns of smoking or on the addiction profiles in this population.
OBJECTIVES: To explore the smoking patterns, motivation for smoking and nicotine addiction among Orthodox Jewish men, compared to non-Orthodox men, as well as the differences in the urge to smoke and withdrawal symptoms on Saturday versus weekdays in the Orthodox group.
METHODS: The participants completed the Fagerstrom test for nicotine dependence, questionnaires on reasons for smoking and smoking patterns, as well as two brief questionnaires on the urge to smoke and withdrawal symptoms after overnight abstinence on a weekday and after the end of the Sabbath.
RESULTS: Both groups were strongly addicted to nicotine and there were no differences in the reasons for smoking, withdrawal symptoms and nicotine craving after an overnight abstinence on weekdays. However, religious smokers had low levels of craving for nicotine and few withdrawal symptoms during Sabbath abstinence when compared to weekdays.
CONCLUSIONS: Although we found no difference in the baseline characteristics with regard to nicotine addiction, smoking motivation, urge to smoke and withdrawal symptoms between religious and non-religious groups, the former are able to abstain from smoking during 25 hours of the Sabbath every week with significantly fewer withdrawal symptoms compared to week days.
PMID: 28457110 [PubMed - in process]
http://ift.tt/2oS5bHD
Salvage Radiation Therapy for Biochemical Failure Following Radical Prostatectomy.
| Related Articles |
Salvage Radiation Therapy for Biochemical Failure Following Radical Prostatectomy.
Isr Med Assoc J. 2017 Jan;19(1):19-24
Authors: Spieler B, Goldstein J, Lawrence YR, Saad A, Berger R, Ramon J, Dotan Z, Laufer M, Weiss I, Tzvang L, Poortmans P, Symon Z
Abstract
BACKGROUND: Radiotherapy to the prostate bed is used to eradicate residual microscopic disease following radical prostatectomy for prostate cancer. Recommendations are based on historical series.
OBJECTIVES: To determine outcomes and toxicity of contemporary salvage radiation therapy (SRT) to the prostate bed.
METHODS: We reviewed a prospective ethics committee-approved database of 229 patients referred for SRT. Median pre-radiation prostate-specific antigen (PSA) was 0.5 ng/ml and median follow-up was 50.4 months (range 13.7-128). Treatment was planned and delivered using modern three-dimensional radiation techniques. Mean bioequivalent dose was 71 Gy (range 64-83 Gy). Progression was defined as two consecutive increases in PSA level > 0.2 ng/ml, metastases on follow-up imaging, commencement of anti-androgen treatment for any reason, or death from prostate cancer. Kaplan-Meier survival estimates and multivariate analysis was performed using STATA.
RESULTS: Five year progression-free survival was 68% (95%CI 59.8-74.8%), and stratified by PSA was 87%, 70% and 47% for PSA < 0.3, 0.3-0.7, and > 0.7 ng/ml (P < 0.001). Metastasis-free survival was 92.5%, prostate cancer-specific survival 96.4%, and overall survival 94.9%. Low pre-radiation PSA value was the most important predictor of progression-free survival (HR 2.76, P < 0.001). Daily image guidance was associated with reduced risk of gastrointestinal and genitourinary toxicity (P < 0.005).
CONCLUSIONS: Contemporary SRT is associated with favorable outcomes. Early initiation of SRT at PSA < 0.3 ng/ml improves progression-free survival. Daily image guidance with online correction is associated with a decreased incidence of late toxicity.
PMID: 28457109 [PubMed - in process]
http://ift.tt/2oSa8A5
Syncope in Primary Prevention Implantable Cardioverter Defibrillator Implantation.
| Related Articles |
Syncope in Primary Prevention Implantable Cardioverter Defibrillator Implantation.
Isr Med Assoc J. 2017 Jan;19(1):15-18
Authors: Goldenberg G, Bental T, Kadmon U, Zabarsky R, Kusnick J, Barsheshet A, Golovchiner G, Strasberg B
Abstract
BACKGROUND: Syncope prognosis varies widely: 1 year mortality may range from 0% in the case of vasovagal events up to 30% in the presence of heart disease.
OBJECTIVES: To assess the outcomes and prognosis of patients with implantable cardiac defibrillator (ICD) and indication of primary prevention and compare patients presenting with or without prior syncope.
METHODS: We reviewed the charts of 75 patients who underwent ICD implantation with the indication of primary prevention and history of syncope and compared them to a control group of 80 patients without prior syncope. We assessed the number of ventricular tachycardia (VT), ventricular fibrillation (VF), shock, anti-tachycardia pacing (ATP), and death in each group during the follow-up.
RESULTS: Mean follow-up was 893 days (810-976, 95% confidence interval) (no difference between groups). Patients with prior syncope had a higher ejection fraction (EF) (35.5 ± 12.6 vs. 31.4 ± 8.76, P = 0.02), more episodes of VT (21.3% vs. 3.8%, P = 0.001) and VF (8% vs. 0%, P = 0.01) and also received more electric shocks (18.7% vs. 3.8%, P = 0.004) and ATP (17.3% vs. 6.2%, P = 0.031). There were no differences in inappropriate shocks (6.7% vs. 5%, P = 0.74), in cardiovascular mortality (cumulative 5 year estimate 29.9% vs. 32.2% P = 0.97) and any death (cumulative 5 year estimate 38.1% vs. 48.9% P = 0.18) during the follow-up.
CONCLUSIONS: Syncopal patients before ICD implantation seem to have more episodes of VT/VF and shock or ATP. No mortality differences were observed.
PMID: 28457108 [PubMed - in process]
http://ift.tt/2oS0P33
Congenital Absence of Salivary Glands in Fetuses with Trisomy 21.
| Related Articles |
Congenital Absence of Salivary Glands in Fetuses with Trisomy 21.
Isr Med Assoc J. 2017 Jan;19(1):12-14
Authors: Odeh M, Bronshtein M, Bornstein J
Abstract
BACKGROUND: The congenital absence of salivary glands has been reported in children but never in fetuses with trisomy 21.
OBJECTIVES: To determine whether the congenital absence of salivary glands can be detected prenatally between 13 and 16 weeks of gestation in normal and trisomy 21 fetuses using transvaginal ultrasound.
METHODS: We performed a retrospective analysis of recordings of normal and trisomy 21 fetuses. Inclusion criteria were a single viable fetus and good visualization of the anatomic area of the salivary glands on both sides of the fetal face. All videos were reviewed by one examiner who reported the presence or absence of one or more salivary glands and was blinded to the fetal karyotype.
RESULTS: Of the 45 videos reviewed, 4 were excluded from the study: namely, a non-viable fetus, twin pregnancy, and in 2 there was unsatisfactory visualization of the anatomic area of the salivary glands. Of the remaining 41 fetuses, 24 had trisomy 21 and 17 were normal. In the trisomy 21 fetuses, 8 (33.3%) had congenital absence of one or more salivary glands compared to 1 of 17 normal fetuses (5.9%) (P < 0.05).
CONCLUSIONS: Congenital absence of the salivary glands has a high specificity but low sensitivity for detecting trisomy 21 fetuses.
PMID: 28457107 [PubMed - in process]
http://ift.tt/2oS6w13
Detection Rate and Sonographic Signs of Trisomy 21 Fetuses at 14-17 Weeks of Gestation.
| Related Articles |
Detection Rate and Sonographic Signs of Trisomy 21 Fetuses at 14-17 Weeks of Gestation.
Isr Med Assoc J. 2017 Jan;19(1):8-12
Authors: Bronshtein E, Solt I, Bronshtein M, Gover A, Wolman I, Blumenfeld Z
Abstract
BACKGROUND: Early prenatal ultrasound is an important part of prenatal screening in Israel. No studies have described the rate of trisomy 21 [T21] identification at 14-17 weeks gestation.
OBJECTIVES: To describe the rate of T21 identification by transvaginal sonograms (TVS) at 14-17 weeks gestation.
METHODS: We conducted a historical prospective study. Since 1986, early TVS of 72,000 fetuses at 14-17 weeks gestation have been prospectively recorded together with prenatal screening data at a private ultrasound center (AL-KOL, Haifa). We calculated the fraction of T21 cases by dividing the total number of cases with abnormal sonographic findings by the total number of diagnosed T21 cases. We also examined the percentage of verified T21 cases that had completely normal prenatal screening tests prior to the early prenatal TVS, thus revealing the contribution of this examination to the existing prenatal screening. Fisher's exact test was used to calculate odds ratios for each sonographic marker.
RESULTS: Of 137 T21 fetuses, 123 had sonographic markers on early TVS, yielding a prediction capability of at least 89.87%. Of all T21 cases, 14% had completely normal nuchal translucency/first-trimester screening prior to the abnormal 14-17 week TVS findings. Isolated abnormal sonographic findings, which were found to increase the risk for T21, were common atrioventricular septal canal (odds ratio 88.88), duodenal atresia (OR 88.23), nuchal edema (OR 39.14), and hydrocephalus (OR 15.78). Fetal hydronephrosis/pyelectasis was non-significant when isolated (OR 1), and cardiac echogenic focus was associated with a decreased risk (OR 0.13).
CONCLUSIONS: Early prenatal TVS at 14-17 weeks may identify almost 90% of T21 and adds 14% to the identification rate at the first-trimester screening.
PMID: 28457106 [PubMed - in process]
http://ift.tt/2oS1TUM
Fifty years on: New lessons from Laron syndrome.
| Related Articles |
Fifty years on: New lessons from Laron syndrome.
Isr Med Assoc J. 2017 Jan;19(1):6-7
Authors: Werner H, Lapkina-Gendler L, Laron Z
PMID: 28457105 [PubMed - in process]
http://ift.tt/2oSgdMU
Delivery of Transverse-Lie Twins in a 15 year old Syrian Mother.
| Related Articles |
Delivery of Transverse-Lie Twins in a 15 year old Syrian Mother.
Isr Med Assoc J. 2017 Jan;19(1):1
Authors: Peleg D, Azogui G, Heib S, Ben Shachar I
PMID: 28457104 [PubMed - in process]
http://ift.tt/2oS0MEp
Association between non-alcoholic fatty liver disease and hospitalized patients with community-acquired pneumonia.
| Related Articles |
Association between non-alcoholic fatty liver disease and hospitalized patients with community-acquired pneumonia.
Isr Med Assoc J. 2017 Mar;19(3):198
Authors: Nseir W, Artul S, Abu Rajab S, Mograbi J, Nasralla N, Mahamid M
PMID: 28457103 [PubMed - in process]
http://ift.tt/2oSr2P9
Delayed Hyperdense Ascites in a Peritoneal Dialysis Patient after Contrast Injection.
| Related Articles |
Delayed Hyperdense Ascites in a Peritoneal Dialysis Patient after Contrast Injection.
Isr Med Assoc J. 2017 Mar;19(3):196-197
Authors: Keddel N, Amitai M, Guranda L, Dreznik Y, Klang E
PMID: 28457102 [PubMed - in process]
http://ift.tt/2oSfyv5
Surviving Blind Decomposition: A Distributional Analysis of the Time-Course of Complex Word Recognition.
Author: Schmidtke, Daniel; Matsuki, Kazunaga; Kuperman, Victor
DOI: 10.1037/xlm0000411
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2qn4TbC
Spatial Biases in Motion Extrapolation for Manual Interception.
Author: Reid, Sinead A.; Dessing, Joost C.
DOI: 10.1037/xhp0000407
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2pzGzRd
Time Course of Motor Affordances Evoked by Pictured Objects and Words.
Author: Bub, Daniel N.; Masson, Michael E. J.; Kumar, Ragav
DOI: 10.1037/xhp0000431
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2qnc1F8
Frontal Theta Band Oscillations Predict Error Correction and Posterror Slowing in Typing.
Author: Kalfaoglu, C[latin dotless i]g[latin dotless i]r; Stafford, Tom; Milne, Elizabeth
DOI: 10.1037/xhp0000417
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2pzOMo8
A Large-Scale Horizontal-Vertical Illusion Produced With Small Objects Separated in Depth.
Author: Li, Zhi; Durgin, Frank H.
DOI: 10.1037/xhp0000426
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2qn50nq
Attentional State Modulates the Effect of an Irrelevant Stimulus Dimension on Perception.
Author: Herrmann, Bjorn; Johnsrude, Ingrid S.
DOI: 10.1037/xhp0000432
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2pzMVQf
Links Between Temporal Acuity and Multisensory Integration Across Life Span.
Author: Stevenson, Ryan A.; Baum, Sarah H.; Krueger, Juliane; Newhouse, Paul A.; Wallace, Mark T.
DOI: 10.1037/xhp0000424
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2qmVi4B
The Speed of Voluntary and Priority-Driven Shifts of Visual Attention.
Author: Jenkins, Michael; Grubert, Anna; Eimer, Martin
DOI: 10.1037/xhp0000438
Publication Date: POST AUTHOR CORRECTIONS, 27 April 2017
http://ift.tt/2pzPDFx
Prevention of Cardiovascular Events in Patients With Diabetes: How Beneficial Is Dual Antiplatelet Therapy?.
Author: Van de Werf, Frans MD, PhD
Page: 1675-1676
http://ift.tt/2pq6s7h
Is Rapid Health Improvement Possible?: Lessons From the Million Hearts Initiative.
Author: Frieden, Thomas R. MD, MPH; Wright, Janet S. MD; Conway, Patrick H. MD, MSc
Page: 1677-1680
http://ift.tt/2qrPgg7
Depression Treatment and 1-Year Mortality After Acute Myocardial Infarction: Insights From the TRIUMPH Registry (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status).
Author: Smolderen, Kim G. PhD; Buchanan, Donna M. PhD; Gosch, Kensey MS; Whooley, Mary MD; Chan, Paul S. MD, MSc; Vaccarino, Viola MD, PhD; Parashar, Susmita MD, MPH, MS; Shah, Amit J. MD, MS; Ho, P. Michael MD, PhD; Spertus, John A. MD, MPH
Page: 1681-1689
http://ift.tt/2pq47JH
Waiting for Godot: Engaging in Discussions About Depression Care in Patients With Acute Myocardial Infarction While Waiting for a Definitive Trial That Never Appears.
Author: Davidson, Karina W. PhD, MASc
Page: 1690-1692
http://ift.tt/2qrQus4
Favorable Cardiovascular Health, Compression of Morbidity, and Healthcare Costs: Forty-Year Follow-Up of the CHA Study (Chicago Heart Association Detection Project in Industry).
Author: Allen, Norrina B. MPH, PhD; Zhao, Lihui PhD; Liu, Lei PhD; Daviglus, Martha MD, PHD; Liu, Kiang PhD; Fries, James MD; Shih, Ya-Chen Tina PhD; Garside, Daniel MS; Vu, Thanh-Huyen MD; Stamler, Jeremiah MD; Lloyd-Jones, Donald M. MD, ScM
Page: 1693-1701
http://ift.tt/2pq9Lvl
Living Longer in Good Cardiovascular Health: Prevention and Wellness Makes Economic Cents.
Author: Nasir, Khurram MD, MPH; Keeley, Brian MBA; Krumholz, Harlan M. MD, SM
Page: 1702-1704
http://ift.tt/2qrYskW
Patients With Long-QT Syndrome Caused by Impaired hERG-Encoded Kv11.1 Potassium Channel Have Exaggerated Endocrine Pancreatic and Incretin Function Associated With Reactive Hypoglycemia.
Author: Hylten-Cavallius, Louise MD; Iepsen, Eva W. MD; Wewer Albrechtsen, Nicolai J. MD, PhD; Svendstrup, Mathilde MD; Lubberding, Anniek F. MSc; Hartmann, Bolette MSc, PhD; Jespersen, Thomas MSc, PhD, DMSci; Linneberg, Allan MD, PhD; Christiansen, Michael MD; Vestergaard, Henrik MD, DMSci; Pedersen, Oluf MD, DMSci; Holst, Jens J. MD, DMSci; Kanters, Jorgen K. MD; Hansen, Torben MD, PhD; Torekov, Signe S. MSc, PhD
Page: 1705-1719
http://ift.tt/2ppXAP0
Myocardial Infarction Risk After Discontinuation of Thienopyridine Therapy in the Randomized DAPT Study (Dual Antiplatelet Therapy).
Author: Stefanescu Schmidt, Ada C. MD; Kereiakes, Dean J. MD; Cutlip, Donald E. MD; Yeh, Robert W. MD, MSc; D'Agostino, Ralph B. Sr. PhD; Massaro, Joseph M. PhD; Hsieh, Wen-Hua PhD; Mauri, Laura MD, MSc; On behalf of the DAPT Investigators
Page: 1720-1732
http://ift.tt/2qs7Sgc
Lower Circulating Folate Induced by a Fidgetin Intronic Variant Is Associated With Reduced Congenital Heart Disease Susceptibility.
Author: Wang, Dan MD, PhD *; Wang, Feng MD, PhD *; Shi, Kai-Hu MD, PhD *; Tao, Hui MD; Li, Yang PhD; Zhao, Rui PhD; Lu, Han MD; Duan, Wenyuan PhD; Qiao, Bin BS; Zhao, Shi-Min PhD; Wang, Hongyan PhD; Zhao, Jian-Yuan PhD
Page: 1733-1748
http://ift.tt/2pqagpn
Aortic Valve Bioprostheses: Leaflet Immobility and Valve Thrombosis.
Author: Holmes, David R. MD; Mack, Michael J. MD
Page: 1749-1756
http://ift.tt/2qrNago
How Useful Are Mouse Models for Understanding Human Atherosclerosis?: Review Examines the Available Evidence.
Author: Hampton, Tracy PhD
Page: 1757-1758
http://ift.tt/2ppUqeo
Not Your Usual Pre-Excitation.
Author: Goyal, Rajat MD; Singh, Abhijeet MD; Fan, Roger MD
Page: 1759-1761
http://ift.tt/2qs0JN5
Depression Treatment and Health Status Outcomes in Young Patients With Acute Myocardial Infarction: Insights From the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients).
Author: Smolderen, Kim G. PhD; Spertus, John A. MD, MPH; Gosch, Kensey MS; Dreyer, Rachel P. PhD; D'Onofrio, Gail MD, MS; Lichtman, Judith H. PhD, MPH; Geda, Mary MSN; Beltrame, John MD; Safdar, Basmah MD, MSc; Bueno, Hector MD, PhD; Krumholz, Harlan M. MD, SM
Page: 1762-1764
http://ift.tt/2pq8C7f
Effects of Ultraearly Intravenous Thrombolysis on Outcomes in Ischemic Stroke: The STEMO (Stroke Emergency Mobile) Group.
Author: Kunz, Alexander MD; Nolte, Christian H. MD; Erdur, Hebun MD; Fiebach, Jochen B. MD; Geisler, Frederik MD; Rozanski, Michal MD; Scheitz, Jan F. MD; Villringer, Kersten MD; Waldschmidt, Carolin MD; Weber, Joachim E. MD; Wendt, Matthias MD; Winter, Benjamin MD; Zieschang, Katja MD; Grittner, Ulrike PhD; Kaczmarek, Sabina; Endres, Matthias MD; Ebinger, Martin MD; Audebert, Heinrich J. MD
Page: 1765-1767
http://ift.tt/2qrMNSV
Letter by Ahmed et al Regarding Article, "Low-Dose Aspirin for Primary Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: 10-Year Follow-Up of a Randomized Controlled Trial".
Author: Ahmed, Sofia B. MD, MMSc; Metcalfe, Amy PhD; Nerenberg, Kara MD, MSc
Page: e1008-e1009
http://ift.tt/2pqkSo7
Response by Saito et al to Letter Regarding Article, "Low-Dose Aspirin for Primary Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: 10-Year Follow-Up of a Randomized Controlled Trial".
Author: Saito, Yoshihiko MD, PhD; Ogawa, Hisao MD, PhD; Morimoto, Takeshi MD, PhD
Page: e1010-e1011
http://ift.tt/2qrQV5q
Letter by Jazayeri et al Regarding Article, "Severe Pulmonary Vein Stenosis Resulting From Ablation for Atrial Fibrillation: Presentation, Management, and Clinical Outcomes".
Author: Jazayeri, Mohammad-Ali MD; Reddy, Y. Madhu MD; Lakkireddy, Dhanunjaya R. MD
Page: e1012-e1013
http://ift.tt/2pq5QP5
Response by Fender et al to Letter Regarding Article, "Severe Pulmonary Vein Stenosis Resulting From Ablation for Atrial Fibrillation: Presentation, Management, and Clinical Outcomes".
Author: Fender, Erin A. MD; Widmer, R. Jay MD, PhD; Holmes, David R. Jr. MD; Packer, Douglas L. MD
Page: e1014-e1015
http://ift.tt/2qrBZ7o
Correction to: Severe Pulmonary Vein Stenosis Resulting From Ablation for Atrial Fibrillation: Presentation, Management, and Clinical Outcomes.
Author:
Page: e1016
http://ift.tt/2pq8DrP
Huffington Post Blog – Not Getting Enough Oxygen and the Health Problems it Can Cause
It is a known fact that oxygen is a basic human need for physical survival and while suffocation is the result when an individual completely lacks air, dangerous conditions occur as a result of low oxygen over an extended amount of time. Normal blood oxygen levels are approximately 85mm Hg.
Hypoxemia is a condition of deficient oxygen levels in the blood (oxygen desaturation as low as 60mm Hg) , which can cause hypoxia – a low amount of oxygen that is able to reach the cells and tissues. Some symptoms of hypoxia are:
To read more of the ASBA Diplomate and Board Member Dr. Elliott Alpher's Huffington Post Blog, click here:
http://ift.tt/2qmYdKx
Comprehensive analysis of parotid mass: A retrospective study of 369 cases
Source:Auris Nasus Larynx
Author(s): Senol Comoglu, Erkan Ozturk, Mehmet Celik, Hakan Avci, Said Sonmez, Bora Basaran, Erkan Kiyak
ObjectiveTo present the results of patients who underwent superficial or total parotidectomy because of parotid gland tumors in our tertiary care clinic.MethodsThe data of 362 patients who underwent parotid surgery from January 2008 to November 2015 were collected and analyzed in demographic, histopathological features, and complications.ResultsThree hundred sixty-nine cases (performed in 359 patients) were analyzed and we assessed complications of parotid surgery such as transient or permanent facial paralysis and Frey's syndrome. Pleomorphic adenomas and Warthin's tumors consisted 74% of all parotid gland tumors. These tumors were generally located in the superficial lobe and tail of the parotid gland (81%). Also, tumor size in the positive surgical margin group was larger than in the negative surgical margin group (p=0.012).ConclusionsMost of parotid gland tumors are benign. However, the frequency of malignancy increases in deep lobe of parotid gland. High grade malignant tumors have more tendency to have positive surgical margin during surgery, and facial paresis preoperatively.
http://ift.tt/2p2vruR
Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan, 2015
Source:Auris Nasus Larynx
Author(s): Makoto Ito, Haruo Takahashi, Yukiko Iino, Hiromi Kojima, Sho Hashimoto, Yosuke Kamide, Fumiyo Kudo, Hitome Kobayashi, Haruo Kuroki, Atsuko Nakano, Hiroshi Hidaka, Goro Takahashi, Haruo Yoshida, Takeo Nakayama
ObjectiveTo (1) indicate the definition, the disease state, methods of diagnosis, and testing for otitis media with effusion (OME) in childhood (<12 years); and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of OME in Children.MethodsWe produced Clinical Questions (CQs) concerning the treatment of OME and searched the literature published until April 2014 according to each theme including CQ, the definition, the disease state, the method of diagnosis, and examination. The recommendations are based on the results of the literature review and the expert opinion of the Subcommittee.ResultsBecause children with Down's syndrome and cleft palate are susceptible to OME, we categorized OME into low-risk and high-risk groups (e.g., Down's syndrome and cleft palate), and recommended the appropriate treatment for each group.ConclusionIn the clinical management of OME in children, Japanese Clinical Practice Guidelines recommend management not only of OME itself, such as effusion in the middle ear and pathological changes in the tympanic membrane, but also pathological abnormality in surrounding organs, such as infectious or inflammatory diseases.
http://ift.tt/2oRGmeO
Is corticosteroid a treatment choice for the management of peritonsillar abscess?
Source:Auris Nasus Larynx
Author(s): Hasan Emre Koçak, Harun Acıpayam, Mustafa Suphi Elbistanlı, Ayşe Pelin Yiğider, Wesam M.E. Alakhras, Mehmet Nurettin Kıral, Fatma Tülin Kayhan
ObjectiveTo investigate the effect of the single systemic use of corticosteroid following drainage procedure in patients with peritonsillar abscess (PTA).MethodsThis retrospective case-control trial included 32 patients with the diagnosis of PTA between December 2013 and January 2016 in our clinic. Patients were divided into two groups based on the approaches of two authors for the treatment after PTA drainage. The study group included the patients treated with single dose systemic corticosteroid after PTA drainage. Other patients who had no corticosteroid treatment were in the control group. Two groups were compared based on time to oral intake, grade of trismus, pain severity and duration of hospitalization.ResultsStatistically significant differences between two groups were observed in terms of time to oral intake, grade of trismus, pain severity and length of hospitalization. The degree of trismus and pain severity significantly decreased in study group comparing to control group at the end of the first day. This difference disappeared at Day 7. Time to oral intake and the duration of hospitalization were shorter in the study group than in control group.ConclusionCorticosteroid treatment following drainage procedure in patients with peritonsillar abscess improves pain severity and trismus thus it decreases time to oral intake and duration of hospitalization.
http://ift.tt/2p2A3Bd
Comprehensive analysis of parotid mass: A retrospective study of 369 cases
To present the results of patients who underwent superficial or total parotidectomy because of parotid gland tumors in our tertiary care clinic.
http://ift.tt/2qrik7s
Novel application of a rigid curved larygno-pharyngoscope for examination and treatment of hypopharyngeal lesions
In endoscopic laryngo-pharyngeal surgery (ELPS), a rigid curved laryngo-pharyngoscope, which was invented by Dr. Sato et al., is necessary to obtain excellent surgical view of both hypopharynx and even the entrance of the esophagus. We have used this instrument for the examination and treatment of several diseases other than cancer located in the hypopharynx, such as difficult-to-find buried fish bones, retropharyngeal abscess, and congenital pyriform sinus fistula. In the result, we could acquire better view of hypopharynx and completed the intended procedure safely, especially for uncovering difficult-to-find fish bone buried in the mucosa.
http://ift.tt/2ppBT1u
Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan, 2015
To (1) indicate the definition, the disease state, methods of diagnosis, and testing for otitis media with effusion (OME) in childhood (<12 years); and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of OME in Children.
http://ift.tt/2qrhIyZ
Is corticosteroid a treatment choice for the management of peritonsillar abscess?
To investigate the effect of the single systemic use of corticosteroid following drainage procedure in patients with peritonsillar abscess (PTA).
http://ift.tt/2ppDFQk
Comprehensive analysis of parotid mass: A retrospective study of 369 cases
To present the results of patients who underwent superficial or total parotidectomy because of parotid gland tumors in our tertiary care clinic.
http://ift.tt/2qrik7s
Novel application of a rigid curved larygno-pharyngoscope for examination and treatment of hypopharyngeal lesions
In endoscopic laryngo-pharyngeal surgery (ELPS), a rigid curved laryngo-pharyngoscope, which was invented by Dr. Sato et al., is necessary to obtain excellent surgical view of both hypopharynx and even the entrance of the esophagus. We have used this instrument for the examination and treatment of several diseases other than cancer located in the hypopharynx, such as difficult-to-find buried fish bones, retropharyngeal abscess, and congenital pyriform sinus fistula. In the result, we could acquire better view of hypopharynx and completed the intended procedure safely, especially for uncovering difficult-to-find fish bone buried in the mucosa.
http://ift.tt/2ppBT1u
Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan, 2015
To (1) indicate the definition, the disease state, methods of diagnosis, and testing for otitis media with effusion (OME) in childhood (<12 years); and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of OME in Children.
http://ift.tt/2qrhIyZ
Is corticosteroid a treatment choice for the management of peritonsillar abscess?
To investigate the effect of the single systemic use of corticosteroid following drainage procedure in patients with peritonsillar abscess (PTA).
http://ift.tt/2ppDFQk
OXIDATIVE STRESS and NEURODEGENERATION
Source:Brain Research Bulletin
Author(s): Jianhua Zhang, D. Allan Butterfield
http://ift.tt/2pprOlg
Pain-relieving effects of clonazepam and amitriptyline in burning mouth syndrome: a retrospective study
This retrospective study aimed to evaluate the efficacy of clonazepam and amitriptyline in the treatment of burning mouth syndrome (BMS). A single-centre retrospective cohort study was performed among patients diagnosed with BMS. Either clonazepam or amitriptyline was administered. Patients were asked to evaluate their pain using a 10-point verbal numerical scale (VNS) at baseline, and at 6 weeks and 3 months of treatment. Mean pain-relief values were assessed according to the treatment received using the Kruskal–Wallis test.
http://ift.tt/2qxPBgR
Evaluation of postoperative complications after mandibular third molar surgery with the use of platelet-rich fibrin: a systematic review and meta-analysis
The current literature was reviewed to analyze the effects of platelet-rich fibrin (PRF) on postoperative complications after mandibular third molar surgery (pain, alveolar osteitis, swelling, and bone healing). A comprehensive literature search was performed up to 2016 in the PubMed/MEDLINE, Cochrane Library, LILACS, and ScienceDirect databases and the grey literature. Additional records were identified through manual and reference searches. The full-text articles of potentially relevant studies were reviewed; only randomized clinical trials were included.
http://ift.tt/2pQUk0B
Synthetic lethal targeting of RNF20 through PARP1 silencing and inhibition
Abstract
Purpose
The identification of novel therapeutic targets that exploit the aberrant genetics driving oncogenesis is critical to better combat cancer. RNF20 is somatically altered in numerous cancers, and its diminished expression drives genome instability, a driving factor of oncogenesis. Accordingly, we sought to determine whether PARP1 silencing and inhibition could preferentially kill RNF20-deficient cells using a synthetic lethal strategy.
Methods
RNF20 and PARP1 were silenced using RNAi-based approaches. Direct synthetic lethal tests were performed by silencing RNF20 with and without PARP1 and the impact on cell numbers was evaluated using semi-quantitative imaging microscopy. Next, Olaparib and BMN673 (PARP1 inhibitors) were evaluated for their ability to induce preferential killing in RNF20 silenced cells, while real-time cell analyses were used to distinguish cell cytotoxicity from cell cycle arrest. Finally, quantitative imaging microscopy was employed to evaluate marks associated with DNA double-strand breaks (γ-H2AX) and apoptosis (cleaved Caspase-3).
Results
We found that PARP1 silencing resulted in a decrease in number of RNF20 silenced cells relative to controls. We further found that Olaparib and BMN673 treatments also resulted in fewer RNF20 silenced cells relative to controls. Finally, we found by quantitative imaging microscopy that RNF20 silenced cells treated with BMN673 exhibited significant increases in γ-H2AX and cleaved Caspase-3, suggesting that these treatments induce DNA double-strand breaks that are not adequately repaired within RNF20-silenced cells.
Conclusions
Collectively, our data indicate that RNF20 and PARP1 are synthetic lethal interactors, suggesting that cancers with diminished RNF20 expression and/or function may be susceptible to PARP1 inhibitors.
http://ift.tt/2qqMGHm
Skin Lightening Under Fire as Indians Seek Whiter Shade of Pale
Mirror, mirror on the wall - who is the fairest of them all? The one with the palest skin, of course.
Reuters Health Information
http://ift.tt/2qf4s2X
Use positional screws for Le Fort I osteotomy fixation: technical note
Abstract
In recent years, several studies related to fixation systems have been published, but few suggest any variations of the Le Fort I osteotomy technique, and the use of plates and screws placed along the canine and zygomatic pillar are common. The 20-year-old patient with Crouzon syndrome presented with severe hypoplasia of the maxillary, mandibular prognathism, and class III facial pattern. The patient underwent orthognathic surgery and high Le Fort I osteotomy with the fixation of eight positional screws. The aim of this paper is to describe a different technique for the fixation in high maxillary osteotomies, which can be used in specific cases.
http://ift.tt/2poClNB
Lifetime Histories of PTSD, Suicidal Ideation, and Suicide Attempts in a Nationally Representative Sample of Adolescents: Examining Indirect Effects via the Roles of Family and Peer Social Support
Source:Journal of Anxiety Disorders
Author(s): Sasha M. Rojas, Sarah A. Bilsky, Courtney Dutton, Christal L. Badour, Matthew T. Feldner, Ellen W. Leen-Feldner
http://ift.tt/2qqpM33
Bacterial microbiome of the nose of healthy dogs and dogs with nasal disease
by Barbara Tress, Elisabeth S. Dorn, Jan S. Suchodolski, Tariq Nisar, Prajesh Ravindran, Karin Weber, Katrin Hartmann, Bianka S. Schulz
The role of bacterial communities in canine nasal disease has not been studied so far using next generation sequencing methods. Sequencing of bacterial 16S rRNA genes has revealed that the canine upper respiratory tract harbors a diverse microbial community; however, changes in the composition of nasal bacterial communities in dogs with nasal disease have not been described so far. Aim of the study was to characterize the nasal microbiome of healthy dogs and compare it to that of dogs with histologically confirmed nasal neoplasia and chronic rhinitis. Nasal swabs were collected from healthy dogs (n = 23), dogs with malignant nasal neoplasia (n = 16), and dogs with chronic rhinitis (n = 8). Bacterial DNA was extracted and sequencing of the bacterial 16S rRNA gene was performed. Data were analyzed using Quantitative Insights Into Microbial Ecology (QIIME). A total of 376 Operational Taxonomic Units out of 26 bacterial phyla were detected. In healthy dogs, Moraxella spp. was the most common species, followed by Phyllobacterium spp., Cardiobacteriaceae, and Staphylococcus spp. While Moraxella spp. were significantly decreased in diseased compared to healthy dogs (p = 0.005), Pasteurellaceae were significantly increased (p = 0.001). Analysis of similarities used on the unweighted UniFrac distance metric (p = 0.027) was significantly different when nasal microbial communities of healthy dogs were compared to those of dogs with nasal disease. The study showed that the canine nasal cavity is inhabited by a highly species-rich bacterial community, and suggests significant differences between the nasal microbiome of healthy dogs and dogs with nasal disease.http://ift.tt/2oQ4jDw
Bacterial microbiome of the nose of healthy dogs and dogs with nasal disease
by Barbara Tress, Elisabeth S. Dorn, Jan S. Suchodolski, Tariq Nisar, Prajesh Ravindran, Karin Weber, Katrin Hartmann, Bianka S. Schulz
The role of bacterial communities in canine nasal disease has not been studied so far using next generation sequencing methods. Sequencing of bacterial 16S rRNA genes has revealed that the canine upper respiratory tract harbors a diverse microbial community; however, changes in the composition of nasal bacterial communities in dogs with nasal disease have not been described so far. Aim of the study was to characterize the nasal microbiome of healthy dogs and compare it to that of dogs with histologically confirmed nasal neoplasia and chronic rhinitis. Nasal swabs were collected from healthy dogs (n = 23), dogs with malignant nasal neoplasia (n = 16), and dogs with chronic rhinitis (n = 8). Bacterial DNA was extracted and sequencing of the bacterial 16S rRNA gene was performed. Data were analyzed using Quantitative Insights Into Microbial Ecology (QIIME). A total of 376 Operational Taxonomic Units out of 26 bacterial phyla were detected. In healthy dogs, Moraxella spp. was the most common species, followed by Phyllobacterium spp., Cardiobacteriaceae, and Staphylococcus spp. While Moraxella spp. were significantly decreased in diseased compared to healthy dogs (p = 0.005), Pasteurellaceae were significantly increased (p = 0.001). Analysis of similarities used on the unweighted UniFrac distance metric (p = 0.027) was significantly different when nasal microbial communities of healthy dogs were compared to those of dogs with nasal disease. The study showed that the canine nasal cavity is inhabited by a highly species-rich bacterial community, and suggests significant differences between the nasal microbiome of healthy dogs and dogs with nasal disease.http://ift.tt/2oQ4jDw
Transcatheter Aortic Valve Implantation Within Degenerated Aortic Surgical Bioprostheses: PARTNER 2 Valve-in-Valve Registry
AbstractBackground
Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results.
ObjectivesThe authors examined 30-day and 1-year outcomes in a large cohort of high-risk patients undergoing VIV TAVR.
MethodsPatients with symptomatic degeneration of surgical aortic bioprostheses at high risk (≥50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 VIV trial and continued access registries.
ResultsValve-in-valve procedures were performed in 365 patients (96 initial registry, 269 continued access patients). Mean age was 78.9 ± 10.2 years, and mean Society of Thoracic Surgeons score was 9.1 ± 4.7%. At 30 days, all-cause mortality was 2.7%, stroke was 2.7%, major vascular complication was 4.1%, conversion to surgery was 0.6%, coronary occlusion was 0.8%, and new pacemaker insertion was 1.9%. One-year all-cause mortality was 12.4%. Mortality fell from the initial registry to the subsequent continued access registry, both at 30 days (8.2% vs. 0.7%, respectively; p = 0.0001) and at 1 year (19.7% vs. 9.8%, respectively; p = 0.006). At 1 year, mean gradient was 17.6 mm Hg, and effective orifice area was 1.16 cm2, with greater than mild paravalvular regurgitation of 1.9%. Left ventricular ejection fraction increased (50.6% to 54.2%), and mass index decreased (135.7 to 117.6 g/m2), with reductions in both mitral (34.9% vs. 12.7%) and tricuspid (31.8% vs. 21.2%) moderate or severe regurgitation (all p < 0.0001). Kansas City Cardiomyopathy Questionnaire score increased (mean: 43.1 to 77.0) and 6-min walk test distance results increased (mean: 163.6 to 252.3 m; both p < 0.0001).
ConclusionsIn high-risk patients, TAVR for bioprosthetic aortic valve failure is associated with relatively low mortality and complication rates, improved hemodynamics, and excellent functional and quality-of-life outcomes at 1 year. (The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves [PARTNER II]; NCT01314313)
http://ift.tt/2pB3e1t
Carotid Artery Stenting Versus Endarterectomy for Stroke Prevention: A Meta-Analysis of Clinical Trials
AbstractBackground
Data conflict regarding the relative effectiveness of carotid artery stenting (CAS) and carotid artery endarterectomy (CEA) for the prevention of stroke due to carotid artery stenosis.
ObjectivesThe authors performed an updated meta-analysis evaluating the efficacy and safety of CAS versus CEA, given recently published clinical trial data.
MethodsDatabases were searched through April 30, 2016. Randomized trials with ≥50 patients, that had exclusive use of embolic-protection devices, and that compared CAS against CEA for the treatment of carotid artery stenosis were selected. We calculated summary odds ratios (ORs) and 95% confidence intervals (CIs) using a random-effects model.
ResultsWe analyzed 6,526 patients from 5 trials with a mean follow-up of 5.3 years. The composite outcome of periprocedural death, stroke, myocardial infarction (MI), or nonperiprocedural ipsilateral stroke was not significantly different between therapies (OR: 1.22; 95% CI: 0.94 to 1.59). The risk of any periprocedural stroke plus nonperiprocedural ipsilateral stroke was higher with CAS (OR: 1.50; 95% CI: 1.22 to 1.84). The risk of higher stroke with CAS was mostly attributed to periprocedural minor stroke (OR: 2.43; 95% CI: 1.71 to 3.46). CAS was associated with significantly lower risk of periprocedural MI (OR: 0.45; 95% CI: 0.27 to 0.75); cranial nerve palsy (OR: 0.07; 95% CI: 0.04 to 0.14); and the composite outcome of death, stroke, MI, or cranial nerve palsy during the periprocedural period (OR: 0.75; 95% CI: 0.60 to 0.93).
ConclusionsCAS and CEA were associated with similar rates of a composite of periprocedural death, stroke, MI, or nonperiprocedural ipsilateral stroke. The risk of long-term overall stroke was significantly higher with CAS, and was mostly attributed to periprocedural minor stroke. CAS was associated with lower rates of periprocedural MI and cranial nerve palsy than CEA.
http://ift.tt/2pB3cGT
Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance: The Young Finns Study
AbstractBackground
In adults, high blood pressure (BP), adverse serum lipids, and smoking associate with cognitive deficits. The effects of these risk factors from childhood on midlife cognitive performance are unknown.
ObjectivesThis study sought to investigate the associations between childhood/adolescence cardiovascular risk factors and midlife cognitive performance.
MethodsFrom 1980, a population-based cohort of 3,596 children (baseline age: 3 to 18 years) have been followed for 31 years in 3- to 9-year intervals. BP, serum lipids, body mass index, and smoking were assessed in all follow-ups. Cumulative exposure as the area under the curve for each risk factor was determined in childhood (6 to 12 years), adolescence (12 to 18 years), and young adulthood (18 to 24 years). In 2011, cognitive testing was performed in 2,026 participants aged 34 to 49 years.
ResultsHigh systolic BP, elevated serum total-cholesterol, and smoking from childhood were independently associated with worse midlife cognitive performance, especially memory and learning. The number of early life risk factors, including high levels (extreme 75th percentile for cumulative risk exposure between ages 6 and 24 years) of systolic BP, total-cholesterol, and smoking associated inversely with midlife visual and episodic memory and visuospatial associative learning (–0.140 standard deviations per risk factor, p < 0.0001) and remained significant after adjustment for contemporaneous risk factors. Individuals with all risk factors within recommended levels between ages 6 and 24 years performed 0.29 standard deviations better (p = 0.006) on this cognitive domain than those exceeding all risk factor guidelines at least twice. This difference corresponds to the effect of 6 years aging on this cognitive domain.
ConclusionsCumulative burden of cardiovascular risk factors from childhood/adolescence associate with worse midlife cognitive performance independent of adulthood exposure.
http://ift.tt/2pBevyX
Tricuspid Valve Dysfunction Following Pacemaker or Cardioverter-Defibrillator Implantation
Abstract
The potential for cardiac implantable electronic device leads to interfere with tricuspid valve (TV) function has gained increasing recognition as having hemodynamic and clinical consequences associated with incremental morbidity and death. The diagnosis and treatment of lead-related (as distinct from functional) tricuspid regurgitation pose unique challenges. Because of pitfalls in routine diagnostic imaging, a high level of clinical suspicion must be maintained to avoid overlooking the possibility that worsening heart failure is a consequence of mechanical interference with TV leaflet mobility or coaptation and is amenable to lead extraction or valve repair or replacement. The future of cardiac implantable electronic devices includes pacing and perhaps defibrillation without a lead traversing the TV.
http://ift.tt/2oYJ9OF
Underuse of Prevention and Lifestyle Counseling in Patients With Peripheral Artery Disease
AbstractBackground
Little is known about patterns of medication use and lifestyle counseling in patients with peripheral artery disease (PAD) in the United States.
ObjectivesThe authors sought to evaluate trends in both medical therapy and lifestyle counseling for PAD patients in the United States from 2005 through 2012.
MethodsData from 1,982 outpatient visits among patients with PAD were obtained from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, a nationally representative assessment of office-based and hospital outpatient department practice. Trends in the proportion of visits with medication use (antiplatelet therapy, statins, angiotensin-converting enzyme inhibitors [ACEIs] or angiotensin receptor blockers [ARBs], and cilostazol) and lifestyle counseling (exercise or diet counseling and smoking cessation) were evaluated.
ResultsOver the 8-year period, the average annual number of ambulatory visits in the United States for PAD was 3,883,665. Across all visits, mean age was 69.2 years, 51.8% were female, and 56.6% were non-Hispanic white. Comorbid coronary artery disease (CAD) was present in 24.3% of visits. Medication use for cardiovascular prevention and symptoms of claudication was low: any antiplatelet therapy in 35.7% (standard error [SE]: 2.7%), statin in 33.1% (SE: 2.4%), ACEI/ARB in 28.4% (SE: 2.0%), and cilostazol in 4.7% (SE: 1.0%) of visits. Exercise or diet counseling was used in 22% (SE: 2.3%) of visits. Among current smokers with PAD, smoking cessation counseling or medication was used in 35.8% (SE: 4.6%) of visits. There was no significant change in medication use or lifestyle counseling over time. Compared with visits for patients with PAD alone, comorbid PAD and CAD were more likely to be prescribed antiplatelet therapy (odds ratio [OR]: 2.6; 95% confidence interval [CI]: 1.8 to 3.9), statins (OR: 2.6; 95% CI: 1.8 to 3.9), ACEI/ARB (OR: 2.6; 95% CI: 1.8 to 3.9), and smoking cessation counseling (OR: 4.4; 95% CI: 2.0 to 9.6).
ConclusionsThe use of guideline-recommended therapies in patients with PAD was much lower than expected, which highlights an opportunity to improve the quality of care in these high-risk patients.
http://ift.tt/2pBe5s1
Ranolazine After Incomplete Percutaneous Coronary Revascularization in Patients With Versus Without Diabetes Mellitus: RIVER-PCI Trial
AbstractBackground
Chronic angina is more common in patients with diabetes mellitus (DM) with poor glucose control. Ranolazine both treats chronic angina and improves glucose control.
ObjectivesThis study sought to examine ranolazine's antianginal effect in relation to glucose control.
MethodsThe authors performed a secondary analysis of the RIVER-PCI (Ranolazine in Patients with Incomplete Revascularization after Percutaneous Coronary Intervention) trial, a clinical trial in which 2,604 patients with chronic angina and incomplete revascularization following percutaneous coronary intervention were randomized to ranolazine versus placebo. Mixed-effects models were used to compare the effects of ranolazine versus placebo on glycosylated hemoglobin (HbA1c) at 6- and 12-month follow-up. Interaction between baseline HbA1c and ranolazine's effect on Seattle Angina Questionnaire angina frequency at 6 and 12 months was tested.
ResultsOverall, 961 patients (36.9%) had DM at baseline. Compared with placebo, ranolazine significantly decreased HbA1c by 0.42 ± 0.08% (adjusted mean difference ± SE) and 0.44 ± 0.08% from baseline to 6 and 12 months, respectively, in DM patients, and by 0.19 ± 0.02% and 0.20 ± 0.02% at 6 and 12 months, respectively, in non-DM patients. Compared with placebo, ranolazine significantly reduced Seattle Angina Questionnaire angina frequency at 6 months among DM patients but not at 12 months. The reductions in angina frequency were numerically greater among patients with baseline HbA1c ≥7.5% than those with HbA1c <7.5% (interaction p = 0.07).
ConclusionsIn patients with DM and chronic angina with incomplete revascularization after percutaneous coronary intervention, ranolazine's effect on glucose control and angina at 6 months was proportionate to baseline HbA1c, but the effect on angina dissipated by 12 months.
http://ift.tt/2pBfzCK
Latex Allergy: Can We Keep Clinicians and Patients Safer?
Latex allergies provoke a variety of reactions, from the annoying to the deadly. Contact prevention is challenging, and clinicians are among the most widely affected. What can we do?
Medscape Allergy & Immunology
http://ift.tt/2owBECZ
Black-blood T2* mapping with delay alternating with nutation for tailored excitation
Source:Magnetic Resonance Imaging, Volume 40
Author(s): Shi Su, Yanan Ren, Caiyun Shi, Xiaoyong Zhang, Jim X. Ji, Yongqin Zhang, Xin Liu, Guoxi Xie
PurposeTo develop a black-blood T2* mapping method using a Delay Alternating with Nutation for Tailored Excitation (DANTE) preparation combined with a multi-echo gradient echo (GRE) readout (DANTE-GRE).Materials and methodsSimulations of the Bloch equation for DANTE-GRE were performed to optimize sequence parameters. After optimization, the sequence was applied to a phantom scan and to neck and lower extremity scans conducted on 12 volunteers at 3T using DANTE-GRE, Motion-Sensitized Driven Equilibrium (MSDE)-GRE, and multi-echo GRE. T2* values were measured using an offset model. Statistical analyses were conducted to compare the T2* values between the three sequences.ResultsSimulation results showed that blood suppression can be achieved with various DANTE parameter adjustments. T2* maps acquired by DANTE-GRE were consistent and comparable to those acquired with multi-echo GRE in phantom experiments. In the in vivo experiments, DANTE-GRE was more comparable to multi-echo GRE than MSDE-GRE regarding the measurement of muscle T2* values.ConclusionDue to its high signal intensity retention and effective blood signal suppression, DANTE-GRE allows for robust and accurate T2* quantification, superior to that of MSDE-GRE, while overcoming blood flow artifacts associated with traditional multi-echo GRE.
http://ift.tt/2qlUiO3
Malnutrition among Hospitalized Children in the United States: Changing Prevalence, Clinical Correlates, and Practice Patterns between 2002 and 2011
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jennifer Carvalho-Salemi, Jason L. Salemi, Molly R. Wong-Vega, Kiara K. Spooner, Marisa D. Juarez, Stacey S. Beer, Nicki L. Canada
BackgroundPediatric malnutrition has been associated with adverse clinical outcomes, longer lengths of stay, and higher health care costs.ObjectiveTo characterize prevalence, temporal trends, and short-term clinical outcomes of coded diagnoses of pediatric malnutrition (CDM) across sociodemographic, clinical, and hospital characteristics from 2002 to 2011.DesignThis study is a retrospective cross-sectional analysis of nationally representative data from the Nationwide Inpatient Sample and the Kids' Inpatient Database.Participants/settingThe study sample included pediatric inpatient hospitalizations in the United States.Main outcome measuresInternational Classification of Diseases-9th Revision-Clinical Modification diagnosis codes were used to identify CDM and coded malnutrition subtypes based on an etiology-related definition of pediatric malnutrition.Statistical analysesThe national frequency and prevalence of CDM overall and across patient- and hospital-level characteristics were estimated for children aged 1 month to 17 years. Logistic regression was used to assess the association between CDM and each characteristic. Analyses evaluated conditions associated with the highest burden and risk of CDM, and compared clinical outcomes across malnutrition subtypes. Joinpoint regression was used to describe temporal trends in CDM.ResultsOf the 2.1 million pediatric patients hospitalized annually, more than 54,600 had CDM, a national prevalence of 2.6%. Considerable variation was observed based on primary diagnosis, with fluid and electrolyte disorders contributing the most malnutrition cases. Highest CDM rates were among patients with stomach cancer, cystic fibrosis, and human immunodeficiency virus. Patients with CDM experienced worse clinical outcomes, longer lengths of stay, and increased costs of inpatient care. The overall prevalence of CDM increased from 1.9% in 2002 to 3.7% in 2011, an 8% annual increase, and temporal increases were observed in nearly all population subgroups.ConclusionsDespite improvements, pediatric malnutrition remains underdiagnosed in inpatient settings when relying exclusively on International Classification of Diseases-based codes, which underscores the need for a national benchmarking program to estimate the true prevalence, clinical significance, and cost of pediatric malnutrition.
http://ift.tt/2oQs7XG
Inhibition of Akt and other AGC Kinases: A Target for Clinical Cancer Therapy?
Source:Seminars in Cancer Biology
Author(s): Vincent Prêtre, Andreas Wicki
AGC kinases have been identified to contribute to cancer development and progression. Currently, most AGC inhibitors in clinical development are Akt inhibitors such as MK-2206 or GDC-0068, which are known to promote cell growth arrest and to sensitize cancer cells to radiotherapy. Response rates in clinical trials with single agent Akt inhibitors are typically low. The observed adverse events are within the expected limits for compounds inhibiting the PI3K-mTOR axis. Preclinical and early clinical data for combination therapies are accumulating. Based on these data, several Akt inhibitors are about to enter phase 3 trials. Besides drugs that target Akt, p70S6K inhibitors have entered clinical development. Again, the response rates were rather low. In addition, relevant toxicities were identified, including a risk for coagulopathies with these compounds. Multi-AGC kinase inhibitors are also in early clinical development but the data is not sufficient yet to draw conclusions regarding their efficacy and side-effect profile. PKC inhibitors have been tested in the phase 3 setting but were found to lack efficacy. More trials with isoform-specific PKC inhibitors are expected. Taken together, therapies with AGC kinase inhibitors as single agents are unlikely to meet success. However, combination therapies and a precise stratification of patients according to the activation of signalling axes may increase the probability to see relevant efficacy with these compounds. The emergence of onco-immunotherapies holds some new challenges for these agents.
http://ift.tt/2pombnk
PDK1: at the crossroad of cancer signaling pathways
Source:Seminars in Cancer Biology
Author(s): Paolo Armando Gagliardi, Alberto Puliafito, Luca Primo
Rational target therapy of cancer would benefit from the identification of new targets that can be easily inhibited by small molecules. An increasing amount of evidence hints at 3-phosphoinositide dependent protein kinase-1 (PDK1 or PDPK1) as an intriguing and underexplored target for cancer therapy. Several reports show that PDK1 expression is dysregulated in multiple cancer types. Furthermore PDK1 is implicated in signaling pathways frequently altered in cancer, such as PI3K/Akt, Ras/MAPK and Myc. PDK1 targeting has been proven to be effective in experimental models harboring alterations of these pathways. In this paper we review PDK1 main biochemical mechanisms, its alterations in cancer and interactions with relevant cancer pathways. A potential role of PDK1 in tumor microenvironment is also discussed.
http://ift.tt/2qqkdSf
G protein-coupled receptor kinases (GRKs) in tumorigenesis and cancer progression: GPCR regulators and signaling hubs
Source:Seminars in Cancer Biology
Author(s): Laura Nogués, Julia Palacios-García, Clara Reglero, Verónica Rivas, María Neves, Catalina Ribas, Petronila Penela, Federico Mayor
Increasing evidences point to G protein-coupled receptor kinases (GRKs), a subfamily of protein kinase A/G/C-like kinases, as relevant players in cancer progression, in a cell-type and tumor-specific way. Alterations in the expression and/or activity of particular GRKs have been identified in several types of tumors, and demonstrated to modulate the proliferation, survival or invasive properties of tumor cells by acting as integrating signaling nodes. GRKs are able to regulate the functionality of both G protein-coupled receptors (GPCR) and growth factor receptors and to directly control cytosolic, cytoskeletal or nuclear signaling components of pathways relevant for these processes. Furthermore, many chemokines as well as angiogenic and inflammatory factors present in the tumor microenvironment act through GPCR and other GRK-modulated signaling modules. Changes in the dosage of certain GRKs in the tumor stroma can alter tumor angiogenesis and the homing of immune cells, thus putting forward these kinases as potentially relevant modulators of the carcinoma-fibroblast-endothelial-immune cell network fostering tumor development and dissemination. A better understanding of the alterations in different GRK isoforms taking place during cancer development and metastasis in specific tumors and cell types and of its impact in signaling pathways would help to design novel therapeutic strategies.
http://ift.tt/2porxiB
Bacterial microbiome of the nose of healthy dogs and dogs with nasal disease
by Barbara Tress, Elisabeth S. Dorn, Jan S. Suchodolski, Tariq Nisar, Prajesh Ravindran, Karin Weber, Katrin Hartmann, Bianka S. Schulz
The role of bacterial communities in canine nasal disease has not been studied so far using next generation sequencing methods. Sequencing of bacterial 16S rRNA genes has revealed that the canine upper respiratory tract harbors a diverse microbial community; however, changes in the composition of nasal bacterial communities in dogs with nasal disease have not been described so far. Aim of the study was to characterize the nasal microbiome of healthy dogs and compare it to that of dogs with histologically confirmed nasal neoplasia and chronic rhinitis. Nasal swabs were collected from healthy dogs (n = 23), dogs with malignant nasal neoplasia (n = 16), and dogs with chronic rhinitis (n = 8). Bacterial DNA was extracted and sequencing of the bacterial 16S rRNA gene was performed. Data were analyzed using Quantitative Insights Into Microbial Ecology (QIIME). A total of 376 Operational Taxonomic Units out of 26 bacterial phyla were detected. In healthy dogs, Moraxella spp. was the most common species, followed by Phyllobacterium spp., Cardiobacteriaceae, and Staphylococcus spp. While Moraxella spp. were significantly decreased in diseased compared to healthy dogs (p = 0.005), Pasteurellaceae were significantly increased (p = 0.001). Analysis of similarities used on the unweighted UniFrac distance metric (p = 0.027) was significantly different when nasal microbial communities of healthy dogs were compared to those of dogs with nasal disease. The study showed that the canine nasal cavity is inhabited by a highly species-rich bacterial community, and suggests significant differences between the nasal microbiome of healthy dogs and dogs with nasal disease.http://ift.tt/2oQ4jDw
Bacterial microbiome of the nose of healthy dogs and dogs with nasal disease
by Barbara Tress, Elisabeth S. Dorn, Jan S. Suchodolski, Tariq Nisar, Prajesh Ravindran, Karin Weber, Katrin Hartmann, Bianka S. Schulz
The role of bacterial communities in canine nasal disease has not been studied so far using next generation sequencing methods. Sequencing of bacterial 16S rRNA genes has revealed that the canine upper respiratory tract harbors a diverse microbial community; however, changes in the composition of nasal bacterial communities in dogs with nasal disease have not been described so far. Aim of the study was to characterize the nasal microbiome of healthy dogs and compare it to that of dogs with histologically confirmed nasal neoplasia and chronic rhinitis. Nasal swabs were collected from healthy dogs (n = 23), dogs with malignant nasal neoplasia (n = 16), and dogs with chronic rhinitis (n = 8). Bacterial DNA was extracted and sequencing of the bacterial 16S rRNA gene was performed. Data were analyzed using Quantitative Insights Into Microbial Ecology (QIIME). A total of 376 Operational Taxonomic Units out of 26 bacterial phyla were detected. In healthy dogs, Moraxella spp. was the most common species, followed by Phyllobacterium spp., Cardiobacteriaceae, and Staphylococcus spp. While Moraxella spp. were significantly decreased in diseased compared to healthy dogs (p = 0.005), Pasteurellaceae were significantly increased (p = 0.001). Analysis of similarities used on the unweighted UniFrac distance metric (p = 0.027) was significantly different when nasal microbial communities of healthy dogs were compared to those of dogs with nasal disease. The study showed that the canine nasal cavity is inhabited by a highly species-rich bacterial community, and suggests significant differences between the nasal microbiome of healthy dogs and dogs with nasal disease.http://ift.tt/2oQ4jDw
Interoceptive Ingredients of Body Ownership: Affective Touch and Cardiac Awareness in the Rubber Hand Illusion
Source:Cortex
Author(s): Laura Crucianelli, Charlotte Krahé, Paul M. Jenkinson, Aikaterini (Katerina) Fotopoulou
The sense of body ownership represents a fundamental aspect of bodily self-consciousness. Using multisensory integration paradigms, recent studies have shown that both exteroceptive and interoceptive information contribute to our sense of body ownership. Interoception refers to the physiological sense of the condition of the body, including afferent signals that originate inside the body and outside the body. However, it remains unclear whether individual sensitivity to interoceptive modalities is unitary or differs between modalities. It is also unclear whether the effect of interoceptive information on body ownership is caused by exteroceptive 'visual capture' of these modalities, or by bottom-up processing of interoceptive information. This study aimed to test these questions in two separate samples. In the first experiment (N = 76), we examined the relationship between two different interoceptive modalities, namely cardiac awareness based on a heartbeat counting task, and affective touch perception based on stimulation of a specialized C tactile (CT) afferent system. This is an interoceptive modality of affective and social significance. In a second experiment (N = 63), we explored whether 'off-line' trait interoceptive sensitivity based on a heartbeat counting task would modulate the extent to which CT affective touch influences the multisensory process during the rubber hand illusion (RHI).We found that affective touch enhanced the subjective experience of body ownership during the RHI. Nevertheless, interoceptive sensitivity, as measured by a heartbeat counting task, did not modulate this effect, nor did it relate to the perception of ownership or of CT-optimal affective touch more generally. By contrast, this trait measure of interoceptive sensitivity appeared most relevant when the multisensory context of interoception was ambiguous, suggesting that the perception of interoceptive signals and their effects on body ownership may depend on individual abilities to regulate the balance of interoception and exteroception in given contexts.
http://ift.tt/2pPBnM2
Medicinal plant uses and names from the herbarium of Francesc Bolòs (1773–1844)
Publication date: 23 May 2017
Source:Journal of Ethnopharmacology, Volume 204
Author(s): Airy Gras, Teresa Garnatje, Neus Ibáñez, Jordi López-Pujol, Neus Nualart, Joan Vallès
Ethnopharmacological relevanceEthnobotany takes into account past uses to be projected into the present and future. Most current ethnobotanical research is focused, especially in industrialised countries, on obtaining information of plant uses from elderly people. Historical ethnobotany is less cultivated, although papers have demonstrated its interest. Particularly poor, but potentially very relevant, is the attention paid to historical herbaria as a source of data on useful plants.Aims of the studyBearing this in mind, we studied the herbarium of the Catalan pharmacist and naturalist Francesc Bolòs (1773–1844), which contains information on medicinal uses and folk names, with the aim of establishing a catalogue of plants and uses and tracing them through old and contemporary literature.MethodologyThe ca. 6000 plant specimens of this herbarium were investigated to assess those including plant uses and names. These taxa have been thoroughly revised. The data have been tabulated, their biogeographic profile, possible endemic or threatened status, or invasive behaviour have been assessed, and the content regarding medicinal uses, as well as folk names, has been studied. The medicinal terms used have been interpreted as per current days' medicine. The popular names and uses have been compared with those appearing in a certain number of works published from 11th to 20th centuries in the territories covered by the herbarium and with all the data collected in 20th and 21st centuries in an extensive database on Catalan ethnobotany.ResultsA total of 385 plant specimens (381 taxa) have been detected bearing medicinal use and folk names information. We collected data on 1107 reports of plant medicinal properties (in Latin), 32 indications of toxicity, nine reports of food use, and 123, 302 and 318 popular plant names in Catalan, Spanish and French, respectively. The most quoted systems are digestive, skin and subcutaneous tissue (plus traumatic troubles) and genitourinary. Relatively high degrees of coincidence of plant names and uses in the herbarium and the literature comparison set have been found. Of the taxa contained in this medicinal herbarium, 294 were native to the Iberian Peninsula, and 86 were alien. Neither endemic nor threatened taxa have been detected, whereas a considerable portion of the alien taxa shows invasive behaviour at present.ConclusionsOur analyses indicate a certain degree of consistency between the medicinal uses of plants recorded in this 18th and 19th century herbarium and the records found in the literature and in recent ethnobotanical datasets, accounting for the robustness of pharmaceutical ethnobotanical knowledge in the area considered. Data appearing on the specimen labels are numerous, pointing out the herbarium as a relevant source of ethnopharmacological information. Special attention should be paid to some original uses contained in the herbarium's labels for further investigation on plant properties and drug design.
Graphical abstract
http://ift.tt/2pnyDDY
In vitro and in vivo antifungal efficacy of plant based lawsone against Fusarium oxysporum species complex
Source:Microbiological Research
Author(s): S.H.S. Dananjaya, R.M.C. Udayangani, Sang Yeop Shin, M. Edussuriya, Chamilani Nikapitiya, Jehee Lee, Mahanama De Zoysa
Fusarium oxysporum is an ascomycete facultative fungus which generally affects to plants. However, it is recently known as a serious emerging opportunistic pathogen of human and other animals. F. oxysporum shows broad resistance to commonly used antifungal agents and therefore development of alternative therapeutic agents is required. In this study, we investigated the antifungal efficacy of plant based natural lawsone against pathogenic F. oxysporum. Antifungal susceptibility test determined the concentration dependent growth inhibition of lawsone against F. oxysporum with minimum inhibitory concentration (MIC) at 100μg/mL. Ultra-structural analysis indicates the prominent damage on cell wall of the mycelium after lawsone treatment and suggests that it could increase the membrane permeability and disintegration of cells leading to cellular death. Propidium iodide (PI) uptake assay results showed the higher level of cell death in lawsone treated F. oxysporum which further confirms the loss of plasma membrane integrity. Also, detection of reactive oxygen species (ROS) using DCFH-DA has clearly indicated that lawsone (100μg/mL) can induce the ROS level in the filaments of F. oxysporum. MTT assay results showed the loss of viability and germination capacity of F. oxysporum spores by lawsone in concentration dependent manner. Moreover, lawsone treatment induced the mRNA of two autophagy related genes (ATG1 and ATG8) indicating that lawsone may activate the autophagy related pathways in F. oxysporum due to the oxidative stress generated by ROS. F. oxysporum infected zebrafish has recovered after lawsone therapy as a topical treatment suggesting that lawsone is a potential natural antifusariosis agent.
http://ift.tt/2oY6wbf
Association of influenza vaccination during pregnancy with birth outcomes in Nicaragua
Publication date: Available online 29 April 2017
Source:Vaccine
Author(s): Carmen S. Arriola, Nancy Vasconez, Mark G. Thompson, Sonja J. Olsen, Ann C. Moen, Joseph Bresee, Alba María Ropero
Background: Studies have shown that influenza vaccination during pregnancy reduces the risk of influenza disease in pregnant women and their offspring. Some have proposed that maternal vaccination may also have beneficial effects on birth outcomes. In 2014, we conducted an observational study to test this hypothesis using data from two large hospitals in Managua, Nicaragua.Methods: We conducted a retrospective cohort study to evaluate associations between influenza vaccination and birth outcomes. We carried out interviews and reviewed medical records post-partum to collect data on demographics, influenza vaccination during pregnancy, birth outcomes and other risk factors associated with adverse neonatal outcomes. We used influenza surveillance data to adjust for timing of influenza circulation. We assessed self-reports of influenza vaccination status by further reviewing medical records of those who self-reported but did not have readily available evidence of vaccination status. We performed multiple logistic regression (MLR) and propensity score matching (PSM).Results: A total of 3268 women were included in the final analysis. Of these, 55% had received influenza vaccination in 2014. Overall, we did not observe statistically significant associations between influenza vaccination and birth outcomes after adjusting for risk factors, with either MLR or PSM. With PSM, after adjusting for risk factors, we observed protective associations between influenza vaccination in the second and third trimester and preterm birth (aOR: 0.87; 95% confidence interval (CI): 0.75–0.99 and aOR: 0.66; 95% CI: 0.45–0.96, respectively) and between influenza vaccination in the second trimester and low birth weight (aOR: 0.80; 95% CI: 0.64–0.97).Conclusions: We found evidence to support an association between influenza vaccination and birth outcomes by trimester of receipt with data from an urban population in Nicaragua. The study had significant selection and recall biases. Prospective studies are needed to minimize these biases.
http://ift.tt/2qp8DXk
Whether to Proceed With Deep Brain Stimulator Battery Change in a Patient With Signs of Potential Sepsis and Parkinson Hyperpyrexia Syndrome: A Case Report
Parkinsonism-hyperpyrexia syndrome (PHS) is a neurologic emergency associated with anti- Parkinson medication withdrawal; however, its clinical presentation mimics sepsis. We describe the case of a 69-year-old man with advanced Parkinson disease who presented for exchange of the depleted battery in his subthalamic deep brain stimulator. The patient's preoperative symptoms of fever, rigidity, altered consciousness, and autonomic instability presented a dilemma whether to proceed with battery exchange to treat PHS or postpone surgery due to potential sepsis. The administration of dopaminergic medications, dantrolene, and antipyretic drugs are temporary supportive measures, while prompt restoration of deep brain stimulator function is the most important therapeutic treatment for PHS.http://ift.tt/2pne4HL
Short-term Vision Loss Following Whipple Surgery: A Case Report
Occipital seizures may result in visual deficits and may be an ictal or postictal phenomenon. A 71-year-old woman underwent pancreatoduodenectomy (Whipple procedure). During recovery in the postanesthesia care unit, the patient complained of blindness. Upon transfer to the intensive care unit, an electroencephalogram indicated bilateral occipital and hemispheric seizure activity. The patient was treated with antiseizure medication, and vision normalized within 3 days. Subtherapeutic concentration of free phenytoin was confirmed. Our experience suggests that electroencephalogram evaluation should be considered in the workup of postoperative patients who present with acute-onset blindness and in whom the cause remains ambiguous even in the absence of obvious clinical signs of seizures.
http://ift.tt/2qoMcl1
http://ift.tt/2qoMcl1
Perioperative Surface Ultrasound for Placement and Confirmation of Central Venous Access: A Case Report
We present a case highlighting that the real-time visualization of the guidewire in the internal jugular vein with ultrasound, and confirmation of correct position of the guidewire tip at the superior vena cava to right atrial junction with surface ultrasound, is possibly the safest method of central venous catheter insertion.http://ift.tt/2qoMskb
The Use of Sugammadex in a Patient With Guillain–Barre Syndrome: A Case Report
Sugammadex encapsulates and inactivates rocuronium and vecuronium. It is used to reverse neuromuscular blockade from these nondepolarizing agents. The safety of sugammadex in patients with neuromuscular disease has not been established. Guillain–Barre Syndrome (GBS) is a neuromuscular disease characterized by acute inflammatory polyneuropathy. Patients with GBS may exhibit autonomic dysfunction, chronic pain, abnormal reactions to neuromuscular blocking agents, and may require postoperative mechanical ventilation. We report the successful use of sugammadex to reverse rocuronium in a patient with chronic GBS, who presented for a hemicolectomy.
http://ift.tt/2pnlMBT
http://ift.tt/2pnlMBT
Postoperative Pediatric Cerebellar Mutism After Posterior Fossa Surgery: A Case Report
Cerebellar mutism syndrome (CMS) is a common complication of posterior fossa surgery that can confound the postanesthetic examination and have long-lasting impacts. There is confusion surrounding its precise description, diagnostic features, and associated morbidity. Here, we discuss the most up-to-date knowledge of CMS drawing from a clinical case in the context of 3 new reports: (1) an international consensus paper presenting a new proposed working definition by the Iceland Delphi Group, (2) a knowledge update by Gadgil et al, (3) and a review of neuroimaging-based data elucidating the etiology of CMS by Patay.http://ift.tt/2pnjv9K
Increased Resistance to Flow and Ventilator Failure Secondary to Faulty CO2 Absorbent Insert Not Detected During Automated Anesthesia Machine Check: A Case Report
Most modern anesthesia workstations provide automated checkout, which indicates the readiness of the anesthesia machine. In this case report, an anesthesia machine passed the automated machine checkout. Minutes after the induction of general anesthesia, we observed a mismatch between the selected and delivered tidal volumes in the volume auto flow mode with increased inspiratory resistance during manual ventilation. Endotracheal tube kinking, circuit obstruction, leaks, and patient-related factors were ruled out. Further investigation revealed a broken internal insert within the CO2 absorbent canister that allowed absorbent granules to cause a partial obstruction to inspiratory and expiratory flow triggering contradictory alarms. We concluded that even when the automated machine checkout indicates machine readiness, unforeseen equipment failure due to unexpected events can occur and require providers to remain vigilant.http://ift.tt/2pnhLgC
AngioVac Suction Thrombectomy Complicated by Thrombus Fragmentation and Distal Embolization Leading to Hemodynamic Collapse: A Case Report
A 35-year-old morbidly obese woman with a history of deep vein thrombosis and pulmonary embolism presented for right atrial thrombectomy via AngioVac suction system. A portion of the thrombus could not be suctioned into the AngioVac cannula, leading to fragmentation and distal embolization with hemodynamic collapse. This sequence, observed in real time under transesophageal echocardiography, also demonstrated that the clot had echocardiographic features of chronicity. A well-organized chronic clot may be more difficult to extract via this method, leading to the complication described. With increasing popularity of this less invasive method, further investigation to understand the indications and contraindications is warranted.http://ift.tt/2pnlHy5
Femoral Neuropathy Following Spontaneous Retroperitoneal Hemorrhage After Cardiac Surgery: A Case Report
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected. Anticoagulation was held but not reversed, and she was transfused. Her impairment resolved fully after 3 days, and anticoagulation was restarted in staggered fashion.http://ift.tt/2pnkuXp
Pectoral Nerve and Transverse Abdominis Plane Block in a Patient Undergoing Mastectomy With Transverse Rectus Abdominis Muscle Flap: A Case Report
Postoperative nausea, vomiting, and pain present considerable concerns after reconstructive breast surgery. We present a case report of a 65-year-old woman with a history of severe postoperative nausea and vomiting, presenting for unilateral mastectomy with transverse rectus abdominis muscle flap. We performed unilateral pectoral nerve block and transverse abdominis plane block, which provided 24 hours of pain control and mitigated nausea and vomiting during the postoperative period.http://ift.tt/2pndObL
Postoperative Hemiplegic Migraine After a Laparoscopic Cholecystectomy: A Case Report
We report the case of a 35-year-old woman who developed severe right-sided hemiplegia and hemisensory loss shortly after emergence from general anesthesia for a laparoscopic cholecystectomy. Her medical history was significant for migraine with aura and a family history of transient hemiparesis thought to be a result of a transient ischemic attack. The patient's deficits slowly resolved, and she was ultimately diagnosed with familial hemiplegic migraine after a negative workup for cerebrovascular accidents.http://ift.tt/2pnku9R
Retropharyngeal Perforation With an Esophageal Dilator: A Case Report
Esophageal "bougie" dilators are frequently used during esophageal surgeries to facilitate reconstruction and manipulation of the esophagus. Insertion of such dilators is usually a blind technique and not without risk. We present a case of retropharyngeal wall perforation resulting from esophageal dilator misplacement in a patient undergoing laparoscopic Heller myotomy and reconstruction. This case report demonstrates the importance of communication between surgery and anesthesiology teams during placement of devices into the oropharynx.http://ift.tt/2pnhsST
Bilateral Congenital Iris Sphincter Agenesis Diagnosed After Massive Bleeding Episode During Repair of Aneurysmal Dilation of Patent Ductus Arteriosus: A Case Report
We report a rare case of an infant with both an aneurysmal dilation of the patent ductus arteriosus (PDA) and bilateral congenital iris sphincter agenesis. Her mydriasis without pupillary light reflex was first noted after a massive intraoperative bleeding episode during the PDA ligation. The assumption that the mydriasis was a sign of cerebral ischemia led to additional examinations and intensive medical therapies that in retrospect were unnecessary. This is the first reported case of combined aneurysmal dilation of a PDA and congenital iris sphincter agenesis in the anesthesia literature.http://ift.tt/2pn2T1O
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