Objective: Speech-in-noise hearing screening tests have become increasingly popular. These tests follow an adaptive procedure with a fixed number of presentations to estimate the speech reception threshold. The speech reception threshold is compared with an established cutoff signal to noise ratio (SNR) for a pass result or refer result. A fixed SNR procedure was developed to improve the efficiency of speech-in-noise hearing screening tests. Design: The cutoff SNR is used for all presentations in the fixed-SNR procedure. After each response a reliable test result is given (pass/refer) or an extra stimulus is presented. The efficiency and pass/refer rates between the adaptive procedure and the fixed-SNR procedure were compared. Results: An average reduction of 67% in the number of presentations can be achieved (from 25 to an average of 8.3 presentations per test). Conclusions: The fixed-SNR procedure is superior in efficiency to the adaptive procedure while having nearly equal refer and pass rates. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2qCdvLT
Παρασκευή 5 Μαΐου 2017
Effects of Stimulus Duration on Event-Related Potentials Recorded From Cochlear-Implant Users.
Objectives: Several studies have investigated the feasibility of using electrophysiology as an objective tool to efficiently map cochlear implants. A pervasive problem when measuring event-related potentials is the need to remove the direct-current (DC) artifact produced by the cochlear implant. Here, we describe how DC artifact removal can corrupt the response waveform and how the appropriate choice of stimulus duration may minimize this corruption. Design: Event-related potentials were recorded to a synthesized vowel /a/ with a 170- or 400-ms duration. Results: The P2 response, which occurs between 150 and 250 ms, was corrupted by the DC artifact removal algorithm for a 170-ms stimulus duration but was relatively uncorrupted for a 400-ms stimulus duration. Conclusions: To avoid response waveform corruption from DC artifact removal, one should choose a stimulus duration such that the offset of the stimulus does not temporally coincide with the specific peak of interest. While our data have been analyzed with only one specific algorithm, we argue that the length of the stimulus may be a critical factor for any DC artifact removal algorithm. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2pfvpiM
http://ift.tt/2pfvpiM
HIF-1α, MDM2, CDK4, and p16 expression in ischemic fasciitis, focusing on its ischemic condition
Abstract
Ischemic fasciitis is a benign myofibroblastic lesion, occurring in the sacral region or proximal thigh of elderly or bedridden individuals. The pathogenesis of ischemic fasciitis is thought to be based on ischemic condition; however, it has never been demonstrated. In this study, we examined the expression of ischemia-associated proteins in ischemic fasciitis by immunohistochemical and genetic methods. Specifically, this study aimed to reveal the expression of HIF-1α, MDM2, CDK4, p16, and gene amplification of MDM2 gene. Seven cases of ischemic fasciitis from among the soft-tissue tumors registered at our institution were retrieved. Histopathological findings were as follows: poorly demarcated nodular masses, a proliferation of spindle-shaped fibroblastic or myofibroblastic cells with oval nuclei and eosinophilic or pale cytoplasm, zonal fibrinous deposition, pseudocystic degeneration, granulation-like proliferation of capillary vessels, ganglion-like cells, myxoid or hyalinized stroma, and chronic inflammatory infiltration. Immunohistochemically, the spindle cells were positive for HIF-1α (7/7 cases), MDM2 (4/7 cases), CDK4 (4/7 cases), p16 (7/7 cases), p53 (2/7 case), cyclin D1 (7/7 cases), and alpha-smooth muscle actin (6/7 cases). Neither MDM2 gene amplification nor USP6 gene split signal was detected in any case. Overexpression of the above proteins may be associated with the pathogenic mechanism of ischemic fasciitis. It is noted that the immunohistochemical positivity of MDM2, CDK4, and p16 do not necessarily indicate malignant neoplasm such as dedifferentiated liposarcoma.
http://ift.tt/2q9GOFq
New Legislation to Expand Access to Audiology Services for Medicare Patients
Rep. Tom Rice (R-SC) has reintroduced the Audiology Patient Choice Act (H.R. 2276) to broaden Medicare patients' access to hearing care by removing existing barriers to audiology services (http://bit.ly/2qLRjej). This bipartisan bill, supported by Reps. Lynn Jenkins (R-KS) and Matt Cartwright (D-PA), will allow Medicare Part B patients with a suspected hearing or balance problem to go directly to an audiologist without having to wait for an order from a medical doctor. Patients will also be able to choose from qualified providers for Medicare-covered hearing care. In its testimony before the Committee on Energy and Commerce Subcommittee on Health, the Academy of Doctors of Audiology (ADA) said Medicare Part B patients are shuffled back and forth between providers in an inefficient process because audiologists are only recognized under Medicare Part B as diagnosticians, even though they are licensed to provide Medicare-covered rehabilitative services. "[This bill], if enacted, will alleviate many of these barriers within the Medicare system, and allow Medicare Part B beneficiaries to have the same access to audiology care as Medicare Advantage beneficiaries and most Americans do," the ADA said.
Published: 5/5/2017 1:54:00 PM
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Update on Adrenal Tumours in 2017 World Health Organization (WHO) of Endocrine Tumours
Abstract
The fourth edition of the World Health Organization (WHO) classification of endocrine tumours contains substantial new findings for the adrenal tumours. The tumours are presented in two chapters labelled as "Tumours of the adrenal cortex" and "Tumours of the adrenal medulla and extra-adrenal paraganglia." Tumours of the adrenal cortex are classified as cortical carcinoma, cortical adenoma, sex cord stromal tumours, adenomatoid tumour, mesenchymal and stromal tumours (myelolipoma and schwannoma), haematological tumours, and secondary tumours. Amongst them, schwannoma and haematological tumours are newly documented. The major updates in adrenal cortical lesions are noted in the genetics of the cortical carcinoma and cortical adenoma based on the data from The Cancer Genome Atlas (TCGA). Also, a system for differentiation of oncocytoma from oncocytic cortical carcinoma is adopted. Tumours of the adrenal medulla and extra-adrenal paraganglia comprise pheochromocytoma, paraganglioma (head and neck paraganglioma and sympathetic paraganglioma), neuroblastic tumours (neuroblastoma, nodular ganglioneuroblastoma, intermixed ganglioneuroblastoma, and ganglioneuroma), composite pheochromocytoma, and composite paraganglioma. In this group, neuroblastic tumours are newly included in the classification. The clinical features, histology, associated pathologies, genetics, and predictive factors of pheochromocytoma and paraganglioma are the main changes introduced in this chapter of WHO classification of endocrine tumours. The term "metastatic pheochromocytoma/paraganglioma" is used to replace "malignant pheochromocytoma/paraganglioma." Also, composite pheochromocytoma and composite paraganglioma are now documented in separate sections instead of one. Overall, the new classification incorporated new data on pathology, clinical behaviour, and genetics of the adrenal tumours that are important for current management of patients with these tumours.
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Activity and in vivo dynamics of Bacillus subtilis DisA are affected by RadA/Sms and by Holliday junction-processing proteins
Source:DNA Repair
Author(s): Carolina Gándara, Daniella K.C. de Lucena, Rubén Torres, Ester Serrano, Stephan Altenburger, Peter L. Graumann, Juan C. Alonso
Bacillus subtilis c-di-AMP synthase DisA and RecA-related RadA/Sms are involved in the repair of DNA damage in exponentially growing cells. We provide genetic, evidence that DisA or RadA/Sms is epistatic to the branch migration translocase (BMT) RecG and the Holliday junction (HJ) resolvase RecU in response to DNA damage Functional DisA-YFP formed dynamic foci in exponentially growing cells, which moved through the nucleoids at a speed compatible with a DNA-scanning mode. DisA formed more static structures in the absence of RecU or RecG than in wild type cells, while dynamic foci were still observed in cells lacking the BMT RuvAB. Purified DisA synthesizes c-di-AMP, but interaction with RadA/Sms or with HJ DNA decreases DisA-mediated c-di-AMP synthesis. RadA/Sms-YFP also formed dynamic foci in growing cells, but the foci moved throughout the cells rather than just on the nucleoids, and co-localized rarely with DisA-YFP foci, suggesting that RadA/Sms and DisA interact only transiently in unperturbed conditions. Our data suggest a model in which DisA moving along dsDNA indicates absence of DNA damage/replication stress via normal c-di-AMP levels, while interaction with HJ DNA/halted forks leads to reduced c-di-AMP levels and an ensuing block in cell proliferation. RadA/Sms may be involved in modulating DisA activities.
http://ift.tt/2pQ2tS6
Prosthetically guided bone sculpturing for a maxillary complete-arch implant-supported monolithic zirconia fixed prosthesis based on a digital smile design: A clinical report
Source:The Journal of Prosthetic Dentistry
Author(s): Fernando Rojas-Vizcaya
A digital smile design was used to create an average smile and to develop a removable interim restoration for an edentulous patient with a high smile line and different bone levels in the maxilla. The interim restoration was used as a guide to perform bone sculpturing to create space for the biological width and to restore a monolithic zirconia implant-supported fixed restoration.
http://ift.tt/2p6I4cD
Neurovascular-neuroenergetic coupling axis in the brain: master regulation by nitric oxide and consequences in aging and neurodegeneration
Publication date: July 2017
Source:Free Radical Biology and Medicine, Volume 108
Author(s): Cátia F. Lourenço, Ana Ledo, Rui M. Barbosa, João Laranjinha
The strict energetic demands of the brain require that nutrient supply and usage be fine-tuned in accordance with the specific temporal and spatial patterns of ever-changing levels of neuronal activity. This is achieved by adjusting local cerebral blood flow (CBF) as a function of activity level – neurovascular coupling – and by changing how energy substrates are metabolized and shuttled amongst astrocytes and neurons – neuroenergetic coupling. Both activity-dependent increase of CBF and O2 and glucose utilization by active neural cells are inextricably linked, establishing a functional metabolic axis in the brain, the neurovascular-neuroenergetic coupling axis. This axis incorporates and links previously independent processes that need to be coordinated in the normal brain. We here review evidence supporting the role of neuronal-derived nitric oxide (•NO) as the master regulator of this axis. Nitric oxide is produced in tight association with glutamatergic activation and, diffusing several cell diameters, may interact with different molecular targets within each cell type. Hemeproteins such as soluble guanylate cyclase, cytochrome c oxidase and hemoglobin, with which •NO reacts at relatively fast rates, are but a few of the key in determinants of the regulatory role of •NO in the neurovascular-neuroenergetic coupling axis. Accordingly, critical literature supporting this concept is discussed. Moreover, in view of the controversy regarding the regulation of catabolism of different neural cells, we further discuss key aspects of the pathways through which •NO specifically up-regulates glycolysis in astrocytes, supporting lactate shuttling to neurons for oxidative breakdown. From a biomedical viewpoint, derailment of neurovascular-neuroenergetic axis is precociously linked to aberrant brain aging, cognitive impairment and neurodegeneration. Thus, we summarize current knowledge of how both neurovascular and neuroenergetic coupling are compromised in aging, traumatic brain injury, epilepsy and age-associated neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease, suggesting that a shift in cellular redox balance may contribute to divert •NO bioactivity from regulation to dysfunction.
Graphical abstract
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Retrospective, cross-sectional study on immediately loaded implant-supported mandibular fixed complete-arch prostheses fabricated with the passive fit cementation technique
Source:The Journal of Prosthetic Dentistry
Author(s): Francine Baldin Able, Ivete Aparecida de Mattias Sartori, Geninho Thomé, Ana Cláudia Moreira Melo
Statement of problemMandibular fixed complete-arch dental prostheses on dental implants have been benefiting patients for a long time, but problems with passive fitting between the metallic framework of the prostheses and the implants might influence its long-term success.PurposeThe purpose of this cross-sectional study of immediately loaded mandibular fixed complete-arch dental prostheses was to evaluate the survival and success rates of prostheses, the survival rates of dental implants, the occurrence of complications in the prostheses and implants, participant satisfaction, and the association between cantilever length and prosthesis complications.Material and methodsData were collected from the participants' records. The exposure variables were participant related (sex and age) and treatment related (number of implants and length of cantilever). The outcome variables were the survival and success of the prostheses and implants, complications, and participant satisfaction. The Fisher or chi-square tests was used for the association between 2 qualitative variables (α=.05).ResultsTwo hundred ninety consecutive participants (1429 implants) with a mean follow-up time of 4.4 years were included. The survival rate for the prostheses was 98.6 and the success rate was 96.6%. The implant survival rate was 99.6%. Sixty-seven participants experienced a prosthetic complication, the most common being tooth fracture. Only 2.45% (n=35) of the implants were associated with screw loosening. Of the total number of participants, 86.9% were completely satisfied with their treatment. The length of the cantilever (up to 25 mm) was not associated with complications (P>.05).ConclusionsImplant-supported mandibular fixed complete-arch dental prostheses fabricated with a passive fit technique provide successful treatment for patients with edentulism. The success and survival rates of implants and prostheses were high. Only straightforward complications were observed. Cantilever length was not associated with complications.
http://ift.tt/2qNpTFd
Comments regarding: Solaberrieta E, Etxaniz O, Ramon Otegi J, Brizuela A, Pradies G. Customized procedure to display T-Scan occlusal contacts. J Prosthet Dent 2017;117:18-21
Source:The Journal of Prosthetic Dentistry
Author(s): Ben Sutter, Nick Yiannios, John Radke
http://ift.tt/2qNt9jO
A multicenter randomized, controlled clinical trial comparing the use of displacement cords, an aluminum chloride paste, and a combination of paste and cords for tissue displacement
Source:The Journal of Prosthetic Dentistry
Author(s): Erna R. Einarsdottir, Niklaus P. Lang, Thor Aspelund, Bjarni E. Pjetursson
Statement of problemGingival recession after soft tissue displacement for impression making in fixed prosthodontics may pose a problem for treatment success in the esthetic areas of the mouth. Knowledge about the soft tissue reaction of common gingival displacement methods is limited.PurposeThe purpose of this clinical randomized controlled trial (RCT) was to evaluate changes in the marginal soft tissue height with 3 different gingival tissue displacement techniques for definitive impression making of natural teeth.Material and methodsA total of 67 individuals were randomized to 3 groups. In test group 1 (P; n=22), only aluminum chloride paste was used to displace the gingiva. In test group 2 (CP; n=23), a cord was inserted, and aluminum chloride paste was also used. In the control group (C; n=22), 2 cords were used to displace the gingiva (double-cord technique). Clinical measurements of the gingival position were made before treatment began and at 30 ±10 days after prosthesis delivery. Study casts were fabricated at different stages of the treatment, standardized photographs were made, and changes in the buccal gingival position were measured using graphics editing software. In addition, the participants' perception of the clinical procedure and the technicians' evaluation of the die preparation were recorded. One-way ANOVA models were applied to compare the response variables among the groups: (a) the position of the gingival margin (millimeters), (b) mean probing pocket depth (millimeters), (c) gingival thickness (millimeters), (d) amount of keratinized tissue (millimeters), and (e) mean changes in gingival margin height (millimeters). Unpaired t tests were also used to compare the mean values between groups. For comparisons between different categories, chi-square tests were performed (α=.05 for all tests).ResultsIn the period between impression and delivery, a minor gain in gingival height of 0.058 mm (±0.13 SD) for P and 0.013 mm (±1.19 SD) for CP. However, a minor gingival recession of 0.049 mm (±0.13 SD) was reported for group C. The results for all groups showed that 21% of abutment teeth gained >0.1 mm in gingival height, 58% had stable gingival height (0 ±0.10 mm), 21% showed minor gingival recession (0.1 to 0.5 mm), and no abutment teeth showed moderate or severe gingival recession (>0.5 mm). The incidence of minor gingival recession was 8% in group P, 23% in group CP, and 32% in group C (P=.015). Fifteen participants (24%) experienced some discomfort after the procedure. The differences between the groups were not significant (P>.05). The laboratory technicians found the definitive die preparation significantly more challenging for group P (visual analog scale [VAS], 79) and CP (VAS, 82) than group C (mean VAS, 93; P=.003).ConclusionsMinor or moderate gingival recession (<1 mm) is more likely to occur when conventional cords are used during impression making. However, the laboratory technicians found the die preparation significantly less challenging when the double-cord technique was used than when impressions were made using the paste displacement technique.
http://ift.tt/2p6pVeR
An in vitro evaluation of the maxillary occlusal plane orientation obtained with an electronic application: A preliminary investigation
Source:The Journal of Prosthetic Dentistry
Author(s): Thomas C. Maveli, Montry Suprono, Mathew T. Kattadiyil, Khaled Bahjri
Statement of problemIn the evaluation and fabrication of dental prostheses, maxillary occlusal plane orientation in the sagittal and coronal planes may affect functional and esthetic outcomes. The accuracy of a recently developed electronic application in transferring this orientation to a semiadjustable articulator has not been evaluated.PurposeThe purpose of this in vitro study was to evaluate the coronal and sagittal orientation of the occlusal plane on maxillary casts mounted with an electronic application facebow system onto a corresponding semiadjustable arcon articulator.Material and methodsA maxillary typodont was placed into a phantom head (control) oriented with the Frankfort horizontal plane parallel to the horizon. A digital protractor was used to measure the angle between the occlusal plane of the maxillary arch of the phantom head and the Frankfort horizontal plane along the sagittal and coronal planes. The commercial system (test group) was used to make 15 facebow records of the maxillary typodont within the phantom head. The system records were used to mount diagnostic casts of the maxillary typodont onto a semiadjustable arcon articulator. The same measurements were made on the mounted diagnostic casts and were compared with the control. Statistical differences between the occlusal plane of the control and the occlusal plane of the mounted maxillary casts were determined using the 1-sample t test (α=.05).ResultsThe coronal orientation of the occlusal plane was significantly different (P<.001) between test group and control. No significant differences (P>.05) were found in the sagittal orientation of the occlusal plane.ConclusionsWithin the limitations of this study, variations in the coronal plane orientation were observed with the system. Variations in this plane may lead to adverse evaluation and clinical outcomes.
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Effect of coping thickness and background type on the masking ability of a zirconia ceramic
Source:The Journal of Prosthetic Dentistry
Author(s): Farhad Tabatabaian, Fateme Taghizade, Mahshid Namdari
Statement of problemThe masking ability of zirconia ceramics as copings is unclear.PurposeThe purpose of this in vitro study was to evaluate the effect of coping thickness and background type on the masking ability of a zirconia ceramic and to determine zirconia coping thickness cut offs for masking the backgrounds investigated.Material and methodsThirty zirconia disks in 3 thickness groups of 0.4, 0.6, and 0.8 mm were placed on 9 backgrounds to measure CIELab color attributes using a spectrophotometer. The backgrounds included A1, A2, and A3.5 shade composite resin, A3 shade zirconia, nickel-chromium alloy, nonprecious gold-colored alloy, amalgam, black, and white. ΔE values were measured to determine color differences between the specimens on the A2 shade composite resin background and the same specimens on the other backgrounds. The color change (ΔE) values were compared with threshold values for acceptability (ΔE=5.5) and perceptibility (ΔE=2.6). Repeated measures ANOVA, the Bonferroni test, and 1-sample t tests were used to analyze data (α=.05).ResultsMean ΔE values ranged between 1.44 and 7.88. The zirconia coping thickness, the background type, and their interaction affected the CIELab and ΔE values (P<.001).ConclusionsTo achieve ideal masking, the minimum thickness of a zirconia coping should be 0.4 mm for A1 and A3.5 shade composite resin, A3 shade zirconia, and nonprecious gold-colored alloy, 0.6 mm for amalgam, and 0.8 mm for nickel-chromium alloy.
http://ift.tt/2p6nxVf
Randomized clinical trial of 2 nonvital tooth bleaching techniques: A 1-year follow-up
Publication date: Available online 5 May 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Diogo Pedrollo Lise, Gustavo Siedschlag, Jussara Karina Bernardon, Luiz Narciso Baratieri
Statement of problemControlled clinical trials comparing the effectiveness of the walking bleaching (WB) technique and the inside-outside (I-O) technique used in a short daily regimen are lacking.PurposeThe purpose of this randomized clinical trial was to investigate the effectiveness of WB with that of the I-O technique conducted over 4 weeks and to compare color changes after 1 year.Material and methodsDiscolored and endodontically treated anterior teeth received a cervical seal and were randomly divided into groups according to the technique. In the WB group (n=9), a mixture of sodium perborate and 20% hydrogen peroxide was applied in the pulp chambers and replaced weekly up to 4 weeks. For the I-O group (n=8), participants applied 10% carbamide peroxide in the pulp chambers and wore custom-fitted trays for 1 hour per day over 4 weeks. CIELab parameters were obtained using a spectrophotometer at baseline, during bleaching (1, 2, 3, and 4 weeks) and after 1 year. Changes in color (ΔE), lightness (ΔL*), green-red axis (Δa*), blue-yellow axis (Δb*), and absolute color parameters (L*, b*, and a*) for each evaluation time were calculated and analyzed by repeated measures analysis of variance (ANOVA) and post hoc Bonferroni test (α=.05).ResultsNo significant differences between WB and I-O techniques were observed for ΔE, ΔL*, Δa*, Δb*, L*, a*, or b* values (P>.05); however, significant differences were observed among the evaluation times (P<.05). Color changes observed after 2 weeks were stable after 1 year; ΔL* and Δa* values after 1 year were not significantly different from the 1-week evaluation, and significant changes in Δb* after 3 weeks were maintained at the 1-year follow-up. The same trend was observed for the absolute CIELab color parameters.ConclusionsBoth WB and I-O regimens were similarly effective as shown by significant ΔE after 2 weeks and no color regression after 1 year.
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Comparative evaluation of 3 microbond strength tests using 4 adhesive systems: Mechanical, finite element, and failure analysis
Source:The Journal of Prosthetic Dentistry
Author(s): Roberto E. Campos, Paulo César F. Santos Filho, Osmir Batista de O. Júnior, Gláucia M.B. Ambrosano, Cristina Alves Pereira
Statement of problemBond strength (BS) values from in vitro studies are useful when dentists are selecting an adhesive system, but there is no ideal measuring method.PurposeThe purpose of this in vitro study was to investigate the influence of the evaluation method in the BS between dentin and composite resin.Material and methodsMolars with exposed superficial dentin (N=240) were divided into 3 groups according to the test: microtensile (μTBS), microshear (μSBS), and micropush-out (μPBS). Each one was subdivided into 4 groups according to the adhesive system: total etch, 3- and 2-step; and self-etch, 2- and 1-step). For the μPBS test, a conical cavity was prepared and restored with composite resin. An occlusal slice (1.5 mm in thickness) was obtained from each tooth. For the μSBS test, a composite resin cylinder (1 mm in diameter) was built on the dentin surface of each tooth. For the μTBS test, a 2-increment composite resin cylinder was built on the dentin surface, and beams with a sectional area of 0.5 mm2 were obtained. Each subgroup was divided into 2 (n=10) as the specimens were tested after 7 days and 1 year of water storage. The specimens were submitted to load, and the failure recorded in units of megapascals. Original BS values from the μTBS and μSBS tests were normalized for the area from μPBS specimens. Original and normalized results were submitted to a 3-way ANOVA (α=.05). The correlation among mechanical results, stress distribution, and failure pattern was investigated.ResultsSignificant differences (P<.05) were found among the adhesive systems and methods within both the original and normalized data but not between the storage times (P>.05). Within the 7 days of storage, the original BS values from μTBS were significantly higher (P<.001) than those from μPBS and μSBS. After 1 year, μSBS presented significantly lower results (P<.001). However, after the normalization for area, the BS values of the μTBS and μPBS tests were similar, and both were higher (P<.001) than that of μSBS in both storage times. In the μSBS and μTBS specimens, cohesive and adhesive failures were observed, whereas μPBS presented 100% of adhesive failures. The failure modes were compatible with the stress distribution.ConclusionsThe storage time did not affect the results, but differences were found among the adhesives and methods. For comparisons of bond strength from tests with different bonding areas, the normalization for area seemed essential. The microshear bond test should not be used for bond strength evaluation, and the microtensile test needs improvement to enable reliable results regarding stress concentration and failure mode. The micropush-out test may be considered more reliable than the microtensile in the bond strength investigation, as demonstrated by the uniform stress concentration and adhesive failure pattern.
http://ift.tt/2p6n3i8
Comparison of 3D displacements of screw-retained zirconia implant crowns into implants with different internal connections with respect to screw tightening
Source:The Journal of Prosthetic Dentistry
Author(s): Hanadi A. Rebeeah, Burak Yilmaz, Jeremy D. Seidt, Edwin McGlumphy, Nancy Clelland, William Brantley
Statement of problemInternal conical implant-abutment connections without horizontal platforms may lead to crown displacement during screw tightening and torque application. This displacement may affect the proximal contacts and occlusion of the definitive prosthesis.PurposeThe purpose of this in vitro study was to evaluate the displacement of custom screw-retained zirconia single crowns into a recently introduced internal conical seal implant-abutment connection in 3D during hand and torque driver screw tightening.Material and methodsStereolithic acrylic resin models were printed using computed tomography data from a patient missing the maxillary right central incisor. Two different internal connection implant systems (both ∼11.5 mm) were placed in the edentulous site in each model using a surgical guide. Five screw-retained single zirconia computer-aided design and computer-aided manufacturing (CAD-CAM) crowns were fabricated for each system. A pair of high-resolution digital cameras was used to record the relationship of the crown to the model. The crowns were tightened according to the manufacturers' specifications using a torque driver, and the cameras recorded their relative position again. Three-dimensional image correlation was used to measure and compare crown positions, first hand tightened and then torque driven. The displacement test was repeated 3 times for each crown. Commercial image correlation software was used to extract the data and compare the amount of displacement vertically, mesiodistally, and buccolingually. Repeated-measures ANOVA calculated the relative displacements for all 5 specimens for each implant for both crown screw hand tightening and after applied torque. A Student t test with Bonferroni correction was used for pairwise comparison of interest to determine statistical differences between the 2 implants (α=.05).ResultsThe mean vertical displacements were statistically higher than the mean displacements in the mesiodistal and buccolingual directions for both implants (P<.001). Mean displacements in all directions were statistically significant between iterations for both implants (P<.001). No statistically significant differences were found for displacements between implants at different directions and at different iterations (P>.05).ConclusionsWithin the limitations of this in vitro study, screw-retained zirconia crowns tended to displace in all 3 directions, with the highest mean displacement in the vertical direction at iteration 1. However, the amount of displacement of crowns between the 2 different implants was statistically insignificant for all directions and iterations.
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A rare mutation in the F12 gene in a patient with ACE inhibitor-induced angioedema
Source:Annals of Allergy, Asthma & Immunology
Author(s): Camila Lopes Veronez, Faradiba Sarquis Serpa, João Bosco Pesquero
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Inadequacy of current pediatric epinephrine autoinjector needle length for use in infants and toddlers
Source:Annals of Allergy, Asthma & Immunology
Author(s): Harold Kim, Chitra Dinakar, Paul McInnis, Dan Rudin, Xavier Benain, William Daley, Elke Platz
BackgroundEpinephrine injection represents the standard of care for anaphylaxis treatment. It is most effective if delivered intramuscularly, whereas inadvertent intraosseous injection may be harmful. The needle length in current pediatric epinephrine autoinjectors (EAIs) is 12.7 mm; however, the ideal needle length for infants and toddlers weighing less than 15 kg is unknown.ObjectiveTo determine the skin-to-bone distance (STBD) and skin-to-muscle distance (STMD) at baseline and after simulated EAI application in infants and toddlers (weighing 7.5–15 kg).MethodsStudy participants recruited from 2 North American allergy clinics underwent baseline and compression (10-lb pressure) ultrasonography of the anterolateral thigh with a modified ultrasound transducer mimicking the footprint and maximum pressure application of an EAI device. Ultrasound images, with clinical data masked, were analyzed offline for STBD and STMD in short-axis approach.ResultsOf 53 infants (mean age, 18.9 months; 54.7% male; 81.1% white; mean weight, 11.0 kg), 51 had adequate images for short-axis STBD measurements. In these infants, the mean (SD) baseline STBD was 22.4 (3.8 mm), and the mean (SD) STMD was 7.9 (1.7) mm. With 10-lb compression, the mean (SD) STBD was 13.3 (2.1) mm, and the mean (SD) STMD was 6.3 (1.2) mm. An EAI with a needle length of 12.7 mm applying 10-lb pressure could strike the bone in 43.1% of infants and toddlers in this cohort.ConclusionOur data suggest that the optimal EAI needle length for infants and toddlers weighing 7.5 to 15 kg should be shorter than the needle length in currently available pediatric EAIs to avoid accidental intraosseous injections.
http://ift.tt/2pLAVgB
Ustekinumab for Behçet's disease
Source:Journal of Autoimmunity
Author(s): Adrien Mirouse, Stéphane Barete, Jean-Benoît Monfort, Matthieu Resche-Rigon, Anne-Sophie Bouyer, Cloé Comarmond, Damien Sène, Fanny Domont, Yasmina Ferfar, Patrice Cacoub, David Saadoun
ObjectiveTo evaluate the efficacy and safety of ustekinumab in the treatment of oral ulcers (OU) in patients with Behçet's disease (BD).Patients and methodsProspective study including 14 patients [median age of 39 (34; 41) years, with 71% of men] fulfilling criteria of the International Study Group for BD and with active OU resistant to colchicine. Patients received ustekinumab 90 mg (n = 11) or 45 mg (n = 3) subcutaneously at inclusion, at week 4, and every 12 weeks. The primary efficacy endpoint was the proportion of patients with complete response (CR), defined as no oral ulcer, at week 12.ResultsAt week 12, 64% were in CR, 21% in partial response and 14% non-responders. The median number of OU decreased from 2 [2; 4] to 1 [0; 1.25] (p = 0.0005) at week 12. Mean change from baseline to week 12 of Behçet's syndrome activity score (BSAS) was 22.8 ± 0.3 (p = 0.01). The median daily corticosteroids dose decreased from 12.5 (10; 16.3) to 5 [5; 10] mg/day (p = 0.02). Three patients reported headaches, leading to discontinuation of ustekinumab in one case. After a median follow-up of 7 [3; 12] months, 10 (71%) patients were still receiving ustekinumab and four (28%) experienced a relapse. Decreased levels of circulating IL-17 and IL-12 [median [IQR]; 3.9 [1.6; 10.6] vs. 29.2 [25.2; 42.7] pg/ml, and 29.4 [23.1; 33.3] vs. 56.1 [51.1; 64.4] pg/ml, p = 0.008 for both] were observed under ustekinumab, respectively.ConclusionUstekinumab seems to be efficient and safe for patient with BD and refractory OU although relapses are frequent.
http://ift.tt/2pjTdCM
Most Alternative Isoforms Are Not Functionally Important
Publication date: Available online 5 May 2017
Source:Trends in Biochemical Sciences
Author(s): Michael L. Tress, Federico Abascal, Alfonso Valencia
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Mechanisms Regulating PRC2 Recruitment and Enzymatic Activity
Publication date: Available online 5 May 2017
Source:Trends in Biochemical Sciences
Author(s): Daniel Holoch, Raphaël Margueron
Polycomb repressive complex 2 (PRC2) and its histone H3 lysine-27 methylation activity are crucial for multicellular development by virtue of their role in maintaining transcriptional repression patterns. The recruitment and enzymatic activity of PRC2 are controlled by a series of intricate mechanisms whose molecular details have been emerging at a rapid pace. Recent studies have uncovered intriguing modes of PRC2 regulation by facultative PRC2 subunits, PRC1, and specific features of the chromatin environment. Together, these findings have produced a rich and fast-evolving picture of the biochemical signals that govern PRC2 function, with many exciting questions still remaining.
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The Relationship between Alternative Splicing and Proteomic Complexity
Publication date: Available online 5 May 2017
Source:Trends in Biochemical Sciences
Author(s): Benjamin J. Blencowe
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Chemotherapy may eradicate ductal carcinoma in situ (DCIS) but not the associated microcalcifications
Publication date: Available online 4 May 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Hadassah Goldberg, Judith Zandbank, Varda Kent, Mia Leonov-Polak, Alejandro Livoff, Anna Chernihovsky, Michal Guindy, Ella Evron
IntroductionWe studied the effect of neoadjuvant chemotherapy (NAC)±trastuzumab on the ductal carcinoma in situ (DCIS) component in patients with locally advanced breast cancer who achieved pathological complete response (pCR).MethodsThe diagnostic biopsies of 92 consecutive breast cancer patients that were treated with neoadjuvant chemotherapy (NAC)±trastuzumab were evaluated for the presence of DCIS. Upon completion of NAC, the surgical specimens were evaluated for complete eradication of both the invasive and noninvasive cancer in the breast.The pretreatment mammograms were evaluated for the presence of microcalcifications and compared to the mammograms that were obtained upon completion of therapy prior to surgery.ResultsThirty of 92 patients (33%) had a substantial component of DCIS in the pretreatment biopsy. Thirty nine patients (42%) achieved pCR: 22 (56%) following NAC+trastuzumab, 17 (32%) following chemotherapy only. Ten of 30 patients (33%) with DCIS component achieved pCR: 4 received chemotherapy only, in 6 trastuzumab was added. Multiple microcalcifications on the pretreatment mammograms were observed in 3 of 10 patients with DCIS who achieved pCR. No reduction in the area of calcifications was observed following NAC.ConclusionsDCIS may be completely eradicated by NAC±trastuzumab. However, associated microcalcificatios probably persist. Patients with locally advanced breast cancer with substantial DCIS may still opt for NAC and breast conservation as the DCIS component may respond and even completely disappear following NAC. Residual widespread microcalcificatios after NAC do not necessarily indicate residual cancer. Larger studies are needed to direct the surgical management of these patients.
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Results after Surgical Treatment of Liver Metastases in Patients with High-Grade Gastroenteropancreatic Neuroendocrine Carcinomas
Publication date: Available online 4 May 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Renate B. Galleberg, Ulrich Knigge, Eva Tiensuu Janson, Lene Weber Vestermark, Sven-Petter Haugvik, Morten Ladekarl, Seppo W. Langer, Henning Grønbæk, Pia Österlund, Geir Olav Hjortland, Jörg Assmus, Laura Tang, Aurel Perren, Halfdan Sorbye
BackgroundGastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC.Methods32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 >20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups.ResultsMedian OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6–51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after five years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67≥55%. A Ki-67<55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA.ConclusionThis study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.
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Performance of novel high throughput multi electrospray systems for forming of polymeric micro/nanoparticles
Publication date: 15 July 2017
Source:Materials & Design, Volume 126
Author(s): M. Parhizkar, P.J.T. Reardon, J.C. Knowles, R.J. Browning, E. Stride, R.B. Pedley, T. Grego, M. Edirisinghe
In order to maintain a stable cone-jet mode in electrospray low flow rates are used while most applications require a high throughput. We compare two different designs of the multiple electrospray system in order to increase the output for large scale production applications. In this study, the solution was fed through four separate needles that were attached to either a circular or a rectangular metallic plate that were connected to a high voltage DC power supply. The behaviour of the electrospray jets as well as the deposition of particles were investigated. It was shown that the throughput of particles was increased while particles with narrow size distribution were produced from all four uniform electrospray jets.
Graphical abstract
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Discrete topology optimization of ply orientation for a carbon fiber reinforced plastic (CFRP) laminate vehicle door
Publication date: 15 August 2017
Source:Materials & Design, Volume 128
Author(s): Chi Wu, Yunkai Gao, Jianguang Fang, Erik Lund, Qing Li
This study addresses the design of ply orientation for a CFRP vehicle door by implementing a Discrete Material Optimization (DMO) method in a general-purpose commercial finite element code (ABAQUS) and mathematical analysis tool (MATLAB). To accommodate multiple loading conditions, the weighted mean compliance of the CFRP vehicle door was taken as the objective function, subject to the constraints on the local displacements, primary natural frequency and manufacturability. The sensitivities of objective and constraints were calculated by using the strain vectors, which is a more general method than using element stiffness matrices and allows extracting local displacements from the commercial finite element code. A gradient-based algorithm was employed in the DMO approach to tackle the large-scale problem. In the discrete topology optimization, four material penalization schemes were attempted in this study. The proposed DMO approach was compared with the empirical design and the existing method in commercial software. The results demonstrated that the proposed method is able to produce a more competent solution than the empirical design and other optimization methods efficiently.
Graphical abstract
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High-temperature oxidation behavior of plasma-sprayed ZrO2 modified La-Mo-Si composite coatings
Publication date: 15 August 2017
Source:Materials & Design, Volume 128
Author(s): Changcong Wang, Kezhi Li, Xiaohong Shi, Qinchuan He, Caixia Huo
Plasma-sprayed ZrO2-modified LaB6-MoSi2 coating (ZLM) was firstly fabricated on SiC pre-coated carbon/carbon (C/C) composites to obtain an improved oxidation resistance at 1773K involving long-term oxidation and short-term cyclic oxidation in an atmospheric environment. A crack-free structure in ZLM coating has been established with interlocking adhesion between the layers of coating. It is shown that the specimen with ZLM coating exhibits superior oxidation with the mass loss of 0.96% after 140h at 1773K and spallation resistance with the mass loss of 0.61% after 30 thermal cycles between 1773K and room temperature. These beneficial effects can be attributed to superior integrated structure of the ZLM coating provided by the continuous Zr-La-Si-O protective scale gave rise to the suppression of oxygen diffusion in ZLM coating. Moreover, the formation of "inlaid phases" in the compound glass layer is helpful to consume the crack propagation energy and restrict the spreading of it. Dual protection of the "inlaid structure" and Zr-La-Si-O compound glass film is responsible for the excellent oxidation resistance of the ZLM coating.
Graphical abstract
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Influences of Mo/Zr minor-alloying on the phase precipitation behavior in modified 310S austenitic stainless steels at high temperatures
Publication date: 15 August 2017
Source:Materials & Design, Volume 128
Author(s): Donghui Wen, Beibei Jiang, Qing Wang, Fengyun Yu, Xiaona Li, Rui Tang, Ruiqian Zhang, Guoqing Chen, Chuang Dong
High-Cr/Ni austenitic stainless steels (ASSs) have attracted more attention as fuel cladding materials of super-critical water reactors due to their excellent comprehensive properties. In order to further improve their microstructural stability at high temperatures, the present work investigated systematically the influences of Mo/Zr contents and Zr/C ratios on the phase precipitation behaviors and mechanical properties of modified 310S ASSs. The designed alloy ingots were hot-rolled, solid-solutioned at 1423K for 0.5h, stabilized at 1173K for 0.5h, and then aged at 973K for different hours. The microstructure and precipitated phases at different heat-treatment states were characterized with OM, SEM, EPMA and TEM, respectively. All the results indicated that the excess addition of Mo and Zr and the inappropriate Zr/C ratios would promote the formation of Cr23C6, G-Ni16Si7Zr6 and (Ni,Fe)23Zr6 phases, resulting in the σ phase precipitation at the early stabilization stage. Furthermore, the formation mechanism of σ phase was discussed. The effects of the precipitated phases on the mechanical properties of alloys were then studied. It was found that the Fe-22Ni-25Cr-0.046C-0.37Mo-0.35Zr (wt%) alloy with appropriate Mo content and Zr/C ratio of 1/1 exhibits the best microstructural stability and good tensile mechanical property, in which only a few σ particles are precipitated from the matrix even after aging at 973K for 408h.
Graphical abstract
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Excitation of thermal dissipation of solid propellants during the fatigue process
Publication date: 15 August 2017
Source:Materials & Design, Volume 128
Author(s): Xin Tong, Xiong Chen, Jinsheng Xu, Chaoxiang Sun, Wei Liang
By using the infrared thermographic method, a non-destructive testing technique was applied to detect the surface-temperature evolution of solid propellants during strain-control fatigue tests within finite cycles. When the applied strains were below the viscoelastic limit, two stages of temperature variation were observed before the initiation of macroscopic cracks: an initial temperature-increase stage, and a steady temperature state. Thermodynamic analysis was carried out and a method was developed to allow the acquisition of stored energy at different stages of cyclic loading, which can reflect the material damage on the macroscopic scale. In addition, temperature localization during fatigue was observed, which implied the occurrence of damage accumulation and crack propagation. The results reveal that the cyclic-loading induced temperature increase of solid propellants during the fatigue process has a significant effect on solid rocket motors in a transportation or storage state.
Graphical abstract
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Structure and properties of carbon intercalated halloysite and its organosilicone hybrid film with low dielectric constant
Publication date: 15 August 2017
Source:Materials & Design, Volume 128
Author(s): Jinpeng Mo, Wenshi Ma, Wencheng Zhang, Jinfang Yuan
Due to its hollow structure, halloysite has been considered for owning the potential of application in preparing low dielectric constant material. However its polarity has suppressed such potential and raised the dielectric constant of its polymeric composite. In this study, the non-polar carbon intercalated halloysite (C-HNT) was successfully prepared via in-situ polymerization and thermal treatments. Characterizations of the carbon intercalated halloysite confirmed that acrylonitrile and acrylamide as monomers had been intercalated and co-polymerized between the halloysite layers. The copolymer carbonized at 600°C under nitrogen atmosphere with the lumen of halloysite being preserved and water being eliminated. A series of carbon intercalated halloysites/organosilicone hybrid films were prepared via sol-gel process, and their hydrophobicity, thermal property, mechanical property and dielectric property were characterized. The results showed that the present of carbon intercalated halloysite strengthened the hydrophobicity, thermal property, mechanical property of the hybrid film. The lowest dielectric constant of the hybrid film samples was 2.46 at 1MHz. It reveals that the intercalated process suppresses the polarity of halloysite and revives halloysite's great potential for being used as low dielectric constant material.
Graphical abstract
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Facile construction of robust fluorine-free superhydrophobic TiO2@fabrics with excellent anti-fouling, water-oil separation and UV-protective properties
Publication date: 15 August 2017
Source:Materials & Design, Volume 128
Author(s): Shouwei Gao, Jianying Huang, Shuhui Li, Hui Liu, Feiyang Li, Yuwei Li, Guoqiang Chen, Yuekun Lai
The superhydrophobic TiO2 coating was fabricated on cotton fabric through a facile one step hot-pressing process after being dipped in n-octyltriethoxysilane and Ti-containing precursor mixed solution. The as-prepared fabric exhibited robust superhydrophobic with a water contact angle higher than 150° and realized an optimized UV protective factor of 45. The as-constructed superhydrophobic fabric was able to withstand more than 800cycles of abrasion. Moreover, there was not apparent decrease of superhydrophobicity after 10cycles of accelerated machine wash and the as-constructed fabric also showed a strong ability to resist acidic and alkaline solutions. Finally, the potential applications of such value-added fabrics self-cleaning, anti-fouling, and water-oil separation were investigated as well. The results demonstrated that the combination of n-octyltriethoxysilane and Ti-containing precursor coating endowed the pristine fabrics with excellent self-cleaning for dusts and anti-fouling for methylene blue dye, as well as excellent separation efficiency for the oil-water mixtures. This facile synthesis stragegy can also be extended to quickly construct multifunctional fabrics with speical wettability in a large scale and utilized in some promising fields.
Graphical abstract
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Damage-tolerant metallic composites via melt infiltration of additively manufactured preforms
Publication date: 5 August 2017
Source:Materials & Design, Volume 127
Author(s): Alexander E. Pawlowski, Zachary C. Cordero, Matthew R. French, Thomas R. Muth, J. Keith Carver, Ralph B. Dinwiddie, Amelia M. Elliott, Amit Shyam, Derek A. Splitter
AbstractA356/316L interpenetrating phase composites were fabricated by infiltrating additively manufactured 316L lattices with molten A356. Measurements of the thermal conductivity of the composites showed an inverse rule-of-mixtures dependence on the 316L volume fraction. Compression tests revealed that the stress-strain response of the composites can be tailored by adjusting both the volume fraction and the topology of the 316L reinforcement. Tension tests on composites with 39vol% 316L showed a strain to failure of 32%, representing an order of magnitude improvement over the strain to failure of monolithic A356. Inspection of the as-tested tensile specimens suggested that this exceptional damage tolerance is a result of the interpenetrating structure of the constituents. These results together demonstrate that this infiltration processing route avoids problems with intermetallic formation, cracking, and poor resolution that limit current fusion-based additive manufacturing techniques for printing metallic composites.
Graphical abstract
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Successful Arthroplasty Using Cadaveric Meniscus for Osteochondral Defects in the Wrist and Hand Joints
Background: Osteochondral defects of the radiocarpal, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints often necessitate joint arthrodesis or mechanical arthroplasty, which has a limited lifespan. In severely arthritic wrist and finger joints, we propose a novel adjunct for joint salvage using cadaveric meniscus for joint resurfacing as an off-the-shelf alternative to address osteochondral defects and restore normal intraarticular contact stress. Methods: A total of 14 patients with osteochondral defects in 5 radiocapitate, 5 MCP, 3 PIP, and 1 carpometacarpal joints received cadaveric meniscus to facilitate arthroplasty. Patient demographic, perioperative pain, range of motion, and complications were examined. Results: Patients aged 17 to 73 years old (average, 54.6 years old) underwent joint reconstruction for scaphoid nonunion (n = 1), scaphoid-lunate advanced collapse (n = 4), or osteoarthritis of MCP/carpometacarpal (n = 6) or PIP (n = 3) joints. Successful arthroplasty with joint space preservation occurred in all joints. Patients had a significant reduction in average pain scale score (Phttp://ift.tt/2o2y40b
Contextual determinants of participation in cervical cancer screening in France, 2010
Source:Cancer Epidemiology, Volume 48
Author(s): Mélanie Araujo, Jeanna-Eve Franck, Emmanuelle Cadot, Arnaud Gautier, Pierre Chauvin, Laurent Rigal, Virginie Ringa, Gwenn Menvielle
BackgroundSome contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France.MethodsMarginal Poisson regression models – taking into account the correlation between women in a given commune – were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level.ResultsThe analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5–11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2–12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high.DiscussionWe observed an association between potential spatial accessibility to care in women's residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes.
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Site-specific conjugation of fibroblast growth factor 2 (FGF2) based on incorporation of alkyne-reactive unnatural amino acid
Publication date: Available online 5 May 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): K.W. Swiderska, A. Szlachcic, A. Czyrek, M. Zakrzewska, J. Otlewski
Recent advances in site-specific protein modification include the increasingly popular incorporation of unnatural amino acid(s) using amber codon, a method developed by Schultz and coworkers. In this study, we employ this technique to introduce propargyllysine (PrK) in human fibroblast growth factor 2 (FGF2). Owing to an alkyne moiety in its side chain, PrK is compatible with Cu(I)-catalyzed azide-alkyne 1,3-dipolar cycloaddition (CuAAC). We successfully tested CuAAC-mediated conjugation of FGF2 with two compounds – a fluorophore carboxyrhodamine 110 or a cytotoxic drug monomethyl auristatin E (MMAE). In the case of the MMAE conjugate we improved the initial poor conjugation yield to achieve nearly 100% efficiency after extensive optimization. The detergent-based optimization approach may help overcome problems with the CuAAC reaction yield for protein modification with hydrophobic compounds, such as MMAE.
Graphical abstract
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Potential inhibitors of human carbonic anhydrase isozymes I and II: Design, synthesis and docking studies of new 1,3,4-thiadiazole derivatives
Publication date: Available online 5 May 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Mehlika Dilek Altıntop, Belgin Sever, Ahmet Özdemir, Kaan Kucukoglu, Hicran Onem, Hayrunnisa Nadaroglu, Zafer Asım Kaplancıklı
In the last years, inhibition of carbonic anhydrase (CA) has emerged as a promising approach for pharmacologic intervention in a variety of disorders such as glaucoma, epilepsy, obesity, and cancer. As a consequence, the design of CA inhibitors (CAIs) is a highly dynamic field of medicinal chemistry. Due to the therapeutic potential of thiadiazoles as CAIs, new 1,3,4-thiadiazole derivatives were synthesized and investigated for their inhibitory effects on hCA I and hCA II. Although the tested compounds did not carry a sulfonamide group, an important pharmacophore for CA inhibitory activity, it was a remarkable finding that most of them were more effective on hCAs than acetazolamide (AAZ), the reference agent. Among these compounds, N'-((5-(4-chlorophenyl)furan-2-yl)methylene)-2-((5-(phenylamino)-1,3,4-thiadiazol-2-yl)thio)acetohydrazide (3) was found to be the most effective compound on hCA I with an IC50 value of 0.14 nM, whereas N'-((5-(2-chlorophenyl)furan-2-yl)methylene)-2-((5-(phenylamino)-1,3,4-thiadiazol-2-yl)thio)acetohydrazide (1) was found to be the most potent compound on hCA II with an IC50 value of 0.15 nM. According to molecular docking studies, all compounds exhibited high affinity and good amino acid interactions similar to AAZ on the both active sites of hCA I and hCA II enzymes.
Graphical abstract
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Revisiting ligation at selenomethionine: insights into native chemical ligation at selenocysteine and homoselenocysteine
Publication date: Available online 5 May 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Rebecca Notis Dardashti, Norman Metanis
Selenomethionine (Sem) has been incorporated recombinantly into proteins many times to elucidate their structure and function. In this paper, we revisit incorporation via chemical protein synthesis to shed light on the mechanism of native chemical ligation. The effect of chalcogen position on ligation is investigated, and selenium-containing peptide ligation is optimized. Additionally, selective methylation is performed on selenolates in a peptide in the presence of unprotected thiols.
Graphical abstract
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Discovery and structure-guided fragment-linking of 4-(2,3-dichlorobenzoyl)-1-methyl- pyrrole-2-carboxamide as a pyruvate kinase M2 activator
Publication date: Available online 5 May 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Yumi Matsui, Isao Yasumatsu, Takashi Asahi, Takahiro Kitamura, Kazuo Kanai, Osamu Ubukata, Hitoshi Hayasaka, Sachiko Takaishi, Hiroyuki Hanzawa, Shinichi Katakura
Tumor cells switch glucose metabolism to aerobic glycolysis by expressing the pyruvate kinase M2 isoform (PKM2) in a low active form, providing glycolytic intermediates as building blocks for biosynthetic processes, and thereby supporting cell proliferation. Activation of PKM2 should invert aerobic glycolysis to an oxidative metabolism and prevent cancer growth. Thus, PKM2 has gained attention as a promising cancer therapy target. To obtain novel PKM2 activators, we conducted a high-throughput screening (HTS). Among several hit compounds, a fragment-like hit compound with low potency but high ligand efficiency was identified. Two molecules of the hit compound bound at one activator binding site, and the molecules were linked based on the crystal structure. Since this linkage succeeded in maintaining the original position of the hit compound, the obtained compound exhibited highly improved potency in an in vitro assay. The linked compound also showed PKM2 activating activity in a cell based assay, and cellular growth inhibition of the A549 cancer cell line. Discovery of this novel scaffold and binding mode of the linked compound provides a valuable platform for the structure-guided design of PKM2 activators.
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Nocturnal sleep architecture is altered by sleep bruxism
Source:Archives of Oral Biology, Volume 81
Author(s): Marcelo Palinkas, Marisa Semprini, João Espir Filho, Graziela de Luca Canto, Isabela Hallak Regalo, César Bataglion, Laíse Angélica Mendes Rodrigues, Selma Siéssere, Simone Cecilio Hallak Regalo
ObjectiveSleep is a complex behaviour phenomenon essential for physical and mental health and for the body to restore itself. It can be affected by structural alterations caused by sleep bruxism. The aim of this study was to verify the effects of sleep bruxism on the sleep architecture parameters proposed by the American Academy of Sleep Medicine.DesignThe sample comprised 90 individuals, between the ages of 18 and 45 years, divided into two groups: with sleep bruxism (n=45) and without sleep bruxism (n=45). The individuals were paired by age, gender and body mass index: a polysomnography was performed at night.ResultsStatistically significant differences were found between (P≤0.05) individuals with sleep bruxism and individuals without sleep bruxism during total sleep time (P=0.00), non-rapid eye movement (NREM) total sleep time (P=0.03), NREM sleep time stage 3 (P=0.03), NREM sleep latency (P=0.05), sleep efficiency (P=0.05), and index of microarousals (P=0.04).ConclusionsSleep bruxism impairs the architecture of nocturnal sleep, interfering with total sleep time, NREM sleep latency, and sleep efficiency.
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Is caffeic acid phenethyl ester more protective than doxycycline in experimental periodontitis?
Source:Archives of Oral Biology, Volume 81
Author(s): Umut Yiğit, Fatma Yeşim Kırzıoğlu, Abdülhadi Cihangir Uğuz, Mustafa Nazıroğlu, Özlem Özmen
Background and objectivesHost modulation therapies (anti-inflammatory drugs, bone-stimulating agents, anti-proteinase etc.) target the inhibition or stabilization of tissue breakdown. The aim of the present study was to evaluate the effects of caffeic acid phenethyl ester (CAPE) and/or low dose doxycycline (LDD) administrations on alveolar bone loss (ABL), serum cytokines and gingival apoptosis, as well as the levels of oxidants and anti-oxidants in rats with ligature-induced periodontitis.Material and methodsThe animals were randomly divided into five groups: Group C (periodontally healthy), Group PC (Periodontitis+CAPE), Group PD (Periodontitis+LDD), Group PCD (Periodontitis+CAPE+LDD), Group P (Periodontitis). Experimental periodontitis was induced for 14days. Levels of ABL, and the serum cytokines, interleukin (IL)-1 β, IL-6, tumor necrosis factor-α (TNF-α) and IL-10 were assessed as were the levels of the oxidants and anti-oxidants, malondialdehyde (MDA), glutathione (GSH) and glutathione peroxidase (GSH-Px), and levels of gingival apoptosis.ResultsThe lowest ABL levels was evident in the PC group, among the experimental groups. There was also less inflammatory infiltration in the PC group than the PD group. IL-1β, IL-6, and IL-10 were lower in the PC group and higher in the P group in comparison to the levels in the other experiment groups. TNF-α levels in the PD group were higher than levels in the PC and PCD groups. The PC and PCD groups did not differ from the C group in regard to MDA levels. The highest GSH-Px level was found in the PC group. Gingival apoptosis in the PC group was not only lower than the PD and PCD groups, but also lower than in the C group.ConclusionThe present study suggests that CAPE has more anti-inflammatory, anti-oxidant and anti-apoptotic effects than LDD, with no additive benefits of a CAPE+LDD combination being evident in rats with periodontitis.
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Influence of masticatory function, dental caries and socioeconomic status on the body mass index of preschool children
Source:Archives of Oral Biology, Volume 81
Author(s): Maria Eliza Soares, Maria Letícia Ramos-Jorge, Bruna Mota de Alencar, Simone Gomes Oliveira, Luciano José Pereira, Joana Ramos-Jorge
ObjectiveThe objective of this study was to determine the influence of masticatory function, dental caries and socioeconomic status on the body mass index (BMI) of preschool children.MethodsA cross-sectional study was conducted with a sample of 285 children aged three to five years allocated to three groups based on the BMI: underweight, ideal weight and overweight/obesity. Socioeconomic status was determined based on the responses of parents/caregivers to a specific form. Cavitated lesions were diagnosed using the criteria of the International Caries Detection and Assessment System. Masticatory function was assessed based on masticatory performance (MP) and the swallowing threshold (ST), which were evaluated based on the results of a test food. Data analysis involved the employment of the Kruskal-Wallis, Mann-Whitney and chi-square tests as well as simple and multiple linear regression analyses.ResultsIn the final multiple regression model, BMI was influenced by monthly household income (β=0.234; 95%CI: 1.014 to 1.647), number of cavitated teeth (β=−0.180; 95%CI: −0.293 to −0.054) and X50 of the ST (β=0.304; 95%CI: 0.213–0.498).ConclusionChildren whose food test resulted in large particles and those from families with a higher monthly income had a higher BMI. Children with a greater number of teeth with cavitated dental caries had a lower BMI.
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Genome-wide analysis of AR binding and comparison with transcript expression in primary human fetal prostate fibroblasts and cancer associated fibroblasts
Source:Molecular and Cellular Endocrinology
Author(s): Claire Nash, Nadia Boufaied, Ian G. Mills, Omar E. Franco, Simon W. Hayward, Axel A. Thomson
The androgen receptor (AR) is a transcription factor, and key regulator of prostate development and cancer, which has discrete functions in stromal versus epithelial cells. AR expressed in mesenchyme is necessary and sufficient for prostate development while loss of stromal AR is predictive of prostate cancer progression. Many studies have characterized genome-wide binding of AR in prostate tumour cells but none have used primary mesenchyme or stroma.We applied ChIPseq to identify genomic AR binding sites in primary human fetal prostate fibroblasts and patient derived cancer associated fibroblasts, as well as the WPMY1 cell line overexpressing AR. We identified AR binding sites that were specific to fetal prostate fibroblasts (7534), cancer fibroblasts (629), WPMY1-AR (2561) as well as those common among all (783). Primary fibroblasts had a distinct AR binding profile versus prostate cancer cell lines and tissue, and showed a localisation to gene promoter binding sites 1 kb upstream of the transcriptional start site, as well as non-classical AR binding sequence motifs.We used RNAseq to define transcribed genes associated with AR binding sites and derived cistromes for embryonic and cancer fibroblasts as well as a cistrome common to both. These were compared to several in vivo ChIPseq and transcript expression datasets; which identified subsets of AR targets that were expressed in vivo and regulated by androgens. This analysis enabled us to deconvolute stromal AR targets active in stroma within tumour samples.Taken together, our data suggest that the AR shows significantly different genomic binding site locations in primary prostate fibroblasts compared to that observed in tumour cells. Validation of our AR binding site data with transcript expression in vitro and in vivo suggests that the AR target genes we have identified in primary fibroblasts may contribute to clinically significant and biologically important AR-regulated changes in prostate tissue.
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Next generation sequencing analysis of soy glyceollins and 17-β estradiol: Effects on transcript abundance in the female mouse brain
Source:Molecular and Cellular Endocrinology
Author(s): Sanaya F. Bamji, Eric Rouchka, Yan Zhang, Xiaohong Li, Ted Kalbfleisch, Cynthia Corbitt
Glyceollins (Glys) are produced by soy plants in response to stress and are known for their anti-estrogenic activity both in vivo and in vitro in cancer cell lines as well as peripheral tissues. Glys can also exhibit non-estrogen receptor (ER) mediated effects. The effects of Glys on gene expression in the brain are still unclear. For this study, 17-β estradiol (E2) or placebo slow-release pellets were implanted into ovariectomized CFW mice followed by 11 days of exposure to either Glys or vehicle i.p. injections. We then examined the female mouse brain transcriptome using paired-end RNA sequencing (RNA-Seq) on the Illumina GAIIx platform. The goal of this study was to compare and contrast the results obtained from RNA-Seq with the results from our previous whole brain microarray experiment, which indicated that Glys potentially act through both ER-mediated and non-ER-mediated mechanisms, exhibiting a gene expression profile distinct from E2-treated groups. Our results suggest that the transcripts regulated by both E2 and Glys alone or in combination annotated to similar pathway maps and networks in both microarray and RNA-Seq experiments. Additionally, unlike our microarray data analysis, RNA-Seq enabled the detection of treatment effects on low expression transcripts of interest (e.g., prolactin and growth hormone). Collectively, our results suggest that depending on the gene, Glys can regulate expression independently of E2 action, similarly to E2, or oppose E2's effects in the female mouse brain.
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Impact of Age on Outcomes with Immunotherapy for Patients with Melanoma
Background.
Monoclonal antibodies (mAb) targeting PD-1/PD-L1 have revolutionized melanoma treatment, yet data regarding effectiveness and tolerability across age groups is limited. We sought to determine the impact of age on overall survival (OS), progression-free survival (PFS), and rates of immune-mediated toxicities in patients treated with anti–PD-1/anti-PD-L1 mAb at two academic medical centers.
Methods.We retrospectively collected data on all patients with metastatic melanoma treated with anti-PD-1/PD-L1 mAb between May 2009 and April 2015. We used Kaplan-Meier and Cox regression analyses to assess OS and PFS and identify factors associated with these outcomes. We also compared rates of autoimmune toxicity across age groups.
Results.Of 254 patients, 57 (22.4%) were <50 years old, 85 (33.5%) were age 50–64, 65 (25.6%) were age 65–74, and 47 (18.5%) were ≥75 years. Across age groups, no differences existed in median OS (age <50: 22.9 months, age 50–64: 25.3 months, age 65–74: 22.0 months, age ≥75: 24.3 months) or PFS (age <50: 4.1 months, age 50–64: 6.5 months, age 65–74: 5.4 months, age ≥75: 7.9 months). The presence of liver metastases and elevated pre-treatment lactate dehydrogenase (LDH) were associated with reduced OS. Presence of liver metastasis, pretreatment LDH, BRAF mutation, and type of melanoma correlated with PFS. Overall, 110 patients (43.3%) experienced immune-mediated toxicities; 25 (9.8%) had colitis and 26 (10.2%) had endocrine toxicity. Rates of colitis, hepatitis, and pneumonitis did not differ across age groups.
Conclusion.We demonstrated that patients could safely tolerate anti-PD1/PDL-1 mAb therapy and achieve similar outcomes regardless of their age. The Oncologist 2017;22:1–8
Implications for Practice: Immunotherapy has revolutionized treatment for patients with metastatic melanoma, yet data are lacking regarding the effectiveness and tolerability of these treatments for older patients. In this study, we demonstrated that patients with melanoma safely tolerate immunotherapy and achieve similar outcomes regardless of their age. Specifically, we utilized data from two academic cancer centers and found no significant difference in overall survival, progression free survival, or immune-related toxicities, other than arthritis, across age groups. As the population ages, studies such as this will become critical to help us understand how best to treat older adults with cancer.
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Implementation of the Edmonton Symptom Assessment System for Symptom Distress Screening at a Community Cancer Center: A Pilot Program
Background.
Distress screening is mandated by the American College of Surgeons Commission on Cancer; however, there is limited literature on its impact in actual practice. We examined the impact of a pilot distress screening program on access to psychosocial care.
Methods.Edmonton Symptom Assessment System (ESAS) screening was routinely conducted at our community-based medical oncology program. Patients who screened positive for severe distress were sent to a social worker for triage and referred to the appropriate services if indicated. We compared the proportion of patients who had ESAS completed, the proportion of patients who screened positive, and the number of patients who had social work assessment and palliative care consultation over the preimplementation (September 2015), training (October/November 2015), and postimplementation (December 2015) periods.
Results.A total of 379, 328, and 465 cancer patients were included in the preimplementation, training, and postimplementation periods, respectively. The proportion of patients who completed ESAS increased over time (83% vs. 91% vs. 96%). Among the patients who had completed ESAS, between 11% and 13% were positive for severe distress, which remained stable over the three periods. We observed a significant increase in social work referrals for psychosocial assessment (21% vs. 71% vs. 79%). There was also a trend towards an increased number of palliative care referrals (12% vs. 20% vs. 28%).
Conclusion.Our community-based cancer center implemented distress screening rapidly in a resource-limited setting, with a notable increase in symptom documentation and psychosocial referral. The Oncologist 2017;22:1–7
Implications for Practice: The American College of Surgeons Commission on Cancer mandates distress screening; however, there is limited literature on how this process should be implemented and its impact on clinical practice. We used the Edmonton Symptom Assessment System for routine symptom distress screening in a community-based medical oncology program that provides care for an underserved population. Comparing before and after program implementation, we found an increase in the number of documentations of symptom burden and an increase in psychosocial referrals. Findings from this study may inform the implementation of routine symptom distress screening in cancer patients.
http://ift.tt/2qNa3ue
Patterns of Chemotherapy Use in a U.S.-Based Cohort of Patients with Metastatic Pancreatic Cancer
Purpose.
Few population studies have examined patterns of systemic therapy administration in metastatic pancreatic cancer (MPC) or the predictors associated with specific treatment choices.
Patients and Methods.We assessed 4,011 consecutive MPC patients who received chemotherapy between January 2005 and December 2015 at academic, private, and community-based oncology practices subscribing to a U.S.-wide chemotherapy order entry system capturing disease, patient, provider, and treatment data. Multivariate analyses of these prospectively recorded characteristics identified significant predictors of specific therapeutic choices.
Results.Overall, 100 different regimens were used in first-line treatment of MPC. First-line gemcitabine monotherapy usage fell steadily from 72% in 2006 to 16% in 2015. This steep decline mirrored increases in first-line usage of both 5 fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) and gemcitabine + nab-paclitaxel. Younger male patients were more likely to receive FOLFIRINOX as first-line treatment, whereas patients treated at community practices and by oncologists with lower MPC patient volume were more likely to receive gemcitabine plus nab-paclitaxel (all p ≤ .05). Among all patients receiving first-line chemotherapy for MPC, 49% went on to receive second-line therapy and 19% received third-line therapy; administration of second- and third-line therapies increased steadily over the time course of follow-up. Younger patients and those treated by oncologists with higher MPC patient volume were more likely to receive second- and third-line therapies.
Conclusion.This population-based study provides insight into treatment patterns of MPC in the U.S. Usage patterns varied greatly according to patient and provider characteristics. The Oncologist 2017;22:1–9
Implications for Practice: This study examined real world metastatic pancreatic cancer treatment patterns in the United States with the goals of understanding changes in chemotherapy treatment frequencies over time and determining the individual predictors that underlie the chemotherapy choices oncologists make for their patients. Our data set is unique in that it captured not only patient-level data, but also oncologist-level data. It also captured data from private and community practices as well as academic centers. To our knowledge, this is the only data set that can give this degree of insight into oncologist decision making practices.
http://ift.tt/2p66eng
Systemic Chemotherapy as Salvage Treatment for Locally Advanced Rectal Cancer Patients who Fail to Respond to Standard Neoadjuvant Chemoradiotherapy
Background.
The potential of chemotherapy as salvage treatment after failure of neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC) has never been explored. We conducted a single-center, retrospective analysis to address this question.
Patients and Methods.Patients with newly diagnosed LARC who were inoperable or candidates for extensive (i.e., beyond total mesorectal excision [TME]) surgery after long-course chemoradiotherapy and who received salvage chemotherapy were included. The primary objective was to estimate the proportion of patients who became suitable for TME after chemotherapy.
Results.Forty-five patients were eligible (39 candidates for extensive surgery and 6 unresectable). Previous radiotherapy was given concurrently with chemotherapy in 43 cases (median dose: 54.0 Gy). Oxaliplatin- and irinotecan-based salvage chemotherapy was administered in 40 (88.9%) and 5 (11.1%) cases, respectively. Eight patients (17.8%) became suitable for TME after chemotherapy, 10 (22.2%) ultimately underwent TME with clear margins, and 2 (4.4%) were managed with a watch and wait approach. Additionally, 13 patients had extensive surgery with curative intent. Three-year progression-free survival and 5-year overall survival in the entire population were 30.0% (95% confidence interval [CI]: 15.0–46.0) and 44.0% (95% CI: 26.0–61.0), respectively. For the curatively resected and "watch and wait" patients, these figures were 52.0% (95% CI: 27.0–73.0) and 67.0% (95% CI: 40.0–84.0), respectively.
Conclusion.Systemic chemotherapy may be an effective salvage strategy for LARC patients who fail to respond to chemoradiotherapy and are inoperable or candidates for beyond TME surgery. According to our study, one out of five patients may become resectable or be spared from an extensive surgery after systemic chemotherapy. The Oncologist 2017;22:1–9
Implications for practice: High-quality evidence to inform the optimal management of rectal cancer patients who are inoperable or candidates for beyond total mesorectal excision surgery following standard chemoradiotherapy is lacking. We show for the first time that systemic chemotherapy may be beneficial and result in one out of five poor prognosis patients becoming resectable or being spared from an extensive surgical approach. Although mores studies are needed to confirm these data, administering salvage systemic chemotherapy in this setting may have the potential to minimize morbidity associated with extensive surgical procedures and improve long-term oncological outcome.
http://ift.tt/2p66cf8
The Effects of Three Physical and Vocal Warm-Up Procedures on Acoustic and Perceptual Measures of Choral Sound
The purpose of this investigation was to assess the effects of three warm-up procedures (vocal-only, physical-only, physical/vocal combination) on acoustic and perceptual measures of choir sound.
http://ift.tt/2qN9e4m
Spectrum of physical deformities in leprosy patients visiting a tertiary care center in Mangalore
Annals of Tropical Medicine and Public Health 2017 10(1):22-26
Background: Presence of physical deformities in patients with leprosy reflects the rate of disease transmission in the community; delay in detection of cases; and inadequacy or failure of treatment. Objectives: To determine the spectrum of physical deformities in patients with leprosy, to analyze the various sociodemographic factors affecting the study population, and to assess the treatment history of the selected number of patients. Materials and Methods: The study was an analytical study conducted on all leprosy patients who visited the dermatology out-patient department in a tertiary care hospital during the period of 1 year. Results: Males constituted 70.66% and females constituted 29.34%. It was found that a majority were in the age group of 21–60 years than in the extreme age groups (0–20 years and 61–80 years). Among the 92 patients studied, it was found that majority of the patients (60.86%) had WHO grade 0 or grade 1 deformity. Those with visible deformities (WHO grade 2 deformity) constituted 39.13% of the study population. Among those with visible deformities, the most common deformity was seen to be trophic ulcer (21.73%). This was followed by claw hand, foot drop, madarosis, claw toes, lagophthalmos, ear lobe deformity, facial palsy, and finally nose deformity. Conclusions: Our study found that more than one third of number of leprosy patients had deformities. It reflects the need for further efforts to curb this infectious disease and increase education among masses.
http://ift.tt/2pjyizE
Rebound thrombocytosis and persistence of clinical symptoms after recovery from dengue hemorrhagic fever
Annals of Tropical Medicine and Public Health 2017 10(1):286-286
http://ift.tt/2pPVAQI
Myopericytom
Annals of Tropical Medicine and Public Health 2017 10(1):261-263
http://ift.tt/2pjsgiL
Elements dictating the fate of artemisinin combination therapy in India
Annals of Tropical Medicine and Public Health 2017 10(1):7-12
Over the course of its existence in India, Artemisinin combination therapy (ACT), has emerged as the titular tool at mankind's disposal to counter falciparum malaria related mortalities. The dramatic slide in reported deaths due to Plasmodium falciparum is a testament to ACT's efficacy. However, a closer look reveals the successes so far achieved with ACT to be only a smokescreen. A large majority of the patients in the more remote and backward regions of India, still remain bereft of ACT, which might be the reason for the startling malaria mortality figures reported by the community surveillances. In our manuscript, we have laid focus on the key facets of the Indian health care system that has purportedly played a central role in the present successes with ACT. Further, we have highlighted as to how these key elements, for instance, health workers like Accredited Social Health Activists (ASHAs), sub-centers, supply chain of ACT can be improved upon further so as to ensure that ACT is able to reach the truly needy.
http://ift.tt/2pPWSLU
Ten lessons learned from the recent outbreak of the Middle East respiratory syndrome
Annals of Tropical Medicine and Public Health 2017 10(1):231-233
From 2012 till the present, the name of Middle East respiratory syndrome (MERS) has been heard many a times in the mass media and many papers that have been published in different scientific journals, but one question has remained – What is the lesson learned about MERS epidemic at the present time and what can really be done in order to prevent the matter? I would like to bring your attention to what could be done at the present time, based on lessons learned from MERS outbreak in the world.
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Sand fly fever: An important vector-borne diseases for travelers?
Annals of Tropical Medicine and Public Health 2017 10(1):13-15
Context: Sand fly fever is a vector-borne viral infection and is endemic in many parts of the world, particularly in areas that are infected with different types of leishmaniasis. Clinical spectrum ranges from asymptomatic infection to very high fever and photophobia in patients. During the last decades, an increase in imported sand fly fever cases in developed and nonendemic countries have been pointed out from an international literature review. Among the possible causes are increasing international travelers, travel of immigrants from endemic area, and army operations. It has been noted that the main region for the diseases are west of Asia and east of Europe, and perhaps imported cases may be seen clinically in different parts of the world, either in developed or in developing countries. Materials and Methods: Two methods were used to gather the information for this article. First, PubMed was searched for English language references to published relevant articles. Second, the term sand fly fever was searched on Google Scholar too. Results: In PubMed, 156 articles and in Google Scholar, 70,400 articles mentioned the term sand fly fever. The most searched items in PubMed were epidemiology, treatment, prevention, and life cycle with incidences of 41.66, 20.51, 13.46, and 1.92%, respectively, and in terms of geographical distribution of the study, the maximum number of articles in PubMed were published from Europe, Asia, Australia, and America, with percentages being 26.92, 17.30, 17.0, 1.28, and 1.28%, respectively. Conclusion: Different countries have reported the disease either as an endemic or as an imported one. co-infection. Sand fly fever must be considered in the diagnostic assessment of patients presenting with a similar clinical syndrome and a history of travel to an endemic area, which are mentioned above. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas; these travelers should receive counseling regarding sand fly fever appropriate protective health measures. In this review article sand fly fever situation will be studied.
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Improving patient safety standards in hospitals: A global public health concern
Annals of Tropical Medicine and Public Health 2017 10(1):275-276
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Interventions for improved retention of skilled health workers in rural and remote areas
Annals of Tropical Medicine and Public Health 2017 10(1):16-21
Background: Worldwide, rural inequitable distribution and dearth of health professionals pose poor functioning of health services. In this study, we gather interventions aimed at increasing the proportion of health professionals working in rural and remote areas. Methods: We searched PUBMED, MEDLINE, EMBASE and google scholar database with key words such as "doctors", "nurses" "health workers", "health care professionals" and "human resources for health". Further, comprehensive data base of relevant literature on recruitment or retention or both, of health workers in rural and remote areas has been searched through the websites of different government, non-government, national and international agencies. Results: We found that, there are mainly four interventions employed for improved rural retention. These interventions are generally grouped into educational, financial, regulatory, personal and professional strategies. We also judged the effectiveness of the intervention provided in the literature. Conclusion: Currently, there is limited reliable evidence regarding the effects of these interventions aimed at addressing the maldistribution of health professionals. Hence, well-designed observational studies are needed to confirm that educational, financial, regulatory, personal and professional strategies might influence the health workers' decision to stay in underserved areas. Further, the state governments, public health schools and medical colleges should ensure that when interventions are implemented, their impacts can be measured through scientifically rigorous approaches to establish the true effects of these measures for improved rural recruitment and retention.
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Prospects of mandibular advancement device (MAD) as a preferred treatment of obstructive sleep apnea in India: a systematic review
Annals of Tropical Medicine and Public Health 2017 10(1):1-6
Obstructive sleep apnea (OSA) is an independent risk factor for increased cardiovascular and cerebro-vascular morbidity and mortality. OSA leads to loss of human life and huge economical burden to our Society worldwide. The adult's prevalence of OSA ranges between 9.3-13.5% in India. India is the second largest populated country of the world and by the end of 2030 it may become the most populated nation. This developing nation is already known as the world's capital of T2 DM, and other non-communicable diseases like Obesity, Hypertension, Stroke, Ischemic heart diseases (IHD), Hypercholesterolemia congestive heart failure are on a rising trend. These cardiovascular disorders were found to be associated with OSA. OSA treatment may improve these co-morbid conditions. Continuous positive airway pressure (CPAP) is a preferred choice for OSA treatment in western and developed countries. In India, where CPAP is out of the reach of most of the OSA affected population due to high cost and other socio-economic and cultural factors, MAD may become a preferred treatment option. MAD is cheaper than CPAP and generally equally effective. The patients suffering from sleep-related breathing disorder (SBD) may have an alternative to CPAP or surgery for their disease management. Mandibular Advancement Device (MAD) may become an additional standard treatment of OSA in India, and has great potential for reducing associated undesirable cardiovascular co-morbidities and mortalities. This review highlights the prospects of MAD as a preferred treatment of Obstructive Sleep Apnea in India by extensively researching scientific literature, PubMed, Google Scholar, scientific, and academic web portals.
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Intestinal amebiasis presenting as life threatening lower GI bleed-A rare presentation
Annals of Tropical Medicine and Public Health 2017 10(1):244-246
Amoebiasis is a common intestinal protozoan infection due to Entamoeba histolytica. In India, the prevalence of the disease varies from 2% to 67%.[1] Acute Fulminant Colitis is a rare complication of intestinal amebiasis. Life threatening lower Gastrointestinal bleed is very rare presentation of amebiasis. Here, we are presenting a case of severe lower GI bleed proved to be caused by amebiasis along with extra intestinal complications.
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Symmetric peripheral gangrene: A rare complication of Plasmodium falciparum malaria
Annals of Tropical Medicine and Public Health 2017 10(1):238-240
Sudden onset of symmetric peripheral gangrene (SPG) is a relatively uncommon clinical entity manifested by distal ischemic damage at two or more sites in the absence of large vessel obstruction. Here, we report a case of a 27-year-old female with complicated falciparum malaria with SPG involving the toes of both the lower limbs.
http://ift.tt/2pPTIYb
Mobile phone dependence among undergraduate medical students in Nanded city
Annals of Tropical Medicine and Public Health 2017 10(1):27-30
Introduction: In recent years, there has been increasing concern regarding problematic use of mobile phones, and accordingly, it has been publicized extensively as an emerging social problem. Objective: The aim of the study was to assess mobile phone dependence among undergraduate medical students of the Nanded city. Material and Methods: A cross-sectional study was conducted among undergraduate medical students of a Government Medical college, Nanded, Maharashtra, during November to December 2016. All the 348 students in the college were enrolled in the study. A predesigned Test of Mobile Phone Dependence (TMD Brief) developed by Chóliz et al was used for collection of information. The participants scoring ≥ 50%, that is, a score of ≥ 30 were considered as mobile dependent. Data analysis was performed using SPSS Version 20 and Graph Pad Prism. Results: Out of 348 participants, data were collected from 251 students, and 206 (82.1%) students were found to be dependent on the mobile phone. In total, 137 (85.1%) students in the age group of 17–20 years were mobile phone dependent. Most of the mobile phone dependents were females 99 (83.9%) than males, that is, 107 (80.5%). Out of 206 mobile-phone-dependent students, majority 77 (90.6%) were from the first year. The chi square test showed that the mobile phone dependence was significantly dependent on the academic year (X2=6.82, P=0.033). The binary logistic regression also proved first year as an independent risk factor for mobile dependence compared to second and third years. Conclusions: A total of 82.1% undergraduate medical students were mobile phone dependent. Health education about the use of mobile phone is necessary in the first year.
http://ift.tt/2pjymzu
Vector-borne diseases quiz for MD students
Annals of Tropical Medicine and Public Health 2017 10(1):267-272
http://ift.tt/2pPTd0B
Indoor air quality at shopping malls in Kota Kinabalu, Sabah (particulate matter and ozone)
Annals of Tropical Medicine and Public Health 2017 10(1):31-35
Background: Indoor air quality (IAQ) in shopping malls is an interesting case of study since a shopping mall is a public place where people favor to spend their time. This study was conducted to investigate the IAQ of shopping malls in Kota Kinabalu, Sabah, whereby three shopping malls were selected as investigation sites. Methods: The parameters being studied include particulate matter (PM0.3-∞, PM0.5-∞, PM2-∞ and PM5-∞) and ozone. Indoor and outdoor air measurements were performed in the three shopping malls on weekdays and weekends to determine the I/O ratios. Results: In this study, overall average indoor PM concentrations on weekends were higher than weekdays, reaching maxima average concentrations of 421.44 ± 102.96 µg/m3 for PM0.3-∞, 41.75 ± 15.54 µg/m3 for PM0.5-∞, 1.30 ± 0.41 µg/m3 for PM2-∞, and 0.21 ± 0.09 µg/m3 for PM5-∞. Correlation between indoor and outdoor PM concentrations mostly showed poor relationship in the three shopping malls, showing that indoor sources such as re-suspension phenomena due to occupant's activities were clearly the main contributors to indoor PM concentrations. Poor ventilation system also affected IAQ by increasing the PM accumulation. However, I/O ratios were often less than 1.0, indicating that PM in indoor air arises predominantly from outdoor air transported to indoors. Average indoor ozone concentration at all the shopping malls was measured to be below the 0.05 ppm of ICOP-IAQ 2010. Conclusion: The overall assessment of IAQ in the three shopping malls showed that SM2 has a better IAQ compared to SM1 and SM3.
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Supporting and encouraging breastfeeding through strengthening of the existing legal provisions globally
Annals of Tropical Medicine and Public Health 2017 10(1):280-282
http://ift.tt/2pPN04I
Evaluate the decision of as low as reasonably practicable (ALARP) solutions for the safe use of pesticide among the pesticide handlers, paddy farm, Tanjung Karang, Selangor
Annals of Tropical Medicine and Public Health 2017 10(1):36-43
Introduction: Most of the farmers encounter the similar problems such as low-financial capacity and lack of information to control over the pesticide hazards. This study highlights the importance of the approach of As Low As Reasonably Practicable (ALARP) solutions to control and reduce the identified health risks from the pesticide use. Objective: To evaluate the decision of ALARP solutions for the safe use of pesticide among the pesticide handlers. Methodology: This cross-sectional study was conducted among 85 pesticide handlers to evaluate the ALARP practical solutions. The solution shall consider the factors that could control and mitigate the health risks suitably and cost-effectively. Result and Discussion: Pesticide handlers were aware of the fact that using hazardous pesticides without appropriate control equipment is detrimental to their health. When ALARP solutions are considered, respondents prefer to utilize the control strategies that are less likely to incur costs. Among all, the practices of the safe system of work and administrative control are highly recommended to mitigate the potential health risks during mixing and loading, application, and drift control and decontamination. Conclusion: It is recommended to apply the ALARP solutions to control and mitigate the pesticide risks sustainable during mixing and loading, application, drift reduction and decontamination.
http://ift.tt/2pjfH74
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