Gyral Net: A New Representation of Cortical Folding Organization

Publication date: Available online 15 July 2017
Source:Medical Image Analysis
Author(s): Hanbo Chen, Yujie Li, Fangfei Ge, Gang Li, Dinggang Shen, Tianming Liu
One distinct feature of the cerebral cortex is its convex (gyri) and concave (sulci) folding patterns. Due to the remarkable complexity and variability of gyral/sulcal shapes, it has been challenging to quantitatively model their organization patterns. Inspired by the observation that the lines of gyral crests can form a connected graph on each brain hemisphere, we propose a new representation of cortical gyri/sulci organization pattern – gyral net, which models cortical architecture from a graph perspective, starting with nodes and edges obtained from the reconstructed cortical surfaces. A novel computational framework is developed to efficiently and automatically construct gyral nets from surface meshes, and four measurements are devised to quantify the folding patterns. Using an MRI dataset for autism study as a test bed, we identified reduced local connectivity cost and increased curviness of gyral net bilaterally on the parietal lobe, occipital lobe, and temporal lobe in autistic patients. Additionally, we found that the cortical thickness and the gyral straightness of gyral joints are higher than the rest of gyral crest regions. The proposed representation offers a new tool for a comprehensive and reliable characterization of the cortical folding organization. This novel computational framework will enable large-scale analyses of cortical folding patterns in the future.

Graphical abstract

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Repeated seasonal influenza vaccination among elderly in Europe: Effects on laboratory confirmed hospitalised influenza

Publication date: 3 August 2017
Source:Vaccine, Volume 35, Issue 34
Author(s): Marc Rondy, Odile Launay, Jesus Castilla, Simona Costanzo, Joan Puig-Barberà, Giedre Gefenaite, Amparo Larrauri, Caterina Rizzo, Daniela Pitigoi, Ritva K. Syrjänen, Ausenda Machado, Sanja Kurečić Filipović, Judit Krisztina Horváth, Iwona Paradowska-Stankiewicz, Sierk Marbus, Alain Moren
In Europe, annual influenza vaccination is recommended to elderly. From 2011 to 2014 and in 2015–16, we conducted a multicentre test negative case control study in hospitals of 11 European countries to measure influenza vaccine effectiveness (IVE) against laboratory confirmed hospitalised influenza among people aged ≥65years. We pooled four seasons data to measure IVE by past exposures to influenza vaccination.We swabbed patients admitted for clinical conditions related to influenza with onset of severe acute respiratory infection ≤7days before admission. Cases were patients RT-PCR positive for influenza virus and controls those negative for any influenza virus. We documented seasonal vaccination status for the current season and the two previous seasons.We recruited 5295 patients over the four seasons, including 465A(H1N1)pdm09, 642A(H3N2), 278 B case-patients and 3910 controls. Among patients unvaccinated in both previous two seasons, current seasonal IVE (pooled across seasons) was 30% (95%CI: −35 to 64), 8% (95%CI: −94 to 56) and 33% (95%CI: −43 to 68) against influenza A(H1N1)pdm09, A(H3N2) and B respectively. Among patients vaccinated in both previous seasons, current seasonal IVE (pooled across seasons) was −1% (95%CI: −80 to 43), 37% (95%CI: 7–57) and 43% (95%CI: 1–68) against influenza A(H1N1)pdm09, A(H3N2) and B respectively.Our results suggest that, regardless of patients' recent vaccination history, current seasonal vaccine conferred some protection to vaccinated patients against hospitalisation with influenza A(H3N2) and B. Vaccination of patients already vaccinated in both the past two seasons did not seem to be effective against A(H1N1)pdm09. To better understand the effect of repeated vaccination, engaging in large cohort studies documenting exposures to vaccine and natural infection is needed.



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Editorial Board/Aims and Scope

Publication date: 3 August 2017
Source:Vaccine, Volume 35, Issue 34





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A bivalent live-attenuated influenza vaccine for the control and prevention of H3N8 and H3N2 canine influenza viruses

Publication date: 3 August 2017
Source:Vaccine, Volume 35, Issue 34
Author(s): Laura Rodriguez, Aitor Nogales, Pablo R. Murcia, Colin R. Parrish, Luis Martínez-Sobrido
Canine influenza viruses (CIVs) cause a contagious respiratory disease in dogs. CIV subtypes include H3N8, which originated from the transfer of H3N8 equine influenza virus (EIV) to dogs; and the H3N2, which is an avian-origin virus adapted to infect dogs. Only inactivated influenza vaccines (IIVs) are currently available against the different CIV subtypes. However, the efficacy of these CIV IIVs is not optimal and improved vaccines are necessary for the efficient prevention of disease caused by CIVs in dogs. Since live-attenuated influenza vaccines (LAIVs) induce better immunogenicity and protection efficacy than IIVs, we have combined our previously described H3N8 and H3N2 CIV LAIVs to create a bivalent vaccine against both CIV subtypes. Our findings show that, in a mouse model of infection, the bivalent CIV LAIV is safe and able to induce, upon a single intranasal immunization, better protection than that induced by a bivalent CIV IIV against subsequent challenge with H3N8 or H3N2 CIVs. These protection results also correlated with the ability of the bivalent CIV LAIV to induce better humoral immune responses. This is the first description of a bivalent LAIV for the control and prevention of H3N8 and H3N2 CIV infections in dogs.



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Post-hoc analysis of a randomized controlled trial: Diabetes mellitus modifies the efficacy of the 13-valent pneumococcal conjugate vaccine in elderly

Publication date: 3 August 2017
Source:Vaccine, Volume 35, Issue 34
Author(s): Susanne M. Huijts, Cornelis H. van Werkhoven, Marieke Bolkenbaas, Diederick E. Grobbee, Marc J.M. Bonten
BackgroundThe 13-valent pneumococcal conjugate-vaccine (PCV13) was effective in preventing vaccine-type Community-Acquired Pneumonia (VT-CAP) and Invasive Pneumococcal Disease (VT-IPD) in elderly subjects, but vaccine efficacy (VE) in patients with comorbidities at time of vaccination is unknown.MethodsThis is a post hoc analysis of the CAPiTA study, a double blind, randomized controlled trial with 84,496 immunocompetent participants aged ⩾65years, receiving PCV13 or placebo vaccination. Presence of diabetes mellitus (DM), heart disease, respiratory disease, liver disease, asplenia, and smoking at the time of immunization was verified on medical records in 139 subjects developing the primary endpoint of VT-CAP. Presence of DM and respiratory disease based on International Classification of Primary Care (ICPC) coding was also determined in 40,427 subjects.FindingsIn the 139 subjects developing VT-CAP, DM caused significant effect modification (p-value 0.002), yielding VE of 89.5% (95%CI, 65.5–96.8) and 24.7% (95%CI, −10.4 to 48.7) for those with and without DM, respectively. Comparable effect modification (p-value 0.020) was found in the 40,427 subjects with and without ICPC-based classification of DM with VE of 85.6% (95%CI, 36.7–96.7) and of 7.0% (95%CI, −58.5 to 45.5) respectively. Effect modification through respiratory disease was not statistically significant, although the point estimate of VE was lower for those with respiratory disease in both analyses. There was no evidence of effect modification in subjects stratified by heart disease, smoking, and presence of any comorbidity.ConclusionsAmong immunocompetent elderly, VE of PCV13 was modified by DM with higher VE among subjects with DM. Significant effect modification was not observed for subjects with heart disease, respiratory disease, smoking, or presence of any comorbidity.CAPiTA trial registration number: http://ift.tt/PmpYKN; trial number NCT00744263.



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Olaratumab: PDGFR-α inhibition as a novel tool in the treatment of advanced soft tissue sarcomas

Publication date: Available online 15 July 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Vincenzi Bruno, Badalamenti Giuseppe, Napolitano Andrea, Spalato Ceruso Mariella, Pantano Francesco, Grignani Giovanni, Russo Antonio, Santini Daniele, Aglietta Massimo, Tonini Giuseppe




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Tolerance to baked and fermented cow's milk in children with IgE-mediated and non-IgE-mediated cow's milk allergy in patients under two years of age

Publication date: Available online 15 July 2017
Source:Allergologia et Immunopathologia
Author(s): A. Uncuoglu, N. Yologlu, I.E. Simsek, Z.S. Uyan, M. Aydogan
BackgroundIgE-mediated cow's milk allergy (CMA) has been shown consistent in milder heated-milk tolerant and severe heated-milk reactant groups in patients older than two years. Little is known whether fermentation of milk gives rise to similar clinical phenotypes.We aimed to determine the influence of extensively heated and fermented cow's milk on the IgE-mediated and non-IgE-mediated CMA in children younger than two years.MethodsSubjects followed with the diagnosis of IgE-mediated and non-IgE-mediated CMA for at least six months underwent unheated milk challenge. IgE-mediated and non-IgE-mediated groups were categorised as unheated milk-reactive and tolerant, separately. Unheated milk-reactive groups were further challenged sequentially with fermented milk (yoghurt) and baked milk, 15 days apart. Allergy evaluation with skin tests, prick-to-prick tests and atopy patch tests were performed.ResultsFifty-seven children (median age: 14 months; range: 7–24 months) underwent unheated milk challenge. Eleven of 27 children with IgE-mediated CMA and 14 of 30 children with non-IgE-mediated CMA tolerated unheated milk. Among subjects who reacted to unheated milk; 15 of 16 subjects (93%) with IgE-mediated CMA also reacted to yoghurt, whereas 11 of 16 subjects (68%) with non-IgE-mediated CMA tolerated fermented milk. Thirteen subjects (81%) of the unheated milk-reactive IgE-mediated group tolerated to heated milk. None of 16 subjects of unheated milk-reactive non-IgE-mediated group reacted to baked milk.ConclusionThe majority of children under the age of two years with both IgE-mediated and non-IgE-mediated CMA tolerated baked-milk products. Yoghurt was tolerated in two thirds of unheated milk reactive patients suffering from non-IgE-mediated CMA.



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Editorial Board

Publication date: July 2017
Source:Cancer Treatment Reviews, Volume 58





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Titanate nanofibers sensitized with ZnS and Ag2S nanoparticles as novel photocatalysts for phenol removal

Publication date: 5 December 2017
Source:Applied Catalysis B: Environmental, Volume 218
Author(s): B. Barrocas, T.J. Entradas, C.D. Nunes, O.C. Monteiro
In this work, the synthesis of new nanocomposite materials, with enhanced optical and photocatalytic properties, was achieved through the combination of photoactive titanate nanofibers (TNF) with crystalline ZnS and Ag2S nanoparticles. The TNF powders were obtained via hydrothermal synthesis and afterwards modified with the semiconductor nanoparticles. The Ag2S and ZnS nanocrystallites were successfully grown onto the TNF surface, through a single-source precursor decomposition method, and ZnS-Ag2S/TNF nanocomposite materials with distinct layouts were produced. After structural, morphological and optical characterization, the samples' photocatalytic performance to hydroxyl radical production was evaluated using terephthalic acid as probe molecule. The nanocomposite powders were investigated for phenol removal, while the identification and the time profiles of some by-products formed during the phenol degradation were carefully analysed.Results suggest distinct photocatalytic pathways for the production of hydroxyl radical, as well as distinct phenol degradation mechanisms. The phenomenon was found to be dependent on the semiconductors layout. Ag2S(ZnS/TNF) was the sample with the best photocatalytic activity, in terms of phenol removal and also considering the amount of by-products formed and time required for their degradation. Based on the photocatalytic degradation results, two energetic mechanisms for Ag2S/TNF and Ag2S(ZnS/TNF) performance were proposed and discussed.

Graphical abstract

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Call for Papers

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9





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Contents

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9





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Dependence of Boiling Histotripsy Treatment Efficiency on HIFU Frequency and Focal Pressure Levels

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Tatiana D. Khokhlova, Yasser A. Haider, Adam D. Maxwell, Wayne Kreider, Michael R. Bailey, Vera A. Khokhlova
Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU)–based method of mechanical tissue fractionation that utilizes millisecond-long bursts of HIFU shock waves to cause boiling at the focus in milliseconds. The subsequent interaction of the incoming shocks with the vapor bubble mechanically lyses surrounding tissue and cells. The acoustic parameter space for BH has been investigated previously and an inverse dependence between the HIFU frequency and the dimensions of a BH lesion has been observed. The primary goal of the present study was to investigate in more detail the ablation rate and reliability of BH in the frequency range relevant to treatment of deep abdominal tissue targets (1–2 MHz). The second goal was to investigate the effect of focal peak pressure levels and shock amplitude on BH lesion formation, given a constant duty factor, a constant ratio of the pulse duration to the time to reach boiling and a constant number of BH pulses. A custom-built 12-element sector array HIFU transducer with F-number = 1.05 was used in all experiments. BH pulses at 5 different frequencies (1, 1.2, 1.5, 1.7 and 1.9 MHz) were delivered to optically transparent polyacrylamide gel phantoms and ex vivo bovine liver and myocardium tissue to observe cavitation and boiling bubble activity with high-speed photography and B-mode ultrasound imaging, correspondingly. In gel phantoms, a cavitation bubble cloud was shown to form prefocally and to shield the focus in all exposures at 1 and 1.2 MHz and in the highest amplitude exposures at 1.5–1.7 MHz; shielding was not observed at 1.9 MHz. In ex vivo tissue, this shielding effect was observed in 25% of exposures when peak negative in situ pressure exceeded 10.2 MPa at 1 MHz and 14.5 MPa at 1.5 MHz. When shielding occurred, the exposures resulted in mild tissue disruption in the prefocal region, but not liquefaction. The dimensions of liquefied lesions followed the inverse proportionality trend with frequency; consequently, the frequency range of 1.2–1.5 MHz appeared to be preferable for BH exposures in terms of the compromise between the ablation rate and reliability. The lesion size was independent of the duration of the BH pulses (or the total "HIFU on" time), provided that the number of pulses was constant and boiling was induced within each pulse. Thus, the use of shorter (1 ms vs. 10 ms), higher amplitude BH pulses allowed up to 10-fold reduction in treatment time for a given duty factor.



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Small Bowel Ultrasound beyond Inflammatory Bowel Disease: An Updated Review of the Recent Literature

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Federica Cavalcoli, Alessandra Zilli, Mirella Fraquelli, Dario Conte, Sara Massironi
The use of bowel ultrasonography (US) for the evaluation of gut diseases has increased in recent years and has been proven to provide a widely available, non-invasive and inexpensive method for the initial work-up and follow-up of different intestinal diseases, limited mostly by technical challenges posed by the patient's anatomy. The present review aims to provide an extensive overview of the main pathologic features at US examination of intestinal diseases other than inflammatory bowel disease, both acute (e.g., acute appendicitis, colonic diverticulitis, infectious diseases and ischemic conditions) and chronic (e.g., celiac disease, cystic fibrosis and other enterocolites). The identification of typical US features may help in the diagnostic process and guide the treatment approach. Therefore, the application of knowledge of the US appearance of gastrointestinal diseases is of relevance in enabling greater diagnostic performance and better patient management.



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Ultrasound Image Despeckling Based on Statistical Similarity

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Fabio Baselice
Ultrasound images are affected by the speckle phenomenon, a multiplicative noise that degrades image quality. Several methods for denoising have been proposed in recent years, based on different approaches. The so-called non-local mean is considered the state-of-the-art method; the idea is to find similar patches across the image and exploit them to regularize the image. The method proposed here is in the non-local family, although instead of partitioning the target image in patches, it works pixelwise. The similarity between pixels is evaluated by analyzing their statistical behavior, in particular, by measuring the Kolmogorov–Smirnov distance between their distributions. To make this possible, a stack of acquired images is required. The proposed method has been tested on both simulated and real data sets and compared with other widely adopted techniques. Performance is interesting, with quality parameters and visual inspection confirming such findings.



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Ultrasound Assessment of Human Meniscus

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Tuomas Viren, Juuso T. Honkanen, Elvis K. Danso, Lassi Rieppo, Rami K. Korhonen, Juha Töyräs
The aim of the present study was to evaluate the applicability of ultrasound imaging to quantitative assessment of human meniscus in vitro. Meniscus samples (n = 26) were harvested from 13 knee joints of non-arthritic human cadavers. Subsequently, three locations (anterior, center and posterior) from each meniscus were imaged with two ultrasound transducers (frequencies 9 and 40 MHz), and quantitative ultrasound parameters were determined. Furthermore, partial-least-squares regression analysis was applied for ultrasound signal to determine the relations between ultrasound scattering and meniscus integrity. Significant correlations between measured and predicted meniscus compositions and mechanical properties were obtained (R² = 0.38–0.69, p < 0.05). The relationship between conventional ultrasound parameters and integrity of the meniscus was weaker. To conclude, ultrasound imaging exhibited a potential for evaluation of meniscus integrity. Higher ultrasound frequency combined with multivariate analysis of ultrasound backscattering was found to be the most sensitive for evaluation of meniscus integrity.



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Masthead

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9





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In Vivo Multiparametric Ultrasound Imaging of Structural and Functional Tumor Modifications during Therapy

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Alexandre Dizeux, Thomas Payen, Delphine Le Guillou-Buffello, Eva Comperat, Jean-Luc Gennisson, Mickael Tanter, Michael Oelze, S. Lori Bridal
Longitudinal imaging techniques are needed that can meaningfully probe the tumor microenvironment and its spatial heterogeneity. Contrast-enhanced ultrasound, shear wave elastography and quantitative ultrasound are ultrasound-based techniques that provide information on the vascular function and micro-/macroscopic tissue structure. Modifications of the tumor microenvironment induced by cytotoxic and anti-angiogenic molecules in ectopic murine Lewis lung carcinoma tumors were monitored. The most heterogenous structures were found in tumors treated with anti-angiogenic drug that simultaneously accumulated the highest levels of necrosis and fibrosis. The anti-angiogenic group presented the highest number of correlations between parameters related to vascular function and those related to the micro-/macrostructure of the tumor microenvironment. Results suggest how patterns of multiparametric ultrasound modifications can be related to provide a more insightful marker of changes occurring within tumors during therapy.



http://ift.tt/2tfpqRE

Three-Dimensional Echocardiography-Derived Non-Invasive Right Ventricular Pressure-Volume Analysis

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Kuan-Chih Huang, Lian-Yu Lin, Juey-Jen Hwang, Lung-Chun Lin
In patients with pulmonary hypertension, repeated evaluations of right ventricular (RV) function are still required for clinical decision making, but the invasive nature of current pressure-volume analysis makes conducting regular follow-ups in a clinical setting infeasible. We enrolled 12 patients with pulmonary arterial hypertension (PAH) and 10 with pulmonary venous hypertension (PVH) May 2016–October 2016. All patients underwent a clinically indicated right heart catheterization (RHC), from which the yielded right ventricular pressure recordings were conjugated with RV volume by 3-D echocardiography to generate a pressure-volume loop. A continuous-wave Doppler envelope of tricuspid regurgitation was transformed into a pressure gradient recording by the simplified Bernoulli equation, and then a systolic pressure gradient-volume (PG-V) diagram was generated from similar methods. The area enclosed by the pressure-volume loop was calculated to represent semi-invasive right ventricular stroke work (RVSWRHC). The area between the PG-V diagram and x-axis was calculated to estimate non-invasive RVSW (RVSWecho). Patients with PAH have higher RV pressure, lower pulmonary arterial wedge pressure and larger RV volume that was contributed by the dilation of RV mid-cavity minor dimension. We found no significant difference of traditional parameters between these two groups, but RVSW values were significantly higher in PAH patients. The RVSW values of these two methods were significantly correlated by the equation RVSWecho = 0.8447 RVSWRHC + 129.38 (R² = 0.9151, p < 0.001). The linearity remained satisfactory in both groups. We conclude that a PG-V diagram is a reliable method to estimate RVSW and to depict pathophysiological status.



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A Machine-Learning Algorithm Toward Color Analysis for Chronic Liver Disease Classification, Employing Ultrasound Shear Wave Elastography

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Ilias Gatos, Stavros Tsantis, Stavros Spiliopoulos, Dimitris Karnabatidis, Ioannis Theotokas, Pavlos Zoumpoulis, Thanasis Loupas, John D. Hazle, George C. Kagadis
The purpose of the present study was to employ a computer-aided diagnosis system that classifies chronic liver disease (CLD) using ultrasound shear wave elastography (SWE) imaging, with a stiffness value-clustering and machine-learning algorithm. A clinical data set of 126 patients (56 healthy controls, 70 with CLD) was analyzed. First, an RGB-to-stiffness inverse mapping technique was employed. A five-cluster segmentation was then performed associating corresponding different-color regions with certain stiffness value ranges acquired from the SWE manufacturer-provided color bar. Subsequently, 35 features (7 for each cluster), indicative of physical characteristics existing within the SWE image, were extracted. A stepwise regression analysis toward feature reduction was used to derive a reduced feature subset that was fed into the support vector machine classification algorithm to classify CLD from healthy cases. The highest accuracy in classification of healthy to CLD subject discrimination from the support vector machine model was 87.3% with sensitivity and specificity values of 93.5% and 81.2%, respectively. Receiver operating characteristic curve analysis gave an area under the curve value of 0.87 (confidence interval: 0.77–0.92). A machine-learning algorithm that quantifies color information in terms of stiffness values from SWE images and discriminates CLD from healthy cases is introduced. New objective parameters and criteria for CLD diagnosis employing SWE images provided by the present study can be considered an important step toward color-based interpretation, and could assist radiologists' diagnostic performance on a daily basis after being installed in a PC and employed retrospectively, immediately after the examination.



http://ift.tt/2tXQphL

Acoustic and Elastic Properties of Glycerol in Oil-Based Gel Phantoms

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Luciana C. Cabrelli, Felipe W. Grillo, Diego R.T. Sampaio, Antonio A.O. Carneiro, Theo Z. Pavan
Phantoms are important tools for image quality control and medical training. Many phantom materials have been proposed for ultrasound; most of them use water as the solvent, but these materials have disadvantages such as dehydration and low temporal stability if not properly stored. To overcome these difficulties, copolymer-in-oil gel was proposed as an inert and stable material; however, speed of sound for these materials is still lower than what is described for most biological tissues. Here, we propose the glycerol dispersion in oil-based gels to modify the acoustic and elastic properties of copolymer-in-oil phantoms. We manufactured copolymer-in-oil gels using styrene-ethylene/butylene-styrene (SEBS) in concentrations 8%–15%. We used 2 types of mineral oils with different viscosities. Glycerol was added in a volume fraction 0%–30% of the total amount of liquid. The acoustic (i.e., speed of sound, attenuation and backscattering) and the mechanical (i.e., density and Young's modulus) properties of the samples were within the range of values observed for soft tissues. The acoustic parameters of the samples were dependent on oil viscosity and glycerol concentration. The speed of sound ranged 1423 m/s – 1502 m/s, while the acoustic attenuation and the ultrasonic backscattering increased by adding glycerol. The density and the Young's moduli were less affected by the presence of glycerol. We conclude that glycerol can be used to control the acoustic parameters of copolymer-in-oil gels. Additionally, it opens the possibility of incorporating other oil-insoluble substances to control further properties of the phantom.



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Peritoneal Carcinomatosis in Primary Ovarian Cancer: Ultrasound Detection and Comparison with Computed Tomography

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Zhenhong Qi, Yixiu Zhang, Qing Dai, Yu Xia, Yuxin Jiang
We retrospectively compared detection rates and consistency for diagnosis of peritoneal carcinomatosis (PC) of primary ovarian cancer (OC) between ultrasound (US) and computed tomography (CT) scans in 41 patients whose PC of OC (stages IIC–IV) had been diagnosed by histopathology findings. Compared with CT detection rates, those for US were significantly higher for metastases to the pelvic area (92.3% vs. 43.6%, p < 0.001) and bowel surface (64.0% vs. 16.0%, p = 0.002); however, they did not significantly differ for other sites: omentum, diaphragm, lateral peritoneum, mesenteric, hepatic and splenic surfaces. Diagnostic consistency between US and CT scans were fair to moderate for splenic (κ = 0.806), hepatic (κ = 0.485), lateral peritoneum (κ = 0.450) and diaphragm (κ = 0.338) surfaces, but poorly consistent for other parts (κ = 0.144–0.229). In summary, US can complement CT scans, especially for detecting PC of primary OC metastases in pelvic and bowel surfaces.



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Sonographic Phenotypes of Molecular Subtypes of Invasive Ductal Cancer in Automated 3-D Breast Ultrasound

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Jan C.M. van Zelst, Maschenka Balkenhol, Tao Tan, Matthieu Rutten, Mechli Imhof-Tas, Peter Bult, Nico Karssemeijer, Ritse M. Mann
Our aim was to investigate whether Breast Imaging Reporting and Data System—Ultrasound (BI-RADS-US) lexicon descriptors can be used as imaging biomarkers to differentiate molecular subtypes (MS) of invasive ductal carcinoma (IDC) in automated breast ultrasound (ABUS). We included 125 IDCs diagnosed between 2010 and 2014 and imaged with ABUS at two institutes retrospectively. IDCs were classified as luminal A or B, HER2 enriched or triple negative based on reports of histopathologic analysis of surgical specimens. Two breast radiologists characterized all IDCs using the BI-RADS-US lexicon and specific ABUS features. Univariate and multivariate analyses were performed. A multinomial logistic regression model was built to predict the MSs from the imaging characteristics. BI-RADS-US descriptor margins and the retraction phenomenon are significantly associated with MSs (both p < 0.001) in both univariate and multivariate analysis. Posterior acoustic features and spiculation pattern severity were only significantly associated in univariate analysis (p < 0.001). Luminal A IDCs tend to have more prominent retraction patterns than luminal B IDCs. HER2-enriched and triple-negative IDCs present significantly less retraction than the luminal subtypes. The mean accuracy of MS prediction was 0.406. Overall, several BI-RADS-US descriptors and the coronal retraction phenomenon and spiculation pattern are associated with MSs, but prediction of MSs on ABUS is limited.



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Feasibility of Combined Doppler–ECG Assessment of Internal Jugular Veins

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Inge Dierickx, Simon Van Hooland, Kathleen Tomsin, Daniel Vanhercke, Wilfried Cools, Hendrik Fransen, Wilfried Gyselaers
A standardized combined Doppler–electrocardiography technique was developed for measurement of the triphasic waveform characteristics in the internal jugular vein. Flow velocities at the A, X, V and Y peaks, the RR interval and the PA and RX times were measured. From these the venous impedance index ([X−A]/X) and the ratios PA/RR and RX/RR were calculated. Six measurements were performed at three different locations by two ultrasonographers in 21 randomly selected pregnant and non-pregnant women. Statistical models proved the feasibility and reproducibility of this technique, with the highest concordance correlation coefficients in the right distal internal vein. Bootstrapping revealed that repeating the measurements more than four times would not significantly enhance the precision of the estimated mean. Concordance correlation coefficients for the venous impedance index, PA time and PA/RR ratio were >0.63 for all three locations, proving their possible use in ongoing and future studies, analogous to previous studies in kidney and liver.



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Determination of Skeletal Muscle Microvascular Flowmotion with Contrast-Enhanced Ultrasound

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Sarah J. Blackwood, Renee M. Dwyer, Eloise A. Bradley, Michelle A. Keske, Stephen M. Richards, Stephen Rattigan
Most methods of assessing flowmotion (rhythmic oscillation of blood flow through tissue) are limited to small sections of tissue and are invasive in tissues other than skin. To overcome these limitations, we adapted the contrast-enhanced ultrasound (CEUS) technique to assess microvascular flowmotion throughout a large region of tissue, in a non-invasive manner and in real time. Skeletal muscle flowmotion was assessed in anaesthetised Sprague Dawley rats, using CEUS and laser Doppler flowmetry (LDF) for comparison. Wavelet transformation of CEUS and LDF data was used to quantify flowmotion. The α-adrenoceptor antagonist phentolamine was infused to predictably blunt the neurogenic component of flowmotion. Both techniques identified similar flowmotion patterns, validating the use of CEUS to assess flowmotion. This study demonstrates for the first time that the novel technique of CEUS can be adapted for determination of skeletal muscle flowmotion in large regions of skeletal muscle.



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Transcranial Doppler and Microemboli Detection: Relationships to Symptomatic Status and Histopathology Findings

Publication date: September 2017
Source:Ultrasound in Medicine & Biology, Volume 43, Issue 9
Author(s): Carol C. Mitchell, Stephanie M. Wilbrand, Bornali Kundu, Catherine N. Steffel, Tomy Varghese, Nirvedh H. Meshram, Geng Li, Thomas D. Cook, M. Shahriar Salamat, Robert J. Dempsey
The purpose of this study was to determine the relationship between symptomatic status, transcranial Doppler (TCD) microemboli presence and plaque histopathology findings. TCD was performed on 60 patients (37 symptomatic, 23 asymptomatic) before undergoing clinically indicated carotid endarterectomy. The frequency of microemboli signals was not significantly different between symptomatic and asymptomatic subject groups (p = 0.88) and there were no differences observed in the macroscopic or histopathology scoring of these plaques (p-values all > 0.05). The presence of microemboli was associated with an ulceration score (regardless of symptomatic or asymptomatic status, p = 0.034), with a one-level increase in ulceration rating associated with an odds ratio of 5.86 (95% [CI] 1.55, 43.4). These findings suggest that both symptomatic and asymptomatic patients may have plaque with similar features of instability and ability to create emboli. Thus, identifying new ways to measure plaque instability may provide important information for optimizing treatment to prevent future stroke.



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Tissue Hemostasis is Shifted Toward Thrombogenesis in the Psoriatic Plaques

Publication date: Available online 15 July 2017
Source:Pathology - Research and Practice
Author(s): Edyta Gębska, Agnieszka Sikora-Żydek, Marek Michalski, Edyta Reichman-Warmusz, Józef Kurek, Damian Dudek, Wiktor Skowron, Jerzy Jarząb, Romuald Wojnicz
BackgroundPsoriasis is a common autoimmune disease of unknown etiology. Recently, much attention has been paid to evidence that a local hypercoagulable state is an important contributing factor to the development of inflammatory skin diseases. Thus, the aim of this study was to characterize the local hemostasis in the affected skin of patients with psoriasis.MethodsSkin biopsies of psoriatic plaques were obtained from 73 consecutive patients (48M, 25F, average age 45 years) with at least a one year history of the disease. The studied patients had not received any specific systemic treatment for at least 4 weeks before the biopsy was done. As a control, normal skin biopsies were obtained from 16 healthy subjects. For immunohistological study, the En-Vision method (DAKO EnVision Kit ®/Alkaline Phosphatase detection system), and monoclonal antibodies anti-tissue factor (TF), anti-thrombomodulin (TM) and anti-von Willebrand Factor (vWF) were used. All these molecules were assessed semi-quantitatively in the frozen sections.ResultsClinically, the Body Surface Area index ranged between 1 to 90% and the Psoriasis Area Severity Index score ranged from 1.6 to 47. Immunohistochemistry revealed redistribution of TF antigens from the upper to lower layers of the epidermis as compared to the control. It was collaborated with the number of TF-positive cells in the psoriatic skin sections (78.3%) as compared with the healthy subjects (34.4%; P<0.001). In addition, TF was uniformly and moderately expressed on capillary endothelial cells of the plaque sections in 43 out of 73 patients (58.9%). As far as the thrombomodulin is concerned, TM was clearly down-regulated and localized mainly in the upper layers of the psoriatic epidermis. It was collaborated with the number of TM positive cells in the psoriatic skin sections (38.9%) as compared with the healthy subjects (66.7%; P<0.001). All capillary vessels found in the biopsy sections were positive for TM and vWF staining, with similar expression (≥2+) in both groups. In the current study, no relationship was found between the TF, TM and vWF expression and the PASI and BAS (NS).ConclusionsA local procoagulable state found in psoriatic plaques suggests a significant role of local tissue hemostasis in pathogenesis of the disease. These findings indicate another potential target for a therapeutic approach in patients with psoriasis, although further research would help elucidate the exact mechanisms.



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Upregulation of Caprin1 Expression is Associated with Poor Prognosis in Hepatocellular Carcinoma

Publication date: Available online 15 July 2017
Source:Pathology - Research and Practice
Author(s): Ning Tan, Ling Dai, Xiaojia Liu, Guangdong Pan, Hui Chen, Jiang Huang, Qing Xu
Caprin-1 has been found to promotes osteosarcoma tumor growth, lung metastasis in mice, regulating the proliferation and invasion of human breast cancer cells and up-regulated in proton beam irradiated human melanoma cells. However, its clinical role, biological function in the hepatocellular carcinoma (HCC) remains unknown. In the present study, we investigated the clinical significance of Caprin1 in the HCC. Caprin1 expression was detected by immunohistochemistry, and the expression level was analyzed in 65 HCC tissues and paired peritumoral tissue. Prognostic value of Caprin1 in HCC was evaluated in 174 cases using Kaplan-Meier analysis. Univariate survival analysis and multiple Cox proportional hazards regression were performed using the Cox regression analysis. Immunohistochemistry revealed that Caprin1 expression in 65 HCC tissues was upregulated compared to paired peritumoral tissue (p=0.0064). Survival analysis in 174 HCC patient tissues was showed that high Caprin1 expression was significantly associated with worse overall survival (HR=1.513, p=0.042). In conclusion, high Caprin1 expression independently predicts a poor outcome for patients with HCC, supporting that Caprin1 may be a promising novel HCC prognostic factor.



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Expression of MyHC isoforms mRNA transcripts in different regions of the masseter and medial pterygoid muscles in chimpanzees

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Neus Ciurana, Rosa Artells, Carmen Muñoz, Júlia Arias-Martorell, Gaëlle Bello-Hellegouarch, Alejandro Pérez-Pérez, Juan Francisco Pastor, Josep Maria Potau
ObjectiveThe aim of this study is to examine the expression pattern of the different myosin heavy chain (MyHC) isoforms in the masseter and medial pterygoid muscles by real time quantitative polymerase chain reaction (RT-qPCR) to obtain information at molecular level which can be related to the functional characteristics of these two muscles.DesignThe masseter, deep and superficial portion, and medial pterygoid muscles of five adult Pan troglodytes were dissected in order to obtain samples of the anterior and posterior regions of each portion of the masseter and of the medial pterygoid. The expression of MyHC isoforms mRNA transcripts was analyzed by RT-qPCR.ResultsNo significant differences in expression of MyHC isoforms between the masseter and the medial pterygoid were found. In contrast, when comparing the superficial and the deep portion of the masseter, we found that the MyHC-IIM isoform was expressed at a significantly higher level in the superficial portion.ConclusionsThe superficial portion of the masseter and the medial pterygoid muscle have the same expression pattern regarding the different MyHC isoforms. On the other hand, the deep portion of the masseter, which is activated mainly during lateral and repositioning movements of the mandible, has a lower MyHC-IIM isoform expression than the superficial portion. Our findings provide new data on functional aspects of the masseter and medial pterygoid that can complement results obtained by other techniques.



http://ift.tt/2ureFLn

In silico search of inhibitors of Streptococcus mutans for the control of dental plaque

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Rodrigo Ochoa, María Cecilia Martínez-Pabón, María Adelaida Arismendi-Echeverri, Willer Leandro Rendón-Osorio, Carlos Enrique Muskus-López
Biofilm is an extremely complex microbial community arranged in a matrix of polysaccharides and attached to a substrate. Its development is crucial in the pathophysiology of oral infections like dental caries, as well as in periodontal, pulp, and periapical diseases. Streptococcus mutans is one of the most effective microorganisms in lactic acid production of the dental biofilm. Identifying essential Streptococcus mutans proteins using bioinformatics methods helps to search for alternative therapies. To this end, the bacterial genomes of several Streptococcus mutans strains and representative strains of other cariogenic and non-cariogenic bacteria were analysed by identifying pathogenicity islands and alignments with other bacteria, and by detecting the exclusive genes of cariogenic species in comparison to the non-pathogenic ones. This study used tools for orthology prediction such as BLAST and OrthoMCL, as well as the server IslandViewer for the detection of pathogenicity islands. In addition, the potential interactome of Streptococcus mutans was rebuilt by comparing it to interologues of other species phylogenetically close to or associated with cariogenicity. This protocol yielded a final list of 20 proteins related to potentially virulent factors that can be used as therapeutic targets in future analyses. The EIIA and EIIC enzymatic subunits of the phosphotransferase system (PTS) were prioritized, as well as the pyruvate kinase enzyme, which are directly involved in the metabolism of carbohydrates and in obtaining the necessary energy for the microorganism's survival. These results will guide a subsequent experimental trial to develop new, safe, and effective molecules in the treatment of dental caries.



http://ift.tt/2vpIwkL

Freshwater fishes of Lower Guinean forest streams: Aquaculture heavily impacts the structure and diversity of communities

Publication date: Available online 15 July 2017
Source:Acta Oecologica
Author(s): Nioking Amadi, Fabio Petrozzi, Godfrey C. Akani, Daniele Dendi, Barineme B. Fakae, Luca Luiselli, Nic Pacini
Little is known about fish diversity in the coastal streams south-eastern Nigeria in this world-renowned biodiversity hotspot. In these ecosystems, the combination of seasonal changes in hydrology as well as the presence of coastal forests provides a greater biotope diversity, food and shelter for many fish species. Currently, however, deforestation, pollution and exotic species invasions impact the system's hydrology, water quality ultimately changing fish assemblage composition. In this paper, we describe the current status of fish diversity in the forested coastal streams of south-eastern Nigerian based on recent collections and data drawn from selected scientific publications. We found a total of 88 fish species from 27 families in 10 orders. . Fish assemblages were generally characterised by a low evenness, with 90% of specimens belonging to over a quarter of the overall number of taxa, and strongly dominated by species of aquaculture interest, such as tilapiine cichlids. The studied stations had a high heterogeneity and non-comparable diversity profiles; stressing the role played by local conditions. Stations closer to the River Niger Delta differed significantly from the remaining large relatively homogeneous cluster. We found that the spatial turnover components of β-diversity were significant, and this was related to longitudinal distance, and not to species replacement by ecological vicariants. The observed species composition and the diversity patterns are consistent with a scenario whereby an originally high biodiversity is being eroded because of habitat degradation and the impact of alien species.



http://ift.tt/2tsEFSM

Cutaneous Manifestations of Scleroderma and Scleroderma-Like Disorders: a Comprehensive Review

Abstract

Scleroderma refers to an autoimmune connective tissue fibrosing disease, including three different subsets: localized scleroderma, limited cutaneous systemic sclerosis, and diffuse cutaneous systemic sclerosis with divergent patterns of organ involvement, autoantibody profiles, management, and prognostic implications. Although systemic sclerosis is considered the disease prototype that causes cutaneous sclerosis, there are many other conditions that can mimic and be confused with SSc. They can be classified into immune-mediated/inflammatory, immune-mediated/inflammatory with abnormal deposit (mucinoses), genetic, drug-induced and toxic, metabolic, panniculitis/vascular, and (para)neoplastic disorders according to clinico-pathological and pathogenetic correlations. This article reviews the clinical presentation with emphasis on cutaneous disease, etiopathogenesis, diagnosis, and treatment options available for the different forms of scleroderma firstly and for scleroderma-like disorders, including scleromyxedema, scleredema, nephrogenic systemic fibrosis, eosinophilic fasciitis, chronic graft-versus-host disease, porphyria cutanea tarda, diabetic stiff-hand syndrome (diabetic cheiroartropathy), and other minor forms. This latter group of conditions, termed also scleroderma mimics, sclerodermiform diseases, or pseudosclerodermas, shares the common thread of skin thickening but presents with distinct cutaneous manifestations, skin histology, and systemic implications or disease associations, differentiating each entity from the others and from scleroderma. The lack of Raynaud's phenomenon, capillaroscopic abnormalities, or scleroderma-specific autoantibodies is also important diagnostic clues. As cutaneous involvement is the earliest, most frequent and characteristic manifestation of scleroderma and sclerodermoid disorders, dermatologists are often the first-line doctors who must be able to promptly recognize skin symptoms to provide the affected patient a correct diagnosis and appropriate management.

http://ift.tt/2tXnzOJ

Glutathione peroxidase 4-catalyzed reduction of lipid hydroperoxides in membranes: The polar head of membrane phospholipids binds the enzyme and addresses the fatty acid hydroperoxide group toward the redox center

Publication date: November 2017
Source:Free Radical Biology and Medicine, Volume 112
Author(s): Giorgio Cozza, Monica Rossetto, Valentina Bosello-Travain, Matilde Maiorino, Antonella Roveri, Stefano Toppo, Mattia Zaccarin, Lucio Zennaro, Fulvio Ursini
GPx4 is a monomeric glutathione peroxidase, unique in reducing the hydroperoxide group (-OOH) of fatty acids esterified in membrane phospholipids. This reaction inhibits lipid peroxidation and accounts for enzyme's vital role. Here we investigated the interaction of GPx4 with membrane phospholipids. A cationic surface near the GPx4 catalytic center interacts with phospholipid polar heads. Accordingly, SPR analysis indicates cardiolipin as the phospholipid with maximal affinity to GPx4. Consistent with the electrostatic nature of the interaction, KCl increases the KD. Molecular dynamic (MD) simulation shows that a -OOH posed in the core of the membrane as 13 - or 9 -OOH of tetra-linoleoyl cardiolipin or 15 -OOH stearoyl-arachidonoyl-phosphaphatidylcholine moves to the lipid-water interface. Thereby, the -OOH groups are addressed toward the GPx4 redox center. In this pose, however, the catalytic site facing the membrane would be inaccessible to GSH, but the consecutive redox processes facilitate access of GSH, which further primes undocking of the enzyme, because GSH competes for the binding residues implicated in docking. During the final phase of the catalytic cycle, while GSSG is produced, GPx4 is disconnected from the membrane. The observation that GSH depletion in cells induces GPx4 translocation to the membrane, is in agreement with this concept.

Graphical abstract

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Photobiomodulation therapy improves both inflammatory and fibrotic parameters in experimental model of lung fibrosis in mice

Abstract

Lung fibrosis (LF) is a chronic and progressive lung disease characterized by pulmonary parenchyma progressive lesion, inflammatory infiltration, and interstitial fibrosis. It is developed by excessive collagen deposition and other cellular matrix components, resulting in severe changes in the alveolar architecture. Considering the absence of effective treatment, the aim of this study was to investigate the effect of photobiomodulation therapy (PBMT) on the development of PF. For this purpose, we used C57BL6 mice subjected to induction of LF by bleomycin administration (1.5 U/kg) by orotracheal route and, after 14 days of the induction, mice were treated with PBMT applied to the thorax 1×/day for 8 days (wavelength 660 ± 20 nm, power 100 mW, radiant exposure 5 J/cm², irradiance 33.3 mW/cm², spot size 2.8cm², total energy 15 J, time of irradiation: 150 s) and inflammatory and fibrotic parameters were evaluated with or without PBMT. Our results showed that PBMT significantly reduced the number of inflammatory cells in the alveolar space, collagen production, interstitial thickening, and static and dynamic pulmonary elastance. In addition, we observed reduced levels of IL-6 e CXCL1/KC released by pneumocytes in culture as well as reduced level of CXCL1/KC released by fibroblasts in culture. We can conclude that the PBMT improves both inflammatory and fibrotic parameters showing a promising therapy which is economical and has no side effects.

http://ift.tt/2teI38z

Toxicity of cypermethrin and deltamethrin insecticides on embryos and larvae of Physalaemus gracilis (Anura: Leptodactylidae)

Abstract

It is important to establish the toxicity pesticides against non-target species, especially those pesticides used in commercial formulations. Pyrethroid insecticides are widely used in agriculture despite their toxicity to aquatic animals. In this study, we determine the toxicity of commercial formulation of two pyrethroid insecticides, cypermethrin and deltamethrin, in two life stages of Physalaemus gracilis, a frog that breeds in agricultural ecosystems and has potential contact with pyrethroid pesticides. The acute toxicity test (96 h) was carried out with embryos of stage 17:18 and larvae of stages 24:25. Embryos were more resistant to both pesticides than larvae. In embryo mobility assays, we found that both pesticides caused spasmodic contractions, suggestive of neurological effects. In acute toxicity assays, we found that P. gracilis is more resistant to these insecticides than other studied species.

http://ift.tt/2vpkPJl

Modified-BRISQUE as no reference image quality assessment for structural MR images

Publication date: Available online 15 July 2017
Source:Magnetic Resonance Imaging
Author(s): Li Sze Chow, Heshalini Rajagopal
An effective and practical Image Quality Assessment (IQA) model is needed to assess the image quality produced from any new hardware or software in MRI. A highly competitive No Reference – IQA (NR – IQA) model called Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE) initially designed for natural images were modified to evaluate structural MR images. The BRISQUE model measures the image quality by using the locally normalized luminance coefficients, which were used to calculate the image features. The modified-BRISQUE model trained a new regression model using MR image features and Difference Mean Opinion Score (DMOS) from 775 MR images. Two types of benchmarks: objective and subjective assessments were used as performance evaluators for both original and modified-BRISQUE models. There was a high correlation between the modified-BRISQUE with both benchmarks, and they were higher than those for the original BRISQUE. There was a significant percentage improvement in their correlation values. The modified-BRISQUE was statistically better than the original BRISQUE. The modified-BRISQUE model can accurately measure the image quality of MR images. It is a practical NR-IQA model for MR images without using reference images.



http://ift.tt/2teYRMI

Three-dimensional adiabatic inversion recovery prepared ultrashort echo time cones (3D IR-UTE-Cones) imaging of cortical bone in the hip

Publication date: Available online 15 July 2017
Source:Magnetic Resonance Imaging
Author(s): Amin Nazaran, Michael Carl, Yajun Ma, Saeed Jerban, Yanchun Zhu, Xing Lu, Jiang Du, Eric Y. Chang
PurposeWe present three-dimensional adiabatic inversion recovery prepared ultrashort echo time Cones (3D IR-UTE-Cones) imaging of cortical bone in the hip of healthy volunteers using a clinical 3T scanner.MethodsA 3D IR-UTE-Cones sequence, based on a short pulse excitation followed by a 3D Cones trajectory, with a nominal TE of 32μs, was employed for high contrast morphological imaging of cortical bone in the hip of heathy volunteers. Signals from soft tissues such as muscle and marrow fat were suppressed via adiabatic inversion and signal nulling. T2^⁎ value of the cortical bone was also calculated based on 3D IR-UTE-Cones acquisitions with a series of TEs ranging from 0.032 to 0.8ms. A total of four healthy volunteers were recruited for this study. Average T2^⁎ values and the standard deviation for four regions of interests (ROIs) at the greater trochanter, the femoral neck, the femoral head and the lesser trochanter were calculated.ResultsThe 3D IR-UTE-Cones sequence provided efficient suppression of soft tissues with excellent image contrast for cortical bone visualization in all volunteer hips. Exponential single component decay was observed for all ROIs, with averaged T2^⁎ values ranging from 0.33 to 0.45ms, largely consistent with previously reported T2^⁎ values of cortical bone in the tibial midshaft.ConclusionsThe 3D IR-UTE-Cones sequence allows in vivo volumetric imaging and quantitative T2^⁎ measurement of cortical bone in the hip using a clinical 3T scanner.



http://ift.tt/2tWV3g1

MRI magic-angle effect in femorotibial cartilages of the red kangaroo

Publication date: Available online 15 July 2017
Source:Magnetic Resonance Imaging
Author(s): Tonima S. Ali, Namal Thibbotuwawa, YuanTong Gu, Konstantin I. Momot
ObjectiveKangaroo knee cartilages are robust tissues that can support knee flexion and endure high levels of compressive stress. This study aimed to develop a detailed understanding of the collagen architecture in kangaroo knee cartilages and thus obtain insights into the biophysical basis of their function.DesignCylindrical/square plugs from femoral and tibial hyaline cartilage and tibial fibrocartilage were excised from the knees of three adult red kangaroos. Multi-slice, multi-echo MR images were acquired at the sample orientations 0° and 55° ("magic angle") with respect to the static magnetic field. Maps of the transverse relaxation rate constant (R2) and depth profiles of R2 and its anisotropic component (R2^A) were constructed from the data.ResultsThe R2^A profiles confirmed the classic three-zone organisation of all cartilage samples. Femoral hyaline cartilage possessed a well-developed, thick superficial zone. Tibial hyaline cartilage possessed a very thick radial zone (80% relative thickness) that exhibited large R2^A values consistent with highly ordered collagen. The R2^A profile of tibial fibrocartilage exhibited a unique region near the bone (bottom 5–10%) consistent with elevated proteoglycan content ("attachment sub-zone").ConclusionsOur observations suggest that the well-developed superficial zone of femoral hyaline cartilage is suitable for supporting knee flexion; the thick and well-aligned radial zone of tibial hyaline cartilage is adapted to endure high compressive stress; while the innermost part of the radial zone of tibial fibrocartilage may facilitate anchoring of the collagen fibres to withstand high shear deformation. These findings may inspire new designs for cartilage tissue engineering.



http://ift.tt/2tesAW2

Trimmed autocalibrating K-space estimation based on structured matrix completion

Publication date: Available online 15 July 2017
Source:Magnetic Resonance Imaging
Author(s): Mark Bydder, Stanislas Rapacchi, Olivier Girard, Maxime Guye, Jean-Philippe Ranjeva
PurposeParallel imaging allows the reconstruction of undersampled data from multiple coils. This provides a means to reject and regenerate corrupt data (e.g. from motion artefact). The purpose of this work is to approach this problem using the SAKE parallel imaging method.Theory and methodsParallel imaging methods typically require calibration by fully sampling the center of k-space. This is a challenge in the presence of corrupted data, since the calibration data may be corrupted which leads to an errors-in-variables problem that cannot be solved by least squares or even iteratively reweighted least squares. The SAKE method, based on matrix completion and structured low rank approximation, was modified to detect and trim these errors from the data.ResultsSimulated and actual corrupted datasets were reconstructed with SAKE, the proposed approach and a more standard reconstruction method (based on solving a linear equation) with a data rejection criterion. The proposed approach was found to reduce artefacts considerably in comparison to the other two methods.ConclusionSAKE with data trimming improves on previous methods for reconstructing images from grossly corrupted data.



http://ift.tt/2tXDxIk

Cancer recurrence monitoring using hyperpolarized [1-13C]pyruvate metabolic imaging in murine breast cancer model

Publication date: Available online 15 July 2017
Source:Magnetic Resonance Imaging
Author(s): Peter J. Shin, Zihan Zhu, Roman Camarda, Robert A. Bok, Alicia Y. Zhou, John Kurhanewicz, Andrei Goga, Daniel B. Vigneron
The purpose of this work was to study the anatomic and metabolic changes that occur with tumor progression, regression and recurrence in a switchable MYC-driven murine breast cancer model. Serial ¹H MRI and hyperpolarized [1-¹³C]pyruvate metabolic imaging were used to investigate the changes in tumor volume and glycolytic metabolism over time during the multistage tumorigenesis. We show that acute de-induction of MYC expression in established tumors results in rapid tumor regression and significantly reduced glycolytic metabolism as measured by pyruvate-to-lactate conversion. Moreover, cancer recurrences occurring at the tumor sites independently of MYC expression were observed to accompany markedly increased lactate production.



http://ift.tt/2tf3beD

Transoral robotic total laryngopharyngectomy and free jejunal flap reconstruction for hypopharyngeal cancer

For locally advanced tumours involving the post-cricoid region and the cervical esophagus, total laryngo-pharyngectomy is required and the subsequent circumferential pharyngeal defect is preferentially reconstructed using microvascular free flaps [1]. The current report describes the surgical protocol utilized by the author to perform total laryngo-pharyngectomy and free jejunal flap reconstruction using the TORS approach.

http://ift.tt/2t2JH8T

Respiratory Virus prior to Hematopoietic Cell Transplantation is associated with allo-immune mediated lung syndromes

This study shows a strong relation between Respiratory Virus prior to transplant, and alloimmune lungsyndromes, which may have therapeutic implications. Our hypothesis, based on biological and pathophysiological factors, can guide reflections on immunemediated disease in general.

http://ift.tt/2t2IHSe

A behavioral intervention for insomnia improves blood pressure

Insomnia is associated with sympathetic nervous system (SNS) arousal1 and hypertension2. We tested whether improving sleep in individuals with insomnia affects blood pressure (BP).

http://ift.tt/2trVWeC

More sleep? An adaptive response to control pain after traumatic brain injury

In a recent issue of Sleep Medicine, Suzuki and coworkers [1] presented several considerations regarding posttraumatic hypersomnia in patients with a recent mild traumatic brain injury (mTBI). After one month, mTBI patients with moderate to severe pain (acute pain) presented more naps (>3 naps/day) and longer sleep (>8h/night) than patients with mild pain. After one year post-injury, mTBI patients continue to sleep longer, despite the presence of chronic pain.

http://ift.tt/2tVMFPB

Nonspecialist Raters Can Provide Reliable Assessments of Procedural Skills

Publication date: Available online 14 July 2017
Source:Journal of Surgical Education
Author(s): Oria Mahmood, Julia Dagnæs, Sarah Bube, Malene Rohrsted, Lars Konge
BackgroundCompetency-based learning has become a crucial component in medical education. Despite the advantages of competency-based learning, there are still challenges that need to be addressed. Currently, the common perception is that specialist assessment is needed for evaluating procedural skills which is difficult owing to the limited availability of faculty time. The aim of this study was to explore the validity of assessments of video recorded procedures performed by nonspecialist raters.MethodsThis study was a blinded observational trial. Twenty-three novices (senior medical students) and 9 experienced doctors were video recorded while each performing 2 flexible cystoscopies on patients. The recordings were anonymized and placed in random order and then rated by 2 experienced cystoscopists (specialist raters) and 2 medical students (nonspecialist raters). Flexible cystoscopy was chosen as it is a simple procedural skill that is crucial to master in a resident urology program.ResultsThe internal consistency of assessments was high, Cronbach's α = 0.93 and 0.95 for nonspecialist and specialist raters, respectively (p < 0.001 for both correlations). The interrater reliability was significant (p < 0.001) with a Pearson's correlation of 0.77 for the nonspecialists and 0.75 for the specialists. The test-retest reliability showed the biggest difference between the 2 groups, 0.59 and 0.38 for the nonspecialist raters and the specialist raters, respectively (p < 0.001).ConclusionOur study suggests that nonspecialist raters can provide reliable and valid assessments of video recorded cystoscopies. This could make mastery learning and competency-based education more feasible.



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A Review of Empathy, Its Importance, and Its Teaching in Surgical Training

Publication date: Available online 14 July 2017
Source:Journal of Surgical Education
Author(s): Jing L. Han, Theodore N. Pappas
BackgroundThere has been much discussion in the medical literature about the importance of empathy and physician communication style in medical practice. Empathy has been shown to have a very real positive effect on patient outcomes. Most of the existing literature speaks to its role in medical education, with relatively little empiric study about empathy in the surgical setting.ObjectiveReview of empathy and its importance as it pertains to the surgeon-patient relationship and improving patient outcomes, and the need for increased education in empathy during surgical training.MethodsThe published, peer-reviewed literature on patient-physician and patient-surgeon communication, medical student and resident education in empathy, and empathy research was reviewed. PubMed was queried for MESH terms including "empathy," "training," "education," "surgery," "resident," and "communication."ResultsThere is evidence of a decline in empathy that begins during the clinical years of medical school, which continues throughout residency training. Surgeons are particularly susceptible to this decline as by-product of the nature of their work, and the current lack of formalised training in empathic patient communication poses a unique problem to surgical residents.ConclusionsThe literature suggests that empathy training is warranted and should be incorporated into surgical residencies through didactics, role-playing and simulations, and apprenticeship to empathic attending role models.



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Undergraduate Clinical Teaching in Orthopedic Surgery: A Randomized Control Trial Comparing the Effect of Case-Based Teaching and Bedside Teaching on Musculoskeletal OSCE Performance

Publication date: Available online 15 July 2017
Source:Journal of Surgical Education
Author(s): Martin Kelly, Iain Feeley, Fiona Boland, John M. O'Byrne
IntroductionMusculoskeletal (MSK) complaints are the second most common reason for a hospital outpatient appointment in the US, and account for 19.5% of general practice consultations. Previous studies have shown that passive teaching in medical school does not imbue students with an adequate degree of confidence in MSK evaluation. The aim of this study was to conduct a randomized control trial to compare the effect of the gold standard small group tutorial of bedside teaching against case-based teaching (CBT) in relation to orthopedic surgery in medical students.MethodsAll third-year medical students at our institution were invited to participate in a randomized control trial comparing CBT and bedside tutorials in relation to MSK. The primary outcome was student performance in an Objective Structured Clinical Examination (OSCE). Participants were randomized into 2 groups, receiving either a bedside tutorial or a case-based tutorial. Participants were then assigned self-directed learning before undergoing a final OSCE assessment. Student feedback was attained through a poststudy questionnaire.ResultsComplete data was acquired for 96 study participants (n = 45 CBT; n = 51 bedside tutorial). The results of a linear regression model used to assess differences in the final OSCE scores, adjusting for the baseline OSCE score, gender, age, previous problem-based learning exposure and whether English was their first language or not showed no evidence of a difference between the bedside teaching group and the CBT group (mean difference: 0.34; 95% confidence interval: −3.79 to 4.47; p = 0.872). Almost all (95%) of the study participants felt that CBT was an important component in their learning.ConclusionThere was no difference in OSCE performance between groups. The introduction of CBT before clinical placement in medical school could accentuate the clinical skills of students before transition into the apprenticeship model of clinical attachment.



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Interaction of cholera toxin B subunit with T and B lymphocytes

Publication date: September 2017
Source:International Immunopharmacology, Volume 50
Author(s): Elena V. Navolotskaya, Vladimir B. Sadovnikov, Dmitry V. Zinchenko, Valery M. Lipkin, Vladimir P. Zav'yalov
We have prepared ¹²⁵I-labeled cholera toxin B subunit (¹²⁵I-labeled CT-B, a specific activity of 98Ci/mmol) and found that its binding to T and B lymphocytes from the blood of healthy donors was high-affinity (Kd 2.8 and 3.0nM, respectively). The binding of labeled protein was completely inhibited by unlabeled thymosin-α1 (TM-α1), interferon-α2 (IFN-α2), and the synthetic peptide LKEKK that corresponds to residues 16–20 in TM-α1 and 131–135 in IFN-α2, but was not inhibited by the synthetic peptide KKEKL with inverted amino acid sequence (Ki>10μM). Thus, TM-α1, IFN-α2, and the peptide: LKEKK bind with high affinity and specificity to CT-B receptor on donor blood T and B lymphocytes. It was found that CT-B and the peptide: LKEKK at concentrations of 10–1000nM increased in a dose-dependent manner the soluble guanylate cyclase activity in T and B lymphocytes.

Graphical abstract

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Respiratory Virus prior to Hematopoietic Cell Transplantation is associated with allo-immune mediated lung syndromes

Publication date: Available online 15 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Birgitta Versluys, Marc Bierings, Jean Luc Murk, Tom Wolfs, Caroline Lindemans, Kors vd Ent, Jaap Jan Boelens
BackgroundAllo-immune mediated lung syndromes (allo-LS) are life-threatening complications after hematopoietic cell transplantation (HCT). Respiratory virus (RV) has been suggested to play a role in the pathogenesis.ObjectiveWe studied the relation between RV-DNA/RNA detection in upper/lower airway before HCT and the occurrence of allo-LS.MethodsWe retrospectively analyzed all HCT recipients between 2004 and 2014, in whom Real-Time PCR for RV was done from Nasal-Pharyngeal-Aspirates (NPA) and Broncho-Alveolar- Lavage (BAL) before HCT. Main outcome of interest was allo-LS, defined as Idiopathic Pneumonia Syndrome or Bronchiolitis Obliterans Syndrome. Other outcomes were overall survival and treatment related mortality (TRM). We used Cox proportional hazard models, logistic regression models and Fine-Gray competing risk regression for analyses.Results179 children (median age 6.8 years) were included. RV was found in 61% (41% in BAL/NPA, 20% in NPA-only). Rhinovirus was the most frequently detected RV (42%). Allo-LS occurred in 13 %. RV-positivity in BAL was a predictor for allo-LS (HR 3·8, 95% CI 1·4 – 10·7; p=0·01), while RV-positivity in NPA-only was not. No other predictors were found. Acute Graft-Versus-Host-Disease grade 2-4, related with steroid treatment, shows a trend towards a protective effect (OR 0·16, 95%CI 0·0–1·3; p=0·08). Allo-LS significantly increased TRM (52 ± 10% in allo-LS, 20 ± 4% in non-allo-LS, p= 0·007).ConclusionsThese results show that pre-HCT BAL RV-positivity was a predictor for allo-LS. Screening for RV before HCT may identify patients at risk for allo-LS. This may have implications for prevention and treatment and may subsequently influence the outcomes of HCT.

Graphical abstract

Teaser

This study shows a strong relation between Respiratory Virus prior to transplant, and alloimmune lungsyndromes, which may have therapeutic implications. Our hypothesis, based on biological and pathophysiological factors, can guide reflections on immunemediated disease in general.


http://ift.tt/2tVOJa7

Differences between genders in colorectal morphology on CT colonography using a quantitative approach: a pilot study

Publication date: Available online 15 July 2017
Source:Clinical Imaging
Author(s): Charles N. Weber, Jason A. Poff, Anna S. Lev-Toaff, Marc S. Levine, Hanna M. Zafar
PurposeTo explore quantitative differences between genders in morphologic colonic metrics and determine metric reproducibility.MethodsQuantitative colonic metrics from 20 male and 20 female CTC datasets were evaluated twice by two readers; all exams were performed after incomplete optical colonoscopy. Intra−/inter-reader reliability was measured with intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC).ResultsWomen had overall decreased colonic volume, increased tortuosity and compactness and lower sigmoid apex height on CTC compared to men (p<0.0001,all). Quantitative measurements in colonic metrics were highly reproducible (ICC=0.9989 and 0.9970; CCC=0.9945).ConclusionQuantitative morphologic differences between genders can be reproducibility measured.



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The Impact of Knowledge Transfer on the Detection of Venous Invasion in Colorectal Cancer

Publication date: Available online 15 July 2017
Source:Human Pathology
Author(s): Richard Kirsch, Naziheh Assarzadegan, David E Messenger, Ari Juda, Robert H Riddell, Aaron Pollett, Catherine J Streutker, Dimitrios X Divaris, Ken J Newell, Russell G Price, Sharyn Smith, Sahar Al-Haddad, Jeremy R Parfitt, David K Driman
Venous invasion (VI) is an independent predictor of hematogenous metastasis and mortality in colorectal cancer (CRC), yet remains widely under-reported. Its detection may require recognition of subtle morphologic clues which at times are only unmasked with an elastin stain. This study evaluates the impact of a knowledge transfer initiative (KTI) on VI detection in a "real world" pathology practice setting. Following participation in an interobserver variability study of VI detection (Kirsch et al 2013), twelve participants received educational materials highlighting key issues in VI detection. Eighteen months later, participants were invited to submit pathology reports from all CRC resections signed-out 18 months prior to and 18 months following the KTI (n=266 and n=244, respectively). Nine pathologists participated. Reports were reviewed for VI and other established prognostic factors. Numbers of elastin stains and tumor-containing blocks were also recorded. Comparative analyses were adjusted for baseline differences in TNM (tumor, lymph node, and metastasis) stage, tumor location, use of neoadjuvant therapy and number of tumor-containing blocks. VI detection increased significantly post-KTI vs. pre-KTI (39.3% vs 18.4%; adjusted odds ratio (OR) 2.86 [1.91-4.28], p<0.001). Increased VI detection post-KTI was observed in both stage II (31.8% vs 12.5%, adjusted OR 3.27 [1.45-7.42], p=0.004) and stage III CRC (62.4% vs 28.2%, adjusted OR 4.23 [2.37-7.55], p<0.001). All pathologists demonstrated increased VI detection post-KTI. Use of elastin stains was significantly higher post-KTI vs. pre-KTI (61.5% vs. 5.3% of cases respectively, p<0.001). This study demonstrates the effectiveness of knowledge transfer in increasing VI detection in routine pathology practice.



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Incipient serous cystic neoplasia of the pancreas is a very rare phenomenon: A systematic prospective observation in pancreatectomy specimens

Publication date: Available online 15 July 2017
Source:Human Pathology
Author(s): Łukasz Liszka




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Incipient serous cystic neoplasia of the pancreas is a very rare phenomenon: A systematic prospective observation in pancreatectomy specimens—reply

Publication date: Available online 15 July 2017
Source:Human Pathology
Author(s): So-Woon Kim




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Renal Cell Carcinoma, Unclassified with Medullary Phenotype: Poorly-Differentiated Adenocarcinomas Overlapping with Renal Medullary Carcinoma

Publication date: Available online 15 July 2017
Source:Human Pathology
Author(s): Deepika Sirohi, Steven C Smith, Chisato Ohe, Piergiuseppe Colombo, Mukul Divatia, Ema Dragoescu, Priya Rao, Michelle S. Hirsch, Ying-Bei Chen, Rohit Mehra, Mahul B Amin
Renal medullary carcinoma (RMC) is a highly aggressive renal cell carcinoma, arising in the collecting system, and requiring careful correlation with status of sickle cell trait. A panel of international experts has recently proposed provisional diagnostic terminology, renal cell carcinoma, unclassified, with medullary phenotype (RCCU-MP), based on encountering an extraordinarily rare tumor with RMC morphology and immunophenotype in an individual proven not to have a hemoglobinopathy. Herein, we extend this observation to a cohort of five such tumors, morphologically similar to RMC, lacking SMARCB1 expression by immunohistochemistry, but each without evidence of a hemoglobinopathy. The tumors arose in 4 males and 1 female with a mean age of 44 years, occurring in 3 left and 2 right kidneys. Clinically, aggression was apparent with involvement of perinephric adipose tissue in all 5 cases, nodal metastasis in 4/5 cases, and death of disease in 4/5 cases within 3-27 months. Histologic sections showed poorly differentiated adenocarcinoma, often with solid and nested growth patterns, as well as infiltrative glandular, tubulopapillary, cribriform, or reticular growth. Rhabdoid and sarcomatoid cytomorphology were seen in a subset. All tumors showed PAX8 nuclear positivity and SMARCB1 loss, with OCT3/4 expression in 4/5 cases. In summary, this first series of RCCU-MPs documents tumors with morphologic, immunophenotypic, and prognostic features of RMC, occurring in individuals without sickle cell trait. While greater biologic and molecular understanding is needed, the available evidence points to these cases representing a sporadic counterpart to sickle cell trait-associated RMC.



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Mechanical strength and fracture point of a dental implant under certification conditions: A numerical approach by finite element analysis

Publication date: Available online 15 July 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Guillermo de la Rosa Castolo, Sonia V. Guevara Perez, Pierre-Jean Arnoux, Laurent Badih, Franck Bonnet, Michel Behr
Statement of problemImplant prosthodontics provides high-quality outcomes thanks to recent technological developments and certification procedures such as International Organization for Standardization (ISO) standard 14801. However, these certification tests are costly, and the result is highly uncertain as the influence of design variables (materials and structure) is still unknown. The design process could be significantly improved if the influence of design parameters were identified.PurposeThe purpose of this in vitro study was to use finite element analysis (FEA) to assess the influence of design parameters on the mechanical performance of an implant in regard to testing conditions of ISO 14801 standard.Material and methodsAn endosseous dental implant was loaded under ISO standard 14801 testing conditions by numerical simulation, with 4 parameters evaluated under the following conditions: conditions of the contact surface area between the implant and the loading tool, length of the fixation screw, implant embedding depth, and material used for implant stiffness. FEA was used to compare the force that needed to reach the implant's yield and fracture strength.ResultsA dental implant's fracture point can be increased by 41% by improving the contact surface area, by 20% depending on the type of material, by 4% depending on the length of the fixation screw, and by 1.4% by changing the implant embedding depth.ConclusionsFEA made it possible to evaluate 4 performance parameters of a dental implant under ISO standard 14801 conditions. Under these conditions, the contact surface area was found to be the major parameter influencing implant performance. This observation was validated experimentally in a fatigue test under ISO standard 14801 conditions.



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Complete denture fabrication using piezography and CAD-CAM: A clinical report

Publication date: Available online 15 July 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Chikahiro Ohkubo, Hidemasa Shimpo, Ai Tokue, Eun-Jin Park, Tae Hyung Kim
To provide maxillary and mandibular complete dentures for a patient with severe ridge resorption, the denture space was recorded using the piezography technique. After the piezographic space was scanned, a virtual tooth arrangement and festooning were performed within the space using computer-aided design software. The denture bases were milled from a polymethylmethacrylate resin block using computer-aided manufacturing, and commercially available denture teeth were bonded with resin adhesive. Using the piezography technique described, physiologically appropriate complete dentures were fabricated based on the neutral zone concept.



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In vitro fit of CAD-CAM complete arch screw-retained titanium and zirconia implant prostheses fabricated on 4 implants

Publication date: Available online 15 July 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Hadi AL-Meraikhi, Burak Yilmaz, Edwin McGlumphy, William Brantley, William M. Johnston
Statement of problemComputer-aided designed and computer-aided manufactured (CAD-CAM) titanium and zirconia implant-supported fixed implant prostheses on 4 implants have become popular. The precision and accuracy of their interface fit has not been widely researched.PurposeThe purpose of this in vitro study was to compare the marginal fit of zirconia and titanium implant-supported screw-retained CAD-CAM complete fixed dental prostheses (CFDP) fit with a standardized cast simulating the all-on-4 implant distribution.Material and methodsRepresentation of an edentulous maxilla with 4 multiunit replicas embedded in sites corresponding to the positions of the maxillary first molars and canines was chosen. Multiunit abutments were digitally scanned using scan bodies and a laboratory scanner. CAD software was used to design screw-retained implant-fixed complete prostheses framework, and the file was sent to a milling machine for CAM. Titanium (n=5) and zirconia (n=5) frameworks were milled on 4 implants, and the frameworks were scanned with an industrial computed tomography (CT) scanner while applying the 1-screw test. The direct CT scans were reconstructed to generate a standard tessellation language (STL) file from the voxel data set and transported to volume graphics analysis software from which measurements were extracted. The circular mating surfaces of the corresponding framework interfaces to their representative multiunit abutment replicas on the standard were measured for implant position left maxillary canine (LMC), implant position right maxillary canine (RMC) and implant position right maxillary first molar (RMFM). In addition, color maps were generated to show the marginal discrepancy between the mating surfaces using ±0.500 mm color scale ranges.ResultsThe material type (zirconia or titanium) was not significant for 3D discrepancy measurements (P=.904). However, 3D discrepancy measurement values were significantly different between RMC and RMFM within each group (P<.001). The mean 3D ±SD discrepancy measurement for LMC for titanium was 48.2 ±2.6 μm. The mean ±3D discrepancy measurement for RMC for titanium was 74 ±15 μm and 84.4 ±12.1 μm for zirconia. The mean 3D discrepancy measurement for RMFM for titanium was 102 ±26.7 μm and 93.8 ±30 μm for zirconia. All 3D discrepancy measurements showed values <135 μm.ConclusionsWithin the limitations of the present in vitro study, implant-supported CAD-CAM fabricated titanium and zirconia complete fixed dental prosthesis frameworks showed comparable marginal fit. Three-dimensional microgap measurements of frameworks showed clinically acceptable misfit values. Absolute passive fit was not achieved.



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Does a male polycystic ovarian syndrome equivalent exist?

Abstract

The occurrence of a genetic background in the etiology of polycystic ovarian syndrome (PCOS) represents the rational basis to postulate the existence of a male PCOS equivalent. Hormonal and metabolic abnormalities have been described in male relatives of women with PCOS. These males also have a higher prevalence of early onset (<35 years) androgenetic alopecia (AGA). Hence, this feature has been proposed as a clinical sign of the male PCOS equivalent. Clinical evidence has shown that men with early onset AGA have hormonal and metabolic abnormalities. Large cohort studies have clearly shown a higher prevalence of type II diabetes mellitus (DM II) and cardiovascular diseases (CVDs) in elderly men with early onset AGA. In addition, prostate cancer, benign prostate hyperplasia (BPH) and prostatitis have been described. These findings support the existence of the male PCOS equivalent, which may represent an endocrine syndrome with a metabolic background, and might predispose to the development of DM II, CVDs, prostate cancer, BPH and prostatitis later in life. Its acknowledgment would be helpful for the prevention of these long-term complications.

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Hyperuricemia is associated with an increased prevalence of paroxysmal atrial fibrillation in patients with type 2 diabetes referred for clinically indicated 24-h Holter monitoring

Abstract

Purpose

Several studies have reported an association between hyperuricemia and increased risk of permanent atrial fibrillation (AF) in patients with and without type 2 diabetes mellitus (T2DM). Currently, no published data are available on the relationship between hyperuricemia and risk of paroxysmal AF.

Methods

We retrospectively evaluated 245 T2DM outpatients without pre-existing AF, cancer, cirrhosis and end-stage renal disease, who underwent a 24-h ECG-Holter monitoring for various clinical indications. Hyperuricemia was defined as a serum uric acid level >7 mg/dl for men and >6 mg/dl for women or allopurinol use. The diagnosis of paroxysmal AF was confirmed in affected individuals on the basis of 24-h ECG-Holter monitoring by experienced cardiologists.

Results

Hyperuricemia was observed in 59 (24.1%) patients, whereas paroxysmal AF was found in 11 (4.5%) patients. The prevalence of paroxysmal AF was higher in patients with hyperuricemia than in those without hyperuricemia (10.2 vs. 2.7%, p = 0.026). Logistic regression analysis showed that hyperuricemia was associated with an increased risk of prevalent paroxysmal AF. This association remained significant even after adjustment for age, metabolic syndrome and chronic kidney disease (adjusted-odds ratio 4.01, 95% CI 1.08–14.9; p = 0.039). Similar results were found when we used serum uric acid levels as a continuous measure.

Conclusions

This study shows for the first time that hyperuricemia is independently associated with an approximately fourfold increased risk of prevalent paroxysmal AF in patients with T2DM. These findings may partly explain the increased risk of permanent atrial fibrillation and cardiovascular death observed among patients with hyperuricemia.

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A Day in the Life of a Third Year Medical Student

I still remember the days when getting into a reputable medical school seemed to me a far-fetched dream only; passing A-level with flying colors, acing the aptitude test and building up the resolve to reach ...

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A brief psychological intervention for mothers of children with food allergy can change risk perception and reduce anxiety: outcomes of a randomised controlled trial

Abstract

Background

Mothers of children with food allergy have increased anxiety, which may be influenced by healthcare professionals' communication of risk.

Objective

To evaluate a brief psychological intervention for reducing anxiety in mothers of children with food allergy.

Methods

Two hundred mothers of children with food allergy were recruited from allergy clinics. A computer-generated randomization list was used to allocate participants to a single-session Cognitive Behavioural Therapy intervention including a risk communication module, or standard care. Anxiety and risk perception were assessed at 6 weeks and 1 year. Primary outcome was state anxiety at 6 weeks. Secondary outcomes included state anxiety at 1 year, risk perception at 6 weeks and 1 year, and salivary cortisol response to a simulated anaphylaxis scenario at 1 year.

Results

We found no significant difference in the primary outcome state anxiety at 6 weeks, with mean 31.9 (sd 10.2) intervention, 34.0 (10.2) control; mean difference 2.1 (95%CI -0.9, 5.0; P=0.17). There was significantly reduced state anxiety at 6 weeks in the intervention group, in the subgroup of participants with moderate/high anxiety at enrolment (103/200, 52%), with mean 33.0 (sd 9.3) intervention, 37.8 (sd 10.0) control; mean difference 4.8 (95% CI 0.9, 8.7; P=0.016; Cohen's d effect size 0.50). The psychological intervention also reduced risk perception and salivary cortisol response (P=0.032; effect size 0.36).

Conclusion

We found evidence that a brief psychological intervention which incorporates accurate risk information may impact on anxiety, risk perception and physiological stress response in mothers of children with food allergy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2voLrtS

Food allergy phenotypes: the key to personalized therapy

Abstract

Food allergies (FAs) are of increasing public health concern and are characterized by a large spectrum of diseases. Their diversity is well known for immunologic pathways (IgE, non-IgE mediated FAs), and natural history. Many other factors and patient characteristics are involved including type of food, exposure route, allergic comorbidities, gender, racial and ethnic backgrounds, co-factors and health conditions. Food allergen components and sensitization profiles are also involved in FA phenotypes. A new approach to chronic disorders based on the identification of phenotypes through extensive knowledge of all the complex components is also applicable to FAs and could lead towards integrative care management. Diagnostic biomarkers for FAs are emerging which also contribute to better care modalities. The aim of this article is to highlight current knowledge regarding the phenotypic diversity of FA. This review will focus on IgE-mediated FAs and how identifying phenotypes may help to better understand the pathophysiological complexity, improve diagnosis and lead to personalized treatment strategies.

This article is protected by copyright. All rights reserved.

http://ift.tt/2uq7D9H

A brief psychological intervention for mothers of children with food allergy can change risk perception and reduce anxiety: outcomes of a randomised controlled trial

Abstract

Background

Mothers of children with food allergy have increased anxiety, which may be influenced by healthcare professionals' communication of risk.

Objective

To evaluate a brief psychological intervention for reducing anxiety in mothers of children with food allergy.

Methods

Two hundred mothers of children with food allergy were recruited from allergy clinics. A computer-generated randomization list was used to allocate participants to a single-session Cognitive Behavioural Therapy intervention including a risk communication module, or standard care. Anxiety and risk perception were assessed at 6 weeks and 1 year. Primary outcome was state anxiety at 6 weeks. Secondary outcomes included state anxiety at 1 year, risk perception at 6 weeks and 1 year, and salivary cortisol response to a simulated anaphylaxis scenario at 1 year.

Results

We found no significant difference in the primary outcome state anxiety at 6 weeks, with mean 31.9 (sd 10.2) intervention, 34.0 (10.2) control; mean difference 2.1 (95%CI -0.9, 5.0; P=0.17). There was significantly reduced state anxiety at 6 weeks in the intervention group, in the subgroup of participants with moderate/high anxiety at enrolment (103/200, 52%), with mean 33.0 (sd 9.3) intervention, 37.8 (sd 10.0) control; mean difference 4.8 (95% CI 0.9, 8.7; P=0.016; Cohen's d effect size 0.50). The psychological intervention also reduced risk perception and salivary cortisol response (P=0.032; effect size 0.36).

Conclusion

We found evidence that a brief psychological intervention which incorporates accurate risk information may impact on anxiety, risk perception and physiological stress response in mothers of children with food allergy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2voLrtS

Food allergy phenotypes: the key to personalized therapy

Abstract

Food allergies (FAs) are of increasing public health concern and are characterized by a large spectrum of diseases. Their diversity is well known for immunologic pathways (IgE, non-IgE mediated FAs), and natural history. Many other factors and patient characteristics are involved including type of food, exposure route, allergic comorbidities, gender, racial and ethnic backgrounds, co-factors and health conditions. Food allergen components and sensitization profiles are also involved in FA phenotypes. A new approach to chronic disorders based on the identification of phenotypes through extensive knowledge of all the complex components is also applicable to FAs and could lead towards integrative care management. Diagnostic biomarkers for FAs are emerging which also contribute to better care modalities. The aim of this article is to highlight current knowledge regarding the phenotypic diversity of FA. This review will focus on IgE-mediated FAs and how identifying phenotypes may help to better understand the pathophysiological complexity, improve diagnosis and lead to personalized treatment strategies.

This article is protected by copyright. All rights reserved.

http://ift.tt/2uq7D9H

BCG — old workhorse, new skills

Publication date: August 2017
Source:Current Opinion in Immunology, Volume 47
Author(s): M Gengenbacher, NE Nieuwenhuizen, SHE Kaufmann
Bacille Calmette-Guérin (BCG), the only tuberculosis (TB) vaccine in clinical practice, has limitations in efficacy, immunogenicity and safety. Much current TB vaccine research focuses on engineering live mycobacteria to interfere with phagosome biology and host intracellular pathways including apoptosis and autophagy, with candidates such as BCG Δzmp1, BCG ΔureC::hly, BCG::ESX-1^Mmar, Mtb ΔphoP ΔfadD26, Mtb ΔRD1 ΔpanCD and M. smegmatis Δesx-3::esx-3(Mtb) in the development pipeline. Correlates of protection in preclinical studies include increased central memory CD4⁺ T cells and recruitment of antigen-specific T cells to the lungs, with mucosal vaccination found to be superior to parenteral vaccination. Finally, recent studies suggest beneficial non-specific effects of BCG on immunity, which should be taken into account when considering these vaccines for BCG replacement.



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Non-human primates as a model for understanding the mechanism of action of toll-like receptor-based vaccine adjuvants

Publication date: August 2017
Source:Current Opinion in Immunology, Volume 47
Author(s): Elizabeth A .Thompson, Karin Loré
While transgenic mouse models are powerful for understanding how the immune system is manipulated by vaccines, they cannot fully recapitulate the characteristics of the innate immune responses leading to adaptive immunity after vaccination in humans. Outbred non-human primates are far more representative models of human vaccine responses as there is high degree of similarities in immune cell subset distributions, receptor expression (including toll-like receptors; TLRs), and immune cell functions, in addition to modeling doses and injection sites more accurately. Vaccine adjuvants targeting TLRs have shown great promise in their ability to enhance responses to non-live vaccines. As TLR ligands are molecularly defined, studies of the mechanisms by which they interact with the immune system are facilitated. In this brief review, we focus on the use of TLR3, 4, 7/8 and 9 stimulating adjuvants in NHPs by evaluating similarities between the specified TLRs in human and NHPs and highlighting recent work studying the mode of action or efficacy of TLR based adjuvants in NHPs.



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Left hemispheric breakdown of LTP-like cortico-cortical plasticity in schizophrenic patients

Publication date: Available online 14 July 2017
Source:Clinical Neurophysiology
Author(s): Michele Ribolsi, Giulia Lisi, Viviana Ponzo, Alberto Siracusano, Carlo Caltagirone, Cinzia Niolu, Giacomo Koch
ObjectiveAltered cortical connectivity and plasticity seems to be asymmetrical between the hemispheres in patients with schizophrenia (SCZ). We evaluated long-term potentiation (LTP) in parietal-frontal circuits of both hemispheres using a cortico-cortical Paired Associative Stimulation (cc-PAS) protocol testing the rules of Hebbian-like spike timing dependent plasticity (SPTD).Methods12 SCZ and 12 healthy subjects (HS) underwent a cc-PAS protocol to activate, by means of paired pulses of transcranial magnetic stimulation (TMS), the short-latency connection between posterior parietal cortex (PPC) and primary motor cortex (M1) of both hemispheres. Motor-evoked potentials (MEPs) were collected to assess the time course of the after effects of cc-PAS protocol measuring MEP amplitude as index of cortico-cortical associative plasticity.ResultsWhile HS showed a similar time course of LTP-like plasticity in the two hemispheres, SCZ revealed a weaker late-LTP-like plasticity in the left compared to the right hemisphere after cc-PAS protocol.ConclusionsSCZ failed to show the typical long-lasting increase of M1 excitability observed after cc-PAS protocol in both hemispheres, with a greater reduction in the left one.Significanceour findings provide novel neurophysiological evidence for an asymmetric impairment of the left parietal-frontal network in SCZ patients.



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Sustained attention ability in schizophrenia: Investigation of conflict monitoring mechanisms

Publication date: September 2017
Source:Clinical Neurophysiology, Volume 128, Issue 9
Author(s): Marc Hoonakker, Nadège Doignon-Camus, José Eduardo Marques-Carneiro, Anne Bonnefond
ObjectiveThe main goal of the current study was to assess, with a time-on-task approach, sustained attention ability in schizophrenia, and to investigate conflict monitoring underlying this ability.MethodsBehavioral and event-related potentials data (N2 and P3a amplitudes) were recorded in a long-lasting sustained attention Go/NoGo task (sustained attention to response task, SART), over a period of 30min, in 29 patients with schizophrenia and 29 pair-matched healthy subjects.ResultsOur results revealed spared sustained attention ability in patients throughout the task. Impairment of conflict detection (N2) in patients was particularly significant at the end of the task. Furthermore, both schizophrenia and healthy subjects exhibited a decline in conflict detection from the beginning to the middle of the task. Whereas controls' conflict detection recovered in the last part of the task, patients' did not, suggesting a deficit in recovery processes reflecting a lack of additional resources sustained attention Go/NoGo task. Conflict resolution (P3a) was preserved throughout the task in both groups.ConclusionsConflict monitoring processes are increasingly impaired in schizophrenia during a long-lasting sustained attention Go/NoGo task.SignificanceThis impairment at the end of the task may rely on deficit in recovery processes, rather than a deficit in conflict detection per se in schizophrenia.



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Celiac disease and a novel association with a multifocal acquired motor axonopathy (MAMA)

Publication date: September 2017
Source:Clinical Neurophysiology, Volume 128, Issue 9
Author(s): Miguel Oliveira Santos, Benjamim Ohana, Mamede de Carvalho




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Feature selection before EEG classification supports the diagnosis of Alzheimer’s disease

Publication date: Available online 14 July 2017
Source:Clinical Neurophysiology
Author(s): L.R. Trambaiolli, N. Spolaôr, A.C. Lorena, R. Anghinah, J.R. Sato
ObjectiveIn many decision support systems, some input features can be marginal or irrelevant to the diagnosis, while others can be redundant among each other. Thus, feature selection (FS) algorithms are often considered to find relevant/non-redundant features.This study aimed to evaluate the relevance of FS approaches applied to Alzheimer's Disease (AD) EEG-based diagnosis and compare the selected features with previous clinical findings.MethodsEight different FS algorithms were applied to EEG spectral measures from 22 AD patients and 12 healthy age-matched controls. The FS contribution was evaluated by considering the leave-one-subject-out accuracy of Support Vector Machine classifiers built in the datasets described by the selected features.ResultsThe Filtered Subset Evaluator technique achieved the best performance improvement both on a per-patient basis (91.18% of accuracy) and on a per-epoch basis (85.29±21.62%), after removing 88.76±1.12% of the original features. All algorithms found out that alpha and beta bands are relevant features, which is in agreement with previous findings from the literature.ConclusionBiologically plausible EEG datasets could achieve improved accuracies with pre-processing FS steps.SignificanceThe results suggest that the FS and classification techniques are an attractive complementary tool in order to reveal potential biomarkers aiding the AD clinical diagnosis.



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