Pharmacokinetic interactions of curcuminoids with conventional drugs: A review

Publication date: 14 September 2017
Source:Journal of Ethnopharmacology, Volume 209
Author(s): Roodabeh Bahramsoltani, Roja Rahimi, Mohammad Hosein Farzaei
Ethnopharmacological relevanceHerb–drug interactions are of great concern in health practices. Curcumin is a natural polyphenol extracted from turmeric, a spice widely used all over the world. Curcumin is clinically used due to its acceptable safety profile and therapeutic efficacy.Aim of the studyCurrent paper aims to highlight the effect of curcumin on concomitantly used drugs.MethodsElectronic databases including PubMed, Scopus and Science Direct were searched with the keywords "curcumin" in the title/abstract and "drug interaction," "drug metabolism," "cytochrome," "P-glycoprotein" and "P450" in the whole text.ResultsCurcumin can induce pharmacokinetic alterations such as changes in Cmax and AUC when concomitantly used with pharmacological agents like cardiovascular drugs, antidepressants, anticoagulants, antibiotics, chemotherapeutic agents, and antihistamines. The underlying mechanisms of these interactions include inhibition of cytochrome (CYP) isoenzymes and P-glycoprotein. There is only one clinical trial which proved a significant alteration of conventional drugs in concomitant use with curcumin indicating the need for further human studies.ConclusionsAlthough in vitro and in vivo studies do not provide enough evidence to judge the clinical drug interactions of curcumin, physicians must remain cautious and avoid drug combinations which may lead to curcumin-drug interactions.

Graphical abstract

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Polysaccharides of Dendrobium officinale Kimura & Migo protect gastric mucosal cell against oxidative damage-induced apoptosis in vitro and in vivo

Publication date: 17 August 2017
Source:Journal of Ethnopharmacology, Volume 208
Author(s): Qiang Zeng, Chun-Hay Ko, Wing-Sum Siu, Long-Fei Li, Xiao-Qiang Han, Liu Yang, Clara Bik-San Lau, Jiang-Miao Hu, Ping-Chung Leung
Ethnopharmacological relevanceDendrobium officinale Kimura & Migo (DO) is a valuable Traditional Chinese Medicine to nourish stomach, in which polysaccharides are identified as active ingredients. However, limited scientific evidences have been reported on the gastroprotective efficacy of DO. The aim of the current study was to investigate the protective effects and underlying mechanism of polysaccharides from DO(DOP) on gastric mucosal injury.Material and methodsFor in vitro study, HFE145 cells were pretreated with DOP before induction of cell apoptosis by H2O2. Cell apoptosis and related proteins expression were detected. In the in vivo study, absolute ethanol was administered orally to induce gastric mucosal injury in rat. The gastric mucosal injury area and histological examination were used to evaluate the effects of DOP treatment on the recovery of the gastric mucosal injury.ResultsH2O2 treatment for 6h significantly induced cell apoptosis in HFE145 cells. However, the destructive effects of H2O2 on HFE 145 cells could be reversed by the pretreatment with DOP. The increased ROS level induced by H2O2 for 4h was reduced after DOP pretreatment. The number of apoptotic cells in both early and late apoptosis stages decreased significantly and the nuclei morphology changes were improved with DOP pretreatment. Furthermore, DOP inhibited caspase 3 activation and PARP cleavage, downregulated Bax expression and upregulated Bcl2 expression in cell model. Further study revealed that pretreatment of DOP inhibited p -NF-κBp65/NF-κBp65 level, indicating DOP inhibited H2O2-mediated apoptosis via suppression of NF-κB activation. In addition, DOP treatment could ameliorate gastric mucosal injury and inhibit mucin loss induced by ethanol in animal model. DOP treatment also interfered with ethanol-induced apoptosis process by downregulating Bax/Bcl2 ratio in gastric mucosa.ConclusionsThe present study was the first one to demonstrate the gastroprotective effect of DOP through inhibiting oxidative stress-induced apoptosis. This study provided a solid evidence for the potential use of DO as a therapy or health supplement for gastric mucosal diseases

Graphical abstract

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Risk of anaphylaxis in complementary and alternative medicine.

Purpose of review: Complementary and alternative medicine (CAM) use is widespread across the world. Patients with asthma and allergy regularly use CAM therapies. Allergic and anaphylactic reactions to CAM have been reported. Recent findings: Recent attempts to regulate and monitor adverse reaction to these therapies have given us further insight into potential causes of severe allergic reactions. Several culprits identified including Andrographis paniculata, Echinacea species, bee products, Ginkgo biloba and Ginseng are discussed here. Summary: Knowing the factors that increase the risk of anaphylaxis allows reactions to be recognized, reported and further investigated. Research to identify key causative allergens is necessary in the future. Collaboration between the allergy community and CAM practitioners can allow better understanding of allergy to these therapies. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2uScvWs

Risk of anaphylaxis in complementary and alternative medicine.

Purpose of review: Complementary and alternative medicine (CAM) use is widespread across the world. Patients with asthma and allergy regularly use CAM therapies. Allergic and anaphylactic reactions to CAM have been reported. Recent findings: Recent attempts to regulate and monitor adverse reaction to these therapies have given us further insight into potential causes of severe allergic reactions. Several culprits identified including Andrographis paniculata, Echinacea species, bee products, Ginkgo biloba and Ginseng are discussed here. Summary: Knowing the factors that increase the risk of anaphylaxis allows reactions to be recognized, reported and further investigated. Research to identify key causative allergens is necessary in the future. Collaboration between the allergy community and CAM practitioners can allow better understanding of allergy to these therapies. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2uScvWs

Comparative metabolic analysis in head and neck cancer and the normal gingiva

Abstract

Objectives

Chronic accumulation of lactate in malignant tumor tissue is associated with increased malignancy and radioresistance. For this study, biopsies of primary head and neck squamous cell carcinoma (HNSCC) and of the normal gingiva of the same patient were compared via metabolic profiling to the healthy gingiva from cancer-free patients.

Materials and methods

Cryobiopsies of 140 HNSCC patients were used to determine ATP, lactate, and glucose concentrations of the tumor and normal gingiva via induced metabolic bioluminescence imaging (imBI). Additionally, these metabolites were quantified in a collective of 79 healthy (non-tumor-bearing) patients. Furthermore, tumor samples were analyzed via immunofluorescence imaging and quantitative real-time PCR for the expression of lactate and glucose transporters.

Results

There were significant differences in ATP concentrations detectable between the tumor, normal gingiva of tumor patients, and gingiva from healthy patients. Lactate concentrations were significantly increased in tumor tissue compared to the normal gingiva of tumor patients as well as the gingiva from healthy patients. Concerning glucose, there was a significant decrease in glucose concentrations detectable in the tumor biopsies compared to the normal gingiva of tumor patients. On the other hand, tumor samples from patients revealed significantly elevated relative expression levels of monocarboxylate transporters (MCT-1 and MCT-4), as well as glucose transporters (GLUT-1 and GLUT-3) compared to the corresponding normal gingiva of each patient.

Conclusions

We could demonstrate that the lactate concentration in HNSCC correlates with primary tumor (T) stage.

Clinical relevance

The aim of this study was to identify metabolic parameters to improve early cancer diagnosis, allow predictions on the degree of malignancy, and contribute to a personalized tumor therapy.

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Approximal morphology as predictor of approximal caries in primary molar teeth

Abstract

Objective

To evaluate the predictive power of the morphology of the distal surface on 1st and mesial surface on 2nd primary molar teeth on caries development in young children.

Sample and methods

Out of 101 3-to 4-year-old children from an on-going study, 62 children, for whom parents' informed consent was given, participated. Upper and lower molar teeth of one randomly selected side received a 2-day temporarily separation. Bitewing radiographs and silicone impressions of interproximal area (IPA) were obtained. One-year procedures were repeated in 52 children (84%). The morphology of the distal surfaces of the first molar teeth and the mesial surfaces on the second molar teeth (n=208) was scored from the occlusal aspect on images from the baseline resin models resulting in four IPA variants: concave-concave; concave-convex; convex-concave, and convex-convex. Approximal caries on the surface in question was radiographically assessed as absent/present.

Results

Of the 52 children examined at follow-up, 31 children (60%) had 1–4 concave surfaces. In total 53 (25%) of the 208 surfaces were concave. A total of 22 children (43%) had 1–4 approximal lesions adding up to 59 lesions. Multiple logistic regression analyses disclosed that gender, surface morphology on one of the approximal surfaces (focus-surface), and adjacent-surface morphology were significantly related to caries development (p values ≤ 0.03). The odds ratio for developing caries in the focus-surface/adjacent-surface in the four IPA variants were convex-convex, 1.0; convex-concave, 5.5 (CI 2.0–14.7); concave-convex, 12.9 (CI 4.1–40.3); and concave-concave, 15.7 (CI 5.1–48.3).

Conclusion

Morphology of approximal surfaces in primary molar teeth, in particular both surfaces being concave, significantly influences the risk of developing caries.

Clinical relevance

The concave morphology of approximal surfaces can predict future caries lesions supporting specific home-care and in-office preventive strategies.

http://ift.tt/2uSoaEH

Risk of anaphylaxis in complementary and alternative medicine.

Purpose of review: Complementary and alternative medicine (CAM) use is widespread across the world. Patients with asthma and allergy regularly use CAM therapies. Allergic and anaphylactic reactions to CAM have been reported. Recent findings: Recent attempts to regulate and monitor adverse reaction to these therapies have given us further insight into potential causes of severe allergic reactions. Several culprits identified including Andrographis paniculata, Echinacea species, bee products, Ginkgo biloba and Ginseng are discussed here. Summary: Knowing the factors that increase the risk of anaphylaxis allows reactions to be recognized, reported and further investigated. Research to identify key causative allergens is necessary in the future. Collaboration between the allergy community and CAM practitioners can allow better understanding of allergy to these therapies. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2uScvWs

Effect of processing conditions on degree of hydrolysis, ACE inhibition, and antioxidant activities of protein hydrolysate from Acetes indicus

Abstract

Protein hydrolysate was prepared from Acetes indicus which is a major bycatch among non-penaeid prawn landings of India. Hydrolysis conditions (enzyme to substrate ratio and time) for preparing protein hydrolysates using alcalase enzyme were optimized by response surface methodology using central composite design. The optimum conditions for enzyme-substrate ratio (mL/100 g) of 1.57, 1.69, 1.60, 1.56, and 1.50 and for hydrolysis time of 97.18, 96.5, 98.15 min, 102.48, and 88.44 min were established for attaining maximum yield, degree of hydrolysis, 2,2-diphenyl-1-picrylhydrazyl, angiotensin I-converting enzyme-inhibiting activity, and metal-chelating activity, respectively. ABTS radical scavenging activity and reducing power assay of optimized protein hydrolysate were found to be increased with the increase in concentration. The higher value of 7.04 (μM Trolox/g), 87.95, and 77.24%, respectively for DPPH, ACE, and metal-chelating activity indicated that the A. indicus protein hydrolysates have beneficial biological properties that could be well-utilized in the application of functional foods and nutraceuticals.

Graphical abstract

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Erratum to: What Type of Food Can Older Adults Masticate?: Evaluation of Mastication Performance Using Color-Changeable Chewing Gum

http://ift.tt/2uS2lVJ

Functional characterization of the Dsc E3 ligase complex in the citrus postharvest pathogen Penicillium digitatum

Publication date: Available online 21 July 2017
Source:Microbiological Research
Author(s): Ruoxin Ruan, Kuang-Ren Chung, Hongye Li
Sterol regulatory element binding proteins (SREBPs) are required for sterol homeostasis in eukaryotes. Activation of SREBPs is regulated by the Dsc E3 ligase complex in Schizosaccharomyces pombe and Aspergillus spp. Previous studies indicated that an SREBP-coding gene PdsreA is required for fungicide resistance and ergosterol biosynthesis in the citrus postharvest pathogen Penicillium digitatum. In this study, five genes, designated PddscA, PddscB, PddscC, PddscD, and PddscE encoding the Dsc E3 ligase complex were characterized to be required for fungicide resistance, ergosterol biosynthesis and CoCl2 tolerance in P. digitatum. Each of the dsc genes was inactivated by target gene disruption and the resulted phenotypes were analyzed and compared. Genetic analysis reveals that, of five Dsc complex components, PddscB is the core subunit gene in P. digitatum. Although the resultant dsc mutants were able to infect citrus fruit and induce maceration lesions as the wild-type, the mutants rarely produced aerial mycelia on affected citrus fruit peels. P. digitatum Dsc proteins regulated not only the expression of genes involved in ergosterol biosynthesis but also that of PdsreA. Yeast two-hybrid assays revealed a direct interaction between the PdSreA protein and the Dsc proteins. Ectopic expression of the PdSreA N-terminus restored fungicide resistance in the dsc mutants. Our results provide important evidence to understand the mechanisms underlying SREBP activation and regulation of ergosterol biosynthesis in plant pathogenic fungi.



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A Single 10 mg Oral Dose of Biotin Interferes with Thyroid Function Tests

Thyroid , Vol. 0, No. 0.


http://ift.tt/2uSaCZQ

Human iPSC Glial Mouse Chimeras Reveal Glial Contributions to Schizophrenia

Publication date: Available online 20 July 2017
Source:Cell Stem Cell
Author(s): Martha S. Windrem, Mikhail Osipovitch, Zhengshan Liu, Janna Bates, Devin Chandler-Militello, Lisa Zou, Jared Munir, Steven Schanz, Katherine McCoy, Robert H. Miller, Su Wang, Maiken Nedergaard, Robert L. Findling, Paul J. Tesar, Steven A. Goldman
In this study, we investigated whether intrinsic glial dysfunction contributes to the pathogenesis of schizophrenia (SCZ). Our approach was to establish humanized glial chimeric mice using glial progenitor cells (GPCs) produced from induced pluripotent stem cells derived from patients with childhood-onset SCZ. After neonatal implantation into myelin-deficient shiverer mice, SCZ GPCs showed premature migration into the cortex, leading to reduced white matter expansion and hypomyelination relative to controls. The SCZ glial chimeras also showed delayed astrocytic differentiation and abnormal astrocytic morphologies. When established in myelin wild-type hosts, SCZ glial mice showed reduced prepulse inhibition and abnormal behavior, including excessive anxiety, antisocial traits, and disturbed sleep. RNA-seq of cultured SCZ human glial progenitor cells (hGPCs) revealed disrupted glial differentiation-associated and synaptic gene expression, indicating that glial pathology was cell autonomous. Our data therefore suggest a causal role for impaired glial maturation in the development of schizophrenia and provide a humanized model for its in vivo assessment.

Graphical abstract

Teaser

Goldman and colleagues use mice chimerized with human patient-derived glial progenitor cells to find out whether glia contribute to childhood-onset schizophrenia. The defects in cell differentiation, myelination, and behavior they see strongly suggest that glial cells do, in fact, have a previously unappreciated role in the pathogenesis of this disease.


http://ift.tt/2uNrUHj

Pathogen-Induced TLR4-TRIF Innate Immune Signaling in Hematopoietic Stem Cells Promotes Proliferation but Reduces Competitive Fitness

Publication date: Available online 20 July 2017
Source:Cell Stem Cell
Author(s): Hitoshi Takizawa, Kristin Fritsch, Larisa V. Kovtonyuk, Yasuyuki Saito, Chakradhar Yakkala, Kurt Jacobs, Akshay K. Ahuja, Massimo Lopes, Annika Hausmann, Wolf-Dietrich Hardt, Álvaro Gomariz, César Nombela-Arrieta, Markus G. Manz
Bacterial infection leads to consumption of short-lived innate immune effector cells, which then need to be replenished from hematopoietic stem and progenitor cells (HSPCs). HSPCs express pattern recognition receptors, such as Toll-like receptors (TLRs), and ligation of these receptors induces HSPC mobilization, cytokine production, and myeloid differentiation. The underlying mechanisms involved in pathogen signal transduction in HSCs and the resulting biological consequences remain poorly defined. Here, we show that in vivo lipopolysaccharide (LPS) application induces proliferation of dormant HSCs directly via TLR4 and that sustained LPS exposure impairs HSC self-renewal and competitive repopulation activity. This process is mediated via TLR4-TRIF-ROS-p38, but not MyD88 signaling, and can be inhibited pharmacologically without preventing emergency granulopoiesis. Live Salmonella Typhimurium infection similarly induces proliferative stress in HSCs, in part via TLR4-TRIF signals. Thus, while direct TLR4 activation in HSCs might be beneficial for controlling systemic infection, prolonged TLR4 signaling has detrimental effects and may contribute to inflammation-associated HSPC dysfunction.

Graphical abstract

Teaser

Takizawa et al. show that self-renewing hematopoietic cells directly sense gram-negative bacterial infection through Toll-like receptor 4 (TLR4) activation, which leads to impaired function via proliferative stress. Genetic and pharmacological blockage of the TLR4-TRIF-ROS-p38 axis can maintain HSC function without disrupting emergency granulopoietic responses to infection.


http://ift.tt/2uN9SoD

High-Content Screening in hPSC-Neural Progenitors Identifies Drug Candidates that Inhibit Zika Virus Infection in Fetal-like Organoids and Adult Brain

Publication date: Available online 20 July 2017
Source:Cell Stem Cell
Author(s): Ting Zhou, Lei Tan, Gustav Y. Cederquist, Yujie Fan, Brigham J. Hartley, Suranjit Mukherjee, Mark Tomishima, Kristen J. Brennand, Qisheng Zhang, Robert E. Schwartz, Todd Evans, Lorenz Studer, Shuibing Chen
Zika virus (ZIKV) infects fetal and adult human brain and is associated with serious neurological complications. To date, no therapeutic treatment is available to treat ZIKV-infected patients. We performed a high-content chemical screen using human pluripotent stem cell-derived cortical neural progenitor cells (hNPCs) and found that hippeastrine hydrobromide (HH) and amodiaquine dihydrochloride dihydrate (AQ) can inhibit ZIKV infection in hNPCs. Further validation showed that HH also rescues ZIKV-induced growth and differentiation defects in hNPCs and human fetal-like forebrain organoids. Finally, HH and AQ inhibit ZIKV infection in adult mouse brain in vivo. Strikingly, HH suppresses viral propagation when administered to adult mice with active ZIKV infection, highlighting its therapeutic potential. Our approach highlights the power of stem cell-based screens and validation in human forebrain organoids and mouse models in identifying drug candidates for treating ZIKV infection and related neurological complications in fetal and adult patients.

Graphical abstract

Teaser

Chen, Studer, and colleagues utilize human pluripotent stem cell-derived neural progenitors to perform a high-content screen for anti-ZIKV drug discovery. Hippeastrine hydrobromide was identified and shown to eliminate ZIKV in infected human neural progenitors, rescue a ZIKV-induced microcephaly phenotype in human forebrain organoids, and suppress virus propagation in adult mice with active ZIKV infection.


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The Feulgen reaction: A brief review and new perspectives

Publication date: Available online 21 July 2017
Source:Acta Histochemica
Author(s): Maria Luiza S. Mello, Benedicto de Campos Vidal
The Feulgen reaction has been proposed by Robert Feulgen and Heinrich Rossenbeck for the identification of DNA nearly a hundred years ago. Since then, many other applications of this cytochemical/topochemical procedure at qualitative and quantitative level have been proposed in relation to DNA and its role in chromatin in human, animal and plant cells. In this article, we briefly review some fundamental aspects of the Feulgen reaction and current applications of such a method in studies of altered chromatin texture, including its association with or preceding changes in transcriptional activities and effect on epigenetic marks. Further perspectives on the use of the Feulgen reaction will depend of the proposal of innovative biological questions in which its reveals appropriate.



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A Single 10 mg Oral Dose of Biotin Interferes with Thyroid Function Tests

Thyroid , Vol. 0, No. 0.


http://ift.tt/2uSaCZQ

Endoscopic transcanal myringoplasty for tympanic perforations: An outpatient minimally invasive procedure

Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty).

http://ift.tt/2uS5pBl

The treatment and outcome analysis of primary squamous cell carcinoma of the thyroid

Primary squamous cell carcinoma (SCC) of the thyroid is a rare disease. It usually presents with locally advanced disease and has an overall poor prognosis. In this study, we investigated the characteristics and outcomes of patients with SCC of the thyroid, and reported our experience with chemotherapy with lenvatinib in the treatment of SCC of the thyroid.

http://ift.tt/2vKx6bE

Endoscopic transcanal myringoplasty for tympanic perforations: An outpatient minimally invasive procedure

Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty).

http://ift.tt/2uS5pBl

The treatment and outcome analysis of primary squamous cell carcinoma of the thyroid

Primary squamous cell carcinoma (SCC) of the thyroid is a rare disease. It usually presents with locally advanced disease and has an overall poor prognosis. In this study, we investigated the characteristics and outcomes of patients with SCC of the thyroid, and reported our experience with chemotherapy with lenvatinib in the treatment of SCC of the thyroid.

http://ift.tt/2vKx6bE

MicroRNA-27b inhibits cell proliferation in oral squamous cell carcinoma by targeting FZD7 and Wnt signaling pathway

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Bingyao Liu, Wei Chen, Gang Cao, Zhen Dong, Jinke Xu, Tingyuan Luo, Senlin Zhang
This study intended to investigate the role of microRNA-27b (miR-27b) in proliferation of oral squamous cell carcinoma (OSCC) cells and to explore the potential molecular mechanism. Cell proliferation was detected by MTT assay. The expression levels of miR-27b, Frizzled7 (FZD7), cyclin D1 and c-myc were detected by quantitative real time polymerase chain reaction (qRT-PCR). The protein expression level of FZD7 was detected by western blot analysis. The relationship between miR-27b and FZD7, and the activity of Wnt signaling pathway were determined using luciferase reporter assay. The miR-27b expression in OSCC cell lines was significantly decreased compared with control. Overexpression of miR-27b remarkably inhibited OSCC cell proliferation. Additionally, miR-27b could target and inhibit FZD7 expression and decrease the activity of Wnt signaling pathway.miR-27b could inhibit OSCC cell proliferation through inhibiting FZD7 and FZD7-mediated Wnt signaling pathway.



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Determinants of Infection Outcome in HCV-Genotype 4

Viral Immunology , Vol. 0, No. 0.


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Large-volume breast fat transfer: technical evolutions and safety aspects based on over 800 cases and 26 years of follow-up

Abstract

Current techniques for augmentation mammoplasty involve the use of alloplastic materials and an open approach. The former may not be well tolerated and often can be the origin of undesirable effects such as capsule contracture. The latter implies residual scars, which can sometimes be less than satisfactory from an esthetic point of view. Considering all the problems mentioned above and seeking to find safe and reliable alternatives to implants, we focused our attention on the possibility of using fat tissue as filling material for breast augmentation. Autologous adipose tissue has been used to correct soft tissue defects for more than a century. Its soft and natural texture, the absence of a line, and its versatility have always made adipose tissue the ideal physiologic filling material. The author describes his surgical experience with breast fat transfer. The clinical outcome described in this Article is based on over 800 patients with a follow-up period of over than 26 years. The surgical techniques described by the author evolved constantly and steadily aiming to achieve more consistent results and trying to increase at the same time patient safety and satisfaction. Analyzing the clinical data clearly appears that complications are strictly related to the oily content of the transplanted tissue, where more TGs in the recipient site is clearly at the origin of a higher level of complications. In order to improve patient's safety and to limit risk of side effects, the author developed a new "oil-free" fat transfer technique. All the technical steps are described in details. An important part of this work is dedicated to a careful evaluation of safety aspects and oncologic concerns. The total oncologic safety of fat transfer in breast reconstruction and in esthetic augmentation has been clearly proved and confirmed.

Level of Evidence: Level IV, therapeutic study.

http://ift.tt/2vu0ByX

A randomized controlled trial to examine the impact of aquatic exercise training on functional capacity, balance, and perceptions of fatigue in female patients with multiple sclerosis

Publication date: Available online 20 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Mehdi Kargarfard, Ardalan Shariat, Lee Ingle, Joshua A. Cleland, Mina Kargarfard
ObjectiveTo assess the effects of 8-weeks aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).DesignA randomized controlled design.SettingReferral center of a multiple sclerosis society.ParticipantsWomen (age: 36.4 ±8.2) diagnosed with relapsing-remitting (RR-type) MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program) or a control group.InterventionsThe intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration; 45-60 min; 50-75% estimated maximum heart rate).Main measuresSix-minute walk test (6-MWT); balance (Berg Balance Scale; BBS), and perceptions of fatigue (Modified Fatigue Impact Scale; MFIS), at baseline and after an 8 week intervention. Differences over time between the experimental and control groups were assessed by a 2x2 (group by time) repeated measures analysis of variance (ANOVA).Results32 women completed the 8-week aquatic training intervention (experimental group, n=17; controls, n = 15). All outcome measures improved in the experimental group; 6-MWT performance (451±58 m to 503±57 m; P<0.001); BBS (pre-test mean, 53.59±1.70; post-test mean, 55.18±1.18; P<0.001), and in the MFIS (pre-test mean, 43.1±14.6, post-test mean, 32.8 ±5.9;P<0.01). A significant group-by-time interaction was evident between the experimental and controls groups for 6-MWT:P<0.001, ηp²=0.551; BBS:P<0.001, ηp²=0.423; and MFIS: P<0.001, ηp²=0.679.ConclusionsAquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS.



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Treatment with Chemotherapy and Cognitive Functioning Among Older Adult Cancer Survivors

Publication date: Available online 20 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ruth T. Morin, Elizabeth Midlarsky
ObjectiveTo investigate whether treatment of cancer with chemotherapy, when compared to surgery and radiation, differentially affects cognitive functioning among older adults.DesignData were examined prospectively from two years prior to cancer diagnosis to four years after cancer diagnosis. Distinct classes of cognitive functioning were identified using latent class growth analysis techniques (LCGA). Treatment type was assessed as a predictor of class membership.SettingData were collected from a large population-based cohort in the context of the Health and Retirement Study.Participants403 older adults with a new diagnosis of cancer, who were still alive 4 years after their diagnosis. Participants had provided informed consent for the data collection, and the use of the data was approved by the Institutional Review Board of Columbia University, Teachers College.InterventionsNot applicable.Main Outcome MeasureCognition (degree of immediate recall and delayed recall of a word list).ResultsFindings indicated that three classes of cognitive functioning best fit the data, specifically High, Middle, and Low Recall classes. Individuals treated with chemotherapy were significantly more likely to be in the High Recall class, with no effect of receiving surgery or radiation. When interactions with demographic predictors were entered into the model, an age x treatment interaction was present, such that individuals under 80 were more likely to both receive chemotherapy and have high recall cognition.ConclusionsThree distinct classes of cognitive functioning emerged among older adults with cancer. Treatment with chemotherapy predicted likely membership in the High Recall class in this sample of cancer survivors, however this was due to an age by treatment interaction. Implications for understanding cognitive sequelae of cancer in late life are discussed.



http://ift.tt/2vuefSG

Prevalence and characteristics of work-anxiety in medical rehabilitation patients – a cross-sectional observation study

Publication date: Available online 20 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Beate Muschalla, Michael Jöbges
ObjectiveTo investigate frequency, type and characteristics of work-anxieties in somatic rehabilitation inpatients. Work-anxieties are serious disorders which affect occupational functioning and often go along with long-term sick leave. Somatic patients may suffer from work-related participation problems due to their chronic health condition. Work-anxieties need specific diagnostic and treatment.DesignThis is a cross-sectional observation study.SettingWe investigated inpatients from a neurological, orthopedic and cardiologic rehabilitation clinic.Participants1610 patients (18-65 years) were investigated for work-anxieties in a short structured interview.Main outcome measuresPatients who scored high in at least two out of nine work-anxiety leading symptoms and reported impairment were investigated with a differential-diagnostic interview on work-anxieties, and with the MINI interview on non-work-related common mental disorders. Patients also filled in a self-rating on their subjective symptom load and sociodemographic data.ResultsAbout 20-27% of the investigated somatic rehabilitation inpatients (altogether n=393) got a work-anxiety diagnosis. Orthopaedic patients report highest work-anxiety and have longest preceding sick leave (20.6 weeks in past 12 months). Orthopaedic patients suffer from work-related adjustment anxieties, social anxieties, and workplace phobia, while cardiology patients are more often affected from hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications.ConclusionsAbout one quarter of somatic rehabilitation patients is in need of additional diagnostic attention due to work-anxieties. Differential diagnostic of work-anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work-anxieties in their patients, especially in orthopaedic patients with preceding long-term sick leave.



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Associations of Sex Hormones and Anthropometry with the Speaking Voice Profile in the Adult General Population

There is evidence that sexual hormone concentrations and anthropometric factors influence the human voice. The goal of this study was to investigate to what extent body mass index (BMI), body height, body weight, breast-to-abdomen-ratio, testosterone, estradiol, dehydroepiandrosterone-sulfate (DHEA-S), follicle-stimulating hormone, and luteinizing hormone are associated with the sound pressure level and the fundamental frequency of the speaking voice in a cross-sectional approach among adults in the general population.

http://ift.tt/2vuoPck

Comparison of Two Multiparameter Acoustic Indices of Dysphonia Severity: The Acoustic Voice Quality Index and Cepstral Spectral Index of Dysphonia

The Acoustic Voice Quality Index (AVQI) and the Cepstral Spectral Index of Dysphonia (CSID) are two multiparameter acoustic indices designed to objectively estimate dysphonia severity and track treatment outcomes. This study compared the performance of these two indices using a common corpus of dysphonic speakers.

http://ift.tt/2tyhcV0

Homozygous mutations in PJVK and MYO15A genes associated with non-syndromic hearing loss in Moroccan families

Autosomal recessive non-syndromic hearing loss is a heterogeneous disorder and the most prevalent human genetic sensorineural defect. In this study, we investigated the geneticcause of sensorineural hearing loss in Moroccan patients and presented the importance of whole exome sequencing (WES) to identify candidate genes in two Moroccan families with profound deafness.

http://ift.tt/2tPqQhb

Vowel intelligibility in children with cochlear implants: An acoustic and articulatory study

In child cochlear implant (CI) users, early implantation generally results in highly intelligible speech. However, for some children developing a high level of speech intelligibility may be problematic. Studies of speech production in CI users have principally been based on perceptual judgment and acoustic measures. Articulatory measures, such as those collected using ultrasound provide the opportunity to more precisely evaluate what makes child CI users more intelligible. This study investigates speech production and intelligibility in children with CI using acoustic and articulatory measures.

http://ift.tt/2gRHTxT

Successful outcome of musculoskeletal injury leads to a reduction in chronic fatigue: A case report

Publication date: Available online 21 July 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Carl Todd DO
BackgroundChronic fatigue syndrome (CFS) is a general term used to describe a number of medical conditions that lead to persistent levels of fatigue and distress.ObjectivesOsteopathic manipulative treatment (OMT) combined with shoulder exercises to resolve musculoskeletal sports injury may have also led to a reduction in pain and improved strength with the patient reporting a change in CFS levels.Clinical features19-year-old male student, (statue 194cm and mass 80kg) who had played county level cricket and hockey. Presented with a two-year history of left shoulder pain (VAS 8/10) and a diagnosis of chronic fatigue syndrome.Intervention and outcomesOMT was performed over four clinical visits throughout a four a month period. Management goal was pain reduction, neural regulation, and facilitation of breathing mechanics to improve lymphatic drainage and restoration of shoulder strength and control.ConclusionClinically a reduction in pain (VAS 8/10–0/10) over four treatments appeared to correlate with improved shoulder strength. It was also reported that due to pain reduction, CFS might have improved.



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A comparison of lower limb muscle activation pattern using voluntary response index between pronated and normal foot structures during forward jump landing

Publication date: Available online 21 July 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Hosein Kouhzad Mohammadi, Mohammad Mehravar, Khosro Khademi Kalantari, Sedighe Sadat Naimi, Alireza Akbarzadeh Baghban, Farshad Okhovatian, Asghar rezasoltani, Mohammad Ali Mohseni Bandpei, Navid Taheri
BackgroundPronated foot is one of the important factors contributing to the musculoskeletal problems of the lower extremities. It is known that in pronated foot, excessive mechanical load is applied to the lower limb structures which may result in altered biomechanics and muscle activation patterns. The aim of this study was to determine changes in the muscle activation pattern of the lower extremities in the pronated compared to normal foot individuals, using the voluntary response index (VRI).MethodsIn this cross sectional study, 15 asymptomatic pronated foot individuals (mean age 23.27 ± 3.28 years) and 15 normal subjects (mean age 23.40 ± 3.11 years) were recruited by simple non-random sampling. Electrical activities of gluteus medius (GM), vastus lateralis (VL), vastus medialis (VM), biceps femoris, semitendinosus (ST), and medial gastrocnemius (MG) muscles were recorded during a forward jump landing task. Voluntary response index (VRI) variables, included similarity index (SI) and magnitude (Mag) were also evaluated.ResultsMuscle activity of VM (p < 0.001) and ST (p = 0.010) were significantly higher but VL (p = 0.039) and MG (p = 0.001) were significantly lower in pronated foot, compared to normal subjects. Similarity index was found to be different (p < 0.001) between pronated foot and healthy individuals. No significant difference was found in terms of Mag between the two groups (p = 0.576).ConclusionThe altered pattern of lower limb muscle activation identified in the pronated foot during landing may be attributed to the different activation in VL, VM, MG and ST muscles. Adaptations to the biomechanical effects due to the pronated foot causing altered activation of VL, VM, MG, and ST muscles, resulting in an altered pattern of muscle activation. This change in activation pattern may harm the effectiveness of movement control processes; and might also predispose individuals with pronated foot to injuries. It seems that an altered motor strategy with the aim of minimizing biomechanical changes, predisposes individuals to injuries. However, further large scale studies are needed to support the findings of the present study.



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An attempt to explain the Vojta therapy mechanism of action using the surface polyelectromyography in healthy subjects: A pilot study

Publication date: Available online 21 July 2017
Source:Journal of Bodywork and Movement Therapies
Author(s): Ewa Gajewska, Juliusz Huber, Aleksandra Kulczyk, Joanna Lipiec, Magdalena Sobieska
BackgroundRehabilitation according to Vojta is a neurophysiological method used to obtain reflex responses in muscles following stimulation of particular activation zones.Objectives: This study aims to objectively evaluate the muscular responses following stimulation according to Vojta's method. The possible routes of spinal transmission responsible for the phenomenon of muscle activation in upper and lower extremities are considered.MethodsPolyelectromyographic (pEMG) recordings in the upper and lower extremities in healthy volunteers (N = 25; aged 24 ± 1 year) were performed to find out the possible routes of spinal transmission, responsible for muscle activation. The left acromion and right femoral epicondyle were stimulated by a Vojta therapist; pEMG recordings were made including the bilateral deltoid and rectus femoris muscles.Resultsand Discussion: Following acromion stimulation, muscle activation was mostly expressed in the contralateral rectus femoris, rather than the contralateral deltoid and the ipsilateral rectus femoris muscles. After stimulation of the lower femoral epicondyle, the following order was observed: contra lateral deltoid, ipsilateral deltoid and the contra lateral rectus femoris muscle.One of the candidates responsible for the main crossed neural transmission involved in the Vojta therapy mechanism would be the long propriospinal tract neurons.



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Promising approaches for treatment and prevention of viral respiratory illnesses

Viral respiratory infections are the most common human ailments, leading to enormous health and economic burden. Hundreds of virus species and subtypes have been associated with these conditions, with influenza viruses (IFV), respiratory syncytial virus (RSV) and the rhinoviruses (RV) being the most frequent and with the highest burden. When considering prevention or treatment of viral respiratory infections, potential targets include the causative pathogens themselves but also the immune response, disease transmission or even just the symptoms.

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Effect of home exposure to Staphylococcus aureus on asthma in adolescents

This is the first study to find that environmental Staphylococcus aureus and staphylococcal enterotoxins in a national population of inner-city adolescents with asthma are common and have the potential to drive asthma symptoms.

http://ift.tt/2eCYNzM

Genetic and epigenetic regulation of YKL-40 in childhood

Circulating YKL-40 and variation in its encoding gene CHI3L1 have been associated with asthma. We found that methylation levels at CHI3L1 CpG sites partly mediated CHI3L1 genetic effects on circulating YKL-40, although they were not associated with childhood asthma.

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Earwax MD Now Available Through Oaktree Products

​Eosera (http://eosera.com/) is partnering with Oaktree Products, a wholesale supplier of clinical supplies to hearing health care professionals, to bring Earwax MD to audiologists, otolaryngologists, and hearing instrument specialists. Oaktree Products will carry two versions of Earwax MD—a 2-ounce bottle for in-office use and a smaller one for health care professionals to resell to their patients. Bob Kemp, CEO of Oaktree Products, said they're very excited to represent a groundbreaking product like Earwax MD. "Historically, earwax softening agents have been formulated with carbamide peroxide," Kemp said. "These products, like Debrox, usually require several days to produce results. The ability to soften and remove wax in minutes will make cerumen removal in the clinic so much easier and more efficient."

Earwax MD is also available through other distributors, including Warner Tech and ADCO Hearing, and to patients on Amazon. CVS stores will also begin carrying Earwax MD in August. 

Published: 7/21/2017 8:32:00 AM

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Perforator based rectus free tissue transfer for head and neck reconstruction: New reconstructive advantages from an old friend

Many donor sites are used for autogenous transplantation to reconstruct soft tissue defects in the head and neck [1]. The ideal soft tissue donor site would have a long vascular pedicle, be accompanied by adipose tissue that is highly moldable so that the volume of adipose within the transplant can be customized, and would not contain muscle, so that the volume of the transplant is not affected by muscle atrophy.

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A review study to evaluate holmium:YAG laser lithotripsy with flexible ureteroscopy in patients on ongoing oral anticoagulant therapy

Abstract

The objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified. Of these patients, 40 were on warfarin, 25 on aspirin, 11 on clopidogrel, and 8 on both aspirin and clopidogrel. The drugs were not discontinued. The baseline characteristics, indications for anticoagulation therapy, perioperative data, stone-free rate, and complications were documented. Evaluation of outcomes was assessed at 1-, 3-, and 6-month follow-up postoperatively. Mean stone size was 19.7 ± 9.4 (range 8 to 31 mm). Twenty patients had upper ureteral and 64 patients had intrarenal calculi. Two patients had bilateral renal calculi. Mean operation time was 78.2 ± 23.8 min (range 17 to 144 min). Two procedures (2.3%) in warfarin group were terminated due to persistent bleeding causing visual impairment. No transfusions were required. The mean serum hemoglobin levels did not change significantly (12.9 ± 3.7 to 12.2 ± 3.3 g/dL). No thromboembolic or cardiac adverse events were observed perioperatively. The double-j (DJ) ureteral catheterization time was 29.6 ± 9.3 days (range 14 to 68 days) and the hospital stay was 1.6 ± 0.6 days (range 1 to 4). The stone-free rate was 95.2% (80 patients) at 6 months. Flexible ureteroscopic Ho:YAG laser lithotripsy in patients requiring long-term anticoagulation therapy seems to be a safe and effective procedure and should be considered as a first-line treatment option in such patients for the surgical management of upper urinary tract stones.

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Editorial changes [EDITORIAL]

Olivier Pourquie and Katherine Brown

Here at Development we are very sad to be saying goodbye to two of our editors: Ottoline Leyser and Geraldine Seydoux. Both Ottoline and Geraldine have been valued members of the editorial team since 2011, and we are hugely grateful for the time and effort they have put in to handling research papers, helping to shape the journal's future plans and, in Ottoline's case, coordinating our 2016 Special Issue on Plant Development. They will both be greatly missed, but will maintain connections with and continue to provide input on the journal as members of our Editorial Advisory Board.

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To4, the first Tityus obscurus β-toxin fully electrophysiologically characterized on human sodium channel isoforms

Publication date: Available online 21 July 2017
Source:Peptides
Author(s): Harry Morales Duque, Caroline Barbosa Farias Mourão, Diogo Vieira Tibery, Eder Alves Barbosa, Leandro Ambrósio Campos, Elisabeth Ferroni Schwartz
Many scorpion toxins that act on sodium channels (NaScTxs) have been characterized till date. These toxins may act modulating the inactivation or the activation of sodium channels and are named α- or β-types, respectively. Some venom toxins from Tityus obscurus (Buthidae), a scorpion widely distributed in the Brazilian Amazon, have been partially characterized in previous studies; however, little information about their electrophysiological role on sodium ion channels has been published. In the present study, we describe the purification, identification and electrophysiological characterization of a NaScTx, which was first described as Tc54 and further fully sequenced and renamed To4. This toxin shows a marked β-type effect on different sodium channel subtypes (hNav1.1–hNav1.7) at low concentrations, and has more pronounced activity on hNav1.1, hNav1.2 and hNav1.4. By comparing To4 primary structure with other Tityus β-toxins which have already been electrophysiologically tested, it is possible to establish some key amino acid residues for the sodium channel activity. Thus, To4 is the first toxin from T. obscurus fully electrophysiologically characterized on different human sodium channel isoforms.



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Managing metastatic bone pain: New perspectives, different solutions

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Iwona Zaporowska-Stachowiak, Jacek Łuczak, Karolina Hoffmann, Katarzyna Stachowiak, Wiesław Bryl, Maciej Sopata
Bone metastases are the most frequent cause of cancer-induced bone pain (CIBP). Although palliative radiotherapy and pharmacotherapy conducted according to World Health Organization (WHO) analgesic ladder are the treatment of choice for CIBP reduction, these methods are not always successful, especially with regard to alleviation of incidental pain. Antiresorptive drugs (bisphosphonates) are able to inhibit bone destruction (loss), proliferation of cancer cells and angiogenesis, but their prolonged use may lead to a spectrum of adverse effects. In this paper, types of bone metastases, their complications, as well as diagnostic and therapeutic implications are presented. Moreover, the paper discusses presently used CIBP treatment methods and research directions for future methods, with special focus on bone metastases.



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Hepatitis transmission risk in kidney transplantation (the HINT study): a cross-sectional survey of transplant clinicians in Australian and New Zealand.

Background: Interpreting hepatitis serology and virus transmission risk in transplantation can be challenging. Decisions must balance opportunity to transplant against potential infection transmission. We aimed to survey understanding among the Australian and New Zealand medical transplant workforce of hepatitis risk in kidney donors and recipients. Methods: An anonymous, self-completed, cross-sectional survey was distributed via electronic mailing lists to Australian and New Zealand clinicians involved in kidney transplantation (2014-2015). We compared interpretation of clinical scenarios with paired donor and recipient hepatitis B and C (HBV, HBC) serology to recommendations in clinical practice guidelines. We used logistic regression modelling to investigate characteristics associated with decisions on transplant suitability in scenarios with poor (

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C1-inhibitor Treatment Decreases Renal Injury in an Established Brain-dead Rat Model.

Background: Kidneys derived from brain-dead (BD) donors have lower graft survival rates compared to kidneys from living donors. Complement activation plays an important role in brain death. The aim of our study was therefore to investigate the effect of C1-inhibitor (C1-INH) on BD-induced renal injury. Methods: Brain death was induced in rats by inflating a subdurally placed balloon catheter. Thirty minutes after BD, rats were treated with saline, low-dose or high-dose C1-INH. Sham-operated rats served as controls. After 4 hours of brain death, renal function, injury, inflammation and complement activation was assessed. Results: High-dose C1-INH treatment of BD donors resulted in significantly lower renal gene expression and serum levels of IL-6. Treatment with C1-INH also improved renal function and reduced renal injury, reflected by the significantly lower KIM-1 gene expression and lower serum levels of LDH and creatinine. Furthermore, C1-INH effectively reduced complement activation by brain death and significantly increased functional levels. However, C1-INH treatment did not prevent renal cellular influx. Conclusions: Targeting complement activation after the induction of brain death reduced renal inflammation and improved renal function, before transplantation. Therefore, strategies targeting complement activation in human BD donors might clinically improve donor organ viability and renal allograft survival. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Oral nucleos(t)ide Analogs Alone After Liver Transplantation in Chronic Hepatitis B with Preexisting rt204 Mutation.

Background: There is currently limited data regarding the use of oral antiviral therapy alone without HBIG for CHB patients with preexisting LAM-resistance (LAM-R) undergoing liver transplantation. Methods: This is a cohort study determining the effectiveness and long-term outcome in this group of patients. Results: Fifty-seven consecutive CHB patients with preexisting rt204 LAM-R mutations or virological load refractory to LAM undergoing liver transplantation were included, with a median follow-up of 73 months. Fifty-five (96.5%) patients received a regimen that included the use of nucleotide analogs. The cumulative rate of HBsAg seroclearance at 1, 5, and 10 years was 82%, 88%, and 91% respectively. At the time of transplantation, 39 (72%) patients had detectable HBV DNA, with a median of 4.5 log copies/mL. The cumulative rate of HBV undetectability was 91% at 1 year, increasing to 100% by 5 years. After 1 year of liver transplantation, over 90% of patients had undetectable HBV DNA, and from 8 years onwards, 100% had undetectable HBV DNA. The overall long-term survival was excellent, with a 12-year survival of 87%. There was no HBV-related graft loss, and no retransplantation or deaths due to HBV reactivation. Conclusion: Oral antiviral therapy alone without HBIG is highly effective in preventing HBV reactivation and graft loss from recurrent hepatitis B after liver transplantation in patients with preexisting lamivudine resistance HBV. The long-term outcome was excellent, with survival of 87% at 12 years after transplantation, without any mortality related to HBV reactivation. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Prognostic Factors in Lung Transplantation after Hematopoietic Stem Cell Transplantation.

Background: Lung transplantation is the final life-saving option for patients with pulmonary complications after hematopoietic stem cell transplantation (HSCT). Patients undergoing HSCT for hematologic diseases are thought to be high-risk candidates for lung transplantation; therefore, few lung transplants are performed for these patients, and few studies have been reported. This study aimed to describe the characteristics and outcomes of lung transplantation in patients with pulmonary complications after HSCT. Methods: We retrospectively investigated 62 patients who underwent lung transplantation after HSCT. All data were collected from 6 lung transplant centers in Japan. Results: Seventeen patients underwent cadaveric lung transplantation, whereas 45 underwent living-donor lobar lung transplantation (LDLLT). In the LDLLT group, 18 patients underwent LDLLT after HSCT in which 1 of the donors had also served as a donor for HSCT. Seven patients underwent single LDLLT for which the donor was the same as the patient from whom stem cells were obtained for HSCT. Preoperative hypercapnia was observed in 52 patients (84%). Thirteen patients (21%) required mechanical ventilation preoperatively. Fifty-five patients underwent HSCT for hematologic malignancies, and 4 (7%) relapsed after lung transplantation. The 5-year survival rate was 64.2%. In a multivariable analysis, patients younger than 45 years and those with the same donor for both procedures exhibited significantly better survival (p = 0.012 and 0.041, respectively). Conclusions: Lung transplantation for pulmonary complications after HSCT was performed safely and yielded better survival, especially in younger recipients for whom both lung transplantation and HSCT involved the same donor. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Trichodysplasia Spinulosa.

No abstract available

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New answers to old conundrums: what antibodies, exosomes and inflammasomes bring to the conversation. Canadian National Transplant Research Program international summit report.

Antibody-mediated injury is a major cause of allograft dysfunction and loss. Antibodies to ABH(O) blood group antigens are classical mediators of ABO-incompatible (ABOi) graft rejection, while donor-specific anti-HLA antibodies and, more recently, autoantibodies are appreciated as important contributors to allograft inflammation and dysfunction. In August 2016, the International Summit of the Canadian National Transplant Research Program focused on recent advances in the field of antibody-mediated rejection. Here, we describe work presented and discussed at the meeting, with a focus on 3 major themes: the importance of 1- Natural antibodies and autoantibodies, 2- tissue injury derived exosomes and autoimmunity, 3- inflammasome activation and innate immune responses in regulating allograft inflammation and dysfunction. Finally, we explore novel areas of therapeutic intervention that have recently emerged from these 3 major and overlapping fields of transplantation research. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Seasonal variability precipitating hand transplant rejection?.

No abstract available

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Expanding the Toolkit for the Study of Allo-specific B and T Cell Responses.

No abstract available

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Terasaki epitope mismatch burden predicts the development of de novo DQ donor specific antibodies and are associated with adverse allograft outcomes.

Background: De novo DQ DSA are associated with antibody-mediated rejection and allograft loss. Given the lack of effective treatment of de novo DQ DSA, their prevention is vital if there is to be an improvement of long term allograft survival. Using the HLA Matchmaker programme, DQ epitope matching has been shown to be superior to HLA antigen mismatching in predicting de novo DQ DSA development. Whether DQ epitopes determined by Terasaki may more accurately predict de novo DQ development over HLA antigen matching is not known. Methods: We retrospectively analysed the immunogenicity of the different HLA antigens, DQB1 alleles and DQB1 Teraskai epitopes (TerEp) in a large cohort of renal transplant recipients, by comparing patient mismatches with de novo DSA development. Results: Patients mismatched at a DQB1 allele were at significantly higher risk of developing de novo DSA compared with other mismatched HLA antigens. Patients mismatched at the DQ7 allele appear to be at specific risk. For patients mismatched at a single DQB1 allele, the risk of de novo DQ DSA development increases with the number of TerEp mismatches. However, the immunogenicity of the different DQ TerEps, do not appear to be equal. Patients who develop antibodies against TerEps are at increased risk of adverse allograft outcomes, specifically antibody-mediated rejection. Conclusion: Epitope mismatch burden, determined by TerEps, helps predict risk of de novo DQ DSA development, and offers an alternative approach to predict an alloimmune response. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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The Relationship Between Environmental Sound Awareness and Speech Recognition Skills in Experienced Cochlear Implant Users.

Hypothesis: 1) Environmental sound awareness (ESA) and speech recognition skills in experienced, adult cochlear implant (CI) users will be highly correlated, and, 2) ESA skills of CI users will be significantly lower than those of age-matched adults with normal hearing. Background: Enhancement of ESA is often discussed with patients with sensorineural hearing loss as a potential benefit of implantation and, in some cases, ESA may be a major motivating factor. Despite its ecological validity and patients' expectations, ESA remains largely a presumed skill. The relationship between ESA and speech recognition is not well-understood. Methods: ESA was assessed in 35 postlingually deaf, experienced CI users and a control group of 41 age-matched, normal hearing listeners using the validated, computerized familiar environmental sounds test-identification (FEST-I) and a diverse speech recognition battery. Demographic and audiological factors as well as nonverbal intelligence quotient (IQ)/nonverbal reasoning and spectral resolution were assessed. Results: Six of the 35 experienced CI users (17%) demonstrated FEST-I accuracy within the range of the NH controls. Among CI users all correlations between FEST-I accuracy and speech recognition scores were strong. Chronological age at the time of testing, duration of deafness, spectral resolution, and nonverbal IQ/nonverbal reasoning were strongly correlated with FEST-I accuracy. Partial correlation analysis showed that correlations between FEST-I and speech recognition measures remained significant when controlling for the demographic and audiological factors. Conclusion: Our findings reinforce the hypothesis that ESA and speech perception share common underlying processes rather than reflecting truly separate auditory domains. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Audiologic Gain of Incus Short Process Vibroplasty With Conventional Incus Long Process Vibroplasty: A Retrospective Analysis of 36 Patients.

Objective: To compare the audiological and non-audiological benefits of incus short process (SP) vibroplasty with those of conventional incus long process (LP) vibroplasty. Study Design: Retrospective analysis. Setting: Tertiary referral center. Patients: Thirty-six patients with sensorineural hearing loss were treated with the semi-implantable middle ear hearing device. Of these, 22 were treated with conventional LP vibroplasty, and 14 were treated with SP vibroplasty using SP couplers. Interventions: Implantation with the semi-implantable middle ear hearing device by different methods. Main Outcome Measures: Pre- and postoperative hearing level, word recognition score, operation time, and duration of hospital stay were compared. We also surveyed a questionnaire to assess postoperative complications. Results: The improvement in hearing gain was comparable between SP vibroplasty and conventional LP vibroplasty, except at 8 kHz, at which LP vibroplasty showed better hearing gain (p

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Proteomic analysis of the secretome of human bone marrow-derived mesenchymal stem cells primed by pro-inflammatory cytokines

Publication date: Available online 21 July 2017
Source:Journal of Proteomics
Author(s): Elisa Maffioli, Nonnis Simona, Roberta Angioni, Fabiana Santagata, Bianca Calì, Lucia Zanotti, Armando Negri, Antonella Viola, Gabriella Tedeschi
Mesenchymal stem cells (MSC) represent an impressive opportunity in term of regenerative medicine and immunosuppressive therapy. Although it is clear that upon transplantation MSC exert most of their therapeutic effects through the secretion of bioactive molecules, the effects of a pro-inflammatory recipient environment on MSC secretome have not been characterized. In this study, we used a label free mass spectrometry based quantitative proteomic approach to analyze how pro-inflammatory cytokines modulate the composition of the human MSC secretome. We found that pro-inflammatory cytokines have a strong impact on the secretome of human bone marrow-derived MSC and that the large majority of cytokine-induced proteins are involved in inflammation and/or angiogenesis. Comparative analyses with results recently obtained on mouse MSC secretome stimulated under the same conditions reveals both analogies and differences in the effect of pro-inflammatory cytokines on MSC secretome in the two organisms. In particular, functional analyses confirmed that tissue inhibitor of metalloproteinase-1 (TIMP1) is a key effector molecule responsible for the anti-angiogenic properties of both human and mouse MSC within an inflammatory microenvironment. Mass spectrometry data are available via ProteomeXchange with identifier PXD005746SignificanceThe secretion of a broad range of bioactive molecules is believed to be the main mechanism by which MSC exert specific therapeutic effects. MSC are very versatile and respond to specific environments by producing and releasing a variety of effector molecules. To the best of our knowledge this is the first study aimed at describing the secretome of human MSC primed using a mixture of cytokines, to mimic pro-inflammatory conditions encountered in vivo, by a quantitative high-resolution mass spectrometry based approach. The main output of the study concerns the identification of a list of specific proteins involved in inflammation and angiogenesis which are overrepresented in stimulated MSC secretome. The data complement a previous study on the secretome of mouse MSC stimulated under the same conditions. Comparative analyses reveal analogies and differences in the biological processes affected by overrepresented proteins in the two organisms. In particular, the key role of TIMP-1 for the anti-angiogenic properties of stimulated MSC secretome already observed in mouse is confirmed in human. Overall, these studies represent key steps necessary to characterize the different biology of MSC in the two organisms and design successful pre-clinical experiments as well as clinical trials.

Graphical abstract

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Revisiting venom of the sea anemone Stichodactyla haddoni: Omics techniques reveal the complete toxin arsenal of a well-studied sea anemone genus

Publication date: Available online 21 July 2017
Source:Journal of Proteomics
Author(s): Bruno Madio, Eivind A.B. Undheim, Glenn F. King
More than a century of research on sea anemone venoms has shown that they contain a diversity of biologically active proteins and peptides. However, recent omics studies have revealed that much of the venom proteome remains unexplored. We used, for the first time, a combination of proteomic and transcriptomic techniques to obtain a holistic overview of the venom arsenal of the well-studied sea anemone Stichodactyla haddoni. A purely search-based approach to identify putative toxins in a transcriptome from tentacles regenerating after venom extraction identified 508 unique toxin-like transcripts grouped into 63 families. However, proteomic analysis of venom revealed that 52 of these toxin families are likely false positives. In contrast, the combination of transcriptomic and proteomic data enabled positive identification of 23 families of putative toxins, 12 of which have no homology known proteins or peptides. Our data highlight the importance of using proteomics of milked venom to correctly identify venom proteins/peptides, both known and novel, while minimizing false positive identifications from non-toxin homologues identified in transcriptomes of venom-producing tissues. This work lays the foundation for uncovering the role of individual toxins in sea anemone venom and how they contribute to the envenomation of prey, predators, and competitors.Biological significanceProteomic analysis of milked venom combined with analysis of a tentacle transcriptome revealed the full extent of the venom arsenal of the sea anemone Stichodactyla haddoni. This combined approach led to the discovery of 12 entirely new families of disulfide-rich peptides and proteins in a genus of anemones that have been studied for over a century.

Graphical abstract

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Predation by female chimpanzees: Toward an understanding of sex differences in meat acquisition in the last common ancestor of Pan and Homo

Publication date: September 2017
Source:Journal of Human Evolution, Volume 110
Author(s): Ian C. Gilby, Zarin P. Machanda, Robert C. O'Malley, Carson M. Murray, Elizabeth V. Lonsdorf, Kara Walker, Deus C. Mjungu, Emily Otali, Martin N. Muller, Melissa Emery Thompson, Anne E. Pusey, Richard W. Wrangham
Among modern foraging societies, men hunt more than women, who mostly target relatively low-quality, reliable resources (i.e., plants). This difference has long been assumed to reflect human female reproductive constraints, particularly caring for and provisioning mates and offspring. Long-term studies of chimpanzees (Pan troglodytes) enable tests of hypotheses about the possible origins of human sex differences in hunting, prior to pair-bonding and regular provisioning. We studied two eastern chimpanzee communities (Kasekela, Mitumba) in Gombe, Tanzania and one (Kanyawara) in Kibale, Uganda. Relative to males, females had low hunting rates in all three communities, even where they encountered red colobus monkeys (the primary prey of chimpanzees) as often as males did. There was no evidence that clinging offspring hampered female hunting. Instead, consistent with the hypothesis that females should be more risk-averse than males, females at all three sites specialized in low-cost prey (terrestrial/sedentary prey at Gombe; black and white colobus monkeys at Kanyawara). Female dominance rank was positively correlated with red colobus hunting probability only at Kasekela, suggesting that those in good physical condition were less sensitive to the costs of possible failure. Finally, the potential for carcass appropriation by males deterred females at Kasekela (but not Kanyawara or Mitumba) from hunting in parties containing many adult males. Although chimpanzees are not direct analogs of the last common ancestor (LCA) of Pan and Homo, these results suggest that before the emergence of social obligations regarding sharing and provisioning, constraints on hunting by LCA females did not necessarily stem from maternal care. Instead, they suggest that a risk-averse foraging strategy and the potential for losing prey to males limited female predation on vertebrates. Sex differences in hunting behavior would likely have preceded the evolution of the sexual division of labor among modern humans.



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Endoscopic transcanal myringoplasty for tympanic perforations: An outpatient minimally invasive procedure

Publication date: Available online 21 July 2017
Source:Auris Nasus Larynx
Author(s): Chih-Chieh Tseng, Ming-Tang Lai, Chia-Che Wu, Sheng-Po Yuan, Yi-Fang Ding
ObjectiveSince the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty).MethodsWe retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane. The main outcome was the overall rate of graft success of endoscopic transcanal myringoplasty.ResultsA total of 181 patients were included in the analysis. The overall graft success was determined in 163 of 181 patients (92.8%). The mean preoperative and postoperative air-bone gaps were 19.3dB and 7.8dB, respectively, revealing a significant improvement of 11.5dB (Cohen's d, 1.27; 95% CI, 1.03–1.50; P<0.05; paired t test) in the air-bone gap. The rate of graft success with partial visualization of the perforation margin was comparable to that with complete visualization of the perforation margin. Larger sizes of perforations were significantly associated with lower rates of graft success (P<0.01).ConclusionOur study revealed that the rate of graft success and hearing results of endoscopic transcanal myringoplasty and microscopic myringoplasty are comparable for repairing perforations of the tympanic membrane. Visualization of the perforation margin by otoscopy did not affect the rate of graft success. However, endoscopic transcanal myringoplasty is less invasive because this technique does not require postauricular incision, canalplasty, and general anesthesia.



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Hand rejuvenation with fat grafting: A 12-year single-surgeon experience

Abstract

Background

Fat grafting has been successfully used for reconstructive and esthetic surgery of the breast, face, and other body parts. In this article, we present our protocol for hand fat grafting and over a decade of clinical experience.

Methods

Fat tissue is obtained from the flanks, peri-umbilical region, or internal side of the thigh or knee. No centrifuge machine is used to prevent fat damage. After decantation, fat is injected into the dorsum of the hand using a cannula from the wrist and not from the fingers. Fat is distributed gently above the dorsal deep fascia to avoid perforation of the vessels.

Results

The proposed technique was applied to 65 patients. The amount of fat injected ranged from 10 to 30 cm³. No allergic reactions were noticed. Each patient's progress was followed-up for a minimum of 12 months. Over this period, contour changes and the effects of the procedure(s) on the skin were analyzed. Fifty-six patients (84%) were satisfied with the results during the observation period, 7 patients (12%) were somewhat satisfied and needed one more fat grafting procedure to achieve complete satisfaction, and 2 patients (4%) were dissatisfied with the results. Three cases of temporary swelling of the hands resolved naturally. No long-term complications were seen.

Conclusions

This study covers over a decade of practical experience in applying fat grafts to hands. The procedure is effective in reshaping and rejuvenating the hand as it shows long-lasting results after 1-year follow-up.

http://ift.tt/2uI4dQj

Types of strain among family members of individuals with autism spectrum disorder across the lifespan

Publication date: September 2017
Source:Research in Developmental Disabilities, Volume 68
Author(s): Carolyn M. Shivers, Katarina Krizova, Gloria K. Lee
BackgroundAlthough increased caregiver strain is often found among family caregivers of individuals with autism spectrum disorder, it is still unclear as to how different types of strain relate to amount and types of caregiving across the lifespan.AimsThe present study examined different types of strain (i.e. subjective internalized strain, subjective externalized strain, and objective strain) and how such strain relates to the amount of caregiving responsibilities.MethodsData was collected via online survey from a sample of 193 family caregivers of individuals with ASD from the United States, Canada, and the Republic of Ireland. Participants completed measures of strain and caregiving responsibilities, as well as coping, demographics, and services needed and received by the individual with ASD.ResultsCaregivers reported higher levels of objective strain than subjective, and caregiving responsibility was related to objective and subjective internalized strain. Coping style was strongly correlated with all types of strain, and unmet service needs were significantly related to objective and subjective internalized strain. Caregiving behaviors were only related to objective strain.ConclusionThe present results indicate that, although caregiving responsibility is related to objective and subjective internalized strain, the relationship is perhaps not as strong as the relationship between coping mechanisms and strain. Future research is needed to understand different types of strain and develop strategies to help caregivers.



http://ift.tt/2gR9IX8

Self-efficacy of physical education teachers in including students with cerebral palsy in their classes

Publication date: September 2017
Source:Research in Developmental Disabilities, Volume 68
Author(s): Yeshayahu Hutzler, Sharon Barak
Children with cerebral palsy (CP) are often mainstreamed into the general education system, but are likely to be excluded from physical education (PE) classes. A questionnaire was constructed and utilized to measure PE teachers' self-efficacy (SE) toward inclusion of students with CP in each of three mobility categories (independent, using assistive devices, using wheelchair mobility) and the impact of experience and training on teachers' SE. Participants in the study were 121 PE teachers from different parts of Israel (mean age: 41.02±9.33 years; range: 25.00–59.00 years). Exploratory factor analysis was used to determine the structure of the sub-scales' factors' structure and Cronbach's Alpha reliability was satisfactory (range 0.872–0.941). Independent t-tests were calculated in order to compare the SE of teachers with and without adapted PE experience. Repeated Analysis of Variance was performed to measure within-group differences in SE. Results revealed that the PE teachers' SE in teaching students who use mobility assistive devices or wheelchairs was significantly lower compared to teaching those who walk and run unaided (F=19.11; p<0.001). The teachers' SE towards including CP children who independently ambulate was influenced (p<0.05; d=0.94) by the teacher's experience (elementary school practicum). SE in the mobility with assistive device group was also significantly influenced (p<0.05; d=0.1) by teaching experience (previous experience and having a specialization in adapted PE). Finally, SE when teaching the wheelchair mobility group was influenced by having an adapted PE specialization (p<0.05; d=0.82). Specialized training in this particular area should be enhanced to increase teachers' SE and enable greater participation of children with CP in general physical education classes



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Bioaccumulation kinetics of arsenite and arsenate in Dunaliella salina under different phosphate regimes

Abstract

Dunaliella salina is a potential candidate for the phycoremediation of saline water contaminated with arsenic (As) due to its strong tolerance of salt and this toxic metalloid. However, the efficiency of As removal by this microalga varies under different phosphate regimes and the underlying mechanisms remain unresolved. Therefore, more detailed studies are needed to optimize As remediation using D. salina. Here, we investigated the dynamic processes of arsenite (As(III)) and arsenate (As(V)) uptake, transformation, and excretion by D. salina under phosphate-deficient (−P) and phosphate-enriched (+P) conditions through short-term and long-term uptake experiments. In the short-term uptake experiment, the absorption of As(III) or As(V) by D. salina was significantly suppressed by an increased phosphate supply. The V _max values for As(III) and As(V) decreased by 2- and 2.5-fold, respectively, under +P conditions, although the Michaelis constants (K _m ) were similar irrespective of the phosphate supply. Long-term uptake experiments also revealed enhanced As(III)/As(V) absorption and efflux rates and As(V) reduction by D. salina under −P conditions. This study quantified the kinetic processes of As metabolism in D. salina. More importantly, the results imply that the optimal As remediation by this microalga may be achieved by regulating the phosphate level in the culture.

http://ift.tt/2vtsszl

Concentrations and inhalation risk assessment of short-chain polychlorinated paraffins in the urban air of Dalian, China

Abstract

The concentrations of short-chain polychlorinated paraffins (SCCPs) in the urban air of Dalian, China, were monitored from March to October 2010 and from September to October 2016 with active high-volume sampler. The total concentration of SCCPs (particulate phase + gas phase) ranged from 15.12 to 66.44 ng m⁻³, with an average of 30.26 ng m⁻³ in 2010, and 65.30 to 91.00 ng m⁻³, with an average of 78.15 ng m⁻³ in 2016. Hexa-chlorinated dodecane and hexa-chlorinated undecane are the predominant components in the gas phase, while octa-chlorinated undecane and hepta-chlorinated tridecane are dominant in the particulate phase. In 2010, 82.57–97.16% of the total SCCPs were found in the gas phase, except that in winter, where 63.11% of the total SCCPs were in the particulate phase; the air concentrations of SCCPs in gas phase were summer > autumn > spring > winter, which was positively correlated with the change of the average ambient temperature, while it was the contrary in particulate phase. In autumn, the gas phase and the total air concentration of SCCPs in 2016 were 2.57 times more than that in 2010, while the congener group patterns of SCCPs were similar. Spearman's rank correlation analysis between the concentrations of SCCPs with meteorological parameters was conducted. The gas-particle distribution was examined through the relationship of the logarithm of the gas-particle partition coefficient with that of the subcooled vapor pressure and the octanol-air partitioning coefficient of SCCPs. Results indicated that the absorption mechanisms contributed more to the partitioning process. The exposure risk of SCCPs was evaluated, which illustrated that the estimated exposure of SCCPs via the outdoor environment in Dalian did not exceed the health concern threshold of the European risk assessment.

http://ift.tt/2tOCMzK

Zero-valent iron particles for PCB degradation and an evaluation of their effects on bacteria, plants, and soil organisms

Abstract

Two types of nano-scale zero-valent iron (nZVI-B prepared by borohydride reduction and nZVI-T produced by thermal reduction of iron oxide nanoparticles in H₂) and a micro-scale ZVI (mZVI) were compared for PCB degradation efficiency in water and soil. In addition, the ecotoxicity of nZVI-B and nZVI-T particles in treated water and soil was evaluated on bacteria, plants, earthworms, and ostracods. All types of nZVI and mZVI were highly efficient in degradation of PCBs in water, but had little degradation effect on PCBs in soil. Although nZVI-B had a significant negative impact on the organisms tested, treatment with nZVI-T showed no negative effect, probably due to surface passivation through controlled oxidation of the nanoparticles.

http://ift.tt/2ujcklf

Neuraxial drug delivery for the management of cancer pain: cost, updates, and society guidelines.

Purpose of review: The present study discusses the utilization of neuraxial drug delivery (NDD) for the management of cancer pain, based on recent trials, reviews, and guidelines with a focus on cost analysis. Recent findings: Almost all recent publications suggest that more stringent research is needed to improve evidence on NDD, particularly as conflicting reports exist regarding cost effectiveness of drug delivery systems. The combination of local anesthetics and opioids, with or without clonidine, continues to be reported as beneficial with the utilization of patient controlled systems providing an advantage over continuous ones. Interestingly, the use of opioids as an adjunct to local anesthetics may not enhance analgesia but the addition of dexamethasone is useful for incident cancer-related bone pain. Ziconitide remains supported as first-line therapy in districts where it is available - United States and Europe. Although new targeted drugs are being designed for cancer pain management, none have seen human clinical trials in the last year. Summary: The ability to demonstrate cost effectiveness of NDD is variable from region to region. Less expensive externalized systems may pose a viable alternative. With the exception of dexamethasone, no new drugs have been shown to provide any benefit to conventional medications. Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Management of complex spine surgery.

Purpose of review: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. Recent findings: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery. Fluid and pain-control protocols combined with an accurate blood management represent the key to success. Summary: A tailored approach to patients undergoing major spine surgeries seems to be effective improving the outcome and quality of life of patients. Future studies should aim to understand which elements of the ERAS can be improved to allow the patient to have a long-term good outcome. Video abstract: http://ift.tt/2vtcsgP Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2ujeGRp

Dog-Bite–Related Craniofacial Fractures among Pediatric Patients: A Case Series and Review of Literature

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1604073

Dog bites in the pediatric population commonly cause injuries to the head and can be associated with fractures, often leading to prolonged hospital stays, multiple surgical interventions, and long-term complications. Our goal was to evaluate our experience with dog-bite–related craniofacial fractures, understand frequency and demographics of these fractures, identify common fracture patterns, and provide recommendations based on management and complications encountered. The institution's electronic medical record was reviewed. A review of the English literature for the past 20 years was also conducted. A retrospective chart review was conducted using ICD-9 codes to include all patients with head and neck dog bites and craniofacial fractures. Fractures resulting from canine bites to the face and scalp were rare, occurring in our study in less than 1% of total facial dog bites (1,069 cases) and 1.5% of pediatric facial dog bites (462 cases). Ages ranged from 5 months to 9 years at the time of presentation. A total of seven patients, all pediatric, were documented. All seven patients required operative intervention for their wounds, and five patients required at least two operative interventions. Midface and skull fractures were the most commonly encountered fracture sites. Dog bite injuries to the face in young children, especially when severe, should raise suspicion for fracture of underlying bone. Management of these injuries should include a multidisciplinary approach and focus on repair of soft tissue and skeletal deformities. Furthermore, it is prudent to follow up patients who require operative management after injury to monitor for long-term complications, given the significant proportion of complications and operative takebacks in this study.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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Contralateral Islanded Facial Artery Myomucosal Flap for the Reconstruction of Floor of the Mouth Defect

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1604071

Reconstruction of floor of the mouth and ventral surface of the tongue defects can be challenging because inadequate correction can lead to mobility restriction of the tongue and resultant impairment of speech and swallowing. Ideal flap should be pliable, provide adequate bulk, be easy to harvest, and cosmetically acceptable. Commonly used ipsilateral facial artery–based myomucosal flaps may not be ideal if facial vessels need resection. We share our experience in a case of simultaneous primary mucoepidermoid carcinoma of right submandibular and sublingual glands, with a postsurgical defect involving floor of the mouth and ventral surface of the tongue, reconstructed with islanded facial artery myomucosal flap raised from left buccal mucosa and tunneled into the right floor of the mouth defect medial to mandible. The case is being reported to share the method of reconstruction as well as for the rare presentation of simultaneous primary mucoepidermoid carcinoma of multiple major salivary glands.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Promising approaches for treatment and prevention of viral respiratory illnesses

Publication date: Available online 21 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Nikolaos G. Papadopoulos, Spyridon Megremis, Nikolaos A. Kitsioulis, Olympia Vangelatou, Peter West, Paraskevi Xepapadaki
Viral respiratory infections are the most common human ailments, leading to enormous health and economic burden. Hundreds of virus species and subtypes have been associated with these conditions, with influenza viruses (IFV), respiratory syncytial virus (RSV) and the rhinoviruses (RV) being the most frequent and with the highest burden. When considering prevention or treatment of viral respiratory infections, potential targets include the causative pathogens themselves but also the immune response, disease transmission or even just the symptoms. Strategies targeting all these aspects are concurrently developing and several novel and promising approaches are emerging. In this perspective, we overview the entire range of options and highlight some of the most promising approaches, including new antivirals, symptomatic or immunomodulatory drugs, the re-emergence of natural remedies, as well as vaccines and public health policies towards prevention. Wide scale prevention through immunisation appears to be within reach for RSV and promising for IFV, while additional effort is needed in regard to RV, as well as other respiratory viruses.



http://ift.tt/2txD4jf

Effect of home exposure to Staphylococcus aureus on asthma in adolescents

Publication date: Available online 21 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Meghan F. Davis
This is the first study to find that environmental Staphylococcus aureus and staphylococcal enterotoxins in a national population of inner-city adolescents with asthma are common and have the potential to drive asthma symptoms.



http://ift.tt/2vtUPNU

Genetic and epigenetic regulation of YKL-40 in childhood

Publication date: Available online 21 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Stefano Guerra, Erik Melén, Jordi Sunyer, Cheng-Jian Xu, Iris Lavi, Marta Benet, Mariona Bustamante, Anne-Elie Carsin, Carlota Dobaño, Mònica Guxens, Christina Tischer, Martine Vrijheid, Inger Kull, Anna Bergström, Ashish Kumar, Cilla Söderhäll, Ulrike Gehring, Dorieke J. Dijkstra, Pieter van der Vlies, Magnus Wickman, Jean Bousquet, Dirkje S. Postma, Josep M. Anto, Gerard H. Koppelman
BackgroundCirculating levels of the chitinase-like protein YKL-40 are influenced by genetic variation in its encoding gene (CHI3L1) and are increased in several diseases, including asthma. Epigenetic regulation of circulating YKL-40 early in life is unknown.ObjectiveTo determine (1) whether methylation levels at CHI3L1 CpG sites mediate the association of CHI3L1 single nucleotide polymorphisms (SNPs) with YKL-40 levels in the blood; and (2) whether these biomarkers (CHI3L1 SNPs, methylation profiles, and YKL-40 levels) are associated with asthma in early childhood.MethodsWe used data from up to 2405 participants from the INMA, BAMSE, and PIAMA birth cohorts. Associations between 68 CHI3L1 SNPs, methylation levels at 14 CHI3L1 CpG sites in whole blood DNA, and circulating YKL-40 levels at 4 years of age were tested using correlation analysis, multivariable regression, and mediation analysis. Each of these biomarkers was also tested for association with asthma at 4 years of age using multivariable logistic regression.ResultsYKL-40 levels were significantly associated with seven SNPs and with methylation at five CpG sites. Consistent associations between these seven SNPs (particularly rs10399931 and rs4950928) and five CpG sites were observed. Alleles linked to lower YKL-40 levels were associated with higher methylation levels. Participants with high YKL-40 levels (defined as the highest YKL-40 tertile) had increased odds for asthma as compared with subjects with low YKL-40 levels [meta-analyzed adjusted odds ratio (adjOR): 1.90, 1.08-3.36]. In contrast, neither SNPs nor methylation levels at CpG sites in CHI3L1 were associated with asthma.ConclusionsThe effects of CHI3L1 genetic variation on circulating YKL-40 are partly mediated by methylation profiles. In our study, YKL-40 levels, but not CHI3L1 SNPs or methylation levels, were associated with childhood asthma.

Teaser

Circulating YKL-40 and variation in its encoding gene CHI3L1 have been associated with asthma. We found that methylation levels at CHI3L1 CpG sites partly mediated CHI3L1 genetic effects on circulating YKL-40, although they were not associated with childhood asthma.


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Thoracic paravertebral block for postoperative pain management after renal surgery: A randomised controlled trial.

BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital. Study conducted from August 2013 to February 2014. PARTICIPANTS: In total, 68 patients scheduled for elective renal surgery (open nephrectomy or open nephron-sparing surgery). INTERVENTIONS: Preoperative ThPVB with 0.5% bupivacaine combined with general anaesthesia, followed by postoperative oxycodone combined with nonopioid analgesics as rescue drugs. Follow-up period: 48 h. MAIN OUTCOME MEASURES: Total dose of postoperative oxycodone required, pain intensity, occurrence of opioid related adverse events, ThPVB-related adverse events and patient satisfaction. RESULTS: A total of 68 patients were randomised into two groups and, of these, 10 were subsequently excluded from analysis. Patients in group paravertebral block (PVB; n = 27) had general anaesthesia and ThPVB, and those in group general (anaesthesia) (GEN) (n = 31) formed a control group receiving general anaesthesia only. Compared with patients in group GEN, patients who received ThPVB required 39% less i.v. oxycodone over the first 48 h and had less pain at rest (P

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Clinical trial registry use in anaesthesiology systematic reviews: A cross-sectional study of systematic reviews published in anaesthesiology journals and the Cochrane Library.

BACKGROUND: Publication bias within systematic reviews may result in incorrect conclusions leading to inappropriate clinical decisions and a decreased quality of patient care. Searching clinical trial registries for unpublished studies is one possible solution to minimise publication bias. OBJECTIVES: To examine rates of clinical trial registry searches in systematic reviews published in respected anaesthesiology journals and whether these searches found trials (or data) eligible for inclusion; to compare rates of registry searches between published reviews and similar reviews within the Cochrane Anaesthesia, Critical and Emergency Care Group; to conduct trial registry searches for a subset of reviews, determining whether eligible studies were overlooked; to investigate whether reporting of results in completed anaesthesia trials on ClinicalTrials.gov followed guidelines. DESIGN: A cross-sectional study of systematic reviews published in 10 anaesthesiology journals and the Cochrane Library. SETTING AND PARTICIPANTS: PubMed and the Cochrane Library were searched for systematic reviews or meta-analyses. MAIN OUTCOME MEASURES: The primary outcome was the number of systematic reviews that searched clinical trial registries for unpublished trials. Secondary outcomes included the number of registered trials in the ClinicalTrial.gov registry and the number of trials reporting trial results which were available on the ClinicalTrials.gov database and which should have been considered in a systematic review. RESULTS: The PubMed search yielded 507 records, and 415 remained after exclusions. Of these, 49 (11.8%) included a search of clinical trial registries. In total, 12 systematic reviews reported finding unpublished data but only five incorporated the data into their analyses. Of the Cochrane reviews, 58.9% (43/73) reported registry searches. Among a sample of 30 systematic reviews that omitted registry searches, we found many studies within the registries that were probably eligible to be included in the systematic reviews. For completed trials within the ClinicalTrials.gov database, only 15.4% reported results. CONCLUSION: The majority of systematic reviews in anaesthesiology did not include data from clinical trial registries. Exclusion of statistically nonsignificant data may lead to a biased interpretation of the data and hence inappropriate clinical interventions. TRIAL REGISTRATION: Registered in University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000021932). (C) 2017 European Society of Anaesthesiology

http://ift.tt/2uJYdX2

History of anaesthesia: the ketamine story - past, present and future.

: Ketamine's history begins in the 1950s in Detroit, Michigan, at Parke-Davis Laboratories. On 26 March 1956, Harold V. Maddox synthesised phencyclidine or PCP. Domino studied PCP effects in animals and in 1958, Greifenstein made the first trials of PCP in humans under the name of Sernyl. Sernyl did not cause depression of cardiovascular and respiratory functions, but elicited severe excitation with a very prolonged postoperative recovery. Because of its psychedelic effects, it became a street drug under the name of 'angel dust' and was placed on schedule II of Federal Controlled Substance Act (CSA) in 1978. Eticyclidine or PCE had no medical career. The chemist Calvin Stevens, consultant to Parke-Davis, synthesised ketamine in 1962. The drug was studied in humans in 1964, by Domino and Corssen. These authors described the so-called 'dissociative anaesthesia'. Ketamine was patented in 1966 under the name of Ketalar for human use and was administered to soldiers during the Vietnam war. Because of abuse, ketamine was placed among the class III substances of CSA in 1999. The psychedelic effects and the arrival of propofol prompted the shelving of ketamine. However, the discovery of the NMDA-receptor and its noncompetitive inhibition by ketamine revolutionized the pathophysiology of hyperalgesia and mental functioning. In early 1990s, the arrival of remifentanil preceded the discovery of opioid-induced hyperalgesia, eliciting a paradigm shift in the management of pain, and a comeback of ketamine, as and antihyperalgesic drug. Ketamine is nowadays under the spotlight in the field of treatment-resistant depression and has been proposed as a potential fast antidepressant in patients with high suicidal risk. In a near future, we may observe new practices like increased S-(+)-ketamine availability, new ultra-short-acting ketamine analogues or the development antagonists. (C) 2017 European Society of Anaesthesiology

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Injectate spread following anterior sub-costal and posterior approaches to the quadratus lumborum block: A comparative cadaveric study.

BACKGROUND: The dermatomal level of analgesia achieved with quadratus lumborum blocks varies according to the location of injection. The most commonly used approaches are either at the postero-lateral aspect or anterior to the quadratus lumborum muscle. The aim of the study was to determine whether the site of injection of contrast dye around the quadratus lumborum muscle of cadavers affects the extent and mechanism of dye spread. METHODS: Six fresh human cadavers received either a posterior quadratus lumborum block or an anterior sub-costal quadratus lumborum block on each side. Cadavers were then dissected to determine the extent of dye spread. RESULTS: The posterior quadratus lumborum block approach revealed consistently deep staining of the iliohypogastric, ilioinguinal, subcostal nerve, T11 to 12 and L1 nerve roots. In addition, staining of the middle thoracolumbar fascia was seen in all specimens but only variable staining of T10 nerve roots. The anterior subcostal quadratus lumborum block approach in all specimens demonstrated predictable deep staining of the iliohypogastric and ilioinguinal nerves, subcostal nerves, T11 to 12 and L1 nerve roots, and in addition traversing the arcuate ligaments to involve T9 to 12 nerve roots with variable staining of higher thoracic nerve roots. CONCLUSION: Our cadaveric study demonstrates that injection of dye on the posterior aspect of quadratus lumborum muscle led to injectate spread through the lateral and posterior abdominal wall but with limited cranial spread, whereas the anterior approach produced broader coverage of the lower to mid-thoracic region. Clinical translation of these findings to determine the practical significance is warranted. (C) 2017 European Society of Anaesthesiology

http://ift.tt/2uJT5lD