We report the case of a 69-year-old female who underwent a Baerveldt implant placement for severe-stage primary open-angle glaucoma and developed a bacterial infection of the conjunctiva and abscess of the scleral patch graft with subsequent tube exposure. The infection was identified 3 weeks postoperatively and a topical antibiotic was immediately initiated. A concurrent systemic staphylococcal infection was discovered by an outside physician and oral cephalexin was initiated. Despite antibiotic treatment, the conjunctival erosion progressed, and tube revision was required. Culture of the abscess revealed coagulase-negative Staphylococcus. As alluded to above, the patient also had multiple abscesses on the skin that cultured positive for Staphylococcus aureus. To our knowledge, this is the first case in the literature of coagulase-negative Staphylococcus causing an early postoperative abscess of the scleral patch graft following glaucoma drainage device placement.
Case Rep Ophthalmol 2017;8:521–526
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Πέμπτη 16 Νοεμβρίου 2017
Baerveldt Scleral Patch Graft Abscess Secondary to Coagulase-Negative Staphylococcus
Effect of different resin luting cements on the marginal fit of lithium disilicate pressed crowns
Source:The Journal of Prosthetic Dentistry
Author(s): Radek Mounajjed, Thomas J. Salinas, Tomas Ingr, Basel Azar
Statement of problemThe vertical marginal discrepancy of restorations can increase upon cementation, and poor marginal fit can lead to cement dissolution, marginal discoloration, microleakage, and secondary caries. The amount of increase is related to the type of luting cement used, but how lithium disilicate pressed crowns are affected by different resin cements is unclear.PurposeThe purpose of this in vitro study was to compare the effect of using different resin luting cements on the vertical marginal discrepancy of lithium disilicate pressed crowns.Material and methodsA total of 18 intact extracted mandibular third molars were disinfected in a solution of 10% formalin for 7 days and were then prepared to receive a ceramic crown. Impressions were made with polyvinyl siloxane and lithium disilicate pressed crowns made and cemented with 1 of 3 resin luting cements. The marginal discrepancy was measured at 4 points on the finishing line of each tooth, with optical microscopy at ×200 magnification before and after cementation. Statistical analysis was done with the Kruskal-Wallis test to compare the median marginal increase among the 3 groups.ResultsThe least amount of marginal increase after cementation was with Harvard PremiumFlow cement, with an average marginal increase of 42 ±11 μm. RelyX Ultimate cement increased the margins by an average 45 ±29 μm. The highest marginal increase was found in the Enamel Plus HRi preheated composite resin group (116 ±47 μm).ConclusionsThe marginal increase of pressed crowns cemented with preheated composite resin (Enamel Plus HRi) exceeded the clinically acceptable range of marginal discrepancy.
http://ift.tt/2zMnfr4
Prosthodontic rehabilitation with monolithic, multichromatic CAD-CAM complete overdentures in an adolescent patient with ectodermal dysplasia: A clinical report
Source:The Journal of Prosthetic Dentistry
Author(s): Hussain D. Alsayed, Nasser M. Alqahtani, Yasmin M. Alzayer, Dean Morton, John A. Levon, Nadim Z. Baba
Ectodermal dysplasia is a rare, hereditary, congenital disease that affects the normal development of certain tissues and structures of ectodermal origin. The disease is manifested to different degrees of severity and may involve the nose, eyes, hair, nails, sweat glands, and enamel. This report describes a 14-year-old boy with ectodermal dysplasia, rehabilitated with monolithic, multichromatic maxillary and mandibular computer-aided design and computer-aided manufacturing (CAD-CAM) acrylic resin complete overdentures.
http://ift.tt/2hzYfZK
Analysis of the golden proportion and width/height ratios of maxillary anterior teeth in Arab and Kurdish populations
Source:The Journal of Prosthetic Dentistry
Author(s): Neda Al-Kaisy, Balkees Taha Garib
Statement of problemDentists providing anterior restorations are guided by the principles of anatomic tooth dimension. Dental biometrics should consider ethnicity to produce a more comprehensive evaluation.PurposeThe purpose of this clinical study was to analyze the anatomic crowns of maxillary central incisors (CI), lateral incisors (LI), and canines (C) with respect to the golden proportion (GP) and width/height (W/H) ratio in Kurdish and Arab populations.Material and methodsMaxillary gypsum casts were obtained from 100 participants (50 from a Kurdish and 50 from an Arab population). Standardized digital photographs of each cast were recorded. The apparent and actual anterior tooth dimensions were determined by ImageJ software for the calculation of the GP and W/H ratio. Data were statistically analyzed using ANOVA to investigate ethnic, sex, and arch side differences. The chi-square test was used to explore the GP, and the 1-sample t test was used to test the ideal W/H ratio (α=.05).ResultsThe GP was found in both the Kurdish and Arab groups in the LI/CI mean (0.62, 0.63), but not in the C/LI mean (0.69, 0.73). No difference due to sex was detected in the LI/CI in either ethnic group, but Kurdish men had significantly larger C/LI than women (0.73, 0.66, P=.006) and larger right-side LI/CI than left (0.63, 0.60, P=.049). The W/H ratio was higher than the predicted ideal ratio of 80% (range, 88% to 90%). The LI W/H ratio in Arabs was significantly larger than in Kurds (90.3% versus 82.7%, respectively; P<.001).ConclusionsThe GP was found to exist between the apparent widths of maxillary anterior teeth LI/CI for the both populations in both men and women but not for C/LI. No ideal ratio was detected for the W/H ratios. Specific population characteristics must be taken into consideration, especially when applying the proportions to Kurdish individuals.
http://ift.tt/2zMndPY
Modification of Makzoume vertical dimension recorder for individuals with a beard
Source:The Journal of Prosthetic Dentistry
Author(s): Jitendra J. Mete, Ulhas E. Tandale, Vilas L. Rajguru, Sonali S. Dahiwale
http://ift.tt/2hxWWKL
Effect of coloring and sintering on the translucency and biaxial strength of monolithic zirconia
Source:The Journal of Prosthetic Dentistry
Author(s): Nazmiye Sen, Ibrahim Bülent Sermet, Sevki Cinar
Statement of problemThe influences of coloring and sintering procedures on the optical and mechanical properties of monolithic zirconia have not been thoroughly investigated.PurposeThe purpose of this in vitro study was to investigate the effects of the coloring procedure and of varying final sintering temperatures on the translucency parameter (TP) and biaxial flexural strength (BFS) of monolithic zirconia.Material and methodsDisk-shaped specimens (N=210) of 2 different monolithic zirconia brands (Vita YZ HTWhite [VYZa]; Vita YZ HTColor A2 [VYZb]; Prettau Zirkonzahn [PZ]; Prettau Anterior Zirkonzahn [PZA]) with a diameter of 15 mm and a thickness of 1.0 ±0.05 mm were prepared. Half of the specimens prepared from noncolored blocks (VYZa, PZ, and PZA) received coloring liquid application. Then, the specimens were divided into 3 subgroups (n=10) according to the final sintering temperatures (1350°C, 1450°C, and 1600°C). The TP was determined by using a reflection spectrophotometer, and the BFS was tested with the piston-on-3-ball method in a universal testing machine. Data were statistically analyzed by multivariate multiple regression and Bonferroni tests (α=.05).ResultsSignificant differences were obtained among the groups based on the results of the TP and BFS (P<.05). The TP was affected by the changes in final sintering temperature. The varying final sintering temperatures demonstrated no significant effect on the BFS, except in group PZ (noncolored) that produced lower BFS when sintered at 1350°C than the subgroups sintered at 1450°C and 1600°C (P<.05). Coloring liquid application significantly decreased the TP of VYZa (sintered at 1350°C) but produced no significant effect on the groups PZ and PZA. Additionally, the coloring procedure had no significant effect on the BFS of tested materials (VYZa, PZ, and PZA) (P>.05).ConclusionsIncreased sintering temperature leads to increased translucency with minimal impact on the BFS. The coloring procedure should be considered at the time of material selection to avoid possible reduction in translucency.
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Aluminum barrier laminate or plastic tube as a dispenser for modeling plastic impression compound for border molding
Source:The Journal of Prosthetic Dentistry
Author(s): Jitendra J. Mete, Vilas L. Rajguru, Shankar P. Dange
http://ift.tt/2hwnqw5
Marginal discrepancy of noble metal–ceramic fixed dental prosthesis frameworks fabricated by conventional and digital technologies
Source:The Journal of Prosthetic Dentistry
Author(s): Ahmed Afify, Stephan Haney, Ronald Verrett, Michael Mansueto, James Cray, Russell Johnson
Statement of problemStudies evaluating the marginal adaptation of available computer-aided design and computer-aided manufacturing (CAD-CAM) noble alloys for metal–ceramic prostheses are lacking.PurposeThe purpose of this in vitro study was to evaluate the vertical marginal adaptation of cast, milled, and direct metal laser sintered (DMLS) noble metal–ceramic 3-unit fixed partial denture (FDP) frameworks before and after fit adjustments.Material and methodsTwo typodont teeth were prepared for metal–ceramic FDP abutments. An acrylic resin pattern of the prepared teeth was fabricated and cast in nickel-chromium (Ni-Cr) alloy. Each specimen group (cast, milled, DMLS) was composed of 12 casts made from 12 impressions (n=12). A single design for the FDP substructure was created on a laboratory scanner and used for designing the specimens in the 3 groups. Each specimen was fitted to its corresponding cast by using up to 5 adjustment cycles, and marginal discrepancies were measured on the master Ni-Cr model before and after laboratory fit adjustments.ResultsThe milled and DMLS groups had smaller marginal discrepancy measurements than those of the cast group (P<.001). Significant differences were found in the number of adjustments among the groups, with the milled group requiring the minimum number of adjustments, followed by the DMLS and cast groups (F=30.643, P<.001).ConclusionsMetal–ceramic noble alloy frameworks fabricated by using a CAD-CAM workflow had significantly smaller marginal discrepancies compared with those with a traditional cast workflow, with the milled group demonstrating the best marginal fit among the 3 test groups. Manual refining significantly enhanced the marginal fit of all groups. All 3 groups demonstrated marginal discrepancies within the range of clinical acceptability.
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Stress generation in mandibular anterior teeth restored with different types of post-and-core at various levels of ferrule
Source:The Journal of Prosthetic Dentistry
Author(s): Anatolii Savychuk, Marianthi Manda, Christos Galanis, Christofer Provatidis, Petros Koidis
Statement of problemPertinent evidence regarding the mechanical integrity of mandibular anterior teeth restored with a post-and-core is limited.PurposeThe purpose of this finite element analysis study was to compare the impact of the post type (glass fiber post-and-resin core or cast post-and-core) along with the ferrule effect on the stress fields generated in endodontically treated mandibular lateral incisors and canines.Material and methodsThree-dimensional models of the segmented mandible were developed. Mandibular incisors and canines with or without a 2-mm circular ferrule and restored with a cast post-and-core or glass fiber post-and-resin core were simulated and subjected to linear elastic static analysis. The principal stress values were calculated. von Mises equivalent stresses were used to evaluate the stress.ResultsMaximum principal stresses in dentin were highest in incisors, with a ferrule. Stress parameters in composite resin core in both incisors and canines were critically close to the tensile failure limit of the core material. Cast post-and-cores cemented in incisors without a ferrule accumulated the highest stresses, exceeding the tensile failure limit of resin-modified glass ionomer cement.ConclusionsTooth preparation with a ferrule led to a remarkable rise in stress in the dentin of mandibular incisors but favored the mechanical integrity of the restoration.
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A 3D-printed guide for lateral approach sinus grafting: A dental technique
Source:The Journal of Prosthetic Dentistry
Author(s): Brian J. Goodacre, Rajesh S. Swamidass, Jaime Lozada, Aladdin Al-Ardah, Erik Sahl
Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.
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Diagnostic accuracy of 4 intraoral radiographic techniques for misfit detection at the implant abutment joint
Source:The Journal of Prosthetic Dentistry
Author(s): Pollyana Darós, Vinícius Cavalcanti Carneiro, Amanda Pasolini Siqueira, Sergio Lins de-Azevedo-Vaz
Statement of problemA misfit or gap at the implant–abutment joint (IAJ) requires detection as it may compromise the health of the peri-implant tissue. However, which radiographic technique provides the most orthogonal relationship between the central beam and the implant/image receptor is unclear.PurposeThe purpose of this in vitro study was to evaluate the diagnostic accuracy of 4 intraoral radiographic techniques on misfit detection at the IAJ.Material and methodsTwenty implants were placed in polyamide jaws, and customized dental implant abutments with a metal collar were installed. Different gaps were simulated by placing one or three 50-μm-thick polyester strips at the IAJ; the absence of the strip represented the control group (no gap). The 4 radiographic techniques were evaluated by using different film holders: a periapical with bisecting angle (PBA), a bitewing interproximal (BI), a periapical with standard paralleling (PSP), and a periapical with modified paralleling (PMP) holder (with a custom-made paralleling index). A total of 240 digital radiographs were evaluated by 4 clinicians experienced with dental implants. Differences were evaluated by using receiver operating characteristic (ROC) curves (Az) and Fisher tests (α=.05). Diagnostic values (sensitivity, specificity, accuracy, and positive and negative predictive values) were also obtained. The Kappa test was used to assess intra- and interevaluator reproducibility, which ranged from moderate to almost perfect.ResultsAll diagnostic values, except specificity, were lower for the PBA technique for both the 50- and 150-μm gaps. Az values for the PBA technique were significantly lower than those obtained for the other 3 techniques (P<.05), which did not differ from each other. The 150-μm gaps were more easily detected than the 50-μm gaps only for PBA (P<.05).ConclusionsThe BI, PSP, and PMP techniques detected misfits at the IAJ most accurately. The PBA technique is not recommended for this purpose.
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Degree of conversion of resin cement with varying methacrylate compositions used to cement fiber dowels: A Raman spectroscopy study
Source:The Journal of Prosthetic Dentistry
Author(s): Abdulelah M. BinMahfooz, Osama A. Qutub, Thamer Y. Marghalani, Mohammed F. Ayad, Abdulhamaid A. Maghrabi
Statement of problemStudies on the degree of conversion of dental cement in relation to the number of methacrylate components are lacking.PurposeThe purpose of this in vitro study was to evaluate the degree of conversion of single- and multicomponent methacrylate-containing dental cements around opaque and translucent fiber dowels at varying depths.Material and methodsTeeth were prepared for standard endodontic therapy, and a dowel space was created. Opaque and translucent fiber dowels consisting of Aestheti-Plus (AP) and FiberKleer were cemented with 4 methacrylate (MA)-containing cements, including RelyX U100 (R), which contains TEGDMA; Duolink (D), which contains TEGDMA and BisGMA; and Variolink N LC (V) and Breeze (B), which contain TEGDMA, BisGMA, and UDMA. Light-emitting diode polymerization was performed for 60 seconds. The specimens were immediately cut into halves and measured within the first hour at depths of 1, 3, and 5 mm using Raman spectroscopy, and the degree of conversion (DC) of resin cement was calculated. Data were analyzed using 3-way ANOVA and the Tukey multiple comparison test (α=.05).ResultsThe measured dowel regions were not significantly different at various depths (P=.10). The dowel and cement types significantly influenced the degree of conversion of the cement (P<.05). The V and B cements exhibited a higher DC than D and R cements. With AP dowels, the DC of cement D was lower than that of the V, B, and R cements.ConclusionsWithin the limitations of this in vitro study, the degrees of conversion of the tested resin cements were not affected by the tested dowel depths. Higher DC was found in cement with more than 2 types of flexible MA. Opaque dowels produced a lower DC than translucent dowels.
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Esthetic abutment design for angulated screw channels: A technical report
Source:The Journal of Prosthetic Dentistry
Author(s): Satoshi Sakamoto, Munehiko Ro, Aladdin Al Ardah, Charles Goodacre
Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength.
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Asymmetric bone remodeling in mandibular and maxillary tori
Abstract
Objectives
Tori are frequent paucisymptomatic bony outgrowths of the oral cavity in three locations: torus palatinus (TP), mandibularis (TM), and maxillaris (TMax). Their usually described histological characteristics are unspecific: normal cortical bone with more or less trabecular bone. The aim of this study was to describe tori's specific morphological and histomorphometric characteristics.
Materials and methods
Histological characteristics in a series of 18 tori collected after surgical removal were analyzed. Microcomputed tomography provided a 3D analysis. Mineral apposition rate (MAR) was measured after double tetracycline labeling. Osteoid tissue was identified by Goldner's trichrome and osteoclasts by the tartrate resistant acid phosphatase identification in undecalcified sections. Iron and aluminum were detected by histochemical staining methods. Osteoid thickness and MAR were determined at the outer surface of the torus and in the Haversian canals.
Results
Tori appeared made of lamellar Haversian bone in 16/18 cases. Osteoid thickness did not differ between the outer surface and within the canals. An asymmetric bone remodeling was observed in the Haversian canals of 15 tori: osteoid seams were deposited on the side close to the free torus surface, and Howship's lacunae with numerous osteoclasts were observed on the opposite side. A high MAR was found at the surface of the tori and within the canals. There was no iron or aluminum deposit.
Conclusions
Tori may be characterized by a specific asymmetric bone remodeling which seems to determine their shape.
Clinical relevance
This finding could constitute a specific histological feature allowing to differentiate tori from exostoses.
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The elevated activation of NFκB and AP-1 is correlated with differential regulation of Bcl-2 and associated with oral squamous cell carcinoma progression and resistance
Abstract
Objectives
Oral cancer is the sixth most common cancer in the world. Failure of chemoradiation therapy is a major concern for treating oral cancer patients. The objective of this study is to determine the B cell lymphoma-2 (bcl-2) expression and its regulation by nuclear factor κB (NFκB) and activator protein 1 (AP-1) in oral cancer progression and chemoradiation resistance.
Materials and methods
In the present study, a total of 123 (n = 123) human samples were included. Briefly, 64 fresh samples were from adjacent normal (AN), primary oral tumors without treatment (PT), and tumors with resistance to chemoradiation therapy with local recurrence (RCRT). Fifty-nine samples were human tongue cancers and normal samples (TMA). Messenger RNA (mRNA) expression levels of bcl-2 and protein levels of bcl-2, NFκB, AP-1, and inactive GSK3α/β were measured by semiquantitative RT-PCR, immunohistochemistry, Western blot, and ChIP analysis.
Results
Increased bcl-2 expression was observed in PT compared to AN. The RCRT tumors showed maximum expression of bcl-2 mRNA and protein over the PT and AN groups. Bcl-2 protein and mRNA expression were positively correlated with NFκB and AP-1 expression. AP-1 expression was strongly correlated with bcl-2 in the RCRT group of tumors. Further, inactive GSK3α/β showed a positive trend with bcl-2 expression in oral tongue cancer specimens.
Conclusion
Collectively, our results demonstrated cumulative effect of AP-1 and NFĸB for bcl-2 gene regulation in overall PT progression and chemoradiation resistance. The study provides evidence of increased bcl-2 mRNA/protein fueled by NFĸB in PT and AP-1 in RCRT. These regulations of bcl-2 by NFκB and AP-1 are important in OSCC progression and chemoradiation resistance.
http://ift.tt/2A6bk8b
Four-year outcomes of restored posterior tooth surfaces—a massive data analysis
Abstract
Objectives
There is only sparse knowledge concerning the outcomes of treatments with posterior permanent restorations in general practice settings. This study aimed at evaluating outcomes based on a large dataset by using a novel approach on a tooth surface basis.
Materials and methods
The study based on routine data from a major German national health insurance company. Respective treatment fee codes allowed for tracking the clinical courses on a tooth surface level. The study intervention was defined as the placement of a restoration on an interproximal or occlusal posterior tooth surface regardless of its actual extension and material on which no information was available. All surfaces restored between January 1st, 2010 and December 31st, 2013 were included. Kaplan-Meier survival analyses were conducted to estimate four-year survival. The primary outcome was a restorative re-intervention on the same tooth surface. Separate analyses were performed for the secondary outcomes "crowning" and "extraction".
Results
Over ten million interproximal surfaces and eight million occlusal surfaces in nine million posterior teeth had been restored. At 4 years, the cumulative survival rates concerning the primary outcome "re-intervention" for mesial surfaces (81.4%; CI 81.3–81.5%) and distal surfaces (81.2%; CI 81.1–81.2%) differed significantly from those for occlusal surfaces (77.0%; CI 76.9–77.0%). Restored surfaces in premolars showed significantly higher survival rates compared to molars. Four-year survival rates for the secondary outcome "crowning" were 91.9% (CI 91.8—91.9%) for mesial surfaces, 92.1% (CI 92.1–92.2%) for distal surfaces and 93.3% (CI 93.2–93.3%) for occlusal surfaces. The respective rates for the secondary outcome "extraction" were 94.5% (CI 94.5–94.5%) for mesial surfaces, 94.8% (CI 94.7–94.8%) for distal surfaces and 95.4% (CI 95.4–95.5%) for occlusal surfaces.
Conclusions
Re-interventions after restorative treatment play a significant role in general practice settings. Surface-related survival rates of restorations reveal a need for improvement.
Clinical relevance
This study allows the estimation of the probability of re-interventions after restoring posterior tooth surfaces. It is based on several million cases from general practises under the terms and conditions of a national health insurance system.
http://ift.tt/2A6TQsy
Photodynamic Diagnosis of Parathyroid Glands with Nano-stealth Aminolevulinic Acid Liposomes
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Shaimaa Elbassiouny, Maha Fadel, Tarek Elwakeel, Mahmoud Saber
Aim of the study: Exploring whether the formulation of ALA in nano-stealth liposomes would inflict its photodiagnostic effectiveness.The present study represents ALA in nano-stealth liposomes as well as in conventional nanoliposomes in order to be used for photodiagnosis of parathyroid glands intraoperatively. Materials and Methods: Preparation of ALA nanovesicles and characterization for the drug encapsulation%, vesicle size, Zeta potential, in vitro drug release profile and stability. Subsequently, intraperitoneal administration of ALA in rats and study the feasibility and efficacy of these formulations in identifying parathyroids intraoperatively by a fluorescence technique and evaluation of fluorescence differences between these delivery forms and the free ALA solution used earlier. Results and conclusion: Stealth liposomes were insignificantly higher in drug encapsulation%, in vitro drug release and zeta potential compared to conventional liposomes. Additionally, they needed less time for the start of the photosensitization and recorded the highest signal after spectrometry compared to the other two preparations. These data provide a new evidence of the potentiality of ALA-stealth Liposomes for identification of PTGs intraoperatively and could lead to propose a non-invasive procedure with reduced postoperative side effects.
http://ift.tt/2mzOsbp
Neural Mechanisms of Episodic Retrieval Support Divergent Creative Thinking
http://ift.tt/2hGrePa
The Laminar Organization of Piriform Cortex Follows a Selective Developmental and Migratory Program Established by Cell Lineage
http://ift.tt/2jzQ0AR
How does sinus surgery affect topical irrigation distribution?.
http://ift.tt/2zNBmtT
How does sinus surgery affect topical irrigation distribution?.
http://ift.tt/2zNBmtT
How does sinus surgery affect topical irrigation distribution?.
http://ift.tt/2zNBmtT
Asthma biomarkers in the age of biologics
The heterogeneous nature of asthma has been understood for decades, but the precise categorization of asthma has taken on new clinical importance in the era of specific biologic therapy. The simple categories ...
http://ift.tt/2hz0NHA
Asthma biomarkers in the age of biologics
The heterogeneous nature of asthma has been understood for decades, but the precise categorization of asthma has taken on new clinical importance in the era of specific biologic therapy. The simple categories ...
http://ift.tt/2hz0NHA
Reliability and Validity of a Coda Motion 3-D Analysis System for Measuring Cervical Range of Motion in Healthy Subjects
Source:Journal of Electromyography and Kinesiology
Author(s): Hui Song, Xu Zhai, Zhongyang Gao, Teng Lu, Qian Tian, Haopeng Li, Xijing He
In the past two decades, many tools have been reported to measure the cervical range of motion (CROM), but most of the results are controversial in healthy individuals and/or individuals with neck pain. The Coda Motion 3-D Analysis system is a new instrument that measures three-dimensional joint movement. However, measurements of CROM using this system have yet to be conducted. Here, we investigate the reliability and validity of the Coda Motion 3-D Analysis System for measuring CROM in healthy adults.Sixty healthy volunteers were involved in this reliability study. Two trained investigators (M1 and M2) used the Coda Motion 3-D Analysis System to measure CROM. M1 and M2 measured all the volunteers once independently; after a short rest, M1 then measured all of them again. The intraclass correlation coefficient (ICC), standard error of the measurements (SEM), smallest detectable difference (SDD), a scatter diagram, and the limits of agreement (LoAs) were applied to evaluate the inter-tester and intra-tester reliability. Thirty healthy volunteers were involved in this validity study. The cervical flexion and extension ranges of motion were measured simultaneously with both the Coda Motion 3-D Analysis System and X-ray. A scatter diagram, the Pearson correlation coefficient and LoAs were used to evaluate the validity.Excellent intra-tester and inter-tester reliabilities were observed for the Coda Motion 3-D Analysis System (intra-tester ICC: 0.84 to 0.95, inter-tester ICC: 0.84 to 0.90). Good validity was achieved in extension and flexion with Pearson correlation coefficients ranging from 0.78 to 0.91.The Coda Motion 3-D Analysis System has excellent reliability for the measurement of CROM and good validity for measurements of flexion and extension in healthy subjects. This system has the potential to be used to measure the normal active CROM in the clinic and is accurate, safe, non-invasive, and radiation free.
http://ift.tt/2zQ9qpa
Hearing Loss in Children With Otitis Media With Effusion: Actual and Simulated Effects on Speech Perception.
http://ift.tt/2yShg0t
Dysphagia in Multiple Sclerosis: Evaluation and Validation of the DYMUS Questionnaire
Abstract
Objective
The 10-item Dysphagia in Multiple Sclerosis (DYMUS) questionnaire is a self-administered tool used to identify swallowing problems in adults with MS. The questionnaire was not validated against other existing questionnaires to assess its convergent validity. Moreover, its test–retest reliability was not measured previously. Therefore, the purpose of this study was to assess the factor analysis, internal consistency and test–retest reliability of the DYMUS, as well as its convergent validity against an established and validated questionnaire, the EAT-10.
Method
English-speaking adults with MS in New South Wales, Australia who were seen for routine medical check-ups were invited to complete two questionnaires across two phases. One hundred participants completed phase 1, while 55 completed phase 2. Statistical analyses were performed to investigate the psychometric properties of the DYMUS questionnaire.
Results
Internal consistency (Cronbach's Alpha) reduced the DYMUS questionnaire from ten to five items. The shortened version of the DYMUS showed high internal consistency (alpha = 0.904). It also showed satisfactory reproducibility, and adequate correlation with the 10-item Eating Assessment Tool (EAT-10).
Conclusion
Evaluation of the DYMUS resulted in a shortened version of the questionnaire with five questions related to dysphagia. This shortened version is considered an easy and useful tool in identifying patients with MS-related dysphagia.
http://ift.tt/2zK4MLD
Alterations to Swallowing Physiology as the Result of Effortful Swallowing in Healthy Seniors
Abstract
A significant proportion of healthy seniors report difficulty swallowing, thought to result from age-related decline in muscle bulk/function. Effortful Swallowing (ES) is used both as a compensatory maneuver to improve pharyngeal propulsion/clearance and has been proposed as an exercise to improve pharyngeal strength. This study sought to quantify the immediate kinematic, temporal, and functional changes during an ES maneuver to quantify its exercise potential to combat age-related changes in swallowing. Videofluoroscopy data were collected from 44 healthy seniors (21 male) over 65 years old (mean = 76.9, SD = 7.1). Each participant swallowed six 5 ml boluses of Varibar nectar-thick liquids: three with regular effort and three using ES. Individual swallows (n = 260) were measured on pharyngeal constriction, pharyngeal shortening, laryngeal closure duration, hyoid movement duration, UES opening duration, stage transition duration, pharyngeal transit time, pharyngeal response duration, Normalized Residue Ratio Scale (NRRS), and the Penetration–Aspiration Scale (PAS). Non-parametric Wilcoxon Rank Sum for repeated measures tested the effect of ES on each outcome. Exact p-values were calculated based on permutation methods, individual p values < 0.008 was deemed to be significant. The ES maneuver significantly prolonged all temporal variables. While we found no significant differences for pharyngeal constriction, significantly less (i.e., worse) pharyngeal shortening was observed in ES condition compared with regular effort swallows. Further, significantly worse pyriform sinus residue (NRRSv) was observed in the ES condition. No differences between ES and regular effort swallows were noted for pharyngeal constriction, NRRSv or PAS. We speculate that these negative manifestations of worse kinematics (less pharyngeal shortening) and function (increase in NRRSp) may be the result of forced volitional manipulation of swallowing in the ES condition in an otherwise normal elderly swallow.
http://ift.tt/2hxpHat
Buccal Mucosal Epithelial Cells Downregulate CTGF Expression in Buccal Submucosal Fibrosis Fibroblasts
Abstract
Introduction
Oral submucosal fibrosis (OSMF) is a chronic debilitating fibrotic disease of the oral cavity and is a serious health hazard in south Asia and, increasingly, the rest of the world. The molecular basis behind various treatment modalities to treat OSMF still remains unclear. In this study, we have investigated the in vitro ability of the buccal mucosal cells to reduce the proliferation of the fibroblasts of the fibrotic area in co-culture of cells and also at the molecular levels to reduce the level of connective tissue growth factor (CTGF) in the OSMF fibroblasts (SMF-F).
Materials and Methods
The study compares isolation, morphological and proliferation kinetics of SMF-F and BMF cells with and without co-culturing with BMEs. In addition, we have compared the mRNA expression levels of CTGF in SMF-F co-cultured BME and non-co-cultured SMF-F cells using validated real-time quantitative PCR (RT-qPCR) method.
Results
The basic morphological characteristics of SMF-F were similar to BMF, but the former cells had higher proliferation rate in early passages compared to late passage state. We also observed that the CTGF expression levels in SMF-F under co-culture conditions of BME were consistently and significantly downregulated in all four different SMF-F-derived cells from four different patients.
Conclusion
Rapid proliferation and collagen synthesis in SMF-F as against BMF cells are the factors that confirm the innate nature of fibrosis fibroblasts (SMF-F). Further, the CTGF expression level in SMF-F was significantly suppressed by BME in co-culture conditions against controls (BMF). Considered together, this suggests that the cell therapeutic candidate of BME could be used in treating OSMF.
http://ift.tt/2APCkFc
Determination of chloromethane and dichloromethane in a tropical terrestrial mangrove forest in Brazil by measurements and modelling
Source:Atmospheric Environment, Volume 173
Author(s): S.R. Kolusu, K.H. Schlünzen, D. Grawe, R. Seifert
Chloromethane (CH3Cl) and dichloromethane (CH2Cl2) are known to have both natural and anthropogenic sources to the atmosphere. From recent studies it is known that tropical and sub tropical plants are primary sources of CH3Cl in the atmosphere. In order to quantify the biogenic emissions of CH3Cl and CH2Cl2 from mangroves, field measurement were conducted in a tropical mangrove forest on the coast of Brazil. To the best of our knowledge these field measurements were the first of its kind conducted in the tropical mangrove ecosystem of Braganca. A mesoscale atmospheric model, MEsoscale TRAnsport and fluid (Stream) model (METRAS), was used to simulate passive tracers concentrations and to study the dependency of concentrations on type of emission function and meteorology. Model simulated concentrations were normalized using the observed field data. With the help of the mesoscale model results and the observed data the mangrove emissions were estimated at the local scale. By using this bottom-up approach the global emissions of CH3Cl and CH2Cl2 from mangroves were quantified. The emission range obtained with different emission functions and different meteorology are 4–7 Gg yr−1 for CH3Cl and 1–2 Gg yr2 for CH2Cl2. Based on the present study the mangroves contribute 0.3 percent of CH2Cl2 and 0.2 percent of CH3Cl in the global emission budget. This study corroborates the study by Manley et al. (2007) which estimated that mangroves produce 0.3 percent of CH3Cl in the global emission budget. Although they contribute a small percentage in the global budget, their long lifetime enables them to contribute to the destruction of ozone in the stratosphere. From the detailed analyses of the model results it can be concluded that meteorology has a larger influence on the variability of concentrations than the temporal variability of the emission function.
http://ift.tt/2zQetpM
Characterisation of methane variability and trends from near-infrared solar spectra over Hefei, China
Source:Atmospheric Environment, Volume 173
Author(s): Yuan Tian, Youwen Sun, Cheng Liu, Wei Wang, Changgong Shan, Xingwei Xu, Qihou Hu
This study presents the characterization of XCH4 (averaged-column dry air mole fraction) variability and trends using the near-infrared (NIR) solar spectra recorded by the ground-based high-resolution Fourier transform spectrometer (FTS) over Hefei, China. An annual increase of 10.55 ± 2.87 ppb yr−1 (0.56 ± 0.15% yr−1) in CH4 concentrations was deduced from the three years' worth of FTS measurements. Seasonal cycles and three typical diurnal variation modes were captured. The maximum CH4 concentration occurred in late summer or early autumn, while the minimum CH4 concentration occurred in winter. CH4 concentrations in August were 30–55 ppb higher than those in January. In most cases, the diurnal variability exhibited an increasing trend in summer or early autumn, while it exhibited a decreasing trend or remained relatively constant in other seasons. We compared the FTS data with the GOSAT data and the GEOS-Chem model data. The average difference between the GOSAT and FTS data (GOSAT minus FTS) was 1.60 ppb (0.09%) ±13.0 ppb (0.70%), and between the smoothed GEOS-Chem model data and FTS data (GEOS-Chem minus FTS) was −8.09 ppb (0.45%) ±17.83 ppb (0.95%). The differences between GOSAT and FTS were season-independent; however, obvious season-dependent differences were observed between GEOS-Chem and FTS. The GOSAT and GEOS-Chem models could reproduce the seasonal cycle observed by FTS with correlation coefficients (r) of 0.77 and 0.86, respectively.
http://ift.tt/2j1fH9N
On the validity of the incremental approach to estimate the impact of cities on air quality
Publication date: January 2018
Source:Atmospheric Environment, Volume 173
Author(s): Philippe Thunis
The question of how much cities are the sources of their own air pollution is not only theoretical as it is critical to the design of effective strategies for urban air quality planning. In this work, we assess the validity of the commonly used incremental approach to estimate the likely impact of cities on their air pollution. With the incremental approach, the city impact (i.e. the concentration change generated by the city emissions) is estimated as the concentration difference between a rural background and an urban background location, also known as the urban increment. We show that the city impact is in reality made up of the urban increment and two additional components and consequently two assumptions need to be fulfilled for the urban increment to be representative of the urban impact. The first assumption is that the rural background location is not influenced by emissions from within the city whereas the second requires that background concentration levels, obtained with zero city emissions, are equal at both locations. Because the urban impact is not measurable, the SHERPA modelling approach, based on a full air quality modelling system, is used in this work to assess the validity of these assumptions for some European cities. Results indicate that for PM2.5, these two assumptions are far from being fulfilled for many large or medium city sizes. For this type of cities, urban increments are largely underestimating city impacts. Although results are in better agreement for NO2, similar issues are met. In many situations the incremental approach is therefore not an adequate estimate of the urban impact on air pollution. This poses issues in terms of interpretation when these increments are used to define strategic options in terms of air quality planning. We finally illustrate the interest of comparing modelled and measured increments to improve our confidence in the model results.
http://ift.tt/2zQe4Ui
Ground-level ozone pollution and its health impacts in China
Source:Atmospheric Environment, Volume 173
Author(s): Huan Liu, Shuai Liu, Boru Xue, Zhaofeng Lv, Zhihang Meng, Xiaofan Yang, Tao Xue, Qiao Yu, Kebin He
In recent years, ground-level ozone pollution in China has become an increasingly prominent problem. This study simulated and analyzed spatiotemporal distribution of ozone and exposure level by the Weather Research and Forecasting (WRF)-Community Multiscale Air Quality (CMAQ) models and monitoring data from 1516 national air quality monitoring stations in China during 2015. The simulation results show that the Sichuan Basin, Shandong, Shanxi, Henan, Anhui, Qinghai-Tibetan Plateau, Yangtze River Delta (YRD), Pearl River Delta (PRD) and Beijing-Tianjin-Hebei (BTH) region had relatively high average annual concentrations of ozone. The regions with more than 10% nonattainment days of 160 μg/m3 (daily maximum 8-h) are mainly concentrated in BTH, Shandong Peninsula and YRD, where large seasonal variations were also found. Exposure levels were calculated based on population data and simulated ozone concentrations. The cumulative population exposed to daily maximum 8-h concentration greater than or equal to 100 μg/m3 was 816.04 million, 61.17% of the total. Three methods were used to estimate the mortality of chronic obstructive pulmonary disease (COPD) attributable to ozone. A comparative study using different exposure concentrations and threshold concentrations found large variations among these methods, although they were all peer-reviewed methods. The estimated mortality of COPD caused by ozone in China in 2015 ranged from 55341 to 80280, which mainly distributed in Beijing, Shandong, Henan, Hubei and Sichuan Province, the YRD and PRD region.
http://ift.tt/2j1fvr5
A model for estimating seasonal trends of ammonia emission from cattle manure applied to grassland in the Netherlands
Source:Atmospheric Environment, Volume 173
Author(s): J.F.M. Huijsmans, G.D. Vermeulen, J.M.G. Hol, P.W. Goedhart
Field data on ammonia emission after liquid cattle manure ('slurry') application to grassland were statistically analysed to reveal the effect of manure and field characteristics and of weather conditions in eight consecutive periods after manure application. Logistic regression models, modelling the emission expressed as a percentage of the ammonia still present at the start of each period as the response variable, were developed separately for broadcast spreading, narrow band application (trailing shoe) and shallow injection. Wind speed, temperature, soil type, total ammoniacal nitrogen (TAN) content and dry matter content of the manure, application rate and grass height were selected as significant explanatory variables. Their effects differed for each application method and among periods. Temperature and wind speed were generally the most important drivers for emission.The fitted regression models were used to reveal seasonal trends in NH3 emission employing historical meteorological data for the years 1991–2014. The overall average emission was higher in early and midsummer than in early spring and late summer. This seasonal trend was most pronounced for broadcast spreading followed by narrow band application, and was almost absent for shallow injection. However, due to the large variation in weather conditions, emission on a particular day in early spring can be higher than on a particular day in summer. The analysis further revealed that, in a specific scenario and depending on the application technique, emission could be reduced with 20–30% by restricting manure application to favourable days, i.e. with weather conditions with minimal emission levels.
http://ift.tt/2zPd42Q
Patient-reported outcome measures following gynecomastia correction: a systematic review
Abstract
Background
A patient's perspective is usually measured by patient-reported outcome instruments, which are becoming increasingly relevant to current research on clinical outcomes. The aims of our review were to identify studies that evaluated patient satisfaction after gynecomastia correction, analyze existing questionnaires, and summarize the development, psychometric properties and content of the questionnaires.
Methods
A multistep search of the web-based PubMed database was performed. Each potential study was examined by 2 independent reviewers for adherence to inclusion/exclusion criteria. The identified studies were categorized by title, authors, date, study type, number of patients, surgical procedures, complications, mean age, mean duration of follow-up, and outcome measurements. We summarized all the questionnaires used.
Results
Our search generated a total of 711 articles; we selected 28 studies for further appraisal. Eight studies were excluded based on the content of the abstracts, and an additional 8 studies were excluded based on the content of the complete article. Thus, we performed a systematic review of the 12 remaining studies. All studies identified from the literature review were assessed to determine the type of surgery used and whether or not the questionnaire used to analyze patient satisfaction had been validated. A total of 847 patients were included in these studies, which reported more than 100 complications.
Conclusions
The rate of patient satisfaction was high, although most studies did not use validated or quantifiable evaluation methods for assessment of satisfaction. A new self-assessment tool, which should include functional, psycho-relational, and cosmetic components, is needed to measure satisfaction and quality of life in patients who have undergone gynecomastia correction.
Level of Evidence: Level III, therapeutic study
http://ift.tt/2j36UUH
Impact of perfluorochemicals on human health and reproduction: a male’s perspective
Abstract
Perfluoroalkyl compounds (PFCs) are a class of organic molecules used in industry and consumer products. PFCs are non-biodegradable and bioaccumulate in the environment and for these reasons they have been a major subject of research regarding their toxicity, environmental fate, and sources of human exposure, since they have been shown to induce severe health consequences, such as neonatal mortality, neurotoxicity and immunotoxicity. The aim of this review is to explore the existing knowledge of the interplay between PFCs exposure and human health, with a focus on male reproductive health, given the emerging gender differences in PFCs clearance and their interaction with sex hormones receptors. A comprehensive PUBMED search was performed using relevant key terms for PFCs and male fertility. Different degrees of evidence suggest an impairment of semen parameters and sex hormones in relation to PFCs exposure. These preliminary results point towards a sex-dependent pharmacodynamics and clearance, with males having a much higher tendency to accumulation. Moreover, because of the widespread environmental occurrence of these chemicals, along with their ability to cross the placental barrier, exposure of the foetus to these compounds is inevitable. This is of concern because foetal development of the male reproductive organs may be disturbed by exposure to exogenous factors. These findings clearly suggest an antiandrogenic potential of PFCs and a link between endocrine disruptors and disorders of male health.
http://ift.tt/2z9U3uV
Potential Effect of Leukocyte-Platelet-Rich Fibrin in Bone Healing of Skull Base: A Pilot Study
Background. Reconstruction of surgical defects following cranial base surgery is challenging. Others have demonstrated that leukocyte-platelet-rich fibrin (L-PRF) stimulates tissue healing and bone regeneration. However, these studies have addressed mostly maxillofacial surgical wounds. Objective. The objective of this study was to assess the possible adjuvant role of L-PRF in inducing neoossification of the surgical bone defect in anterior skull base surgery. Methods. We identified patients who had undergone an endoscopic endonasal surgery of the anterior skull base in which L-PRF membranes were used for the reconstruction of the bone defect and who were followed up with postoperative CT scans. CT findings were then correlated with baseline scans and with the CT scans of a patient who had undergone imaging and histologic analysis after maxillofacial surgery in which L-PRF was used and in which we demonstrated bone formation. Results. Five patients fulfilled the inclusion criteria. In four patients, the CT scan demonstrated closure of the bony defect by neoosteogenesis; however, the bone appeared less dense than the surrounding normal bone. A comparison with the control patient yielded similar radiological features. Conclusion. This case series suggests that L-PRF may induce bone healing and regeneration at the surgical site defect. Multi-institutional studies with a larger series of patients are required to confirm this possibility.
http://ift.tt/2hwfv1I
Potential Effect of Leukocyte-Platelet-Rich Fibrin in Bone Healing of Skull Base: A Pilot Study
Background. Reconstruction of surgical defects following cranial base surgery is challenging. Others have demonstrated that leukocyte-platelet-rich fibrin (L-PRF) stimulates tissue healing and bone regeneration. However, these studies have addressed mostly maxillofacial surgical wounds. Objective. The objective of this study was to assess the possible adjuvant role of L-PRF in inducing neoossification of the surgical bone defect in anterior skull base surgery. Methods. We identified patients who had undergone an endoscopic endonasal surgery of the anterior skull base in which L-PRF membranes were used for the reconstruction of the bone defect and who were followed up with postoperative CT scans. CT findings were then correlated with baseline scans and with the CT scans of a patient who had undergone imaging and histologic analysis after maxillofacial surgery in which L-PRF was used and in which we demonstrated bone formation. Results. Five patients fulfilled the inclusion criteria. In four patients, the CT scan demonstrated closure of the bony defect by neoosteogenesis; however, the bone appeared less dense than the surrounding normal bone. A comparison with the control patient yielded similar radiological features. Conclusion. This case series suggests that L-PRF may induce bone healing and regeneration at the surgical site defect. Multi-institutional studies with a larger series of patients are required to confirm this possibility.
http://ift.tt/2hwfv1I
Immunomodulatory effects of a bioactive fraction of Strobilanthes crispus in NMU-induced rat mammary tumor model
Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Hassan Muhammad Yankuzo, Yusha'u Shu'aibu Baraya, Zulkarnain Mustapha, Kah Keng Wong, Nik Soriani Yaacob
Ethnopharmacological relevanceStrobilanthes crispus Blume is traditionally consumed among local Malay and indigenous communities for the treatment of cancer and other ailments such as gastrointestinal disorders, inflammatory wounds of snake bite and immune system activation amongst others. We previously demonstrated that a bioactive fraction of S. crispus leaves (F3) was cytotoxic to breast cancer cells in vitro and inhibited tumor growth in N-methyl-N-nitrosourea (NMU)-induced breast cancer rat model. F3 also normalized the white blood cell count in the tumor-bearing animals, indicating its potential immuno-stimulatory effect.Aim of the studyTo evaluate the immune stimulatory effects of F3 from S. crispus in NMU-induced rat mammary tumor model.Materials and methodsImmunohistochemistry analysis of cellular immune parameters (CD4+ or CD8+ T cells, CIITA, MHC-II and CD68) was performed on NMU-induced rat mammary tumor nodules, followed by evaluation of the serum level of 34 cytokines using the cytokine antibody array.ResultsSignificant increase in MHC-II, CD4+ and CD8+ T cell and CIITA expression by tumor cells was observed in F3-treated rats compared to the tumor control group. F3-treated rats also displayed a significant decrease in the serum level of CCL2 and CD68+ infiltrating macrophages. Serum IFN-γ level in this group was increased by 1.7-fold suggesting enhanced infiltration of T cells, and upregulation of CIITA and MHC-II expression in the tumor cells might be triggered by F3-induced production of IFN-γ.ConclusionOur findings demonstrated for the first time that a subfraction from S. crispus, F3, is capable of activating the immune system in rats-bearing NMU-induced mammary tumor, which may contribute to the anticancer effects of F3, and additionally support the traditional use of S. crispus leaves to boost the immune system.
Graphical abstract
http://ift.tt/2yOkeD5
A proanthocyanidin-rich extract from Cassia abbreviata exhibits antioxidant and hepatoprotective activities in vivo
Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Mansour Sobeh, Mona F. Mahmoud, Mohamed A.O. Abdelfattah, Haroan Cheng, Assem M. El-Shazly, Michael Wink
Ethnopharmacological relevanceCassia abbreviata is a small to medium sized branched umbrella-shaped deciduous tree. It is widely spread in the tropics, especially in Africa, having a long history in traditional medicine for the treatment of numerous conditions such as headaches, diarrhea, constipation, some skin diseases, malaria, syphilis, pneumonia, stomach troubles, uterine pains, and against gonorrhea.Aim of the studyWe investigated the phytochemical constituents of a root extract from Cassia abbreviata using HPLC-PDA-ESI-MS/MS. We also determined the antioxidant activities in vitro and in vivo using the nematode Caenorhabditis elegans as a model organism. The hepatoprotective activities in case of D-galactosamine (D-GaIN)-induced hepatotoxicity were studied in a rat model.Materials and methodsHPLC-PDA-ESI-MS/MS analysis allowed the identification of the secondary metabolites of the methanol extract. DPPH and FRAP assays were used to determine the antioxidant activities in vitro. Using the C. elegans model, survival rates under juglone induced oxidative stress, intracellular ROS content, quantification of Phsp-16.2: GFP expression and subcellular DAF-16: GFP localization were investigated to determine the antioxidant activities in vivo. The in vivo hepatoprotective potential of the root extract was evaluated for D-galactosamine (D-GaIN)-induced hepatotoxicity in rats. The activity of the liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT), in addition to liver peroxidation product malondialdehyde (MDA) and glutathione content (GSH), as well as albumin and total bilirubin concentration, were determined. A histopathological study was also performed.Results and conclusionsC. abbreviata root extract is rich in polyphenolics, particularly proanthocyanidins. HPLC-PDA-ESI-MS/MS analysis resulted in the identification of 57 compounds on the bases of their mass spectra. (epi)-Catechin, (epi)-afzelechin, (epi)-guibourtinidol, and (ent)-cassiaflavan monomers as well as their dimers, trimers, and their diastereomers are the main components of the extract.The total phenolic content amounted for 474mg/g root extract expressed as gallic acid equivalent using the Folin-Ciocalteu method. The extract exhibited powerful antioxidant activity with EC50 of 6.3μg/mL in DPPH and 19.15mM FeSO4 equivalent/mg sample in FRAP assay. In C. elegans model, the extract (200μg/mL) was able to increase the survival rate by 44.56% and reduced the ROS level to 61.73%, compared to control group.Pretreatment of rats with 100mg extract/kg (b. wt.) reduced MDA by 47.36% and elevated GSH by 59.1%. The extract caused a significant reduction of ALT, AST and GGT activities by 11%, 35.7% and 65%, respectively.The findings of this study suggest that the proanthocyanidin-rich extract from C. abbreviata may be an interesting candidate for hepatoprotective activity in case of hepatocellular injury.
Graphical abstract
http://ift.tt/2yS6V4o
Comprehensive Geriatric Assessment and Head and Neck Elderly Cancer Patients
Intervention: Other: CGA and geriatric follow-up
Sponsors: Assistance Publique - Hôpitaux de Paris; National Cancer Institute (NCI); Cancéropole Ile De France
Recruiting
http://ift.tt/2j0QOed
Comprehensive Geriatric Assessment and Head and Neck Elderly Cancer Patients
Intervention: Other: CGA and geriatric follow-up
Sponsors: Assistance Publique - Hôpitaux de Paris; National Cancer Institute (NCI); Cancéropole Ile De France
Recruiting
http://ift.tt/2j0QOed
Pre-Neolithic evidence for dog-assisted hunting strategies in Arabia
Source:Journal of Anthropological Archaeology
Author(s): Maria Guagnin, Angela R. Perri, Michael D. Petraglia
The function of prehistoric dogs in hunting is not readily visible in the archaeological record; interpretations are thus heavily reliant on ethnographic data and remain controversial. Here we document the earliest evidence for dogs on the Arabian Peninsula from rock art at the sites of Shuwaymis and Jubbah, in northwestern Saudi Arabia. Hunting scenes depicted in the rock art illustrate dog-assisted hunting strategies from the 7th and possibly the 8th millennium BC, predating the spread of pastoralism. Though the depicted dogs are reminiscent of the modern Canaan dog, it remains unclear if they were brought to the Arabian Peninsula from the Levant or represent an independent domestication of dogs from Arabian wolves. A substantial dataset of 147 hunting scenes shows dogs partaking in a range of hunting strategies based on the environment and topography of each site, perhaps minimizing subsistence risk via hunting intensification in areas with extreme seasonal fluctuations. Particularly notable is the inclusion of leashes on some dogs, the earliest known evidence in prehistory. The leashing of dogs not only shows a high level of control over hunting dogs before the onset of the Neolithic, but also that some dogs performed different hunting tasks than others.
http://ift.tt/2z9tPZD
Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell Carcinoma
AbstractCabozantinib was recently approved for the treatment of advanced renal cell carcinoma (RCC) after treatment with vascular endothelial growth factor (VEGF)‐targeted therapy. Cabozantinib is a multikinase inhibitor targeting VEGF receptor (VEGFR) 2, mesenchymal‐epithelial transition receptor, and "anexelekto" receptor tyrosine kinase. A 60‐mg daily dose led to improved overall survival and progression‐free survival (PFS) versus everolimus in advanced RCC patients as a second‐ or later‐line treatment in the METEOR trial. Improved PFS with cabozantinib versus sunitinib has also been demonstrated in the first‐line setting in CABOSUN. However, cabozantinib, like other VEGFR inhibitors, is associated with toxicity that may affect the patient's quality of life. The most frequent adverse events (AEs) are diarrhea, fatigue, hypertension, hand‐foot syndrome, weight loss, nausea, and stomatitis. This article summarizes the safety profile of cabozantinib in RCC patients and offers guidance for the management of these AEs. We discuss the underlying mechanisms of these AEs and, based on our experiences with cabozantinib and other multikinase inhibitors, we present approaches to manage toxicity. Prophylactic and therapeutic solutions are available to help with the management of toxicity associated with cabozantinib, and adequate interventions can ensure optimum adherence and maximize patient outcomes.Implications for Practice.Cabozantinib leads to improved survival outcomes in renal cell carcinoma patients compared with everolimus. However, management of the adverse event profile is crucial to achieve optimum adherence and outcomes with the use of cabozantinib. This review aims to provide appropriate guidance that will minimize the impact of adverse events and help to maximize the utility of this agent in patients with advanced renal cell carcinoma.
http://ift.tt/2zaC3AI
Cure in Advanced Renal Cell Cancer: Is It an Achievable Goal?
AbstractBackground.Immunotherapy has historically been of interest in the management of metastatic renal cell cancer (mRCC) because of its relative chemoresistance and the reproducible but low incidence of spontaneous remission in metastatic disease. Recently, targeted immunotherapies in the form of checkpoint inhibitors have shown durable responses in approximately 20%–30% of patients with solid tumors, with a much more acceptable side‐effect profile. Anti‐programmed death receptor 1 (PD‐1)/programmed death receptor ligand 1 antibodies rely on the presence of host T cells in the tumor microenvironment to be stimulated in order to activate an antitumor response. The presence of tumor antigens augments this stimulation. This has led to further research into combination therapy with anti‐PD‐1 inhibitors and radiotherapy, chemotherapy, or targeted therapy with the aim of increasing the response rate to these agents.Materials and Methods.We describe three cases of patients with mRCC treated with anti‐PD‐1 antibody therapy in combination with targeted therapy (bevacizumab), anti‐cytotoxic T lymphocyte antigen 4 therapy (ipilimumab), or radiotherapy. We perform a comprehensive literature review on combination immunotherapy and the scope for the future.Results.Two patients had a complete clinical response within 3 months of commencing treatment. The third patient had a further significant response to radiotherapy outside the field of treatment after initial response to anti‐PD‐1 therapy, which lasted for over 12 months.Conclusion.We are now in the era of immunotherapy with promising results in select patients. However, the number of complete remissions with single agents are low. This report demonstrates the potential for combination therapy in mRCC to produce complete responses and improved survival rates. Whether these results equate to cure in a subset of patients requires longer follow‐up. Further evaluation of dosing regimens, sequencing methods, and biomarkers to select patient population is required to advance this treatment strategy.Implications for Practice.Multiple phase I–III studies exploring the benefit of combination immunotherapy are currently under way. Further research into predictive biomarkers to identify the cohort of patients who gain this benefit is pertinent. This case series demonstrates that the combination of immunotherapy with other treatments can lead to complete responses, even in patients with initially bulky disease. Combination therapy with immunotherapy seems to cause more durable responses in patients with metastatic renal cell cancer compared with monotherapy. Significantly longer follow‐up is necessary to determine whether durable complete response confers a cure in a select group of patients.
http://ift.tt/2mye20j
Therapeutic Potential of Afatinib for Cancers with ERBB2 (HER2) Transmembrane Domain Mutations G660D and V659E
AbstractWe previously reported on a family with hereditary lung cancer, in which a germline mutation in the transmembrane domain (G660D) of avian erythroblastic leukemia viral oncogene homolog 2 (erb‐b2 receptor tyrosine kinase 2) (ERBB2; human epidermal growth factor receptor 2 [HER2]) seemed to be responsible for the cancer predisposition. Although few data are available on treatment, anti‐ERBB2 therapeutic agents may be effective for ERBB2‐mutant cancers. The familial lung cancer patient in one of the authors' institutes developed bone metastasis with enlarging lung tumors and was treated with the ERBB2 inhibitor afatinib. We also encountered a patient with ampullary adenocarcinoma with ERBB2 G660D and S310F comutations in another institute of the authors', revealed by comprehensive genomic profiling. This patient was then treated with afatinib and also achieved transitory response. We also searched for ERBB2 transmembrane mutations in various types of cancers in PubMed, The Cancer Genome Atlas (TCGA), and the Memorial Sloan Kettering‐Integrated Mutation Profiling of Actionable Cancer Targets (MSK‐IMPACT) database. Besides our two cases, two patients with V659E mutations were found via PubMed. Three potential patients were found in TCGA. In addition, MSK‐IMPACT allowed identification of three additional urothelial carcinomas with G660D mutations and two lung adenocarcinomas with V659E mutations. Our experience suggests that establishing a database of integrated information regarding the clinical genome and therapeutic outcome of patients with recurrent but less common mutations is essential to implement precision oncology.
http://ift.tt/2z8jM6R
Asymmetric distribution of CRUMBS polarity complex proteins from compacted 8-cell to blastocyst stage during mouse preimplantation development
Source:Gene Expression Patterns
Author(s): Xinlong Jiang, Wenzhong An, Xiao Yang, Jieye Lin, Shiliang Ma, Dajia Wang, Shuang Tang
During mouse preimplantation development, blastomeres are equipotent until polarity establishment at compacted 8-cell stage. The intrinsic nature of polarity is the asymmetric distribution of polarity proteins between inside and outside blastomeres along the direction of apical-basal axis. This study investigated the early developmental temporal and spatial expression of the main CRUMBS polarity complex proteins in the mouse preimplantation embryo. We observed that Crb3, Pals1, Patj and Mpdz are transcribed in the mouse preimplantation embryo. However, the asymmetric distribution of these polarity proteins is not established until the compacted 8-cell stage. From compaction and thereafter, CRB3 and PALS1 are progressively enriched in the apical membrane, while PATJ and MPDZ are discretely localized at both tight junctions and the apical membrane adjacent to tight junctions. These temporal and spatial distribution patterns suggest that CRUMBS polarity complex might be involved in the cell polarity establishment in the early mouse embryo and reinforce the viewpoint that developmentally spatial asymmetries are first set up at the compaction stage. The present study provides a foundation for further investigation on the functions of CRUMBS polarity complex in trophectoderm specification and blastocyst morphogenesis.
http://ift.tt/2A6LX6n
Characterization of abnormal sleep patterns in patients with obesity, type 2 diabetes, or combined
Publication date: Available online 15 November 2017
Source:Alexandria Journal of Medicine
Author(s): Aliaa Ali El-Aghoury, Tamer Mohamed Elsherbiny, Neveen Lewis, Tarek Mohamed Salem, Nesma Osman
Introduction: Obesity and type 2 diabetes mellitus have reached epidemic proportions worldwide. Abnormal sleep has been linked to both incident and prevalent obesity and type 2 diabetes. We aimed to characterize abnormal sleep patterns [ASP's] in patients with obesity, type 2 diabetes, or both. Subjects: The study included 92 subjects divided into four groups: Group 1, 23 obese patients (BMI > 30) with type 2 diabetes mellitus; Group 2, 23 non-obese diabetic patients; group 3, 23 obese subjects without diabetes; group 4, 23 matched healthy control subjects. Methods: Waist circumference and BMI [body mass index] estimation, fasting and post challenge plasma glucose "groups 2 & 4", HOMA-IR [Homeostatic model assessment- Insulin resistance] estimation, and finally evaluation for ASP's using a CDC [Centers for Disease Control and prevention] validated questionnaire. Results: Post-prandial glucose and BMI significantly predicted Sleep latency and sleep hours at night respectively. Both group 1 and 3 compared to group 4 showed higher prevalence of: Insomnia [p < .01], snoring [p < .01], fragmented sleep [p < .05], excessive day time sleepiness [p < .001], and daytime dysfunction [p < .001]. Group 2 compared to group 4 showed higher prevalence of: Insomnia, snoring, fragmented sleep, and finally, daytime dysfunction [All p < .01]. Group 1 compared to groups 3 and 4 had significantly less hours of sleep at night [p < .01]. Group 1 compared to group 2 showed higher prevalence of: Insomnia, fragmented sleep, excessive day time sleepiness, and daytime dysfunction [All p < .05]. Finally, group 3 compared to group 2 showed higher prevalence of: Excessive day time sleepiness, and daytime dysfunction [p < .01]. Conclusion: The combination of obesity and diabetes mellitus is associated with poor quality and quantity of sleep with resultant significant daytime dysfunction. Glycemic, and adiposity measures predicted sleep latency and hours.
http://ift.tt/2yPnpu5
Extraocular Muscle Findings in Myasthenia Gravis Associated Treatment-Resistant Ophthalmoplegia
Abstract: We report the histopathological and ultrastructural tissue analysis of extraocular muscle (EOM) obtained from a patient with seronegative myasthenia gravis (MG) with treatment-resistant ophthalmoplegia for 3.5 years. The EOM demonstrated predominantly myopathic features and ultrastructural evidence of mitochondrial dysfunction, but the most striking features were increased endomysial collagen and adipocyte replacement of muscle fibers. By contrast, control EOM from a patient undergoing strabismus surgery for a sensory exotropia in a nonseeing eye and a similar duration of deviation, showed normal muscle histology. Although the histopathological and ultrastructural findings largely resemble those of limb muscle in MG, the abundant endomysial collagen may be nonspecific and secondary to poor force generation as a result of chronic ophthalmoplegia.http://ift.tt/2zM0Ny6
Infantile Myofibroma of the Carotid Space Presenting as Horner Syndrome
No abstract availablehttp://ift.tt/2zMLjKc
Optical Coherence Tomography Angiography in Nonarteritic Anterior Ischemic Optic Neuropathy
Background: Optical coherence tomography angiography (OCTA) has demonstrated good utility in qualitative analysis of retinal and choroidal vasculature and therefore may be relevant in the diagnostic and treatment efforts surrounding nonarteritic anterior ischemic optic neuropathy (NAION). Methods: Retrospective, cross-sectional study of 10 eyes of 9 patients with a previous or new diagnosis of NAION that received imaging with OCTA between November 2015 and February 2016. Two independent readers qualitatively analyzed the retinal peripapillary capillaries (RPC) and peripapillary choriocapillaris (PCC) for flow impairment. Findings were compared with automated visual field and structural optical coherence tomography (OCT) studies. Results: Flow impairment seen on OCTA in the RPC corresponded to structural OCT deficits of the retinal nerve fiber layer (RNFL) and ganglion cell layer complex (GCC) in 80% and 100% of eyes, respectively, and to automated visual field deficits in 90% of eyes. Flow impairment seen on OCTA in the PCC corresponded to structural OCT deficits of the RNFL and GCC in 70% and 80% of eyes, respectively, and to visual field deficits in 60%–80% of eyes. Conclusions: OCTA can noninvasively visualize microvascular flow impairment in patients with NAION.http://ift.tt/2zKd1aB
Should Oral Corticosteroids Be Used to Treat Demyelinating Optic Neuritis?
No abstract availablehttp://ift.tt/2zLQr1l
Comparing Hypertropia in Upgaze and Downgaze Distinguishes Congenital From Acquired Fourth Nerve Palsies
Background: Isolated fourth nerve palsies are commonly caused by decompensation of a congenitally dysfunctional superior oblique muscle ("decompensated congenital palsies"). Distinguishing such palsies at initial presentation from palsies caused by presumed microvascular ischemia ("ischemic palsies") has value for patient reassurance and in forestalling ancillary testing. Abnormally large vertical fusional amplitudes traditionally have been used to identify decompensated congenital palsies, but that may not be a reliable distinguishing feature. This study was undertaken to determine if the amount of hypertropia in upgaze and downgaze might be a more efficient separator. We also studied traumatic and tumorous fourth nerve palsies to see if they could be distinguished from decompensated congenital palsies by using this hypertropia comparison. Methods: Retrospective review of case records of patients diagnosed with isolated fourth nerve palsies at the University of Michigan Neuro-Ophthalmology Clinics over the past 15 years. We recorded the age, gender, vascular risk factors, duration of follow-up, cause, side of palsy, and alignment measurements in all patients. Results: Inclusion criteria were met by 118 patients. Hypertropia was equal or greater in upgaze than downgaze in 50 of the 58 decompensated congenital palsies (86%) in whom those data were recorded. Hypertropia was never greatest in upgaze in the 15 patients with traumatic palsies. Vertical fusional amplitudes were increased in only 15 of 27 patients (56%) with decompensated palsies in whom those data were recorded. Torsional misalignment on double Maddox rod testing was present in 16 (94%), 13 (87%), and 3 (100%) patients with ischemic, traumatic, and tumorous palsies, but also in 19 patients (54%) with decompensated congenital palsies in whom those data were recorded. Conclusions: Hypertropia greater in upgaze than downgaze or equal in upgaze and downgaze was an efficient separator of congenital from ischemic and tumorous fourth nerve palsies, being characteristic of patients with decompensated congenital palsies and never present in patients with ischemic, traumatic, or tumorous palsies. Vertical fusional amplitudes and torsional misalignment did not effectively differentiate between the patient groups. Comparing the hypertropia in upgaze and downgaze improved differential diagnosis and reduces the potential for unnecessary ancillary tests.http://ift.tt/2zNdpVx
Contiguous Silicone Oil Migration From the Vitreous Cavity to the Optic Tract
No abstract availablehttp://ift.tt/2zNEUye
Intracranial Aneurysms of Neuro-Ophthalmologic Relevance
Background: Intracranial saccular aneurysms are acquired lesions that often present with neuro-ophthalmologic symptoms and signs. Recent advances in neurosurgical techniques, endovascular treatments, and neurocritical care have improved the optimal management of symptomatic unruptured aneurysms, but whether the chosen treatment has an impact on neuro-ophthalmologic outcomes remains debated. Evidence Acquisition: A review of the literature focused on neuro-ophthalmic manifestations and treatment of intracranial aneurysms with specific relevance to neuro-ophthalmologic outcomes was conducted using Ovid MEDLINE and EMBASE databases. Cavernous sinus aneurysms were not included in this review. Results: Surgical clipping vs endovascular coiling for aneurysms causing third nerve palsies was compared in 13 retrospective studies representing 447 patients. Complete recovery was achieved in 78% of surgical patients compared with 44% of patients treated with endovascular coiling. However, the complication rate, hospital costs, and days spent in intensive care were reported as higher in surgically treated patients. Retrospective reviews of surgical clipping and endovascular coiling for all ocular motor nerve palsies (third, fourth, or sixth cranial nerves) revealed similar results of complete resolution in 76% and 49%, respectively. Improvement in visual deficits related to aneurysmal compression of the anterior visual pathways was also better among patients treated with clipping than with coiling. The time to treatment from onset of visual symptoms was a predictive factor of visual recovery in several studies. Few reports have specifically assessed the improvement of visual deficits after treatment with flow diverters. Conclusions: Decisions regarding the choice of therapy for intracranial aneurysms causing neuro-ophthalmologic signs ideally should be made at high-volume centers with access to both surgical and endovascular treatments. The status of the patient, location of the aneurysm, and experience of the treating physicians are important factors to consider. Although a higher rate of visual recovery was reported with neurosurgical clipping, this must be weighed against the potentially longer intensive care stays and increased early morbidity.http://ift.tt/2hwjXhd
International Consensus Statement on the Clinical and Therapeutic Management of Leber Hereditary Optic Neuropathy
Abstract: Leber hereditary optic neuropathy (LHON) is currently estimated as the most frequent mitochondrial disease (1 in 27,000–45,000). Its molecular pathogenesis and natural history is now fairly well understood. LHON also is the first mitochondrial disease for which a treatment has been approved (idebenone–Raxone, Santhera Pharmaceuticals) by the European Medicine Agency, under exceptional circumstances because of the rarity and severity of the disease. However, what remains unclear includes the optimal target population, timing, dose, and frequency of administration of idebenone in LHON due to lack of accepted definitions, criteria, and general guidelines for the clinical management of LHON. To address these issues, a consensus conference with a panel of experts from Europe and North America was held in Milan, Italy, in 2016. The intent was to provide expert consensus statements for the clinical and therapeutic management of LHON based on the currently available evidence. We report the conclusions of this conference, providing the guidelines for clinical and therapeutic management of LHON.http://ift.tt/2hxtoNl
Relative Frequencies of Arteritic and Nonarteritic Anterior Ischemic Optic Neuropathy in an Arab Population
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Vertical Head Thrusting in Acquired Supranuclear Vertical Ophthalmoplegia
Abstract: Patients with congenital ocular motor apraxia (OMA) typically show head thrusts while attempting to shift gaze. In congenital OMA, this compensatory head motion mostly occurs in the horizontal plane. Two patients with acquired palsy of voluntary vertical gaze and continuous upward gaze deviation, one from aortic surgery and the other from multiple infarctions involving the mesodiencephalic junction, showed intermittent downward head thrusting to redirect the eyes straight ahead or downward. The head thrusting behavior improved markedly after surgical correction of the upward gaze deviation in one patient. Vertical head thrusting may be a characteristic sign of acquired vertical gaze palsy when combined with vertical gaze deviation.http://ift.tt/2zLYQ4A
Sleep-Induced Apraxia of Eyelid Opening
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Clinical and Oculographic Analysis of Inferior Oblique Myokymia
Abstract: A 63-year-old man experienced transient vertical oscillopsia lasting several seconds for 2 months. Examination disclosed paroxysmal excyclotorsion of the right eye, spontaneously or triggered by adduction. Eye movements using 3D video-oculography showed intermittent, monocular phasic movements which consisted of excyclotorsion of the right eye mixed with a small amount of supraduction and abduction, and a tonic movement with excyclotorsion and slight elevation. Orbital and brain MRI was unremarkable. Administration of oxcarbazepine markedly decreased the severity and frequency of the episodes. The oculographic characteristics in our patient may indicate that inferior oblique myokymia may be attributed to aberrant, spontaneous discharges in the inferior oblique motor unit.http://ift.tt/2zLXRSi
Treatment Response in Pediatric Patients With Pseudotumor Cerebri Syndrome
Background: Pseudotumor cerebri syndrome (PTCS) is a disorder defined by increased intracranial pressure in the absence of an intracranial space-occupying lesion. This retrospective study aimed to examine the outcomes in children with PTCS. Methods: Data was collected retrospectively from the charts of consecutive pediatric patients treated for PTCS at our hospital between 2000 and 2007 (60 patients; 36 females, 24 males). Results: Forty-six patients (76.6%) responded well to acetazolamide therapy, with full resolution of symptoms, including papilledema (average treatment duration 1 year; range: 1 month–5 years). Of the 14 patients with no response to treatment, 9 (23.4%) required surgical intervention. Nonresponders tended to be younger at presentation (8.7 vs 11.5 years, P = 0.04). Twelve patients (26%) experienced relapse after acetazolamide was discontinued. The group that experienced relapse was significantly younger than the nonrelapsers (8.9 vs 12.1 years, Phttp://ift.tt/2zM6iN9
Multiple Cranial Nerve Palsies in Giant Cell Arteritis
Abstract: Giant cell arteritis (GCA) is a systemic vasculitis of medium and large arteries often with ophthalmic involvement, including ischemic optic neuropathy, retinal artery occlusion, and ocular motor cranial nerve palsies. This last complication occurs in 2%–15% of patients, but typically involves only 1 cranial nerve. We present 2 patients with biopsy-proven GCA associated with multiple cranial nerve palsies.http://ift.tt/2zLXJ5g
Literature Commentary.
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Accelerating knee MR imaging: Compressed sensing in isotropic three-dimensional fast spin-echo sequence
Source:Magnetic Resonance Imaging, Volume 46
Author(s): Seung Hyun Lee, Young Han Lee, Jin-Suck Suh
PurposeTo compare image quality between compressed sensing (CS)-3D-fast spin-echo (FSE) and conventional 3D-FSE sequences for knee magnetic resonance imaging (MRI).MethodsKnee MRI of 43 patients (male:female, 14:29; mean age, 53years) were acquired using conventional and CS-3D-FSE with an acceleration factor of 1.5. Overall image quality was assessed by correlation coefficient, root-mean-square error (RMSE), and structural similarity (SSIM) index. Regional image quality was evaluated using signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs). Subjective image quality was evaluated using a four-point scale. Diagnostic agreement for meniscal lesions between the two sequences was evaluated.ResultsThe scan time was reduced from 7:14–8:08 to 4:53–5:08 with CS. A strong positive correlation was observed between data of the two sequences (mean r=0.880). The RMSE (mean, 126.861) and SSIM index (mean, 0.987) were acceptable. The SNRs and CNRs were not significantly different between the two sequences (P>0.05, each). There were no significant differences in the evaluation of the menisci and cruciate ligaments, while the CS images demonstrated inferior quality of cartilage–subchondral bone delineation. Diagnostic agreement for meniscal lesions between the two sequences was very good (κ=0.943–1).ConclusionCompressed sensing-3D-FSE knee MRI produces images of acceptable quality while reducing scan time.
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