Head and Neck Diseases by Alexandros G.Sfakianakis: 01/20/18

Σάββατο 20 Ιανουαρίου 2018

High-performance electrochemical sensing of circulating tumor DNA in peripheral blood based on poly-xanthurenic acid functionalized MoS2 nanosheets

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Wei Zhang, Zhichao Dai, Xue Liu, Jimin Yang
A high-performance sensing platform based on poly-xanthurenic acid (PXA) film functionalized MoS2 nanosheets was developed for electrochemical detection of circulating tumor DNA in peripheral blood. The MoS2 nanosheets were obtained using a simple ultrasonic method from bulk MoS2. The physical adsorption between MoS2 and aromatic XA monomers effectively improved the electropolymerization efficiency, accompanied with an increased electrochemical response of PXA. The obtained PXA/MoS2 nanocomposite not only served as a substrate for DNA immobilization but also reflected the electrochemical transduction originating from DNA immobilization and hybridization without any complex labelling processes or outer indicators. The immobilization of the probe ssDNA was achieved via noncovalent assembly due to the π–π interaction between PXA and DNA bases. After the hybridization of the probe ssDNA with the target DNA, the formation of helix structure induced the resulted dsDNA to be released from the surface of the PXA/MoS2 nanocomposite. The detection limit of this constructed DNA biosensor was calculated in the linear target DNA concentrations range from 1.0 × 10^–16 mol/L to 1.0 × 10^-10 mol/L and it was found to be 1.8 × 10^–17 mol/L.

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Analytical characterization of products obtained from slow pyrolysis of Calophyllum inophyllum seed cake: study on performance and emission characteristics of direct injection diesel engine fuelled with bio-oil blends

Abstract

This paper aims to analyse the characteristics and properties of the fractions obtained from slow pyrolysis of non-edible seed cake of Calophyllum inophyllum (CI). The gas, bio-oil and biochar obtained from the pyrolysis carried out at 500 °C in a fixed bed batch type reactor at a heating rate of 30 °C/min were characterized by various analytical techniques. Owing to the high volatile content of CI biomass (72.61%), it was selected as the raw material in this present investigation. GC-MS and FT-IR analysis of bio-oil showed the presence of higher amount of oxygenated compounds, phenol derivatives, esters, acid and furans. The physicochemical properties of the bio-oil were tested as per ASTM norms which imply that bio-oil is a highly viscous liquid with lower heating value as compared to that of diesel fuel. The chemical composition of evolved gas was analysed by using GC testing which revealed the presence of combustible components. The FT-IR characterization of biochar showed the presence of aliphatic and aromatic hydrocarbons whereas the elevated amount of carbon in biochar indicates its potential to be used as solid fuel. The performance and emission characteristics of CI engine were assessed with different CI bio-oil blends and compared with baseline diesel fuel. The results showed that addition of bio-oil leads to decreased brake thermal efficiency and increased brake specific energy consumption. Meanwhile, increase in blend ratio reduces harmful pollutants such as oxides of nitrogen and smoke in the exhaust. From the engine testing, it is suggested to employ 20% of CI bio-oil blends in CI engine to obtain better operation.

http://ift.tt/2G1PLVZ

Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis

Abstract

Objectives

The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images.

Methods

Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square's test and descriptive analyses were performed.

Results

Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (p < 0.05). Endodontic treatment quality and coronal restoration were associated with periapical status (p < 0.05). Underfilling was the most frequent technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively.

Conclusions

There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals.

Clinical relevance

Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.

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Combined treatment of contaminated soil with a bacterial Stenotrophomonas strain DXZ9 and ryegrass ( Lolium perenne ) enhances DDT and DDE remediation

Abstract

Bioremediation of contaminated soils by a combinational approach using specific bacterial species together with ryegrass is a promising strategy, resulting in potentially highly efficient degradation of organic contaminants. The present study tested the combination of strain DXZ9 of Stenotrophomonas sp. with ryegrass to remove DDT and DDE contaminants from soil under natural conditions in a pot experiment. The strain DXZ9 was successfully colonized in the natural soil, resulting in removal rates of approximately 77% for DDT, 52% for DDE, and 65% for the two pollutants combined after 210 days. Treatment with ryegrass alone resulted in slightly lower removal rates (72 and 48%, respectively, 61% for both combined), while the combination of strain DXZ9 and ryegrass significantly (p < 0.05) improved the removal rates to 81% for DDT and 55% for DDE (69% for both). The half-life of the contaminants was significantly shorter in combined treatment with DXZ9 and ryegrass compared to the control. The remediation was mostly due to degradation of the contaminants, as the net uptake of DDT and DDE by the ryegrass accounted for less than 3% of the total amount in the soil. DDT is reductively dechlorinated to DDD and dehydrochlorinated to DDE in the soil; the metabolites of DDE and DDD were multiple undefined substances. The toxicity of the soil was significantly reduced as a result of the treatment. The present study demonstrates that the bioremediation of soil contaminated with DDT and DDE by means of specific bacteria combined with ryegrass is feasible.

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Is trade openness good for environment in South Korea? The role of non-fossil electricity consumption

Abstract

The paper investigates the linkage of carbon dioxide (CO₂) emissions, per capita real output, share of non-fossil electricity consumption, and trade openness in South Korea from 1971 to 2013. The empirical results indicate that the environmental Kuznets curve (EKC) is supported by autoregressive distributed lag (ARDL) test. Both short- and long-run estimates indicate that increasing non-fossil electricity consumption can mitigate environmental degradation, and increasing trade aggravates carbon dioxide emissions. By Granger causality, long-run causalities are found in both equations of CO₂ emissions and trade openness, as well as exports and imports. In the short-run, evidence indicates feedback linkage between output and trade, unidirectional linkages from trade to emissions, from emissions to output, and from output to non-fossil electricity use. Therefore, South Korea should strengthen the sustainable economy, consume clean energy, and develop green trade.

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Effect of the carbon dioxide 10,600-nm laser and topical fluoride gel application on enamel microstructure and microhardness after acid challenge: an in vitro study

Abstract

The aim of this in-vitro study was to evaluate positive effects of the carbon dioxide laser (CO₂, 10,600 nm) with acidulated phosphate fluoride (APF) gel on enamel acid resistance. Twenty extracted human third molars (40 surfaces) were randomly assigned into four groups: group C, untreated control; group L, CO₂ laser alone group; group F, APF 1.23% fluoride gel; and group FL, APF 1.23% gel and laser. Samples from group L were irradiated with a CO₂ laser for 30s. The parameter settings used were average power, 0.73 W; time on, 100 μs; time off, 40 ms; tip-to-tissue distance, 20 mm; tip diameter 700 μm; and energy density with movements, 5 J/cm². Samples from group F were treated with the APF gel for 4 min, and the gel was washed off with distilled water. The enamel samples from group FL were treated with APF gel for 4 min and then irradiated with the CO₂ laser for 30s without removing the gel. Each enamel sample was placed in 50 ml soft drink (pH = 2.75) for 10 min then rinsed with deionized water and stored in artificial saliva at 37 °C for 1 h. Samples were assessed for Vickers hardness number (VHN) before and after treatments and subjected to SEM analysis. Data were analyzed using a one-way analysis of variance (ANOVA) and Tukey's test (α < 0.05). After the acid challenge, the untreated C group was demineralized to a great extent and the enamel surface was with the lowest mean score of microhardness. The observed VHN in the control (C group) had a mean value of 176.13, the scores in the CO₂ laser group (L group) were with mean value of 238.40, the F group with a mean value of 218.45, and the fluoride-treated and laser-irradiated FL group—with a mean of 268.28 VHN. Paired t test performed to compare groups C, L, F, and FL has shown that group FL has greater resistance to decrease in microhardness of dental enamel (P ≤ 0.05) on exposure to acidic protocol. After the acid challenge, the fluoride-treated and laser-irradiated samples (group FL) showed the least diminution in enamel surface microhardness. The sub-ablative carbon dioxide laser irradiation in combination with fluoride treatment is more effective in protecting enamel surface and resisting demineralization than CO₂ laser irradiation or fluoride alone.

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The effect of caregiver-delivered social-communication interventions on skill generalization and maintenance in ASD

Publication date: March 2018
Source:Research in Developmental Disabilities, Volume 74
Author(s): Ee Rea Hong, Leslie Neely, Stephanie Gerow, Candace Gann
BackgroundAlthough caregiver-delivered social communication interventions have been considered scientifically proven practices for individuals with autism spectrum disorders, it is not well examined if these types of intervention modes are truly effective in promoting skill generalization and maintenance within those individuals with autism spectrum disorders.AimsThe purpose of this meta-analysis was to evaluate the status of the extant literature regarding the measures on generalization and/or maintenance of effects of caregiver-delivered communication interventions for children with autism spectrum disorders.Methods and proceduresThis systematic literature review and meta-analysis evaluated peer-reviewed research regarding the effects of caregiver-implemented interventions on the maintenance and generalization of the social-communication skills for children with autism spectrum disorders. A total of 34 articles were included following a systematic search. Articles were summarized according to the following categories: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) generalization/maintenance teaching strategy, and (e) latency to maintenance probes. After application of design standards, aggregate Tau-U and non-overlap of pairs effect sizes were calculated with a total of 67 separate contrasts across seven studies.Outcomes and resultsOverall, effect size scores ranged from small to large effects across all comparisons. On average, most of the baseline to maintenance and generalization comparisons produced moderate to large effects. Whereas, small to moderate or even deteriorate effects were found in most of the intervention to maintenance and generalization comparisons.Conclusions and implicationsThe findings in this review suggest that caregiver-delivered social-communication interventions are likely to result in mixed effects on skill generalization and maintenance within children with autism spectrum disorders. Implications for future research and practice are discussed.

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Breaking paradigms in severe epistaxis: the importance of looking for the S-point

Publication date: Available online 20 January 2018
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Eduardo Macoto Kosugi, Leonardo Balsalobre, João Mangussi Gomes, Miguel Soares Tepedino, Daniel Marcus San da Silva, Erika Mucciolo Cabernite, Diego Hermann, Aldo Cassol Stamm
IntroductionSince the introduction of nasal endoscopy into the field of Otorhinolaryngology, the treatment paradigm for cases of severe epistaxis has shifted toward early and precise identification of the bleeding site. Although severe epistaxis is usually considered to arise from posterior bleeding, an arterial vascular pedicle in the superior portion of the nasal septum, around the middle turbinate axilla projection, frequently has been observed. That vascular pedicle was named the S-point.ObjectiveThe aim of this study was to describe the S-point and report cases of severe epistaxis originating from it.MethodsA retrospective case series study was conducted. Nine patients with spontaneous severe epistaxis, where the S-point was identified as the source of bleeding, were treated between March 2016 and March 2017.ResultsMale predominance (77.8%) with age average of 59.3 years old were reported. Most cases presented comorbidities (88.9%) and were not taking acetylsalicylic acid (66.7%). A predominance of left sided involvement (55.6%) anteroposterior bleeding being the principal initial presentation (77.8%) was seen. Six patients (66.7%) presented with hemoglobin levels below 10g/dL, and four (44.4%) required blood transfusion. Cauterization of S-point was performed in all patients, with complete resolution of bleeding. No patient experienced recurrence of severe epistaxis.ConclusionThe S-point, a novel source of spontaneous severe epistaxis, is reported, and its cauterization was effective and safe. Otolaryngologists must actively seek this site of bleeding in cases of severe epistaxis.

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Pictorial atlas of symptomatic accessory ossicles by 18F-Sodium Fluoride (NaF) PET-CT.

Pictorial atlas of symptomatic accessory ossicles by 18F-Sodium Fluoride (NaF) PET-CT.

Am J Nucl Med Mol Imaging. 2017;7(6):275-282

Authors: Usmani S, Sit C, Gnanasegaran G, den Wyngaert TV, Marafi F

Abstract
Accessory ossicles are developmental variants which are often asymptomatic. When incidentally picked up on imaging, they are often inconsequential and rarely a cause for concern. However, they may cause pain or discomfort due to trauma, altered stress, and over-activity. Nuclear scintigraphy may play a role in the diagnosis and localizing pain generators. 18F-Sodium Fluoride (NaF) is a PET imaging agent used in bone imaging. Although commonly used in imaging patients with cancer imaging malignancy, 18F-NaF may be useful in the evaluation of benign bone and joint conditions. In this article, we would like to present a spectrum of clinical cases and review the potential diagnostic utility of 18F-NaF in the assessment of symptomatic accessory ossicles in patients referred for staging cancers.

PMID: 29348982 [PubMed]

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The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis.

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis.

Am J Nucl Med Mol Imaging. 2017;7(6):255-262

Authors: Vensby PH, Schmidt G, Kjær A, Fischer BM

Abstract
The incidence of melanoma (MM) is among the fastest rising cancers in the western countries. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. However, research on the value of PET/CT in follow-up of melanoma patients is limited. This study assesses the diagnostic value of PET/CT for follow-up after melanoma surgery. This retrospective study includes patients with MM who performed at least one PET/CT scan after initial surgery and staging. PET/CT findings were compared to histology, MRI or fine needle aspiration (FNA) to estimate the diagnostic accuracy. The diagnostic performance of PET/CT performed in patients with and without a clinical suspicion of relapse was compared. 238 patients (526 scans) were included. Of the 526 scans 130 (25%) scans were PET-positive, 365 (69%) PET-negative, and 28 (5%) had equivocal findings. Sensitivity was 89% [0.82-0.94], specificity 92% [0.89-0.95], positive and negative predictive values of 78% [0.70-0.84] and 97% [0.94-0.98] respectively. When stratified for reason of referral there was no statistical significant difference in the diagnostic accuracy of PET/CT between patients referred with or without a clinical suspicion of relapse. This study demonstrates that PET/CT despite a moderate sensitivity has a high negative predictive value in the follow-up of melanoma patients. Thus, a negative PET/CT-scan essentially rules out relapse. However, the frequency of false positive findings is relatively high, especially among patients undergoing a "routine" PET/CT with no clinical suspicion of relapse, potentially causing anxiety and leading to further diagnostic procedures.

PMID: 29348980 [PubMed]

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Sparse domain approaches in dynamic SPECT imaging with high-performance computing.

Sparse domain approaches in dynamic SPECT imaging with high-performance computing.

Am J Nucl Med Mol Imaging. 2017;7(6):283-294

Authors: Pan H, Chang H, Mitra D, Gullberg GT, Seo Y

Abstract
Iterative reconstruction algorithms often have relatively large computation time affecting their clinical deployment. This is especially true for 4D reconstruction in dynamic imaging (DI). In this work, we have shown how sparse domain approaches and parallelization for static 3D image reconstruction and 4D dynamic image reconstruction (directly from sinogram) in Single Photon Emission Computed Tomography (SPECT), without any intermediate 3D reconstructions, can improve computational efficiency. DI in SPECT is one of the hardest inverse problems in medical image reconstruction area and slow reconstruction is a challenge for this promising protocol. Our work hopefully, paves a new direction toward making DI in SPECT clinically viable. Our 4D reconstruction also is a novel application of non-negative matrix factorization (NNMF) in an inverse problem.

PMID: 29348983 [PubMed]

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Development of a clinically feasible [11C]PE2I PET method for differential diagnosis of parkinsonism using reduced scan duration and automated reference region extraction.

Development of a clinically feasible [11C]PE2I PET method for differential diagnosis of parkinsonism using reduced scan duration and automated reference region extraction.

Am J Nucl Med Mol Imaging. 2017;7(6):263-274

Authors: Jonasson M, Appel L, Danfors T, Nyholm D, Askmark H, Frick A, Engman J, Furmark T, Sörensen J, Lubberink M

Abstract
[11C]PE2I is a highly selective dopamine transporter PET ligand. Parametric images based on dynamic [11C]PE2I scans, showing dopamine transporter availability (BPND) and relative cerebral blood flow (R1), can be used in differential diagnosis of parkinsonism. This work aimed to investigate a shortened scan duration and automated generation of parametric images which are two prerequisites for routine clinical application. Twelve subjects with parkinsonism and seventeen healthy controls underwent 80 min dynamic [11C]PE2I PET scans. BPND and R1 images were generated using cerebellum reference region defined on a co-registered MRI, as well as a supervised cluster analysis (SVCA)-based reference. Initial 20, 30 and 40 min of the scans were extracted and images of standardized uptake value ratio (SUVR) and R1 were computed using MRI- and SVCA-based reference. Correlation was high between striatal 80 min MRI-based BPND and 40 min SVCA-based SUVR-1 (R2=0.95). High correlation was also found between R1 values in striatal and limbic regions (R2≥0.91) whereas correlation was moderate for cortical regions (R2=0.71). The results indicate that dynamic [11C]PE2I scans can be restricted to 40 min and that SVCA can be used for automatic extraction of a reference region. These outcomes will support routine applications of [11C]PE2I PET in clinical settings.

PMID: 29348981 [PubMed]

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Simplified estimation of binding parameters based on image-derived reference tissue models for dopamine transporter bindings in non-human primates using [18F]FE-PE2I and PET.

Simplified estimation of binding parameters based on image-derived reference tissue models for dopamine transporter bindings in non-human primates using [18F]FE-PE2I and PET.

Am J Nucl Med Mol Imaging. 2017;7(6):246-254

Authors: Odano I, Varrone A, Hosoya T, Sakaguchi K, Gulyás B, Padmanabhan P, Ghosh KK, Yang CT, Guenther I, Wang Z, Serrano R, Chimon NG, Halldin C

Abstract
The aim of this study on dopamine transporter binding by [18F]FE-PE2I and PET was to describe an image-derived approach using reference tissue models: the Logan DVR approach and simplified reference tissue model (SRTM), the features of which were simple to operate and precise in the measurements. Using the approach, the authors sought to obtain binding images and parameters. [18F]FE-PE2I and dynamic PET as well as an MRI was performed on three rhesus monkeys, and metabolite corrected arterial plasma inputs were obtained. After co-registering of PET to MR images, both image sets were resliced. The time-activity curve of the cerebellum was used as indirect input, and binding parametric images were computed voxel-by-voxel. Voxel-wise linear calculations were used for the Logan DVR approach, and nonlinear least squares fittings for the SRTM. To determine the best linear regression in the Logan DVR approach, the distribution volume ratio was obtained using the optimal starting frame analysis. The obtained binding parameters were compared with those obtained by the other independent ROI-based numerical approaches: two-tissue compartment model (2TCM), Logan DVR approach and SRTM using PMOD software. Binding potentials (BP) obtained by the present approach agreed well with those obtained by ROI-based numerical approaches, although reference tissue models tended to underestimate the BP value than 2TCM. Image-derived Logan approach provided a low-noise image, the computation time was short, and the error in the optimal starting frame analysis was small. The present approach provides a high-quality binding parametric image and reliable parameter value easily.

PMID: 29348979 [PubMed]

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Biochemical properties, antibacterial and cellular antioxidant activities of buckwheat honey in comparison to manuka honey

Publication date: 30 June 2018
Source:Food Chemistry, Volume 252
Author(s): Jianling Deng, Rui Liu, Qun Lu, Peiyan Hao, Anqi Xu, Jiuliang Zhang, Jun Tan
The biochemical properties of buckwheat honey, including contents of sugars, proteins, total phenols, methylglyoxal (MGO), minerals and phenolic compounds, were determined in comparison with those of manuka honey. Buckwheat honey has higher contents of sugars, proteins and total phenols but a lower content of MGO than manuka honey. Buckwheat honey contains abundant minerals involved in a number of vital functions of the human body as does manuka honey, and has even higher contents of Fe, Mn and Zn. In buckwheat honey, p-hydroxybenzoic acid, chlorogenic acid and p-coumaric acid are the dominant phenolic compounds. Moreover, the antibacterial and cellular antioxidant activities of buckwheat honey were compared with those of manuka honey. Buckwheat honey exhibits antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa, comparable with manuka honey, and the cellular antioxidant activity of buckwheat honey is higher than that of manuka honey. Our results suggest that buckwheat honey has great nutritional and commercial potentials.

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Intratidal Analysis of Intraoperative Respiratory System Mechanics: Keep it Simple

No abstract available

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Alkalinized Lidocaine Preloaded Endotracheal Tube Cuffs Reduce Emergence Cough After Brief Surgery: A Prospective Randomized Trial

BACKGROUND: Alkalinized lidocaine in the endotracheal tube (ETT) cuff decreases the incidence of cough and throat pain on emergence after surgery lasting more than 2 hours. However, alkalinized lidocaine needs 60–120 minutes to cross the ETT cuff membrane; therefore, its usefulness in shorter duration surgery is unknown. This prospective double-blind randomized controlled trial tested the hypothesis that alkalinized lidocaine would reduce the incidence of emergence cough after surgeries lasting 90 minutes before intubation with either 2 mL of 2% lidocaine and 8 mL of 8.4% bicarbonate (group AL) or 10 mL of normal saline (group S). Cuffs were emptied immediately before intubation. After intubation, either 2 mL of 2% lidocaine (AL) or 2 mL of saline (S) were injected into the cuff. Additional 8.4% bicarbonate (AL) or saline (S) was injected into the cuff until there was no air leak. Anesthesia was maintained using desflurane, rocuronium, and either fentanyl or sufentanil to maintain vital signs within 20% of baseline values. Opioids administered in prophylaxis of extubation cough were proscribed. A standardized "no touch" emergence technique was used. A blinded assessor noted any cough above 0.2 minimum alveolar concentration (MAC) of expired desflurane. At 0.2 MAC, once every 30 seconds, the patient was instructed to open his eyes and extubation occurred once a directed response was noted. RESULTS: A total of 213 patients were randomized and 100 patients in each group completed the experimental protocol. The incidence of extubation cough in group AL was 12%, significantly lower (1-sided P = .045) than the 22% incidence in group S. The 1-tailed risk ratio for cough in group AL was 0.55 (0–0.94, P = .045). Total amount of opioids administered (P = .194), ETT cuff preloading times (P = .259), and extubation times (P = .331) were not significantly different between groups. The average duration of surgery was 59 ± 28 minutes in group AL and 52 ± 29 minutes in group S (P = .057). CONCLUSIONS: Alkalinized lidocaine in the ETT cuff significantly decreased general anesthesia emergence cough after surgeries with an average duration of slightly

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“Mirror, Mirror on the Wall”: Learning From Reflections on Quality

No abstract available

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Sugammadex and Oral Contraceptives: Is It Time for a Revision of the Anesthesia Informed Consent?

No abstract available

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Pediatric Anesthesiology Fellows’ Perception of Quality of Attending Supervision and Medical Errors

BACKGROUND: Appropriate supervision has been shown to reduce medical errors in anesthesiology residents and other trainees across various specialties. Nonetheless, supervision of pediatric anesthesiology fellows has yet to be evaluated. The main objective of this survey investigation was to evaluate supervision of pediatric anesthesiology fellows in the United States. We hypothesized that there was an indirect association between perceived quality of faculty supervision of pediatric anesthesiology fellow trainees and the frequency of medical errors reported. METHODS: A survey of pediatric fellows from 53 pediatric anesthesiology fellowship programs in the United States was performed. The primary outcome was the frequency of self-reported errors by fellows, and the primary independent variable was supervision scores. Questions also assessed barriers for effective faculty supervision. RESULTS: One hundred seventy-six pediatric anesthesiology fellows were invited to participate, and 104 (59%) responded to the survey. Nine of 103 (9%, 95% confidence interval [CI], 4%–16%) respondents reported performing procedures, on >1 occasion, for which they were not properly trained for. Thirteen of 101 (13%, 95% CI, 7%–21%) reported making >1 mistake with negative consequence to patients, and 23 of 104 (22%, 95% CI, 15%–31%) reported >1 medication error in the last year. There were no differences in median (interquartile range) supervision scores between fellows who reported >1 medication error compared to those reporting ≤1 errors (3.4 [3.0–3.7] vs 3.4 [3.1–3.7]; median difference, 0; 99% CI, −0.3 to 0.3; P = .96). Similarly, there were no differences in those who reported >1 mistake with negative patient consequences, 3.3 (3.0–3.7), compared with those who did not report mistakes with negative patient consequences (3.4 [3.3–3.7]; median difference, 0.1; 99% CI, −0.2 to 0.6; P = .35). CONCLUSIONS: We detected a high rate of self-reported medication errors in pediatric anesthesiology fellows in the United States. Interestingly, fellows' perception of quality of faculty supervision was not associated with the frequency of reported errors. The current results with a narrow CI suggest the need to evaluate other potential factors that can be associated with the high frequency of reported errors by pediatric fellows (eg, fatigue, burnout). The identification of factors that lead to medical errors by pediatric anesthesiology fellows should be a main research priority to improve both trainee education and best practices of pediatric anesthesia.

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Ischemic Preconditioning and the Role of Antifibrinolytic Drugs: Translation From Bench to Bedside

No abstract available

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Emergency General Surgery: Time for Anesthesiology and Surgery to Work Together to Drive Improvement in Outcomes

No abstract available

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Developing Reflective Practice: A Guide for Medical Students, Doctors, and Teachers

No abstract available

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Not All Calcium Formulations Are Alike

No abstract available

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“That’s Not What I Said”: Seeking Fidelity in Citations

No abstract available

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Disparities in Anesthesia Care

No abstract available

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Informed Consent and Cognitive Dysfunction After Noncardiac Surgery in the Elderly

Cognitive dysfunction 3 months after noncardiac surgery in the elderly satisfies informed consent thresholds of foreseeability in 10%–15% of patients, and materiality with new deficits observed in memory and executive function in patients with normal test performance beforehand. At present, the only safety step to avoid cognitive dysfunction after surgery is to forego surgery, thereby precluding the benefits of surgery with removal of pain and inflammation, and resumption of normal nutrition, physical activity, and sleep. To assure that consent for surgery is properly informed, risks of both cognitive dysfunction and alternative management strategies must be discussed with patients by the surgery team before a procedure is scheduled.

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Low-dose ethanol excites lateral habenula neurons projecting to VTA, RMTg, and raphe.

Low-dose ethanol excites lateral habenula neurons projecting to VTA, RMTg, and raphe.

Int J Physiol Pathophysiol Pharmacol. 2017;9(6):217-230

Authors: Fu R, Mei Q, Zuo W, Li J, Gregor D, Bekker A, Ye J

Abstract
It is unclear how social drinking can contribute to the development of addiction in susceptible individuals. However, alcohol's aversive properties are a well-known factor contributing to its abuse. The lateral habenula (LHb) is a key brain structure responding to various aversive stimuli, including those related to alcohol. We recently reported that ethanol at 10 mM or less that can be achieved by social drinking activates many LHb neurons and drives aversive conditioning. The current study sought to identify LHb circuits that are activated by a low-dose of ethanol using immunohistochemistry and anatomic tracing techniques on adult Sprague-Dawley rats. We showed here that an intraperitoneal injection of ethanol (0.25 g/kg), resulting in a blood ethanol concentration of 5.6 mM, significantly increased the number of cFos immunoreactive (IR) neurons in the LHb. Most of the ethanol-activated cFos-IR LHb neurons expressed vGluT2 (vesicular glutamate transporters 2, a marker of a glutamatergic phenotype). These LHb neurons projected to the ventral tegmental area (VTA), rostromedial tegmental nucleus (RMTg), and dorsal raphe. Moreover, injections of the anterograde tracer AAV-CaMKIIa-eGFP into the lateral hypothalamus produced a significant amount of labeled fibers with vGluT2 positive terminals on the ethanol-activated LHb cells. These results indicate that the LHb neurons stimulated by a low-dose of ethanol project to the VTA, RMTg, and dorsal raphe, and receive excitatory projections from the lateral hypothalamus. These neurocircuits may play a crucial role in mediating the initial aversive effects produced by a low-dose of ethanol.

PMID: 29348799 [PubMed]

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TRPM7 is a unique target for therapeutic intervention of stroke.

TRPM7 is a unique target for therapeutic intervention of stroke.

Int J Physiol Pathophysiol Pharmacol. 2017;9(6):211-216

Authors: Lin J, Xiong ZG

Abstract
Ischemic stroke is a leading cause of death and long-term disabilities. The current therapy is limited to thrombolysis and mechanical recanalization, which have limited success. A better understanding of the mechanisms underlying ischemic brain injury is therefore needed for the development of more effective interventions. Glutamate receptor-mediated Ca2+ overload and neurotoxicity have been well established for decades. However, clinical trials failed to show a satisfactory effect with the antagonists of glutamate receptors. Other glutamate-independent mechanisms, such as activation of acid-sensing ion channels and transient receptor potential melastatin 7 (TRPM7), have recently emerged as important events responsible for neuronal injury under ischemic conditions. In this review, we discuss how TRPM7 channels participate in ischemic brain injury.

PMID: 29348798 [PubMed]

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Experimentally-induced ventricular arrhythmias.

Experimentally-induced ventricular arrhythmias.

Int J Physiol Pathophysiol Pharmacol. 2017;9(6):202-210

Authors: Merrill GF

Abstract
Hypoxia and reoxygenation, ischemia and reperfusion, catecholamine infusion, ouabain, sodium pentobarbital and caffeine, can all be used experimentally to induce ventricular arrhythmias. According to the Lambeth Convention guidelines our experimentally-induced ventricular arrhythmias include but are not limited to: ventricular premature beats (VPB), ventricular salvos (VS), ventricular bigeminy (VB), nonsustained ventricular tachycardia (VTn), sustained ventricular tachycardia (VTs) and ventricular fibrillation (VF, or if the heart is not defibrillated, sudden cardiac death). We have studied these arrhythmias in the absence and presence of adenosine deaminase, methyl xanthines, and more recently, acetaminophen. Our laboratory was the first to discover the anti-arrhythmic properties of acetaminophen an analgesic used in Western medicine for more than 100 years before our publication. We have also identified other cardioprotective properties of acetaminophen, and have begun to work out some of the cellular/molecular mechanisms. For example, we know that acetaminophen protects hypoxic/ischemic cardiac mitochondria, in part, by sustaining function of the mitochondrial permeability transition pore (MPTP, a protein involved in regulating mitochondrial pH). Acetaminophen also attenuates the actions of matrix metalloproteinases that can be harmful to myocardial contractile proteins. Of course, like all science, more work is needed to expand on these and related topics.

PMID: 29348797 [PubMed]

http://ift.tt/2mUI8Ij

Therapeutic angiogenesis of exosomes for ischemic stroke.

Therapeutic angiogenesis of exosomes for ischemic stroke.

Int J Physiol Pathophysiol Pharmacol. 2017;9(6):188-191

Authors: Manuel GE, Johnson T, Liu D

Abstract
Angiogenesis is the process through which new blood vessels are formed, while therapeutic angiogenesis aims to promote and control the angiogenic response. Ischemia results from the lack of blood flow with oxygen and nutrients. Therapeutic angiogenesis is crucial in preserving brain tissue and bodily functions after ischemic stroke. Various approaches have been proposed to promote angiogenesis in ischemic diseases. Traditional protein/gene and subsequent stem/progenitor cell approaches have not shown consistent efficacy for ischemic diseases in clinical trials. Exosomes are microparticles secreted from cells and conduct cell-cell communication including stem cell or cancer cell induced pro-angiogenesis. Utilization of exogenous exosomes for the treatment of ischemic diseases is an emerging approach which may prevent certain disadvantages such as easy degradation and tumor formation happened in other strategies. This review highlights recent reports on the use of exosomes as a therapeutic agent to promote angiogenesis in ischemic stroke.

PMID: 29348795 [PubMed]

http://ift.tt/2mSlAYB

Tubby-like protein 1 (Tulp1) is a target of microRNA-134 and is down-regulated in experimental epilepsy.

Tubby-like protein 1 (Tulp1) is a target of microRNA-134 and is down-regulated in experimental epilepsy.

Int J Physiol Pathophysiol Pharmacol. 2017;9(6):178-187

Authors: Rodriguez AS, Engel T, Palfi A, Farrar GJ, Henshall DC, Jimenez-Mateos EM

Abstract
MicroRNAs are important determinants of gene expression via post-transcriptional control of the protein levels of their mRNA targets. MicroRNA-134 (miR-134) has emerged as an important brain-specific microRNA which has been implicated in the control of dendritic spine morphology, neuronal differentiation and apoptosis. Here we show that Tubby-like protein 1 (Tulp1) is a target of miR-134. Tulp1 protein showed a similar cellular distribution pattern in the hippocampus to miR-134 and displayed an inverse expression pattern in the mouse retina. Bioinformatics analyses identified a conserved miR-134 binding site in the 3' untranslated region of both mouse and human Tulp1 and luciferase reporter assays confirmed miR-134 targets Tulp1 in vitro. Induction of prolonged seizures in mice resulted in upregulation of miR-134 and downregulation of protein levels of Tulp1 which were reversed in animals injected with locked nucleic acid-modified antagomirs targeting miR-134. Finally, knockdown of Tulp1 in human neurons caused an increase in vulnerability to excitotoxicity. These data identify Tulp1/TULP1 as a novel target of miR-134, which may contribute to underlying pathomechanisms in epilepsy.

PMID: 29348794 [PubMed]

http://ift.tt/2EYZxHm

Inflammasome in drug abuse.

Inflammasome in drug abuse.

Int J Physiol Pathophysiol Pharmacol. 2017;9(6):165-177

Authors: Xu E, Liu J, Wang X, Xiong H

Abstract
Drug abuse disorders refer to a set of related negative health implications associated with compulsive drug seeking and use. Because almost all addictive drugs act on the brain, many of them cause neurological impairments after long-term abuse. Neuropathological studies have revealed a widespread impairment of the cellular elements. As the key components to limit the damage of neural cells, CNS immune system is also found affected by these drugs, directly or indirectly. It has been shown that drugs of abuse alter neuroimmune gene expression and signaling. Growing studies on neuroimmune factors further demonstrate their indispensable role in drugs-induced neurotoxicity. As an important proinflammatory intracellular receptor, inflammasome is activated in many neurodegenerative diseases in response to a broad range of damage-associated molecular patterns (DAMPs) signals. In the cases of drug abuse, especially in those with comorbid of HIV infection and sustained pain, inflammasome activation significantly promotes the neuroinflammation-associated toxicities. To understand inflammasome in drug-associated neurotoxic activity, we reviewed the role played by inflammasome in drug abuse-induced microglial neurotoxicity and evaluated the potential of imflammasone as a therapeutic target for drug abuse disorders based on recent development of various selective small-molecular inflammasome inhibitors.

PMID: 29348793 [PubMed]

http://ift.tt/2G0hQx1

Sparse domain approaches in dynamic SPECT imaging with high-performance computing.

Sparse domain approaches in dynamic SPECT imaging with high-performance computing.

Am J Nucl Med Mol Imaging. 2017;7(6):283-294

Authors: Pan H, Chang H, Mitra D, Gullberg GT, Seo Y

PMID: 29348983 [PubMed]

http://ift.tt/2Dn0Qzs

Pictorial atlas of symptomatic accessory ossicles by 18F-Sodium Fluoride (NaF) PET-CT.

Pictorial atlas of symptomatic accessory ossicles by 18F-Sodium Fluoride (NaF) PET-CT.

Am J Nucl Med Mol Imaging. 2017;7(6):275-282

Authors: Usmani S, Sit C, Gnanasegaran G, den Wyngaert TV, Marafi F

PMID: 29348982 [PubMed]

http://ift.tt/2DWkvY8

Development of a clinically feasible [11C]PE2I PET method for differential diagnosis of parkinsonism using reduced scan duration and automated reference region extraction.

Development of a clinically feasible [11C]PE2I PET method for differential diagnosis of parkinsonism using reduced scan duration and automated reference region extraction.

Am J Nucl Med Mol Imaging. 2017;7(6):263-274

Authors: Jonasson M, Appel L, Danfors T, Nyholm D, Askmark H, Frick A, Engman J, Furmark T, Sörensen J, Lubberink M

PMID: 29348981 [PubMed]

http://ift.tt/2DlTn3I

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis.

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis.

Am J Nucl Med Mol Imaging. 2017;7(6):255-262

Authors: Vensby PH, Schmidt G, Kjær A, Fischer BM

PMID: 29348980 [PubMed]

http://ift.tt/2F0n0YJ

Simplified estimation of binding parameters based on image-derived reference tissue models for dopamine transporter bindings in non-human primates using [18F]FE-PE2I and PET.

Simplified estimation of binding parameters based on image-derived reference tissue models for dopamine transporter bindings in non-human primates using [18F]FE-PE2I and PET.

Am J Nucl Med Mol Imaging. 2017;7(6):246-254

Authors: Odano I, Varrone A, Hosoya T, Sakaguchi K, Gulyás B, Padmanabhan P, Ghosh KK, Yang CT, Guenther I, Wang Z, Serrano R, Chimon NG, Halldin C

PMID: 29348979 [PubMed]

http://ift.tt/2DUWXD0

Caspase-3/MAPK pathways as main regulators of the apoptotic effect of the phyto-mediated synthesized silver nanoparticle from dried stem of Eleutherococcus senticosus in human cancer cells

Publication date: March 2018
Source:Biomedicine & Pharmacotherapy, Volume 99
Author(s): Chun Gon Kim, Verónica Castro-Aceituno, Ragavendran Abbai, Hyun A. Lee, Shakina Yesmin Simu, Yaxi Han, Joon Hurh, Yeon-Ju Kim, Deok Chun Yang
Siberian ginseng (Eleutherococcus senticosus) was used for the synthesis of an ecofriendly silver nanoparticle (Sg-AgNP), which has exhibited antibacterial, antioxidant effect and lower cytotoxicity to normal cells in comparison to human cancer cells. Although, the potential anticancer activity of Sg-AgNP has not been determined. In this study, two cancer cell lines were used to evaluate the cytotoxicity and apoptotic effect of Sg-AgNP along with the determination of the role of the Caspase-3 / p38 MAPK pathways. Results shown that Sg-AgNP reduced the cell viability of colon cancer cells HT29 and lung cancer cells A549. The cytotoxic effect was higher than the effect exhibited by a commercial silver nanoparticle and Cisplatin. Reactive oxygen species were observed to be superior in both cell lines in the presence of Sg-AgNPs than c-AgNPs and Cisplatin. It was observed an activation of MAPK14 gene and phosphorylation of p38 MAPK protein in both cell lines induced by Sg-AgNPs treatment. Furthermore, induction of morphological changes in the nucleus was done by Sg-AgNPs at 10 μg/mL in both cell lines. On the other hands, the activation of CASP3 gene and Caspase-3 protein was observed in HT29 cells but only at protein level in A549 cells. These results, suggest that Sg-AgNPs anticancer potential activity might be linked to the induction of apoptosis though the generation of ROS by activation of the Caspase-3/p38 MAPK pathway.

http://ift.tt/2n1LwlN

Astragaloside IV inhibits cell migration and viability of hepatocellular carcinoma cells via suppressing long noncoding RNA ATB

Publication date: March 2018
Source:Biomedicine & Pharmacotherapy, Volume 99
Author(s): Yaling Li, Yun Ye, Hongyan Chen
Astragaloside IV (AS-IV), the major active component of Astragalus membranaceus, has shown attractive anticancer effects in certain cancers. However, the roles and action mechanisms of AS-IV in hepatocellular carcinoma (HCC) are largely unclear. Long noncoding RNAs (lncRNAs) are recently revealed to have crucial roles in HCC initiation and progression, but whether lncRNAs participate in the anticancer roles of AS-IV are unknown. In this study, we demonstrated that AS-IV significantly downregulated lncRNA-ATB expression in a dose- and time-dependent manner in HCC cells. Through downregulating lncRNA-ATB, AS-IV repressed epithelial-mesenchymal transition (EMT) and migration of HCC cells. Furthermore, through downregulating lncRNA-ATB, AS-IV inactivated IL-11/STAT3 signaling, induced HCC cell apoptosis, and decreased HCC cell viability. Overexpression of lncRNA-ATB reversed the effects of AS-IV on HCC cell migration, EMT, cell apoptosis, cell viability, and IL-11/STAT3 signaling. Taken together, our results showed that AS-IV inhibited migration and cell viability of HCC cells via downregulating lncRNA-ATB. Thus, our data provided a novel molecular basis for the applications of AS-IV in the therapy of HCC.

http://ift.tt/2BfnoA5

Prevention of articular cartilage degeneration in a rat model of monosodium iodoacetate induced osteoarthritis by oral treatment with Withaferin A

Publication date: March 2018
Source:Biomedicine & Pharmacotherapy, Volume 99
Author(s): Dharmendra Choudhary, Sulekha Adhikary, Naseer Ahmad, Priyanka Kothari, Ashwni Verma, Prabodh Kumar Trivedi, Prabhat Ranjan Mishra, Ritu Trivedi
Withaferin A (WFA), a highly oxygenated withanolide is used for anti-osteoporotic, fracture healing, obesity control as medicine and dietary supplement in Ayurveda and Unani medicine but its potential remains to be investigate for the osteoarthritis studies. In the present study, chondro-protective effects of WFA, under in vitro and in vivo conditions were evaluated. In-vitro pharmacological activity of WFA was tested on rat articular chondrocytes through MTT, DPPH, different staining, FACS and translation studies. In-vivo studies of WFA were evaluated through monosodium iodoacetate (MIA) induced osteoarthritis studies. DPPH assay, alcian blue and toluidine blue staining indicated the chondrogenic potential of WFA. Similarly, WFA enhance chondrogenesis through up-regulation of SOX9 protein. In addition, WFA reduced the ROS generation, mitochondrial depolarization and apoptosis induced by inflammatory cytokines IL-1β and TNF-α. Furthermore, WFA treatment in MIA treated rats alleviated cartilage erosion and improvement in sub-chondral bone micro-architecture by decrease in Tissue volume (∼32%), and trabecular bone pattern factor (∼28%). Taken together, our study provides convincing evidence for the candidature of WFA (10 mg kg⁻¹ day⁻¹) as a potential agent for the treatment of cartilage degenerative diseases like osteoarthritis.

Graphical abstract

http://ift.tt/2mXu6X8

Suppression of Capn4 by microRNA-1271 impedes the proliferation and invasion of colorectal cancer cells

Publication date: March 2018
Source:Biomedicine & Pharmacotherapy, Volume 99
Author(s): Jibin Li, Jian Xu, Xiaofei Yan, Keer Jin, Wenya Li, Rui Zhang
Accumulating evidence has suggested that calpain small subunit 1 (Capn4) plays an important role in the development and progression of malignant tumors. However, little is known about the role of Capn4 in colorectal cancer (CRC). In this study, we aimed to investigate the potential role of Capn4 in CRC and the regulation of Capn4 by microRNAs (miRNAs). Here, we found that Capn4 expression was highly up-regulated in CRC cell lines. Knockdown of Capn4 by siRNA significantly inhibited the proliferation and invasion of CRC cell lines. Furthermore, knockdown of Capn4 suppressed Wnt signaling in CRC cells. Interestingly, Capn4 was found to be a target gene of miR-1271, a tumor suppressive miRNA. The results showed that miR-1271 negatively regulated Capn4 expression in CRC cells. An inverse correlation between miR-1271 and Capn4 was also shown in CRC clinical tissues. Moreover, the overexpression of miR-1271 suppressed the proliferation, invasion and Wnt signaling of CRC cells. Importantly, we found that the restoration of Capn4 expression significantly reversed the antitumor effects of miR-1271 in CRC cells. Overall, these results suggest that miR-1271 inhibits the proliferation and invasion of CRC cells by down-regulating Capn4. Our study suggests that Capn4 and miR-1271 may serve as potential therapeutic targets for the treatment of CRC.

http://ift.tt/2Bi97m9

Inhibition of isoprenylcysteine carboxylmethyltransferase sensitizes common chemotherapies in cervical cancer via Ras-dependent pathway

Publication date: March 2018
Source:Biomedicine & Pharmacotherapy, Volume 99
Author(s): Qin Pan, Rong Liu, Hasina Banu, Liang Ma, Hui Li
Isoprenylcysteine carboxylmethyltransferase (Icmt) catalyzes the last step of post-translational protein prenylation, which is essential for the stability and proper functions of many oncogenic proteins, such as Ras. Despite extensive studies on the roles of Icmt in tumor transformation and progression, little is known on the involvement ofIcmt in the development of tumor resistance to chemotherapy. Here we show the upregulation of Icmt as a persistent response to chemotherapy in cervical cancer cells. In-depth functional analysis demonstrated that Icmt inhibition significantly inhibited growth, induced apoptosis and augmented the inhibitory effects of chemotherapy drugs in cervical cancer in cell culture system and xenograft mouse model. Importantly, combination of Icmt specific inhibitor cysmethynil with doxorubicin or paclitaxel at sublethal concentration achieved almost full inhibition of tumor cell growth and survival. The remarkable synergy between chemotherapy drugs and Icmt inhibition in cervical cancer cells is likely due to the additional suppression of Ras and its downstream signaling pathways. We are the first to demonstrate the contribution of Icmt in tumor cells in response to chemotherapy. Our work also highlights Icmt inhibition as a sensitizing strategy for the treatment of cervical cancer or other Ras-driven tumors.

http://ift.tt/2mXLk6R

An immunohistochemical analysis of folate receptor beta expression and distribution in giant cell arteritis - a pilot study.

An immunohistochemical analysis of folate receptor beta expression and distribution in giant cell arteritis - a pilot study.

Am J Clin Exp Immunol. 2017;6(6):107-114

Authors: Albano-Aluquin S, Malysz J, Aluquin VR, Ratnam M, Olsen N

Abstract
BACKGROUND: Giant cell arteritis (GCA) is a chronic vasculitis of large and medium vessels in which no targetable biomarkers exist to allow selective treatment, predict disease activity and monitor therapeutic responses. The accessibility of the temporal artery (TA) for biopsy allows morphologic studies to characterize macrophages and T cells in the microenvironment of the arterial wall. We evaluated the expression of folate receptor beta (FRB), a candidate diagnostic/therapeutic biomarker, compared its expression with key macrophage markers and correlated it with GCA severity.
METHODS: Formalin-fixed paraffin-embedded tissue sections were examined from 6 patients with GCA and 2 controls. Immunohistochemistry was performed using FRB, ETB, CD68 and CD3 antibodies to evaluate for activated macrophages and T cells, assess FRB distribution along the intima, media and adventitial layers and composition of inflammatory infiltrates. We compared the expression of FRB, ETB and CD68 in GCA versus negative controls and in severe (with visual loss) versus mild (without visual loss) disease.
RESULTS: In GCA, moderate to severe inflammation was accompanied by >90% destruction of the internal elastic lamina. Macrophages comprised 36.3 ± 4.1% while CD3+ lymphocytes accounted for 61.7 ± 4.1% of total leukocytes. FRB was selectively expressed in macrophages and localized to the adventitia. GCA patients had marginally increased median FRB (9.8 cells/hpf vs. 0; p=0.095), ETB (20.5 vs. 0; p=0.095) and CD68 (38.8 vs. 5; p=0.071) expression versus controls. ETB was found in endothelial cells, smooth muscle cells and macrophages in intima/media. FRB positively correlated with ETB (r=0.90; p-0.037) and CD68 levels (r=0.90; p=0.037). ETB expression positively correlated with CD68 (r=1.0; p<0.0001). There was no difference in FRB between severe and mild GCA.
CONCLUSION: FRB is a potential diagnostic and therapeutic biomarker with restricted expression in GCA macrophages. FRB+ macrophages localized to the adventitia and their expression correlated with ETB and CD68 macrophages, suggesting that they contribute to GCA pathogenesis.

PMID: 29348986 [PubMed]

http://ift.tt/2DrYgMr

The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.

The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.

Am J Clin Exp Immunol. 2017;6(6):97-106

Authors: Zhang Q, Zhou J, Wang Y, Chen D

Abstract
The Background: Diacerein has been proposed as a treatment option for management of type 2 diabetes due to its anti-inflammatory properties.
PURPOSE: The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to examine the effect and safety of diacerein in patients with type 2 diabetes.
DATA SOURCES AND STUDY SELECTION: We searched Pubmed, Embase, and Cochrane Library for RCTs published from database inception to September 2017.
DATA EXTRACTION AND DATA SYNTHESIS: Among 44 studies that were initially identified, four were eligible and were included in the following analysis. Diacerein significantly reduced fasting glycemia [weighted mean differences (WMD) -0.66, 95% confidence interval (95% CI) -1.16 to -0.16] and glycated hemoglobin A1c (HbA1c ) (WMD -0.85, 95% CI -1.44 to -0.26). And the patients with a diacerein supplementation duration of ≤12 weeks had a greater decrease of fasting glycemia and HbA1c than the supplementation duration of >12 weeks. Furthermore, compared with placebo, diacerein revealed a significant increase in the relative risk (RR) of gastrointestinal symptoms (RR=2.50, 95% CI: 1.10 to 5.65), especially in the study subgroup with supplementation duration of >12 weeks (RR=4.01, 95% CI: 2.32 to 6.95).
LIMITATIONS: The sample size was relatively small and the duration of included studies was short so that the treatment efficacy and safety for longer duration was unknown.
CONCLUSIONS: Although further studies are needed, our findings clearly provide support to the use of diacerein in the clinical management of subjects with type 2 diabetes.

PMID: 29348985 [PubMed]

http://ift.tt/2mY5ygb

Human immune system during sleep.

Human immune system during sleep.

Am J Clin Exp Immunol. 2017;6(6):92-96

Authors: Asif N, Iqbal R, Nazir CF

Abstract
A joint function of tissues, organs and cells for the protection of body develops immune system. The human immune response against various infections during sleep, its mechanism, neuroimmune interactions, immunoregulatory effect of sleep along with sleep deprivation and role of cytokines in sleep deprivation were addressed. It is revealed that human immune system and sleep both are associated and influenced by each other. Sleep deprivation makes a living body susceptible to many infectious agents. In the result, immune system of human body is altered by releasing immunomodulators in the response of infections as reported by various researchers. Basic reasons and mechanisms of most of the poor sleep networks and release of proinflammatory modulators are still uncertain. The current situation requires improved sleep habits to make immune system efficient for a healthy life.

PMID: 29348984 [PubMed]

http://ift.tt/2DqWN9a

Patterns of age-specific socioeconomic inequalities in net survival for common cancers in Taiwan, a country with universal health coverage

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Li-Hsin Chien, Tzu-Jui Tseng, Fang-Yu Tsai, Jie-Huei Wang, Chao A. Hsiung, Tsang-Wu Liu, I-Shou Chang
IntroductionIn high-income countries, advances in early diagnosis and treatment have improved cancer survival. However, socioeconomic inequalities in survival have persisted or increased for some adult cancers.Materials and methodsWe assessed net survival for the 20 most common adult cancers in Taiwan. They were stratified into six age groups and three socioeconomic groups.ResultsOut of 120 cancer site and age group combinations, 49 showed improvements in 5-year net survival from 2000–2004 to 2005–2010. Only cervix uteri cancer in the 35–49-year age group showed a deterioration. During 2000–2010, 13 of the 20 cancer cases experienced socioeconomic inequalities for all age groups combined, and the deprivation gaps varied with cancer site and age at diagnosis. For the five most common cancers – liver, colon and rectum, lung, breast, and oral – there were socioeconomic inequalities, and 5-year net survival improved for most or all of the six age groups from 2000–2004 to 2005–2010.ConclusionReducing socioeconomic inequality in survival may lead to improvements in survival overall. We should focus on the age groups with large deprivation gaps. Our results are useful for prioritizing cancer sites and age groups for in-depth socioeconomic disparity studies and for proposing interventions for health disparity reductions and net cancer survival improvements.

http://ift.tt/2DrF2H4

Utility of a High-Resolution Superficial Diagnostic Ultrasound System for Assessing Skin Thickness: A Cross-Sectional Study

BACKGROUND Compared with other imaging modalities, ultrasound is relatively deeply penetrating and can be used to evaluate deep dermal and subcutaneous structures. OBJECTIVE Image skin thickness of the face and neck using high-frequency diagnostic ultrasound devices. MATERIALS AND METHODS Skin overlying 20 different predesignated face and neck anatomic sites in 32 individuals was imaged using 2 commercially available high-frequency diagnostic ultrasound devices, a dedicated imaging device and a diagnostic device bundled with a therapeutic device. At each site, the subcutaneous and combined epidermal and dermal layer thicknesses were assessed by blinded expert raters. RESULTS Similar skin thickness measurements were obtained. Notably, subcutaneous fat depth was measured to be 0.2 cm at the forehead; 0.5 cm at the mental eminence; and 0.6 cm at the submental, supraglenoid, and temporal regions. The combined epidermal and dermal thickness was approximately 0.1 cm at the zygomatic process, suborbital area, inferior malar region, gonion, supraglenoid area, and nasolabial-buccal, and nasolabial fold regions. CONCLUSION This is the first study using high-resolution superficial diagnostic ultrasound to map skin thickness of the face and neck at standard anatomic locations. Ultrasound is an inexpensive, noninvasive, and convenient means to monitor dermatologic conditions and guide their treatment. Address correspondence and reprint requests to: Murad Alam, MD, Department of Dermatology, 676 N. St. Clair Street, Suite 1600, Chicago, IL 60611, or e-mail: m-alam@northwestern.edu I.R. Makin is a research adviser to Ulthera-Merz and receives consultation fees for specific tasks. The remaining authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2DkOQ1q

Liming induces carbon dioxide (CO 2 ) emission in PSB inoculated alkaline soil supplemented with different phosphorus sources

Abstract

Agricultural land is a major sink of global organic carbon (C). Its suitable management is crucial for improving C sequestration and reducing soil CO₂ emission. Incubation experiments were performed to assess the impact of phosphate solubilizing bacterial (PSB) inoculation (inoculated and uninoculated) and soil calcification (4.78, 10, 15, and 20% crushed CaCO₃) with phosphorus (P) sources [single superphosphate (SSP), rock phosphate (RP), farm yard manure (FYM), and poultry manure (PM)] in experiment 1 and with various rates of PM (4, 8, and 12 kg ha⁻¹) in experiment 2 on cumulative soil respiration. These experiments were arranged in three factorial, complete randomize design (CRD) with three replications. Interactively, lime with P sources (at day 1 and 3) and lime with PSB (at day 1) significantly expedited soil respiration. Mainly, PSB inoculation, liming, PM fertilization, and its various rates significantly enhanced soil respiration with time over control/minimum in alkaline soil at all incubation periods. Higher CO₂ emission was detected in soil supplemented with organic P sources (PM and FYM) than mineral sources (SSP and RP). CO₂ emission was noted to increase with increasing PM content. Since liming intensified CO₂ discharge from soil, therefore addition of lime to an alkaline soil should be avoided; instead, integrated approaches must be adopted for P management in alkaline calcareous soils for climate-smart agriculture.

http://ift.tt/2mWOXsK

The effects of rainfall regimes and terracing on runoff and erosion in the Three Gorges area, China

Abstract

Changes in natural rainfall regimes have taken place and are expected to become more pronounced in future decades. These changes are also likely to be accompanied by changes in crop management practices. The main purpose of this study was to analyze runoff and soil loss in relation to rainfall regimes and terracing in the Three Gorges area, China. Based on 10 years of field observation and k-mean clusters, 101 rainfall events were grouped into three rainfall regimes. Rainfall regime I was the group of events with strong rainfall intensity, high frequency, and short duration. Rainfall regime III consisted of events with low intensity, long duration, and high rainfall amount. Rainfall regime II was the aggregation of events of high intensity and amount, and less frequent occurrence. The results showed that event runoff coefficients were not significantly different among rainfall regimes. However, the average soil erosion rates in rainfall regimes I and II were significantly higher than that in regime III. The average erosion rates under rainfall regimes I, II, and III were 21.6, 39.7, and 9.8 g m⁻², respectively. The effect of rainfall regime on soil erosion also was changed by terracing. On unterraced cropland, soil erosion rate in rainfall regime I is significantly higher than that in regime III. However, the situation did not exist in unterraced orchard. Terracing significantly reduced runoff and soil erosion, and compensated the effects of rainfall regime on soil erosion, which indicated that runoff and erosion in terraced system may be little influenced by climate change. Based on these results, it was suggested more attention should be paid to the timing of rainfall events in relation to crop development and the high erosion on unterraced citrus orchard to control soil erosion in this area.

http://ift.tt/2EW8EZq

In situ monitoring of the Sinos River, southern Brazil: water quality parameters, biomarkers, and metal bioaccumulation in fish

Abstract

The Sinos River is an important water supply in Southern Brazil and receives industrial, agricultural, and domestic effluents which may affect aquatic biota. Water physicochemical and microbiological analyses, biomarker responses (scaled mass index (SMI), gill histopathology, and micronucleus and nuclear abnormality (MN and NA) frequencies), and metal bioaccumulation in muscle were assessed in the fish species Bryconamericus iheringii (Characidae) captured at three sampling sites (S1, S2, and S3) in four sampling periods. The mean values of five parameters (total phosphorus, thermotolerant coliforms, aluminum, iron, and lead) exceeded the limits established by the Brazilian legislation at the three sampling sites. Although physicochemical analysis indicated higher impacts at S3, in some samples, significantly higher MN frequencies and bioaccumulation of manganese in fish muscle were observed at S1, whereas low SMI and higher concentrations of aluminum and zinc in fish muscle were found at S2. Histopathological alterations in gills were observed in fish collected at the three sampling sites; however, no spatial differences were observed, indicating similar environmental conditions with respect to this biomarker. Moreover, temporal variation of biomarker responses and metal bioaccumulation were found at all sampling sites. Furthermore, the consumption of fish from the Sinos River should be avoided given the concentrations of chromium (all samples), cadmium, and lead in fish muscle above the threshold for safe human consumption.

http://ift.tt/2Du8r2y

Eroding Abscess After use of MYNX Closure Device

Publication date: Available online 20 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Konstantin Hellwig, Susanne Regus

http://ift.tt/2DmNao2

Predictors of Change in the Ankle Brachial Index with Exercise

Publication date: Available online 20 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Khalid M. Alqahtani, Munveer Bhangoo, Florin Vaida, Julie O. Denenberg, Matthew A. Allison, Michael H. Criqui
ObjectiveA 20% or greater decrease in the ankle brachial index (ABI) with exercise is suggestive of peripheral artery disease (PAD), and could identify patients with an increased mortality risk. The predictors of a change in the ABI with exercise have received little attention.MethodsThis was a cross-sectional analysis. Two hundred and sixty five participants of the San Diego Population Study with a resting ABI between 0.90 and 1.10 performed 50 heel raises and immediately had their ABIs measured again. The relationship between the change in the ABI with exercise and multiple potential risk prediction variables were examined using linear regression. In addition, the categorical percent change in the ABI with exercise was analysed by multinomial logistic regression.ResultsThe mean age of participants was 71.8 years, and 80.4% were female. At rest, the average ABI was 1.04 (SD 0.04) before and 0.94 (SD 0.13) after exercise; a mean decrease of 9.5%. In analyses of ABI change as a continuous variable, higher age, any smoking history, and a diagnosis of chronic obstructive pulmonary disease (COPD) were associated with a significant decrease in the ABI with exercise (p = .01, .04, and .03, respectively). Categorical analyses of the risk factors associated with a 20% or greater ABI decrease with exercise confirmed these results. Congestive heart failure was associated with an increased ABI with exercise (p = .04) in continuous ABI change analyses only.ConclusionsOlder age, a positive history of smoking, and a history of COPD were independently and significantly associated with a greater ABI decrease with exercise. These risk variables may help identify persons with subclinical PAD.

http://ift.tt/2DSimwh

Mechanisms of Arterial Calcification: The Role of Matrix Vesicles

Publication date: Available online 20 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Luca Zazzeroni, Gianluca Faggioli, Gianandrea Pasquinelli
Vascular calcification is related to vascular diseases, for example, atherosclerosis, and its comorbidities, such as diabetes and chronic kidney disease. In each condition, a distinctive histological pattern can be recognised that may influence technical choices, possible intra-operative complications, and procedure outcomes, no matter if the intervention is performed by open or endovascular means. This review considers the classification and initiating mechanisms of vascular calcification. Dystrophic and metastatic calcifications, Monckeberg's calcification, and genetic forms are firstly outlined, followed by their alleged initiation mechanisms; these include (a) ineffective macrophage efferocytosis; (b) ectopic osteogenesis driven by modified resident or circulating osteoprogenitors. As in physiological bio-mineralisation, active calcification starts with the deposition of cell derived matrix vesicles into the extracellular matrix. To substantiate this belief, an in depth ultra-structural documentation of hydroxyapatite crystal deposition on such vesicles is provided in an ex-vivo human vascular cell model. Revealing the vesicle composition and phenotype in normal and pathological vascular conditions will be essential for the development of new therapeutic strategies, in order to prevent and treat vascular calcification.

http://ift.tt/2mQliSa

Modeling the impact of combined vaccination programs against varicella and herpes zoster in Norway

Publication date: Available online 20 January 2018
Source:Vaccine
Author(s): Sabina Marchetti, Giorgio Guzzetta, Elmira Flem, Grazina Mirinaviciute, Gianpaolo Scalia Tomba, Piero Manfredi
BackgroundAdoption of varicella immunization in Europe is limited due to a predicted increase in the incidence of herpes zoster (HZ) resulting from a removal of exogenous boosting by varicella vaccination. Most available assessments of immunization strategies only considered universal varicella vaccination (alone or in combination with HZ by the live vaccine). The development of a new subunit recombinant zoster vaccine may provide new perspectives of HZ control.MethodsWe used a mathematical model for VZV in Norway based on the progressive immunity formulation of exogenous boosting. We evaluated a complete range of alternative immunization options against varicella and HZ including both universal and targeted varicella vaccination, either alone or with zoster immunization, and zoster immunization alone. We considered all values of the boosting intensity consistent with the Norwegian HZ incidence and compared the performance of the currently available live vaccine vs. a new recombinant vaccine.ResultsUniversal varicella vaccination alone resulted in a marked increase in the incidence of HZ under all scenarios considered. Even under the most favorable hypotheses on the magnitude of the boosting intensity, this increase could be mitigated only by a parallel HZ immunization with a recombinant vaccine, assuming a long duration of protection. Targeted varicella immunization of adolescents resulted in a modest increase in the HZ incidence which could be counterbalanced by both the live and, especially, the recombinant vaccine.ConclusionsGiven current knowledge on HZ pathogenesis and exogenous boosting, targeted varicella vaccination of adolescents was the only strategy that was not predicted to impact the epidemiology of HZ, and therefore it may represent a suitable alternative to universal vaccination. These results are aimed to support vaccine policy decisions in Norway and other countries with a similar VZV epidemiology.

http://ift.tt/2Bgy2Xk

Importin-β and exportin-5 are indicators of acute viral infection: Correlation of their detection with commercially available detection kits

Publication date: Available online 10 January 2018
Source:Annals of Diagnostic Pathology
Author(s): Gerard J. Nuovo, Cecilia Vianna de Andrade, Chandini Thirukkumaran, Alcina F. Nicol
This work focused on immunohistochemistry markers of acute viral infections. Viral infected cells were detected by in situ based methods (reovirus, rabies virus) or cytologic changes (human papillomavirus, molloscum contagiosum virus, herpes simplex virus). Two proteins involved in nuclear trafficking, importin-β and exportin-5, were detected in the infected cells for each virus and not in the control tissues. A wide variety of other proteins, including caspase-3, and bcl-2 family members (bcl2, bclX, MCL1, BAK, BAX, BIM, BAD) showed wide variations in expression among the different viral infections. Specificity of the importin-β and exportin-5 signals varied greatly with different commercially available peroxidase conjugates. It is concluded that immunohistochemistry detection of importin-β and exportin-5 may be useful markers of acute viral infection, which suggests that increased nuclear trafficking may be an important concomitant of viral proliferation.

http://ift.tt/2Dm16ib

Myositis ossificans – Another condition with USP6 rearrangement, providing evidence of a relationship with nodular fasciitis and aneurysmal bone cyst

Publication date: Available online 12 January 2018
Source:Annals of Diagnostic Pathology
Author(s): Elise M. Bekers, Astrid Eijkelenboom, Katrien Grünberg, Rona C. Roverts, Jacky W.J. de Rooy, Ingrid C.M. van der Geest, Joost M. van Gorp, David Creytens, Uta Flucke
Myositis ossificans is defined as a self-limiting pseudotumor composed of reactive hypercellular fibrous tissue and bone.USP6 rearrangements have been identified as a consistent genetic driving event in aneurysmal bone cyst and nodular fasciitis. It is therefore an integral part of the diagnostic workup when dealing with (myo)fibroblastic lesions of soft tissue and bone. Two cases of myositis ossificans with USP6 rearrangement were published so far.We determine herein the incidence of USP6 rearrangement in myositis ossificans using USP6 fluorescence in situ hybridization analysis (FISH). Of the 11 cases included, seven patients were female and four were male. Age ranged from 6 to 56 years (mean 27 years). Lesions were located in the thigh (n = 5), knee (n = 1), lower leg (n = 1), lower arm (n = 1), perineum (n = 1), gluteal (n = 1) and thoracic wall (n = 1).All assessable cases except one (8/9) showed rearrangement of USP6 providing evidence that myositis ossificans is genetically related to nodular fasciitis and aneurysmal bone cyst.

http://ift.tt/2DTUTv1

Detection of synchronous primary lung adenocarcinomas with genomic sequencing

Publication date: Available online 11 January 2018
Source:Annals of Diagnostic Pathology
Author(s): Debra Berry, Mani Mahadevan, Mark R. Wick
In the setting of synchronous pulmonary carcinomas, distinguishing between a monoclonal process with intrapulmonary metastasis and two independent tumors has significant therapeutic and prognostic implications. We describe two cases in which molecular profiling was used to characterize synchronous, primary pulmonary tumors and guide clinical management. In both cases, the patients underwent surgical resection without adjuvant chemotherapy or radiation and remain free of disease.

http://ift.tt/2Dm0Mjt

Cellular fibroepithelial lesions of the breast: A long term follow up study

Publication date: Available online 10 January 2018
Source:Annals of Diagnostic Pathology
Author(s): Saba Yasir, Aziza Nassar, Rafael E. Jimenez, Sarah M. Jenkins, Lynn C. Hartmann, Amy C. Degnim, Marlene Frost, Daniel W. Visscher
Some fibroepithelial lesions (FEL) of the breast are difficult to classify as cellular fibroadenoma (CFA) or benign phyllodes tumor (BPT) due to overlapping histologic features. This indeterminate group is histologically characterized by prominent stromal cellularity, mild atypia, and mitotic activity. The local recurrence potential of cellular FEL (CFEL) has been insufficiently studied. The objective of this study was to evaluate the histologic features, characterize the long-term follow-up and recurrence rate of CFEL, and compare this data with the recurrence rate of definitive BPT. Ninety CFEL that were <4 cm were recovered from the benign breast disease cohort. The control group comprised of 10 randomly selected patients with BPT. Cases were classified based on a combination of mitotic activity, intracanalicular growth, stromal atypia, stromal prominence, and fat infiltration. None of the CFEL was widely excised. Of the 90 CFEL cases, there were 22 BPT-like, 35 CFA, and 33 indeterminate. The mean age of the patients was 40.1 years. The mean tumor size was 2.4 cm. All patients had at least two years of follow-up (median 27). None of the patients with BPT-like CFEL showed ipsilateral recurrence. Five of the 35 patients with CFA had recurrent ipsilateral CFA. This occurred within 1 to 11 years after the initial diagnosis. One of 33 patients with indeterminate type had a recurrent ipsilateral lesion five years after the initial diagnosis with histologic features of CFA. None of the patients in control group had any recurrence. In conclusion, as a group, CFEL have a low proclivity for recurrence, even when enucleated with close or positive margins. The presence of histologic features of BPT did not correlate with an increased potential for recurrence.

http://ift.tt/2mV7OEN

Brain metastases epidemiology in a Tunisian population: trends and outcome.

Brain metastases epidemiology in a Tunisian population: trends and outcome.

CNS Oncol. 2018 Jan 19;:

Authors: Benna M, Mejri N, Mabrouk M, El Benna H, Labidi S, Daoud N, Boussen H

Abstract
AIM: We reported anatomo-clinical features of brain metastases (BMs) collected in a Tunisian medical oncology department.
PATIENTS & METHODS: We retrospectively identified all cases of BM within a cohort of 7055 patients, treated for a histologically confirmed nonhematological cancer between 2000 and 2016. Data about age, sex and primary tumor were collected.
RESULTS: Incidence was 1.9% and mean age was 54 years with a 1.24 sex ratio. BMs were symptomatic in 73.7% of cases after a median time of 16 months. A total of 73.4% patients receiving local therapy, 88% by whole brain radiation therapy and 21.6% had a metastasectomy. Lung and breast cancers were the primary in 80% of the BM.
CONCLUSION: BM showed trends of young with underestimated incidence.

PMID: 29347839 [PubMed - as supplied by publisher]

http://ift.tt/2mV7HZN

Severe cutaneous adverse reactions due to inappropriate medication use

Summary

Backgroud

The proportion of severe cutaneous adverse reactions (SCARs) that could be avoided if medication use was consistent with good medical practice is unknown.

Objectives

To estimate the proportion of SCARs related to inappropriate medication use.

Methods

Retrospective study of all validated SCARs collected in a French registry between 2003 and 2016. For each case, all plausible drugs suspected to induce SCARs (i.e., not just the drug regarded as "the most probable") were considered regarding three causes of preventability: (1) prescription for an inappropriate indication, (2) unintentional rechallenge despite a previous allergy to the drug, or (3) self-medication with prescription medicines.

Results

602 cases were included in the analyses. Antibiotics, anticonvulsants and allopurinol were the drugs most frequently involved, accounting for more than 50% of all cases. All suspected medications were considered appropriately used for 417 of the 602 individuals included in the study population (69.3%, 95% CI [65.6-73.0]),and inappropriately used. for 144 individuals (23.9% [20.5-27.3]).. These inappropriate uses were mainly due to prescriptions for inappropriate indication (65.8% [58.4-73.2]) or unintentional rechallenge (20.9% [14.6-27.2]). Allopurinol and cotrimoxazole were the drugs most frequently involved in inappropriate indications (accounting for 51.9% [42.3-61.5] and 13.5% [6.9-20.1] of cases, respectively). Antibiotics were the largest group involved in unintentional rechallenge. Non-steroidal anti-inflammatory drugs available on prescription were most involved in inappropriate self-medication.

Conclusions

Our results underline the need for respecting the appropriate indication of drugs to reduce the incidence of SCARs. All efforts to reduce unintentional rechallenge also seem to be necessary preventive measures.

http://ift.tt/2EZMViW

A multi-centre, open, investigator initiated phase IV clinical trial to evaluate the efficacy and safety of ingenol mebutate gel, 0.015% on the face and scalp, and 0.05% on the trunk and extremities, in Korean patients with actinic keratosis (PERFECT)

Abstract

Background

Ingenol mebutate gel is a novel, field-directed topical treatment for actinic keratosis (AK). Most pivotal studies have targeted Western populations. No clinical study has been conducted to investigate its efficacy and safety in Asian populations.

Objectives

To evaluate the efficacy and safety of ingenol mebutate gel for treating AK of face/scalp and trunk/extremities in a large Asian (Korean) population.

Methods

In this multi-centre, open-label, interventional, parallel group, prospective phase 4 study (PERFECT, NCT02716714), the eligible subjects were allocated into either the face/scalp or the trunk/extremities group, according to their selected treatment area location. After application of ingenol mebutate gel, the subjects were followed-up for 6 months. The primary efficacy endpoint was complete clearance (CC) rate of AK lesions in the selected treatment area on Day 57. The quality of life was evaluated using Skindex-29. Safety endpoints included local skin responses, scar, pigmentation, pain, and adverse events.

Results

In total, 78.1% (95% CI: 66.86–86.92%) of subjects had CC on day 57, with 76.6% (95% CI: 64.31–86.25%) in face/scalp group and 88.9% (95% CI: 51.75–99.72%) in trunk/extremities group. Among them, the CC rate was sustained in 88.9% (48/54 subjects, 95% CI: 77.37–95.81%) on Month 6. The local skin responses significantly increased 1 day after the treatment compared to baseline, and decreased afterwards. Among the total subjects, 7.8% (6/77 subjects) had hyperpigmentation on the application area. Scars were not reported.

Conclusions

Ingenol mebutate is effective for the treatment of AK in Asians, with tolerable safety profiles.

http://ift.tt/2DxXZXA

Severe cutaneous adverse reactions due to inappropriate medication use

Summary

Backgroud

The proportion of severe cutaneous adverse reactions (SCARs) that could be avoided if medication use was consistent with good medical practice is unknown.

Objectives

To estimate the proportion of SCARs related to inappropriate medication use.

Methods

Results

Conclusions

http://ift.tt/2EZMViW

Heath risk among pesticide sellers in Bamenda (Cameroon) and peripheral areas

Abstract

In Bamenda and peripheral zones, studies have been focused on the effects of pesticides on farmers (pesticide users) while nothing has been done to assess the exposure of sellers to pesticides. This study aimed at evaluating the exposure of pesticide sellers in the same area. Thirty-two questionnaires were administered to 32 pesticide sellers systematically selected, and chi-square was used for statistical analysis. From each shop, a respondent was chosen among the workers according to its daily time spent in the workplace. The results showed that there is similarity between sellers in Bamenda and peripheral area; one active ingredient (metalaxyl) and one formulation (beauchamp) sold are not registered; throat irritation, headaches, fatigue, skin irritation, eye irritation, and difficulty in breathing with more cases of nose irritation were symptoms observed; pesticides are stored either in the shops or in warehouses; safety measures generally applied are sitting outside the shop, taking medicated charcoal and the use of protective clothing; 56% have less than 5 years experience. Permanent pesticide sellers are then exposed to chronic intoxication in Bamenda and neighboring zones. Employers should make use of protective clothing in their shops when manipulating pesticides in the application of safety measures.

http://ift.tt/2DRDfb7

Modeling the impact of transport energy consumption on CO 2 emission in Pakistan: Evidence from ARDL approach

Abstract

The objective of this research is to examine the relationship between transport energy consumption, economic growth, and carbon dioxide emission (CO₂) from transport sector incorporating foreign direct investment and urbanization. This study is carried out in Pakistan by applying autoregressive distributive lag (ARDL) and vector error correction model (VECM) over 1990–2015. The empirical results indicate a strong significant impact of transport energy consumption on CO₂ emissions from the transportation sector. Furthermore, foreign direct investment also contributes to CO₂ emission. Interestingly, the impact of economic growth and urbanization on transport CO₂ emission is statistically insignificant. Overall, transport energy consumption and foreign direct investment are not environmentally friendly. The new empirical evidence from this study provides a complete picture of the determinants of emissions from the transport sector and these novel findings not only help to advance the existing literature but also can be of special interest to the country's policymakers. So, we urge that government needs to focus on promoting the energy efficient means of transportation to improve environmental quality with less adverse influence on economic growth.

http://ift.tt/2DoN4fH

Cortical visual prostheses: from microstimulation to functional percept.

Cortical visual prostheses: from microstimulation to functional percept.

J Neural Eng. 2018 Jan 19;:

Authors: Najarpour Foroushani A, Pack C, Sawan M

Abstract
Cortical visual prostheses are intended to restore vision by targeted electrical stimulation of the visual cortex. The perception of spots of light, called phosphenes, resulting from microstimulation of the visual pathway, suggests the possibility of creating meaningful percept made of phosphenes. However, to date electrical stimulation of V1 has still not resulted in perception of phosphenated images that goes beyond punctate spots of light. In this review, we summarize the clinical and experimental progress that has been made in generating phosphenes and modulating their associated perceptual characteristics in human and macaque primary visual cortex (V1). We focus specifically on the effects of different microstimulation parameters on perception and we analyse key challenges facing the generation of meaningful artificial percepts. Finally, we propose solutions to these challenges based on the application of supervised learning of population codes for spatial stimulation of visual cortex.

PMID: 29350199 [PubMed - as supplied by publisher]

http://ift.tt/2DtxPW9

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! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Σάββατο 20 Ιανουαρίου 2018

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