Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 20 Απριλίου 2018

In vivo quantification of hydrogen gas concentration in bone marrow surrounding magnesium fracture fixation hardware using an electrochemical hydrogen gas sensor

Publication date: Available online 20 April 2018
Source:Acta Biomaterialia
Author(s): Daoli Zhao, Andrew Brown, Tingting Wang, Sayuri Yoshizawa, Charles Sfeir, William R. Heineman
Magnesium (Mg) medical devices are currently being marketed for orthopedic applications and have a complex degradation process which includes the evolution of hydrogen gas (H2). The effect of H2 exposure on relevant cell types has not been studied; and the concentration surrounding degrading Mg devices has not been quantified to enable such mechanistic studies. A simple and effective method to measure the concentration of H2 in varying microenvironments surrounding Mg implants is the first step to understanding the biological impact of H2 on these cells. Here, the in vivo measurement of H2 surrounding fracture fixation devices implanted in vivo is demonstrated. An electrochemical H2 microsensor detected increased levels of H2 at three anatomical sites with a response time of about 30 s. The sensor showed the H2 concentration in the bone marrow at 1 week post-implantation (1460 ± 320 µM) to be much higher than measured in the subcutaneous tissue (550 ± 210 µM) and at the skin surface (120 ± 50 µM). Additionally, the H2 concentrations measured in the bone marrow exceeded the concentration in a H2 saturated water solution (∼800 µM). These results suggest that H2 emanating from Mg implants in bone during degradation pass through the bone marrow and become at least partially trapped because of slow permeation through the bone. This study is the first to identify H2 concentrations in the bone marrow environment and will enable in vitro experiments to be executed at clinically relevant H2 concentrations to explore possible biological effects of H2 exposure.Statement of significanceAn electrochemical H2 sensor was used to monitor the degradation of a magnesium fracture fixation system in a lapine ulna fracture model. Interestingly, the H2 concentration in the bone marrow is 82% higher than H2 saturated water solution. This suggests H2 generated in situ is trapped in the bone marrow and bone is less permeable than the surrounding tissues. The detectable H2 at the rabbit skin also demonstrates a H2 sensor's ability to monitor the degradation process under thin layers of tissue. H2 sensing shows promise as a tool for monitoring the degradation of Mg alloy in vivo and creating in vitro test beds to more mechanistically evaluate the effects of varying H2 concentrations on cell types relevant to osteogenesis.

Graphical abstract

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Setd7 and its contribution to boron-induced bone regeneration in B-MBG scaffolds

Publication date: Available online 20 April 2018
Source:Acta Biomaterialia
Author(s): Chengcheng Yin, Xiaoshi Jia, Richard J. Miron, Qiaoyun Long, Hudi Xu, Yan Wei, Min Wu, Yufeng Zhang, Zubing Li
Boron (B), a trace element found in the human body, plays an important role for health of bone by promoting the proliferation and differentiation of osteoblasts. Our research group previously fabricated B-mesoporous bioactive glass (MBG) scaffolds, which successfully promoted osteogenic differentiation of osteoblasts when compared to pure MBG scaffolds without boron. However, the mechanisms of the positive effect of B-MBG scaffolds on osteogenesis remains unknown. Therefore, we performed in-vivo experiments in an OVX rat models with pure MBG scaffolds and compared them to B-MBG scaffold. As a result, we found that B-MBG scaffold induced more new bone regeneration compared to pure MBG scaffold and examined genes related to bone regeneration induced by B-MBG scaffold through RNA-seq to obtain target genes and epigenetic mechanisms. The results demonstrated an increased expression and affiliation of Setd7 in the B-MBG group when compared to the MBG group. Immunofluorescent staining from our in vivo samples further demonstrated a higher localization of Setd7 and H3K4me3 in Runx2-positive cells in defects treated with B-MBG scaffolds. KEGG results suggested that specifically Wnt/β-catenin signaling pathway was highly activated in new bone area associated with B-MBG scaffolds. Thereafter, in vitro studies with human bone marrow stem cells (hBMSCs) stimulated by extracted liquid of B-MBG was associated with significantly elevated levels of Setd7, as well as H3K4me3 when compared to MBG alone. To verify the role of Setd7 in new bone formation in the presence of Boron, Setd7 was knocked down in hBMSCs with stimulation of the extracted liquids of B-MBG or MBG scaffolds. The result showed that osteoblast differentiation of hBMSCs was inhibited when Setd7 was knocked down, which could not be rescued by the extract liquids of B-MBG scaffolds confirming its role in osteoblast differentiation and bone regeneration. As a histone methylase, Setd7 may be expected to be a potential epigenetic target for new treatment schemes of osteoporosis.Statement of SignificanceBoron-containing MBG scaffold has already been proved to promote bone regeneration in femoral defects of OVX rats by our research group, however, the epigenetic mechanism of Boron's positive effects on bone generation remains ill-informed. In our present study, we found an increased expression and affiliation of Setd7 and H3K4me3 in Runx2-positive osteoblasts in vivo. And in vitro, the higher expression of Setd7 enhanced osteogenic differentiation of human BMSCs stimulated by extracted liquids of B-MBG scaffold compared to MBG, which was associated with the activation of Wnt/β-catenin signaling pathway. Above all, it suggests that Setd7 plays an positive role in osteogenic differentiation and it may become a potential epigenetic target for new scheme for osteoporosis.

Graphical abstract

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Phase I Study of Multiple Epitope Peptide Vaccination in Patients With Recurrent or Persistent Cervical Cancer

imageCancer immunotherapy has now been established as a leading standard therapeutic option in a subset of patients with cancer. In this study, we conducted a phase I dose-escalation trial using a mixture of 5 peptides to vaccinate cervical cancer patients with HLA-A*2402. The primary endpoints were safety and determination of a recommended vaccine dose, and the secondary endpoints were evaluations of immunologic responses and clinical efficacy. All patients had recurrent or persistent disease and had failed to respond to or were intolerant to prior standard chemotherapy. Peptides derived from forkhead box protein M1 (FOXM1), maternal embryonic leucine zipper kinase (MELK), Holliday junction-recognition protein, and vascular endothelial growth factor receptors 1 and 2 were administered to 9 patients in a 3 patient-cohort design, with doses of 0.5, 1, or 2 mg of each of the individual peptides in a mixture with incomplete Freund's adjuvant. The major adverse events were anemia and injection site reactions, which were seen in 77.8% (7/9) and 66.7% (6/9) of patients, respectively. Grade 3 anemia was observed in 1 patient. No dose-limiting toxicity of the vaccine was observed. Seven (78%) patients achieved stable disease, and the median progression-free survival was 3.3 months (102 d). Interferon-γ enzyme-linked immunospot assays for each of the 5 antigens showed that 8 (89%) and 7 (78%) patients had high T-cell responses to FOXM1 and MELK, respectively. In conclusion, we demonstrated that this 5-peptide vaccine was tolerable, and that FOXM1 and MELK could be promising targets for immunotherapy in patients with cervical cancer.

https://ift.tt/2HGFYZa

Anti-IL-10–mediated Enhancement of Antitumor Efficacy of a Dendritic Cell–targeting MIP3α-gp100 Vaccine in the B16F10 Mouse Melanoma Model Is Dependent on Type I Interferons

imageThe chemokine MIP3α (CCL20) binds to CCR6 on immature dendritic cells. Vaccines fusing MIP3α to gp100 have been shown to be effective in therapeutically reducing melanoma tumor burden and prolonging survival in a mouse model. Other studies have provided evidence that interleukin-10 (IL-10) neutralizing antibodies (αIL-10) enhance immunologic melanoma therapies by modulating the tolerogenic tumor microenvironment. In the current study, we have utilized the B16F10 syngeneic mouse melanoma model to demonstrate for the first time that a therapy neutralizing IL-10 enhances the antitumor efficacy of a MIP3α-gp100 DNA vaccine, leading to significantly smaller tumors, slower growing tumors, and overall increases in mouse survival. The additive effects of αIL-10 were not shown to be correlated to vaccine-specific tumor-infiltrating lymphocytes (TILs), total TILs, or regulatory T cells. However, we discovered an upregulation of IFNα-4 transcripts in tumors and a correlation of increased plasmacytoid dendritic cell numbers with reduced tumor burden in αIL-10–treated mice. Interferon α receptor knockout (IFNαR1−/−) mice received no benefit from αIL-10 treatment, demonstrating that the additional therapeutic value of αIL-10 is primarily mediated by type I IFNs. Efficient targeting of antigen to immature dendritic cells with a chemokine-fusion vaccine provides an effective anticancer therapeutic. Combining this approach with an IL-10 neutralizing antibody therapy enhances the antitumor efficacy of the therapy in a manner dependent upon the activity of type I IFNs. This combination of a vaccine and immunomodulatory agent provides direction for future optimization of a novel cancer vaccine therapy.

https://ift.tt/2Jb4ZJg

Natural Compounds as Epigenetic Regulators of Human Dendritic Cell-mediated Immune Function

imageDendritic cells (DCs) are the most potent professional antigen-presenting cells (APCs) and are poised to capture antigen, migrate to draining lymphoid organs, and postmaturation process. Recent evidences have suggested that tumor microenvironment has an effect on DCs by inactivating various components of the immune system responsible for tumor clearance, eventually leading to tumorigenesis. This inactivation is owed to the epigenetic modifications [ie, microRNA (miRNA)] at the posttranscriptional level, thus regulating the differentiation patterns and functional behavior of DCs. Thus, need of the hour is to develop protocols for ex vivo generation of DCs which may provide a foundation for designing and developing DC-based vaccination for treatment of solid tumors. To achieve this, it is crucial to modulate DCs by identifying miRNAs which may increase the efficacy of DC-based vaccines by reprogramming the immunosuppressive nature of tumor microenvironment. Furthermore, it would be an interesting aspect to check the immunomodulatory potential of natural compounds in reprogramming the immune responses through DCs. Thus, this review aims to improvise the understanding of DC immune biology and miRNAs at genetic level in cancer which can be pivotal for designing novel or improved therapeutic approaches that will allow proper functioning of DCs in patient care. Furthermore, we have highlighted the candidate target molecules and signaling mechanisms having a vital role in the immune-modulatory activities of natural compounds and its derived phytocompounds. This review also establishes a link between miRNA expressions and biological roles of natural compounds modulating the activity of DCs.

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PD-1 Inhibitor-associated Myopathies: Emerging Immune-mediated Myopathies

imageProgrammed death-1 (PD-1) inhibitors are increasingly used in cancer immunotherapy. Various immune-related adverse events are reported, including infrequent individual case reports of myositis or rhabdomyolysis. The frequency and diagnostic spectrum of immune-related adverse events affecting skeletal muscle in PD-1 inhibitor-treated patients are unknown. We searched the Mayo Clinic Pharmacy database (2014–2016) to identify patients who developed myopathies during or after PD-1 inhibitor therapy. Among 654 cancer patients received PD-1 inhibitors (pembrolizumab=389; nivolumab=264; both=1), we identified 5 patients (pembrolizumab=5) with biopsy-proven myopathies (2 necrotizing myopathy, 1 early dermatomyositis, and 2 nonspecific myopathy). Four patients developed concomitant autoimmune disorders. Weakness occurred after a median of 2 treatments (range, 1–4). All patients had proximal or axial weakness. Four patients had either bulbar or extraocular weakness, but only 1 patient had acetylcholine receptor antibodies. Creatine kinase levels were elevated in 3 patients (necrotizing myopathy=2; nonspecific myopathy=1). Brain magnetic resonance imaging revealed abnormal T2 signal and enhancement of extraocular muscles in 1 patient with ophthalmoparesis. Pembrolizumab was discontinued in all patients. All patients received immunosuppressive therapy, with fatal outcome in 2 necrotizing myopathy patients and favorable outcome in others. We conclude that myopathy is a rare, but unique complication of PD-1 inhibitors with frequent involvement of extraocular or bulbar muscles, mimicking myasthenia gravis. Muscle biopsy is an important test for PD-1 inhibitor-treated patients who develop oculobulbar weakness and hyperCKemia, to distinguish patients with necrotizing myopathy from myasthenia gravis. Necrotizing myopathy patients may require more aggressive immunotherapy due to their grave prognosis.

https://ift.tt/2HGFGl2

In Response

No abstract available

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Differential Effects of Anesthetics and Opioid Receptor Activation on Cardioprotection Elicited by Reactive Oxygen Species–Mediated Postconditioning in Sprague-Dawley Rat Hearts

imageBACKGROUND: Despite an array of cardioprotective interventions identified in preclinical models of ischemia–reperfusion (IR) injury, successful clinical translation has not been achieved. This study investigated whether drugs routinely used in clinical anesthesia influence cardioprotective effectiveness by reducing effects of reactive oxygen species (ROS), upstream triggers of cardioprotective signaling. Effects of propofol, sevoflurane, or remifentanil were compared on postischemic functional recovery induced by ROS-mediated postconditioning with Intralipid. METHODS: Recovery of left ventricular (LV) work, an index of IR injury, was measured in isolated Sprague-Dawley rat hearts subjected to global ischemia (20 minutes) and reperfusion (30 minutes). Hearts were either untreated or were treated with postconditioning with Intralipid (1%, throughout reperfusion). Propofol (10 μM), sevoflurane (2 vol%), remifentanil (3 nM), or combinations thereof were administered peri-ischemically (before and during IR). The effects of anesthetics on ROS production were measured in LV cardiac fibers by Amplex Red assay under phosphorylating and nonphosphorylating conditions. RESULTS: Recovery of LV work (expressed as percentage of the preischemic value ± standard deviation) in untreated hearts was poor (20% ± 7%) and was improved by Intralipid postconditioning (58% ± 8%, P = .001). In the absence of Intralipid postconditioning, recovery of LV work was enhanced by propofol (28% ± 9%, P = .049), sevoflurane (49% ± 5%, P

https://ift.tt/2vvwA63

A Pain in the Abs: Predicting Post-Cesarean Analgesia

imageNo abstract available

https://ift.tt/2HgOACh

Delineating the Trajectory of Cognitive Recovery From General Anesthesia in Older Adults: Design and Rationale of the TORIE (Trajectory of Recovery in the Elderly) Project

imageBACKGROUND: Mechanistic aspects of cognitive recovery after anesthesia and surgery are not yet well characterized, but may be vital to distinguishing the contributions of anesthesia and surgery in cognitive complications common in the elderly such as delirium and postoperative cognitive dysfunction. This article describes the aims and methodological approach to the ongoing study, Trajectory of Recovery in the Elderly (TORIE), which focuses on the trajectory of cognitive recovery from general anesthesia. METHODS: The study design employs cognitive testing coupled with neuroimaging techniques such as functional magnetic resonance imaging, diffusion tensor imaging, and arterial spin labeling to characterize cognitive recovery from anesthesia and its biological correlates. Applying these techniques to a cohort of age-specified healthy volunteers 40–80 years of age, who are exposed to general anesthesia alone, in the absence of surgery, will assess cognitive and functional neural network recovery after anesthesia. Imaging data are acquired before, during, and immediately after anesthesia, as well as 1 and 7 days after. Detailed cognitive data are captured at the same time points as well as 30 days after anesthesia, and brief cognitive assessments are repeated at 6 and 12 months after anesthesia. RESULTS: The study is underway. Our primary hypothesis is that older adults may require significantly longer to achieve cognitive recovery, measured by Postoperative Quality of Recovery Scale cognitive domain, than younger adults in the immediate postanesthesia period, but all will fully recover to baseline levels within 30 days of anesthesia exposure. Imaging data will address systems neuroscience correlates of cognitive recovery from general anesthesia. CONCLUSIONS: The data acquired in this project will have both clinical and theoretical relevance regardless of the outcome by delineating the mechanism behind short-term recovery across the adult age lifespan, which will have major implications for our understanding of the effects of anesthetic drugs.

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Auditing Intraoperative Transfusions to Promote High-Value Perioperative Care

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Treatment of Chronic Pain Conditions: A Comprehensive Handbook

No abstract available

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Postoperative Troponin Elevation, Myocardial Injury, and Pulmonary Embolism

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In Response

No abstract available

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The American College of Surgeons Children’s Surgery Verification and Quality Improvement Program: Be Careful What You Wish For!

imageNo abstract available

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Effect of Stellate Ganglion Block on the Regional Hemodynamics of the Upper Extremity: A Randomized Controlled Trial

imageBACKGROUND: The success of stellate ganglion block (SGB) is traditionally determined on the basis of findings such as Horner's syndrome, temperature rise in the face, hyperemia of the tympanic membrane, and nasal congestion. However, decreases in vascular resistance and increases in blood flow in the arm may be more meaningful findings. To date, the effect of SGB on the regional hemodynamics of the arm has not been evaluated using pulsed-wave Doppler ultrasound. METHODS: A total of 52 patients who were to undergo orthopedic surgery of the forearm were randomly assigned to either the mepivacaine group (SGB with 5 mL of 0.5% mepivacaine) or the saline group (SGB with 5 mL of normal saline). Before surgery, a single anesthesiologist performed a SGB under ultrasound guidance. The temperature of the upper extremity and the resistance index and blood flow in the brachial artery were measured before SGB, 15 and 30 minutes after SGB, and 1 hour after surgery. The severity of pain, requirement for rescue analgesics, and side effects of the local anesthetic agent were all documented. RESULTS: After SGB, the resistance index decreased significantly and the blood flow increased significantly in the brachial artery of members of the mepivacaine group (15 minutes: P = .004 and P

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The Pros of Publishing Standalone Clinical Trial Protocols in Anesthesiology Journals

No abstract available

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Can Lung Ultrasound Be the First-Line Tool for Evaluation of Intraoperative Hypoxemia?

imageNo abstract available

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Publishing Methods Without Results: A First That Hopefully Will Not Last

No abstract available

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Pain Medicine: An Essential Review

No abstract available

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The Eye: What You Don’t Know Can Hurt Your Patient

imageNo abstract available

https://ift.tt/2HjlwKL

Renal Interstitial Exhaustion and SGLT2 Blockers

No abstract available

https://ift.tt/2HNo5FG

Looking Beyond the Pain: Can Effective Labor Analgesia Prevent the Development of Postpartum Depression?

No abstract available

https://ift.tt/2qMY6Hd

Perioperative Cardiac Arrest: Focus on Local Anesthetic Systemic Toxicity (LAST) Erratum

No abstract available

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Testing Times: Routine to Indicated!

No abstract available

https://ift.tt/2HfCyJt

Teaching Medical Students Clinical Anesthesia

imageThere are many reasons for evaluating our approach and improving our teaching of America's future doctors, whether they become anesthesiologists (recruitment) or participate in patient management in the perioperative period (general patient care). Teaching medical students the seminal aspects of any medical specialty is a continual challenge. Although no definitive curricula or single clinical approach has been defined, certain key features can be ascertained from clinical experience and the literature. A survey was conducted among US anesthesiology teaching programs regarding the teaching content and approaches currently used to teach US medical students clinical anesthesia. Using the Accreditation Council for Graduate Medical Education website that lists 133 accredited anesthesiology programs, residency directors were contacted via e-mail. Based on those responses and follow-up phone calls, teaching representatives from 125 anesthesiology departments were identified and asked via e-mail to complete a survey. The survey was returned by 85 programs, yielding a response rate of 68% of individuals contacted and 63% of all departments. Ninety-one percent of the responding departments teach medical students, most in the final 2 years of medical school. Medical student exposure to clinical anesthesia occurred as elective only at 42% of the institutions, was requirement only at 16% of responding institutions, and the remainder had both elective and required courses. Anesthesiology faculty at 43% of the responding institutions reported teaching in the preclinical years of medical school, primarily in the departments of pharmacology and physiology. Forty-five percent of programs reported interdisciplinary teaching with other departments teaching classes such as gross anatomy. There is little exposure of anesthesiology faculty to medical students in other general courses. Teaching in the operating room is the primary teaching method in the clinical years. Students are allowed full access to patient care, including performing history and physical examinations, participating in the insertion of IVs and airway management. Simulation-based teaching was used by 82% of programs during medical student anesthesia clerkships. Sixty-eight percent of respondents reported that they have no formal training for their anesthesiology faculty teachers, 51% stated that they do not receive nonclinical time to teach, and 38% of respondents stated that they received some form of remuneration for teaching medical students, primarily nonclinical time. This article presents a summary of these survey results, provides a historical review of previous evaluations of teaching medical students clinical anesthesia, and discusses the contributions of anesthesiologists to medical student education.

https://ift.tt/2HP7amj

Transfer Appropriate Fluency: Encoding and Retrieval Interactions in Fluency-Based Memory Illusions.

Author: Lanska, Meredith; Westerman, Deanne
DOI: 10.1037/xlm0000496
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


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Resisting Attraction: Individual Differences in Executive Control Are Associated With Subject-Verb Agreement Errors in Production.

Author: Veenstra, Alma; Antoniou, Kyriakos; Katsos, Napoleon; Kissine, Mikhail
DOI: 10.1037/xlm0000516
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


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Validating Semantic Illusions: Competition Between Context and General World Knowledge.

Author: Williams, Christopher R.; Cook, Anne E.; O'Brien, Edward J.
DOI: 10.1037/xlm0000526
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


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Context Retrieval and Description Benefits for Recognition of Unfamiliar Faces.

Author: Jones, Todd C.; Robinson, Kealagh; Steel, Brenna C.
DOI: 10.1037/xlm0000537
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


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Effects of Aging, Word Frequency, and Text Stimulus Quality on Reading Across the Adult Lifespan: Evidence From Eye Movements.

Author: Warrington, Kayleigh L.; McGowan, Victoria A.; Paterson, Kevin B.; White, Sarah J.
DOI: 10.1037/xlm0000543
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


https://ift.tt/2HfI6rw

Stimulus Effects and the Mediation of Recognition Memory.

Author: McAdoo, Ryan M.; Key, Kylie N.; Gronlund, Scott D.
DOI: 10.1037/xlm0000550
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


https://ift.tt/2qP7ZDq

Word Length, Set Size, and Lexical Factors: Re-Examining What Causes the Word Length Effect.

Author: Guitard, Dominic; Gabel, Andrew J.; Saint-Aubin, Jean; Surprenant, Aimee M.; Neath, Ian
DOI: 10.1037/xlm0000551
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


https://ift.tt/2HgttV5

The Semantic Stroop Effect is Controlled by Endogenous Attention.

Author: Kinoshita, Sachiko; Mills, Luke; Norris, Dennis
DOI: 10.1037/xlm0000552
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


https://ift.tt/2qP7OYM

Increased Cognitive Load Enables Unlearning in Procedural Category Learning.

Author: Crossley, Matthew J.; Maddox, W. Todd; Ashby, F. Gregory
DOI: 10.1037/xlm0000554
Publication Date: POST AUTHOR CORRECTIONS, 19 April 2018


https://ift.tt/2Hgt6d0

Health risk assessment of VOC emissions in laboratory rooms via a modeling approach

Abstract

One of the important agents menacing buildings' employees and residents' health is the emission of volatile organic compounds (VOCs) into the indoor environment. The present research studied the VOC emission to evaluate indoor air quality (IAQ) through studying in-laboratory processes and tasks. On account of that, three different pollutants (acetone, benzene, and toluene) were chosen as candidate VOCs, and Environmental Engineering Research Center at Sahand University of Technology was selected as a sample laboratory for each VOC. Using CFD model, concentrations of pollutants under unsteady state in a three-dimensional geometry at various temperatures were provided. To validate the considered model, the modeling results were compared to experimental data. Health risk was evaluated through the building using the OEL-C, OEL-STEL, and OEL-TWA parameters for the three pollutants. According to the mentioned parameters and the modeling results, 1 h following the emission, in order to reduce the health risk associated with short-term exposure to the emission, the staff should observe a minimum distance of 3, 2, and 1.8 m to the sources of acetone, benzene, and toluene, respectively. This is while, since average concentration of emission within the laboratory in an 8-h period is several times as large as OEL-TWA, then the laboratory staffs are strictly recommended not to work in the laboratory for long hours. Furthermore, using the results of this research, the staff can detect safe locations within the laboratory without any need to use emission monitoring equipment.



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Enhanced peroxidase-like properties of Au@Pt DNs/NG/Cu2+ and application of sandwich-type electrochemical immunosensor for highly sensitive detection of CEA

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Publication date: 30 July 2018
Source:Biosensors and Bioelectronics, Volume 112
Author(s): Hui Lv, Yueyun Li, Xiaobo Zhang, Zengqiang Gao, Chunyan Zhang, Shuan Zhang, Yunhui Dong
Effective treatment of cancer depends upon the early detection of the tumor marker. Here, we report on the development of a new immunosensor for early detection of carcinoembryonic antigen (CEA). Cubic Au@Pt dendritic nanomaterials functionalized nitrogen-doped graphene loaded with copper ion (Au@Pt DNs/NG/Cu2+) with enhanced peroxidase-like properties was synthesized as labels to effectively capture and immobilize secondary anti-CEA. The Au@Pt DNs with more active surface area could efficiently enhance electrocatalysis for reduction of hydrogen peroxide (H2O2). Meanwhile, with good conductivity and large specific surface area, NG can immobilize a large amount of Au@Pt DNs. Furthermore, after adsorbed Cu2+ can further promote the redox of H2O2 and amplify the signal of the immunosensor. For the immobilization of primary antibodies, Au nanoparticles functionalized polydopamine (Au@PDA) were used as transducing materials to modify glassy carbon electrodes and enhance the electron transfer efficiently. Under optimal conditions, the immunosensor exhibited a satisfactory response to CEA with a limit detection of 0.167 pg/mL and linear detection range from 0.5 pg/mL to 50 ng/mL. Based on the high sensitivity and specificity of the immunosensor, we propose this multiple amplified biosensor for early detection of CEA.



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The marginalisation of dreams in clinical psychological practice

The longstanding human interest in dreams has led to a significant body of psychological and philosophical discourse, including research. Recently, however, dreams have been relegated to the periphery of clinical psychological practice. This is potentially problematic as clients continue to bring dreams to therapy and many psychologists lack the confidence or competence to respond effectively to dream material. Building on the structural, professional and research cultures surrounding psychology using a cultural-historical activity theory framework, we argue the marginalisation of dreams is due to cultural-historical factors.

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Perinatal risk factors for asthma in children with allergic rhinitis and grass pollen sensitization



https://ift.tt/2J90sXy

Epidemiology of childhood asthma in mainland China (1988‐2014): A meta-analysis



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Nonprescription medications for respiratory symptoms: Facts and marketing fictions



https://ift.tt/2J8pnuv

Evaluating children with suspected allergic reactions to vaccines for infectious diseases

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Diagnosis, pathogenesis, and treatment of chronic spontaneous urticaria



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Health care burden and treatment patterns in commercially insured children with chronic idiopathic/spontaneous urticaria: A real-world study in the United States



https://ift.tt/2HhQ5QZ

Pharmacokinetics of intranasal olopatadine in the fixed-dose combination GSP301 versus two monotherapy intranasal olopatadine formulations



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Pharmacokinetics of intranasal mometasone in the fixed-dose combination GSP301 versus two monotherapy intranasal mometasone formulations



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Prevalence of allergen sensitization detected by patch tests



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Utilization and timeliness of an inpatient penicillin allergy evaluation



https://ift.tt/2K204LT

Drug-induced eosinophilia



https://ift.tt/2HfyNnr

For the Patient



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Abstracts from the Western Society of Allergy, Asthma, and Immunology (WSAAI) Annual Scientific Session, Kapalua, Hawaii, January 21‐25, 2018



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Perinatal risk factors for asthma in children with allergic rhinitis and grass pollen sensitization



https://ift.tt/2J90sXy

Correlation between vitamin D serum levels and passive smoking exposure in children with asthma



https://ift.tt/2K1OxMI

Epidemiology of childhood asthma in mainland China (1988‐2014): A meta-analysis



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The Floralia: A festive time for Romans and a demanding time for the allergist/immunologist



https://ift.tt/2K1Ows8

Nonprescription medications for respiratory symptoms: Facts and marketing fictions



https://ift.tt/2J8pnuv

Diagnosis, pathogenesis, and treatment of chronic spontaneous urticaria



https://ift.tt/2J908YQ

Real-world use of omalizumab in patients with chronic idiopathic/spontaneous urticaria in the United States



https://ift.tt/2K1Vqxq

Health care burden and treatment patterns in commercially insured children with chronic idiopathic/spontaneous urticaria: A real-world study in the United States



https://ift.tt/2HhQ5QZ

Hereditary angioedema from the patient's perspective: A follow-up patient survey

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https://ift.tt/2K4nK2i

Pharmacokinetics of intranasal olopatadine in the fixed-dose combination GSP301 versus two monotherapy intranasal olopatadine formulations



https://ift.tt/2Hj4SuK

Pharmacokinetics of intranasal mometasone in the fixed-dose combination GSP301 versus two monotherapy intranasal mometasone formulations



https://ift.tt/2K1Ouk0

Prevalence of allergen sensitization detected by patch tests



https://ift.tt/2JdBxSV

Utilization and timeliness of an inpatient penicillin allergy evaluation



https://ift.tt/2K204LT

Drug-induced eosinophilia



https://ift.tt/2HfyNnr

For the Patient



https://ift.tt/2K2uWMl

Abstracts from the Western Society of Allergy, Asthma, and Immunology (WSAAI) Annual Scientific Session, Kapalua, Hawaii, January 21‐25, 2018



https://ift.tt/2JbMGU9

The influence of marital status on survival for patients aged 65 years and younger with oral cavity cancer

In Taiwan, the median age of diagnosis for oral cavity cancer is 51 year old, which is about 10 years earlier than that in Western countries. A recent study assessing the effect of marriage on outcomes for elderly oral cavity cancer patients (≥66 years old) showed that marriage was associated with better survival. However, little is known about the prognostic significance of marital status in oral cavity cancer patients aged 65 years and younger.

https://ift.tt/2HSFxZG

Predictive value of the Hyodo score in endoscopic evaluation of aspiration during swallowing

The Hyodo scoring system during the endoscopic procedure has been proposed as a new tool for evaluating oral intake feasibility. However, the effectiveness of the information obtained from this procedure in predicting aspiration is not fully elucidated. The aim of this study was to assess the significance of clinical factors, including Hyodo scores, for predicting the risk of aspiration.

https://ift.tt/2vwGunR

The red cell distribution width as a prognostic indicator in upper aerodigestive tract (UADT) cancer: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to investigate the relationship between the Red Cell Distribution Width (RDW) and prognosis in upper aerodigestive tract (UADT) cancer.

https://ift.tt/2K4lS9K

Current trends in food allergy-induced anaphylaxis management at school

To review the evidence and current policies regarding the use of epinephrine at schools and child care centers Data Sources and Study Selection: A narrative review was performed based on the result of conference proceedings of a group of inter-professional stakeholders who attended the USAnaphylaxis Summit 2017 presented by Allergy & Asthma Network.

https://ift.tt/2vCplJE

Food allergy to previously tolerated foods: course and patient characteristics

IgE-mediated food allergy is a life threatening disease with an increasing prevalence in developed countries (1). Food proteins are innocuous non–self-antigens which are regularly absorbed through the gastro-intestinal tract without provoking a significant immune reaction. The mechanisms responsible for the development of primary immune tolerance to food-related proteins are still not well understood (2). IgE-mediated food allergy results when the adaptive immune system fails to develop tolerance to these food proteins and instead develops IgE antibodies directed against allergenic epitopes (2).

https://ift.tt/2qMhUub

Mepolizumab in the treatment of severe eosinophilic asthma: “results from a physician in the field”

We would like to report our real-world results of using mepolizumab in patients with severe eosinophilic asthma in an office environment. This was a retrospective study; written permission was granted by all patients to use results of their treatment with mepolizumab, a monoclonal antibody directed against the interleukin 5 cytokine.

https://ift.tt/2J9vCyk

Radiation-induced carotid artery lesions

Abstract

Purpose

To review the current aspects of knowledge related to the risk of cerebrovascular events in patients receiving head and neck radiotherapy.

Methods

A literature search was performed in PubMed. Papers meeting selection criteria were reviewed.

Results

We provide an update on the problem by identifying key studies that have contributed to our current understanding of the epidemiology, radiologic features, pathogenesis, and treatment of the disease. The incidence of carotid artery stenosis ranged from 18 to 38% in patients who underwent radiotherapy for head and neck cancer versus from 0 to 9.2% among the nonirradiated patients. Neck irradiation increases the intima-media thickness of the carotid artery wall. These changes are the earliest visible alteration in the carotid wall and are also detected with color Doppler ultrasonography. Endovascular treatment with a carotid angioplasty and stenting is the first-line treatment for most symptomatic patients.

Conclusions

Radiation-induced atherosclerosis is a different and accelerated form of atherosclerosis, which implies a more aggressive disease with a different biologic behavior. The disease is characterized by a high rate of carotid artery stenosis compared to those observed in nonirradiated control group patients. To prevent the risk of stroke, surveillance and imaging with ultrasonography should enable detection of severe stenosis. Endovascular treatment with a carotid angioplasty and stenting has been proposed as an attractive and minimally invasive alternative for some radiation-induced stenoses.



https://ift.tt/2Hh2jxj

Diverse expression of TNF-α and CCL27 in serum and blister of Stevens–Johnson syndrome/toxic epidermal necrolysis

The pathogenesis of Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is not fully understood. Our previous study reported that chemokine CCL27 was overexpressed in serum of SJS/TEN patients. The...

https://ift.tt/2HfDOjP

Vitamin D deficiency promotes prostatic hyperplasia in middle-age mice through exacerbating local inflammation

Publication date: Available online 20 April 2018
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Zhi-Hui Zhang, Biao Luo, Shen Xu, Lin Fu, Yuan-Hua Chen, Cheng Zhang, Hua Wang, Dong-Dong Xie, De-Xiang Xu
Vitamin D deficiency is especially prevalent in pregnant women and children. Our recent study demonstrated that vitamin D deficiency in early life disturbed testicular development. This study investigated the effects of vitamin D deficiency in early life on prostatic hyperplasia in middle-aged mice. In control group, dams and their male pups were fed with standard-chow diets. In VDD group, dams were fed with vitamin D deficient (VDD) diets throughout pregnancy and lactation. After weaning, male pups continued to be fed with VDD diets. As expected, prostate weight was elevated and prostatic hyperplasia was observed in VDD-fed mice. The number of prostatic Ki-67-positive epithelial cells, a proliferation marker, was increased in VDD-fed mice. Further analysis found that vitamin D deficiency promoted inflammatory infiltration and stromal fibrosis in prostate of middle-aged mice. Moreover, vitamin D deficiency activated NF-κB and up-regulated Il-6 mRNA in prostate of middle-aged mice. In addition, vitamin D deficiency activated prostatic STAT3, a proliferation pathway in middle-aged mice. Of interest, VDD-induced prostatic inflammation and hyperplasia were partially reversed when VDD diets was replaced with standard diets. These results provide evidence that vitamin D deficiency in early life promotes prostatic hyperplasia in middle-aged mice through exacerbating local inflammation.

Graphical abstract

image


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Hearing loss and social support in urban and rural communities.

Related Articles

Hearing loss and social support in urban and rural communities.

Int J Audiol. 2018 Apr 19;:1-8

Authors: Hay-McCutcheon MJ, Hyams A, Yang X, Parton J

Abstract
OBJECTIVE: Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama.
DESIGN: The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered.
STUDY SAMPLE: Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss.
RESULTS: Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction).
CONCLUSIONS: Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.

PMID: 29671659 [PubMed - as supplied by publisher]



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The role of communication partners in the audiological rehabilitation.

Related Articles

The role of communication partners in the audiological rehabilitation.

Int J Audiol. 2018 Apr 19;:1

Authors: Danermark B

PMID: 29671651 [PubMed - as supplied by publisher]



https://ift.tt/2qNOJ9C

The potential role of statins in preeclampsia and dyslipidemia during gestation: a narrative review.

Related Articles

The potential role of statins in preeclampsia and dyslipidemia during gestation: a narrative review.

Expert Opin Investig Drugs. 2018 Apr 19;:

Authors: Maierean SM, Mikhailidis DP, Toth PP, Grzesiak M, Mazidi M, Maciejewski M, Banach M

Abstract
INTRODUCTION: Statins have several pleiotropic effects that have the potential to be beneficial during pregnancy. This study evaluates the available evidence for the teratogenicity of statins, and their utility in treating preeclampsia and dyslipidemia in pregnancy, as good alternatives in these domains are currently lacking. Areas covered: The possible teratogenicity of statins is a primary focus of this paper. We also evaluated for some possible non-teratogenic effects, such as changes in birth weight and rates of spontaneous abortion, among mothers exposed to statins during pregnancy. Regarding potential uses, this study mainly discusses statin utility in preventing and treating preeclampsia and treating dyslipidemia in pregnancy. Within the latter, we explore the relationship between dyslipidemia and preeclampsia, the potential consequences of delaying statin therapy where indicated, and the impact of supra-physiological levels of cholesterol in utero on offspring. The literature search was conducted using Embase, Web of Science, PubMed, and Scopus. Expert opinion: Based on current evidence, statins are likely not teratogenic. Limited, but promising evidence exists for their efficacy in treating and preventing preeclampsia. In utero exposure to high cholesterol may negatively impact offspring, and should be thoroughly investigated.

PMID: 29672173 [PubMed - as supplied by publisher]



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Evolution of deceased organ donation activity vs. efficiency over a 15 year period: an international comparison

Background The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs. Methods This is a retrospective analysis of 2001–2015 deceased organ donation and mortality registry data. Included are 27 Council of Europe countries, as well as the USA. A donor conversion index (DCI) was calculated for assessing donation program efficiency over time and in international comparisons. Results According to the DCI and of the countries included in the study, Spain, France, and the USA had the most efficient donation programs in 2015. Even though mortality from the selected causes decreased in most countries during the study period, differences in international comparisons persist. This indicates that the potential for deceased organ donation and its conversion into actual donation is far from being similar internationally. Conclusions Compared with the DR, the DCI takes into account the potential for deceased organ donation, and therefore is a more accurate metric of performance. National donation programs could optimize performance by identifying the areas where most potential is lost, and by implementing measures to tackle these issues. Correspondence to: Franz F. Immer, MD, consultant cardiovascular surgeon FMH, Swisstransplant, Effingerstrasse 1/Postfach, CH-3011 Bern, Switzerland., franz.immer@swisstransplant.org **Please refer to Appendix 1, SDC, https://ift.tt/2HDeOT2 for information about Council of Europe European Committee on Organ Transplantation (CD-P-TO) membership Authors' contributions JW: acquired and analyzed data, reviewed the literature, wrote the manuscript; AE acquired and analyzed data, contributed to the writing of the manuscript; BM, provided the donation data from the Newsletter Transplant database; BDG, DA, ANC, BHK, KL: members of the Council of Europe's project TO077 CD-P-TO working group, participated in the study design, revised the manuscript critically; FFI conceived the study, advised on its design and revised the manuscript critically, member of the TO077 CD-P-TO working group. Conflict of interest: The authors declare no conflicts of interest. Funding: This study received no external funding. Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (https://ift.tt/2EZJQTY). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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State of the Art: Role of the Dendritic Cell in Induction of Allograft Tolerance

Despite decades of research, the induction and maintenance of long-term allograft tolerance without immunosuppression remains an elusive goal in the field of solid organ and cell transplantation. Immunosuppressive medications frequently prevent or minimize acute cellular rejection but have failed to halt anti-donor antibody production and chronic organ rejection. Past efforts aimed at promoting lasting allograft tolerance have focused primarily on peripheral T cell depletion,1 augmentation of regulatory T cells,2 or induction via simultaneous hematopoietic stem cell transplantation and facilitation of donor chimerism.3 So far, none of these methods have led to consistently safe, feasible and long lasting donor organ acceptance. Over the course of the past 4 decades, the study of a unique population of antigen-presenting cells known as dendritic cells (DCs) has shown promise for breaking new ground in achieving indefinite allograft survival without immunosuppression and its associated adverse effects. In this review, we discuss the discovery and early investigations of DCs and chronicle some of the key studies demonstrating their role in transplantation, particularly in indirect allorecognition, the immunologic pathway thought to drive chronic rejection and perhaps tolerance induction. Sarah J. Rosen, M.D., 630 W. 168th St., Rm. 10-502, New York, NY 10032. sr2490@cumc.columbia.edu Sarah J. Rosen participated in the writing of the paper. Paul E. Harris participated in the writing of the paper. Mark A. Hardy participated in the writing of the paper. The authors declare no conflicts of interest. Funding for this work was provided by the National Institutes for Health 2T32HL007854-21. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2F4Lvn8

Health care costs for the evaluation, surgery, and follow-up care of living kidney donors

Background The health care costs to evaluate, perform surgery, and follow a living kidney donor for the year after donation are poorly described. Methods We obtained information on the health care costs of 1099 living kidney donors between April 1, 2004 and March 31, 2014 from Ontario, Canada using comprehensive health care administrative databases. We estimated the cost of 3 periods of the living donation process: the predonation evaluation period (start of evaluation until the day before donation), perioperative period (day of donation until 30-days postdonation), and 1 year of follow-up period (after perioperative period until 1-year postdonation). We analyzed data for donors and healthy matched nondonor controls using regression-based methods to estimate the incremental cost of living donation. Costs are presented from the perspective of the Canadian health care payer (2017 $CAD). Results The incremental health care costs (compared with controls) for the evaluation, perioperative, and follow-up periods were $3,596 (95% confidence interval (CI) $3,350-$3,842), $11,694 ($11,415-$11,973), and $1,011 ($793-$1,230), respectively, totalling $16,290 ($15,814-$16,767). The evaluation cost was higher if the intended recipient started dialysis part-way through the donor evaluation [$886 ($19, $1,752)]. The perioperative cost varied across transplant centers (p

https://ift.tt/2HDeFPu

Outcomes after Cardiac Transplant for Wild Type Transthyretin Amyloidosis

Background The true prevalence of heart failure (HF) due to wild type transthyretin amyloidosis (ATTRwt) is likely underestimated. There is a paucity of data with regard to the management of ATTRwt-related advanced HF and the natural history of extracardiac ATTRwt. Methods We conducted a retrospective cohort study of patients undergoing cardiac transplant (HTx) for ATTRwt at a single institution. Comprehensive clinical data, including baseline hemodynamic and echocardiographic characteristics, and posttransplant outcomes were obtained. Results Seven patients with ATTRwt underwent HTx between 2007 and 2015. All patients were male with a mean age of 66 ± 9. Patients had a reduced ejection fraction (mean 37 ± 14%) and elevated filling pressures pre-HTx (mean pulmonary capillary wedge pressure 22 ± 7 mmHg) prior to HTx. Three year survival was 100%; 1 patient died of pancreatic cancer 45 months post-HTx (1 death per 30.8 patient-years). Oxygen consumption (Δ +6.8 ± 4.9 ml/kg/min) and 6-minute walk distances (Δ +189 ± 60 m) improved. Symptomatic gastrointestinal involvement (n=2) and peripheral nerve involvement (n=4) by ATTRwt developed late. Conclusions This is the first report of a series of ATTRwt patients receiving HTx in which excellent outcomes are demonstrated. Although cardiac death is averted, systemic manifestations of ATTRwt may develop posttransplantation. REPRINTS AND CORRESPONDENCE: Andrew N. Rosenbaum, M.D., Mayo Clinic Rochester, 200 1st St. SW, Rochester, MN 55905. Phone#: +15072842511. Fax#: +1 5072840161. Email: Rosenbaum.Andrew@mayo.edu PI: Brooks S. Edwards: Phone#: +15072663841 Email: Edwards.Brooks@mayo.edu AUTHORSHIP: Andrew N Rosenbaum: Participated in research design, writing of the paper, performance of the research, and data analysis Omar F. Abou Ezzeddine: Participated in writing of the paper and data analysis Martha Grogan: Participated in research design, writing of the paper, and data analysis Angela Dispenzieri: Participated in writing of the paper and data analysis Sudhir Kushwaha: Participated in writing of the paper and data analysis Alfredo Clavell: Participated in writing of the paper and data analysis Richard C. Daly: Participated in writing of the paper and data analysis Brooks S Edwards: Participated in research design, writing of the paper, and data analysis DISCLOSURES: The authors declare no conflicts of interest SOURCES OF FUNDING: No funding was provided for the current study Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2HkLCN6

Frailty, Inflammatory Markers, and Waitlist Mortality Among Patients with End-Stage Renal Disease in a Prospective Cohort Study

Background Among community-dwelling older adults, frailty is associated with heightened markers of inflammation and subsequent mortality. Although frailty is common among ESRD patients, the role of frailty and markers of inflammation in this population remains unclear. We quantified these associations in patients on the kidney transplant (KT) waitlist and tested whether frailty and/or markers of inflammation improve waitlist mortality risk prediction. Methods We studied 1,975 ESRD patients on the KT waitlist (11/1/09-2/28/17) in a multi-center cohort study of frailty. Serum inflammatory markers (interleukin-6 [IL-6], soluble tumor necrosis factor-α receptor-1 [sTNFR1], and C-reactive protein [CRP]) were analyzed in 605 of these participants; we calculated the inflammatory index score using IL-6 and sTNFR1. We compared the C-statistic of an established registry-based prediction model for waitlist mortality adding frailty and/or inflammatory markers (1SD change in log IL-6, sTNFR1, CRP, or inflammatory index). Results The registry-based model had moderate predictive ability (c-statistic=0.655). Frailty was associated with increased mortality (2.19, 95%CI:1.26-3.79) but did not improve risk prediction (c-statistic=0.646; P=0.65). Like frailty, IL-6 (2.13, 95%CI:1.41-3.22), sTNFR1 (1.70, 95%CI:1.12-2.59), CRP (1.68, 95%CI:1.06-2.67), and the inflammatory index (2.09, 95%CI:1.38-3.16) were associated with increased mortality risk; unlike frailty, adding IL-6 (c-statistic=0.777; P=0.02), CRP (c-statistic=0.728; P=0.02), or inflammatory index (c-statistic=0.777; P=0.02) substantially improved mortality risk prediction. Conclusion Frailty and markers of inflammation were associated with increased waitlist mortality risk, but only markers of inflammation significantly improved ESRD risk prediction. These findings help clarify the accelerated aging physiology of ESRD and highlight easy to measure markers of increased waitlist mortality risk. Contact Information: Mara McAdams-DeMarco, Ph.D. Department of Epidemiology, 615, N. Wolfe St, W6033, Baltimore, MD 21205 (410) 502-1950 email: mara@jhu.edu Authorship Mara A. McAdams-DeMarco: Research design, data analysis, writing of the paper and review of the paper Hao Ying: Performance of the research, data analysis, writing of the paper and review of the paper Alvin Thomas: Writing of the paper and review of the paper Fatima Warsame: Performance of the research, writing of the paper and review of the paper Ashton A. Shaffer: Writing of the paper and review of the paper Christine E. Haugen: Performance of the research, writing of the paper and review of the paper Jacqueline M. Garonzik-Wang: Performance of the research, writing of the paper and review of the paper Niraj M. Desai: Performance of the research, writing of the paper and review of the paper Ravi Varadhan: Performance of the research, writing of the paper and review of the paper Jeremy D. Walston: Writing of the paper and review of the paper Silas P. Norman: Performance of the research, writing of the paper and review of the paper Dorry L. Segev: Research design, writing of the paper and review of the paper Disclosure The authors declare no conflicts of interest. Funding This study was supported by NIH grant R01AG042504 (PI: Dorry Segev), R01AG055781 (PI: McAdams-DeMarco) and K24DK101828 (PI: Dorry Segev). Mara McAdams-DeMarco was also supported by the Johns Hopkins University Claude D. Pepper Older Americans Independence Center (P30AG021334), National Institute on Aging (K01AG043501). Christine Haugen was supported by the National Institute on Aging (F32AG053025). Ashton Shaffer was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (F30DK116658). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2HCSx7K

Measured Glomerular Filtration Rate After Kidney Donation: No Evidence of Accelerated Decay

Background The rate of measured GFR change in kidney donors years after donation has not been adequately addressed. Whether this change is accelerated in the setting of 1 kidney is also understudied. Methods 214 randomly selected donors underwent serial GFR measurements of nonradioactive iohexol. eGFR at each visit was calculated using the CKD EPI and MDRD study equations. Results GFR visits were 4.8 ±1.3 years apart and the second occurring 16.9±9.1 years after donation. The majority (97.7%) were White; 60.8% female and 78.5% were related to their recipient. Most, 84.6%, had a GFR ≥60 ml/min/1.73m2, 14.0% had a GFR between 45-60 ml/min/1.73m2 and 1.4% had a GFR

https://ift.tt/2HiC3hS

Gearing Up for Stem Cell-Derived Beta Cells – Are We Ready?

No abstract available

https://ift.tt/2HCSoBe

Measured vs estimated glomerular filtration (eGFR) rate in the assessment of living kidney donors: eGFR has its limitations

No abstract available

https://ift.tt/2F43GJx

Therapeutic outcomes of haploidentical allogeneic hematopoietic stem cell transplantation in patients with severe aplastic anemia: a multicenter study

Background Haploidentical donor allogeneic hematopoietic stem cell transplantation (HID-HSCT) is an alternative curative treatment for patients with severe aplastic anemia (SAA) who do not have suitable matched related donors (MRD). The aim of this study was to compare the therapeutic outcomes of HID-HSCT with those of MRD-HSCT for SAA. Methods A total of 235 SAA patients who underwent HID-HSCT (116) or MRD-HSCT (119) at 11 transplantation centers from January 2007 to January 2016 were included. Complications and survival outcomes were evaluated and compared between the 2 groups. Results The HID group had a lower incidence of secondary graft failure (GF) but higher incidences of acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD). However, the incidence of severe aGVHD (grade III-IV), poor graft function (PGF), and infections was comparable between groups. Patients in the HID group had a significantly lower survival and overall survival rates than those in the MRD group. The estimated 3-year survival rates for the MRD and HID groups were 82.82% and 75.00%, respectively. Ferritin levels, GF, PGF, severe aGVHD, and infections were the significant risk factors for survival. Conclusion The overall survival rate is acceptable for patients who underwent HID-HSCT, making it a feasible treatment choice for SAA patients. Corresponding author: Professor Yang Xiao, Stem Cell Translational Medicine Center, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China & Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China. Email: jdxiao111@163.com Yonghua Li, Fengqi Duan and Haowen Xiao contributed equally to this work. Author contributions Yonghua Li and Yang Xiao designed the research. Yonghua Li and Fengqi Duan analyzed the data and wrote the manuscript. All authors conducted the research, collected the clinical data, and approved the submitted and final versions of the manuscript. Conflicts of interest The authors declare that there are no conflicts of interest. Funding This work was partly supported by the State Natural Sciences Fund (Project number 81570107), Natural Science Foundation of Guangdong Province (Project number 2014A030311006) and Guangzhou Pearl River Scientific and Technological New Star Capitals (grant no. 2012 J2200008). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2qN1cLg

Cytomegalovirus: a Guide for the Perplexed

No abstract available

https://ift.tt/2Jf7nii

CORM-401 reduces ischemia reperfusion injury in an ex vivo renal porcine model of the donation after cardiac death

Background Carbon monoxide (CO) inhalation protects organ by reducing inflammation and cell death during transplantation processes in animal model. However, using CO in clinical transplantation is difficult due to its delivery in a controlled manner. A manganese-containing CORM-401 has recently been synthesized which can efficiently deliver 3 molar equivalents of CO. We report the ability of this anti-inflammatory CORM-401 to reduce ischemia reperfusion injury associated with prolonged cold storage of renal allografts obtained from donation after cardiac death in a porcine model of transplantation. Methods To stimulate DCD condition, kidneys from large male Landrace pig were retrieved after 1h warm ischemia in situ by cross-clamping the renal pedicle. Procured kidneys, after a brief flushing with HTK solution were subjected to pulsatile perfusion at 4°C with UW solution for 4h and both kidneys were treated with either 200μM CORM-401 or inactive CORM-401 (iCORM-401) respectively. Kidneys were then reperfused with normothermic isogeneic porcine blood through oxygenated pulsatile perfusion for 10h. Urine was collected, vascular flow was assessed during reperfusion and histopathology was assessed after 10h of reperfusion. Results We have found that CORM-401 administration reduced urinary protein excretion, attenuated kidney damage markers (KIM-1 and NGAL), and reduced ATN and TUNEL staining in histopathologic sections. CORM-401 also prevented intrarenal hemorrhage and vascular clotting during reperfusion. Mechanistically, CORM-401 appeared to exert anti-inflammatory actions by suppressing Toll-like receptors 2, 4 and 6. Conclusions CORM-401 provides renal protection following cold storage of kidneys and provides a novel clinically relevant ex vivo organ preservation strategy. Correspondence: Patrick P.W. Luke, London Health Sciences, 339 Windermere Road, London, Ontario, Canada N6A 5A5. Email: patrick.luke@lhsc.on.ca Authorship R.N.B. participated in the performance of the research, data analysis, construction of figures and article writing. M.R.M participated in kidney perfusion and preparation of perfusion circuit. A.H participated in data analysis and pathological evaluation of tissue sections. G.A. participated in surgical procedures. P.B participated in kidney perfusion and urine collection. R.M. participated in kidney perfusion and blood collection. I.A. participated in surgical procedures. K.P.S participated in surgical procedures. Q. S., H.A and L.J. participated in data analysis. M.S. participated in performing RT-PCR experiments of TLR data. E.P. participated in measuring CO from CORM-401. A.S. participated in article editing. G.C participated in technical support regarding CORM-401 release. A.M.J. participated in intellectual conception of project, article editing and approval of the article. P.P.L participated in the intellectual conception of project, extensive literature review, partial article writing, editing and final approval of the article. Conflicts of Interest. All the authors declared no competing interests. Funding We would like to thank the Canadian National Transplantation Research Program sponsored by Canadian Institutes for Health Research (PPL), Physicians Services Incorporated Foundation (PSIF) (PPL, RNB), Academic Medical Organization of Southwestern Ontario (PPL, RNB), HSFO grant (G-17-0018622) to GC and Internal Research Fund (RNB, PPL), Department of Surgery at LHSC for financial support. HTK and UW solutions were provided by Methapharm Inc. and Bridge to life respectively. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2qLTnWb

Changes in pediatric heart transplant hospitalization costs over time

Background Despite significant changes in the past decade for children undergoing heart-transplantation, including the evolution of mechanical circulatory support and increasing patient complexity, costs and resource utilization have not been reassessed. We sought to utilize a novel linkage of clinical-registry and administrative data to examine changes in hospitalization costs over time in this population. Methods We identified all pediatric heart transplant recipients in a unique linked PHIS/SRTR dataset (2002-2016). Hospital costs were estimated from charges using cost-to-charge ratios, inflated to 2016 dollars. Severity-adjusted costs were calculated using generalized linear mixed-effects models. Costs were compared across 3 eras (Era-1:2002-2006; Era-2:2007-2011; and Era-3:2012-2016). Results A total of 2896 pediatric heart transplant recipients were included; Era-1:649 (22.4%), Era-2:1028 (35.5%), and Era-3:1219 (42.1%). ECMO support at transplant decreased over time, concurrent with an increase in VAD-supported patients. Between Era-1 and Era-2 there was an increase in pretransplant hospitalization costs ($343,692 vs. $435,554; p

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Crizotinib active in patients of East Asian ethnicity.

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Crizotinib active in patients of East Asian ethnicity.

Nat Rev Clin Oncol. 2018 Apr 18;:

Authors:

PMID: 29670245 [PubMed - as supplied by publisher]



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Combination effective against brain metastases.

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Combination effective against brain metastases.

Nat Rev Clin Oncol. 2018 Apr 18;:

Authors:

PMID: 29670244 [PubMed - as supplied by publisher]



https://ift.tt/2HgOejo

Nivolumab effective in treatment-resistant HL.

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Nivolumab effective in treatment-resistant HL.

Nat Rev Clin Oncol. 2018 Apr 18;:

Authors:

PMID: 29670243 [PubMed - as supplied by publisher]



https://ift.tt/2qN5rG1

High-level heteroplasmy for the m.7445A>G mitochondrial DNA mutation can cause progressive sensorineural hearing loss in infancy.

https:--linkinghub.elsevier.com-ihub-ima Related Articles

High-level heteroplasmy for the m.7445A>G mitochondrial DNA mutation can cause progressive sensorineural hearing loss in infancy.

Int J Pediatr Otorhinolaryngol. 2018 May;108:125-131

Authors: Matsushima K, Nakano A, Arimoto Y, Mutai H, Yamazawa K, Murayama K, Matsunaga T

Abstract
OBJECTIVE: Hearing loss caused by mutation of mitochondrial DNA typically develops in late childhood or early adulthood, but rarely in infancy. We report the investigation of a patient to determine the cause of his early onset hearing loss.
MATERIALS AND METHODS: The proband was a boy aged 1 year and 2 months at presentation. Newborn hearing screening test by automated auditory brainstem response generated "pass" results for both ears. His reaction to sound deteriorated by 9 months. Average pure tone threshold at 0.5, 1, and 2 kHz was 55 dB by conditioned orientation response audiometry. His father had congenital hearing loss, and his mother had progressive hearing loss since childhood. Invader assays and Sanger sequencing were performed to investigate genetic causes of the hearing loss in the proband, and heteroplasmy was assessed by PCR-restriction fragment length polymorphism, Sanger sequencing, and pyrosequencing. Additionally, mitochondrial function was evaluated by measurement of the oxygen consumption rate of patient skin fibroblasts.
RESULTS: An m.7445A > G mitochondrial DNA mutation and a heterozygous c.235delC (p.L79Cfs*3) mutation of GJB2 were detected in the proband. His mother carried the m.7445A > G mitochondrial DNA mutation, and his father was a compound heterozygote for GJB2 mutations (c.[235delC]; [134G > A; 408C > A]). Tissue samples from both the proband and his mother exhibited a high degree of heteroplasmy. Fibroblasts from the proband exhibited markedly reduced oxygen consumption rates. These data indicate that the proband had impaired mitochondrial function, resulting in hearing loss.
CONCLUSION: This research demonstrates that hearing loss in a proband who presented in infancy and that of his mother resulted from a high level of heteroplasmy for the m.7445A > G mitochondrial DNA mutation, indicating that this alteration can cause hearing loss in infancy.

PMID: 29605341 [PubMed - indexed for MEDLINE]



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Enhanced perceptual processing of self-generated motion: Evidence from steady-state visual evoked potentials

elsevier-non-solus.png

Publication date: 15 July 2018
Source:NeuroImage, Volume 175
Author(s): Wen Wen, Elisa Brann, Steven Di Costa, Patrick Haggard
The sense of agency emerges when our voluntary actions produce anticipated or predictable outcomes in the external world. It remains unclear how the sense of control also influences our perception of the external world. The present study examined perceptual processing of self-generated motion versus non-self-generated motion using steady-state visual evoked potentials (SSVEPs). Participants continuously moved their finger on a touchpad to trigger the movements of two shapes (Experiment 1) or two groups of dots (Experiment 2) on a monitor. Degree of control was manipulated by varying the spatial relation between finger movement and stimulus trajectory across conditions. However, the velocity, onset time, and offset time of visual stimuli always corresponded to participants' finger movement. Stimuli flickered at a frequency of either 7.5 Hz or 10 Hz, thus SSVEPs of these frequencies and their harmonics provided a frequency-tagged measurement of perceptual processing. Participants triggered the motion of all stimuli simultaneously, but had greater levels of control over some stimuli than over others. Their task was to detect a brief colour change on the border(s) of one shape (Experiment 1) or of one group of dots (Experiment 2). Although control over shapes/dots was irrelevant to the visual detection task, we found stronger SSVEPs for stimuli that were under a high level of control, compared with the stimuli that were under a low level of control. Our results suggest that the spatial regularity between self-generated movements and visual input boosted the neural responses underlying perceptual processing. Our results support the preactivation account of sensory attenuation, suggesting that perceptual processing of self-generated events is enhanced rather than inhibited.



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Young Age Is Associated With Increased Rates of Residual & Recurrent Pediatric Differentiated Thyroid Carcinoma.

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Young Age Is Associated With Increased Rates of Residual & Recurrent Pediatric Differentiated Thyroid Carcinoma.

Clin Endocrinol (Oxf). 2018 Apr 19;:

Authors: Hampson S, Stephens D, Wasserman JD

Abstract
OBJECTIVE: Differentiated thyroid carcinoma is rare in young children. There are conflicting data as to whether disease in this age group differs from that in adolescents and specifically, if it is more aggressive. Current practice guidelines do not differentiate treatment between these groups, but speculate that differences may exist. We sought to compare clinical features, treatment and outcomes between children (<12 years) and adolescents (12-18 years) with thyroid nodules and thyroid malignancy over a 20 year period.
DESIGN: Retrospective case series at a single tertiary-care hospital.
PATIENTS: 177 children 0-18 years of age at the time of diagnosis of a thyroid nodule and/or malignancy between 1992-2012.
RESULTS: There was a significantly higher female to male ratio in patients 12-18 years with benign and malignant nodules compared to those under 12. There was no difference across age groups with respect to cytology or histology, size, surgical approach or nodal status. Younger patients had a higher lymph node ratio. Younger patients received a higher cumulative dose of radioactive iodine (97.6 mCi/m2 ) versus older patients (75.9 mCi/m2 ), and had higher rates of pulmonary metastatic disease, although the differences did not achieve significance. Finally, children were less likely than adolescents to achieve a state of undetectable disease and fewer of the younger children remained disease-free.
CONCLUSIONS: Despite comparable apparent initial disease burden and treatment, younger children have poorer outcomes when compared to adolescents, even in the absence of nodal metastases, and thus may warrant intensification of primary therapy and/or tumour surveillance. This article is protected by copyright. All rights reserved.

PMID: 29672887 [PubMed - as supplied by publisher]



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Nitrogen-Rich Porous Polymers for Carbon Dioxide and Iodine Sequestration for Environmental Remediation.

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Nitrogen-Rich Porous Polymers for Carbon Dioxide and Iodine Sequestration for Environmental Remediation.

ACS Appl Mater Interfaces. 2018 Apr 19;:

Authors: Abdelmoaty YH, Tessema TD, Choudhury FA, El-Kadri OM, El-Kaderi HM

Abstract
The use of fossil fuels for energy production is accompanied by carbon dioxide release into the environment causing catastrophic climate changes. Meanwhile, replacing fossil fuels with carbon-free nuclear energy has the potential to release radioactive iodine during nuclear waste processing and in case of a nuclear accident. Therefore, developing efficient adsorbents for carbon dioxide and iodine capture is of great importance. Two nitrogen-rich porous polymers (NRPPs) derived from 4-bis-(2,4-diamino-1,3,5,-triazine)-benzene building block were prepared and tested for use in CO2 and I2 capture. Copolymerization of 1,4-bis-(2,4-diamino-1,3,5,-triazine)-benzene with terephthalaldehyde and 1,3,5-tris(4-formylphenyl)benzene in DMSO at 180 oC afforded highly porous NRPP-1 (SABET = 1579 m2 g-1) and NRPP-2 (SABET = 1028 m2 g-1), respectively. The combination of high nitrogen content, π-electron conjugated structure, and microporosity makes NRPPs very effective in CO2 uptake and I2 capture. NRPPs exhibit high CO2 uptakes (NRPP-1, 6.1 mmol g-1) and (NRPP-2, 7.06 mmol g-1) at 273 K and 1.0 bar. The 7.06 mmol g-1 CO2 uptake by NRPP-2 is the second highest value reported to date for porous organic polymers. According to vapor iodine uptake studies, the polymers display high capacity and rapid reversible uptake-release for I2 (NRPP-1, 192 wt. %) and (NRPP-2: 222 wt. %). Our studies show that the green nature (metal-free) of NRPPs and their effective capture of CO2 and I2 make this class of porous materials promising for environmental remediation.

PMID: 29671571 [PubMed - as supplied by publisher]



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Hearing loss and social support in urban and rural communities.

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Hearing loss and social support in urban and rural communities.

Int J Audiol. 2018 Apr 19;:1-8

Authors: Hay-McCutcheon MJ, Hyams A, Yang X, Parton J

Abstract
OBJECTIVE: Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama.
DESIGN: The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered.
STUDY SAMPLE: Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss.
RESULTS: Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction).
CONCLUSIONS: Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.

PMID: 29671659 [PubMed - as supplied by publisher]



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The Impact of Surgical Volume on Outcomes and Cost in Cleft Repair: A Kids' Inpatient Database Analysis.

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The Impact of Surgical Volume on Outcomes and Cost in Cleft Repair: A Kids' Inpatient Database Analysis.

Ann Plast Surg. 2018 Apr;80(4 Suppl 4):S174-S177

Authors: Bucknor A, Chattha A, Wu W, Egeler S, Ultee K, Afshar S, Lin SJ

Abstract
BACKGROUND: Centralization of specialist services, including cleft service delivery, is occurring worldwide with the aim of improving the outcomes. This study examines the relationship between hospital surgical volume in cleft palate repair and outcomes.
METHODS: A retrospective analysis of the Kids' Inpatient Database was undertaken. Children 3 years or younger undergoing cleft palate repair in 2012 were identified. Hospital volume was categorized by cases per year as low volume (LV; 0-14), intermediate volume (IV; 15-46), or high volume (HV; 47-99); differences in complications, hospital costs, and length of stay (LOS) were determined by hospital volume.
RESULTS: Data for 2389 children were retrieved: 24.9% (n = 595) were LV, 50.1% (n = 1196) were IV, and 25.0% (n = 596) were HV. High-volume centers were more frequently located in the West (71.9%) compared with LV (19.9%) or IV (24.5%) centers (P < 0.001 for hospital region). Median household income was more commonly highest quartile in HV centers compared with IV or LV centers (32.3% vs 21.7% vs 18.1%, P < 0.001). There was no difference in complications between different volume centers (P = 0.74). Compared with HV centers, there was a significant decrease in mean costs for LV centers ($9682 vs $,378, P < 0.001) but no significant difference in cost for IV centers ($9260 vs $9682, P = 0.103). Both IV and LV centers had a significantly greater LOS when compared with HV centers (1.97 vs 2.10 vs 1.74, P < 0.001).
CONCLUSIONS: Despite improvement in LOS in HV centers, we did not find a reduction in cost in HV centers. Further research is needed with analysis of outpatient, long-term outcomes to ensure widespread cost-efficiency.

PMID: 29672335 [PubMed - in process]



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Targeting the gut microbiome to treat the osteoarthritis of obesity.

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Targeting the gut microbiome to treat the osteoarthritis of obesity.

JCI Insight. 2018 Apr 19;3(8):

Authors: Schott EM, Farnsworth CW, Grier A, Lillis JA, Soniwala S, Dadourian GH, Bell RD, Doolittle ML, Villani DA, Awad H, Ketz JP, Kamal F, Ackert-Bicknell C, Ashton JM, Gill SR, Mooney RA, Zuscik MJ

Abstract
Obesity is a risk factor for osteoarthritis (OA), the greatest cause of disability in the US. The impact of obesity on OA is driven by systemic inflammation, and increased systemic inflammation is now understood to be caused by gut microbiome dysbiosis. Oligofructose, a nondigestible prebiotic fiber, can restore a lean gut microbial community profile in the context of obesity, suggesting a potentially novel approach to treat the OA of obesity. Here, we report that - compared with the lean murine gut - obesity is associated with loss of beneficial Bifidobacteria, while key proinflammatory species gain in abundance. A downstream systemic inflammatory signature culminates with macrophage migration to the synovium and accelerated knee OA. Oligofructose supplementation restores the lean gut microbiome in obese mice, in part, by supporting key commensal microflora, particularly Bifidobacterium pseudolongum. This is associated with reduced inflammation in the colon, circulation, and knee and protection from OA. This observation of a gut microbiome-OA connection sets the stage for discovery of potentially new OA therapeutics involving strategic manipulation of specific microbial species inhabiting the intestinal space.

PMID: 29669931 [PubMed - as supplied by publisher]



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Potent prion-like behaviors of pathogenic α-synuclein and evaluation of inactivation methods.

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Potent prion-like behaviors of pathogenic α-synuclein and evaluation of inactivation methods.

Acta Neuropathol Commun. 2018 Apr 18;6(1):29

Authors: Tarutani A, Arai T, Murayama S, Hisanaga SI, Hasegawa M

Abstract
The concept that abnormal protein aggregates show prion-like propagation between cells has been considered to explain the onset and progression of many neurodegenerative diseases. Indeed, both synthetic amyloid-like fibrils and pathogenic proteins extracted from patients' brains induce self-templated amplification and cell-to-cell transmission in vitro and in vivo. However, it is unclear whether exposure to exogenous prion-like proteins can potentially cause these diseases in humans. Here, we investigated in detail the prion-like seeding activities of several kinds of pathogenic α-synuclein (α-syn), including synthetic fibrils and detergent-insoluble fractions extracted from brains of patients with α-synucleinopathies. Exposure to synthetic α-syn fibrils at concentrations above 100 pg/mL caused seeded aggregation of α-syn in SH-SY5Y cells, and seeded aggregation was also observed in C57BL/6 J mice after intracerebral inoculation of at least 0.1 μg/animal. α-Syn aggregates extracted from brains of multiple system atrophy (MSA) patients showed higher seeding activity than those extracted from patients with dementia with Lewy bodies (DLB), and their potency was similar to that of synthetic α-syn fibrils. We also examined the effects of various methods that have been reported to inactivate abnormal prion proteins (PrPSc), including autoclaving at various temperatures, exposure to sodium dodecyl sulfate (SDS), and combined treatments. The combination of autoclaving and 1% SDS substantially reduced the seeding activities of synthetic α-syn fibrils and α-syn aggregates extracted from MSA brains. However, single treatment with 1% SDS or generally used sterilization conditions proved insufficient to prevent accumulation of pathological α-syn. In conclusion, α-syn aggregates derived from MSA patients showed a potent prion-like seeding activity, which could be efficiently reduced by combined use of SDS and autoclaving.

PMID: 29669601 [PubMed - in process]



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A comparative study of quantitative assessment with fluorine-18-fluorodeoxyglucose positron-emission tomography and endoscopic ultrasound in oesophageal cancer.

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A comparative study of quantitative assessment with fluorine-18-fluorodeoxyglucose positron-emission tomography and endoscopic ultrasound in oesophageal cancer.

Nucl Med Commun. 2018 Apr 18;:

Authors: Borakati A, Razack A, Cawthorne C, Roy R, Usmani S, Ahmed N

Abstract
OBJECTIVES: This study aims to assess the correlation between PET/CT and endoscopic ultrasound (EUS) parameters in patients with oesophageal cancer.
PATIENTS AND METHODS: All patients who had complete PET/CT and EUS staging performed for oesophageal cancer at our centre between 2010 and 2016 were included. Images were retrieved and analysed for a range of parameters including tumour length, volume and position relative to the aortic arch.
RESULTS: Seventy patients were included in the main analysis. A strong correlation was found between EUS and PET/CT in the tumour length, the volume and the position of the tumour relative to the aortic arch. Regression modelling showed a reasonable predictive value for PET/CT in calculating EUS parameters, with r higher than 0.585 in some cases.
CONCLUSION: Given the strong correlation between EUS and PET parameters, fluorine-18 fluorodeoxyglucose (F-FDG) PET can provide accurate information on the length and the volume of tumour in patients who either cannot tolerate EUS or have impassable strictures.

PMID: 29672466 [PubMed - as supplied by publisher]



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Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis.

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Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis.

Nucl Med Commun. 2018 Apr 18;:

Authors: Goense L, Meziani J, van Rossum PSN, Wessels FJ, Meijer GJ, Lam MGEH, van Hillegersberg R, Ruurda JP

Abstract
OBJECTIVE: To assess the additional value of cervical ultrasonography as supplement to a negative fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer.
METHODS: PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated F-FDG PET/CT or standalone F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography.
RESULTS: Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on F-FDG PET/CT or standalone F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%).
CONCLUSION: Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer.

PMID: 29672463 [PubMed - as supplied by publisher]



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Isolated Traumatic Diastasis of the Clival Synchondroses without Clival Fracture.

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Isolated Traumatic Diastasis of the Clival Synchondroses without Clival Fracture.

Pediatr Neurosurg. 2018 Apr 19;:

Authors: Faraji AH, Ochalski PG, Ozpinar A, Blatt JE, Pollack IF

Abstract
Traumatic clival fractures in the pediatric population are associated with high mortality rates. In our previously reported series, a subset of clival fractures were associated with traumatic diastasis of the surrounding clival synchondroses. Herein, we describe a pediatric case of an isolated traumatic diastasis of the clival synchondroses without clival fracture with significant injury to neurovascular structures. To our knowledge this is the first report to describe this entity. Careful radiological attention should be made towards the clival synchondroses in crushing head injuries to best tailor screening for cerebrovascular injury even in the absence of clival fractures.

PMID: 29672322 [PubMed - as supplied by publisher]



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Synoptic reporting of pituitary magnetic resonance imaging.

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Synoptic reporting of pituitary magnetic resonance imaging.

ANZ J Surg. 2018 Apr 19;:

Authors: Dhillon RS, King JA, Goldschlager T, Wang YY

Abstract
BACKGROUND: Pituitary adenomas are common, often asymptomatic tumours that are diagnosed incidentally by magnetic resonance imaging (MRI) of the brain. There is considerable variation in the reporting of pituitary MRI, in part because there is no consensus as to what information should be included in such reports. Synoptic reporting consists of using structured checklists to standardize communication. It has been adopted in the surgical pathology literature and more recently in the breast imaging field. The purpose of this study was to assess what parameters of a pituitary MRI report were useful to surgeons and in doing so, to propose a synoptic reporting template.
METHODS: We used the Delphi technique to obtain group consensus between three neuroradiologists, three otolaryngologists and three anterior skull base neurosurgeons across three tertiary Melbourne hospitals. Answers from the three speciality groups were then converted into numerical scores for analysis.
RESULTS: There was statistically significant consensus between specialties over which characteristics were deemed most important. These were T1 pre- and post-contrast sequences in the coronal and sagittal planes, the degree of displacement of the optic chiasm, invasion of the medial wall of the cavernous sinus, the size and pneumatization pattern of the sphenoid sinus and the differential diagnosis of aneurysm. There were also significant differences between groups.
CONCLUSIONS: There are similarities and differences between what radiologists, otolaryngologists and neurosurgeons deem as important features when reporting pituitary MRI. A synoptic reporting system template is proposed to improve consistency in pituitary imaging reports.

PMID: 29671958 [PubMed - as supplied by publisher]



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Neuroimaging of Meckel's cave in normal and disease conditions.

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Neuroimaging of Meckel's cave in normal and disease conditions.

Insights Imaging. 2018 Apr 18;:

Authors: Malhotra A, Tu L, Kalra VB, Wu X, Mian A, Mangla R, Michaelides E, Sanelli P, Gandhi D

Abstract
Meckel's cave is a dural recess in the posteromedial portion of the middle cranial fossa that acts as a conduit for the trigeminal nerve between the prepontine cistern and the cavernous sinus, and houses the Gasserian ganglion and proximal rootlets of the trigeminal nerve. It serves as a major pathway in perineural spread of pathologies such as head and neck neoplasms, automatically upstaging tumours, and is a key structure to assess in cases of trigeminal neuralgia. The purpose of this pictorial review is threefold: (1) to review the normal anatomy of Meckel's cave; (2) to describe imaging findings that identify disease involving Meckel's cave; (3) to present case examples of trigeminal and non-trigeminal processes affecting Meckel's cave.
TEACHING POINTS: • Meckel's cave contains the trigeminal nerve ganglion and rootlets between the prepontine cistern and cavernous sinus. • Assessment is essential for perineural spread of disease and trigeminal neuralgia. • Key imaging: neural enhancement, enlargement, perineural fat/CSF effacement and skull base foraminal changes.

PMID: 29671218 [PubMed - as supplied by publisher]



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Betamethasone gel compared with lidocaine jelly to reduce tracheal tube related postoperative airway symptoms: a randomized controlled trial.

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Betamethasone gel compared with lidocaine jelly to reduce tracheal tube related postoperative airway symptoms: a randomized controlled trial.

BMC Res Notes. 2017 Aug 01;10(1):361

Authors: Thapa P, Shrestha RR, Shrestha S, Bajracharya GR

Abstract
BACKGROUND AND OBJECTIVES: Post-operative airway symptoms can be troublesome to patients following an uneventful general anesthesia with endotracheal intubation. In this study, we compared the effectiveness of lubricating an endotracheal tube with betamethasone gel or lidocaine jelly with using an unlubricated tube in reducing the incidence and severity of postoperative sore throat, hoarseness and cough.
METHODS: This was a prospective, randomized, single-blind comparative study carried out among 120 ASA I and II patients aged 18-65 years undergoing elective surgery under general anesthesia with endotracheal intubation. Patients were randomly divided into three groups of 40 patients each. Endotracheal tube used for patients in group C was unlubricated, while that for group B and group L were lubricated up to 15 cm mark with 2.5 ml of 0.05% betamethasone gel or 2% lidocaine jelly respectively. Incidence and severity of postoperative sore throat, hoarseness and cough were observed at 1, 6 and 24 h following extubation.
RESULTS: At 24 h following extubation, group B had the lowest incidence of postoperative sore throat among the three groups (group B: 12.5% vs group L: 37.5% vs group C: 25%; p = 0.036). Severity of postoperative sore throat at 24 h was less with betamethasone (score 0: 87.5%, 1: 10%) compared with lidocaine (score 0: 62.5%, 1: 37.5%) and control (score 0:75%, 1: 20%) (p = 0.006). Observations at other times and of other variables were comparable.
CONCLUSION: Wide spread application of 0.05% betamethasone gel to lubricate the endotracheal tube significantly reduces the incidence and severity of sore throat at 24 h of extubation but not of hoarseness or cough.

PMID: 28764777 [PubMed - indexed for MEDLINE]



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Scintillation Yield Estimates of Colloidal Cerium-Doped LaF3 Nanoparticles and Potential for "Deep PDT".

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Scintillation Yield Estimates of Colloidal Cerium-Doped LaF3 Nanoparticles and Potential for "Deep PDT".

Radiat Res. 2018 Apr 19;:

Authors: Kudinov KA, Cooper DR, Ha JK, Hill CK, Nadeau JL, Seuntjens JP, Bradforth SE

Abstract
A hybrid of radiotherapy and photodynamic therapy (PDT) has been proposed in previously reported studies. This approach utilizes scintillating nanoparticles to transfer energy to attached photosensitizers, thus generating singlet oxygen for local killing of malignant cells. Its effectiveness strongly depends upon the scintillation yield of the nanoparticles. Using a liquid scintillator as a reference standard, we estimated the scintillation yield of Ce0.1La0.9F3/LaF3 core/shell nanoparticles at 28.9 mg/ml in water to be 350 photons/MeV under orthovoltage X-ray irradiation. The subsequent singlet oxygen production for a 60 Gy cumulative dose to cells was estimated to be four orders of magnitude lower than the "Niedre killing dose," used as a target value for effective cell killing. Without significant improvements in the radioluminescence properties of the nanoparticles, this approach to "deep PDT" is likely to be ineffective. Additional considerations and alternatives to singlet oxygen are discussed.

PMID: 29672241 [PubMed - as supplied by publisher]



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