Insulin-like growth factor-1 and insulin-like growth factor binding protein 3 and risk of postoperative cognitive dysfunction.

Insulin-like growth factor-1 and insulin-like growth factor binding protein 3 and risk of postoperative cognitive dysfunction.

Springerplus. 2015;4:787

Authors: Jiang J, Chen Z, Liang B, Yan J, Zhang Y, Jiang H

Abstract
Insulin-like growth factor (IGF)-1 is implicated in learning and memory. Experimental studies have suggested that the IGF-1 system is beneficial in cognition, especially in Alzheimer's disease (AD), by opposing Aβ amyloid processing and hyperphosphorylated tau toxicity. Low IGF-I and insulin-like growth factor binding protein (IGFBP)-3 serum levels are significantly associated with AD. To assess the relationship between circulating IGF-I and IGFBP3 levels and change of postoperative cognition. The study was performed in patients scheduled for elective head and neck carcinoma surgery under general anesthesia. On the day before the operation and postoperative days 1, 3 and 7, mini-mental state examination (MMSE) was performed by the same doctor, and blood samples were collected at 08:00 h after overnight fasting. The circulating levels of IGF-1 and IGFBP3 were measured by enzyme-linked immunosorbent assay. One hundred and two patients completed all four MMSE tests and forty-four of them completed all the four blood samples collection. Postoperative circulating IGF-1 level, ratio of IGF-1/IGFBP3 and MMSE score significantly decreased, whereas IGFBP3 level significantly increased compared with preoperative values in total patients. The change trends of circulating IGF-1 level and MMSE score were similar. Preoperative circulating IGF-1 level, ratio and MMSE score were significantly lower in POCD group compared to non-POCD group. There was no significant difference in preoperative level of circulating IGFBP3 between the two groups. Preoperative circulating IGF-1 level was negatively correlated with age and positively with MMSE. Logistic regression analysis revealed that lower preoperative IGF-1 level and elderly patients increased the odds of POCD. Down-regulation of circulating IGF-1 level may be involved in the mechanism of postoperative cognitive dysfunction. Older patients had lower circulating IGF-1 levels and were more susceptible to POCD.

PMID: 26702376 [PubMed]

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Small is the new big: An overview of newer supraglottic airways for children.

Small is the new big: An overview of newer supraglottic airways for children.

J Anaesthesiol Clin Pharmacol. 2015 Oct-Dec;31(4):440-9

Authors: Goyal R

Abstract
Almost all supraglottic airways (SGAs) are now available in pediatric sizes. The availability of these smaller sizes, especially in the last five years has brought a marked change in the whole approach to airway management in children. SGAs are now used for laparoscopic surgeries, head and neck surgeries, remote anesthesia; and for ventilation during resuscitation. A large number of reports have described the use of SGAs in difficult airway situations, either as a primary or a rescue airway. Despite this expanded usage, there remains little evidence to support its usage in prolonged surgeries and in the intensive care unit. This article presents an overview of the current options available, suitability of one over the other and reviews the published data relating to each device. In this review, the author also addresses some of the general concerns regarding the use of SGAs and explores newer roles of their use in children.

PMID: 26702197 [PubMed]

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Intrauterine Lipopolysaccharide-Induced Chorioamnionitis in a Sheep: Does It Affect the Auditory System?

Intrauterine Lipopolysaccharide-Induced Chorioamnionitis in a Sheep: Does It Affect the Auditory System?

Reprod Sci. 2015 Dec 23;

Authors: Smit AL, Lambermont VA, Stokroos RJ, Anteunis LJ, Chenault MN, Schaefer SM, Schoenmakers LW, Kremer B, Kramer BW

Abstract
BACKGROUND: Fetal exposure to in utero inflammation such as chorioamnionitis is related to central nervous system injury. We hypothesized that chorioamnionitis can provoke inflammatory changes in the perilymph and alter hearing outcome.
METHODS: Pregnant ewes were randomized into 2 groups: intrauterine injection with lipopolysaccharide (LPS; n = 19) or saline (n = 21). In the first experiment, fetal perilymph samples were taken for cytokine analysis. In the second experiment, consecutive bone-conducted auditory brain stem responses were obtained from 1 to 7 months after birth.
RESULTS: Perilymph samples showed a significant elevation in interleukin 8 in the LPS group. Auditory brain stem response analysis demonstrated higher response thresholds and a prolongation of absolute peak V and interpeak intervals I to V and III to V in the LPS group compared to sham treatment.
CONCLUSION: Our study confirms the hypothesis that an intrauterine inflammation by LPS can result in a fetal perilymphatic inflammatory response and functional impaired hearing outcomes after birth in a sheep model.

PMID: 26702124 [PubMed - as supplied by publisher]

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Environmental Microbial Exposure and Protection against Asthma

Despite the increasing availability of highly specific T-helper type 2 (Th2) antagonists, atopic asthma remains a major cause of morbidity among children and adults and may require lifelong treatment. Prospective birth-cohort studies have shown that asthma usually begins to develop during infancy…

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Sports-related eye and adnexal injuries in the Western Australian paediatric population

Acta Ophthalmologica

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Unraveling Myelodysplastic Syndromes: Current Knowledge and Future Directions

Abstract

Myelodysplastic syndromes (MDS) affect more than 30,000 patients in the USA per year, most of whom are elderly, and these diseases are associated with dismal prognoses. The main features of MDS are ineffective hematopoiesis and aberrant myeloid differentiation. Furthermore, MDS are heterogeneous, both clinically and molecularly. This heterogeneity and the frequent occurrence of age-related comorbidities make the management of these diseases challenging. In fact, there have been no new drug approvals for MDS in the USA in the last 9 years, and few currently available investigational drugs are likely to be approved in the near future. Novel targeted treatment based on better understanding of the pathogenesis of MDS is needed to maximize patient outcomes. Here, we discuss new insights into diagnostic accuracy, prognostic assessment, pathogenic mechanisms, and effective treatments for MDS.

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The effect of footwear and footfall pattern on running stride interval long-range correlations and distributional variability

Publication date: February 2016
Source:Gait & Posture, Volume 44
Author(s): Joel T. Fuller, Avelino Amado, Richard E.A van Emmerik, Joseph Hamill, Jonathan D. Buckley, Margarita D. Tsiros, Dominic Thewlis
The presence of long-range correlations (self-similarity) in the stride-to-stride fluctuations in running stride interval has been used as an indicator of a healthy adaptable system. Changes to footfall patterns when running with minimalist shoes could cause a less adaptable running gait. The purpose of this study was to investigate stride interval variability and the degree of self-similarity of stride interval in runners wearing minimalist and conventional footwear. Twenty-six trained habitual rearfoot footfall runners, unaccustomed to running in minimalist footwear, performed 6-min sub-maximal treadmill running bouts at 11, 13 and 15 km·h⁻¹ in minimalist and conventional shoes. Force sensitive resistors were placed in the shoes to quantify stride interval (time between successive foot contacts). Footfall position, stride interval mean and coefficient of variation (CV), were used to assess performance as a function of shoe type. Long-range correlations of stride interval were assessed using detrended fluctuation analysis (α). Mean stride interval was 1-1.3% shorter (P=0.02) and 27% of runners adopted a midfoot footfall (MFF) in the minimalist shoe. There was a significant shoe effect on α and shoe*speed*footfall interaction effect on CV (P<0.05). Runners that adopted a MFF in minimalist shoes, displayed reduced long-range correlations (P<0.05) and CV (P<0.06) in their running stride interval at the 15 km·h⁻¹ speed. The reduced variability and self-similarity observed for runners that changed to a MFF in the minimalist shoe may be suggestive of a system that is less flexible and more prone to injury.



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