Παρασκευή, 12 Φεβρουαρίου 2016

Plain language summaries



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Rare inherited skin diseases and the Genomics England 100 000 Genome Project



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Labelling: do we have it right?



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Editor's Choice



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Prediction of high total naevus count to estimate melanoma risk. We need more, don't we?



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Cover Image: Music box spines



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Response to ‘Kidney disease in moderate-to-severe psoriasis: a critical appraisal’



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Time for a patient-oriented outcome in vitiligo: the vitiligo noticeability scale



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A biosimilarity index for psoriasis



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CARD14 alterations and psoriasis: are psoriasis and related disorders genetic autoinflammatory diseases?



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Potential threat of meningitis from ampoule impurities: Prevention is always better than cure!

Thilaka Muthiah, Lailu Mathews, KR Sivashankar

Indian Journal of Anaesthesia 2016 60(2):145-146



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Comparative evaluation of two different loading doses of dexmedetomidine with midazolam-fentanyl for sedation in vitreoretinal surgery under peribulbar anaesthesia

Suman Shree Ramaswamy, B Parimala

Indian Journal of Anaesthesia 2016 60(2):89-93

Background and Aims: Midazolam-fentanyl (MDZ:FEN) combination has been routinely used for intravenous sedation in ophthalmic surgeries. Dexmedetomidine (DEX), a recent α2 adrenoreceptor agonist indicated for sedation for ophthalmic use at a loading dose of 0.5 μg/kg over 10 min, can cause deeper plane of sedation and surgeon dissatisfaction. Therefore, we proposed to evaluate the efficacy and safety of two different loading doses of DEX. Methods: In a prospective study, 60 patients aged 50-70 years, scheduled for retinal surgery under peribulbar block were divided equally to receive either MDZ:FEN or DEX 0.5 μg/kg (DEX full) or DEX 0.25 μg/kg (DEX half) loading dose over 10 min followed by titrated maintenance dose of DEX 0.25-0.4 μg/kg/h. Vital parameters, level of sedation (Ramsay Sedation Scale 1–6), effect on respiration and surgeon satisfaction were assessed at regular intervals. Surgeon satisfaction score (0–3) was noted. Results: 'DEX half' group patients had predominantly stable haemodynamics, level 3 sedation and surgeon satisfaction score of 2–3 (good to excellent operating conditions). This group had no vomiting and no respiratory depression. 'DEX full' group had a higher incidence of bradycardia, hypotension, level 4 sedation (Ramsay Sedation Scale) and lower surgeon satisfaction. Incidence of nausea and vomiting was higher in MDZ:FEN group compared to other two groups. Conclusion: DEX 0.25 μg/kg loading dose over 10 min followed by titrated maintenance dose is an effective alternative to MDZ:FEN and provides controlled (level 3) sedation and stable haemodynamics maximising surgeon satisfaction. Avoiding narcotic analgesics with its associated post-operative nausea and vomiting is an additional benefit.

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Prion body contamination: Is it not relevant in Indian context?

MC Rajesh

Indian Journal of Anaesthesia 2016 60(2):140-140



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A comparison of high-dose and low-dose tranexamic acid antifibrinolytic protocols for primary coronary artery bypass surgery

Stephen M McHugh, Lavinia Kolarczyk, Robert S Lang, Lawrence M Wei, Marquez Jose, Kathirvel Subramaniam

Indian Journal of Anaesthesia 2016 60(2):94-101

Background and Aims: Tranexamic acid (TA) is used for prophylactic antifibrinolysis in coronary artery bypass surgeries to reduce bleeding. We evaluated the efficacy of two different doses of TA for prophylactic antifibrinolysis in patients undergoing primary coronary artery bypass grafting (CABG) surgery in this retrospective cohort study at a tertiary care referral centre. Methods: One-hundred eighty-four patients who underwent primary CABG with cardiopulmonary bypass (CPB) via sternotomy between January 2009 and June 2011 were evaluated. Pre-operative patient characteristics, intraoperative data, post-operative bleeding, transfusions, organ dysfunction and 30-day mortality were compared between high-dose TA (30 mg/kg loading dose followed by infusion of 15 mg/kg/h until the end of surgery along with 2 mg/kg priming dose in the bypass circuit) and low-dose TA (15 mg/kg loading dose followed by infusion of 6 mg/kg/h until the end of surgery along with 1 mg/kg priming dose in the bypass circuit) groups. Univariate comparative analysis of all categorical and continuous variables was performed between the two groups by appropriate statistical tests. Linear and logistic regression analyses were performed to control for the effect of confounding on the outcome variables. Results: Chest tube output, perioperative transfusion of blood products and incidence of re-exploration for bleeding did not differ significantly (P> 0.05) between groups. Post-operative complications and 30-day mortality were comparable between the groups. The presence of cardiogenic shock and increased pre-operative creatinine were found to be associated with increased chest tube output on the post-operative day 2 by multivariable linear regression model. Conclusions: Low-dose TA protocol is as effective as high-dose protocol for antifibrinolysis in patients undergoing primary CABG with CPB.

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Effectiveness of transcutaneous electrical nerve stimulation as a supplement to multimodal analgesia for acute post-operative pain following abdominal surgery

Stephen Rajan Samuel, Arun G Maiya, Nita Varghese

Indian Journal of Anaesthesia 2016 60(2):151-152



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Association between frailty, cerebral oxygenation and adverse post-operative outcomes in elderly patients undergoing non-cardiac surgery: An observational pilot study

Shariq Ali Khan, Henry Wenjie Chua, Premila Hirubalan, Ranjith Baskar Karthekeyan, Harikrishnan Kothandan

Indian Journal of Anaesthesia 2016 60(2):102-107

Background and Aims: Although both frailty and low cerebral oxygen saturation increase the risk of post-operative complications, their relationship is yet to be investigated. The purpose of this observational study was to investigate the association between frailty, intraoperative cerebral oxygen saturation and post-operative complications in elderly patients undergoing non-cardiac surgery. Methods: After approval from the Institutional Review Board, 25 elderly patients (>65 years) undergoing non-cardiac major surgery were included in this study. Pre-operatively, all included patients were assessed for frailty and classified into frail and non-frail groups. All patients had routine intraoperative monitors, and a cerebral oximeter applied during anaesthesia. The 'intraoperative' anaesthesiologist and the post-operative study investigator were blinded to cerebral oximeter readings throughout the study. The incidence of significant intraoperative cerebral oxygen desaturation, adverse post-operative outcomes and length of hospital stay were compared. Statistical significance was defined as a value of P < 0.05. Results: We found that the frail group had more intraoperative cerebral desaturation (odds ratio [OR] [95% confidence interval [CI]]: 1.75 [1.11–2.75]) and longer median (interquartile range) length of hospital stay compared to the non-frail group (13.5 days [8.75–27.5] and 8 days [6–11], respectively). Furthermore, in patients with a low-baseline cerebral oxygen saturation (<55%), intraoperative cerebral desaturation (OR [95% CI]: 2.10 [1.00–4.42]), adverse post-operative outcomes (OR [95% CI]: 1.80 [1.00–3.23]) and median (interquartile range) length of hospital stay (15 days [9–31.5] vs. 9 days [6.25–13.75], P = 0.04) were significantly higher compared to subjects with higher baseline (≥55%) cerebral oxygen saturation. Conclusions: Frail patients have more intraoperative cerebral desaturation and longer lengths of hospital stay compared to non-frail patients.

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Complicated airway management in a neonate of congenital trachea-oesophageal fistula with subglottic stenosis

Sukhyanti Kerai, Alka Gupta, Jasvinder Kaur Kohli, Jyoti Sharma, Rajesh Sood

Indian Journal of Anaesthesia 2016 60(2):142-143



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Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study

K Asish, Varun Suresh

Indian Journal of Anaesthesia 2016 60(2):108-114

Background and Aims: Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs), presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. Methods: This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected.The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. Results: The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI), separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. Conclusion: The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians.

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Spontaneous repositioning of a malpositioned peripherally inserted central catheter

Sunil Rajan, Jerry Paul, Lakshmi Kumar

Indian Journal of Anaesthesia 2016 60(2):148-149



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Maternal and foetal outcome after epidural labour analgesia in high-risk pregnancies

Sukhen Samanta, Kajal Jain, Neerja Bhardwaj, Vanita Jain, Sujay Samanta, Rini Saha

Indian Journal of Anaesthesia 2016 60(2):115-120

Background and Aims: Low concentration local anaesthetic improves uteroplacental blood flow in antenatal period and during labour in preeclampsia. We compared neonatal outcome after epidural ropivacaine plus fentanyl with intramuscular tramadol analgesia during labour in high-risk parturients with intrauterine growth restriction of mixed aetiology. Methods: Forty-eight parturients with sonographic evidence of foetal weight <1.5 kg were enrolled in this non-randomized, double-blinded prospective study. The epidural (E) group received 0.15% ropivacaine 10 ml with 30 μg fentanyl incremental bolus followed by 7–15 ml 0.1% ropivacaine with 2 μg/ml fentanyl in continuous infusion titrated until visual analogue scale was three. Tramadol (T) group received intramuscular tramadol 1 mg/kg as bolus as well as maintenance 4–6 hourly. Neonatal outcomes were measured with cord blood base deficit, pH, ionised calcium, sugar and Apgar score after delivery. Maternal satisfaction was also assessed by four point subjective score. Results: Baseline maternal demographics and neonatal birth weight were comparable. Neonatal cord blood pH, base deficit, sugar, and ionised calcium levels were significantly improved in the epidural group in comparison to the tramadol group. Maternal satisfaction (P = 0.0001) regarding labour analgesia in epidural group was expressed as excellent by 48%, good by 52% whereas it was fair in 75% and poor in 25% in the tramadol group. Better haemodynamic and pain scores were reported in the epidural group. Conclusion: Epidural labour analgesia with low concentration local anaesthetic is associated with less neonatal cord blood acidaemia, better sugar and ionised calcium levels. The analgesic efficacy and maternal satisfaction are also better with epidural labour analgesia.

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Middle East respiratory syndrome: A new global threat

Pradeep Kumar Bhatia, Priyanka Sethi, Neeraj Gupta, Ghansham Biyani

Indian Journal of Anaesthesia 2016 60(2):85-88

The outbreak of Middle East respiratory syndrome (MERS) is reported from Saudi Arabia and the Republic of Korea. It is a respiratory disease caused by coronavirus. Camels are considered as a source for MERS transmission in humans, although the exact source is unknown. Human-to-human transmission is reported in the community with droplet and contact spread being the possible modes. Most patients without any underlying diseases remain asymptomatic or develop mild clinical disease, but some patients require critical care for mechanical ventilation, dialysis and other organ support. MERS is a disease with pandemic potential and awareness, and surveillance can prevent such further outbreaks.

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Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children

Shreepathi Krishna Achar, Maddani Shanmukhappa Sagar, Ranjan Shetty, Gurudas Kini, Jyothi Samanth, Chaitra Nayak, Vidya Madhu, Thara Shetty

Indian Journal of Anaesthesia 2016 60(2):121-126

Background and Aims: Dynamic parameters such as the respiratory variation in aortic flow peak velocity (ΔVpeak) and inferior vena cava distensibility index (dIVC) are accurate indices of fluid responsiveness in adults. Little is known about their utility in children. We studied the ability of these indices to predict fluid responsiveness in anaesthetised and mechanically ventilated children. Methods: This prospective study was conducted in 42 children aged between one to 14 years scheduled for elective surgery under general endotracheal anaesthesia. Mechanical ventilation was initiated with a tidal volume of 10 ml/kg. ΔVpeak, dIVC and stroke volume index (SVI) were measured before and after volume expansion (VE) with 10 ml/kg of crystalloid using transthoracic echocardiography. Patients were considered to be responders (R) and non-responders (NR) when SVI increased to either ≥15% or <15% after VE. ΔVpeak and dIVC were analysed between R and NR. Results: The best cut-off value for ΔVpeak as defined by the receiver operator characteristics (ROC) curve analysis was 12.2%, for which sensitivity, specificity, positive predictive value and negative predictive value were 100%, 94%, 96% and 100%, respectively, the area under the curve was 0.975. The best cut-off value for dIVC as defined by the ROC curve analysis was 23.5%, for which sensitivity, specificity, positive predictive value and negative predictive value were 91%, 89%, 91% and 89%, respectively, the area under the curve was 0.95. Conclusion: ΔVpeak and dIVC are reliable indices of fluid responsiveness in children.

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'Jaws of steel' after rocuronium

Monish S Raut, Arun Maheshwari, Aman Jyoti, Sandeep Joshi

Indian Journal of Anaesthesia 2016 60(2):141-142



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Challenges in Anaesthetic management of a child for thoracoscopic assisted oesophageal replacement

KR Chandrakala, Bindu Nagaraj, DV Bhagya, YR Chandrika

Indian Journal of Anaesthesia 2016 60(2):127-130

The loss of oesophageal length or obliteration of oesophageal lumen due to stricture acquired by accidental caustic ingestion is more common in children that may require major operative reconstruction. A number of procedures have been developed for anatomic replacement of oesophagus of which thoracoscopic assisted gastric transposition has shown the best outcome in children. This demands an extensive pre-operative evaluation, preparation and anaesthetic management since this is challenging and prolonged procedure done under one lung ventilation (OLV). Though it is a minimally invasive procedure, providing OLV and management of complications associated with it are the anaesthetic challenges among these children. We report anaesthetic management of an 8-year-old boy with oesophageal stricture following corrosive injury posted for thoracoscopic assisted gastric transposition.

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Videolaryngoscopy using an Android smartphone: A direct digital technique

John George Karippacheril, Minh Le Cong

Indian Journal of Anaesthesia 2016 60(2):143-145



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Simultaneous pancreas–kidney transplant for type I diabetes with renal failure: Anaesthetic considerations

Lakshmi Kumar, Sudhindran Surendran, Rajesh Kesavan, Ramachandran Narayana Menon

Indian Journal of Anaesthesia 2016 60(2):131-134

Pancreatic grafts have been successfully used in patients with diabetes and are combined with kidney transplantation in patients with renal failure. The propagation of awareness in organ donation in India has increased the donor pool of transplantable organs in the last few years making multi visceral transplants feasible in our country. We present the anaesthetic management of a 32-year-old male with diabetes mellitus and end-stage renal failure who was successfully managed with a combined pancreas and kidney transplantation.

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Dexmedetomidine in anaesthesia for a high-risk case of pheochromocytoma with poor left ventricular function

Harihar Vishwanath Hegde, Shivi Maheshwari, B Srinivas Pai, Sameer Ahmed

Indian Journal of Anaesthesia 2016 60(2):146-148



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Screening for inpatient hyperglycaemia in surgical patients under 40 years at the time of securing intravenous access on the operative table

Anjana Sagar Wajekar

Indian Journal of Anaesthesia 2016 60(2):135-137



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Palatal pressure necrosis due to inappropriate size of Guedel's airway?

Neeraj Kumar, Bikram Kumar Gupta, Prakash Kumar Dubey, Alok Kumar Bharti

Indian Journal of Anaesthesia 2016 60(2):150-150



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Iatrogenic surgical emphysema and pneumomediastinum in a case of emergency lower segment caesarean section

Upasana Goswami, Sushmita Sarangi

Indian Journal of Anaesthesia 2016 60(2):137-139



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Inactivation of Glutamate Racemase (MurI) Eliminates Virulence in Streptococcus mutans

Publication date: Available online 11 February 2016
Source:Microbiological Research
Author(s): Jianying Zhang, Jia Liu, Junqi Ling, Zhongchun Tong, Yun Fu, Min Liang
Inhibition of enzymes required for bacterial cell wall synthesis is often lethal or leads to virulence defects. Glutamate racemase (MurI), an essential enzyme in peptidoglycan biosynthesis, has been an attractive target for therapeutic interventions. Streptococcus mutans, one of the many etiological factors of dental caries, possesses a series of virulence factors associated with cariogenicity. However, little is known regarding the mechanism by which MurI influences pathogenesis of S. mutans. In this work, a stable mutant of S. mutans deficient in glutamate racemase (S. mutans FW1718) was constructed to investigate the impact of murI inactivation on cariogenic virulence in S. mutans UA159. Microscopy revealed that the murI mutant exhibited an enlarged cell size, longer cell chains, diminished cell-cell aggregation, and altered cell surface ultrastructure compared with the wild-type. Characterization of this mutant revealed that murI deficiency weakened acidogenicity, aciduricity, and biofilm formation ability of S. mutans (P<0.05). Real-time quantitative polymerase chain reaction (qRT-PCR) analysis demonstrated that the deletion of murI reduced the expression of the acidogenesis-related gene ldh by 44-fold (P<0.0001). The expression levels of the gene coding for surface protein antigen P (spaP) and the acid-tolerance related gene (atpD) were down-regulated by 99% (P<0.0001). Expression of comE, comD, gtfB and gtfC, genes related to biofilm formation, were down-regulated 8-, 43-, 85- and 298-fold in the murI mutant compared with the wild-type (P<0.0001), respectively. Taken together, the current study provides the first evidence that MurI deficiency adversely affects S. mutans virulence properties, making MurI a potential target for controlling dental caries.



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RT @myESMO : Young #oncologists! Apply now to join the #TranslationalResearch visit to Second University of Naples, 4-7 Apr https://t.co/YSh…

RT @myESMO : Young #oncologists! Apply now to join the #TranslationalResearch visit to Second University of Naples, 4-7 Apr https://t.co/YSh…

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@Karunashraya @FionaRawlinson1 @ecancer launch the #India #PalliativeCare course. Start now: https://t.co/4ngmCtiaOv https://t.co/QZE0ZM3yNr

@Karunashraya @FionaRawlinson1 @ecancer launch the #India #PalliativeCare course. Start now: https://t.co/4ngmCtiaOv https://t.co/QZE0ZM3yNr

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Increase in BRCA testing rates in young women with breast cancer https://t.co/JKmUIZ4MW6

Increase in BRCA testing rates in young women with breast cancer https://t.co/JKmUIZ4MW6

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Strong partnerships: an important resource for coping with the effects of cancer

The partners of women suffering from breast cancer show considerable signs of distress, but the more satisfied men are with their relationship, the less heavy their burden seems. What is more, a happy marriage reduces the likelihood that women will...

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Plasma cells in primary melanoma. Prognostic significance and possible role of IgA - Nature.com


Plasma cells in primary melanoma. Prognostic significance and possible role of IgA
Nature.com
In LN, clusters/sheets of IgA+ PCs were found both in the sinuses and subcapsular areas. Analysis of VDJ-rearrangements showed the IgA to be oligoclonal. Melanomas with clusters/sheets of ... In fact, the phenomenon of regression in primary melanomas ...



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Predictors of adherence to a 12-week exercise program among men treated for prostate cancer: ENGAGE study

Abstract

Understanding the factors that influence adherence to exercise programs is necessary to develop effective interventions for people with cancer. We examined the predictors of adherence to a supervised exercise program for participants in the ENGAGE study – a cluster randomized controlled trial that assessed the efficacy of a clinician-referred 12-week exercise program among men treated for prostate cancer. Demographic, clinical, behavioral, and psychosocial data from 52 participants in the intervention group were collected at baseline through self-report and medical records. Adherence to the supervised exercise program was assessed through objective attendance records. Adherence to the supervised exercise program was 80.3%. In the univariate analyses, cancer-specific quality of life subscales (role functioning = 0.37, = 0.01; sexual activity = 0.26, = 0.06; fatigue = −0.26, = 0.06, and hormonal symptoms = −0.31, = 0.03) and education (d = −0.60, = 0.011) were associated with adherence. In the subsequent multivariate analysis, role functioning (B = 0.309, = 0.019) and hormonal symptoms (B = −0.483, = 0.054) independently predicted adherence. Men who experienced more severe hormonal symptoms had lower levels of adherence to the exercise program. Those who experienced more positive perceptions of their ability to perform daily tasks and leisure activities had higher levels of adherence to the exercise program. Hormonal symptoms and role functioning need to be considered when conducting exercise programs for men who have been treated for prostate cancer.

Thumbnail image of graphical abstract

Adherence to a structured exercise program among men treated for prostate cancer was predicted by severity of hormonal symptoms and ability to perform daily tasks and leisure activities. Cancer-specific quality of life factors need to be considered when conducting exercise programs for men who have been treated for prostate cancer.



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A Few of My Favorite Spaces: The Long Line

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"My love for you is like the long line - similar to real love in most respects, just longer." Meet the cheesy Valentine's Day card of topological spaces.

-- Read more on ScientificAmerican.com
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Effects of meditation practice on spontaneous eyeblink rate

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Abstract

A rapidly growing body of research suggests that meditation can change brain and cognitive functioning. Yet little is known about the neurochemical mechanisms underlying meditation-related changes in cognition. Here, we investigated the effects of meditation on spontaneous eyeblink rates (sEBR), a noninvasive peripheral correlate of striatal dopamine activity. Previous studies have shown a relationship between sEBR and cognitive functions such as mind wandering, cognitive flexibility, and attention–functions that are also affected by meditation. We therefore expected that long-term meditation practice would alter eyeblink activity. To test this, we recorded baseline sEBR and intereyeblink intervals (IEBI) in long-term meditators (LTM) and meditation-naive participants (MNP). We found that LTM not only blinked less frequently, but also showed a different eyeblink pattern than MNP. This pattern had good to high degree of consistency over three time points. Moreover, we examined the effects of an 8-week course of mindfulness-based stress reduction on sEBR and IEBI, compared to an active control group and a waitlist control group. No effect of short-term meditation practice was found. Finally, we investigated whether different types of meditation differentially alter eyeblink activity by measuring sEBR and IEBI after a full day of two kinds of meditation practices in the LTM. No effect of meditation type was found. Taken together, these findings may suggest either that individual difference in dopaminergic neurotransmission is a self-selection factor for meditation practice, or that long-term, but not short-term meditation practice induces stable changes in baseline striatal dopaminergic functioning.



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Differential heart rate responses to social and monetary reinforcement in women with obesity

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Abstract

Obesity is often accompanied by weight stigmatization; subsequently, individuals with obesity frequently face social rejection. It has been shown that recurrent negative social experiences can alter the perception of social cues. However, the way individuals with obesity process social stimuli is not well understood. This study aims to investigate obesity-related alterations in social compared to nonsocial information processing. Women with obesity (n = 14) and without obesity (n = 14) participated in a social and a monetary incentive delay task in which they anticipated and received positive, negative, and neutral outcomes in the form of faces or money. During the experiment, phasic heart rate changes and reaction times were measured. Women with obesity, compared to lean women, exhibited a stronger differentiation during the anticipation of monetary and social reinforcement, showing slower reaction times to social cues compared to monetary cues. During the outcome processing phase, women with obesity relative to controls demonstrated diminished heart rate responses particularly to negative social outcomes. Interestingly, differences in cardiac responses in participants with obesity were moderated by weight-related teasing experiences. In women with obesity, a higher BMI was associated with blunted cardiac responses to social cues relative to monetary cues only if they reported more emotional pain after weight-related teasing. Our results contribute to a better understanding of social information processing in obesity and give first evidence for the role of negative social experiences in reinforcement processing.



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Dental Calculus Arrest of Dental Caries

The post Dental Calculus Arrest of Dental Caries appeared first on Welcome to Avens.



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Randomized trial of a physical activity intervention in women with metastatic breast cancer

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BACKGROUND

Exercise interventions improve fitness, functional capacity, and quality of life in patients with early-stage breast cancer, but to the authors' knowledge there are few data regarding the feasibility or potential benefits of exercise in women with metastatic breast cancer.

METHODS

Individuals with metastatic breast cancer were randomized 1:1 to a 16-week moderate-intensity exercise intervention or wait-list control group. Intervention goals included 150 minutes of moderate-intensity aerobic exercise per week. The baseline and 16-week evaluations included a modified Bruce Ramp treadmill test, 7-day Physical Activity Recall interview, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C-30) questionnaire.

RESULTS

A total of 101 participants were randomized (48 to the intervention group and 53 to the control group). The median age of the participants was 49 years, the median time since the diagnosis of metastatic breast cancer was 1.1 years, and approximately 42% of participants were undergoing chemotherapy at the time of enrollment. Study attrition was higher in the intervention arm (14 participants vs 8 participants; P = .15). Women randomized to the exercise intervention experienced a nonsignificant increase with regard to minutes of weekly exercise (62.4 minutes vs 46.0 minutes; P = .17) and physical functioning (EORTC QLQ C30: 4.79 vs 0.93 [P = .23] and Bruce Ramp Treadmill test: 0.61 minutes vs 0.37 minutes [P = .35]) compared with control participants.

CONCLUSIONS

Participation in an exercise intervention did not appear to result in significant improvements in physical functioning in a heterogeneous group of women living with advanced breast cancer. Given the significant benefits of exercise in women with early-stage breast cancer, more work is needed to explore alternative interventions to determine whether exercise could help women with metastatic disease live more fully with fewer symptoms from disease and treatment. Cancer 2016. © 2016 American Cancer Society.



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Editorial Board

Publication date: February 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 133, Issue 1





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Thanks to reviewers

Publication date: February 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 133, Issue 1





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Contents

Publication date: February 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 133, Issue 1





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Your journal at the outset of 2016: A progress report

Publication date: February 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 133, Issue 1
Author(s): C. Martin, D. Chevalier, O. Laccourreye




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Virtual planning and guided surgery in fibular free-flap mandibular reconstruction: A 29-case series

Publication date: Available online 11 February 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): D. Culié, O. Dassonville, G. Poissonnet, J.-C. Riss, J. Fernandez, A. Bozec
IntroductionVirtual planning and guided surgery (VPGS) has been recently developed for mandibular reconstruction, but benefit remains to be assessed. The aim of this study was to analyze the impact of VPGS on operative time and postoperative course.Material and methodsAll patients who underwent fibula free-flap mandibular reconstruction between 2013 and 2014 in our institution were included in a retrospective study. Operative times and postoperative course were compared between patients who underwent conventional surgery in 2013 and those who underwent VPGS in 2014.ResultsA total of 29 patients were included: 11 in 2013 and 18 in 2014. Taking all types of mandibular defect together, ischemia time was significantly decreased by VPGS (75min, vs 150min for conventional surgery; P<0.001), whereas overall operative time was not significantly reduced (481 and 516min, respectively; P=0.4). VPGS had no impact on postoperative course: local or general complications, time to decannulation and nasogastric tube removal, or length of stay.ConclusionVPGS significantly reduced fibula free-flap ischemia time. Long-term functional and esthetic benefit remains to be evaluated.



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New test could help select the best treatment for bowel cancer patients https://t.co/DLEGty2zEm

New test could help select the best treatment for bowel cancer patients https://t.co/DLEGty2zEm

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Clinical profile of megaloblastic anemia in China: a single center experience from MegA-1710 program over two decades



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Unilateral prurigo pigmentosa: A report of two cases



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