Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 11/19/17

Κυριακή 19 Νοεμβρίου 2017

Oral and Maxillofacial Radiology

Publication date: Available online 6 November 2017
Source:Radiologic Clinics of North America
Author(s): Dania Tamimi

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Imaging of Odontogenic Infections

Publication date: Available online 21 October 2017
Source:Radiologic Clinics of North America
Author(s): Shaza Mardini, Anita Gohel

Teaser

Odontogenic infections represent a common clinical problem in patients of all ages. The presence of teeth enables the direct spread of inflammatory products from dental caries, trauma, and/or periodontal disease into the maxilla and mandible. The radiographic changes seen depend on the type and duration of the inflammatory process and host body response. Imaging plays a central role in identifying the source of infection and the extent of the disease spread and in detecting any complications. Many different imaging modalities can be used. The radiographic features associated with acute and chronic inflammatory processes are discussed.

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Malignant Lesions in the Dentomaxillofacial Complex

Publication date: Available online 19 October 2017
Source:Radiologic Clinics of North America
Author(s): Susan M. White

Teaser

Malignancies in the maxillofacial region are rare but comprise a broad spectrum of lesions. Given the potential for malignancies to mimic dental/sinus/temporomandibular joint pathology or remain asymptomatic, the judicious radiologist will be familiar with the initial and unique malignant changes affecting the dentition, periodontium, and supporting osseous structures on conventional film, dental, and sinus imaging. This article is meant to serve as a complement to the many excellent texts dedicated to advanced imaging techniques for the staging of known malignancies. The lesions discussed are a representative sample of malignancies involving hard tissues of the maxillofacial complex but are far from complete.

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Fibroosseous and Other Lesions of Bone in the Jaws

Publication date: Available online 19 October 2017
Source:Radiologic Clinics of North America
Author(s): Mansur Ahmad, Laurence Gaalaas

Teaser

Fibroosseous lesions in the jaws have similar histologic and radiographic features. Despite their similarity, management varies significantly. In this article, common fibroosseous lesions and key radiographic features are described. Many of the fibroosseous lesions are diagnosed radiographically, without performing histologic examinations. For some of the fibroosseous lesions, for example, periapical osseous dysplasia, histologic examination is contraindicated. Cherubism and fibrous dysplasia have specific radiographic findings; these conditions can be diagnosed radiographically. Accurate diagnosis conditions is essential; some conditions do not require any intervention, while others require surgical resection. Patient demographics, for example, age, gender, and race, play important roles in diagnosis.

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Radiology of Implant Dentistry

Publication date: Available online 16 October 2017
Source:Radiologic Clinics of North America
Author(s): Asma'a Abdurrahman Al-Ekrish

Teaser

The article presents an overview of the goal of imaging at each stage of implant therapy and the usefulness and limitations of multidetector computed tomography (MDCT) in achieving those goals. Various MDCT protocols of use in implant imaging also are presented, with an emphasis on dose reduction and the use of iterative reconstruction techniques. Also discussed are options for viewing and analysis of CT images, issues related to appropriate image reformatting and interpretation, interactive treatment planning, and transfer of information from the images to the surgical field during implant surgery using surgical guides and CT-guided navigation systems.

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Incidentally detected Carotid Body Tumour : Case Report

Female, 60 years old, with headache and recurrent left tinnitus. Has been to several ENT clinics. Stayed unexplained for 5 Yrs. MRI brain incidentally detected the finding described below.

Case submitted by Dr. A. Altamimi, MD, DMRD, FRCR, Consultant Radiologist

MRI Brain revealed : special note is the presence of an incidentaloma in the form of a lobulated oval mass (about 2.5 x 3 x 4.5 cm) embedded in the left upper neck at the level of the carotid bifurcation (splaying the ICA and ECA carotid arteries) with some localized mass effect. It is generally iso-to-hypointense to muscle on T1, moderately hyperintense on T2 and FLAIR and becomes even brighter in STIR images and shows a more or less typical salt-and-pepper appearance representing flow voids (pepper) combined with punctate hyperintensities due to slow flow &/or hemorrhage (salt) in keeping with carotid body tumor (aka chemodectoma or carotid body paraganglioma). Brain MRI was otherwise normal.

Overview

Paragangliomas (PGLs) are uncommon tumors, incidence rate is 1 to 2 per 100,000, and the tumors are often given special designations, depending on their locations. Only 3% of all PGLs occur in head and neck, majority located in carotid body (carotid body tumors), temporal-bone/middle-ear (glomus jugulare) and vagus nerve in neck (vagal PGLs). 90% of head and neck PGLs are sporadic, while only 10% are hereditary in nature.

In literature, cases of PGL mimicking thyroid nodules are rarely encountered.

Abstract

Paragangliomas (PGLs) are neuroendocrine tumors arising from the extra-adrenal chromaffin tissue of the autonomic nervous system. They are most frequently found in the head and neck, mainly associated with the carotid body, vagus nerve, jugulotympanic paraganglia, and occasionally, the superior-inferior paraganglia.

Paragangliomas are rarely encountered in thyroid as well, and thyroid paragangliomas can be misinterpreted as medullary thyroid carcinomas. Tumors associated with arterial vessels and cranial nerves of the ontogenetic brachial arches, usually nonchromaffin and nonfunctioning, like carotid body PGs

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Evidence-Efficient Multihop Clustering Routing Scheme for Large-Scale Wireless Sensor Networks

Energy consumption and transmission reliability are the most common issues in wireless sensor networks (WSNs). By studying the broadcast nature of data transmission in WSNs, the mechanism of guaranteeing reliable transmission is abstracted as propagation of responsibility and availability. The responsibility and availability represent the accumulated evidence of nodes to support reliable transmission. Based on the developed mechanism, an evidence-efficient cluster head rotation strategy and algorithm are presented. Furthermore, backbone construction algorithm is studied to generate the minimum aggregation tree inside the candidate cluster heads. A minimum aggregation tree-based multihop routing scheme is also investigated, which allows the elected cluster heads to choose the optimally main path to forward data locally and dynamically. As a hybridization of the above, an evidence-efficient multihop clustering routing (EEMCR) method is proposed. The EEMCR method is simulated, validated, and compared with some previous algorithms. The experimental results show that EEMCR outperforms them in terms of prolonging network lifetime, improving transmission reliability, postponing emergence of death nodes, enhancing coverage preservation, and degrading energy consumption.

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Glaucomatocyclitic Crises May Occur in Patients with Narrow or Closed Angles

Purpose. To report cases of glaucomatocyclitic crises and discuss the possibility of occurrence in patients with narrow or closed angles. Background. The prevalence of angle closure is much higher among Asians than among the Western population. Currently, there is no evidence for a direct relationship between the etiology and angle structure. Design. A retrospective and observational case series. Methods. We retrospectively collected data from nine adult patients (three males and six females) who were diagnosed with a glaucomatocyclitic crisis and a shallow anterior chamber over a 21-year period, from 1995 to 2016, at the Kaohsiung Medical University Hospital. A narrow angle was defined as a grade less than the Shaffer system grade II. Ophthalmic examinations, including anterior segment biomicroscopy, direct ophthalmoscopy, intraocular pressure measurements, anterior chamber reaction, visual field tests, and the grade of the anterior chamber angle according to the Shaffer system, were reviewed. Results. These patients experienced at least one typical unilateral ocular hypertensive episode that fulfilled the criteria of a glaucomatocyclitic crisis without the angle feature. All patients had gonioscopically narrow or closed angles with or without peripheral anterior synechiae. Conclusions. The coexistence of narrow or closed angles and a glaucomatocyclitic crisis is possible, especially in patients of Asian descent. In patients with shallow anterior chambers, a glaucomatocyclitic crisis may be a cause of acute glaucoma episodes.

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Advances in Modelling Connected and Automated Vehicles

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A Language as a Self-Organized Critical System

A natural language (represented by texts generated by native speakers) is considered as a complex system, and the type thereof to which natural languages belong is ascertained. Namely, the authors hypothesize that a language is a self-organized critical system and that the texts of a language are “avalanches” flowing down its word cooccurrence graph. The respective statistical characteristics for distributions of the number of words in the texts of English and Russian languages are calculated; the samples were constructed on the basis of corpora of literary texts and of a set of social media messages (as a substitution to the oral speech). The analysis found that the number of words in the texts obeys power-law distribution.

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New Insights into the Benefits of Polyphenols in Chronic Diseases

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Lymphocytes in Placental Tissues: Immune Regulation and Translational Possibilities for Immunotherapy

Immune modulation at the fetomaternal interface is crucial to ensure that the fetal allograft is not rejected. In the present review, the focus is to describe basic functions of lymphocyte populations and how they may contribute to fetomaternal immune regulation, as well as determining what proportions and effector functions of these cells are reported to be present in placental tissues in humans. Also explored is the possibility that unique cell populations at the fetomaternal interface may be targets for adoptive cell therapy. Increasing the understanding of immune modulation during pregnancy can give valuable insight into other established fields such as allogeneic hematopoietic stem cell transplantation and solid organ transplantation. In these settings, lymphocytes are key components that contribute to inflammation and rejection of either patient or donor tissues following transplantation. In contrast, an allogeneic fetus eludes rejection by the maternal immune system.

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The Prognostic Value of HRAS mRNA Expression in Cutaneous Melanoma

This study aimed to investigate the prognostic value of HRAS mRNA expression in cutaneous melanoma. Cutaneous melanoma is an aggressive cancer with an increasing incidence. Few studies have focused on the transcriptional level of RAS isoforms (KRAS, NRAS, and HRAS) in cutaneous melanoma. To gain further insight into RAS isoforms at transcriptional level, we obtained the cutaneous melanoma data from cBioPortal and investigated the RAS mRNA expression levels in different stages of melanoma and evaluated their correlation with clinical characteristics and patients’ survival. Furthermore, we retrieved and analyzed the coexpression data and performed pathway enrichment analysis. Totally, 452 cutaneous melanoma cases were included in this study. We found that lower HRAS expression level was associated with longer patient survival. 206 genes that negatively correlated with HRAS expression were positively correlated with KRAS and NRAS expression. In contrast, no gene that positively correlated with HRAS expression was positively correlated with KRAS and NRAS expression. In conclusion, our data showed that transcriptional regulation was different for the three RAS isoforms in cutaneous melanoma. This study highlighted the prognostic value of HRAS mRNA expression and revealed that HRAS greatly differs from KRAS and NRAS at the transcriptional level.

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Changes in Etiologies of Hospitalized Patients with Liver Cirrhosis in Beijing 302 Hospital from 2002 to 2013

Background. Over the last 20 years, the prevalence of hepatitis B virus (HBV) infection in China has decreased gradually due to the application of a national HBV vaccination program. In contrast, the prevalence of alcoholic liver disease (ALD), nonalcoholic fatty liver disease, autoimmune liver disease, and drug-induced liver injury has markedly increased. Methods. We conducted a retrospective review of 82,562 hospitalized patients diagnosed with liver cirrhosis in Beijing 302 Hospital from 2002 to 2013. Results. The top four etiologies of cirrhosis were HBV, HCV, ALD, and autoimmune liver disease. The percentage of HBV cirrhosis decreased from 81.53% in 2002 to 66.0% in 2013, whereas the frequency of alcoholic cirrhosis increased from 3.34% in 2002 to 8.40% in 2013. Females (84.34%) accounted for the majority of cirrhotic patients with autoimmune liver diseases. Males accounted for 80.16% of HBV cirrhosis patients and 98.02% of alcoholic cirrhosis patients. Conclusion. In Beijing 302 Hospital, the top four etiologies of cirrhosis were HBV, HCV, ALD, and autoimmune liver disease. Over the last 12 years, the prevalence of HBV cirrhosis has decreased gradually, whereas that of alcoholic cirrhosis has increased significantly.

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What makes you a psychopath or an extreme altruist?

Psychopathy and altruism seem to be poles apart, but in her book The Fear Factor Abigail Marsh suggests how one can explain the other

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Put your best foot forward to help animal conservation

Animal footprints can help in the fight to save endangered species. Wild Track would like your help to collect images and develop its footprint identification technique

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Influence of Restorative Materials on Color of Implant-Supported Single Crowns in Esthetic Zone: A Spectrophotometric Evaluation

Restorations of 98 implant-supported single crowns in anterior maxillary area were divided into 5 groups: zirconia abutment, titanium abutment, and gold/gold hue abutment with zirconia coping, respectively, and titanium abutment with metal coping as well as gold/gold hue abutment with metal coping. A reflectance spectrophotometer was used to evaluate the color difference between the implant crowns and contralateral/neighboring teeth, as well as the color difference between the peri-implant soft tissue and the natural marginal mucosa. The mucosal discoloration score was used for subjective evaluation of the esthetic outcome of soft tissue around implant-supported single crowns in the anterior zone, and the crown color match score was used for subjective evaluation of the esthetic outcome of implant-supported restoration. ANOVA analysis was used to compare the differences among groups and Spearman correlation was used to test the relationships. A gold/gold hue abutment with zirconia coping was the best choice for an esthetic crown and the all-ceramic combination was the best for peri-implant soft tissue. Significant correlation was found between the spectrophotometric color difference of peri-implant soft tissue and mucosal discoloration score, while no significant correlation was found between the total spectrophotometric color difference of implant crown and crown color match score.

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Worldline Path-Integral Representations for Standard Model Propagators and Effective Actions

We develop the formalism to do worldline calculations relevant for the Standard Model. For that, we first figure out the worldline representations for the free propagators of massless chiral fermions of a single generation and gauge bosons of the Standard Model. Then we extend the formalism to the massive and dressed cases for the fermions and compute the QED vertex. We then go over fermionic one-loop effective actions and anomalies. To our knowledge, in the places where there has been an attempt at deriving the gauge boson propagator, the derivation is somewhat contrived, and we believe our derivation is more straightforward. Moreover, our incorporation of internal degrees of freedom is novel and sports some new features. The derivation of the QED vertex is also new. The treatment of the fermionic one-loop effective actions leads to a particularly economical derivation of chiral anomalies and the gauge anomaly freedom in the Standard Model, improving upon the state of the art in the literature. The appropriate worldline formalism developed thus sets the stage for Standard Model calculations beyond the tree and one-loop cases that incorporate Bern-Kosower type formulae for multiloop amplitudes, relevant for processes at the LHC.

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Inhibition of miR-200b/miR-429 Contributes to Neuropathic Pain development Through Targeting Zinc finger E box binding protein-1.

Inhibition of miR-200b/miR-429 Contributes to Neuropathic Pain development Through Targeting Zinc finger E box binding protein-1.

J Cell Physiol. 2017 Nov 18;:

Authors: Yan XT, Zhao Y, Cheng XL, He XH, Wang Y, Zheng WZ, Chen H, Wang YL

Abstract
Many studies have reported that microRNAs participate in neuropathic pain development. Previously, miR-200b and miR-429 are reported to be involved in various diseases. In our current study, we focused on their roles in neuropathic pain and we found that miR-200b and miR-429 were significantly decreased in chronic constriction injury (CCI) rat spinal cords and isolated microglials. miR-200b and miR-429 overexpression were able to relieve neuropathic pain through modulating PWT and PWL in CCI rats. Meanwhile, we observed that both miR-200b and miR-429 upregulation could repress neuroinflammation via inhibiting inflammatory cytokines such as IL-6, IL-1β and TNF-α in CCI rats. By carry out bioinformatics technology, Zinc finger E box binding protein-1 (ZEB1) was predicted as target of miR-200b and miR-429 and dual-luciferase reporter assays confirmed the correlation between them. ZEB1 has been reported to regulate a lot of diseases. Here, we found that ZEB1 was greatly increased in CCI rats and miR-200b and miR-429 overexpression markedly suppressed ZEB1 mRNA expression in rat microglial cells. In addition, knockdown of ZEB1 can reduce neuropathic pain development and co-transfection of LV-anti-miR-200b/miR-429 reversed this phenomenon in vivo. Taken these together, our results suggested that miR-200b/miR-429 can serve as an important regulator of neuropathic pain development by targeting ZEB1. This article is protected by copyright. All rights reserved.

PMID: 29150958 [PubMed - as supplied by publisher]

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Maternal mood disorders and lithium exposure in utero were not associated with poor cognitive development during childhood.

Maternal mood disorders and lithium exposure in utero were not associated with poor cognitive development during childhood.

Acta Paediatr. 2017 Nov 18;:

Authors: Forsberg L, Adler M, Römer Ek I, Ljungdahl M, Navér L, Gustafsson LL, Berglund G, Chotigasatien A, Hammar U, Böhm B, Wide K

Abstract
AIM: This study evaluated whether maternal mood disorders, particularly bipolar disorder, and lithium treatment during pregnancy influenced the neonatal health and cognition of children born from 2006- 2010.
METHODS: Our study at Karolinska University Hospital, Stockholm, Sweden, focused on women with and without mood disorders and their children. Information on pharmacotherapy, mental health, delivery and neonatal complications was retrospectively collected from electronic patient records. Children were tested in a blinded manner at 4-5 years of age with the Wechsler Preschool and Primary Scale of Intelligence, 3(rd) edition. Maternal health, child health and social situations were evaluated.
RESULTS: Of the 39 children, 20 were exposed to lithium and maternal mood disorders during pregnancy, eight were exposed to maternal mood disorders but not lithium and 11 were not exposed to maternal mood disorders or lithium. The children's Full Scale Intelligence Quotient (IQ), Performance IQ and Verbal IQ results did not differ significantly between the groups. The processing speed quotient was significantly lower in children exposed to mood disorders, but there was a high level of missing data for this subtest.
CONCLUSION: This small, clinical cohort showed no significant association between mothers' prenatal exposure to lithium or mood disorders and their offspring's IQ. This article is protected by copyright. All rights reserved.

PMID: 29150869 [PubMed - as supplied by publisher]

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Family behaviours that have an impact on the self-management activities of adults living with Type 2 diabetes: a systematic review and meta-synthesis.

Family behaviours that have an impact on the self-management activities of adults living with Type 2 diabetes: a systematic review and meta-synthesis.

Diabet Med. 2017 Nov 18;:

Authors: Vongmany J, Luckett T, Lam L, Phillips JL

Abstract
AIMS: To identify family behaviours that adults with Type 2 diabetes' perceive as having an impact on their diabetes self-management.
BACKGROUND: Research suggests that adults with Type 2 diabetes perceive that family members have an important impact on their self-management; however, it is unclear which family behaviours are perceived to influence self-management practices.
METHODS: This meta-synthesis identified and synthesized qualitative studies from the databases EMBASE, Medline and CINAHL published between the year 2000 and October 2016. Studies were eligible if they provided direct quotations from adults with Type 2 diabetes, describing the influence of families on their self-management. This meta-synthesis adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement.
RESULTS: Of the 2606 studies screened, 40 were included. This meta-synthesis identified that adults with Type 2 diabetes perceive family behaviours to be either: 1) facilitators of diabetes self-management; 2) barriers to diabetes self-management; or 3) equivocal behaviours with the potential to both support and/or impede diabetes self-management. Seven sub-themes were identified within these themes, including: four facilitator sub-themes ('positive care partnerships'; 'family watchfulness'; 'families as extrinsic motivator' and 'independence from family'); two barrier sub-themes ('obstructive behaviours' and 'limited capacity for family support'); and one equivocal behaviours subtheme ('regular reminders and/or nagging').
CONCLUSION: While most family behaviours are unambiguously perceived by adults with Type 2 diabetes to act as facilitators of or barriers to self-management, some behaviours were perceived as being neither clear facilitators nor barriers; these were termed 'equivocal behaviours'. If the concept of 'equivocal behaviours' is confirmed, it may be possible to encourage the adult living with Type 2 diabetes to reframe these behaviours so that they are perceived as enabling their diabetes self-management. This article is protected by copyright. All rights reserved.

PMID: 29150863 [PubMed - as supplied by publisher]

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Legislation of direct-to-consumer genetic testing in Europe: a fragmented regulatory landscape.

Legislation of direct-to-consumer genetic testing in Europe: a fragmented regulatory landscape.

J Community Genet. 2017 Nov 18;:

Authors: Kalokairinou L, Howard HC, Slokenberga S, Fisher E, Flatscher-Thöni M, Hartlev M, van Hellemondt R, Juškevičius J, Kapelenska-Pregowska J, Kováč P, Lovrečić L, Nys H, de Paor A, Phillips A, Prudil L, Rial-Sebbag E, Romeo Casabona CM, Sándor J, Schuster A, Soini S, Søvig KH, Stoffel D, Titma T, Trokanas T, Borry P

Abstract
Despite the increasing availability of direct-to-consumer (DTC) genetic testing, it is currently unclear how such services are regulated in Europe, due to the lack of EU or national legislation specifically addressing this issue. In this article, we provide an overview of laws that could potentially impact the regulation of DTC genetic testing in 26 European countries, namely Austria, Belgium, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, the Netherlands and the United Kingdom. Emphasis is placed on provisions relating to medical supervision, genetic counselling and informed consent. Our results indicate that currently there is a wide spectrum of laws regarding genetic testing in Europe. There are countries (e.g. France and Germany) which essentially ban DTC genetic testing, while in others (e.g. Luxembourg and Poland) DTC genetic testing may only be restricted by general laws, usually regarding health care services and patients' rights.

PMID: 29150824 [PubMed - as supplied by publisher]

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Metabolic dynamics and physiological adaptation of Panax ginseng during development.

Metabolic dynamics and physiological adaptation of Panax ginseng during development.

Plant Cell Rep. 2017 Nov 17;:

Authors: Kim YJ, Joo SC, Shi J, Hu C, Quan S, Hu J, Sukweenadhi J, Mohanan P, Yang DC, Zhang D

Abstract
KEY MESSAGE: The dynamics of metabolites from leaves to roots of Panax ginseng during development has revealed the tissue-specific and year-specific metabolic networks. Being an essential Oriental medicinal plant, ginseng (Panax ginseng Meyer) is a slow-growing perennial herb-accumulating pharmaceutically active metabolites such as ginsenosides in roots during growth. However, little is known about how ginseng plants survive in the harsh environments such as winter cold and summer heat for a longer period and accumulates those active metabolites as the plant grows. To understand the metabolic kinetics in both source and sink organs such as leaves and roots of ginseng plant, respectively, and to assess the changes in ginsenosides biosynthesis during ginseng growth, we investigated the metabolic profiles from leaves and roots of 1-, 4-, and 6-year-old field-grown ginseng plants. Using an integrated non-targeted metabolomic approach, we identified in total 348 primary and secondary metabolites, which provided us for the first time a global metabolomic assessment of ginseng during growth, and morphogenesis. Strikingly, the osmoprotectants and oxidized chemicals were highly accumulated in 4- and 6-year-old ginseng leaves suggested that ginseng develop a wide range of metabolic strategies to adapt unfavorable conditions as they mature. In 6-year-old plants, ginsenosides were decreased in leaves but increased in roots up to 1.2- to sixfold, supporting the view that there is a long-distance transport of ginsenosides from leaves to roots as ginseng plants mature. Our findings provide insights into the metabolic kinetics during the development of ginseng plant and this could complement the pharmacological importance of ginseng and its compounds according to their age.

PMID: 29150823 [PubMed - as supplied by publisher]

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Cd271 mediates proliferation and differentiation of epidermal stem cells to support cutaneous burn wound healing.

Cd271 mediates proliferation and differentiation of epidermal stem cells to support cutaneous burn wound healing.

Cell Tissue Res. 2017 Nov 18;:

Authors: Zhang M, Cao Y, Li X, Hu L, Taieb SK, Zhu X, Zhang J, Feng Y, Zhao R, Wang M, Xue W, Yang Z, Wang Y

Abstract
Burn wounds can significantly reduce the quality of life of patients with respect to their physiology and psychology and can even threaten their lives. Many treatments have been proposed, including stem cell therapy but no effective method can as yet cure such damage. Our study highlights the role of Cd271 in epidermal stem cells (eSC) during the healing of burn wounds. The expression of Cd271 increases together with burn wound healing. Injection of Cd271-over-expressing eSC into wounds promotes the healing rate in a mouse burn model. Over-expression of Cd271 enhances the abilities of eSC with regard to their differentiation, proliferation and migration and even their resistance to apoptosis in vitro. These results are in accordance with a hypothesis suggesting that Cd271 promotes the healing of skin burn wounds by improving the potential of eSC for differentiation, proliferation and migration. Our findings shed light on the role of Cd271 in wound healing and may provide new therapeutic approaches for curing burn wounds of the skin.

PMID: 29150821 [PubMed - as supplied by publisher]

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Beat-to-beat estimation of stroke volume using impedance cardiography and artificial neural network.

Beat-to-beat estimation of stroke volume using impedance cardiography and artificial neural network.

Med Biol Eng Comput. 2017 Nov 18;:

Authors: Naidu SMM, Pandey PC, Bagal UR, Hardas SP

Abstract
Impedance cardiography is a low-cost noninvasive technique, based on monitoring of the thoracic impedance, for estimation of stroke volume (SV). Impedance cardiogram (ICG) is the negative of the first derivative of the impedance signal. A technique for beat-to-beat SV estimation using impedance cardiography and artificial neural network (ANN) is proposed. A three-layer feed-forward ANN with error back-propagation algorithm is optimized by examining the effects of number of neurons in the hidden layer, activation function, training algorithm, and set of input parameters. The input parameters are obtained by automatic detection of the ICG characteristic points, and the target values are obtained by beat-to-beat SV measurements from time-aligned Doppler echocardiogram. The technique is evaluated using an ICG-echocardiography database with recordings from subjects with normal health in the under-rest and post-exercise conditions and from subjects with cardiovascular disorders in the under-rest condition. The proposed technique performed much better than the earlier established equation-based estimations, and it resulted in correlation coefficient of 0.93 for recordings from subjects with cardiovascular disorders. It may be helpful in improving the acceptability of impedance cardiography in clinical practice. Graphical abstract ᅟ.

PMID: 29150800 [PubMed - as supplied by publisher]

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SpinoBot: An MRI-Guided Needle Positioning System for Spinal Cellular Therapeutics.

SpinoBot: An MRI-Guided Needle Positioning System for Spinal Cellular Therapeutics.

Ann Biomed Eng. 2017 Nov 17;:

Authors: Squires A, Oshinski JN, Boulis NM, Tse ZTH

Abstract
The neurodegenerative disease amyotrophic lateral sclerosis (ALS) results in the death of motor neurons in voluntary muscles. There are no cures for ALS and few available treatments. In studies with small animal models, injection of cellular therapeutics into the anterior horn of the spinal cord has been shown to inhibit the progression of ALS. It was hypothesized that spinal injection could be made faster and less invasive with the aid of a robot. The robotic system presented-SpinoBot-uses MRI guidance to position a needle for percutaneous injection into the spinal cord. With four degrees of freedom (DOF) provided by two translation stages and two rotational axes, SpinoBot proved capable of advanced targeting with a mean error of 1.12 mm and standard deviation of 0.97 mm in bench tests, and a mean error of 2.2 mm and standard deviation of 0.85 mm in swine cadaver tests. SpinoBot has shown less than 3% signal-to-noise ratio reduction in 3T MR imaging quality, demonstrating its compliance to the MRI environment. With the aid of SpinoBot, the length of the percutaneous injection procedure is reduced to less than 60 min with 10 min for each additional insertion. Although SpinoBot is designed for ALS treatment, it could potentially be used for other procedures that require precise access to the spine.

PMID: 29150766 [PubMed - as supplied by publisher]

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Cellular and molecular responses of adult zebrafish after exposure to CuO nanoparticles or ionic copper.

Cellular and molecular responses of adult zebrafish after exposure to CuO nanoparticles or ionic copper.

Ecotoxicology. 2017 Nov 17;:

Authors: Vicario-Parés U, Lacave JM, Reip P, Cajaraville MP, Orbea A

Abstract
Due to their antimicrobial, electrical and magnetic properties, copper nanoparticles (NPs) are suitable for a vast array of applications. Copper can be toxic to biota, making it necessary to assess the potential hazard of copper nanomaterials. Zebrafish (Danio rerio) were exposed to 10 µg Cu/L of CuO NPs of ≈100 nm (CuO-poly) or ionic copper to compare the effects provoked after 3 and 21 days of exposure and at 6 months post-exposure (mpe). At 21 days, significant copper accumulation was only detected in fish exposed to ionic copper. Exposure to both copper forms caused histopathological alterations that could reduce gill functionality, more markedly in the case of ionic copper. Nevertheless, at 6 mpe higher prevalences of gill lesions were detected in fish previously exposed to CuO-poly NPs. No relevant histological alterations were detected in liver, but the lysosomal membrane stability test showed significantly impaired general health status after exposure to both metal forms that lasted up to 6 mpe. 69 transcripts appeared regulated after 3 days of exposure to CuO-poly NPs, suggesting that NPs could produce oxidative stress and reduce metabolism and transport processes. Thirty transcripts were regulated after 21 days of exposure to ionic copper, indicating possible DNA damage. Genes of the circadian clock were identified as the key genes involved in time-dependent differences between the two copper forms. In conclusion, each copper form showed a distinct pattern of liver transcriptome regulation, but both caused gill histopathological alterations and long lasting impaired health status in adult zebrafish.

PMID: 29150731 [PubMed - as supplied by publisher]

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Re-educating immunity in respiratory allergies: the potential for hematopoietic stem cell-mediated gene therapy.

Re-educating immunity in respiratory allergies: the potential for hematopoietic stem cell-mediated gene therapy.

J Mol Med (Berl). 2017 Nov 17;:

Authors: Brooks JF, Davies JM, Wells JW, Steptoe RJ

Abstract
Respiratory allergies represent a significant disease burden worldwide affecting up to 300 million people globally. Medication and avoidance of known triggers do not address the underlying pathology. Traditional immunotherapies for allergy aim to reinstate immune homeostasis but require years of treatment and have poor long-term efficacy. Novel approaches, such as gene-engineered hematopoietic stem cell transplantation, induce profound antigen-specific tolerance in autoimmunity. Recent evidence shows this approach may also have therapeutic utility for allergy. Here, we review the mechanisms of antigen-specific tolerance and the potential of stem cell-mediated gene therapy to induce tolerance in allergic respiratory diseases.

PMID: 29150718 [PubMed - as supplied by publisher]

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Gene expression profile changes in the jejunum of weaned piglets after oral administration of Lactobacillus or an antibiotic.

Gene expression profile changes in the jejunum of weaned piglets after oral administration of Lactobacillus or an antibiotic.

Sci Rep. 2017 Nov 17;7(1):15816

Authors: Zhang D, Shang T, Huang Y, Wang S, Liu H, Wang J, Wang Y, Ji H, Zhang R

Abstract
The small intestine plays an essential role in the health and well-being of animals. Previous studies have shown that Lactobacillus has a protective effect on intestinal morphology, intestinal epithelium integrity and appropriate maturation of gut-associated tissues. Here, gene expression in jejunum tissue of weaned piglets was investigated by RNA-seq analysis after administration of sterile saline, Lactobacillus reuteri, or an antibiotic (chlortetracycline). In total, 401 and 293 genes were significantly regulated by chlortetracycline and L. reuteri, respectively, compared with control treatment. Notably, the HP, NOX1 and GPX2 genes were significantly up-regulated in the L. reuteri group compared with control, which is related to the antioxidant ability of this strain. In addition, the expression of genes related to arachidonic acid metabolism and linoleic acid metabolism enriched after treatment with L. reuteri. The fatty acid composition in the jejunum and colon was examined by GC-MS analysis and suggested that the MUFA C18:1n9c, and PUFAs C18:2n6c and C20:4n6 were increased in the L. reuteri group, verifying the GO enrichment and KEGG pathway analyses of the RNA-seq results. The results contribute to our understanding of the probiotic activity of this strain and its application in pig production.

PMID: 29150660 [PubMed - in process]

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Transcriptome sequencing and differential gene expression analysis of the schistosome-transmitting snail Oncomelania hupensis inhabiting hilly and marshland regions.

Transcriptome sequencing and differential gene expression analysis of the schistosome-transmitting snail Oncomelania hupensis inhabiting hilly and marshland regions.

Sci Rep. 2017 Nov 17;7(1):15809

Authors: Zhao JS, Wang AY, Zhao HB, Chen YH

Abstract
The freshwater snail Oncomelania hupensis is the unique intermediate host of the blood fluke Schistosoma japonicum, which is the major cause of schistosomiasis. The snail inhabits two contrasting environments: the hilly and marshland regions. The hilly snails are smaller in size and have the typical smooth shell, whereas the marshland snails are larger and possess the ribbed shell. To reveal the differences in gene expression between the hilly and marshland snails, a total of six snails, three per environment, were individually examined by RNA sequencing technology. All paired-end reads were assembled into contigs from which 34,760 unigenes were predicted. Based on single nucleotide polymorphisms, principal component analysis and neighbor-joining clustering revealed two distinct clusters of hilly and marshland snails. Analysis of expression changes between environments showed that upregulated genes relating to immunity and development were enriched in hilly snails, while those associated with reproduction were over-represented in marshland snails. Eight differentially expressed genes between the two types of snails were validated by qRT-PCR. Our study identified candidate genes that could be targets for future functional studies, and provided a link between expression profiling and ecological adaptation of the snail that may have implications for schistosomiasis control.

PMID: 29150650 [PubMed - in process]

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Shedding light on the neonatal brain: probing cerebral hemodynamics by diffuse optical spectroscopic methods.

Shedding light on the neonatal brain: probing cerebral hemodynamics by diffuse optical spectroscopic methods.

Sci Rep. 2017 Nov 17;7(1):15786

Authors: Farzam P, Buckley EM, Lin PY, Hagan K, Grant PE, Inder TE, Carp SA, Franceschini MA

Abstract
Investigating the cerebral physiology of healthy term newborns' brains is important for better understanding perinatal brain injuries, of which the most common etiologies are hypoxia and ischemia. Hence, cerebral blood flow and cerebral oxygenation are important biomarkers of brain health. In this study, we employed a hybrid diffuse optical system consisting of diffuse correlation spectroscopy (DCS) and frequency-domain near infrared spectroscopy (FDNIRS) to measure hemoglobin concentration, oxygen saturation, and indices of cerebral blood flow and metabolism. We measured 30 term infants to assess the optical and physiological characteristics of the healthy neonatal brain in the frontal, temporal, and parietal lobes. We observed higher metabolism in the right hemisphere compared to the left and a positive correlation between gestational age and the level of cerebral hemoglobin concentration, blood volume, and oxygen saturation. Moreover, we observed higher cerebral blood flow and lower oxygen saturation in females compared to males. The delayed maturation in males and the sexual dimorphism in cerebral hemodynamics may explain why males are more vulnerable to perinatal brain injuries than females.

PMID: 29150648 [PubMed - in process]

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One-pot synthesis of trifunctional chitosan-EDTA-β-cyclodextrin polymer for simultaneous removal of metals and organic micropollutants.

One-pot synthesis of trifunctional chitosan-EDTA-β-cyclodextrin polymer for simultaneous removal of metals and organic micropollutants.

Sci Rep. 2017 Nov 17;7(1):15811

Authors: Zhao F, Repo E, Yin D, Chen L, Kalliola S, Tang J, Iakovleva E, Tam KC, Sillanpää M

Abstract
The global contamination of water resources with inorganic and organic micropollutants, such as metals and pharmaceuticals, poses a critical threat to the environment and human health. Herein, we report on a bio-derived chitosan-EDTA-β-cyclodextrin (CS-ED-CD) trifunctional adsorbent fabricated via a facile and green one-pot synthesis method using EDTA as a cross-linker, for the adsorption of toxic metals and organic micropollutants from wastewater. In this system, chitosan chain is considered as the backbone, and the immobilized cyclodextrin cavities capture the organic compounds via host-guest inclusion complexation, while EDTA-groups complex metals. The thoroughly characterized CS-ED-CD was employed for batch adsorption experiments. The adsorbent displayed a monolayer adsorption capacity of 0.803, 1.258 mmol g(-1) for Pb(II) and Cd(II) respectively, while a heterogeneous sorption capacity of 0.177, 0.142, 0.203, 0.149 mmol g(-1) for bisphenol-S, ciprofloxacin, procaine, and imipramine, respectively. The adsorption mechanism was verified by FT-IR and elemental mapping. Importantly, the adsorbent perform is effective in the simultaneous removal of metals and organic pollutants at environmentally relevant concentrations. All these findings demonstrate the promise of CS-ED-CD for practical applications in the treatment of micropollutants. This work adds a new insight to design and preparation of efficient trifunctional adsorbents from sustainable materials for water purification.

PMID: 29150635 [PubMed - in process]

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Constructing Genetic Networks using Biomedical Literature and Rare Event Classification.

Constructing Genetic Networks using Biomedical Literature and Rare Event Classification.

Sci Rep. 2017 Nov 17;7(1):15784

Authors: Al-Aamri A, Taha K, Al-Hammadi Y, Maalouf M, Homouz D

Abstract
Text mining has become an important tool in bioinformatics research with the massive growth in the biomedical literature over the past decade. Mining the biomedical literature has resulted in an incredible number of computational algorithms that assist many bioinformatics researchers. In this paper, we present a text mining system called Gene Interaction Rare Event Miner (GIREM) that constructs gene-gene-interaction networks for human genome using information extracted from biomedical literature. GIREM identifies functionally related genes based on their co-occurrences in the abstracts of biomedical literature. For a given gene g, GIREM first extracts the set of genes found within the abstracts of biomedical literature associated with g. GIREM aims at enhancing biological text mining approaches by identifying the semantic relationship between each co-occurrence of a pair of genes in abstracts using the syntactic structures of sentences and linguistics theories. It uses a supervised learning algorithm, weighted logistic regression to label pairs of genes to related or un-related classes, and to reflect the population proportion using smaller samples. We evaluated GIREM by comparing it experimentally with other well-known approaches and a protein-protein interactions database. Results showed marked improvement.

PMID: 29150626 [PubMed - in process]

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Reduced orbitofrontal-thalamic functional connectivity related to suicidal ideation in patients with major depressive disorder.

Reduced orbitofrontal-thalamic functional connectivity related to suicidal ideation in patients with major depressive disorder.

Sci Rep. 2017 Nov 17;7(1):15772

Authors: Kim K, Kim SW, Myung W, Han CE, Fava M, Mischoulon D, Papakostas GI, Seo SW, Cho H, Seong JK, Jeon HJ

Abstract
Despite recent developments in neuroimaging, alterations of brain functional connectivity in major depressive disorder (MDD) patients with suicidal ideation are poorly understood. This study investigated specific changes of suicidal ideation in functional connectivity of MDD patients. Whole brain functional connectivity in 46 patients with MDD (23 with suicidal ideation and 23 without) and 36 age- and gender- matched healthy controls were compared using resting-state functional Magnetic Resonance Imaging (fMRI) analyzed with network-based statistics (NBS) and graph-theoretical methods. Decreased functional connectivity in a characterized sub-network was observed in patients with MDD and suicidal ideation (FDR-adjusted p < 0.05). The sub-network included the regions of the fronto-thalamic circuits in the left hemisphere. The network measures of the left superior frontal gyrus, pars orbitalis (r = -0.40, p = 0.009), left thalamus (r = -0.41, p = 0.009), and right thalamus (r = -0.51, p = -0.002) were shown, through graph theoretical analysis, to be significantly negatively correlated with severity of suicidal ideation. The reduced functional connectivity in left orbitofrontal-both thalamic regions with suicidal ideation in MDD were inversely proportional to the severity of suicidality independent from depression severity. These findings suggest problems with decision-making and information integration in MDD patients with suicidal ideation.

PMID: 29150619 [PubMed - in process]

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Psychometric validation of the needs assessment tool: progressive disease in interstitial lung disease.

Psychometric validation of the needs assessment tool: progressive disease in interstitial lung disease.

Thorax. 2017 Nov 17;:

Authors: Johnson MJ, Jamali A, Ross J, Fairhurst C, Boland J, Reigada C, Hart SP, Grande G, Currow DC, Wells AU, Bajwah S, Papadopoulos T, Bland JM, Yorke J

Abstract
The inter-rater/test-retest reliability and construct validity of a palliative care needs assessment tool in interstitial lung disease (NAT:PD-ILD) were tested using NAT:PD-ILD-guided video-recorded consultations, and NAT:PD-ILD-guided consultations, and patient and carer-report outcomes (St George's Respiratory Questionnaire (SGRQ)-ILD, Carer Strain Index (CSI)/Carer Support Needs Assessment Tool (CSNAT)). 11/16 items reached at least fair inter-rater agreement; 5 items reached at least moderate test-retest agreement. 4/6 patient constructs demonstrated agreement with SGRQ-I scores (Kendall's tau-b, 0.24-20.36; P<0.05). 4/7 carer constructs agreed with the CSI/CSNAT items (kappa, 0.23-20.53). The NAT:PD-ILD is reliable and valid. Clinical effectiveness and implementation are to be evaluated.

PMID: 29150549 [PubMed - as supplied by publisher]

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Availability, Sales, and Affordability of Tobacco Cessation Medicines in Kerala, India.

Availability, Sales, and Affordability of Tobacco Cessation Medicines in Kerala, India.

Circ Cardiovasc Qual Outcomes. 2017 Nov;10(11):

Authors: Sarma S, Harikrishnan S, Baldridge AS, Devarajan R, Mehta A, Selvaraj S, Ali MK, Mohanan PP, Prabhakaran D, Huffman MD

Abstract
BACKGROUND: India is the world's second largest consumer of tobacco, but tobacco cessation remains uncommon due, at least in part, to underutilization of cessation pharmacotherapy. We evaluated the availability, sales, and affordability of nicotine replacement therapy, bupropion, and varenicline in the South Indian state of Kerala to understand potential reasons for underutilization.
METHODS AND RESULTS: From November 2016 to April 2017, we collected data on availability, inventory, and pricing of cessation medication through a cross-sectional survey of 199 public, semiprivate (Karunya), and private pharmacies across 5 districts in Kerala using World Health Organization/Health Action International methodology. Revenue and sales data were obtained from the latest Pharmatrac medication database. We assessed affordability using individual- and household-level income and expenditure data collected from November 2014 to November 2016 through the Acute Coronary Syndrome Quality Improvement in Kerala randomized trial. Cessation medications were not available in public hospitals (0%, n=58) nor in public specialty centers (0%, n=10) including those designated to provide cessation services. At least 1 cessation medicine was available at 63% of private pharmacies (n=109) and 27% of Karunya (semiprivate) pharmacies (n=22). Among the 75 pharmacies that stocked cessation medications, 96% had nicotine replacement therapy, 28% had bupropion, and 1% had varenicline. No outlets had sufficient inventory for a patient to purchase a 12-week treatment regimen. There were an estimated 253 270 treatment regimens sold throughout India and 14 092 in Kerala in 2013 to 2014. Treatment regimens cost 1.9 to 13.0× the median amount spent on smoked tobacco and between 8% and 52% of nonsubsistence income.
CONCLUSIONS: Tobacco cessation medications are unavailable in the Kerala public sector and have limited availability in the private and semiprivate sectors. When available, medications are unaffordable for most patients. Addition of tobacco cessation medication onto national and state essential medicines lists may help increase access.
CLINICAL TRIAL REGISTRATION: URL: http://ift.tt/1xHjpsE. Unique identifier: NCT02256657.

PMID: 29150536 [PubMed - in process]

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Migration and Cardiovascular Disease Risk Among Ghanaian Populations in Europe: The RODAM Study (Research on Obesity and Diabetes Among African Migrants).

Migration and Cardiovascular Disease Risk Among Ghanaian Populations in Europe: The RODAM Study (Research on Obesity and Diabetes Among African Migrants).

Circ Cardiovasc Qual Outcomes. 2017 Nov;10(11):

Authors: Boateng D, Agyemang C, Beune E, Meeks K, Smeeth L, Schulze M, Addo J, de-Graft Aikins A, Galbete C, Bahendeka S, Danquah I, Agyei-Baffour P, Owusu-Dabo E, Mockenhaupt FP, Spranger J, Kengne AP, Grobbee DE, Stronks K, Klipstein-Grobusch K

Abstract
BACKGROUND: For migrant populations from sub-Saharan Africa, adverse cardiovascular disease (CVD) risk factors have been observed to be higher than found in their home country-based counterparts or among the host populations in high-income countries. Differences in absolute overall CVD risk, however, remain largely unexplained. We, therefore, predicted the differences in 10-year CVD risk among sub-Saharan African migrants (Ghanaians) living in 3 European cities and Ghana.
METHODS AND RESULTS: For 3864 subjects aged 40 to 70 years from the multicenter RODAM study (Research on Obesity and Diabetes Among African Migrants) conducted among Ghanaian adults residing in rural and urban Ghana and 3 European cities (Amsterdam, Berlin, and London), 10-year risk of CVD was estimated using the Pooled Cohort Equations with estimates ≥7.5% defining high CVD risk. Logistic regressions were used to determine the association of migration on CVD risk. The proportion with CVD risk ≥7.5% among Ghanaian men was 34.7% in rural Ghana, 45.4% in urban Ghana, 53.9% in Amsterdam, 61.0% in Berlin, and 52.2% in London. Compared with rural Ghana, CVD risk was significantly increased for Ghanaian men living in Berlin (adjusted odds ratio, 2.80; 95% confidence interval, 1.76-4.45) and Amsterdam (1.88; 1.25-2.84). Increased risk observed for men was largely not seen for women. CVD risk increased with longer stay in Europe.
CONCLUSIONS: Knowledge about predictors of increased CVD risk among sub-Saharan African migrants in Europe and nonmigrants in urban centers will inform and support targeted health care and interventions to these populations.

PMID: 29150534 [PubMed - in process]

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Diagnostic Accuracy of Neonatal Assessment for Gestational Age Determination: A Systematic Review.

Diagnostic Accuracy of Neonatal Assessment for Gestational Age Determination: A Systematic Review.

Pediatrics. 2017 Nov 17;:

Authors: Lee AC, Panchal P, Folger L, Whelan H, Whelan R, Rosner B, Blencowe H, Lawn JE

Abstract
CONTEXT: An estimated 15 million neonates are born preterm annually. However, in low- and middle-income countries, the dating of pregnancy is frequently unreliable or unknown.
OBJECTIVE: To conduct a systematic literature review and meta-analysis to determine the diagnostic accuracy of neonatal assessments to estimate gestational age (GA).
DATA SOURCES: PubMed, Embase, Cochrane, Web of Science, POPLINE, and World Health Organization library databases.
STUDY SELECTION: Studies of live-born infants in which researchers compared neonatal signs or assessments for GA estimation with a reference standard.
DATA EXTRACTION: Two independent reviewers extracted data on study population, design, bias, reference standard, test methods, accuracy, agreement, validity, correlation, and interrater reliability.
RESULTS: Four thousand nine hundred and fifty-six studies were screened and 78 included. We identified 18 newborn assessments for GA estimation (ranging 4 to 23 signs). Compared with ultrasound, the Dubowitz score dated 95% of pregnancies within ±2.6 weeks (n = 7 studies), while the Ballard score overestimated GA (0.4 weeks) and dated pregnancies within ±3.8 weeks (n = 9). Compared with last menstrual period, the Dubowitz score dated 95% of pregnancies within ± 2.9 weeks (n = 6 studies) and the Ballard score, ±4.2 weeks (n = 5). Assessments with fewer signs tended to be less accurate. A few studies showed a tendency for newborn assessments to overestimate GA in preterm infants and underestimate GA in growth-restricted infants.
LIMITATIONS: Poor study quality and few studies with early ultrasound-based reference.
CONCLUSIONS: Efforts in low- and middle-income countries should focus on improving dating in pregnancy through ultrasound and improving validity in growth-restricted populations. Where ultrasound is not possible, increased efforts are needed to develop simpler yet specific approaches for newborn assessment through new combinations of existing parameters, new signs, or technology.

PMID: 29150458 [PubMed - as supplied by publisher]

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Prospective evaluation of a nonsurgical device for rhinoplasty.

Prospective evaluation of a nonsurgical device for rhinoplasty.

Rhinology. 2017 Nov 18;:

Authors: Deggeller MA, Holzmann D, Soyka MB

Abstract
BACKGROUND: Rhinoplasty represents one of the most challenging and frequently performed procedures in plastic surgery and non-surgical rhinoplasty is rarely considered. The aim of this study was to investigate whether the Nasella Nose Former (NNF), a newly developed non-surgical rhinoplasty device, could improve objective and subjective results following surgical rhinoplasty and even correct the shape of the nose without any surgery at all.
METHODOLOGY: In this prospective, monocentric, two-armed, non-blinded randomized, controlled clinical trial, a total of 43 participants were included. In the Surgical group, 22 patients undergoing open or closed rhinoplasty with osteotomies were randomised based on their birth year; 15 of them got to wear the NNF over 8 weeks postoperatively and 7 patients getting surgery without the NNF formed the control group. In the Cosmetic group, 21 participants wore the NNF without surgery over 14 months. At every follow-up exam, angles for crookedness, nasal hump and width were measured, the investigator assessed the patients nose and asked for patient satisfaction using a Likert-scale.
RESULTS: Patients in the Surgical group wearing the NNF did not show any significant difference concerning objective measurements, investigator assessments and patient satisfaction compared to those not wearing the NNF. In the Cosmetic group, participants did not show objective improvements in measurements and investigator assessment. However, participants were significantly more satisfied after 14 months with their nasal back, nasal axis and outer nose in general.
CONCLUSIONS: Considering the results of this study, we conclude that this perfectly customised external device to enhance surgical rhinoplasty outcomes or correct the shape of the nose without surgery does not seem to be effective and that further investigations in this field are not meaningful.

PMID: 29150922 [PubMed - as supplied by publisher]

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quality of care; +35 new citations

35 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

quality of care

These pubmed results were generated on 2017/11/19

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Η αρχαία προέλευση και το πραγματικό νόημα της λέξης «γενέθλια»

Η πανίερη ελληνική γλώσσα μας αποκαλύπτει με την υψίστης θεολογικής-εσωτερικής σημασίας λέξη Γενέθλια τα εξής: Γενέθλια : Γένεσις δηλαδή η αρχή η εκκίνηση το ξεκίνημα του Άθλου Και γι αυτό το λόγο γράφεται με ένα ν Δεν ετυμολογείται η λέξη Γενέθλια από την λέξη Γέννηση που γράφεται με δύο ν που όπως γνωρίζουμε νοηματοδοτεί την […]

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Adjuvant radiotherapy in sinonasal mucosal melanoma: A retrospective analysis.

Adjuvant radiotherapy in sinonasal mucosal melanoma: A retrospective analysis.

Clin Otolaryngol. 2017 Nov 18;:

Authors: Caspers CJI, Dronkers EAC, Monserez D, Wieringa MH, de Jong RJB, Hardillo JAU

Abstract
OBJECTIVES: Evaluation of outcome after curative treatment for sinonasal mucosal melanoma, focused on the effect of adjuvant radiotherapy on recurrence and survival.
DESIGN: Retrospective chart analysis.
SETTING: Tertiary referral hospital.
PARTICIPANTS: 51 patients with primary sinonasal mucosal melanoma who underwent surgical resection with curative intention between 1980 and 2016 at Erasmus Medical Center Rotterdam.
MAIN OUTCOME MEASURES: Patients were categorised into two groups: surgery alone and surgery with adjuvant radiotherapy. Log-rank test was used to compare rates of recurrence and survival between treatment groups. Predictors for treatment modality, recurrence and survival were assessed with multivariate statistical analysis.
RESULTS: Of all patients, 23.5% developed local recurrence and 47.1% developed distant metastasis. Estimated 5-year disease free survival was 25.2% and 5-year overall survival was 38.1%. 43 patients (84.3%) were treated with postoperative radiotherapy. Patients who underwent surgery with adjuvant radiotherapy presented more often with high tumour stage, tumour involving multiple sites and positive margins. Postoperative radiotherapy seemed to be associated with better local control (p=0.549). No effect was found on occurrence of distant metastasis and overall survival. Positive margin status was an independent negative predictor for distant metastasis-free survival and overall survival CONCLUSIONS: Our treatment outcomes are consistent with literature. Postoperative radiotherapy seems to be associated with improved local control despite advanced disease and positive margin status in this treatment group. This article is protected by copyright. All rights reserved.

PMID: 29150980 [PubMed - as supplied by publisher]

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Prospective evaluation of a nonsurgical device for rhinoplasty.

Prospective evaluation of a nonsurgical device for rhinoplasty.

Rhinology. 2017 Nov 18;:

Authors: Deggeller MA, Holzmann D, Soyka MB

PMID: 29150922 [PubMed - as supplied by publisher]

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Toxicological characterization of ZnO nanoparticles in malignant and non-malignant cells.

Toxicological characterization of ZnO nanoparticles in malignant and non-malignant cells.

Environ Mol Mutagen. 2017 Nov 18;:

Authors: Moratin H, Scherzad A, Gehrke T, Ickrath P, Radeloff K, Kleinsasser N, Hackenberg S

Abstract
The increasing usage of zinc oxide nanoparticles (ZnO-NPs) in industrial applications as well as in consumer products raises concern regarding their potential adverse effects to a greater extend. Numerous studies have demonstrated toxic properties of NPs, however there is still a lack of knowledge concerning the underlying mechanisms. This study was designed to systematically investigate cytotoxicity, apoptosis, cell cycle alterations, and genotoxicity induced by ZnO-NP. Moreover, it was an aim of the investigations to specify the diverse effects of nanoparticle exposure in malignant in comparison with non-malignant cells. Therefore, human head and neck squamous cell carcinoma-derived FaDu cells were incubated with 4-20 µg/ml of ZnO-NPs for 1-48 hr and tested for cell viability, cell cycle alterations, apoptosis and caspase-3 gene expression as a sensitive marker of molecular apoptotic processes with regard to time- and dose-dependent effects. Human mesenchymal bone marrow stem cells were used as non-malignant representatives to examine oxidative stress-related genotoxicity. Results showed a significant reduction in cell viability as well as dose- and time-dependent increase of apoptotic cells following nanoparticle treatment. Likewise, caspase-3 gene expression enhanced already before first apoptotic cells were detectable. It could be observed that doses that were cytotoxic in tumor cells did not reduce viability in stem cells. However, the same concentrations already induced significant DNA damage. The findings of the study suggest to keep a more critical eye on the use of nanoparticles as anti-cancer agents. Yet, additional in vivo studies are needed to assess safety concerns for consumers and patients. Environ. Mol. Mutagen., 2017. © 2017 Wiley Periodicals, Inc.

PMID: 29150876 [PubMed - as supplied by publisher]

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Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States: An analysis from the EAACI AIT Guidelines Project.

Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States: An analysis from the EAACI AIT Guidelines Project.

Allergy. 2017 Nov 17;:

Authors: Bonertz A, Roberts G, Slater JE, Bridgewater J, Rabin RL, Hoefnagel M, Timon M, Pini C, Pfaar O, Sheikh A, Ryan D, Akdis C, Goldstein J, Poulsen LK, van Ree R, Rhyner C, Barber D, Palomares O, Pawankar R, Hamerlijnk D, Klimek L, Agache I, Angier E, Casale T, Fernandez-Rivas M, Halken S, Jutel M, Lau S, Pajno G, Sturm G, Varga EM, van Wijk RG, Bonini S, Muraro A, Vieths S

Abstract
Adequate quality is essential for any medicinal product to be eligible for marketing. Quality includes verification of the identity, content and purity of a medicinal product in combination with a specified production process and its control. Allergen products derived from natural sources require particular considerations to ensure adequate quality. Here, we describe key aspects of the documentation on manufacturing and quality aspects for allergen immunotherapy products in the European Union and the United States. In some key parts, requirements in these areas are harmonized while other fields are regulated separately between both regions. Essential differences are found in the use of Reference Preparations, or the requirement to apply standardized assays for potency determination. Since the types of products available are different in specific regions, regulatory guidance for such products may also be available in one specific region only, such as for allergoids in the European Union. Region-specific issues and priorities are a result of this. As allergen products derived from natural sources are inherently variable in their qualitative and quantitative composition, these products present special challenges to balance the variability and ensuring batch-to-batch consistency. Advancements in scientific knowledge on specific allergens and their role in allergic disease will consequentially find representation in future regulatory guidelines. This article is protected by copyright. All rights reserved.

PMID: 29150848 [PubMed - as supplied by publisher]

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Frontal sinus revision rate after nasal polyposis surgery including frontal recess clearance and middle turbinectomy: A long-term analysis.

Frontal sinus revision rate after nasal polyposis surgery including frontal recess clearance and middle turbinectomy: A long-term analysis.

Auris Nasus Larynx. 2017 Nov 14;:

Authors: Benkhatar H, Khettab I, Sultanik P, Laccourreye O, Bonfils P

Abstract
OBJECTIVE: To determine the frontal sinus revision rate after nasal polyposis (NP) surgery including frontal recess clearance (FRC) and middle turbinectomy (MT), to search for predictive factors and to analyse surgical management.
METHODS: Longitudinal analysis of 153 patients who consecutively underwent bilateral sphenoethmoidectomy with FRC and MT for NP with a minimum follow-up of 7 years. Decision of revision surgery was made in case of medically refractory chronic frontal sinusitis or frontal mucocele. Univariate and multivariate analysis incorporating clinical and radiological variables were performed.
RESULTS: The frontal sinus revision rate was 6.5% (10/153). The mean time between the initial procedure and revision surgery was 3 years, 10 months. Osteitis around the frontal sinus outflow tract (FSOT) was associated with a higher risk of frontal sinus revision surgery (p=0.01). Asthma and aspirin intolerance did not increase the risk, as well as frontal sinus ostium diameter or residual frontoethmoid cells. Among revised patients, 60% required multiple procedures and 70% required frontal sinus ostium enlargement.
CONCLUSIONS: Our long-term study reports that NP surgery including FRC and MT is associated with a low frontal sinus revision rate (6.5%). Patients developing osteitis around the FSOT have a higher risk of frontal sinus revision surgery. As mucosal damage can lead to osteitis, FSOT mucosa should be preserved during initial NP surgery. However, as multiple procedures are common among NP patients requiring frontal sinus revision, frontal sinus ostium enlargement should be considered during first revision in the hope of reducing the need of further revisions.

PMID: 29150349 [PubMed - as supplied by publisher]

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De novo head and neck cancer arising in solid organ transplantation recipients: The Asan Medical Center experience.

De novo head and neck cancer arising in solid organ transplantation recipients: The Asan Medical Center experience.

Auris Nasus Larynx. 2017 Nov 14;:

Authors: Park MJ, Roh JL, Choi SH, Nam SY, Kim SY, Lee YS

Abstract
OBJECTIVE: De novo cancers of head and neck area in solid organ transplantation recipients show standardized incidence ratio (SIR) of 3.8. Immunosuppression following transplantation is suggested to play as a crucial factor in pathogenesis of secondary malignancy. Prognosis of head and neck cancer arising in solid organ transplantation recipients is proven to have poor prognosis. The incidence, risk, prognosis, and survival of de novo malignancy of head and neck area in solid organ transplantation recipients in single-tertiary medical center followed up for 20 years.
METHODS: A retrospective medical record review of the patients who received solid organ transplantation in Asan Medical Center from 1997 to 2016 was conducted. Patients confirmed as de novo malignancy in the head and neck area after organ transplantation were included, and presented as in the case-series format. Patients with previous history of head and neck malignancy, irradiation history of head and neck area, cutaneous malignant lesion, hematopoietic malignant lesion, malignancy of thyroid and parathyroid gland and metastatic lesions newly developed in head and neck area were excluded. The incidence of head and neck malignancy in South Korea were reviewed from the National Cancer Information Center of South Korea. For the statistical analysis, standardized incidence ratio (SIR) was obtained with 95% confidence interval.
RESULTS: Solid organ transplantation recipients show 20 times higher incidence of de novo cancer of head and neck area compared to general population. Of 13 de novo head and neck malignancy arising after solid organ transplantation, 2 (15.4%) patients were unable to withstand definitive management due to poor general condition. 2 (15.4%) patients had loco-regional recurrence, 1 (7.7%) patient with distant metastasis, and 3 (23.1%) patients died of cancer progression.
CONCLUSION: Immunosuppression following solid organ transplantation gives a twenty-fold increased risk for the development of de novo head and neck cancer. A more precise and frequent checkup on head and area should be planned, suggesting a multi-disciplinary approach in combination with organ transplantation team.

PMID: 29150348 [PubMed - as supplied by publisher]

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Glutamate is down-regulated and tinnitus loudness-levels decreased following rTMS over auditory cortex of the left hemisphere: A prospective randomized single-blinded sham-controlled cross-over study.

Glutamate is down-regulated and tinnitus loudness-levels decreased following rTMS over auditory cortex of the left hemisphere: A prospective randomized single-blinded sham-controlled cross-over study.

Hear Res. 2017 Nov 14;:

Authors: Cacace AT, Hu J, Romero S, Xuan Y, Burkard RF, Tyler RS

Abstract
Using a prospective randomized single-blinded sham-controlled cross-over design, we studied the efficacy of low frequency (1-Hz) repetitive transcranial magnetic stimulation (rTMS) over auditory cortex of the left temporal lobe as an experimental treatment modality for noise-induced tinnitus. Pre/post outcome measures for sham vs. active rTMS conditions included differential changes in tinnitus loudness, self-perceived changes in the Tinnitus Handicap Questionnaire (THQ), and neurochemical changes of brain metabolite concentrations using single voxel proton magnetic resonance spectroscopy ((1)H-MRS) obtained from left and right auditory cortical areas. While no subject in our sample had complete abatement of their tinnitus percept, active but not sham rTMS significantly reduced the loudness level of the tinnitus perception on the order of 4.5 dB; improved subscales in several content areas on the THQ, and down regulated (reduced) glutamate concentrations specific to the auditory cortex of the left temporal lobe that was stimulated. In addition, significant pair-wise correlations were observed among questionnaire variables, metabolite variables, questionnaire-metabolite variables, and metabolite-loudness variables. As part of this correlation analysis, we demonstrate for the first time that active rTMS produced a down regulation in the excitatory neurotransmitter glutamate that was highly correlated (r = 0.77, p < 0.05) with a reduction in tinnitus loudness levels measured psychoacoustically with a magnitude estimation procedure. Overall, this study provides unique information on neurochemical, psychoacoustic, and questionnaire-related profiles which emphasizes the emerging fields of perceptual and cognitive MRS and provides a perspective on a new frontier in auditory and tinnitus-related research.

PMID: 29150051 [PubMed - as supplied by publisher]

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Tailored resections in oral and oropharyngeal cancer using narrow band imaging.

Tailored resections in oral and oropharyngeal cancer using narrow band imaging.

Am J Otolaryngol. 2017 Nov 10;:

Authors: Tirelli G, Piovesana M, Marcuzzo AV, Gatto A, Biasotto M, Bussani R, Zandonà L, Giudici F, Boscolo Nata F

Abstract
PURPOSE: In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study.
MATERIALS AND METHODS: The resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined "NBI positive", "NBI null", and "NBI negative", respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the "NBI-positive" and the "NBI-negative" areas were recorded.
RESULTS: We obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site.
CONCLUSIONS: NBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.

PMID: 29150027 [PubMed - as supplied by publisher]

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Interleukin-37 Relieves Allergic Inflammation in a House Dust Mite Allergic Rhinitis Murine Model.

Interleukin-37 Relieves Allergic Inflammation in a House Dust Mite Allergic Rhinitis Murine Model.

Iran J Allergy Asthma Immunol. 2017 Oct;16(5):404-417

Authors: Kim DH, Kim SW, Kim SW, Kang JM

Abstract
The purpose of this study was to investigate the effects of interleukin-37 (IL-37) on a Dermatophagoides farinae (Der f)-induced murine model of allergic rhinitis (AR). BALB/c mice, except the control groups, were sensitized intraperitoneally and challenged intranasally with Der f (Der f group). The IL-37 and IL-37+anti-CD25 groups were administered IL-37 intranasally. The IL-37+anti-CD25 groups were administered anti-CD25 monoclonal antibody intraperitoneally before challenge. Allergic symptoms and the average eosinophil number were counted. The levels of cytokines and transcription factors in the nasal mucosa were measured by Real-Time polymerase chain reaction (PCR) and western blotting. The levels of Der f-specific immunoglobulin E (IgE) were measured. The CD4+CD25+Foxp3+T cells among splenic mononuclear cells were analyzed by flow cytometry. The allergic symptom scores and Der f-specific IgE levels were lower in the IL-37 group compared to the Der f group. Additionally, the levels of the transcription factor GATA-3 and ROR-γt and those of the cytokines IL-4, IL-5, IL-13, and IL-17, representing both T helper (Th)2 and Th17 responses, were lower in the IL-37 group in comparison with the Der f group. However, the Th1 responsewas not suppressed after administration of IL-37. IL-37 increased the IL-10 level; however, Real-Time PCR, western blotting, and flow cytometry results showed the limited action of IL-37 on CD4+CD25+Foxp3+T cells. This study demonstrates that intranasal IL-37 can suppress Th2 and Th17 responses in an AR murine model. Furthermore, these data suggest that IL-10 is increased, but CD4+CD25+Foxp3+T cells are not correlated with the IL-37-induced mechanism.

PMID: 29149780 [PubMed - in process]

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The practical update for family physicians in the diagnosis and management of overactive bladder and lower urinary tract symptoms.

The practical update for family physicians in the diagnosis and management of overactive bladder and lower urinary tract symptoms.

Can J Urol. 2017 Oct;24(5S1):1-11

Authors: Barkin J, Habert J, Wong A, Lee LYT

Abstract
OBJECTIVE: To provide family physicians with an up-to-date, practical overview of the diagnosis and management of overactive bladder (OAB) alone or with bladder outlet obstruction.
MAIN MESSAGE: OAB is urinary urgency with or without incontinence, often accompanied by frequency and nocturia, in the absence of urinary tract infection and can affect both men and women. Men often have co-existing OAB associated with bladder outlet obstruction, and benign prostatic hyperplasia. OAB can interfere with sleep, social activities, and sexual encounters, and it increases the risk of falls.
CONCLUSION: Many patients with OAB seek initial evaluation and treatment from their family physicians. Optimal management of OAB by family physicians will improve patients' quality of life. More severe cases or 'red flags' uncovered while making the diagnosis, might warrant referral to a urologist.

PMID: 29151006 [PubMed - in process]

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General illness and psychological factors in patients with chronic nasal symptoms.

General illness and psychological factors in patients with chronic nasal symptoms.

Clin Otolaryngol. 2017 Nov 18;:

Authors: Kara N, Yao AC, Newton J, Deary V, O'Hara J, Wilson JA

Abstract
OBJECTIVES: Only a minority of patients referred to specialists with sinonasal symptoms have clear evidence of chronic rhinosinusitis. This study aims to estimate the prevalence of and associations between (i) general illness factors (fatigue, autonomic dysfunction) and (ii) psychological factors (anxiety, depression, somatisation, personality traits) in patients presenting with sinonasal symptoms.
DESIGN: The following validated questionnaires were administered to patients: the Sino-Nasal Outcome Test-22 (SNOT-22) to identify symptom burden, Composite Autonomic Symptom Score-31 (COMPASS-31) measuring autonomic function, Chalder fatigue questionnaire, Patient Health Questionnaire-15 (PHQ-15) addressing somatisation symptoms, Hospital Anxiety and Depression Scale (HADS), and the International Personality Item Pool-50 (IPIP-50). Comparisons were made with normative and general population data, and relationships were analysed using nonparametric correlation.
SETTING: Secondary care ENT outpatients.
PARTICIPANTS: Adults referred with chronic sinonasal symptoms.
MAIN OUTCOME MEASURES: SNOT-22, COMPASS-31, Chalder, PHQ-15, HADS, and IPIP-50 questionnaire scores.
RESULTS: Sixty-one patients were included. There was a high prevalence of all general and psychological factors assessed compared with controls. Total SNOT-22 scores showed significant correlation with Chalder fatigue scores, total autonomic dysfunction score, anxiety, depression, somatisation tendencies, and the emotionally unstable personality trait. Emotional instability and psychological dysfunction correlated significantly with sleep and psychological subscales of SNOT-22 but not the rhinological or ear/facial subscales.
CONCLUSION: Patients with sinonasal symptoms demonstrate high prevalence and complex associations of general illness factors, psychological distress and certain personality traits. The SNOT-22 is a valuable tool, but it's utility is limited by correlations with these confounding factors (e.g. psychological factors) that may exaggerate the total score. Use of the SNOT-22 component subscales is likely to provide more clinically meaningful and discriminant information. This article is protected by copyright. All rights reserved.

PMID: 29150985 [PubMed - as supplied by publisher]

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Expression of the clock gene Rev-erbα in the brain controls the circadian organization of food intake and locomotor activity, but not daily variations of energy metabolism.

Expression of the clock gene Rev-erbα in the brain controls the circadian organization of food intake and locomotor activity, but not daily variations of energy metabolism.

J Neuroendocrinol. 2017 Nov 18;:

Authors: Sen S, Dumont S, Sage-Ciocca D, Reibel S, de Goede P, Kalsbeek A, Challet E

Abstract
The nuclear receptor REV-ERBα is part of the molecular clock mechanism and thought to be involved in a variety of biological processes within metabolically active peripheral tissues as well. To investigate whether Rev-erbα (also known as Nr1d1) in the brain plays a role in the daily variations of energy metabolism, feeding behaviour and the sleep-wake cycle, we studied mice with global (GKO) or brain (BKO) deletion of Rev-erbα. Mice were studied both in a light-dark cycle and constant darkness, and 24-h variations of Respiratory quotient (RQ) and energy expenditure, as well as the temporal patterns of rest-activity and feeding behavior were recorded. The RQ increase of GKO mice was not detected in BKO animals, indicating a peripheral origin for this metabolic alteration. Arrhythmic patterns of locomotor activity were only found in BKO mice. By contrast, the circadian rhythm of food intake was lost both in GKO and BKO mice, mostly by increasing the number of daytime meals. These changes in the circadian pattern of feeding behaviour were, to some extent, correlated with a loss of rhythmicity of hypothalamic Hcrt (also named Orx) mRNA levels. Together, these findings highlight that Rev-erbα in the brain is involved in the temporal partitioning of feeding and sleep, whereas its effects on energy metabolism are mainly exerted through its peripheral expression. This article is protected by copyright. All rights reserved.

PMID: 29150901 [PubMed - as supplied by publisher]

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Predicting the onset of freezing of gait: A longitudinal study.

Predicting the onset of freezing of gait: A longitudinal study.

Mov Disord. 2017 Nov 18;:

Authors: Ehgoetz Martens KA, Lukasik EL, Georgiades MJ, Gilat M, Hall JM, Walton CC, Lewis SJG

Abstract
BACKGROUND: Freezing of gait is a disabling symptom of Parkinson's disease that ultimately affects approximately 80% of patients, yet very little research has focused on predicting the onset of freezing of gait and tracking the longitudinal progression of symptoms prior to its onset. The objective of the current study was to examine longitudinal data spanning the transition period when patients with PD developed freezing of gait to identify symptoms that may precede freezing and create a prediction model that identifies those "at risk" for developing freezing of gait in the year to follow.
METHODS: Two hundred and twenty-one patients with PD were divided into 3 groups (88 nonfreezers, 41 transitional freezers, and 92 continuing freezers) based on their responses to the validated Freezing of Gait-Questionnaire item 3 at baseline and follow-up. Critical measures across motor, cognitive, mood, and sleep domains were assessed at 2 times approximately 1 year apart.
RESULTS: A logistic regression model that included age, disease duration, gait symptoms, motor phenotype, attentional set-shifting, and mood measures could predict with 70% and 90% accuracy those patients who would and would not develop, respectively, freezing of gait over the next year. Notably, the Freezing of Gait-Questionnaire total and the anxiety section of the Hospital Anxiety and Depression Scale were the strongest predictors and alone could significantly predict if one might develop freezing of gait in the next 15 months with 82% accuracy.
CONCLUSIONS: Our results suggest that it is possible to identify the majority of patients who will develop freezing of gait in the following year, potentially allowing targeted interventions to delay or possibly even prevent the onset of freezing.

PMID: 29150872 [PubMed - as supplied by publisher]

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Influences of obstructive sleep apnea on blood pressure variability might not be limited only nocturnally in middle-aged hypertensive males.

Influences of obstructive sleep apnea on blood pressure variability might not be limited only nocturnally in middle-aged hypertensive males.

Sleep Breath. 2017 Nov 17;:

Authors: Shao L, Heizhati M, Yao X, Wang Y, Abulikemu S, Zhang D, Zhou L, Hong J, Li N

Abstract
PURPOSE: In this cross-sectional study, we analyzed the potential association between sleep measures and blood pressure variability.
METHODS: Ninety-three middle-aged hypertensive males, who underwent polysomnography and 24-h ambulatory blood pressure monitoring, were enrolled. Blood pressure variability was assessed by blood pressure standard deviation. Obstructive sleep apnea (apnea hypopnea index ≥ 15) was diagnosed in 52 (55.91%) patients. Mean body mass index and age were 27.77 ± 3.11 kg/m(2) and 44.05 ± 8.07 years, respectively.
RESULTS: Hypertensive males with obstructive sleep apnea showed significantly higher 24-h, diurnal, and nocturnal diastolic blood pressure variability, compared to those without obstructive sleep apnea. While total cohort was further divided into two groups using the median of oxygen desaturation index, another indicator for severity of OSA, significant differences were also observed in 24-h, diurnal, and nocturnal diastolic blood pressure variability between two groups with higher and lower oxygen desaturation index. While subjects were also divided into two groups via the mean of sleep stage 1, hypertensive males with sleep stage 1 ≥ 8.1% showed significantly higher diurnal diastolic blood pressure variability than those with sleep stage 1 < 8.1%. Apnea hypopnea index was independently associated with 24-h and nocturnal diastolic blood pressure variability; oxygen desaturation index of 3% with 24-h diastolic, diurnal, and nocturnal diastolic blood pressure; and sleep stage 1 was with 24-h and with diurnal diastolic blood pressure variability in all study subjects.
CONCLUSION: Effects of obstructive sleep apnea on blood pressure variability may not be limited nocturnally.

PMID: 29150775 [PubMed - as supplied by publisher]

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Κυριακή 19 Νοεμβρίου 2017

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