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Δευτέρα, 18 Δεκεμβρίου 2017

Gastrointestinal Stromal Tumour : RadioPath Correlation

Discussing the Radiology and Pathological aspects of GIST in a integrated medical teaching video

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Increased infiltration of CD11c+/CD123+ dendritic cell subsets and upregulation of TLR/IFN-α signaling participate in pathogenesis of oral lichen planus

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Publication date: Available online 18 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yufeng Wang, Shu Shang, Qianqian Sun, Junjun Chen, Guanhuan Du, Hong Nie, Xiaozhe Han, Guoyao Tang
ObjectiveInvestigation of dendritic cell (DC) subsets and expression patterns of Toll-like receptors (TLRs) was conducted to understand the pathogenesis in oral lichen planus (OLP).Study DesignBlood, OLP lesion and control samples were collected. Four DC subsets (CD11c+CD123-myeloid DC-mDC1, CD141+myeloid DC-mDC2, CD11c-CD123+plasmacytoid DC-pDC and CD1a+CD207+Langerhans cells-LC) were investigated via flow cytometry (FCM) and immunohistochemical (IHC) staining. Expression patterns of TLRs and their downstream molecules were analyzed via qRT-PCR and IHC in situ.ResultsThirty-two samples were collected (9 controls and 23 OLP patients). FCM results showed the percentages of LC, mDC1, mDC2 and pDC in situ were 0.0119±0.0251%, 0.0064±0.0134%, 0.0005±0.0011%, and 0.0022±0.0019% in control mucosa, respectively. The mDC1 (0.0300±0.0276%) and pDC (0.0204±0.0186%) subsets were significantly increased in OLP lesions (p<0.01). No marked differences were evident, when comparing all four DC subsets from blood, between control and OLP groups. Significant upregulation of TLR7, TLR8 and TLR9 were disclosed in OLP (p<0.01), along with their downstream interferon-α(IFN-α) signaling molecules(IRF7 and IFN-α, p<0.01).ConclusionOur findings of increased infiltration of pDC and mDC1, along with upregulation of TLR/IFN-α signaling, provide valuable information for further understanding the immunity in OLP.



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An actionable test using loss of heterozygosity in identifying high-risk oral premalignant lesions

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Publication date: Available online 18 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Kelly Y.P. Liu, X.J. David Lu, Yi-Shing L. Cheng, Hagen Klieb, Samson Ng, Kelly McNeil, Aly Karsan, Catherine F. Poh
Objectives.To develop an actionable test using fluorescent-labeled primers with capillary gel electrophoresis (FCE) to assess loss of heterozygosity (LOH) of histologically similar low-grade lesions (LGLs) to identify high-risk lesions for oral cancer progression.Study Design.To determine the cut-offs of LOH, the FCE results of 52 surgical margin samples were used to compare to the existing LOH results from the previously validated 32P-GE approach. Using the developed FCE workflow, an independent set of 102 LGLs with known progression status was used to determine the LOH molecular risk (MR) patterns and associated risk of progression.Results.Using 65% cut-off LOH-FCE, the agreement of LOH-32P-GE showed an average of 82.3% (76.8-87.8). Comparing to non-progressors (n=61), anatomical site, and MR patterns (LOH at 9p21, 3p14, or 17p13) were independent risk factors. High-risk profile of tongue and MR3 (LOH at 9p21 and/or 3p14, and 17p13) was significantly associated with progression (HR, 6.7; 95% CI, 2.6-17.6) with specificity of 98.4% at identifying progressors.Conclusions.We have developed an objective, fast, environmental-safe, and cost-effective test using LOH to stratify the risk of LGLs. With further validation, it can be used in the clinical settings to provide clinicians additional information guiding the management of these lesions.



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Detection of Intra-Articular Screw Penetration of Proximal Humerus Fractures

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Publication date: Available online 18 December 2017
Source:Academic Radiology
Author(s): Xiaoyang Jia, Yanxi Chen, Minfei Qiang, Kun Zhang, Haobo Li, Yuchen Jiang, Yijie Zhang
Rationale and ObjectiveScrew penetration is the common complication of proximal humerus fractures treated with locking plates. This study compared postoperative plain radiography to computed tomography (CT) for their abilities in determining screw penetration, and was to evaluate whether advanced imaging modalities (two-dimensional [2D] CT; three-dimensional [3D] CT) could increase surgeons' level of confidence regarding their diagnoses.Materials and MethodsTwo observers reviewed radiological images of 134 patients who sustained proximal humerus fractures treated with locking plates. The observers were asked to answer two questions: (1) Is there screw penetrating into glenohumeral joint for this patient (Yes/No)? and (2) On a scale from 0 to 10, how confident are you about this diagnosis: (0–10) (0 = not at all confident; 10 = very confident)? Three evaluations were performed: (1) plain radiography alone, (2) radiography and 2D CT 4 weeks later, and (3) radiography in combination with 2D and 3D CT after that. This process was then repeated for intraobserver analysis.ResultsCT obtained almost perfect interobserver and intraobserver agreement (0.818–0.961), which was higher than radiography (0.377–0.655). For incidence of screw penetration, the significant difference was found between radiographs and CT images (P < .0125), but not between 2D and 3D CT images (P > .05). For confidence of diagnosis, the differences between imaging modalities were significant (all P < .001).ConclusionsWe suggest that postoperative CT scans (especially 3D CT images) should be used to evaluate the intra-articular screw penetration of proximal humerus fractures, especially when surgeons have not enough confidence in determining screw penetration using radiography alone.



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ESTRO ACROP: Technology for precision small animal radiotherapy research: Optimal use and challenges

Many radiotherapy research centers have recently installed novel research platforms enabling the investigation of the radiation response of tumors and normal tissues in small animal models, possibly in combination with other treatment modalities. Many more research institutes are expected to follow in the coming years. These novel platforms are capable of mimicking human radiotherapy more closely than older technology. To facilitate the optimal use of these novel integrated precision irradiators and various small animal imaging devices, and to maximize the impact of the associated research, the ESTRO committee on coordinating guidelines ACROP (Advisory Committee in Radiation Oncology Practice) has commissioned a report to review the state of the art of the technology used in this new field of research, and to issue recommendations.

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Prospect of robotic assistance for fully automated brachytherapy seed placement into skull base: Experimental validation in phantom and cadaver

To investigate the feasibility and accuracy of robot-assisted brachytherapy for skull base tumours.

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ESTRO ACROP: Technology for precision small animal radiotherapy research: Optimal use and challenges

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Publication date: Available online 18 December 2017
Source:Radiotherapy and Oncology
Author(s): Frank Verhaegen, Ludwig Dubois, Stefano Gianolini, Mark A. Hill, Christian P. Karger, Kirsten Lauber, Kevin M. Prise, David Sarrut, Daniela Thorwarth, Christian Vanhove, Boris Vojnovic, Robert Weersink, Jan J. Wilkens, Dietmar Georg
Many radiotherapy research centers have recently installed novel research platforms enabling the investigation of the radiation response of tumors and normal tissues in small animal models, possibly in combination with other treatment modalities. Many more research institutes are expected to follow in the coming years. These novel platforms are capable of mimicking human radiotherapy more closely than older technology. To facilitate the optimal use of these novel integrated precision irradiators and various small animal imaging devices, and to maximize the impact of the associated research, the ESTRO committee on coordinating guidelines ACROP (Advisory Committee in Radiation Oncology Practice) has commissioned a report to review the state of the art of the technology used in this new field of research, and to issue recommendations. This report discusses the combination of precision irradiation systems, small animal imaging (CT, MRI, PET, SPECT, bioluminescence) systems, image registration, treatment planning, and data processing. It also provides guidelines for reporting on studies.



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CT Radiomics in Thoracic Oncology: Technique and Clinical Applications

Abstract

Precision medicine offers better treatment options and improved survival for cancer patients based on individual variability. As the success of precision medicine depends on robust biomarkers, the requirement for improved imaging biomarkers that reflect tumor biology has grown exponentially. Radiomics, the field of study in which high-throughput data are generated and large amounts of advanced quantitative features are extracted from medical images, has shown great potential as a source of quantitative biomarkers in the field of oncology. Radiomics provides quantitative information about the morphology, texture, and intratumoral heterogeneity of the tumor itself as well as features related to pulmonary function. Hence, radiomics data can be used to build descriptive and predictive clinical models that relate imaging characteristics to tumor biology phenotypes. In this review, we describe the workflow of CT radiomics, types of CT radiomics, and its clinical application in thoracic oncology.



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PERCIST in Perspective

Abstract

Positron Emission tomography Response Criteria In Solid Tumors (PERCIST) version 1.0 was introduced in 2009 for objective assessment of tumor metabolic response using 18F-FDG PET/CT. Practical PERCIST: A Simplified Guide to PET Response Criteria in Solid Tumors 1.0 was published in 2016 to review and clarify some of the issues with the PERCIST. In this article, we reflect on the benefits and challenges of implementing PERCIST, and speculate on topics that could be discussed in PERCIST 1.1 in the future.



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A Direct Correlation between Viscosity and Liquid Structure in Cu-Sn Alloys

The viscosity and liquid structure of (, ,,, at.%) melts were investigated. Temperature dependence of viscosity and correlation length all shows an exponential decay function (Arrhenius-type equation), which is similar to our former studied Cu-Ag alloys. The correlation between viscosity and liquid structure had been studied. A simple relation between viscosity and correlation length was found. The ratio of and shows a linear relationship with temperature, which is different from our former studied results in Cu-Ag alloys. Among the four Cu-Sn alloys, and alloys have higher activation energy for viscous flow , activation energy for structural evolution , and the slope of the linear relationship of / with temperature due to the clusters formation.

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Yangyin Runchang Decoction Improves Intestinal Motility in Mice with Atropine/Diphenoxylate-Induced Slow-Transit Constipation

This study assessed the efficacy and mechanism of action of Yangyin Runchang decoction (YRD) in the treatment of slow-transit constipation (STC). ICR mice were randomly divided into four groups (/group) and treated with saline (normal control; NC), atropine/diphenoxylate (model control; MC; 20 mg/kg), or atropine/diphenoxylate plus low-dose YRD (L-YRD; 29.6 g/kg) or high-dose YRD (H-YRD; 59.2 g/kg). Intestinal motility was assessed by evaluating feces and the intestinal transit rate (ITR). The serum level of stem cell factor (SCF) and changes in interstitial cells of Cajal (ICCs) were also evaluated. Additionally, the expression of SCF and c-kit and the intracellular Ca2+ concentration [Ca2+]I were investigated. Fecal volume and ITR were greater in the L-YRD and H-YRD groups than in the MC group. The serum SCF level was lower in the MC group than in the NC group; this effect was ameliorated in the YRD-treated mice. Additionally, YRD-treated mice had more ICCs and elevated expression of c-kit and membrane-bound SCF, and YRD also increased [Ca2+]I in vitro in isolated ICCs. YRD treatment in this STC mouse model was effective, possibly via the restoration of the SCF/c-kit pathway, increase in the ICC count, and enhancement of ICC function by increasing [Ca2+]i.

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Associated Factors and Outcome of Uterine Rupture at Suhul General Hospital, Shire Town, North West Tigray, Ethiopia 2016: A Case-Control Study

Background. Uterine rupture is tearing of the uterine wall during pregnancy or delivery. It may extend to partial or whole thickness of the uterine wall. It is usually a case where obstetric care is poor. In extensive damage, death of the baby and sometimes even maternal death are evident. Objective. This study assesses associated factors and outcome of uterine rupture at Suhul General Hospital, Tigray Region, Ethiopia, 2016. Methodology. A case-control study was conducted by review of data from September 2012 to August 2016. A total of 336 samples were studied after calculating by EPI-INFO using proportion of multiparity (53%) and ratio of 1 : 2 for cases and controls, respectively. Analysis was done using SPSS version 20. Bivariate and multivariate logistic regression was applied with .Result. ANC, grand multiparity, malpresentation, and obstructed labor had association, but previous cesarean delivery was not significant. Perinatal mortality was 105 (93%) versus 13 (5.8%) in cases and controls, respectively. Anemia was highest for both groups (53.7% versus 32.1%). Conclusion. Majority of uterine rupture is attributed to prolonged or obstructed labor. Cases of uterine rupture had prompt management preventing maternal mortality, but burden of perinatal death is still high.

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Collaboration, leadership and human resources are key in the development of palliative care for all - see how it's… https://t.co/kiDN2KGITl

Collaboration, leadership and human resources are key in the development of palliative care for all - see how it's… https://t.co/kiDN2KGITl

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Center for Open Science is giving away $1000 to 1000 researchers who preregister their projects before they publish… https://t.co/ejLGTC0vL3

Center for Open Science is giving away $1000 to 1000 researchers who preregister their projects before they publish… https://t.co/ejLGTC0vL3

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Dermatologic Reactions to Immune Checkpoint Inhibitors

Abstract

The development of immune checkpoint inhibitors [monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein 1 (PD-1) or programmed death ligand 1 (PD-L1)] represents a major breakthrough in cancer therapy. Although they present a favorable risk/benefit ratio, immune checkpoint blockade therapies have a very specific safety profile. Due to their unique mechanism of action, they entail a new spectrum of adverse events that are mostly immune related [immune-related adverse events (irAEs)], notably mediated by the triggering of cytotoxic CD4+/CD8+ T cell activation. Cutaneous toxicities appear to be one of the most prevalent irAEs, both with anti-PD-1 and anti-CTLA-4 agents or with the newly developed anti-PD-L1 agents, which corresponds to a class effect. They are observed in more than one-third of the treated patients, mainly in the form of a maculopapular rash (eczema-like spongiotic dermatitis) and pruritus. A wide range of other dermatologic manifestations can also occur, including lichenoid reactions, psoriasis, acneiform rashes, vitiligo-like lesions, autoimmune skin diseases (e.g., bullous pemphigoid, dermatomyositis, alopecia areata), sarcoidosis or nail and oral mucosal changes. In addition, the use of anti-CTLA-4 and anti-PD-1 therapies in combination is associated with the development of more frequent, more severe and earlier cutaneous irAEs compared to single agents. In most cases, these dysimmune dermatologic adverse events remain self-limiting and readily manageable. Early recognition and adequate management, however, are critical to prevent exacerbation of the lesions, to limit treatment interruption and to minimize quality of life impairment. This review describes the variable clinical and histopathologic aspects of dermatologic irAEs induced by immune checkpoint inhibitors. Appropriate treatment and counseling are also proposed, with a step-by-step approach for optimized management by both practicing oncologists and dermatologists.



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Cosmetics, Vol. 4, Pages 57: Guidelines for Formulating Anti-Pollution Products

Cosmetics, Vol. 4, Pages 57: Guidelines for Formulating Anti-Pollution Products

Cosmetics doi: 10.3390/cosmetics4040057

Authors: Niraj Mistry

Anti-pollution skin care and cosmetic products are witnessing a significant growth in the last couple of years due to worsening air quality across the world, and increasing awareness and concern regarding the adverse impact of various environmental pollutants on skin. The various pollutants, like particulate matter, oxides of nitrogen and sulphur, ozone, and polyaromatic hydrocarbons damage skin by different mechanism resulting in skin dryness, loss of firmness, dark spots, uneven skin tone, fine lines and wrinkles, aggravation of acne, and inflammation. The task of developing globally harmonized products is very challenging due differences in skin types according to ethnicity, variation in seasonal weather pattern, differences in benefit expectations, and variances in personal care and cosmetics usage habits of consumers in different regions of the world. However, an increasing understanding about the mechanism by which various pollutants damage the skin manifesting into various extrinsic signs of skin damage and development of various actives that counter the impact of different environmental aggressors has helped formulators to develop different products and to establish efficacy by in vitro and in vivo tests. The article summarizes approaches for formulation development, and a list of few actives classified based in their mechanism action is given. A representative list of products based on their mechanism of action is also given and few potential opportunities for the future are suggested.



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IJMS, Vol. 18, Pages 2748: Canadine from Corydalis turtschaninovii Stimulates Myoblast Differentiation and Protects against Myotube Atrophy

IJMS, Vol. 18, Pages 2748: Canadine from Corydalis turtschaninovii Stimulates Myoblast Differentiation and Protects against Myotube Atrophy

International Journal of Molecular Sciences doi: 10.3390/ijms18122748

Authors: Heyjin Lee Sang-Jin Lee Gyu-Un Bae Nam-In Baek Jae-Ha Ryu

Cachexia and sarcopenia are the main causes of muscle atrophy. These result in a reduction in the muscle fiber area, myo-protein content, and muscle strength, with various molecular modulators being involved. Although several reports have proposed potential therapeutic agents, no effective treatments have been found for muscle atrophy. We searched for myogenic modulators from medicinal plants to treat muscle diseases. We isolated six alkaloids from Corydalis turtschaninovii and evaluated their myogenic potential by using the MyoD reporter gene assay in C2C12 cells. Among the tested compounds, canadine showed the strongest transactivation of MyoD and increased MHC expression during myogenesis. The activation of p38 MAP kinase and Akt are major mechanisms that contribute to the myogenesis by canadine. Canadine increased the number of multinucleated and cylinder-shaped myotubes during myogenesis of C2C12 myoblasts. To determine the preventive effect of canadine in cancer-induced muscle wasting, differentiated C2C12 myotubes were treated with conditioned media from CT26 colon carcinoma culture (CT26 CM) in the presence of canadine. Canadine ameliorated the muscle protein degradation caused by CT26-CM by down-regulating the muscle specific-E3 ligases, MAFbx/atrogin-1 and MuRF1. In this study, we found that canadine from C. turtschaninovii stimulates myogenesis and also inhibits muscle protein degradation. Therefore, we suggest canadine as a protective agent against muscle atrophy.



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IJMS, Vol. 18, Pages 2747: A Molecular Interpretation on the Different Penetration Enhancement Effect of Borneol and Menthol towards 5-Fluorouracil

IJMS, Vol. 18, Pages 2747: A Molecular Interpretation on the Different Penetration Enhancement Effect of Borneol and Menthol towards 5-Fluorouracil

International Journal of Molecular Sciences doi: 10.3390/ijms18122747

Authors: Ran Wang Zhimin Wu Shufang Yang Shujuan Guo Xingxing Dai Yanjiang Qiao Xinyuan Shi

Borneol and menthol are terpenes that are widely used as penetration enhancers in transdermal drug delivery. To explore their penetration-enhancement effects on hydrophilic drugs, 5-fluorouracil (5-FU) was selected as a model drug. An approach that combined in vitro permeation studies and coarse-grained molecular dynamics was used to investigate their penetration-enhancement effect on 5-FU. The results showed that although both borneol and menthol imparted penetration-enhancement effects on 5-FU, these differed in terms of their mechanism, which may account for the observed variations in penetration-enhancement effects. The main mechanism of action of menthol involves the disruption of the stratum corneum (SC) bilayer, whereas borneol involves multiple mechanisms, including the disruption of the SC bilayer, increasing the diffusion coefficient of 5-FU, and inducing the formation of transient pores. The findings of the present study improve our understanding of the molecular mechanism that is underlying 5-FU penetration-enhancement by borneol and menthol, which may be utilized in future investigations and applications.



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Urinary infections are complex and hard to treat

Kronenberg and colleagues find that a quinolone beats a non-steroidal anti-inflammatory drug at treating dipstick positive urinary tract infections (UTIs).1 Why are we testing this? We have vastly...
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No country for old men: on mentoring in medicine, by David Loxterkamp

When I entered family practice in the 1980s my concept of “the work of medicine” was exactly like my father’s. The science of medicine had advanced well beyond sulfa, penicillin, and the Salk...
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North-South? Pitfalls of Dividing the World by Words



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Die Kognitive Verhaltenstherapie der Zwangsstörungen State of the Art Themenschwerpunkt

Die zentralen psychotherapeutischen Interventionen der kognitiven Verhaltenstherapie umfassen eine ausführliche Diagnostik und Bedingungsanalyse, die Entwicklung eines Entstehungs- und Aufrechterhaltungsmodells und - nach einer umfassenden kognitiven Vorbereitungsphase - schließlich eine intensive Übungsphase mit Expositionsübungen und Verhaltensexperimenten. Kognitive und verhaltenstherapeutische Elemente sind eng miteinander verwoben. Dysfunktionale, automatisch auftretende Fehlinterpretationen der Zwangsgedanken sowie langfristig bestehende hinderliche Grundannahmen werden sowohl durch Methoden der kognitiven Umstrukturierung auf der Gesprächsebene als auch durch gezielte Verhaltensexperimente und Expositionsübungen hinterfragt. Die klassische Exposition mit Habituationsrational wird somit ergänzt und eingebettet in eine systematische Hinterfragung hinderlicher Einstellungen. Ein besonderer Schwerpunkt liegt im weiteren Verlauf der Therapie auf dem Übergang ins Selbstmanagement mit dem Ziel, eigenständig Expositionen und Verhaltensexperimente zu entwerfen und anzuwenden.

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Plasmodesmata and intercellular transport of viral RNA

Cell-to-cell communication in plants involves the symplastic trafficking of informational protein and RNA macromolecules through cytoplasmic bridges in the plant cell wall known as plasmodesmata. Viruses exploit this route for the spread of infection and are used as a model to study the mechanisms by which macromolecules are targeted to the pore. Studies using tobacco mosaic virus have led to the identification of host components that participate in plasmodesmal targeting of viral RNA and movement protein.

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A process model of the formation of Spatial Presence experiences

In order to bridge interdisciplinary differences in Presence research and to establish connections between Presence and “older” concepts of psychology and communication, a theoretical model of the formation of Spatial Presence is proposed. It is applicable to the exposure to different media and intended to unify the existing efforts to develop a theory of Presence. The model includes assumptions about attention allocation, mental models, and involvement, and considers the role of media factors and user characteristics as well, thus incorporating much previous work. It is argued that a commonly accepted model of Spatial Presence is the only solution to secure further progress within the international, interdisciplinary and multiple-paradigm community of Presence research.

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Funktionelle Hemisphärenasymmetrie der Selbstkontrolle?

Durch die Fähigkeit zur Selbstkontrolle gelingt es uns, diejenigen Aktivitäten zu unterdrücken, die einem angestrebten Ziel oder dem aktuellen sozialen Kontext entgegenstehen. Welche neuronalen Prozesse liegen der Selbstkontrolle zugrunde? Ein vertieftes Verständnis der relevanten neuronalen Mechanismen kann insofern von therapeutischer Relevanz sein, als Störungen der Selbstkontrolle ein zentrales Merkmal vieler neurologischer und psychiatrischer Erkrankungen darstellen. Der vorliegende Artikel fasst vorwiegend eigene experimentelle Arbeiten zusammen, deren Resultate die - aufgrund von Beobachtungen an Patienten mit Schädigungen im Frontalhirn formulierte - Annahme einer lateralisierten Organisation der Selbstkontrolle stützen. Basierend auf diesen Berichten formulieren wir die Schlussfolgerung, dass die Fähigkeit zur Selbstkontrolle, die für ein adäquates Entscheidungsverhalten von fundamentaler Bedeutung ist, über rechtsseitige Regelsysteme organisiert ist und durch kortikale Stimulation vorübergehend moduliert werden kann.

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Behandlungsqualität von Hausärzten in Einzel- und Gruppenpraxen der Schweiz



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Die medizinische Statistik für orthopädische Behandlungen



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Analyse der Hauptbehandlungskodierung der medizinischen Statistik für orthopädische Behandlungen mittels Spitaleinzugsgebieten (small area analysis)



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Defining the Optimal Time of Adaptive Replanning in Prostate Cancer Patients with Weight Change during Volumetric Arc Radiotherapy: A Dosimetric and Mathematical Analysis Using the Gamma Index

We evaluated the changes in the dose distribution of radiation during volumetric arc radiotherapy (VMAT), to determine the right time for adaptive replanning in prostate cancer patients with progressive weight (WT) changes. Five prostate cancer patients treated with VMAT were selected for dosimetric analysis. On the original computed tomography images, nine artificial body contours were created to reflect progressive WT changes. Combined with three different photon energies (6, 10, and 15-MV), 27 comparable virtual VMAT plans were created per patient. The dosimetric analysis included evaluation of target coverage , conformity index, homogeneity index, and organs at risk doses. The dose differences among the plans were determined using the gamma index analysis and were compared with the dosimetric analysis. Mean became lower than 98% when body contour expanded by 2.0 cm or more and became higher than 107% when body contour contracted by 1.5 cm or more in 10-MV plans. This cut-off values correlated well with gamma index analysis results. Adaptive replanning should, therefore, be considered if the depth of body contour becomes 1.5 cm smaller (WT loss) or 2.0 cm larger (WT gain) in patients treated by VMAT with 10-MV photons.

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Pattern and Appropriateness of Medicines Prescribed to Outpatients at a University Hospital in Northwestern Ethiopia

The study assessed the pattern and appropriateness of medicines prescribed to outpatients at Gondar University Referral Hospital in northwestern Ethiopia. An institution-based cross-sectional study was employed, through interviews and prescription reviews, among 346 patients at the outpatient pharmacy, from 2nd to 20th of May 2016. Data on sociodemographic profile of patients and medicines prescribed to them were collected. A mean of 1.72 medicines per encounter was prescribed, over a third of the total being anti-infectives. Patients were able to get about 85% of these medicines. An unskilled government employee would be required to work more than one and a half day to be able to afford the average priced medicine. Among prescriptions with two or more medicines, more than a third had at least one potential drug-drug interaction (PDDI), the commonest pair containing amoxicillin and doxycycline. Being male, being older (50–59 years), and increased number of medicines were associated with higher likelihood of PDDIs. In conclusion, the number of medicines prescribed per encounter was up to accepted standard. However, their availability fell short, together with considerable cost. Regarding appropriateness, a significant proportion of potential drug-drug interactions is identified and associated with patient’s sex, age, and number of medicines prescribed.

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EGCG Maintains Th1/Th2 Balance and Mitigates Ulcerative Colitis Induced by Dextran Sulfate Sodium through TLR4/MyD88/NF-κB Signaling Pathway in Rats

Objective. To observe the protective effect of epigallocatechin gallate (EGCG) on dextran sulfate sodium- (DSS-) induced ulcerative colitis in rats and to explore the roles of TLR4/MyD88/NF-κB signaling pathway. Methods. Rat models of ulcerative colitis were established by giving DSS. EGCG (50 mg/kg/d) was given to assess disease activity index. HE staining was applied to observe histological changes. ELISA and qPCR detected the expression of inflammatory factors. Flow cytometry was used to measure the percentage of CD4+IFN-γ+ and CD4+IL-4+ in the spleen and colon. TLR4 antagonist E5564 was given in each group. Flow cytometry was utilized to detect CD4+IFN-γ+ and CD4+IL-4+ cells. Immunohistochemistry, qPCR, and western blot assay were applied to measure the expression of TLR4, MyD88, and NF-κB. Results. EGCG improved the intestinal mucosal injury in rats, inhibited production of inflammatory factors, maintained the balance of Th1/Th2, and reduced the expression of TLR4, MyD88, and NF-κB. After TLR4 antagonism, the protective effect of EGCG on intestinal mucosal injury was weakened in rats with ulcerative colitis, and the expressions of inflammatory factors were upregulated. Conclusion. EGCG can inhibit the intestinal inflammatory response by reducing the severity of ulcerative colitis and maintaining the Th1/Th2 balance through the TLR4/MyD88/NF-κB signaling pathway.

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Cognitive Security of Wireless Communication Systems in the Physical Layer

While the wireless communication systems provide the means of connectivity nearly everywhere and all the time, communication security requires more attention. Even though current efforts provide solutions to specific problems under given circumstances, these methods are neither adaptive nor flexible enough to provide security under the dynamic conditions which make the security breaches an important concern. In this paper, a cognitive security (CS) concept for wireless communication systems in the physical layer is proposed with the aim of providing a comprehensive solution to wireless security problems. The proposed method will enable the comprehensive security to ensure a robust and reliable communication in the existence of adversaries by providing adaptive security solutions in the communication systems by exploiting the physical layer security from different perspective. The adaptiveness relies on the fact that radio adapts its propagation characteristics to satisfy secure communication based on specific conditions which are given as user density, application specific adaptation, and location within CS concept. Thus, instead of providing any type of new security mechanism, it is proposed that radio can take the necessary precautions based on these conditions before the attacks occur. Various access scenarios are investigated to enable the CS while considering these conditions.

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Squamous cell carcinoma (SCC) arising in esophageal colon interposition

Abstract
The idea of using the colon to replace a resected esophagus has a long history. The colon has become a favored organ for esophageal reconstruction in adults with esophageal cancer when the stomach is not suitable or is unavailable. In this article, we introduce an 84-year-old woman that she had surgery 40 years ago and presented with an invasive well differentiated squamous cell carcinoma of colonic origin in reconstructed esophagus.

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Breast cancer metastasis to the spleen: a case report and literature review

Abstract
Splenic metastasis from cancers is extremely rare. They usually occur and are detected simultaneously with metastasis to other organs. We present a case of splenic metastasis from carcinoma of the breast occurring 5 years after initial treatment. The metastatic recurrence was an oligometastic form made from the association of a unique bone metastasis to a rib and the metastasis to the spleen. Treatment of the metastatic recurrence was a second line hormonotherapy as the primitive tumor was estrogen receptors positive and gave a 2 year’s long control of the disease. A clinical progression occurred then, the patient complained from pain in the left hypochondrium and was objective on [18F]-FDG PET which leaded to splenectomy. This case is being reported because of the rarity of the lesion and its originality is the first reported case with use of an in vivo demonstration of estrogen receptors expression in the spleen metastasis using PET/CT with 16α-[18F]-Fluoroestradiol.

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RT @DaleYuzuki : Oncologists, Beware: Expensive Liquid Biopsy Tests Produce Conflicting Results | Forbes https://t.co/0JxY0WHKSG

RT @DaleYuzuki : Oncologists, Beware: Expensive Liquid Biopsy Tests Produce Conflicting Results | Forbes https://t.co/0JxY0WHKSG

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What do our contributors have to say about ten years of working with ecancer? https://t.co/sl3k0go9U4 https://t.co/rvOcFEDfXI

What do our contributors have to say about ten years of working with ecancer? https://t.co/sl3k0go9U4 https://t.co/rvOcFEDfXI

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Viruses, Vol. 9, Pages 388: Stress Granule-Inducing Eukaryotic Translation Initiation Factor 4A Inhibitors Block Influenza A Virus Replication

Viruses, Vol. 9, Pages 388: Stress Granule-Inducing Eukaryotic Translation Initiation Factor 4A Inhibitors Block Influenza A Virus Replication

Viruses doi: 10.3390/v9120388

Authors: Patrick Slaine Mariel Kleer Nathan Smith Denys Khaperskyy Craig McCormick

Eukaryotic translation initiation factor 4A (eIF4A) is a helicase that facilitates assembly of the translation preinitiation complex by unwinding structured mRNA 5′ untranslated regions. Pateamine A (PatA) and silvestrol are natural products that disrupt eIF4A function and arrest translation, thereby triggering the formation of cytoplasmic aggregates of stalled preinitiation complexes known as stress granules (SGs). Here we examined the effects of eIF4A inhibition by PatA and silvestrol on influenza A virus (IAV) protein synthesis and replication in cell culture. Treatment of infected cells with either PatA or silvestrol at early times post-infection resulted in SG formation, arrest of viral protein synthesis and failure to replicate the viral genome. PatA, which irreversibly binds to eIF4A, sustained long-term blockade of IAV replication following drug withdrawal, and inhibited IAV replication at concentrations that had minimal cytotoxicity. By contrast, the antiviral effects of silvestrol were fully reversible; drug withdrawal caused rapid SG dissolution and resumption of viral protein synthesis. IAV inhibition by silvestrol was invariably associated with cytotoxicity. PatA blocked replication of genetically divergent IAV strains, suggesting common dependence on host eIF4A activity. This study demonstrates that the core host protein synthesis machinery can be targeted to block viral replication.



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Measured parental height in Turner syndrome—a valuable but underused diagnostic tool

Abstract

Early diagnosis of Turner syndrome (TS) is necessary to facilitate appropriate management, including growth promotion. Not all girls with TS have overt short stature, and comparison with parental height (Ht) is needed for appropriate evaluation. We examined both the prevalence and diagnostic sensitivity of measured parental Ht in a dedicated TS clinic between 1989 and 2013. Lower end of parental target range (LTR) was calculated as mid-parental Ht (correction factor 12.5 cm minus 8.5 cm) and converted to standard deviation scores (SDS) using UK 1990 data, then compared with patient Ht SDS at first accurate measurement aged > 1 year. Information was available in 172 girls of whom 142 (82.6%) were short at first measurement. However, both parents had been measured in only 94 girls (54.6%). In 92 of these girls age at measurement was 6.93 ± 3.9 years, Ht SDS vs LTR SDS − 2.63 ± 0.94 vs − 1.77 ± 0.81 (p < 0.001), Ht SDS < LTR in 78/92 (85%). Eleven of the remaining 14 girls were < 5 years, while karyotype was 45,X/46,XX in 2 and 45,X/47,XXX in 3.

Conclusion: This study confirms the sensitivity of evaluating height status against parental height but shows that the latter is not being consistently measured.

What is Known:
Girls with Turner syndrome are short in relation to parental heights, with untreated final height approximately 20 cm below female population mean.
Measured parental height is more accurate than reported height.
What is New:
In a dedicated Turner clinic, there was 85% sensitivity when comparing patient height standard deviation score at first accurate measurement beyond 1 year of age with the lower end of the parental target range standard deviation.
However, measured height in both parents had been recorded in only 54.6% of the Turner girls attending the clinic. This indicates the need to improve the quality of growth assessment in tertiary care.


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20 dicembre 2017: Giornata della Trasparenza



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Ärztenetzwerke im Kanton Bern / nur Hoffnung oder die Realität von morgen?



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Ethics of transcranial magnetic stimulation



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Umfassende Behandlung: Psychotherapeutische Ansatzpunkte bei HIV



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A proteomic study to identify soya allergens - the human response to transgenic versus non-transgenic soya samples

BACKGROUND: In spite of being among the main foods responsible for allergic reactions worldwide, soybean (Glycine max)-derived products continue to be increasingly widespread in a variety of food products due to their well-documented health benefits. Soybean also continues to be one of the elected target crops for genetic modification. The aim of this study was to characterize the soya proteome and, specifically, IgE-reactive proteins as well as to compare the IgE response in soya-allergic individuals to genetically modified Roundup Ready soya versus its non-transgenic control. METHODS: We performed two-dimensional gel electrophoresis of protein extracts from a 5% genetically modified Roundup Ready flour sample and its non-transgenic control followed by Western blotting with plasma from 5 soya-sensitive individuals. We used peptide tandem mass spectrometry to identify soya proteins (55 protein matches), specifically IgE-binding ones, and to evaluate differences between transgenic and non-transgenic samples. RESULTS: We identified 2 new potential soybean allergens--one is maturation associated and seems to be part of the late embryogenesis abundant proteins group and the other is a cysteine proteinase inhibitor. None of the individuals tested reacted differentially to the transgenic versus non-transgenic samples under study. CONCLUSION: Soybean endogenous allergen expression does not seem to be altered after genetic modification. Proteomics should be considered a powerful tool for functional characterization of plants and for food safety assessment.

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Continental extension: Introduction



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[Review of] Three-dimensional electron microscopy of macromolecular assemblies

Three-Dimensional Electron Microscopy of Macro-molecular Assemblies: Visualization of Biological Molecules in Their Native State. By Joachim Frank. Oxford University Press, New York (2006). ISBN 0195182189; softback; 432 pages

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The Health and Safety in Employment Act and the influenza vaccination of healthcare workers

Despite studies demonstrating that the annual influenza vaccination of healthcare workers has a statistically significant reduction of morbidity and mortality among the patients they care for, and District Health Boards (DHBs) establishing voluntary programs to provide the influenza vaccine to healthcare workers free of charge, vaccination rates among healthcare workers are dismal, with only about 20%–40% coverage rates being achieved. With these low rates posing a serious health threat to the vulnerable patient populations that are entrusted into healthcare workers’ care, and the current voluntary programmes clearly failing to adequately address this issue, we believe the time has come for the annual influenza vaccination to be made a mandatory requirement for all healthcare workers with direct patient contact unless a medical contraindication exists. Indeed, a compelling case may be made that the duties imposed on DHBs and healthcare workers under the Health and Safety in Employment Act 1992 requires making the annual influenza vaccination an occupational requirement.

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Supplementary dimensional assessment in anxiety disorders

Anxiety disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), comprise a relatively heterogeneous group of clinical conditions that range from specific phobias to obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). The grouping under one heading refers to the fact that these seemingly heterogeneous disorders share a number of common psychopathological features and also share at least some common principles in treatment. Among the shared elements are broadly defined prototypical anxiety reactions, panic attacks, anticipatory anxiety, avoidance behaviour, a predominantly early onset, and relatively high persistence rates over time. Many of the shared diagnostic features of anxiety disorders are by their nature dimensional, and hundreds of psychometric scales have been developed to measure these diagnostic constructs across anxiety disorder and for specific diagnostic classes. This paper explores different types of dimensional approaches used in the literature and discusses how an integrated categorical/dimensional strategy might enhance the usefulness of the DSM-V. We suggest the use of cross-cutting dimensional ratings that might ultimately lead to an improved classification model. We also suggest that a staging approach to illness, based upon supplementary dimensional rating could provide useful information for clinical and research purposes.

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Anatomical variant of the meniscus related to posterior junction: a case report

There are several reports on anatomical differences of the meniscus. However, there are only a few reports on abnormalities in both menisci and anatomical differences in anterior cruciate ligament insertions.

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Genes, Vol. 8, Pages 392: Deciphering the Relationship between Obesity and Various Diseases from a Network Perspective

Genes, Vol. 8, Pages 392: Deciphering the Relationship between Obesity and Various Diseases from a Network Perspective

Genes doi: 10.3390/genes8120392

Authors: Lei Chen Yu-Hang Zhang JiaRui Li ShaoPeng Wang YunHua Zhang Tao Huang Yu-Dong Cai

The number of obesity cases is rapidly increasing in developed and developing countries, thereby causing significant health problems worldwide. The pathologic factors of obesity at the molecular level are not fully characterized, although the imbalance between energy intake and consumption is widely recognized as the main reason for fat accumulation. Previous studies reported that obesity can be caused by the dysfunction of genes associated with other diseases, such as myocardial infarction, hence providing new insights into dissecting the pathogenesis of obesity by investigating its associations with other diseases. In this study, we investigated the relationship between obesity and diseases from Online Mendelian Inheritance in Man (OMIM) databases on the protein–protein interaction (PPI) network. The obesity genes and genes of one OMIM disease were mapped onto the network, and the interaction scores between the two gene sets were investigated on the basis of the PPI of individual gene pairs, thereby inferring the relationship between obesity and this disease. Results suggested that diseases related to nutrition and endocrine are the top two diseases that are closely associated with obesity. This finding is consistent with our general knowledge and indicates the reliability of our obtained results. Moreover, we inferred that diseases related to psychiatric factors and bone may also be highly related to obesity because the two diseases followed the diseases related to nutrition and endocrine according to our results. Numerous obesity–disease associations were identified in the literature to confirm the relationships between obesity and the aforementioned four diseases. These new results may help understand the underlying molecular mechanisms of obesity–disease co-occurrence and provide useful insights for disease prevention and intervention.



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De Gruyter and United Nations cooperate on open access book project

Diese Pressemitteilung ist nur auf Englisch erhältlich.



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Risk of suicide within 1 year of cancer diagnosis

Abstract

The association of the risk of suicide with cancer at different time points after a new cancer diagnosis is unclear. This study explored the suicide hazard at different time points after a first cancer diagnosis during the 1-year period before suicide. This case–crossover study included 2,907 suicide cases from 2002 to 2012 in Taiwan and compared the odds of suicide risk at different time points during one year after any cancer diagnosis with self-matched periods. The 13th month preceding the suicide date was used as the control period, and the hazard period was the duration from the 1st to 12th month in the conditional logistic regression for case–crossover comparisons. Among major groups of cancers, group of lip, oral cavity, and pharynx cancers tended to have higher risk of suicide than other groups of cancers. The first month of cancer diagnosis was associated with the highest risk of suicide compared with the 13th month before suicide. The odds ratio of suicide were significantly in the first six months after cancer diagnosis but declined afterwards. For example, the adjusted odds ratio [OR] was 3.47 (95% confidence interval [CI]=2.60-4.62) in the first month and 1.53 (95% CI=1.11-2.12) in the sixth month following cancer diagnosis. These findings provide clinicians with a vital reference period during which sufficient support and necessary referral to mental health support should be provided to reduce the risk of suicide among patients with newly diagnosed cancer morbidity. This article is protected by copyright. All rights reserved.



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Neuroblastoma among children in Southern and Eastern European cancer registries: Variations in incidence and temporal trends compared to US

Abstract

Neuroblastoma comprises the most common neoplasm during infancy (first year of life). This study describes incidence of neuroblastoma in Southern-Eastern Europe (SEE), including -for the first time- the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)/Greece, compared to the US population, while controlling for Human Development Index (HDI). Age-adjusted incidence rates (AIR) were calculated for 1859 childhood (0-14 years) neuroblastoma cases, retrieved from 13 collaborating SEE registries (1990-2016), and were compared with those of SEER/US (N=3166; 1990-2012); temporal trends were assessed using Poisson regression and Joinpoint analyses. The overall AIR was significantly lower in SEE (10.1/million) compared to SEER (11.7 per million); the difference was maximum during infancy (43.7 vs. 53.3 per million, respectively), when approximately one third of cases were diagnosed. Incidence rates of neuroblastoma at ages <1 and 1-4 years were positively associated with HDI, whereas lower median age at diagnosis was correlated with higher overall AIR. Distribution of primary site and histology were similar in SEE and SEER. Neuroblastoma was slightly more common among males compared to females (male-to-female ratio: 1.1), mainly among SEE infants. Incidence trends decreased in infants in Slovenia, Cyprus and SEER and increased in Ukraine and Belarus. The lower incidence in SEE compared to SEER, especially in infants living in low HDI countries possibly indicates a lower level of overdiagnosis in SEE. Hence, increases in incidence rates in infancy noted in some subpopulations should be carefully monitored to avoid the unnecessary costs health impacts of tumors that could potentially spontaneously regress. This article is protected by copyright. All rights reserved.



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XIAP Overexpression Promotes Bladder Cancer Invasion in Vitro and Lung Metastasis in Vivo via Enhancing Nucleolin-Mediated Rho-GDIβ mRNA Stability

Abstract

Our recent studies demonstrate that X-linked inhibitor of apoptosis protein (XIAP) is essential for regulating colorectal cancer invasion. Here we discovered that RhoGDIβ was a key XIAP downstream effector mediating bladder cancer (BC) invasion in vitro and in vivo. We found that both XIAP and RhoGDIβ expressions were consistently elevated in BCs of N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN)-treated mice in comparison to bladder tissues from vehicle-treated mice and human BCs in comparison to the paired adjacent normal bladder tissues. Knockdown of XIAP attenuated RhoGDIβ expression and reduced cancer cell invasion, whereas RhoGDIβ expression was attenuated in BBN-treated urothelium of RING-deletion knockin mice. Mechanistically, XIAP stabilized RhoGDIβ mRNA by its positively regulating nucleolin mRNA stability via Erks-dependent manner. Moreover, ectopic expression of GFP-RhoGDIβ in T24T(shXIAP) cells restored its lung metastasis in nude mice. Our results demonstrate that XIAP-regulated Erks/nucleolin/RhoGDIβ axis promoted BC invasion and lung metastasis. This article is protected by copyright. All rights reserved.



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La cultura como política: los intercambios culturales entre Europa y América Latina en los años de entreguerras



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Batak Képe a Bolgárok Kollektív Emlékezetében

In May 2007, a public conference was scheduled in Bulgaria by Martina Baleva and Ulf Brunnbauer aiming to present research in an effort to form the official report of the events of the Batak Massacre. Bulgarian media reported that the authors were denying the massacre, which gave rise to a substantial media controversy

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[Review of] Im langen Schatten des Nationalsozialismus: Faschistische Bewegungen in Chile zwischen der Weltwirtschaftskrise und dem Ende des Zweiten Weltkriegs



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Phylogeny of Ten Kenyan Plectranthus Species in the Coleus Clade Inferred from Leaf Micromorphology, Rbcl and MatK Genes

Plectranthus species are difficult to taxonomically delimit due to lack of clear-cut morphological synapomorphies. This study is aimed at bringing insights into classification of ten Plectranthus species in the Coleus clade by using leaf micromorphology and molecular data. Stomatal counts and observation of microtome leaf sections generated leaf micromorphology data, while molecular data was obtained from sequencing MatK and Rbcl genes from each species. Phylogeny based on the MatK and Rbcl gene sequences clustered four species P. caninus, P. otostegioides, P. barbatus, and P. lanuginosus together (Clusters A and D, respectively), while P. pseudomarrubioides, P. ornatus, and P. aegyptiacus were grouped together into Clusters B and E, respectively, and P. montanus and P. amboinicus were grouped together (Cluster C). A dendrogram was generated through a cluster analysis of the leaf micromorphological characters grouped together, P. caninus, P. ornatus, P. otostegioides, P. montanus, and P. pseudomarrubioides (Cluster F). The dendrogram also grouped together P. aegyptiacus, P. amboinicus, P. edulis, P. barbatus, and P. lanuginosus (Cluster G). The present study has grouped the ten studied Plectranthus species using molecular and leaf micromorphology characters into phylogenies, which are supported by previous studies, and proved that these characters can aid in plant identification and phylogenetic studies.

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miR-503 Is Involved in the Protective Effect of Phase II Enzyme Inducer (CPDT) in Diabetic Cardiomyopathy via Nrf2/ARE Signaling Pathway

Diabetic cardiomyopathy (DCM) is a common heart disease. The Phase II enzyme inducer (CPDT) is a complex enzyme that promotes the expression of antioxidant enzymes through activating nuclear factor erythroid 2-related factor 2 (Nrf2); these compounds have been shown to protect against oxidative stress. However, whether these compounds have similar protective effects in DCM still remains unclear. The purpose of this study is to investigate the protective effects and potential mechanism of CPDT in diabetic cardiomyopathy. In the results, firstly, compared with control rats, myocardial cell size, left ventricular mass index, and myocardial apoptosis index were increased, miR-503 was increased, and Nrf2, malondialdehyde (MDA), and heme oxygenase 1 (HO-1) were decreased in diabetic cardiomyopathy rats. Furthermore, compared with diabetic cardiomyopathy rats, these above parameters show the opposite change in CPDT treatment rats. In addition, the bioinformatics and luciferase reporter assay demonstrated that Nrf2 is a direct target of miR-503. Finally, the miR-503 could also regulate Nrf2 in the myocardial cells. Therefore, miR-503 is involved in the protective effect of CPDT in diabetic cardiomyopathy via Nrf2/ARE signaling pathway; miR-503 and Nrf2 may be a promising therapeutic target for the management of diabetic cardiomyopathy.

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Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study

Background. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with increased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing protocols. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1988 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody (ANCA) serology were included. Standardised incidence ratios (SIRs) were calculated to compare the study cohort with the general population. Results. The study cohort included 419 patients. During 3010 person-years, cancer developed in 41 patients (9.79%); the expected number of cancer cases was 37.5 (8.95%). The cohort had SIRs as follows: 1.09, all cancer types (95% CI, 0.81 to 1.49); 0.96, all types except nonmelanoma skin cancer (95% CI, 0.69 to 1.34); 3.40, nonmelanoma skin cancer (95% CI, 1.62 to 7.14); 3.52, hematologic cancer (95% CI, 1.32 to 9.37); 2.12, posttransplant cancer (95% CI, 1.01 to 4.44); and 1.53, during the 1–5-year follow-up after diagnosis (95% CI, 1.01 to 2.32). Conclusions. Cancer risk did not increase significantly in this cohort with ANCA-associated glomerulonephritis. However, increased risk of nonmelanoma skin cancer, posttransplant cancer, and hematologic cancer indicates an association between immunosuppression and malignancy.

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Carbon Nanoparticles Based Electrochemical Biosensor Strip for Detection of Japanese Encephalitis Virus

We reported a disposable and sensitive electrochemical biosensor strip based on carbon nanoparticles modified screen-printed carbon electrode (SPCE) for rapid and sensitive detection of Japanese Encephalitis Virus (JEV). Amino group functionalized carbon nanoparticles were prepared from preformed chitosan nanoparticles. Japanese Encephalitis Virus (JEV) antibody was immobilized onto the surfaces of carbon nanoparticles through amide bonds formation between amino groups of carbon nanoparticles and carboxylic groups of JEV antibody. The analytical performance of SPCE electrochemical biosensor strip was characterized using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). SPCE electrochemical biosensor strip exhibited a linear detection range of 1–20 ngmL−1 with a low detection limit of 0.36 ngmL−1 (at S/N = 3) for JEV, detection sensitivity was 0.024 ngmL−1 for JEV, and analysis results were obtainable within 10 minutes. The potential clinical application of this SPCE electrochemical biosensor strip was demonstrated by the detection of JEV in human serum.

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Prevalence of Cam and Pincer Deformities in the X-Rays of Asymptomatic Individuals

Objective. The presence of radiological signs of femoroacetabular impingement (FAI) is not necessarily associated with symptoms. Hence, the prevalence of cam and pincer deformities in the overall population may be underestimated. The purpose of this study was to screen an unselected cohort of people without hip symptoms for native radiological signs of cam and pincer deformities to determine their actual prevalence. Materials and Methods. 110 asymptomatic patients had AP pelvis X-rays and cross-table hip X-rays performed. We evaluated the images for the presence of cross-over signs and measured lateral center edge (LCE) angles, alpha angles (α-angles), and femoral offset ratios. Results. Positive cross-over signs were seen in 34%; LCE angles > 40° in 13%; and femoral offset ratios 50°. Male patients showed significantly higher α-angles, lower offset ratios, and a higher prevalence of cross-over signs. In contrast, female patients had significantly higher LCE angles. Conclusion. According to our data, radiological signs of cam and pincer deformities are common in asymptomatic people. In clinical practice, patients presenting with hip pain and radiological signs of FAI should undergo further diagnostic evaluation. However, in asymptomatic patients, no further evaluation is recommended.

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Asynchronous Bilateral Ovarian Torsion: Three Cases, Three Lessons

Background. Ovarian torsion (OT) is a serious condition, and delay in surgical intervention may result in loss of the ovary. Children and adolescents who have suffered from ovarian torsion may be at risk for asynchronous torsion of the contralateral ovary. Study objective. Three cases of asynchronous bilateral ovarian torsion were reported to analyse clinical history of three patients, to review the current literature, and to draw a conclusion for future treatment. Design. Case reports and review of the literature. Result. When a prepubertal girl presents with an ovarian torsion, several considerations have to be taken in account in order to preserve her future fertility; in particular, the pediatric surgeon/gynecologist has to preserve as much as possible the twisted ovary in addition to considering the fate of the contralateral ovary. Summary and Conclusions. Pelvic pain in a young girl has always raised the clinical suspect of an ovarian torsion; the possibility of asynchronous bilateral ovarian torsion is rare, but it is described in the literature and has catastrophic consequences; this condition has to be known and treated in the proper way by pediatric surgeons as well as by gynecologists in order to maximize the future fertility of the young patients.

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Cost-Effectiveness Analysis of Total Hip Arthroplasty Performed by a Canadian Short-Stay Surgical Team in Ecuador

Background. Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. Methods. We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY. Results. The average lifetime QALYs (95% CI) gained were 1.46 (1.4–1.5), 2.5 (2.4–2.6), and 2.9 (2.7–3.1) for unilateral, bilateral, and staged (two THAs in different years) operations, respectively. The ICERs were $4,442 for unilateral, $2,939 for bilateral, and $4392 for staged procedures. Seventy percent of the mission budget was spent on the transport and accommodation of volunteers. Conclusion. THA by a Canadian short-stay surgical team was highly cost-effective, according to criteria from the National Institute for Health and Care Excellence and the World Health Organization. We encourage other international missions to provide similar cost-effectiveness data to enable better comparison between mission types and between mission and nonmission care.

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A Pilot Study of the Normative Range of Overnight Urinary Free Cortisol Corrected for Creatinine in Children

Abstract

Background

For more than a decade, urinary free cortisol corrected for creatinine (OUFCC) has been used to assess the systemic bioactivity of inhaled corticosteroids in children with asthma. Paediatric normative ranges, however, have not been established. The aim of the present study was to define a preliminary range for OUFCC in Tanner stage 1 children.

Methods

A post hoc analysis was performed of 26 Tanner stage one children (aged 5–11 years) with mild asthma only requiring prn (pro re nata) treatment with short-acting β2-agonists, who participated in a 3-way cross-over knemometry study. The study comprised a run-in, two washout periods and three treatment periods (2 weeks each). Urine was collected at the end of each period. A normative range was derived using the 95% prediction interval for the geometric mean OUFCC, calculated from run-in and washout periods.

Results

Twenty-six children contributed 41 OUFCC values. The geometric mean OUFCC was 9.0 nmol/mmol (95% PI: 3.6, 22.7 nmol/mmol).

Conclusions

The OUFCC preliminary normative range was 3.6 to 22.7 nmol/mmol in Tanner stage one children. A larger study in healthy children is warranted to confirm these findings and to assess potential differences in OUFCC across developmental stages and age groups, and by gender and race.

EudraCT number

2013-004719-32,

ClinicalTrials.gov identifier

NCT02063139



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Finnish Soundscapes

Järviluoma, Helmi et al. (eds.) 2006. Sata suomalaista äänimaisemaa. (One Hundred Finnish Soundscapes.) Helsinki: Suomalaisen Kirjallisuuden Seura, 250 pp. III. ISBN 952-5264-51-3 [Add to Citavi project by ISBN] . ISSN 1456-0011.

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Nuklearmedizin: Die systemische Radionuklidtherapie beim metastasierten medullären Schilddrüsenkarzinom



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Safety and effectiveness of transcatheter embolization in the treatment of internal mammary artery injuries

Abstract

Purpose

Demonstrate the role of endovascular management in the treatment of internal mammary artery (IMA) injuries using transcatheter embolization reviewing our 7-year experience.

Materials and methods

Our retrospective analysis of cases consists of a total of 12 patients (8 M and 4 F; mean age 52 years) who underwent angiographic studies and transcatheter embolization for IMA injuries. Causes of vascular injury were divided in high-energy trauma (n = 6), iatrogenic (n = 3) and penetrating injuries (n = 3). Type of trauma, associated injury, imaging findings, treatments and complications were assessed. Imaging findings included active haemorrhage, pseudoaneurysm and focal dissection.

Results

Embolization was performed with microcoils in all patients; complete thrombosis was obtained in four patients by additional injection of Spongostan pledgets and in two patients with 300–500 μm particles. The technical success rate was 100%. No patient died as a direct result of vascular injury; one died of myocardial contusion and one for severe multiorgan failure related to high-energy trauma. No major and minor complications were registered. No patient required emergency surgery or subsequent surgical treatment.

Conclusion

Transcatheter embolization offers an effective, efficient and safe alternative to conventional surgical management of IMA injuries.



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Decreased miR-17-92 cluster expression level in serum and granulocytes preceding onset of antithyroid drug-induced agranulocytosis

Abstract

Purpose

We aimed to determine changes in miR-17-92 cluster expression in serum and granulocytes from patients with antithyroid drug (ATD)-induced agranulocytosis.

Methods

In this study, real-time polymerase chain reaction (PCR) was used to detect serum miR-17-92 expression levels in 20 ATD-induced agranulocytosis and 16 control patients. Importantly, dynamic changes in neutrophil counts from granulocytopenia to agranulocytosis were observed in 6 of the 20 patients. miR-17-92 expression levels in granulocytes of those six patients under the granulocytopenia condition were measured and compared with corresponding granulocyte samples after recovery. Additionally, the expression levels of these miRNAs in patients with type I or type II bone marrow characteristics were analyzed, and the correlation between miR-17-92 and serum free thyroxine level was analyzed.

Results

We found that levels of miR-17-92 expression decreased in both serum and pre-agranulocytosis granulocytes from patients with ATD-induced agranulocytosis compared with those in serum and granulocytes from both recovered patients and control patients. However, no difference among patients with either type of bone marrow characteristics was observed, and no correlation between serum miR-17-92 and free thyroxine levels was found.

Conclusion

In ATD-induced agranulocytosis, expression of the miR-17-92 cluster is reduced in both serum and granulocytes, though this alteration does not correlate with bone marrow characteristics or thyroid function.



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Recurrent Enlarging Mesenteric Desmoid Tumor following Remote Surgical Resection

Intra-abdominal desmoid tumors are commonly associated with genetic syndromes such as familial polyposis coli. Radiological cross imaging studies such as CT and MRI are used in the preoperative work-up of such tumors. Postoperatively, CT and MRI are useful in the assessment of recurrent desmoid tumors. MRI is more accurate in tissue characterization. Where possible, surgical resection remains the standard first-line treatment. For patients where surgery is not possible, or the resection margins are not clear, other forms of treatment are possible. These include hormonal and nonhormonal options. We present a case of a recurrent sporadic intra-abdominal (mesenteric) desmoid tumor. Such an entity is rare with few cases reported in the literature. Treatment options regarding intra-abdominal desmoid tumors will be discussed.

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Tumor-Like Reaction to Polypropylene Mesh from a Mid-Urethral Sling Material Resembling Giant Cell Tumor of Vagina

Background. Polypropylene material is widely used in gynecological surgery. There are few reports regarding its carcinogenic potential. There is lack of evidence supporting tumor formation directly attributed to the use of polypropylene material. Case. This patient is a 49-year-old woman with a history of stress urinary incontinence which required a MiniArc® Sling who presented with a hard, tender, immobile mass on the anterior vaginal wall. Pathological analysis of the mass revealed a tumor-like reaction to the polypropylene material that resembled a giant cell tumor of soft tissue. Conclusion. The use of polypropylene in surgery is ubiquitous across disciplines; thus consideration for a tumor-like reaction to the material should exist for patients who present with a mass near the surgical site.

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Groundwater and Subsidence Modeling Combining Geological and Multi-Satellite SAR Data over the Alto Guadalentín Aquifer (SE Spain)

In the current context of climate change, improving groundwater monitoring and management is an important issue for human communities in arid environments. The exploitation of groundwater resources can trigger land subsidence producing damage in urban structures and infrastructures. Alto Guadalentín aquifer system in SE Spain has been exploited since 1960 producing an average piezometric level drop of 150 m. This work presents a groundwater model that reproduces groundwater evolution during 52 years with an average error below 10%. The geometry of the model was improved introducing a layer of less permeable and deformable soft soils derived from InSAR deformation and borehole data. The resulting aquifer system history of the piezometric level has been compared with ENVISAT deformation data to calculate a first-order relationship between groundwater changes, soft soil thickness, and surface deformation. This relationship has been validated with the displacement data from ERS and Cosmo-SkyMed satellites. The resulting regression function is then used as an empirical subsidence model to estimate a first approximation of the deformation of the aquifer system since the beginning of the groundwater extraction, reaching 1 to 5.5 m in 52 years. These rough estimations highlight the limitations of the proposed empirical model, requiring the implementation of a coupled hydrogeomechanical model.

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Primary Resonance of van der Pol Oscillator under Fractional-Order Delayed Feedback and Forced Excitation

The primary resonance of van der Pol oscillator under fractional-order delayed negative feedback and forced excitation is studied. Firstly, the approximate analytical solution is obtained based on the averaging method, and it could be found that the fractional-order delayed feedback has not only the property of delayed velocity feedback but also that of delayed displacement feedback. Moreover, the amplitude-frequency equation for the steady-state solution is established, and its stability conditions are also obtained. Then, the results of the approximate analytical solution and numerical integration are compared and analyzed. The agreement between the two methods is very high, so that the correctness and accuracy of the approximate analytical solution are verified. Finally, the effects of all the parameters in the fractional-order delayed feedback on the amplitude-frequency curves are analyzed. It could be concluded that fractional-order delayed feedback has important influences on the dynamical behavior of van der Pol oscillator, which is very significant to the optimization and control of a similar system.

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Fatal Mesenteric Ischemia Induced by Synthetic Cannabinoids: A Case Report and Literature Review

Worldwide use of synthetic cannabinoids (SCs) is rapidly increasing, in part due to the generation of numerous new compounds, sidestepping legal restrictions. Their detection using standard toxicology panels is difficult, due to their vast heterogeneity and lack of structural resemblance to cannabinoids. Sympathetic overactivity and arterial spasm play a role in some of the life-threatening reactions to SCs, such as coronary or cerebral vasoconstriction. Here we report a patient with repeated consumption of SCs that led to mesenteric ischemia and death. A 29-year-old man was frequently evaluated in the Emergency Medicine Department for recurrent transient crampy abdominal pain, associated with the use of the SCs colloquially known as “Mr. Nice Guy.” He was finally hospitalized with a protracted attack, associated with diarrhea and leukocytosis. Initial evaluation including computed tomography was unremarkable. Diarrhea and leukocytosis gradually resolved, but bouts of hypertension and abdominal pain occurred in association with repeated consumption of the SCs. On the fifth hospital day, the patient developed abrupt abdominal pain, associated with profound shock and signs of peritoneal irritation and succumbed within an hour. Postmortem CT scan was consistent with intestinal perforation most probably due to a nonobstructive mesenteric infarction. There was no evidence of a single vessel infarction.

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IJERPH, Vol. 14, Pages 1590: Time-Dependent Toxic and Genotoxic Effects of Zinc Oxide Nanoparticles after Long-Term and Repetitive Exposure to Human Mesenchymal Stem Cells

IJERPH, Vol. 14, Pages 1590: Time-Dependent Toxic and Genotoxic Effects of Zinc Oxide Nanoparticles after Long-Term and Repetitive Exposure to Human Mesenchymal Stem Cells

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14121590

Authors: Pascal Ickrath Martin Wagner Agmal Scherzad Thomas Gehrke Marc Burghartz Rudolf Hagen Katrin Radeloff Norbert Kleinsasser Stephan Hackenberg

Zinc oxide nanoparticles (ZnO-NP) are widely spread in consumer products. Data about the toxicological characteristics of ZnO-NP is still under controversial discussion. The human skin is the most important organ concerning ZnO-NP exposure. Intact skin was demonstrated to be a sufficient barrier against NPs; however, defect skin may allow NP contact to proliferating cells. Within these cells, stem cells are the most important toxicological target for NPs. The aim of this study was to evaluate the genotoxic and cytotoxic effects of ZnO-NP at low-dose concentrations after long-term and repetitive exposure to human mesenchymal stem cells (hMSC). Cytotoxic effects of ZnO-NP were measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Furthermore, genotoxicity was evaluated by the comet assay. For long-term observation over 6 weeks, transmission electron microscopy (TEM) was applied. The results of the study indicated cytotoxic effects of ZnO-NP beginning at high concentrations of 50 μg/mL and genotoxic effects in hMSC exposed to 1 and 10 μg/mL ZnO-NP. Repetitive exposure enhanced cyto- but not genotoxicity. Intracellular NP accumulation was observed up to 6 weeks. The results suggest cytotoxic and genotoxic potential of ZnO-NP. Even low doses of ZnO-NP may induce toxic effects as a result of repetitive exposure and long-term cellular accumulation. This data should be considered before using ZnO-NP on damaged skin.



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Thromboelastometry for diagnosis of neonatal sepsis-associated coagulopathy: an observational study

Abstract

Our aim was to evaluate the potential role of standard extrinsically activated thromboelastometry (EXTEM) assay in the early detection of neonatal sepsis. We studied 91 hospitalized neonates categorized in two groups: group A included 35 neonates with confirmed sepsis, while group B included 56 neonates with suspected sepsis; 274 healthy neonates served as controls. Whenever sepsis was suspected, EXTEM assay was performed, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE) and Tοllner score were calculated, and clinical findings and laboratory results were recorded. Septic neonates had significantly prolonged clotting time (CT) and clot formation time (CFT), and reduced maximum clot firmness (MCF), compared to neonates with suspected sepsis (p values 0.001, 0.001, and 0.009, respectively) or healthy neonates (p values 0.001, 0.001, and 0.021, respectively). EXTEM parameters (CT, CFT, MCF) demonstrated a more intense hypocoagulable profile in septic neonates with hemorrhagic diathesis than those without (p values 0.021, 0.007, and 0.033, respectively). In septic neonates, CFT was correlated with platelet count, SNAPPE, Tollner score, and day of full enteral feeding (p values 0.01, 0.02, 0.05, and 0.03, respectively).

Conclusions: A ROTEM hypocoagulable profile at admission seems promising for the early detection of sepsis in neonates while the degree of hypocoagulation may be associated with sepsis severity.

What is Known:
The early phase of septicemia might be difficult to be recognized in neonates. In adult septic patients, the diagnostic and prognostic role of thromboelastometry (ROTEM) have been extensively investigated.
Limited data are available on the role of ROTEM as an indicator of early neonatal sepsis.
What is New:
ROTEM measurements indicate an early appearance of hypocoagulability in neonatal sepsis, while the degree of hypocoagulation might be associated with severity of sepsis.
ROTEM could be a useful tool in the early detection of sepsis in neonates.


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Neuroanatomical Correlates of Transcranial Magnetic Stimulation in Presymptomatic Granulin Mutation Carriers

Abstract

Frontotemporal dementia (FTD) is characterized by behavioural and language impairment, accompanied by atrophic changes in fronto-temporo-insular cortices. In the presymptomatic phases of genetic FTD, subtle or no volumetric changes have been reported. Transcranial magnetic stimulation (TMS) represents an approach to explore cortical connectivity, and some TMS measures have been demonstrated to be impaired in Granulin (GRN) mutation carriers. We aimed at exploring cross-sectional changes in cortical thickness (CT) and surface area (SA) in the presymptomatic phases of GRN-related FTD, and their relationship with TMS parameters. Nineteen presymptomatic GRN mutation carriers and seventeen age and sex-matched non-carriers underwent 3T MRI scanning and a paired-pulse TMS protocol. The surface-based pipeline of FreeSurfer was applied in order to obtain cortical volumes (CVs), CT and SA measures. Then, between groups differences and correlation with TMS parameters were assessed. GRN carriers showed increased CT and decreased SA of the right parietal lobe, without significant volume changes. TMS parameters of intracortical inhibition and facilitation, which were significantly impaired in presymptomatic GRN mutation carriers, correlated with reduced SA and CV of the right insula. Our results suggest that splitting CV into its two main components could improve the sensitivity when exploring structural brain changes in presymptomatic or early phases of neurodegenerative conditions. TMS parameters might reflect damage within cortical regions reported to be affected early in the conversion to the symptomatic phase of the disease.



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Cover Image

Thumbnail image of graphical abstract

The cover image, by Erez Shmuel Davidi et al., is based on the Original Article Cisplatin-conjugated gold nanoparticles as a theranostic agent for head and neck cancer, DOI: 10.1002/hed.24935.



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Issue Information



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The Clinical Significance of GP73 in Immunologically Mediated Chronic Liver Diseases: Experimental Data and Literature Review

Abstract

There is significant void in establishing validated non-invasive surrogate biomarkers of liver fibrosis/cirrhosis in chronic liver diseases (CLD). Golgi protein 73 (GP73) has been suggested as a potential serum marker for the diagnosis of hepatocellular carcinoma (HCC). However, significant background of cirrhosis could have accounted for the elevation of serum GP73 in HCC. In this study, we have taken advantage of a well-defined extensive cohort of 3044 patients with either compensated cirrhosis (n = 1247), decompensated cirrhosis (n = 841) or pre-cirrhotic CLD (n = 956) and our ability to quantify serum GP73 to define the potential of serum GP73 as a biomarker of liver cirrhosis/fibrosis in CLD. The diagnostic value of GP73 was compared with aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis index based on four factors (FIB-4) and liver stiffness measurement (LSM). Immunohistochemical analysis was performed to measure hepatic GP73 expression. Receiver operating characteristic curve analysis demonstrated that serum GP73 had a good diagnostic potential for compensated cirrhosis regardless of etiology. The diagnostic performance of GP73 is better than APRI, FIB-4 and similar with LSM, especially in patients with severe inflammation, steatosis and cholestasis. Notably, in patients of autoimmune liver diseases, non-alcoholic fatty liver disease and viral hepatitis, serum GP73 also exhibited diagnostic value for advanced fibrosis as well as cirrhosis. Furthermore, there is also a gradual increase in GP73 expression with disease progression from mild fibrosis to cirrhosis. In conclusion, GP73 is an effective and reliable serological marker for the diagnosis of advanced fibrosis and prediction of appearance of cirrhosis.



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Therapeutic effect of andiroba oil ( Carapa guianensis Aubl.) against oral mucositis: an experimental study in golden Syrian hamsters

Abstract

Objectives

The aim of this study was to investigate the healing activity of andiroba (Carapa guianensis Aubl.) against oral mucositis (OM) induced by 5-fluorouracil in golden Syrian hamsters.

Materials and methods

A total of 122 animals were randomized and divided into six groups: andiroba oil 100%, andiroba oil 10%, andiroba oil 10% refined, no treatment group, all n = 28; and negative control (NC) and cyclophosphamide (CPA) groups, both n = 5. OM was induced by intraperitoneal administration of 60 mg/kg 5-FU on days 0, 5 and 10 followed by mechanical trauma on the oral mucosa on days 1 and 2. From day 1 to day 15, the animals of the andiroba group were treated three times a day. On days 4, 8, 12 and 15, the mucosa was photographed and removed for clinical and histopathological analysis. The bone marrow of the femur was removed and the micronucleus test was performed to evaluate the cytotoxicity and genotoxicity. The data were subjected to analysis of variance, followed by the Tukey and Bonferroni test.

Results

Treatment with 100% andiroba oil reduced the degree of OM compared to that reported in the other groups (p < 0.05). Andiroba oil at both concentrations was not cytotoxic, but treatment with 100% andiroba oil showed a genotoxic potential (p < 0.001).

Conclusions

Frequent administration of andiroba oil accelerated the healing process in an experimental model of 5-fluorouracil-induced OM. However, the genotoxicity of andiroba in other cell systems and under other conditions are being tested.

Clinical relevance

The use of andiroba in topical form may be associated with reduced intensity of OM. Seek therapeutic alternatives to minimize the pain and suffering that these side effects cause cancer patients is an important scientific step.



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PET/MRI outclasses MRI alone for pelvic cancer recurrence

2017_12_08_18_29_3110_2017_12_11_Sawiki_PET/MRI can better detect and classify local lesions and distant metastases...


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Florbetapir shows promise in preclinical Alzheimer's study

2017_12_15_23_13_3928_Florbetapir_JNM_miA preclinical study from Belgium has shown promising results with the PET tracer...


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Guided bone regeneration with asymmetric collagen-chitosan membranes containing aspirin-loaded chitosan nanoparticles

15_dec_2017_148179_fig990.jpg



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Mechanical Vibrations Applied to Nondestructive Evaluation of Materials and Structures



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Increased Abundance of Plasmacytoid Dendritic Cells and Interferon-Alpha Induces Plasma Cell Differentiation in Patients of IgA Nephropathy

The roles of pDC and IFN-α have not been well defined in IgA nephropathy (IgAN). In this study, we investigated the abundance of pDCs and IFN-α in IgAN patients and the response of peripheral blood mononuclear cells (PBMCs) after stimulation of the pDC-preferred TLR9 ligand CpG2216. The effects of IFN-α on plasma cell differentiation and leukocyte migration were also investigated. Here, we found that the percentages of pDCs were increased in PBMCs of IgAN patients, than in those of healthy controls. Plasma levels of IFN-α proteins and abundance of plasma cells were higher in IgAN patients than in healthy donors. Plasma IFN-α levels were positively associated with proteinuria, renal IgM deposition, and renal tubular atrophy/interstitial fibrosis grade in IgAN patients. Ex vivo activation of TLR9 on pDCs resulted in increased IFN-α production and enhanced plasma cell differentiation in IgAN patients as compared with healthy donors. IFN-α treatment led to increased plasma cell differentiation in vitro. IFN-α also significantly promoted expression of chemokines IP-10 and MCP-1 in human mesangial cells, which subsequently facilitated the transendothelial migration of human CD4+ and CD14+ cells. In conclusion, pDC and its secreted cytokine IFN-α may play important roles in pathological changes of IgA nephropathy.

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The “Invisible Hand” of Economic Markets Can Be Visualized through the Synergy Created by Division of Labor

Inspired by Adam Smith and Friedrich Hayek, economists promoting free markets postulate the existence of invisible forces that drive economic growth. Simulations with Sociodynamica allowed the emergence of market forces in virtual economies, showing that the synergistic working of division of labor in complex settings favors a stable state where all actors benefit (win-win interaction). By visualizing the detailed dynamics underlying this phenomenon in a simple virtual economy, the elements underpinning the synergistic effect on economic output produced by the division of labor between agents could be dissected. These are heterogeneity or spatial or temporal heterogeneous environment and/or agents; complementary activities of agents, with divergent optimization options; and synchrony. Markets help synchronize agent’s actions. The larger the contact horizon between participants of the market is, the more efficient the market forces act. These features allow for social processes that increase the information available and increase simultaneously the capacity of producing useful economic work, that is, synergy. This insight, although trivial if viewed a posteriori, improves our understanding of the source and nature of synergies in real economic markets and might render economic and natural sciences more consilient.

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Sinus Floor Elevation with Modified Crestal Approach and Single Loaded Short Implants: A Case Report with 4 Years of Follow-Up

Tooth extraction is usually followed by bone reduction. In the maxillary posterior region, this remodelling combined with sinus pneumatisation and periodontal defects may lead to a reduced basal bone height available for implant placement. Sinus floor elevation can be performed with different surgical techniques. Crestal approach has demonstrated to be effective, less invasive, and associated with a reduced morbidity. This article reports a modified sinus floor elevation by means of rotary, noncutting instruments, addition of xenograft, and 2 short-threaded implant placements. The aim of the study was to evaluate the implant’s success and intrasinus radiographical bone gain after 4 years of functional loading. The premolar implant site presented a starting basal bone height of 6 mm, while the molar site was of 2 mm. In the first surgical step, sinus floor elevation was performed mesially and the implant was inserted, and distally only sinus floor elevation was performed. After 6 months, the mesial implant was uncovered and the second implant was inserted; 4 months later, the second fixture was uncovered, and both fixtures were loaded with single provisional screw-retained crowns and later with single screw-retained porcelain fused to metal crowns. Implants integrated successfully, and crestal bone remodelling did not exceed the smooth collar. Bone gain was 3 mm for the mesial implant and more than 5 mm for the distal one.

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Sparse Learning of the Disease Severity Score for High-Dimensional Data

Learning disease severity scores automatically from collected measurements may aid in the quality of both healthcare and scientific understanding. Some steps in that direction have been taken and machine learning algorithms for extracting scoring functions from data have been proposed. Given the rapid increase in both quantity and diversity of data measured and stored, the large amount of information is becoming one of the challenges for learning algorithms. In this work, we investigated the direction of the problem where the dimensionality of measured variables is large. Learning the severity score in such cases brings the issue of which of measured features are relevant. We have proposed a novel approach by combining desirable properties of existing formulations, which compares favorably to alternatives in accuracy and especially in the robustness of the learned scoring function. The proposed formulation has a nonsmooth penalty that induces sparsity. This problem is solved by addressing a dual formulation which is smooth and allows an efficient optimization. The proposed approach might be used as an effective and reliable tool for both scoring function learning and biomarker discovery, as demonstrated by identifying a stable set of genes related to influenza symptoms’ severity, which are enriched in immune-related processes.

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