Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: Δεκεμβρίου 2017

Κυριακή 31 Δεκεμβρίου 2017

Morphometric study of the posterior longitudinal ligament at the lumbar spine.

Morphometric study of the posterior longitudinal ligament at the lumbar spine.

Surg Radiol Anat. 2017 Dec 29;:

Authors: Salaud C, Ploteau S, Hamel O, Armstrong O, Hamel A

Abstract
PURPOSE: There are only two descriptions of posterior longitudinal ligament (PLL) at the lumbar spine level but its morphologic characteristics are different to cervical and thoracic levels.
METHOD: Spine explantation (from Th12 to L5) followed by resection of the neural arch and the dural sheath in 13 fresh cadavers was performed. The PLL was isolated from other epidural structures and its width was measured and compared to the vertebral body width at each vertebral levels. It was conducted at a microanatomic study concerning the PLL and the posterior outer annulus fibrosus.
RESULTS: The PLL width was reduced craniocaudaly significantly, becoming thin from L4. The average width of PLL was 7.8 mm at L1 and 1.9 mm at L5. The width decreased gradually from L1 to L5 or abruptly from L4. The ratio of PLL width compared to the vertebral body width was 21% at L1 and 3% at L5. Microanatomic study confirmed that the PLL is less thick at its annulus fibrosus adhesion at L4-L5 and L5-S1. The relationship between the PLL and other epidural structures are discussed.
CONCLUSIONS: The presence and function of the ilio-lumbar ligaments and the articular process orientation of L5-S1 may be explanations for PLL width decrease at L4-L5 and L5-S1. Furthermore, this aspect may be considered as one factor contributing to the occurrence of disc herniations at these levels, which levels are more frequently involved in this pathology.

PMID: 29288395 [PubMed - as supplied by publisher]

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Drug-associated hyperpigmentation of the oral mucosa: report of four cases.

Drug-associated hyperpigmentation of the oral mucosa: report of four cases.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Nov 03;:

Authors: Tosios KI, Kalogirou EM, Sklavounou A

Abstract
OBJECTIVE: The aim of this study was to describe 4 patients with oral mucosa hyperpigmentation associated with 4 drug classes and to review the relevant literature.
STUDY DESIGN: Two patients under imatinib and hydroxychloroquine treatment exhibited diffuse palatal hyperpigmentation and 2 patients treated with minocycline and golimumab showed multifocal pigmented macules. In all cases, biopsy was performed.
RESULTS: Microscopically, in all cases, there was no increase in the number of melanocytes in the epithelium, and pigment granules were present in the lamina propria. The pigment granules in minocycline- and golimumab-associated hyperpigmentation were seen in the superficial lamina propria and reacted for silver but not iron, whereas in imatinib- and hydroxychloroquine-associated hyperpigmentation, pigment granules were found in the reticular lamina propria and reacted for both silver and iron. A review of the literature found 38 cases of hyperpigmentation of the oral mucosa attributed to minocycline, 23 to imatinib, 1 to hydroxychloroquine without microscopic documentation, and none to golimumab.
CONCLUSIONS: The temporal relationship between pigmentation and onset of drug effect, resolution following drug withdrawal, and exclusion of other causes support the diagnosis of drug-induced hyperpigmentation. Microscopic examination may be contributory to diagnosis, as there are differences among drugs with regard to the distribution of pigment granules and the histochemical reactions of the drugs.

PMID: 29287748 [PubMed - as supplied by publisher]

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Assessing the Different Oncologic Disease Distribution and Postoperative Complications of Octogenarian and Nonagenarian Head and Neck Oncology Patients.

Assessing the Different Oncologic Disease Distribution and Postoperative Complications of Octogenarian and Nonagenarian Head and Neck Oncology Patients.

J Oral Maxillofac Surg. 2017 Dec 07;:

Authors: Sagiv D, Nadel S, Talmi YP, Yahalom R, Wolf M, Alon EE

Abstract
PURPOSE: The admission rate of patients aged 80 years or older (oldest-old) with head and neck (HN) oncologic disease is on the rise. Our goal was to study the demographic characteristics, reasons for admission, types of surgical procedures, and postoperative complications of the oldest-old patients with HN malignancy.
MATERIALS AND METHODS: We conducted a retrospective cohort study including all inpatients aged 80 years or older who were admitted to the department of otolaryngology-head and neck surgery or department of oral and maxillofacial surgery because of HN oncologic disease between 2009 and 2013. The control group was composed of a matched number of randomly selected patients aged 60 to 79 years. We compared the demographic characteristics, diagnoses, comorbidities, surgical interventions, and postoperative complications of the 2 age groups to characterize the oldest-old patients' admissions and determine whether age alone increases the risk of postoperative complications.
RESULTS: The study included 109 oldest-old patients (median age, 83 years) and 107 patients in the control group (median age, 68 years). Although the oldest-old patients had significantly more underlying diseases (4.41 vs 2.86) and drugs prescribed (4.76 vs 3.21), similar rates of postoperative complications occurred in both groups. An important finding was that ischemic heart disease and chronic lung disease were the only significant risk factors for postoperative complications among the oldest-old patients (odds ratio on multivariate analysis of 5.5 and 4.5, respectively).
CONCLUSIONS: Although comorbidities and prescribed drugs are more prevalent in the oldest-old patients, the rate of postoperative complications did not differ between the age groups, suggesting that age alone should not be a factor in the surgical treatment of HN malignancies.

PMID: 29288647 [PubMed - as supplied by publisher]

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Applications of 3-Dimensional Ultrasonography in the Neck, Excluding the Thyroid.

Applications of 3-Dimensional Ultrasonography in the Neck, Excluding the Thyroid.

J Ultrasound Med. 2017 Dec 30;:

Authors: Frank SJ, Koenigsberg T, Gutman D, Koenigsberg M

Abstract
Ultrasonography (US) of the neck is an accepted, useful imaging modality for many applications beyond its usefulness in thyroid disease. Two-dimensional US has been effectively used for evaluation of many types of neck conditions, and now, 3-dimensional US can be added to the imaging armamentaria. Three-dimensional US is useful in the evaluation of cervical lymph nodes, recurrent/residual thyroid neoplasia, parathyroid glands, parotid and submandibular glands, as well as thyroglossal duct cysts and other assorted palpable and visible abnormalities because of its unique capabilities, including multiplanar reconstruction, accessibility of the coronal view, volume calculation, and regularly spaced incremental slice evaluation.

PMID: 29288583 [PubMed - as supplied by publisher]

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Type III interferons are critical host factors that determine susceptibility to Influenza A viral infection in allergic nasal mucosa.

Type III interferons are critical host factors that determine susceptibility to Influenza A viral infection in allergic nasal mucosa.

Clin Exp Allergy. 2017 Dec 30;:

Authors: Jeon YJ, Lim JH, An S, Jo A, Han DH, Won TB, Kim DY, Rhee CS, Kim HJ

Abstract
BACKGROUND: Allergic respiratory conditions have been associated with increased susceptibility to viral infection due to impaired interferon (IFN)-related immune responses but the mechanisms for reinforcement of mucosal immunity against viral infection in allergic diseases are largely unknown.
OBJECTIVES: To determine whether IFN induction would be impaired in allergic nasal mucosa and to identify if higher loads of influenza A virus (IAV) in allergic nasal mucosa could be controlled with IFN treatment.
METHODS: IAV mRNA, viral titers and IFN expression were compared in IAV-infected normal human nasal epithelial (NHNE, N=10) and allergic rhinitis nasal epithelial (ARNE, N=10) cells. We used in vivo model of allergic rhinitis (BALB/C mouse, N=10) and human nasal mucosa from healthy volunteers (N=72) and allergic rhinitis patients (N=29) to assess the induction of IFNs after IAV infection.
RESULTS: IAV mRNA levels and viral titers were significantly higher in ARNE compared with NHNE cells. IFN-β and -λs were induced in NHNE and ARNE cells up to 3 days after IAV infection. Interestingly, induction of IFN-λs mRNA levels and the amount of secreted proteins were considerably lower in ARNE cells. The mean IFN-λs mRNA level was also significantly lower in the nasal mucosa of AR patients and we found that recombinant IFN-λ treatment attenuated viral mRNA levels and viral titers in IAV-infected ARNE cells. In vivo AR mouse were exhibited higher viral load after IAV infection but intranasal inoculation of IFN-λ completely decreased IAV protein expression and viral titer in nasal mucosa of IAV-infected AR mouse.
CONCLUSION: Higher susceptibility of the allergic nasal mucosa to IAV may depend on impairment of type III IFN induction, and type III IFN is a key mechanistic link between higher viral loads and control of IAV infection in allergic nasal mucosa. This article is protected by copyright. All rights reserved.

PMID: 29288502 [PubMed - as supplied by publisher]

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Jet ventilation in obese patients undergoing airway surgery for subglottic and tracheal stenosis.

Jet ventilation in obese patients undergoing airway surgery for subglottic and tracheal stenosis.

Laryngoscope. 2017 Dec 30;:

Authors: Philips R, deSilva B, Matrka L

Abstract
OBJECTIVES/HYPOTHESIS: To assess the feasibility of jet ventilation in obese patients and to compare complications of jet ventilation in obese and nonobese patients.
STUDY DESIGN: Retrospective review of medical records.
METHODS: We reviewed 46 patient charts (70 procedures) with the diagnosis of tracheal or subglottic stenosis who underwent endoscopic surgery with jet ventilation between March 2014 and January 2017. Adequacy of jet ventilation was assessed by chest rise, avoidance of endotracheal intubation, and length of case and ventilation. Records were reviewed for demographic details, anesthesia records, and complications.
RESULTS: In 29/70 (41.4%) of cases, patients were obese; in 9/29 (31.0%) of these cases, patients were morbidly obese. Jet ventilation was successful in 28/29 (97%) of obese cases. In 1/29 (3.4%) of cases, the patient required alternative airway management. There were no significant differences between obese and nonobese patients in chest rise, need for endotracheal intubation, and length of surgery or ventilation (P > .05). There were 2/29 (6.9%) cases of intra- and postoperative complications including laryngospasm (1/29, 3.4%) and tachycardia (1/29, 3.4%). Rate of complications did not differ between obese and nonobese patients (P = .178).
CONCLUSIONS: Jet ventilation in obese patients can be done successfully, and complications are similar between obese patients and nonobese patients.
LEVEL OF EVIDENCE: 4. Laryngoscope, 00:000-000, 2017.

PMID: 29288493 [PubMed - as supplied by publisher]

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Interactions between bradykinin and plasmin in the endothelial Ca2+ response.

Interactions between bradykinin and plasmin in the endothelial Ca2+ response.

Mol Cell Biochem. 2017 Dec 29;:

Authors: Obata Y, Takeuchi K, Wei J, Hakamata A, Odagiri K, Nakajima Y, Watanabe H

Abstract
Plasmin is a fibrinolytic factor and a serine protease that activates protease-activated receptors (PARs) to produce endothelium-derived relaxing factors such as nitric oxide and prostacyclin. Nitric oxide and prostacyclin production is regulated, at least in part, by the intracellular Ca2+ concentration in various blood vessel types. Bradykinin and plasmin stimulate vascular endothelial cells and work simultaneously in pathophysiological conditions such as thrombosis and inflammation. Here, we explored the interactions between bradykinin and plasmin in the endothelial Ca2+ response using the fluorescent indicator, Fura-2/AM, in primary cultures of porcine aortic endothelial cells (PAECs). Plasmin (0.15-15 µg/ml) and bradykinin (0.1-10 nM) increased intracellular Ca2+ concentrations in PAECs in a dose-dependent manner, and the plasmin-induced endothelial Ca2+ response occurred only once. Bradykinin (0.1-10 nM) inhibited the plasmin-induced endothelial Ca2+ response in a dose-dependent manner, however, plasmin did not affect the bradykinin-induced endothelial Ca2+ response. Pretreatment with gabexate mesilate (GM, 100 µM), a serine protease inhibitor, that blocks plasmin's proteolytic activity, fully suppressed the plasmin-induced Ca2+ response. After washout of GM and the first plasmin, the second administration of plasmin caused Ca2+ increases. However, when the first plasmin-induced Ca2+ response was blocked by pretreatment with bradykinin, the second plasmin (15 µg/ml) application did not cause any Ca2+ response, even 30 min after the washout of the first plasmin and bradykinin. Our data suggested that bradykinin regulated the plasmin-induced endothelial Ca2+ response by inhibiting the pathway downstream of the PARs' N-terminus cleavage.

PMID: 29288468 [PubMed - as supplied by publisher]

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A cadaveric study of aortic arch variation in an Irish population.

A cadaveric study of aortic arch variation in an Irish population.

Ir J Med Sci. 2017 Dec 29;:

Authors: O'Malley AM, El Kininy WH, Debebe H, Burukan AB, Davy SW

Abstract
AIM: The aim of this study is to investigate the incidence of variation in the branching pattern of aortic arch (AA) vessels in an Irish population.
METHOD: A cadaveric study of 24 subjects was conducted. The vessels of the AA were identified, their branching patterns were noted and photographed and the following measurements were recorded: the angle of the AA to the coronal plane, the distance from the midline to the brachiocephalic trunk (BCT); the left common carotid artery (LCC) ; the left subclavian artery (LSC), the distance between the BCT and the right subclavian artery (RSC); the RSC and the right vertebral artery (RVA), and between the LSC and left vertebral artery (LVA).
RESULTS: The 'normal' branching pattern (BCT, LCC, LSC) was observed in 79%. Thirteen percent had a two-branched AA (bovine variant), while the remainder had an aberrant left vertebral artery (LVA) originating from the AA. The mean distances from the midline to the BCT, LCC and LSC were 9.1, 10.8 and 21.4 mm, respectively. Mean distance from BCT to RSC was 34.09 mm. The mean distance from LSC to LVA was 39.79 mm, and the mean distance from RSC to RVA was 23.38 mm. The mean angle of the AA to the coronal plane was 59.02°.
CONCLUSION: This is the first study documenting the rates of variation of the AA in Ireland. Variation of AA branching is of radiological and surgical significance, particularly in the diagnosis and treatment of thoracic and head and neck diseases. Awareness of these variations is particularly relevant for interventionalists who access these vessels during endovascular surgery.

PMID: 29288397 [PubMed - as supplied by publisher]

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Repetitive nonpersistent protrusion of the tongue on prenatal ultrasound.

Repetitive nonpersistent protrusion of the tongue on prenatal ultrasound.

Arch Gynecol Obstet. 2017 Dec 29;:

Authors: Kesrouani A, AbdelKhalek Y, Nasr B, Torbey PH, Hachem R, Rassi S

PMID: 29288319 [PubMed - as supplied by publisher]

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Factors Predicting the Recovery of Unilateral Vocal Fold Paralysis After Thyroidectomy.

Factors Predicting the Recovery of Unilateral Vocal Fold Paralysis After Thyroidectomy.

World J Surg. 2017 Dec 30;:

Authors: Choi YS, Joo YH, Park YH, Kim SY, Sun DI

Abstract
BACKGROUND: We used voice analysis and clinicopathological factors to explore the prognosis of unilateral vocal fold paralysis after thyroid surgery.
METHODS: The medical records of 63 females who developed unilateral vocal fold paralysis after thyroidectomy were reviewed. All patients were divided into two groups: those who recovered from vocal fold paralysis and those who did not. We analyzed clinical parameters and voice analysis results in a search for correlations with recovery from paralysis.
RESULTS: Of the 63 patients, 37 (58%) recovered from paralysis. A small tumor size, incomplete paralysis, the absence of arytenoid tilting, no compensatory movement of the normal side, lower postoperative shimmer, a higher postoperative maximum phonation time (MPT), and lower postoperative subglottic pressure correlated significantly with recovery from vocal fold paralysis. Multivariate analysis confirmed that the absence of compensatory movement of the normal side on videostroboscopy was independently prognostic. A postoperative MPT of 6.86 appeared to be optimal for prediction of recovery. Most patients recovered within 6 months, but those with incomplete paralysis recovered about 3 months earlier. At the 12-month follow-up, the thyroidectomy-related voice questionnaire scores had returned to preoperative values in only 12 patients (19.0%); 51 patients (81.0%) did not fully recover.
CONCLUSION: Compensatory movement of the normal side evident on videostroboscopy was a poor prognostic factor. Voice analysis can be helpful in counseling vocal fold paralysis patients after thyroidectomy, and early intervention may be considered in patients who are expected to have a poor prognosis.

PMID: 29288312 [PubMed - as supplied by publisher]

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Long-Lasting Voice-Related Symptoms in Patients Without Vocal Cord Palsy After Thyroidectomy.

Long-Lasting Voice-Related Symptoms in Patients Without Vocal Cord Palsy After Thyroidectomy.

World J Surg. 2017 Dec 29;:

Authors: Kim CS, Park JO, Bae JS, Lee SH, Joo YH, Park YH, Hwang YS, Shim MR, Sun DI

Abstract
BACKGROUND: Some patients complain of long-lasting voice symptoms after thyroid surgery without objective vocal fold pathology. We assessed the factors that may influence voice symptoms more than 12 months after thyroidectomy.
METHODS: We performed a retrospective analysis of 68 patients from July 2010 to May 2012. The voices of all patients were analyzed before and after thyroid surgery (2 weeks and 2, 4, 6, 8, 10, and 12 months after surgery). According to the recovery of postoperative voice symptoms, patients were divided into two groups: the non-recovery group and the recovery group. Voice symptoms were measured using a thyroidectomy-related voice questionnaire (TVQ). We compared voice analysis data for each group and investigated the factors related to long-lasting postoperative voice symptoms.
RESULTS: Forty-nine patients were included in the recovery group, and 19 patients were included in the non-recovery group. No differences in sex ratio, tumor size, and surgical extent were found between the groups. However, the proportion of professional voice users (odds ratio 4.121; 95% confidence interval 0.983-17.267; p < 0.043) was significantly higher in the non-recovery group. The cutoff score of the TVQ, at 2 months after thyroid surgery, for the differentiation of the recovery and non-recovery groups was 25, and the sensitivity and specificity values were 84.2 and 87.8%, respectively.
CONCLUSIONS: Professional voice users may be presented long-lasting voice symptoms after thyroid surgery. The cutoff TVQ score of 25, at 2 months after thyroid surgery, may be a guideline for counseling patients who have voice symptoms.

PMID: 29288310 [PubMed - as supplied by publisher]

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Anterolateral Thigh Flap Combined with Reconstruction Plate Versus Double Free Flaps for Composite Mandibular Reconstruction: A Propensity Score-Matched Study.

Anterolateral Thigh Flap Combined with Reconstruction Plate Versus Double Free Flaps for Composite Mandibular Reconstruction: A Propensity Score-Matched Study.

Ann Surg Oncol. 2017 Dec 30;:

Authors: Offodile AC, Lin JA, Chang KP, Abdelrahman M, Kou HW, Loh CYY, Aycart MA, Kao HK

Abstract
OBJECTIVE: This study was designed to examine the comparative effectiveness of oromandibular defect reconstruction via anterolateral thigh flap and bridging plate (ALT only) versus simultaneous soft tissue and vascularized bone flap (DFF), with regards to long-term plate exposure and complications.
METHODS: A propensity score-matched analysis of patients with an oncologic head and neck defect who underwent microvascular reconstruction was performed. Two surgical groups, i.e., ALT only and DFF, were created. Incidence and subsequent management strategies for postoperative plate exposure were evaluated along with complications, overall survival, and postoperative quality of life (QoL).
RESULTS: Sixty-two patients were 1:1 propensity matched (31 per group). The DFF group had a significantly larger soft tissue and bone defect than the single-flap group. The 5-year probability of not having a plate exposure was 45.5 and 47.4% for the double-flaps and single-flap groups, respectively (p = 0.186). The ALT-only group had a significantly higher rate of wound infections (38.7% vs. 12.9%, p = 0.02). The incidence of flap loss, reexploration, inpatient mortality, plate fracture, medical complications, and overall survival were not significantly different. Although mean score for pain was significantly worse in the ALT-only group (75.2 vs. 88.5, p < 0.001), the remainder of our QoL assessments (cosmesis, swallow, employment, and speech) were comparable.
CONCLUSIONS: The utilization of an ALT with plate strategy is associated with competitive rates of plate exposure and overall survival relative to DFF but higher wound infections and long-term pain. These results have considerable salience for patient-counseling regarding expectations for functional and clinical outcomes.

PMID: 29288289 [PubMed - as supplied by publisher]

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The top 50 most-cited articles on acoustic neuroma.

The top 50 most-cited articles on acoustic neuroma.

World Neurosurg. 2017 Dec 26;:

Authors: Alfaifi A, Almutairi O, Allhaidan M, Alsaleh S, Ajlan A

Abstract
BACKGROUND: Acoustic neuroma is the most common extra-axial primary cerebellopontine angle tumour in adults. A plethora of studies have been published about acoustic neuroma, but none of the previous works have highlighted the most influential articles.
OBJECTIVES: Our objective was to perform a bibliometric analysis on the 50 most-cited articles concerning acoustic neuroma.
METHODS: We performed a title-specific search on the Scopus database, using the following terms: 'acoustic neuroma,' 'vestibular schwannoma,' and 'cerebellopontine angle' as search queries. Through this, we recorded the 50 most-cited articles and reviewed them.
RESULTS: Overall, the 50 most-cited articles had an average of 175 citations per paper. All articles were published between 1980 and 2006, with 1997 the most prolific year, when seven articles were published. In publication medium, the journals Neurosurgery and Laryngoscope published 10 and eight of these articles, respectively. The most common study categories were nonsurgical management (17 of 50) and surgical management (13 of 50). The studies were predominantly published by otolaryngologists (22 of 50) and neurosurgeons (14 of 50). The author with the highest number of contributions was Douglas Kondziolka, with seven publications. Finally, the majority of the most-cited articles were produced in the United States (64%).
CONCLUSIONS: Identifying the works with the most impact concerning acoustic neuroma provides an important overview of the historical development of treatment methods and publication trends related to this condition. A finalised, comprehensive list of the most important works represents an excellent tool that can serve as a guide for evidence-based clinical practice.

PMID: 29288105 [PubMed - as supplied by publisher]

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Immunoglobulin G4-related Chronic Rhinosinusitis: A Pitfall in the Differential Diagnosis of Granulomatosis with Polyangiitis, Rosai-Dorfman Disease and Fungal Rhinosinusitis.

Immunoglobulin G4-related Chronic Rhinosinusitis: A Pitfall in the Differential Diagnosis of Granulomatosis with Polyangiitis, Rosai-Dorfman Disease and Fungal Rhinosinusitis.

Hum Pathol. 2017 Dec 26;:

Authors: Piao Y, Zhang Y, Yue C, Wang C, Zhang L

Abstract
Immunoglobulin G4 (IgG4)-related chronic rhinosinusitis (CRS) has recently been proposed to be a new clinical entity of nasal disease, with no consensually agreed criteria for diagnosis. Moreover, the pathological features if IgG4-related CRS often overlap with other sinonasal inflammatory and autoimmune diseases such as Granulomatosis with Polyangiitis (GPA), Rosai-Dorfman disease (RDD) and Fungal Rhinosinusitis (FRS). We aimed to explore the specific similarities and differences in clinicopathologic features between IgG4-related CRS, and GPA, RDD and FRS, in order that these conditions can be diagnosed more accurately. Biopsy specimens collected from nasal mucosa of 20 IgG4-related CRS, 10 GPA, 10 RDD and 10 FRS patients were assessed by haematoxylin and eosin staining and immunohistochemical techniques for specific histochemical differences. The number of IgG4-positive plasma cells /high-power fields (HPF) in biopsies from IgG4-related CRS patients (mean= 79.6±51.59; range= 15/HPF to 230/HPF) was significantly higher than in biopsies from GPA (mean= 13±9.428; p<0.0001) and RDD (mean= 12.5±8.267; p<0.0001) patients, but not from FRS (mean=47.4±26.48; p>0.05) patients. Similarly, the ratio of IgG4/IgG-positive plasmacytes was>40% in 90% (18/20) of IgG4-related CRS patients, compared to >40% in 10% (1/10) GPA patients, 20% (2/10) RDD patients and 20% (2/10) FRS patients. The sinonasal diseases GPA, RDD and FRS might present with similar histopathologic features such as the increased numbers of plasma cells and fibrosis which are characteristic of IgG4-related CRS. A comprehensive consideration combining the clinical signs and symptoms with a histopathological assessment of IgG4- positive plasma cells may provide accurate diagnoses of these conditions.

PMID: 29288039 [PubMed - as supplied by publisher]

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When and how to treat an IMRT patient on a second accelerator without replanning?

When and how to treat an IMRT patient on a second accelerator without replanning?

Med Dosim. 2017 Dec 26;:

Authors: Lin T, Hossain M, Fan J, Ma CC

Abstract
When a linear accelerator is unavailable for treatment, a clinical decision is imminent regarding whether a patient should be treated on a linear accelerator other than the machine the patient was scheduled on, or whether treatment should be postponed until the original Linac becomes available. This work investigates the feasibility of switching patients to different accelerators for intensity-modulated radiation therapy (IMRT). We have performed Monte Carlo simulations of photon beams from different Linac models and vendors. Prostate and head and neck (H&N) treatment plans for Siemens Primus, Primart, and Varian 21EX accelerators are studied in this work. Dose distributions for given plans are recalculated using different beam data with the same nominal energy from different Linacs. We have compared dose-volume histograms (DVHs) and the maximum, the minimum, and the mean doses to the target and critical structures because of switching accelerators. In the process of switching a treatment plan to a different accelerator, issues exist, including optimum penumbra compensation, dose distribution at the boundary of target and critical structures, and multileaf collimator (MLC) leaf-width effects, which need to be considered and verified with measurements. Our Monte Carlo simulation results confirm that, for the cases we tested, the dose received by 95% of the planning target volume differs by 0.2% to 1.5% between Siemens Primus and Varian 21EX Linacs. The discrepancy is within our clinical acceptance criteria of 3% for IMRT treatments. In making the final decision on whether to switch machines or not, the tumor control probabilities (TCPs) based on a linear-quadratic model are compared. Based on the analyses performed in this work, it is therapeutically more beneficial to switch a patient to a different machine than to postpone a treatment until the original machine is available, especially for fast-growing tumors such as H&N cancers.

PMID: 29287919 [PubMed - as supplied by publisher]

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Characteristics of electrically evoked auditory brainstem responses in patients with cochlear nerve canal stenosis receiving cochlear implants.

Characteristics of electrically evoked auditory brainstem responses in patients with cochlear nerve canal stenosis receiving cochlear implants.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:98-103

Authors: Wang Z, Liu Y, Wang L, Shen X, Han S, Wang W, Gao F, Liang W, Peng KA

Abstract
OBJECTIVE: To explore the characteristics of the electrically evoked auditory brainstem responses (EABR) in children with cochlear nerve canal stenosis (CNCs) following cochlear implantation (CI), and the EABR thresholds in children with stenotic versus normal cochlear nerve canals.
METHOD: Sixteen children with profound sensorineural hearing loss were included in this study: 8 with CNCs (CNCs group) and 8 with normal cochlear nerve canals (control group). All children underwent cochlear implantation with full insertion of all electrodes. EABR was performed 6 months postoperatively in both groups.
RESULTS: The EABR extraction rate was 100% in children with normal cochlear nerve canals and only 50% in children with CNCs. EABR thresholds were significantly higher in children with CNCs of electrodes No. 11and 22 than in children with normal cochlear nerve canals (P < 0.05 for both comparisons). There was no significant difference in EABR thresholds among electrode No. 1, 11 and 22 in CNCs group (P > 0.05 for all comparisons); while in the control group, the EABR threshold at electrode No 22 was lower than those at both electrodes No. 11 and 1 (P < 0.05 for both comparisons), and the EABR threshold at electrode No. 11 was also lower than that at electrode No. 1 (P < 0.05).
CONCLUSION: The EABR thresholds in children with normal cochlear nerve canals vary according to the different locations of electrodes in the cochlea; while in children with CNCs, there was no significant difference among different electrode locations. The EABR thresholds in CNCs children were higher than those of children with normal cochlear nerve canals at electrode 11 and 22.

PMID: 29287891 [PubMed - in process]

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Infection rates of MRSA in complicated pediatric rhinosinusitis: An up to date review.

Infection rates of MRSA in complicated pediatric rhinosinusitis: An up to date review.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:79-83

Authors: Hamill CS, Sykes KJ, Harrison CJ, Weatherly RA

Abstract
INTRODUCTION: Published studies have reported a rise in MRSA isolates in head and neck infections, but the microbiology of complicated pediatric rhinosinusitis is unclear. One study of such patients showed that MRSA isolates were seen only in the last three years of data collection, suggesting a possible recent increased prevalence. Given the public health concerns of increasing rates of antimicrobial resistance, the goal of this study was to investigate the microbiologic patterns and outcomes of complicated pediatric rhinosinusitis.
METHODS: Retrospective cohort of pediatric patients admitted to our children's hospital with complicated acute rhinosinusitis from 2004 to 2014.
RESULTS: The mean age of 250 hospitalized children with complicated rhinosinusitis was 7.6 ± 4.9 years; 109 of these (43%) underwent surgical procedures. Although MRSA prevalence was highest in 2014, no significant trend in overall MRSA prevalence occurred when considering the entire study period. No significant relationship was identified between MRSA and intra-orbital versus intra-cranial complications. Interestingly, 22.7% of patients with anaerobes detected by culture had persistent abnormal physical examination (PE) findings versus 6.1% of patients without anaerobes (p = 0.025). Furthermore, multivariate analysis also revealed that detection of anaerobes or MRSA was associated with persistent PE findings being 21.8 and 14.8 times more likely, respectively, when compared to other detected pathogens.
DISCUSSION: Our data indicate modest variability in the annual rates of MRSA associated pediatric rhinosinusitis, however there was no statistically significant pattern of change in MRSA prevalence during 2004-2014. Although detection of MRSA was not significantly associated with either intraorbital or intracranial complications of sinusitis, a significant association with a poorer outcome was observed by multivariate analysis for patients from whom MRSA or anaerobes were detected. These data raise the question as to whether clindamycin is adequate for MRSA and anaerobic coverage.

PMID: 29287887 [PubMed - in process]

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Effects of transient auditory deprivation during critical periods on the development of auditory temporal processing.

Effects of transient auditory deprivation during critical periods on the development of auditory temporal processing.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:66-71

Authors: Kim BJ, Kim J, Park IY, Jung JY, Suh MW, Oh SH

Abstract
OBJECTIVES: The central auditory pathway matures through sensory experiences and it is known that sensory experiences during periods called critical periods exert an important influence on brain development. The present study aimed to investigate whether temporary auditory deprivation during critical periods (CPs) could have a detrimental effect on the development of auditory temporal processing.
MATERIALS AND METHODS: Twelve neonatal rats were randomly assigned to control and study groups; Study group experienced temporary (18-20 days) auditory deprivation during CPs (Early deprivation study group). Outcome measures included changes in auditory brainstem response (ABR), gap prepulse inhibition of the acoustic startle reflex (GPIAS), and gap detection threshold (GDT). To further delineate the specific role of CPs in the outcome measures above, the same paradigm was applied in adult rats (Late deprivation group) and the findings were compared with those of the neonatal rats.
RESULTS: Soon after the restoration of hearing, early deprivation study animals showed a significantly lower GPIAS at intermediate gap durations and a larger GDT than early deprivation controls, but these differences became insignificant after subsequent auditory inputs. Additionally, the ABR results showed significantly delayed latencies of waves IV, V, and interpeak latencies of wave I-III and wave I-V in study group. Late deprivation group didn't exhibit any deterioration in temporal processing following sensory deprivation.
CONCLUSION: Taken together, the present results suggest that transient auditory deprivation during CPs might cause reversible disruptions in the development of temporal processing.

PMID: 29287884 [PubMed - in process]

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Association between chloride content of intravenous fluids and acute kidney injury in critically ill medical patients with sepsis.

Association between chloride content of intravenous fluids and acute kidney injury in critically ill medical patients with sepsis.

J Crit Care. 2017 Dec 20;44:363-367

Authors: Jaynes MP, Murphy CV, Ali N, Krautwater A, Lehman A, Doepker BA

PMID: 29288964 [PubMed - as supplied by publisher]

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Understanding the direction of the relationship between white matter hyperintensities of vascular origin, sleep quality, and chronic kidney disease-Results from the Atahualpa Project.

Understanding the direction of the relationship between white matter hyperintensities of vascular origin, sleep quality, and chronic kidney disease-Results from the Atahualpa Project.

Clin Neurol Neurosurg. 2017 Dec 24;165:10-14

Authors: Del Brutto OH, Mera RM, Atahualpa Project Investigators

Abstract
OBJECTIVE: The burden of cerebral small vessel disease, sleep disorders, and chronic kidney disease is on the rise in remote rural settings. However, information on potential links between these conditions is limited. We aimed to assess the relationships between these conditions in community-dwelling older adults living in rural Ecuador.
PATIENTS AND METHODS: Atahualpa residents aged ≥60 years were offered a brain MRI. A venous blood sample was obtained for serum creatinine determination. Baseline interviews and procedures were directed to assess demographics, cardiovascular risk factors, and sleep quality. Using generalized structural equation modeling (GSEM), we assessed the associations between white matter hyperintensities (WMH) of vascular origin, sleep quality and kidney function, as well as the directions of the relationships between these variables.
RESULTS: Of 423 candidates, 314 (74%) were enrolled. Moderate-to-severe WMH were noticed in 74 (24%) individuals, poor sleep quality in 101 (31%), and moderate-to-severe chronic kidney disease in 28 (9%). GSEM showed that the direction of the effect was from kidney function to WMH and from the latter to sleep quality. Of independent variables investigated, worse kidney function was associated with age, high glucose levels and male sex. WMH was associated with cholesterol blood levels, blood pressure, level of education and severe edentulism. Poor sleep quality was associated with poor physical activity.
CONCLUSION: This population based study shows that chronic kidney disease is associated with increased severity of WMH, which, in turn, is associated with a poor sleep quality.

PMID: 29288961 [PubMed - as supplied by publisher]

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Enhanced wakefulness following lesions of a mesopontine locus essential for the induction of general anesthesia.

Enhanced wakefulness following lesions of a mesopontine locus essential for the induction of general anesthesia.

Behav Brain Res. 2017 Dec 27;:

Authors: Lanir-Azaria S, Meiri G, Avigdor T, Minert A, Devor M

Abstract
The induction of general anesthesia shares many features with the transition from wakefulness to non-rapid eye movement (NREM) sleep, suggesting that the two types of brain-state transition are orchestrated by a common neuronal mechanism. Previous studies revealed a brainstem locus, the mesopontine tegmental anesthesia area (MPTA), that is of singular importance for anesthetic induction. Microinjection there of GABAergic anesthetics induces rapid loss-of-consciousness and lesions render the animal relatively insensitive to anesthetics administered systemically. Here we show that MPTA lesions also alter the natural sleep-wake rhythm by increasing overall wake time at the expense of time asleep (NREM and REM sleep equally), with nearly all of the change occurring during the dark hours of the light-dark cycle. The effect was proportional to the extent of the lesion and was not seen after lesions just outside of the MPTA, or following sham lesions. Thus, MPTA neurons appear to play a role in natural bistable brain-state switching (sleep-wake) as well as in loss and recovery of consciousness induced pharmacologically.

PMID: 29288749 [PubMed - as supplied by publisher]

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Phenylethanolamine N-methyltransferase Gene Expression in PC12 cells exposed to Intermittent Hypoxia.

Phenylethanolamine N-methyltransferase Gene Expression in PC12 cells exposed to Intermittent Hypoxia.

Neurosci Lett. 2017 Dec 27;:

Authors: Khurana S, Peng S, McDonald E, Yates W, Venkataraman K, Tai TC

Abstract
Epidemiological studies show a strong correlation between Obstructive Sleep Apnea (OSA) and cardiovascular disorders. OSA patients experience intermittent hypoxia (IH), characterized by brief, but recurring episodes of cessation in breathing. These patients have higher levels of circulating catecholamines and an increased incidence of hypertension; however the mechanisms defining this association are not clearly established. Genetic linkage studies have associated the phenylethanolamine N-methyltransferase (PNMT) gene to the development of hypertension. PNMT, the terminal enzyme in the catecholamine biosynthetic pathway, directly responsible for adrenaline synthesis, is elevated in hypertensive animals. Recent studies utilizing PC12 cells show an increase in the expression of PNMT and its regulatory transcription factors when exposed to continuous hypoxia. The current study examined the regulation of PNMT under conditions of IH. The mRNA of PNMT was analyzed to assess if the regulation of PNMT expression entails alternative splicing. The mRNA and protein of transcription factors HIF1α, Egr-1, GR, and Sp1, were analyzed to assess the cellular pathways involved in regulating PNMT expression. A PNMT promoter-driven luciferase assay was performed to evaluate promoter activity under IH. Preliminary results lay an antecedent for the regulation of PNMT by IH conceivably via an altered regulation of its transcription factors and establish a possible role for PNMT in IH mediated hypertension in OSA patients.

PMID: 29288726 [PubMed - as supplied by publisher]

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Chronic sleep disorder induced by psychophysiological stress induces glucose intolerance without adipose inflammation in mice.

Chronic sleep disorder induced by psychophysiological stress induces glucose intolerance without adipose inflammation in mice.

Biochem Biophys Res Commun. 2017 Dec 27;:

Authors: Oishi K, Ohyama S, Higo-Yamamoto S

Abstract
Sleep disturbances are associated with various metabolic diseases such as hypertension and diabetes. We had previously established a mouse model of a psychophysiological stress-induced chronic sleep disorder (CSD) characterized by disrupted circadian rhythms of wheel-running activity, core body temperature, and sleep-wake cycles. To evaluate the underlying mechanisms of metabolic disorders induced by CSD, we created mice with CSD for six weeks and fed them with a high-fat diet. Glucose intolerance with hyperglycemia resulted, although plasma insulin levels and body weight increases were identical between control and CSD mice. Gluconeogenesis and glycolysis were enhanced and suppressed, respectively, in the livers of CSD mice, because the mRNA expression of Pck1 was significantly increased, whereas that of Gck and Pklr were significantly decreased in the CSD mice. Adipose inflammation induced by the high-fat diet seemed suppressed by the CSD, because the mRNA expression levels of Adgre1, Ccl2, and Tnf were significantly downregulated in the adipose tissues of CSD mice. These findings suggest that CSD impair glucose tolerance by inducing gluconeogenesis and suppressing glycolysis. Hyperphasia with hypoleptinemia, hypercorticosteronemia, and increased plasma free fatty acids might be involved in the impaired glucose metabolism under a CSD. Further studies are needed to elucidate the endocrine and molecular mechanisms underlying the associations between sleep disorders and impaired glucose homeostasis that consequently causes diabetes.

PMID: 29288667 [PubMed - as supplied by publisher]

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Posterior Airway Changes Following Orthognathic Surgery in Obstructive Sleep Apnea.

Posterior Airway Changes Following Orthognathic Surgery in Obstructive Sleep Apnea.

J Oral Maxillofac Surg. 2017 Dec 06;:

Authors: Gottsauner-Wolf S, Laimer J, Bruckmoser E

Abstract
PURPOSE: The purpose of this systematic review was to describe and compare the different approaches of radiologic posterior airway space (PAS) assessment in obstructive sleep apnea (OSA) and analyze the correlations of PAS changes with polysomnographically evaluated parameters after orthognathic surgery.
MATERIALS AND METHODS: For this systematic review, a PubMed query was designed to search for original studies radiographically evaluating the PAS in patients before and after orthognathic surgery for treatment of their OSA. To account for the clinical relevance of PAS changes after surgery, only studies providing pre- and postoperative polysomnographic (PSG) data were included. The authors investigated whether the predictor variables (PAS changes) would be correlated with the primary outcome variables (PSG parameters).
RESULTS: The final sample included 15 publications in which the PAS was evaluated by lateral cephalography in 8 studies, cone-beam computed tomography in 3, conventional computed tomography in 5, and magnetic resonance imaging in 1. Most linear, areal, and volumetric PAS changes after surgery (predictor variables) were found to be statistically relevant. Maxillomandibular advancement (MMA) was the only orthognathic procedure performed in all studies included and was combined with additional surgical procedures in 9 studies. Improvement (ie, decrease) of the apnea-hypopnea index (AHI) as the primary outcome variable was reported in all publications.
CONCLUSION: After MMA (with or without additional surgical procedures), most linear, areal, and volumetric PAS parameters showed relevant changes. The PAS changes correlated with clinical improvement in PSG parameters. In particular, decreased AHI was reported in all studies. For better inter-study comparability, internationally accepted standards regarding the methods used for PAS evaluation are needed. Moreover, statistical analysis should account for multiple testing when various PAS parameters are evaluated.

PMID: 29288649 [PubMed - as supplied by publisher]

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A Review of Women's Neurology.

A Review of Women's Neurology.

Am J Med. 2017 Dec 27;:

Authors: O'Neal MA

Abstract
The concern about what is best practice when caring for women with neurologic disease is a common clinical scenario. Therefore, knowledge about women's health issues and their intersection with neurologic disorders is imperative. This review will discuss the appropriate gender based considerations in epilepsy, multiple sclerosis, migraine, autoimmune disease, sleep, stroke and paraneoplastic disorders.

PMID: 29288630 [PubMed - as supplied by publisher]

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Double Suspension Sutures: a simple Surgical Technique for Selected Cases of obstructive Sleep Apnea: our experience with twenty two patients.

Double Suspension Sutures: a simple Surgical Technique for Selected Cases of obstructive Sleep Apnea: our experience with twenty two patients.

Clin Otolaryngol. 2017 Dec 30;:

Authors: Askar SM, El-Anwar MW

Abstract
This work aimed at presenting a simple modification of expansion pharyngoplasty using bilateral double palatal suspension sutures for the treatment of selected cases of snoring and OSA. Between Marsh 2013 and August 2017, twenty- two patients underwent the double suspension sutures technique as a treatment for retropalatal collapse of obstructive sleep apnea. Postoperatively, the mean AHI and the mean lowest oxygen saturation level showed highly significant improvement. Both the retropalatal and interpillar distances were increased significantly. No persistent postoperative complications were reported. Snoring disappeared in 86.4% of patients. The procedure is simple, well-tolerated by patients and reversible. It is an economic and less traumatic maneuver. It could be applied as a part of multilevel surgery. This article is protected by copyright. All rights reserved.

PMID: 29288566 [PubMed - as supplied by publisher]

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Psychological Outcomes of Within-Group Sexual Violence: Evidence of Cultural Betrayal.

Psychological Outcomes of Within-Group Sexual Violence: Evidence of Cultural Betrayal.

J Immigr Minor Health. 2017 Dec 29;:

Authors: Gómez JM, Freyd JJ

Abstract
Cultural betrayal trauma theory is a new framework for understanding trauma-related mental health outcomes in immigrant and minority populations. The purpose of the current study is to empirically test cultural betrayal trauma theory. We hypothesized that the association between within-group sexual violence and mental health outcomes would be stronger for minorities. Participants (N = 368) were minority and majority college students, who completed online measures of sexual violence victimization and mental health outcomes. A MANOVA revealed that the link between within-group sexual violence and total trauma symptoms, depression, sexual abuse sequelae, sleep disturbance, and sexual problems was stronger for minorities. This study provides evidence for cultural betrayal trauma theory, as the findings suggest that outcomes from the same experience-within-group sexual violence-is affected by minority status. This work has implications for how mental health is understood, investigated, and treated in immigrant and minority populations.

PMID: 29288343 [PubMed - as supplied by publisher]

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Oxidative stress in critically ill ventilated adults: effects of vitamin D3 and associations with alveolar macrophage function.

Oxidative stress in critically ill ventilated adults: effects of vitamin D3 and associations with alveolar macrophage function.

Eur J Clin Nutr. 2017 Dec 29;:

Authors: Han JE, Alvarez JA, Staitieh B, Tangpricha V, Hao L, Ziegler TR, Martin GS, Brown LAS

Abstract
BACKGROUND/OBJECTIVES: Disruptions in redox balance lead to oxidative stress, a promoter of morbidity in critical illness. This study aimed to: (1) characterize the plasma and alveolar thiol/disulfide redox pools, (2) examine their associations with alveolar macrophage phagocytosis, and (3) determine the effect of high dose vitamin D3 on plasma thiol/disulfide redox.
SUBJECTS/METHODS: Subjects were 30 critically ill, ventilated adults in a double-blind randomized trial of high-dose (250 000 or 500 000 IU) vitamin D3 or placebo. Baseline bronchoalveolar lavage fluid (BALF) samples were analyzed for determination of alveolar phagocytosis index (PI) and for concentrations of glutathione (GSH), glutathione disulfide (GSSG), cysteine (Cys), cystine (CySS), and their respective redox potentials (EhGSSG and EhCySS). Plasma redox outcomes were assessed at baseline and days 7 and 14.
RESULTS: Baseline plasma Cys was inversely associated with alveolar PI (ρ = -0.69, P = 0.003), and EhCySS was positively associated with PI (ρ = 0.61, P = 0.01). Over time, among all subjects there was an increase in plasma GSH levels and a decrease in EhGSSG (P < 0.01 for both), with no difference by treatment group. Vitamin D3 decreased oxidized plasma GSSG to a more normal state (P for group x time = 0.009).
CONCLUSIONS: Oxidative stress indicators were positively associated with alveolar macrophage phagocytic function in acutely ill ventilated adults. High-dose vitamin D3 decreased plasma GSSG concentrations, which suggests that vitamin D can possibly improve the oxidative stress environment.

PMID: 29288250 [PubMed - as supplied by publisher]

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Mechanisms of pulse pressure amplification dipping pattern during sleep time: the SAFAR study.

Mechanisms of pulse pressure amplification dipping pattern during sleep time: the SAFAR study.

J Am Soc Hypertens. 2017 Dec 14;:

Authors: Argyris AA, Nasothimiou E, Aissopou E, Papaioannou TG, Zhang Y, Blacher J, Safar ME, Sfikakis PP, Protogerou AD

Abstract
The difference in pulse pressure (PP) between peripheral arteries and the aorta, called pulse pressure amplification (PPamp), is a well-described physiological phenomenon independently associated with cardiovascular events. Recent studies suggest that it exhibits circadian variability. Our aim was to detect the factors associated with the circadian variability of PPamp. In 497 consecutive subjects (aged 54 years, 56.7% male, 79.7% hypertensives), we assessed the circadian pattern of peripheral and central arterial hemodynamics by 24-hour evaluation of brachial and aortic blood pressure (BP), augmentation index (AI), and pulse wave velocity (PWV) using a validated oscillometric device (Mobil-O-Graph). All parameters exhibited a circadian variation. Sleep dipping (decrease) pattern was observed for PPamp, brachial and aortic systolic BP, mean BP, and PWV, whereas a rising pattern (higher sleep than wake values) was observed for brachial PP, aortic PP, and AI. The factors independently associated with the less sleep dipping in PPamp were older age, lower height, the use of antihypertensive medication, and sleep decrease in arterial stiffness (PWV), whereas female gender, the presence of hypertension, sleep increase of pressure wave reflections (AI), sleep decrease in heart rate, and mean BP were associated with a greater sleep-dipping in PPamp. These data provide further pathophysiological understanding of the mechanisms leading to PPamp dipping. Several implications regarding the clinical use of the aortic and brachial BP, especially during sleep time, are raised that should be addressed in future research.

PMID: 29287945 [PubMed - as supplied by publisher]

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Mandibular advancement devices in the treatment of obstructive sleep apnea. A necessary and effective option.

Mandibular advancement devices in the treatment of obstructive sleep apnea. A necessary and effective option.

Med Clin (Barc). 2017 Dec 26;:

Authors: Sampol Rubio G, Macías Escalada E, Montserrat Canal JM, Terán Santos J

PMID: 29287937 [PubMed - as supplied by publisher]

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Changes in the epidemiology and clinical features of acute mastoiditis following the introduction of the pneumococcal conjugate vaccine.

Changes in the epidemiology and clinical features of acute mastoiditis following the introduction of the pneumococcal conjugate vaccine.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:54-57

Authors: Cavel O, Tauman R, Simsolo E, Yafit D, Reindorf-Kfir E, Wasserzug O, Unger O, Handzel O, Fishman G, Oestreicher-Kedem Y, DeRowe A

Abstract
OBJECTIVES: Seven years after the introduction of the pneumococcal conjugate vaccines (PCV) in Israel, its effect on the incidence and severity of episodes of acute mastoiditis (AM) remains unclear. The primary objective of this study was to determine the incidence of AM and describe its clinical features in children during the years that followed the introduction of the PCV13 in comparison with the pre-PCV period.
METHODS: Included in this retrospective comparative case series were all pediatric patients diagnosed with AM between Jan. 2007 and Dec. 2015 in one tertiary medical center. The patients were divided into 3 groups: pre-PCV, post-PCV7 (July 2009 through Dec. 2010) and post-PCV13 (Jan. 2011 through Dec. 2015). The patients' medical records were reviewed, and data on age at presentation, gender, presenting signs, bacterial ear cultures, hospitalization course, complications, surgical interventions, inflammatory response and outcome were retrieved and compared between the groups. Comparison was made between the pre-PCV and the post-PCV13 groups.
RESULTS: 216 children were identified for analysis, 80 children in the pre-PCV period, 31 in the post-PCV7 period and 105 in the post-PCV13 period. Their mean age was 2.6 years. The number of AM cases per 1000 visits at the emergency room decreased by 46% in the post-PCV13 period compared to the pre-PCV period. There was no difference in the rate of AM between the post-PCV7 and post-PCV13 periods. No differences were found in age, gender, hospitalization length, C-reactive protein level, white blood cell count, rate of surgical interventions (mastoidectomy and incision and drainage) and rate of complications between the 3 groups.
CONCLUSION: The incidence of AM was lower in the post-PCV13 period compared to the pre-PCV period. The rate of AM complications, however, has not changed, nor has the number of mastoidectomies.

PMID: 29287882 [PubMed - in process]

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Postoperative bradycardia following adenotonsillectomy in children: Does intraoperative administration of dexmedetomidine play a role?

Postoperative bradycardia following adenotonsillectomy in children: Does intraoperative administration of dexmedetomidine play a role?

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:210-215

Authors: Bush B, Tobias JD, Lin C, Ruda J, Jatana KR, Essig G, Cooper J, Tumin D, Elmaraghy CA

Abstract
INTRODUCTION: Dexmedetomidine is a novel pharmacologic agent that has become a frequently used adjunct during care of pediatric patients with obstructive sleep apnea (OSA) undergoing tonsillectomy. While generally safe and effective, dexmedetomidine is associated with adverse effects of hypotension and bradycardia from its central sympatholytic effects. Due to safety concerns, our institution routinely admits patients with OSA for overnight cardiorespiratory monitoring following tonsillectomy. With such monitoring, we have anecdotally noted bradycardia in our patients and sought to investigate whether this was related to the increased use of intra-operative dexmedetomidine.
METHODS: We retrospectively reviewed records over an 11-month period to compare the incidence of postoperative bradycardia following hospital admission for tonsillectomy in patients who received dexmedetomidine versus those who did not.
RESULTS: The study cohort included 921 patients (371 received dexmedetomidine and 550 did not). Bradycardia was asymptomatically noted in 66 patients (7.2%). No patient required medical intervention for the bradycardia or developed clinical symptoms. There was no association of bradycardia with the intra-operative administration of dexmedetomidine (8.9% of patients who received dexmetomidine vs. 9.4% who did not). In multivariable analysis, bradycardia was more common among older patients, with the administration of topical or injected lidocaine, and with specific associated procedures (inferior turbinate coblation with out-fracture or direct laryngoscopy and bronchoscopy).
CONCLUSION: The increased incidence of asymptomatic bradycardia in our post-adenotonsillectomy patients seemed to relate more to increased utilization of postoperative cardiac telemetry, and did not appear associated with the use of dexmedetomidine use intra-operatively.

PMID: 29287870 [PubMed - in process]

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The protective effect of 20(S)-protopanaxadiol (PPD) against chronic sleep deprivation (CSD)-induced memory impairments in mice.

The protective effect of 20(S)-protopanaxadiol (PPD) against chronic sleep deprivation (CSD)-induced memory impairments in mice.

Brain Res Bull. 2017 Dec 26;:

Authors: Lu C, Dong L, Lv J, Wang Y, Fan B, Wang F, Liu X

Abstract
Sleep deprivation (SD) is associated with oxidative stress that causes learning and memory impairment. 20(S)-Protopanaxadiol (PPD), one of the protopanaxadiol-type saponins, has antioxidant and neuroprotective effect. This study was designed to research the protective effect of PPD against cognitive deficits induced by chronic sleep deprivation (CSD) in mice. The CSD model was induced by subjecting the mice to our self-made Sleep Interruption Apparatus (SIA) continuously for 14 days. The memory enhancing effects of PPD were evaluated by behavioral tests and the related mechanism was further explored by observing the oxidative stress changes in the cortex and hippocampus of mice. The results revealed that PPD (20 and 40 μmol/kg, i.p.) administration significantly improved the cognitive performance of CSD model mice in object location recognition experiment, novel object recognition task and Morris water maze test. Furthermore, PPD effectively restored the levels/activities of antioxidant defense biomarkers in the cortex and hippocampus, including the superoxide dismutase (SOD) enzyme activity, catalase (CAT) enzyme activity, glutathione (GSH), and lipid peroxidation (LPO). In conclusion, PPD could attenuate cognitive deficits induced by CSD, and the neuroprotective effect of PPD might be mediated by alleviation of oxidative stress. It was assumed that PPD has the potential to be a neuroprotective substance for cognition dysfunction.

PMID: 29287793 [PubMed - as supplied by publisher]

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Persistent induction of goblet cell differentiation in the airways: Therapeutic approaches.

Persistent induction of goblet cell differentiation in the airways: Therapeutic approaches.

Pharmacol Ther. 2017 Dec 26;:

Authors: Reid AT, Veerati PC, Gosens R, Bartlett NW, Wark PA, Grainge CL, Stick SM, Kicic A, Moheimani F, Hansbro PM, Knight DA

Abstract
Dysregulated induction of goblet cell differentiation results in excessive production and retention of mucus and is a common feature of several chronic airways diseases. To date, therapeutic strategies to reduce mucus accumulation have focused primarily on altering the properties of the mucus itself, or have aimed to limit the production of mucus-stimulating cytokines. Here we review the current knowledge of key molecular pathways that are dysregulated during persistent goblet cell differentiation and highlights both pre-existing and novel therapeutic strategies to combat this pathology.

PMID: 29287707 [PubMed - as supplied by publisher]

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Pharyngeal airway evaluation after isolated mandibular setback surgery using cone-beam computed tomography.

Pharyngeal airway evaluation after isolated mandibular setback surgery using cone-beam computed tomography.

Am J Orthod Dentofacial Orthop. 2018 Jan;153(1):46-53

Authors: Irani SK, Oliver DR, Movahed R, Kim YI, Thiesen G, Kim KB

Abstract
INTRODUCTION: In this study, we investigated volumetric and dimensional changes to the pharyngeal airway space after isolated mandibular setback surgery for patients with Class III skeletal dysplasia.
METHODS: Records of 28 patients who had undergone combined orthodontic and mandibular setback surgery were obtained. The sample comprised 17 men and 11 women. Their mean age was 23.88 ± 6.57 years (range, 18-52 years). Cone-beam computed tomography scans were obtained at 3 time points: before surgery, average of 6 months after surgery, and average of 1 year after surgery. Oropharyngeal, hypopharyngeal, and total volumes were calculated. The lateral surface and anteroposterior dimensions at the minimal axial areas for oropharyngeal and hypopharyngeal volumes and mean mandibular setback were determined.
RESULTS: The mean mandibular setback was 9.93 ± 5.26 mm. Repeated measures analysis of variance determined an overall significant decrease between the means for 6 months and up to 1 year after surgery for oropharyngeal and hypopharyngeal volumes, anteroposterior at oropharyngeal, lateral surface at oropharyngeal, and anteroposterior at hypopharyngeal. No strong correlation between mandibular setback surgery and pharyngeal airway volumes or dimensions was determined.
CONCLUSIONS: After mandibular setback surgery, pharyngeal airway volume, and transverse and anteroposterior dimensions were decreased. Patients undergoing mandibular setback surgery should be evaluated for obstructive sleep apnea and the proposed treatment plan modified according to the risk for potential airway compromise.

PMID: 29287649 [PubMed - in process]

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Transcranial magnetic stimulation and subjective tinnitus. A review of the literature, 2014-2016.

Transcranial magnetic stimulation and subjective tinnitus. A review of the literature, 2014-2016.

Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Dec 26;:

Authors: Londero A, Bonfils P, Lefaucheur JP

Abstract
Subjective tinnitus is a symptom in many ENT pathologies, for which there is no curative treatment. It may be poorly tolerated by some patients, who develop attention or sleep disorder or even major anxiety and depression, severely impairing quality of life. Pathophysiological models of the genesis and maintenance of tinnitus symptomatology highlight maladaptive cerebral plasticity induced by peripheral hearing loss. Although not fully elucidated, these changes in neuronal activity are the target of various attempts at neuromodulation, particularly using repetitive transcranial magnetic stimulation (rTMS), which has been the focus of various clinical studies and meta-analyses. A recent consensus statement (Lefaucheur, 2014) reported level-C evidence (possible efficacy) for rTMS using low frequency (1Hz) tonic stimulation targeting the left cerebral cortex. However, many questions remain concerning the use of this technique in everyday practice. The present article reports a recent literature review using the search-terms "tinnitus" and "rTMS" in the PubMed and Cochrane databases for April 2014 to December 2016.

PMID: 29287622 [PubMed - as supplied by publisher]

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Viruses, Vol. 10, Pages 16: Analyses of Tissue Culture Adaptation of Human Herpesvirus-6A by Whole Genome Deep Sequencing Redefines the Reference Sequence and Identifies Virus Entry Complex Changes

Viruses, Vol. 10, Pages 16: Analyses of Tissue Culture Adaptation of Human Herpesvirus-6A by Whole Genome Deep Sequencing Redefines the Reference Sequence and Identifies Virus Entry Complex Changes

Viruses doi: 10.3390/v10010016

Authors: Joshua Tweedy Eric Escriva Maya Topf Ursula Gompels

Tissue-culture adaptation of viruses can modulate infection. Laboratory passage and bacterial artificial chromosome (BAC)mid cloning of human cytomegalovirus, HCMV, resulted in genomic deletions and rearrangements altering genes encoding the virus entry complex, which affected cellular tropism, virulence, and vaccine development. Here, we analyse these effects on the reference genome for related betaherpesviruses, Roseolovirus, human herpesvirus 6A (HHV-6A) strain U1102. This virus is also naturally “cloned” by germline subtelomeric chromosomal-integration in approximately 1% of human populations, and accurate references are key to understanding pathological relationships between exogenous and endogenous virus. Using whole genome next-generation deep-sequencing Illumina-based methods, we compared the original isolate to tissue-culture passaged and the BACmid-cloned virus. This re-defined the reference genome showing 32 corrections and 5 polymorphisms. Furthermore, minor variant analyses of passaged and BACmid virus identified emerging populations of a further 32 single nucleotide polymorphisms (SNPs) in 10 loci, half non-synonymous indicating cell-culture selection. Analyses of the BAC-virus genome showed deletion of the BAC cassette via loxP recombination removing green fluorescent protein (GFP)-based selection. As shown for HCMV culture effects, select HHV-6A SNPs mapped to genes encoding mediators of virus cellular entry, including virus envelope glycoprotein genes gB and the gH/gL complex. Comparative models suggest stabilisation of the post-fusion conformation. These SNPs are essential to consider in vaccine-design, antimicrobial-resistance, and pathogenesis.

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A show uniting art and nature that should just be experienced

mumok_naturgeschichten_nhm-006-800x533.j

A famous gallery in Vienna shows what can happen when curators get in the way of the natural enjoyment of the art

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IJMS, Vol. 19, Pages 112: Apolipoprotein M Inhibits Angiogenic and Inflammatory Response by Sphingosine 1-Phosphate on Retinal Pigment Epithelium Cells

IJMS, Vol. 19, Pages 112: Apolipoprotein M Inhibits Angiogenic and Inflammatory Response by Sphingosine 1-Phosphate on Retinal Pigment Epithelium Cells

International Journal of Molecular Sciences doi: 10.3390/ijms19010112

Authors: Ryo Terao Megumi Honjo Makoto Aihara

Sphingosine 1-phosphate (S1P) is a potent lipid mediator that modulates inflammatory responses and proangiogenic factors. It has been suggested that S1P upregulates choroidal neovascularization (CNV) and may be deeply involved in the pathogenesis of exudative age-related macular degeneration (AMD). Recent studies have suggested that apolipoprotein M (ApoM), a carrier protein for S1P, modulates the biological properties of S1P in the pathogenesis of atherosclerosis. However, the role of ApoM/S1P in AMD has not been explored. We investigated the effect of S1P on proangiogenic factors in human retinal pigment epithelium (RPE) cell lines in vitro. S1P promoted the expression of vascular endothelial growth factor in RPE cells. Hypoxia inducible factor-1α expression was also upregulated. These S1P-induced enhancements in growth factors and chemotactic cytokines in RPE cells were significantly inhibited by ApoM treatment. Additionally, in vivo experiments using a laser-induced CNV murine model demonstrated that intravitreal ApoM injection significantly reduced the progression of CNV formation. Although the detailed mechanisms remain to be elucidated, the present results provide a novel potential therapeutic target for AMD, and demonstrate a suppressive role for ApoM and S1P in the pathology of CNV progression.

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The competence system of Streptococcus anginosus and its use for genetic engineering

Abstract

Streptococcus anginosus is considered a human commensal but improvements in species identification in recent years highlighted its role as an emerging pathogen. However, our knowledge about the pathogenicity mechanisms in this species is rare. One reason for this is the lack of published genetic manipulation techniques in the Streptococcus anginosus group. To establish a novel mutation technique we investigated the competence system of S. anginosus and created a Cre-recombinase based mutation method that allows the generation of markerless gene deletions in S. anginosus. In silico analysis of the competence system demonstrated that S. anginosus encodes homologues for the vast majority of genes that are known to be essential for the transformation of S. pneumoniae. Analysis of transformation kinetics confirmed that S. anginosus SK52 possesses a S. pneumoniae-like competence development with a rapid increase of competence after CSP treatment reaching a maximum transformation efficiency of 0.24% ± 0.08%. The combination of CSP induced transformation and the Cre-lox system allows the efficient and fast creation of markerless gene deletions and will facilitate the investigation of the pathogenicity of S. anginosus on a genetic level.

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Unilateral Arm Crank Exercise Test for Assessing Cardiorespiratory Fitness in Individuals with Hemiparetic Stroke

Cardiorespiratory fitness assessment with leg cycle exercise testing may be influenced by motor impairments in the paretic lower extremity. Hence, this study examined the usefulness of a unilateral arm crank exercise test to assess cardiorespiratory fitness in individuals with stroke, including sixteen individuals with hemiparetic stroke (mean ± SD age, years) and 12 age- and sex-matched healthy controls. Participants performed the unilateral arm crank and leg cycle exercise tests to measure oxygen consumption (O2) and heart rate at peak exercise. The O2 at peak exercise during the unilateral arm crank exercise test was significantly lower in the stroke group than in the control group (). In the stroke group, the heart rate at peak exercise during the unilateral arm crank exercise test did not significantly correlate with the Brunnstrom recovery stages of the lower extremity (), whereas there was a significant correlation during the leg cycle exercise test (rho = 0.775, ). The unilateral arm crank exercise test can detect the deterioration of cardiorespiratory fitness independently of lower extremity motor impairment severity in individuals with hemiparetic stroke. This study is registered with UMIN000014733.

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Optimal Retail Price Model for Partial Consignment to Multiple Retailers

This paper investigates the product pricing decision-making problem under a consignment stock policy in a two-level supply chain composed of one supplier and multiple retailers. The effects of the supplier’s wholesale prices and its partial inventory cost absorption of the retail prices of retailers with different market shares are investigated. In the partial product consignment model this paper proposes, the seller and the retailers each absorb part of the inventory costs. This model also provides general solutions for the complete product consignment and the traditional policy that adopts no product consignment. In other words, both the complete consignment and nonconsignment models are extensions of the proposed model (i.e., special cases). Research results indicated that the optimal retail price must be between 1/2 (50%) and 2/3 (66.67%) times the upper limit of the gross profit. This study also explored the results and influence of parameter variations on optimal retail price in the model.

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Influence of Al2O3, CaO/SiO2, and B2O3 on Viscous Behavior of High Alumina and Medium Titania Blast Furnace Slag

The effect of Al2O3, CaO/SiO2, and B2O3 on the viscosity of high alumina and medium titania blast furnace slag was analyzed. An increase in CaO/SiO2 ratio from 1.14 to 1.44 resulted in higher slag viscosity and break point temperature. They also increased with increasing Al2O3 content but decreased with adding B2O3 and Al2O3 simultaneously at a fixed CaO/SiO2 ratio of 1.14, which suggested that the effect of B2O3 on viscosity and break point temperature is predominant compared to Al2O3. Apparent activation energies of CaO–SiO2–MgO–Al2O3–TiO2–B2O3 slag were found to be between 74 and 169 kJ/mol.

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LPA Gene Polymorphisms and Gene Expression Associated with Coronary Artery Disease

The aim of our study was to investigate the influence of LPA gene polymorphisms for CAD risk and Lp(a) in a case-control study of Chinese Han population. In addition, we further analyzed the effect of LPA gene expression on plasma levels of Lp(a) and CAD risk. First, five SNPs (rs1367211, rs3127596, rs6415085, rs9347438, and rs9364559) in LPA gene were genotyped using the SEQUENOM Mass-ARRAY system in two groups. Second, we used quantitative real-time PCR to examine the mRNA expression levels of LPA gene in 92 cases and 32 controls. Results showed that the frequency of rs6415085-T allele was significantly higher in case group than that in control group (). Haplotypes were not associated with CAD risk (). And cases with the TT/TG genotype had significantly higher plasma Lp(a) levels compared with those that have the rs6415085 GG genotype (). Additionally, the mRNA expression levels in case group are significantly higher than that in control group (). Our study confirmed that rs6415085 was associated with CAD and increased plasma Lp(a) levels. And increased mRNA expression level of LPA gene may be a mechanism in development of CAD.

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Health Behaviour among Nurses Working in Public Hospitals in Kakamega County, Kenya

Health behaviour refers to actions undertaken by a person who perceives self to be ill for the purpose of finding an appropriate remedy. Nurses as gate keepers of health are expected to seek formal treatment when they are taken ill because this is what they teach their patients. Nurses’ working conditions all over the world are described as squalid with long working hours and workload. This scenario predisposes them to occupational health hazards and at the same time denies them time for self-care. Although nurses are knowledgeable about disease and its treatment and have access to health care, they engage in self-treatment in contrast to what they teach patients. Health behaviour among nurses in Kakamega County was investigated using a cross-sectional design. Data was collected using self-administered questionnaires and subjected to bivariate and logistic regression analyses. The study found that health behaviour of nurses in Kakamega County is below expectation, as 33% engaged in voluntary screening services. Further, 34.8% said that their health would improve if they engaged in health promotion activities. The study recommends empowering nurses to engage in positive health behaviour through education. The county should also provide affordable screening services to its nurses.

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Achievements of Diabetes Goals and Their Determinants in Type 2 Diabetic Patients Attending Outpatient Diabetic Clinic in Northern Ethiopia

Background. The aim of this study was to assess target diabetic goal achievements and to explore variables associated with them. Methods. A cross-sectional study was conducted between December 2015 and April 2016 on 188 type 2 diabetic patients attending Ayder Referral Hospital’s outpatient diabetic clinic. Glycemic control was assessed using fasting plasma glucose values and total cholesterol and triglyceride were used to evaluate lipid profiles. Bivariate and multivariate logistic regression analyses were done to identify factors associated with poor glycemic control, hypertension, and dyslipidemia. Result. Mean duration of diabetes was 6.5 years. Combined glycemic, lipid, and blood pressure targets were achieved only in 8.5% of the participants. More males achieved combined targets than females. Separately, while above two-thirds of the patients had poor glycemic control (67%), more than half of the participants have had poor lipid (58.5%) and blood pressure (52.1%) control. A significant portion of the patients (68.1%) had also comorbidities other than hyperglycemia. In bivariate and multivariate analyses, longer duration of diabetes disease (AOR: 3.4; ) and marked month to month fasting plasma glucose (FPG) variability as measured by large standard deviation (AOR: 2.5; ) were significantly associated with overall poor mean FPG results. Female sex was also significantly associated with dyslipidemia (AOR: 1.9; ). Conclusion. The study showed that achievements of combined diabetic goals are generally poor.

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Resveratrol Ameliorates Experimental Alcoholic Liver Disease by Modulating Oxidative Stress

The aim of this study was to investigate the hepatoprotective effects of resveratrol in alcoholic liver disease (ALD). Alcohol was administered to healthy female rats starting from 6% (v/v) and gradually increased to 20% (v/v) by the fifth week. After 16 weeks of intervention, liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) were analyzed using a chemistry analyzer, while hepatic antioxidant enzymes, oxidative stress markers, and caspase 3 activity were assessed using ELISA kits. Furthermore, hepatic CYP2E1 protein levels and mRNA levels of antioxidant and inflammation-related genes were determined using western blotting and RT-PCR, respectively. The results showed that resveratrol significantly attenuated alcohol-induced elevation of liver enzymes and improved hepatic antioxidant enzymes. Resveratrol also attenuated alcohol-induced CYP2E1 increase, oxidative stress, and apoptosis (caspase 3 activity). Moreover, genes associated with oxidative stress and inflammation were regulated by resveratrol supplementation. Taken together, the results suggested that resveratrol alleviated ALD through regulation of oxidative stress, apoptosis, and inflammation, which was mediated at the transcriptional level. The data suggests that resveratrol is a promising natural therapeutic agent against chronic ALD.

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Decreased Expression of Semaphorin3A/Neuropilin-1 Signaling Axis in Apical Periodontitis

Apical periodontitis (AP) is a chronic infection of endodontic origin accompanied with bone destruction around the apical region. Semaphorin3A (Sema3A) and neuropilin-1 (Nrp1) are regarded as a pair of immune regulators in bone metabolism. In this study, we firstly investigated the expression pattern of Sema3A/Nrp1 in apical periodontitis and its correlation with bone destruction. Using rat animal model, we analysed the level of mandibular bone destruction and the expression of Sema3A/Nrp1 on days 0, 7, 14, 21, 28, and 35 after pulp exposure. In addition, clinical samples from apical periodontitis patients were obtained to analyse the expression of Sema3A/Nrp1. These results indicated that the bone destruction level expanded from days 7 to 35. The number of positive cells and level of mRNA expression of Sema3A/Nrp1 were significantly decreased from days 7 to 35, with a negative correlation with bone destruction. Moreover, expression of Sema3A/Nrp1 in the AP group was reduced compared to the control group of clinical samples. In conclusion, decreased expression of Sema3A/Nrp1 was observed in periapical lesions and is potentially involved in the bone resorption of the periapical area, suggesting that Sema3A/Nrp1 may contribute to the pathological development of apical periodontitis.

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Chemical Profiling of Polyfloral Belgian Honey: Ellagic Acid and Pinocembrin as Antioxidants and Chemical Markers

Chemical profiling of northern Belgian polyfloral honeys was performed to analyse their phenolic compound content (flavonoids and phenolic acids). First, samples were subjected to a standard analysis of their physicochemical properties, and then, the phenolic fraction was isolated and analysed using a HPLC/PAD method. All of the tested honeys showed a common and specific phenolic profile that could be the basis for the differentiation of polyfloral honeys of the Antwerp region from other polyfloral honeys. Chromatographic data indicated a high content of ellagic acid (9.13–13.66 mg/100 g honey), as well as the flavonoid pinocembrin (1.60–1.85 mg/100 g honey) in these honeys. Ellagic acid, a compound with well-defined prohealth activities, might be used as a chemical marker for these honeys. With respect to total phenolic and flavonoid contents, 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays were determined spectrophotometrically. The honey exhibited a moderate antioxidant activity, typical for light honeys.

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Characterization of Elastic and Plastic Behaviors in Steel Plate Based on Eddy Current Technique Using a Portable Impedance Analyzer

A portable impedance analyzer (PIA) was developed based on a TiePie-HS3 device to provide the comparable impedance measurement accuracy of the Agilent 4294a impedance analyzer in the frequency range of 0~250 kHz. Then the PIA was applied to monitor the tensile stress-induced variation of the eddy current sensor’s impedance in a medium-carbon steel sample. A model of equivalent magnetic field induced by the elastic stress and the number of pinning sites indicated that the inductance of the eddy current loop firstly increased with the increase in the tensile stress and then decreased at the yield point of the material. The experimental results testified that the variation of impedance amplitude, the variation of phase angle, and the shift of two featured frequencies demonstrated opposite variation trends before and after the yield point, as predicated by the model. A new parameter, which combined the impedance variation information of the selected two frequencies, was found to exhibit nearly monotonous dependency on the tensile stress in elastic and plastic stages. The new parameter together with the developed portable impedance analyzer provided the solution to identify the elastic and plastic behaviors in ferromagnetic materials in practical applications with an eddy current technique.

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Protein Glutathionylation in the Pathogenesis of Neurodegenerative Diseases

Protein glutathionylation is a redox-mediated posttranslational modification that regulates the function of target proteins by conjugating glutathione with a cysteine thiol group on the target proteins. Protein glutathionylation has several biological functions such as regulation of metabolic pathways, calcium homeostasis, signal transduction, remodeling of cytoskeleton, inflammation, and protein folding. However, the exact role and mechanism of glutathionylation during irreversible oxidative stress has not been completely defined. Irreversible oxidative damage is implicated in a number of neurological disorders. Here, we discuss and highlight the most recent findings and several evidences for the association of glutathionylation with neurodegenerative diseases and the role of glutathionylation of specific proteins in the pathogenesis of neurodegenerative diseases. Understanding the important role of glutathionylation in the pathogenesis of neurodegenerative diseases may provide insights into novel therapeutic interventions.

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Diagnostic Value of the lncRNA NEAT1 in Peripheral Blood Mononuclear Cells of Patients with Sepsis

Background. This study aims to evaluate the diagnostic value of nuclear-enriched abundant transcript 1 (NEAT1) expression in peripheral blood mononuclear cells (PBMCs) for the early diagnosis of sepsis. Methods. A total of 59 patients with sepsis, 52 noninfectious SIRS patients, and 56 healthy controls were recruited fort this study. The levels of NEAT1 expression in PBMCs were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Results. Compared with healthy controls, NEAT1 expression of PBMCs in sepsis and SIRS groups were significantly increased (3.76 ± 0.71- and 1.64 ± 0.43-fold, resp.) (), but NEAT1 levels are significantly lower in the SIRS group than in the sepsis group, and there was no statistical significant relevance between survivors and nonsurvivors in patients with sepsis. NEAT1 with an area under the curve (AUC) of 0.851 (95% CI: 0.812–0.935) indicated sensitivity (67.85%) and specificity (87.27%) for the diagnosis for sepsis, the positive predictive value (PPV) was 83.3%, and the negative predictive value (NPV) was 71.6%. The AUC for NEAT1 in the diagnosis of SIRS versus healthy controls was 0.755 (95% CI: 0.664–0.847), with 69.23% sensitivity and 70.91% specificity, the PPV was 72.3%, and the NPV was 72.49%. Conclusion. Measurement of NEAT1 expression in PBMCs could be considered as a good additive marker for the diagnosis of sepsis.

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Distribution of Adiponectin Receptors 1 and 2 in the Rat Olfactory Bulb and the Effect of Adiponectin Injection on Insulin Receptor Expression

Background. Adiponectin (APN) is an adipocyte-derived hormone that has peripheral beneficial effects. Although its receptors AdipoR1 and AdipoR2 are expressed in the brain, their function in neurons is poorly understood. The aims of this work were to describe the distribution of APN receptors in the olfactory bulb (OB) as well as the possible effects of APN injection on the insulin receptor (InsR) content and Akt kinase. Method. We performed the double immunofluorescence technique to describe the distribution of AdipoRs and the cellular type they were expressing. mRNA transcript and protein content were assessed by RT-PCR and Western blot, respectively. APN injection was performed to analyze its possible effect on the insulin pathway. Results. We found that AdipoRs were localized in all cell layers and in both neurons and astrocytes. We observed the presence of mRNA transcripts and immunoblot analysis confirmed the protein on the intact OB; APN injection in the OB resulted in a slight decrease of the total InsR and Akt phosphorylation and a reduction of phopho-InsR content. Conclusions. These data demonstrated that AdipoRs are expressed in OB regions, and APN injection could act as an insulin pathway modulator in the OB and thus possibly contribute to olfaction physiology.

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The Role of Stress-Induced O-GlcNAc Protein Modification in the Regulation of Membrane Transport

O-linked N-acetylglucosamine (O-GlcNAc) is a posttranslational modification that is increasingly recognized as a signal transduction mechanism. Unlike other glycans, O-GlcNAc is a highly dynamic and reversible process that involves the addition and removal of a single N-acetylglucosamine molecule to Ser/Thr residues of proteins. UDP-GlcNAc—the direct substrate for O-GlcNAc modification—is controlled by the rate of cellular metabolism, and thus O-GlcNAc is dependent on substrate availability. Serving as a feedback mechanism, O-GlcNAc influences the regulation of insulin signaling and glucose transport. Besides nutrient sensing, O-GlcNAc was also implicated in the regulation of various physiological and pathophysiological processes. Due to improvements of mass spectrometry techniques, more than one thousand proteins were detected to carry the O-GlcNAc moiety; many of them are known to participate in the regulation of metabolites, ions, or protein transport across biological membranes. Recent studies also indicated that O-GlcNAc is involved in stress adaptation; overwhelming evidences suggest that O-GlcNAc levels increase upon stress. O-GlcNAc elevation is generally considered to be beneficial during stress, although the exact nature of its protective effect is not understood. In this review, we summarize the current data regarding the oxidative stress-related changes of O-GlcNAc levels and discuss the implications related to membrane trafficking.

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Gait Speed Measurement for Elderly Patients with Risk of Frailty

The ageing of the population poses a threat to both public and private health and social systems. In the last 50 years, life expectancy has increased by an average of 20 years, and by the year 2050, life expectancy will exceed 90 years of age. However, quality of life in the last years of life is not guaranteed due to conditions such as functional decline and frailty, ultimately progressing to disability. Thus, the detection of such a condition in time is of utmost importance. This paper presents an ultrasonic sensor-based gait speed measurement device controlled via a mobile interface, which permits patients to self-assess physical performance. The system was developed and validated in an iterative process involving a total of 28 subjects (21 in the first round and 7 in the second one). After first evaluation at Hospital Universitario de Getafe, some technical problems arose whereas usability testing was well evaluated. The second version addressing the identified issues was technically validated at university premises with good and promising results. Future work envisages deployment of the system developed at subjects’ homes to be remotely and unobtrusively monitored.

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The Tubular Penetration Depth and Adaption of Four Sealers: A Scanning Electron Microscopic Study

Background. The tubular penetration and adaptation of the sealer are important factors for successful root canal filling. The aim of this study was to evaluate the tubular penetration depth of four different sealers in the coronal, middle, and apical third of root canals as well as the adaptation of these sealers to root canal walls. Materials and Methods. 50 single-rooted teeth were prepared in this study. Forty-eight of them were filled with different sealers (Cortisomol, iRoot SP, AH-Plus, and RealSeal SE) and respective core filling materials. Then the specimens were sectioned and scanning electron microscopy was employed to assess the tubular penetration and adaptation of the sealers. Results. Our results demonstrated that the maximum penetration was exhibited by RealSeal SE, followed by AH-Plus, iRoot SP, and Cortisomol. As regards the adaptation property to root canal walls, AH-Plus has best adaptation capacity followed by iRoot SP, RealSeal SE, and Cortisomol. Conclusion. The tubular penetration and adaptation vary with the different sealers investigated. RealSeal SE showed the most optimal tubular penetration, whereas AH-Plus presented the best adaptation to the root canal walls.

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Metabolomic Insights into the Nutritional Status of Adults and Adolescents with Phenylketonuria Consuming a Low-Phenylalanine Diet in Combination with Amino Acid and Glycomacropeptide Medical Foods

Background. Nutrient status in phenylketonuria (PKU) requires surveillance due to the restrictive low-Phe diet in combination with amino acid medical foods (AA-MF) or glycomacropeptide medical foods (GMP-MF). Micronutrient profiles of medical foods are diverse, and optimal micronutrient supplementation in PKU has not been established. Methods. In a crossover design, 30 participants with PKU were randomized to consume AA-MF and Glytactin™ GMP-MF in combination with a low-Phe diet for 3 weeks each. Fasting venipunctures, medical food logs, and 3-day food records were obtained. Metabolomic analyses were completed in plasma and urine by Metabolon, Inc. Results. The low-Phe diets in combination with AA-MF and GMP-MF were generally adequate based on Dietary Reference Intakes, clinical measures, and metabolomics. Without micronutrient supplementation of medical foods, >70% of participants would have inadequate intakes for 11 micronutrients. Despite micronutrient supplementation of medical foods, inadequate intakes of potassium in 93% of participants and choline in >40% and excessive intakes of sodium in >63% of participants and folic acid in >27% were observed. Sugar intake was excessive and provided 27% of energy. Conclusions. Nutrient status was similar with AA-MF and Glytactin GMP-MF. More research related to micronutrient supplementation of medical foods for the management of PKU is needed.

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Πληροφορίες

Κυριακή 31 Δεκεμβρίου 2017

Abstract

Δημοφιλείς αναρτήσεις