Publication date: Available online 24 November 2017
Source:Cryobiology
Author(s): Zhong-yi He, Hong-Yan Wang, Xue Zhou, Xue-yun Liang, Bei Yan, Rui Wang, Liang-hong Ma, Yi-li Wang
Transplantation of cryopreserved ovarian tissue has been considered as a promising way of fertility preservation for women. however, this cryopreservation method is prone to post-resuscitation follicle proliferation and oocyte development stagnation, affecting late transplant survival. To evaluate current vitrification works, we investigated the critical pathway alternations in vitrified-warmed juvenile 10-day-old mouse ovary. We showed a significant decrease of protein kinase B (Akt) and Mitogen-activated protein kinase (Mapk) phosphorylation, during which serine/threonine kinases play central roles in coordinating follicle and oocyte development and stress response. Inhibition of Akt and Mapk activity were associated with one of the imprinted insulin pathway negative regulatory genes, Growth factor receptor-binding protein 10 (Grb10) which remarkably increased in vitrified-warmed juvenile mouse ovary than that of fresh group (p < 0.05). RNAi-induced Grb10 down-regulation reversed the decrease in Akt and Mapk phosphorylation. The increase of Grb10 expression was partially caused by the hyper-methylation of the promoter region, associated with the decrease of follicular DNA methyltransferase (Dnmt) 1 protein in different stages of vitrified-warmed group, compared to fresh group (p < 0.05). The mRNA and protein expression of Dnmt1 in ovary of vitrified-warmed juvenile mouse were remarkably lower than those in fresh group (p < 0.05). Dnmt1 overexpression dramatically reversed Grb10 up-regulation and Akt and Mapk phosphorylation reduction. Taken together, our findings suggest that Grb10 expression might be helpful in evaluation of effectiveness of vitrification, and considered as a potential target for further vitrification protocols improvement in the future.
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Σάββατο 25 Νοεμβρίου 2017
Vitrification of human pronuclear oocytes by direct plunging into cooling agent: Non sterile liquid nitrogen vs. sterile liquid air
Publication date: Available online 22 November 2017
Source:Cryobiology
Author(s): Vladimir Isachenko, Plamen Todorov, Akerke Seisenbayeva, Yerzhan Toishibekov, Evgenia Isachenko, Gohar Rahimi, Peter Mallmann, Dolores Foth, Markus Merzenich
In fact, a full sterilization of commercially-produced liquid nitrogen contaminated with different pathogens is not possible. The aim of this study was to compare the viability of human pronuclear oocytes subjected to cooling by direct submerging of open carrier in liquid nitrogen versus submerging in clean liquid air (aseptic system). One- and three-pronuclei stage embryos (n = 444) were cryopreserved by direct plunging into liquid nitrogen (vitrified) in ethylene glycol (15%), dimethylsulphoxide (15%) and 0.2M sucrose. Oocytes were exposed in 20, 33, 50 and 100% vitrification solution for 2, 1 and 1 min, and 30–50 s, respectively at room temperature. Then first part of oocytes (n = 225) were directly plunged into liquid nitrogen, and second part of oocytes (n = 219) into liquid air. Oocytes were thawed rapidly at a speed of 20,000 °C/min and then subsequently were placed into a graded series of sucrose solutions (0.5, 0.25, 0.12 and 0.06M) at 2.5 min intervals and cultured in vitro for 3 days. In both groups, the rate of high-quality embryos (Grade 6A: 6 blastomeres, no fragmentation; Grade 8A: 8 blastomeres, no fragmentation; Grade 8A compacting: 8 blastomeres, beginning of compacting) was noted. The rates of high-quality embryos developed from one-pronuclear oocytes vitrified by cooling in liquid nitrogen and liquid air were: 39.4% ± 0.6 and 38.7% ± 0.8, respectively (P > 0.1). These rates for three-pronuclear oocytes were: 45.8 ± 0.8% and 52.0 ± 0.7%, respectively (P < 0.05). In conclusion, vitrification by direct submerging of oocytes in clean liquid air (aseptic system) is a good alternative for using of not sterile liquid nitrogen.
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Source:Cryobiology
Author(s): Vladimir Isachenko, Plamen Todorov, Akerke Seisenbayeva, Yerzhan Toishibekov, Evgenia Isachenko, Gohar Rahimi, Peter Mallmann, Dolores Foth, Markus Merzenich
In fact, a full sterilization of commercially-produced liquid nitrogen contaminated with different pathogens is not possible. The aim of this study was to compare the viability of human pronuclear oocytes subjected to cooling by direct submerging of open carrier in liquid nitrogen versus submerging in clean liquid air (aseptic system). One- and three-pronuclei stage embryos (n = 444) were cryopreserved by direct plunging into liquid nitrogen (vitrified) in ethylene glycol (15%), dimethylsulphoxide (15%) and 0.2M sucrose. Oocytes were exposed in 20, 33, 50 and 100% vitrification solution for 2, 1 and 1 min, and 30–50 s, respectively at room temperature. Then first part of oocytes (n = 225) were directly plunged into liquid nitrogen, and second part of oocytes (n = 219) into liquid air. Oocytes were thawed rapidly at a speed of 20,000 °C/min and then subsequently were placed into a graded series of sucrose solutions (0.5, 0.25, 0.12 and 0.06M) at 2.5 min intervals and cultured in vitro for 3 days. In both groups, the rate of high-quality embryos (Grade 6A: 6 blastomeres, no fragmentation; Grade 8A: 8 blastomeres, no fragmentation; Grade 8A compacting: 8 blastomeres, beginning of compacting) was noted. The rates of high-quality embryos developed from one-pronuclear oocytes vitrified by cooling in liquid nitrogen and liquid air were: 39.4% ± 0.6 and 38.7% ± 0.8, respectively (P > 0.1). These rates for three-pronuclear oocytes were: 45.8 ± 0.8% and 52.0 ± 0.7%, respectively (P < 0.05). In conclusion, vitrification by direct submerging of oocytes in clean liquid air (aseptic system) is a good alternative for using of not sterile liquid nitrogen.
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Bark cells and xylem cells in Japanese white birch twigs initiate deacclimation at different temperatures
Publication date: Available online 21 November 2017
Source:Cryobiology
Author(s): Maya Takeuchi, Jun Kasuga
Appropriate timing of cold deacclimation is an important component of winter survival of perennial plants, such as trees, in temperate and boreal zones. Recently, concerns about predicted global climate change disturbing deacclimation timing have been increasing. The relationship between ambient temperatures and the manner by which cells' freezing resistance changes is essential for forecasting the timing of deacclimation. In this study, Japanese white birch twigs that underwent deacclimation treatment at a constant temperature of −2, 0, 4, 10, or 20 °C were separated into bark in which cells adapted to subfreezing temperatures by extracellular freezing and xylem in which cells adapted to subfreezing temperatures by deep supercooling, and the freezing resistance of cells in each tissue type was investigated by measuring percentage electrolyte leakage. Birch cells deacclimated in a different manner according to tissue type. Within 7 days under deacclimation treatment, xylem cells decreased their freezing resistance significantly at a high subfreezing temperature (−2 °C). In contrast, bark cells required a temperature of 10 or 20 °C for a detectable decrease in freezing resistance to occur within the same period. At a temperature lower than 0 °C, bark cells did not decrease their freezing resistance, even after 28 days of treatment. The difference in freezing behavior of cells might involve the difference in how deacclimation occurred in bark and xylem cells.
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Source:Cryobiology
Author(s): Maya Takeuchi, Jun Kasuga
Appropriate timing of cold deacclimation is an important component of winter survival of perennial plants, such as trees, in temperate and boreal zones. Recently, concerns about predicted global climate change disturbing deacclimation timing have been increasing. The relationship between ambient temperatures and the manner by which cells' freezing resistance changes is essential for forecasting the timing of deacclimation. In this study, Japanese white birch twigs that underwent deacclimation treatment at a constant temperature of −2, 0, 4, 10, or 20 °C were separated into bark in which cells adapted to subfreezing temperatures by extracellular freezing and xylem in which cells adapted to subfreezing temperatures by deep supercooling, and the freezing resistance of cells in each tissue type was investigated by measuring percentage electrolyte leakage. Birch cells deacclimated in a different manner according to tissue type. Within 7 days under deacclimation treatment, xylem cells decreased their freezing resistance significantly at a high subfreezing temperature (−2 °C). In contrast, bark cells required a temperature of 10 or 20 °C for a detectable decrease in freezing resistance to occur within the same period. At a temperature lower than 0 °C, bark cells did not decrease their freezing resistance, even after 28 days of treatment. The difference in freezing behavior of cells might involve the difference in how deacclimation occurred in bark and xylem cells.
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Protocol for cryopreservation of the turbot parasite Philasterides dicentrarchi (Ciliophora, Scuticociliatia)
Publication date: Available online 24 November 2017
Source:Cryobiology
Author(s): I. Folgueira, A.P. de Felipe, R.A. Sueiro, J. Lamas, J. Leiro
Philasterides dicentrarchi is a free-living marine ciliate that can become an endoparasite that causes a severe disease called scuticociliatosis in cultured fish. Long-term maintenance of this scuticociliate in the laboratory is currently only possible by subculture, with periodic passage in fish to maintain the virulence of the isolates. In this study, we developed and optimized a cryopreservation protocol similar to that used for the long-term storage of scuticociliates of the genus Miamiensis. The cryogenic medium comprised ATCC medium 1651 and a combination of 11% dimethylsulfoxide and 5% glycerol. We have verified that the most important factor ensuring the efficiency of the cryopreservation procedure is the growth phase of the culture, and that ciliates should be cryopreserved at the stationary phase (around the sixth day of culture). The cryopreservation protocol described here can be used for all strains of P. dicentrarchi as well as commercial strains of Miamiensis and enables the virulence of the strains to be maintained. Finally, this cryopreservation protocol has been shown to be more effective than others routinely applied to scuticociliates, yielding a higher survival rate with a lower initial concentration of ciliates. The results obtained indicate that the cropreservation protocol enables the long-term storage of scuticociliate parasites while maintaining the virulence of the isolates. The protocol is therefore suitable for use in vaccine production and related studies.
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Source:Cryobiology
Author(s): I. Folgueira, A.P. de Felipe, R.A. Sueiro, J. Lamas, J. Leiro
Philasterides dicentrarchi is a free-living marine ciliate that can become an endoparasite that causes a severe disease called scuticociliatosis in cultured fish. Long-term maintenance of this scuticociliate in the laboratory is currently only possible by subculture, with periodic passage in fish to maintain the virulence of the isolates. In this study, we developed and optimized a cryopreservation protocol similar to that used for the long-term storage of scuticociliates of the genus Miamiensis. The cryogenic medium comprised ATCC medium 1651 and a combination of 11% dimethylsulfoxide and 5% glycerol. We have verified that the most important factor ensuring the efficiency of the cryopreservation procedure is the growth phase of the culture, and that ciliates should be cryopreserved at the stationary phase (around the sixth day of culture). The cryopreservation protocol described here can be used for all strains of P. dicentrarchi as well as commercial strains of Miamiensis and enables the virulence of the strains to be maintained. Finally, this cryopreservation protocol has been shown to be more effective than others routinely applied to scuticociliates, yielding a higher survival rate with a lower initial concentration of ciliates. The results obtained indicate that the cropreservation protocol enables the long-term storage of scuticociliate parasites while maintaining the virulence of the isolates. The protocol is therefore suitable for use in vaccine production and related studies.
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Labia
Labia: Lips, the fleshy folds that surround the opening of the mouth (oral labia) or the vagina (the labia majora and labia minora).
MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
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Hyperhomocysteinemia-induced autophagy and apoptosis with downregulation of hairy enhancer of split 1/5 in cortical neurons in mice.
Hyperhomocysteinemia-induced autophagy and apoptosis with downregulation of hairy enhancer of split 1/5 in cortical neurons in mice.
Int J Immunopathol Pharmacol. 2017 Nov 01;:394632017740061
Authors: Zhang JW, Yan R, Tang YS, Guo YZ, Chang Y, Jing L, Wang YL, Zhang JZ
Abstract
It has been reported that hyperhomocysteinemia (HHcy) is associated with neurodegenerative and cardiovascular diseases. However, little is known about brain histomorphology, neuronal organelles, and hairy enhancer of split ( hes) expression under HHcy. In this study, non-HHcy and HHcy induced by high-methionine diet in apolipoprotein E-deficient (Apo E(-/-)) mice were comparatively investigated. The histomorphology, ultrastructure, autophagosomes, apoptosis, and expression of proteins, HES1, HES5 and P62, were designed to assess the effects of HHcy on brain. The results showed that compared to the non-HHcy mice, the HHcy group had an increase in autophagosomes, vacuolization in mitochondria, and neuron apoptosis; treatment with folate and vitamin B12 reduced the extent of these lesions. However, the elementary histomorphology, the numbers of cortical neurons, and Nissl bodies had no significant difference between the HHcy and the non-HHcy groups or the group treated with folate and vitamin B12. Immunohistochemistry and immunofluorescence demonstrated a decrease in HES1- or HES5-positive neurons in the HHcy group when compared to the non-HHcy groups, wild-type, and Apo E(-/-) controls, or the HHcy mice with folate and vitamin B12 supplement. Western blots showed that HHcy induced a decreased expression of HES1 and HES5, or P62, in which the expression of HES1 and P62 was elevated by treating with folate and vitamin B12 supplement. These results suggest that HHcy-enhanced brain damage is associated with increased autophagy and neuronal apoptosis in Apo E(-/-) mice, in which downregulation of hes1 and hes5 is involved.
PMID: 29171783 [PubMed - as supplied by publisher]
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Lichen striatus successfully treated with oral cyclosporine.
Lichen striatus successfully treated with oral cyclosporine.
Int J Immunopathol Pharmacol. 2017 Nov 01;:394632017744097
Authors: Romita P, Ettorre G, Bufano T, Marzullo A, Ballini A, Di Palma G, Inchingolo F, Foti C
Abstract
Lichen striatus is an acquired, benign, linear inflammatory dermatosis characterized by a sudden skin eruption along Blaschko's lines that usually is not associated with specific etiologic agents. In most cases, it is a self-limited dermatosis, but may relapse. Topical steroids are its first-line therapy, but this treatment is not always effective. We describe the case of a 45-year-old woman affected by a lichen striatus on her right limb resistant to topical corticosteroid therapy. The patient was successfully treated with cyclosporine (4 mg/kg/die) for 4 weeks with no recurrence of the dermatitis during the subsequent 1-year follow-up period.
PMID: 29171311 [PubMed - as supplied by publisher]
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quality of care; +60 new citations
60 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2017/11/25
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
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On computational fluid dynamics models for sinonasal drug transport: relevance of nozzle subtraction and nasal vestibular dilation.
On computational fluid dynamics models for sinonasal drug transport: relevance of nozzle subtraction and nasal vestibular dilation.
Int J Numer Method Biomed Eng. 2017 Nov 24;:
Authors: Basu S, Frank-Ito DO, Kimbell JS
Abstract
Generating anatomically realistic three-dimensional (3D) models of the human sinonasal cavity for numerical investigations of sprayed drug transport presents a host of methodological ambiguities. For example, subject-specific radiographic images used for 3D reconstructions typically exclude spray bottles. Subtracting a bottle contour from the 3D airspace and dilating the anterior nasal vestibule for nozzle placement augment the complexity of model-building. So, we explored the question: how essential are these steps to adequately simulate nasal airflow and identify the optimal delivery conditions for intranasal sprays? In particular, we focused on particle deposition patterns in the maxillary sinus, a critical target site for chronic rhinosinusitis (CRS). The models were reconstructed from post-surgery computed tomography scans for a 39-year-old Caucasian male, with CRS history. Inspiratory airflow patterns during resting breathing are reliably tracked through CFD-based steady state laminar-viscous modeling and such regimes portray relative lack of sensitivity to inlet perturbations. Consequently, we hypothesized that the posterior airflow transport and the particle deposition trends should not be radically affected by the nozzle subtraction and vestibular dilation. The study involved 1 base model and 2 derived models; the latter two with nozzle contours (two different orientations) subtracted from the dilated anterior segment of the left vestibule. We analyzed spray transport in the left maxillary sinus for multiple release conditions. Similar release points, localized on an approximately 2mm-by-4.5mm contour, facilitated improved maxillary deposition in all three test cases. This suggests functional redundancy of nozzle insertion in a 3D numerical model for identifying the optimal spray release locations. This article is protected by copyright. All rights reserved.
PMID: 29172251 [PubMed - as supplied by publisher]
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AHNS Series: Do you know your guidelines? Principles of treatment for locally advanced or unresectable head and neck squamous cell carcinoma.
AHNS Series: Do you know your guidelines? Principles of treatment for locally advanced or unresectable head and neck squamous cell carcinoma.
Head Neck. 2017 Nov 24;:
Authors: Fulcher CD, Haigentz M, Ow TJ, Education Committee of the American Head and Neck Society (AHNS)
Abstract
This article is a continuation of the "Do You Know Your Guidelines" series, initiated by the Education committee of the American Head and Neck Society. Treatment guidelines for advanced head and neck squamous cell carcinoma are reviewed here, including the critical roles of radiotherapy, chemotherapy, and the recent application of immunotherapy agents. We will be limiting this discussion to include cancers of the oral cavity, oropharynx, hypopharynx, and larynx. It should be noted that much of the article pertains to human papillomavirus (HPV)-negative oropharyngeal cancer where applicable, as HPV-positive oropharyngeal squamous cell carcinoma carries a different natural history, different prognosis, and now different staging criteria. Additionally, the article will not include information on nasopharyngeal or sinus cancers, as these latter topics are covered in separate "Do you know your guidelines?" installments and these diagnoses carry somewhat different approaches to diagnosis and management that diverge from the focus of this article.
PMID: 29171929 [PubMed - as supplied by publisher]
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Long-term outcomes in unilateral vocal fold paralysis patients.
Long-term outcomes in unilateral vocal fold paralysis patients.
Laryngoscope. 2017 Nov 24;:
Authors: McLaughlin CW, Swendseid B, Courey MS, Schneider S, Gartner-Schmidt JL, Yung KC
Abstract
OBJECTIVES/HYPOTHESIS: At presentation, unilateral vocal fold paralysis (UVFP) patients have different treatment options, including conservative management (CM), injection laryngoplasty (IL) with a temporary agent, or permanent medialization (PM). This study evaluates long-term outcomes for UVFP patients relative to intervention.
STUDY DESIGN: Retrospective chart review.
METHODS: A retrospective chart review was performed of UVFP patients who presented to the University of California San Francisco Voice and Swallowing Center. Videolaryngostroboscopy examinations were reviewed. Maximum glottic closure was quantified with the normalized glottic gap area (NGGA). Perceptual voice analysis was performed using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) at corresponding time points.
RESULTS: Fifty-three patients met inclusion criteria. Six underwent CM only, 20 went on to require PM, 19 underwent IL only, and eight underwent IL and subsequent PM. NGGA at presentation was similar among groups; however, the CM group was noted to have more favorable CAPE-V scores for Breathiness (P = .007) and Loudness (P = .018). All groups had similar NGGA and CAPE-V scores at last follow-up. When compared to pooled data for patients who underwent PM, the IL group was noted to have similar NGGA and CAPE-V scores at presentation. Although improvements in both groups were noted following intervention, both groups appeared similar at last follow-up with the exception of Roughness, for which the IL group retained a slightly improved outcome (13.3 vs. 18.3, P = .03).
CONCLUSIONS: At presentation, UVFP patients have similar NGGA. This finding suggests that treatment recommendations cannot be made on the size of the glottic gap alone. Furthermore, in many patients, IL results in long-term benefit with glottic closure and CAPE-V scores equivalent to that obtained with PM.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2017.
PMID: 29171729 [PubMed - as supplied by publisher]
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Perspectives in allergen immunotherapy: 2017 and beyond.
Perspectives in allergen immunotherapy: 2017 and beyond.
Allergy. 2017 Nov 24;:
Authors: Pfaar O, Bonini S, Cardona V, Demoly P, Jakob T, Jutel M, Kleine-Tebbe J, Klimek L, Klysner S, Kopp MV, Kuna P, Larché M, Muraro A, Schmidt-Weber CB, Shamji M, Simonsen K, Somoza C, Valovirta E, Zieglmayer P, Zuberbier T, Wahn U, FASIT group
Abstract
The Future of the Allergists and Specific Immunotherapy (FASIT) workshop provides a regular platform for global experts from academia, allergy clinics, regulatory authorities and industry to review developments in the field of allergen immunotherapy (AIT). The most recent meeting, held in February 2017, had two main themes: advances in AIT and hot topics in AIT from the regulatory point of view. The first theme covered opportunities for personalised AIT, advances in adjuvants and delivery systems, and the development of new molecules and future vaccines for AIT. Key topics in the second part of the meeting were the effects of the enactment of European Directive 2001/83 on the availability of allergens for therapy and diagnosis across the EU, the challenges of conducting Phase III studies in the field, the future role of allergen exposure chambers in AIT-studies, and specific considerations in performing AIT-studies in the paediatric population. Finally, the group highlighted the forthcoming EAACI guidelines and their particular importance for the standardisation of practice in the treatment of allergies. This supplement presents a comprehensive insight into those panel discussions and highlights unmet needs and also possible solutions to them for the future. This article is protected by copyright. All rights reserved.
PMID: 29171712 [PubMed - as supplied by publisher]
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Teaching frontal sinus anatomy using the frontal sinus masterclass 3- D conceptualization model.
Teaching frontal sinus anatomy using the frontal sinus masterclass 3- D conceptualization model.
Laryngoscope. 2017 Nov 24;:
Authors: Chen PG, McMains KC, Tewfik MA, Aden JK, Brown S, Weitzel EK
Abstract
OBJECTIVE: Frontal sinus anatomy is complex and often is a difficult subject to both teach and learn. The traditional surgical dogma of "see one, do one, teach one" is impractical and dangerous in the frontal sinus. Based on the building block three-dimensional conceptualization module, the Frontal Sinus Masterclass (FSMC) was created to teach this anatomy.
METHODS: Study was performed at two academic centers among second- to fifth-year otolaryngology residents. A pretest assessed knowledge prior to the course. Computed tomography scans of the sinuses were evaluated in triplanar view, and participants attempted to reconstruct the anatomy. Subsequently, the course instructor explained the anatomy using the building block method and showed a short video of the surgical dissection, pointing out relevant anatomy. Cases progressed in anatomical difficulty and inflammatory load. A posttest determined knowledge after the course.
RESULTS: Thirty of 50 participating residents completed the pre- and posttests (14 junior, 16 senior residents). Correct identification of the frontal sinus drainage pathway increased from 42% to 63% correct (P = 0.054). Anatomical assessment increased from 61% to 68% correct (P = 0.047), and overall assessment increased from 52% to 66% correct (P = 0.016).
CONCLUSION: Objectively, participants of the FSMC expanded on their ability to recognize cells of the frontal recess on CT scans. Before the class, residents could answer less than half of the answers correctly, and by the end of the class they were answering over two-thirds of these complex questions correctly. Subjectively, participants reported benefit from the course and felt they would be better surgeons.
LEVEL OF EVIDENCE: NA. Laryngoscope, 2017.
PMID: 29171672 [PubMed - as supplied by publisher]
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Meta-analysis of induction chemotherapy as selection marker for chemoradiation in the head and neck.
Meta-analysis of induction chemotherapy as selection marker for chemoradiation in the head and neck.
Laryngoscope. 2017 Nov 24;:
Authors: Kiong KL, de Souza NN, Sultana R, Iyer NG
Abstract
OBJECTIVE: Many trials incorporate induction chemotherapy (IC) in selecting for organ preservation in head and neck squamous cell carcinomas (HNSCC). However, few studies examine IC response in predicting for chemoradiation therapy (CRT) response. This meta-analysis aims to determine the predictive accuracy of IC for subsequent response to CRT and overall survival (OS).
DATA SOURCES: Medline, EMBASE, Cochrane register.
METHODS: A systematic search identified studies from database inception to October 2016 that used IC prior to CRT as definitive treatment for advanced HNSCC. The sensitivities and specificities of IC response predicting for complete CRT response were calculated, and the results were pooled in a summary receiver operating curve. One-, 2- and 5-year OS data were extracted.
RESULTS: Seven studies (n = 423 patients) were analyzed for response and six (n = 439) for OS. Pooled median sensitivity and specificity of IC response predicting CRT response were 0.95 (95% confidence interval [CI]: 0.72-0.98) and 0.43 (95% CI: 0.00-0.61), respectively. Patients were more likely to respond to CRT given previous response to IC (positive likelihood ratio = 1.6; 95% CI: 1.21-2.11) and less likely to respond to CRT if they failed to respond to IC (negative likelihood ratio = 0.16; 95% CI: 0.07-0.38). At 2 years, good response to IC was a statistically significant prognostic marker with a risk ratio of 1.35 (95% CI: 1.12-1.64).
CONCLUSION: Our data suggests that patients with poor IC response will have poorer response to CRT and should be directed to other modalities. In contrast, good IC response does not guarantee a favorable outcome to CRT; however, because these patients are likely to have better prognoses, they should be offered salvage therapies of curative intent despite treatment failure.
LEVEL OF EVIDENCE: NA. Laryngoscope, 2017.
PMID: 29171671 [PubMed - as supplied by publisher]
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Potential treatment for vocal fold scar with pirfenidone.
Potential treatment for vocal fold scar with pirfenidone.
Laryngoscope. 2017 Nov 24;:
Authors: Kodama H, Kumai Y, Nishimoto K, Toya Y, Miyamaru S, Furushima S, Yumoto E
Abstract
OBJECTIVES/HYPOTHESIS: Pirfenidone (PFD) is a strong antifibrotic agent that has been clinically approved in Japan for idiopathic pulmonary fibrosis. We examined the antifibrotic effects of PFD on fibroblasts isolated from scarred vocal folds (VFs) of ferrets in vitro.
STUDY DESIGN: Prospective animal experiments with controls.
METHODS: Scar fibroblasts (SFs) were isolated from scarred VFs that had been electrocauterized 2 weeks before harvesting (N = 4). Normal fibroblasts (NFs) were isolated from intact VFs (N = 4). SFs and NFs were incubated in the presence of 10 ng/mL transforming growth factor β1 (TGF-β1), with or without PFD. After the 48-hour incubation, mRNA expression levels of α smooth muscle actin (αSMA), TGF-β1, collagen type I, and hyaluronan synthase 2 (HAS2) were examined by real-time polymerase chain reaction. Immunohistochemistry with anti-αSMA anti-collagen type I and phosphorylated Smad (p-Smad)2/3 antibodies in SFs with or without PFD was performed. SFs and NFs were cultured in collagen gel with or without PFD for 48 hours, and the extent of gel contraction was examined quantitatively.
RESULTS: PFD treatment significantly (P < .05) decreased mRNA expression of collagen type I, significantly increased mRNA expression of TGF-β1 and HAS2, and significantly suppressed collagen gel contraction. However, it did not have a significant effect on the expression of αSMA. The expression of p-Smad2/3 in the nucleus was faded with PFD, possibly demonstrating the suppression of translocation of p-Smad2/3 from cytoplasm to nucleus with PFD.
CONCLUSIONS: This is the first report to demonstrate the in vitro antifibrotic effects of PFD on fibroblasts isolated from scarred VFs of ferrets.
LEVEL OF EVIDENCE: NA Laryngoscope, 2017.
PMID: 29171670 [PubMed - as supplied by publisher]
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Relationship between degree of obstruction and airflow limitation in subglottic stenosis.
Relationship between degree of obstruction and airflow limitation in subglottic stenosis.
Laryngoscope. 2017 Nov 24;:
Authors: Lin EL, Bock JM, Zdanski CJ, Kimbell JS, Garcia GJM
Abstract
OBJECTIVES: Subglottic stenosis (SGS) is one of the most common airway disorders in pediatric patients. Currently, treatment decisions rely primarily on the Cotton-Myer scale, which classifies SGS severity based on percentage reduction in airspace cross-sectional area (CSA). However, the precise relationship between upper airway resistance and subglottic CSA is unknown. We hypothesize that airway resistance can be described by the Bernoulli Obstruction Theory, which predicts that airway resistance is inversely proportional to airspace CSA ( R∝A-1) in cases of severe constriction.
METHODS: Computed tomography (CT) scans of six healthy subjects and five SGS patients were used to create three-dimensional models of the respiratory tract from nostrils to carina. Cylindrical segments of varying lengths and varying diameters were digitally inserted in the subglottis of the healthy subjects to create simulated SGS models. Computational fluid dynamics simulations were run, and airway resistance was computed in the simulated SGS models and actual SGS models.
RESULTS: Constriction diameter had a greater impact in airway resistance than constriction length. In agreement with the Bernoulli Obstruction Theory, airway resistance in the simulated SGS models was well represented by the power law R=aAb, where a is a constant and the exponent b ranged from -0.85 to -1.07. The percentage reduction in airflow (QOBSTRUCTIONQHEALTHY) at a constant pressure drop was found to be directly proportional to the percentage reduction in CSA (AOBSTRUCTIONAHEALTHY) in the limit of severe constrictions, namely QOBSTRUCTIONQHEALTHY=kAOBSTRUCTIONAHEALTHY, where k=2.25 ± 0.15. Airway resistances in the simulated SGS models were similar to resistances in models based on CT scans of actual SGS patients, suggesting that our simulated SGS models were representative of airway resistance in actual SGS patients.
CONCLUSION: Our computer simulations suggest that the degree of airflow limitation in SGS patients may be estimated based on anatomic measurements alone. Future studies are recommended to test these predictions in larger cohorts.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.
PMID: 29171660 [PubMed - as supplied by publisher]
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Epistaxis in children and adolescents with hereditary hemorrhagic telangiectasia.
Epistaxis in children and adolescents with hereditary hemorrhagic telangiectasia.
Laryngoscope. 2017 Nov 24;:
Authors: Gonzalez CD, Mcdonald J, Stevenson DA, Whitehead KJ, Petersen MG, Presson AP, Ding Q, Wilson KF
Abstract
OBJECTIVES/HYPOTHESIS: Our objective was to describe epistaxis onset and severity in pediatric hereditary hemorrhagic telangiectasia (HHT) patients and study the cumulative incidence of epistaxis by age of onset within each genetic subtype.
STUDY DESIGN: Retrospective cohort chart review.
METHODS: Charts were reviewed of patients age 0 to 18 years with a clinical or genetic diagnosis of HHT who were evaluated at a tertiary multidisciplinary HHT clinic from January 2010 to June 2016. The epistaxis severity score (ESS), a validated tool for assessing epistaxis severity, was used to assess epistaxis. Statistical analyses were conducted on the full HHT cohort as well as subgroups stratified by the HHT causative gene (HHT1 = ENG and HHT2 = ACVRL1).
RESULTS: Sixty-nine pediatric subjects were identified; 60 had HHT confirmed by genetic testing, and nine (from families with known mutations) met published clinical diagnostic criteria alone. Fifty-nine (85%) had onset of epistaxis. The median age of onset of epistaxis was 5 years (interquartile range [IQR]: 2-9 years). The median ESS for the entire cohort was 1.6 (IQR: 0-2.6). The median ESS was higher in HHT1 versus HHT2 (2.3 vs. 1.1, P = .002), and age of epistaxis onset was earlier in HHT1 (3 vs. 5 years, P = .03). Sex and age were not associated with ESS.
CONCLUSIONS: Epistaxis may present early in HHT, but is typically mild in the pediatric period. Severity in the pediatric population is worse in patients with HHT1. By recognizing the significance of even mild, infrequent epistaxis in a child with a family history of HHT, and understanding that not all HHT patients have epistaxis during childhood, community providers and otolaryngologist can assist in the early detection of HHT.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2017.
PMID: 29171658 [PubMed - as supplied by publisher]
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Investigation of the presence of HPV on KTP laser fibers following KTP laser treatment of papilloma.
Investigation of the presence of HPV on KTP laser fibers following KTP laser treatment of papilloma.
Laryngoscope. 2017 Nov 24;:
Authors: Dodhia S, Baxter PC, Ye F, Pitman MJ
Abstract
OBJECTIVES: Recurrent respiratory papillomatosis is often treated with in-office laser procedures using a potassium titanyl phosphate (KTP) laser transmitted through a laser fiber. Although effective, this procedure has notable downsides, including the possibility of transmitting human papillomavirus (HPV) in the smoke plume and the high cost of these single-use fibers. The objective of this study is to determine if HPV can be detected on a laser fiber after use, with or without sterilization.
METHODS: Twelve patients with laryngeal papillomas were treated with KTP laser energy transmitted via a KTP fiber. Ten fibers were sterilized in CIDEX (ASP, Irvine, California), a glutaraldehyde disinfectant, for 12 minutes, whereas two fibers were left unsterilized. Human papillomavirus DNA amplification was done on all 12 fiber samples with real-time polymerase chain reaction (PCR) using general primer mediated 5+ and 6+. Human papillomavirus genotyping detection was done using type specific probes and/or Sanger sequencing.
RESULTS: Over 27 strains of HPV were not detected on KTP fibers after use, with or without sterilization.
CONCLUSION: Human papillomavirus was undetectable by PCR on KTP laser fibers that were sterilized or unsterilized after use. Further studies are needed utilizing a transmission model to determine if HPV can be incubated from this fiber after sterilization.
LEVEL OF EVIDENCE: NA. Laryngoscope, 2017.
PMID: 29171656 [PubMed - as supplied by publisher]
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Oral sampling methods are associated with differences in immune marker concentrations.
Oral sampling methods are associated with differences in immune marker concentrations.
Laryngoscope. 2017 Nov 24;:
Authors: Fakhry C, Qeadan F, Gilman RH, Yori P, Kosek M, Patterson N, Eisele DW, Gourin CG, Chitguppi C, Marks M, Gravitt P
Abstract
OBJECTIVE: To determine whether the concentration and distribution of immune markers in paired oral samples were similar.
STUDY TYPE: Clinical research.
STUDY DESIGN: Cross-sectional study.
METHODS: Paired saliva and oral secretions (OS) samples were collected. The concentration of immune markers was estimated using Luminex multiplex assay (Thermo Fisher Scientific, Waltham, MA). For each sample, the concentration of respective immune markers was normalized to total protein present and log-transformed. Median concentrations of immune markers were compared between both types of samples. Intermarker correlation in each sampling method and across sampling methods was evaluated.
RESULTS: There were 90 study participants. Concentrations of immune markers in saliva samples were significantly different from concentrations in OS samples. Oral secretions samples showed higher concentrations of immunoregulatory markers, whereas the saliva samples contained proinflammatory markers in higher concentration.
CONCLUSION: The immune marker profile in saliva samples is distinct from the immune marker profile in paired OS samples.
LEVEL OF EVIDENCE: 2b. Laryngoscope, 2017.
PMID: 29171655 [PubMed - as supplied by publisher]
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Tubeless Total Intravenous Anesthesia Spontaneous Ventilation for Adult Suspension Microlaryngoscopy.
Tubeless Total Intravenous Anesthesia Spontaneous Ventilation for Adult Suspension Microlaryngoscopy.
Ann Otol Rhinol Laryngol. 2017 Nov 01;:3489417744223
Authors: Yoo MJ, Joffe AM, Meyer TK
Abstract
INTRODUCTION: Maintaining spontaneous ventilation (SV) under total intravenous anesthesia (TIVA) without an endotracheal tube provides uninterrupted and unobstructed surgical access for suspension microlaryngoscopy (SML). This study describes the method and outcome of adults who underwent SML under tubeless TIVA-SV.
METHODS: Retrospective review of adults who underwent SML between June 2014 and September 2016 using TIVA-SV without an endotracheal tube.
RESULTS: Sixty-six cases in 36 patients were included with mean age of 50.6 years and 52.7% were female. Airway pathology included 41.6% subglottic or tracheal stenosis, 19.4% laryngeal lesion or mass, 16.7% glottic stenosis, 13.9% recurrent respiratory papilloma, and 8.3% supraglottic stenosis. Anesthesia was most commonly provided by continuous infusion of propofol and remifentanil (57.6%). Approximately half (53%) of cases received superior laryngeal nerve block. Average operative time was 72.9 minutes (range, 27-166 minutes). Eight cases required supplemental ventilation: 6 cases required transient endotracheal ventilation or mask ventilation, and 2 cases were converted to alternative ventilation.
CONCLUSIONS: Total intravenous anesthesia is an attractive alternative to traditional endotracheal tube intubation, jet ventilation, or intermittent apneic ventilation for adult SML. During episodes of hypoventilation or desaturation, endotracheal ventilation, mask ventilation, or jet ventilation can effectively recover oxygenation.
PMID: 29171300 [PubMed - as supplied by publisher]
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Complete Malleus Removal for Cholesteatoma: A Multivariate Analysis of Ossiculoplasty Success and Residual Disease.
Complete Malleus Removal for Cholesteatoma: A Multivariate Analysis of Ossiculoplasty Success and Residual Disease.
Ann Otol Rhinol Laryngol. 2017 Nov 01;:3489417743519
Authors: Shapiro S, Bennett D, Wetmore S, Cassis A
Abstract
OBJECTIVE: Determine the effect of complete malleus removal during canal wall up tympanomastoidectomy for cholesteatoma on ossiculoplasty success and rate of residual cholesteatoma.
METHODS: We reviewed the operative, audiogram, and clinical reports of patients who underwent canal wall up tympanomastoidectomy for cholesteatoma between 2009 and 2016 at a tertiary academic medical center with at least 8 months of follow-up after surgery. To control for extent of disease, we independently catalogued the subsites of the middle ear and mastoid that cholesteatoma involved from each operation. We performed multivariate logistic regression to determine the independent effect of complete removal of the malleus on the rate of residual disease and success of ossiculoplasty.
RESULTS: One hundred eighty surgeries were included in the analysis. For ossiculoplasty success, the adjusted odds ratio of complete malleus removal was 1.7 (95% CI, 0.43-7.0, P = .43), which was not statistically significant. For residual disease, the adjusted odds ratio of complete malleus removal versus not was 0.29 (95% CI, 0.074-1.1, P = .076), which approached but did not meet statistical significance.
CONCLUSION: Though complete malleus removal does not independently decrease the rate of residual cholesteatoma, it may be a safe technique as it did not compromise ossiculoplasty success.
PMID: 29171281 [PubMed - as supplied by publisher]
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Cause-specific mortality in HPV+ and HPV- oropharyngeal cancer patients: insights from a population-based cohort.
Cause-specific mortality in HPV+ and HPV- oropharyngeal cancer patients: insights from a population-based cohort.
Cancer Med. 2017 Nov 24;:
Authors: Nørregaard C, Grønhøj C, Jensen D, Friborg J, Andersen E, von Buchwald C
Abstract
Identifying the causes of death in head and neck cancer patients can optimize follow-up and therapeutic strategies, but studies in oropharyngeal squamous cell carcinoma (OPSCC) patients stratified by HPV status are lacking. We report cause-specific mortality in a population-based cohort of patients with OPSCC. Patients who had been diagnosed with OPSCC (n = 1541) between 2000 and 2014 in eastern Denmark were included in the study. Causes of death were collected through medical files and the Danish National Cause of Death registry. Deaths were grouped as (1) primary oropharyngeal cancer, (2) secondary malignancies, (3) cardiovascular and pulmonary disease, or (4) other/unspecified. The cumulative incidence of death and specific causes of death were determined using risk analysis. At follow-up, 723 (47.5%) patients had died. The median time to and cause of death were determined: oropharyngeal cancer (n = 432; 1.00 year), secondary malignancies (n = 131; 2.37 years), cardiovascular and pulmonary causes (n = 58; 3.48 years), and unspecified causes (n = 102; 3.42 years). HPV/p16 status was the strongest predictor of improved survival across all causes of death. The only cause of death to decrease in incidence over the 2 years after treatment was death from OPSCC. HPV/p16 positivity was an independent factor for improved survival across all causes of death in patients with OPSCC. In addition, both HPV-positive and HPV-negative OPSCC patients faced high 5- and 10-year mortality rates. Implementing secondary screening and prevention strategies for late toxicity and mortality are major goals in managing the treatment of these patients.
PMID: 29171183 [PubMed - as supplied by publisher]
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Contemplating Resectability.
Contemplating Resectability.
Hastings Cent Rep. 2017 Nov;47(6):3-4
Authors: Shuman AG
Abstract
Suzie loves to talk. A successful mid-thirties businesswoman, she is a self-described social butterfly-which made her diagnosis of tongue cancer even more devastating. She came to the clinic complaining of a lump in her throat, which in most young healthy people turns out to be benign and easily treated. But not for Suzie, who had a very rare salivary tumor arising in the back of her tongue. Its slow growth was both a blessing and a curse; such tumors do not kill people quickly, but they typically require surgery. It would slowly and relentlessly grow until and unless we removed most of her tongue. In head and neck surgery, issues of appearance, identity, function, and communication are the foremost considerations when we decide when, and whether, to operate. As the adage goes, knowing when not to operate is the sine qua non of the wise surgeon. But the inverse is also true.
PMID: 29171050 [PubMed - in process]
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Letter to the editor of Acta Neurochirurgica: simultaneous pericranial and nasoseptal "double-flap" reconstruction after combined transcranial and endoscopic endonasal resection of anterior skull base tumors.
Letter to the editor of Acta Neurochirurgica: simultaneous pericranial and nasoseptal "double-flap" reconstruction after combined transcranial and endoscopic endonasal resection of anterior skull base tumors.
Acta Neurochir (Wien). 2017 Nov 24;:
Authors: Gabriel PJ, Eloy JA, Liu JK
PMID: 29170846 [PubMed - as supplied by publisher]
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Application of endoscopy in otology: Changes over the last 8years in Korean Otological Society.
Application of endoscopy in otology: Changes over the last 8years in Korean Otological Society.
Am J Otolaryngol. 2017 Sep 22;:
Authors: Oh SJ, Goh EK, Lee HM, Kong SK, Moon IJ, Chung JW, Lee IW
Abstract
OBJECTIVES: Despite the worldwide availability of endoscope in otology, it still has not replaced the microscopic surgery as it has for nose surgery. In 2008, we administered a questionnaire on the preference of using otoscopes in Korea. In light of the worldwide availability of endoscopic ear surgery, we have now conducted a more detailed survey to determine if this preference has changed over 8years.
SUBJECTS AND METHODS: A questionnaire consisting of 10 questions was used to survey members of the Korean Otological Society who were actively performing middle ear surgery. The responses to this questionnaire were compared to those from 2008. The study also determined the preference for endoscope use based on the surgeon's experience.
RESULTS: The mean surgical experience of the otologists was 12.7years. Endoscopy for tympanoplasty and tympanomastoidectomy increased over a period of 8years. In the outpatient clinic, the use of endoscopy also increased; over 8-year period, it surpassed the microscope as the most preferred diagnostic tool in the outpatient clinic. Greater than half of the operating rooms were equipped with endoscopic sets; however, only 4.5% of otologists acknowledged having endoscopic instruments.
CONCLUSION: Endoscopy for surgery and in outpatient clinic assessment increased in otology in Korea; however, endoscopes have consistently been used as an adjuvant to the microscope to improve visualization of the tympanic cavity rather than as a tool for totally endoscopic ear surgery.
PMID: 29169954 [PubMed - as supplied by publisher]
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Total caloric eye speed in patients with vestibular migraine.
Total caloric eye speed in patients with vestibular migraine.
Am J Otolaryngol. 2017 Nov 14;:
Authors: Thompson-Harvey A, Mikulec AA
Abstract
PURPOSE: Vestibular migraine is a common cause of dizziness that lacks a known objective test. This study examined total eye speed on caloric testing as a diagnostic marker for vestibular migraine.
MATERIALS AND METHODS: Retrospective chart review of patients seen in a tertiary otologic practice between 2004 and 2016 who had undergone caloric testing with water irrigation and had a diagnosis of vestibular migraine (n=34). A group of patients with benign paroxysmal positional vertigo (n=10) were used as a control group. Patients were grouped into quartiles based on total eye speed.
RESULTS: Only patients in the lowest quartile (total eye speed<79) had a diagnosis of vestibular migraine. All other quartiles included a mix of control and vestibular migraine patients.
CONCLUSION: Low total eye speed may be suggestive of a diagnosis of vestibular migraine, but most patients with vestibular migraine do not have low total eye speed.
PMID: 29169953 [PubMed - as supplied by publisher]
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Aggressive differentiated thyroid cancer.
Aggressive differentiated thyroid cancer.
Eur J Surg Oncol. 2017 Oct 06;:
Authors: Janjua N, Wreesmann VB
Abstract
Differentiated thyroid cancer is characteristically associated with an innocuous clinical course, but a minority of cases may manifest surprisingly aggressive behaviour. Such aggressive DTC are directly responsible for the majority of thyroid cancer related deaths. Moreover, they contribute indirectly to increased DTC-related morbidity, because our inability to differentiate these tumours from innocuous DTC at an early stagefuels a significant degree of DTC overtreatment around the globe. In the present paper we describe how improved understanding of the clinicopathological thyroid tumour progression model and optimization of clinical staging systems continues to improve our ability to diagnose and treat aggressive DTC. Early recognition of aggressive DTC allows instillation of an aggressive management strategy which is based upon surgical-oncologic completeness, and minimization of treatment-related sequelae through continued development of reconstructive options and focussed delivery of adjuvant treatments.
PMID: 29169931 [PubMed - as supplied by publisher]
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Serological prevalence and public health significance of brucellosis on a dairy farm in Namibia from 2011 to 2014
The main objective of this study was to determine the serological prevalence of brucellosis on a dairy farm with no past history of abortions, but where Brucella control measures including test and slaughter and ...
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Effectiveness of case management in the prevention of COPD re-admissions: a pilot study
Chronic obstructive pulmonary disease (COPD) exacerbations are associated with high disease burden and costs, especially in the case of hospitalizations. The overall number of hospital admissions due to exacer...
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Nutritional supplements in Anxiety Disorder.
Nutritional supplements in Anxiety Disorder.
Actas Esp Psiquiatr. 2017 Sep;45(Supplement):1-7
Authors: Fernández-Rodríguez M, Rodríguez-Legorburu I, López-Ibor Alcocer MI
Abstract
In recent years, a direct relation between the occurrence of anxiety disorders, sleep disturbances, and mood disorders has been observed as a consequence of poor or inadequate diet. Eating habits in Western societies have greatly changed in recent decades, with an increase in the consumption of foods low in vitamin and mineral content, high in caloric value, and rapidly prepared and easily consumed. It may be that the new lifestyles that directly affect family organization and planning interfere with following a proper diet. However, with increasing frequency, especially among young adults, there is interest in healthy and balanced nutrition, as well as learning culinary techniques. We reviewed the literature for this study, and describe the concept of anxiety and its existence in relation to dietary disorders, as well as alternatives for the treatment of these symptoms. The characteristics of these disorders and their impact on patients are analyzed. The information used in this work was obtained mainly from PubMed, PsycARTICLES, PsycCRITIQUES, and PsycINFO. It was retrieved using the keywords “mental health”, “nutrition”, “diet”, “phytotherapy”, “natural alternatives”, “anxiety”, “mood”, and “sleep disturbance”.
PMID: 29171640 [PubMed - in process]
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[Melatonin in the treatment of low back pain and predictors of its efficacy].
[Melatonin in the treatment of low back pain and predictors of its efficacy].
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(10):49-54
Authors: Kurganova YM, Danilov AB
Abstract
AIM: To assess analgesic properties of melatonin in the treatment of chronic non-specific low back pain and to study predictors of its efficacy.
MATERIAL AND METHODS: A study included 178 patients, aged from 40 to 65 years, with chronic non-specific low back pain during >3 month and the VAS score >3. Patients were stratified into 6 groups (3 pairs of comparison). In the first pair, patients of both groups received a combination of 500 mg of glucosamine hydrochloride and 500 mg of chondroitin sulfate; in the second pair - a combination of 500 mg of glucosamine hydrochloride and 500 mg of chondroitin sulfate and diclofenac, in the third pair - diclofenac. All patients received additionally melaxen. The duration of the study was 3 month in the first pair and one month in the second and third pairs. With regard to response to melatonin, patients of the main groups were divided into responders and non-responders. Baseline factors determining the efficacy of treatment with melatonin were studied.
RESULTS AND CONCLUSION: A significant reduction in pain intensity at movement and resting state was noted in all main groups compared to comparison groups. This result indicates possible analgesic properties of melatonin. Moreover, factors predicting the efficacy of such therapy were determined. Addition of melatonin to the standard scheme of low back pain treatment increases its efficacy, in particular in case of comorbidity of pain and sleep disorders and depressive symptoms.
PMID: 29171489 [PubMed - in process]
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[Intermittent hypoxia due to sleep apnea syndrome in patients with type 2 diabetes mellitus].
[Intermittent hypoxia due to sleep apnea syndrome in patients with type 2 diabetes mellitus].
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(10):16-21
Authors: Burchakov DI, Mayorov AY
Abstract
OBJECTIVES: To evaluate the possible association between intermittent hypoxia (IH) and HbA1c in patients with insufficient control type of 2 diabetes mellitus (T2DM).
MATERIAL AND METHODS: In this cross-sectional study 183 patients with HbAc1≥7% underwent three-channel overnight monitoring (ApneaLink) and completed Berlin Questionnaire, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Patients were divided in two groups, based on the cut-off value of oxygen desaturation index≥15.
RESULTS AND CONCLUSION: There were 79 (43%) patients with intermittent hypoxia, which was associated with poorer glycaemic control, defined as HbA1c>8.7% (sample median) in the univariate analysis and after adjustment for body mass index OR 2,40 (CI 1.21-4.95, p=0.021). Neither of three questionnaires yielded satisfactory results as a screening method in patients with T2DM. There is a need to implement instrumental screening of sleep-disordered breathing in this population and to study the effects of CPAP-therapy on glycaemic control and carbohydrate metabolism.
PMID: 29171483 [PubMed - in process]
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[Sleep quality and hormone levels in the morning and evening hours under chemical pollution].
[Sleep quality and hormone levels in the morning and evening hours under chemical pollution].
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(10):10-15
Authors: Budkevich RO, Budkevich EV
Abstract
AIM: To evaluate self-assessment of sleep and the level of hormones in the morning and evening in chemical pollution conditions.
MATERIAL AND METHODS: Three hundred adolescent and adult men living in the regions with low and high levels of chemical pollution were examined using questionnaires for self-assessment of quality of sleep, sleep hygiene, daytime sleepiness. Levels of cortisol and testosterone in the saliva were determined in the morning and evening hours by ELISA.
RESULTS AND CONCLUSION: In areas with low pollution level, there were normal changes in hormone levels with an increase in the morning and decrease in the evening. In high pollution conditions, the average levels of hormones increased, the morning-evening gradient disappeared. These conditions were also associated with an increase in daytime sleepiness and disturbances in the sleep-wake cycle and the endocrine regulation system that indicate the possibility of the development of internal desynchronosis.
PMID: 29171482 [PubMed - in process]
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Sleep-related hypermotor epilepsy activated by rapid eye movement sleep.
Sleep-related hypermotor epilepsy activated by rapid eye movement sleep.
Epileptic Disord. 2017 Nov 24;:
Authors: Wang X, Marcuse LV, Jin L, Zhang Y, Zhang W, Chen B, Yuan N, Wang B, Liu Y
Abstract
Most sleep-related seizures occur during non-rapid eye movement (NREM) sleep, particularly during stage changes. Sleep-related hypermotor epilepsy (SHE) is a rare epileptic syndrome characterized by paroxysmal motor seizures, mainly arising from NREM sleep. Here, we report a patient with SHE who had seven seizures captured on video-EEG-polysomnography during REM sleep. Ictal semiology of this patient ranged from brief paroxysmal arousals to hypermotor seizures. On EEG-polysomnography, the spontaneous arousals were more frequent during REM than NREM sleep, with a considerably higher arousal index in REM sleep (20/hour). While the reason for seizures during REM sleep in this patient is unclear, we speculate that the threshold and mechanisms of arousal during different sleep stages may be related to the occurrence of seizures. [Published with video sequences on http://ift.tt/1JI1vMB].
PMID: 29171396 [PubMed - as supplied by publisher]
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Canadian stroke best practice recommendations: Secondary prevention of stroke, sixth edition practice guidelines, update 2017.
Canadian stroke best practice recommendations: Secondary prevention of stroke, sixth edition practice guidelines, update 2017.
Int J Stroke. 2017 Jan 01;:1747493017743062
Authors: Wein T, Lindsay MP, Côté R, Foley N, Berlingieri J, Bhogal S, Bourgoin A, Buck BH, Cox J, Davidson D, Dowlatshahi D, Douketis J, Falconer J, Field T, Gioia L, Gubitz G, Habert J, Jaspers S, Lum C, McNamara Morse D, Pageau P, Rafay M, Rodgerson A, Semchuk B, Sharma M, Shoamanesh A, Tamayo A, Smitko E, Gladstone DJ, Heart and Stroke Foundation Canadian Stroke Best Practice Committees
Abstract
The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions. Notable changes in this sixth edition include the development of core elements for delivering secondary stroke prevention services, the addition of a section on cervical artery dissection, new recommendations regarding the management of patent foramen ovale, and the removal of the recommendations on management of sleep apnea. The Canadian Stroke Best Practice Recommendations include a range of supporting materials such as implementation resources to facilitate the adoption of evidence to practice, and related performance measures to enable monitoring of uptake and effectiveness of the recommendations. The guidelines further emphasize the need for a systems approach to stroke care, involving an interprofessional team, with access to specialists regardless of patient location, and the need to overcome geographic barriers to ensure equity in access within a universal health care system.
PMID: 29171361 [PubMed - as supplied by publisher]
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Sleep restriction and cognitive load affect performance on a simulated marksmanship task.
Sleep restriction and cognitive load affect performance on a simulated marksmanship task.
J Sleep Res. 2017 Nov 24;:
Authors: Smith CD, Cooper AD, Merullo DJ, Cohen BS, Heaton KJ, Claro PJ, Smith T
Abstract
Sleep restriction degrades cognitive and motor performance, which can adversely impact job performance and increase the risk of accidents. Military personnel are prone to operating under sleep restriction, and previous work suggests that military marksmanship may be negatively affected under such conditions. Results of these studies, however, are mixed and have often incorporated additional stressors (e.g. energy restriction) beyond sleep restriction. Moreover, few studies have investigated how the degree of difficulty of a marksmanship task impacts performance following sleep restriction. The purpose of the current experiment was to study the effects of sleep restriction on marksmanship while minimizing the potential influence of other forms of stress. A friend-foe discrimination challenge with greater or lesser degrees of complexity (high versus low load) was used as the primary marksmanship task. Active duty Soldiers were recruited, and allowed 2 h of sleep every 24 h over a 72-h testing period. Marksmanship tasks, cognitive assessment metrics and the NASA-Task Load Index were administered daily. Results indicated that reaction times to shoot foe targets and signal friendly targets slowed over time. In addition, the ability to correctly discriminate between friend and foe targets significantly decreased in the high-cognitive-load condition over time despite shot accuracy remaining stable. The NASA-Task Load Index revealed that, although marksmanship performance degraded, participants believed their performance did not change over time. These results further characterize the consequences of sleep restriction on marksmanship performance and the perception of performance, and reinforce the importance of adequate sleep among service members when feasible.
PMID: 29171171 [PubMed - as supplied by publisher]
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Reestablishment of individual sleep structure during a single 14-h recovery sleep episode after 58 h of wakefulness.
Reestablishment of individual sleep structure during a single 14-h recovery sleep episode after 58 h of wakefulness.
J Sleep Res. 2017 Nov 24;:
Authors: Hennecke E, Elmenhorst D, Mendolia F, Putzke M, Bauer A, Aeschbach D, Elmenhorst EM
Abstract
Sleep structure is highly stable within individuals but different between individuals. The present study investigated robustness of the individual sleep structure to extended total sleep deprivation. Seventeen healthy men spent a baseline night (23:00-07:00 hours), 58 h of sleep deprivation and a 14-h recovery night (17:00-07:00 hours) in the laboratory. Intraclass correlation coefficients showed that the agreement between baseline and recovery with respect to the proportion of the different sleep stages increased as a function of recovery sleep duration. High values were reached for most of the sleep stages at the end of 14 h of recovery sleep (intraclass correlation coefficients between 0.38 and 0.76). If sleep duration of the recovery night is extended to 14 h, sleep stage distribution resembles that of a baseline night underlining the robustness of the individual sleep structure.
PMID: 29171170 [PubMed - as supplied by publisher]
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The prevalence of narcolepsy in Catalunya (Spain).
The prevalence of narcolepsy in Catalunya (Spain).
J Sleep Res. 2017 Nov 24;:
Authors: Tió E, Gaig C, Giner-Soriano M, Romero O, Jurado MJ, Sansa G, Pujol M, Sans O, Álvarez-Guerrico I, Caballol N, Jimenez M, Becerra JL, Escartin A, Monasterio C, Molins A, Bove A, Viña J, Iranzo A, Cambrodi R, Calvo G, Morros R, Santamaria J
Abstract
Previous studies have estimated an overall prevalence for narcolepsy between 15 and 70 cases per 100 000 inhabitants. We aimed to estimate the prevalence of narcolepsy in Catalunya (Catalonia), a north-east region of Spain (7 424 754 inhabitants), on 31 December 2014 by identifying all living subjects diagnosed with narcolepsy. First, we identified patients diagnosed by one of the 13 sleep, paediatric or neurological departments that perform tests regularly to diagnose narcolepsy. In a second phase, we searched for additional patients with narcolepsy in a clinical database of the primary health-care system. Clinical files were reviewed and narcolepsy diagnosis validated according to the Brighton Collaboration case definitions. Three hundred and twenty-five patients had a validated diagnosis of narcolepsy in the specialized centres (mean age: 44.6 years, range: 6-89; male: 60.3%; 85% with narcolepsy type 1), including 17.8% cases in Brighton, definition level 1, 62.5% in level 2, 15.4% in level 3 and 4.3% in level 4a. The overall prevalence for narcolepsy was 4.4; 3.7 for narcolepsy type 1 and 0.7 cases per 100 000 inhabitants for narcolepsy type 2. Fifty-six additional narcoleptic patients were identified in the primary health-care system, increasing the overall prevalence to 5.2 cases per 100 000 inhabitants. Prevalence rates for narcolepsy type 1 increased from childhood to adulthood, but in subjects aged more than 50 years there was a substantial drop in prevalence rates, suggesting the presence of a significant pool of undiagnosed cases in this population. Narcolepsy can be considered a rare neurological disorder in Catalunya.
PMID: 29171110 [PubMed - as supplied by publisher]
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Assessing sleep quality using self-report and actigraphy in PTSD.
Assessing sleep quality using self-report and actigraphy in PTSD.
J Sleep Res. 2017 Nov 24;:
Authors: Slightam C, Petrowski K, Jamison AL, Keller M, Bertram F, Kim S, Roth WT
Abstract
Sleep disturbance is commonly reported by participants with post-traumatic stress disorder, but objective evidence of poor sleep is often absent. Here we compared self-report and actigraphic evaluations of sleep between veterans with post-traumatic stress disorder and controls. Participants reported their sleep retrospectively for the month before the recording night and on the recording night. On the recording night, they wore an Actiwatch-64 and were instructed to press the marker button upon getting into bed, each time they awoke, and at their final awakening. The post-traumatic stress disorder group reported much worse sleep than controls on the Pittsburgh Sleep Quality Index for the previous month and somewhat poorer sleep on the recording night. However, on the recording night, neither diary nor actigraphic measures of number of awakenings, total time in bed, nor time lying awake after sleep onset differed between participants with and without post-traumatic stress disorder. Diary-reported number of awakenings was fewer than actigraphically captured awakenings. These results suggest a memory bias towards remembering worse sleep on the nights before the recording night.
PMID: 29171107 [PubMed - as supplied by publisher]
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Elevated perseveration errors on a verbal fluency task in frequent nightmare recallers: a replication.
Elevated perseveration errors on a verbal fluency task in frequent nightmare recallers: a replication.
J Sleep Res. 2017 Nov 24;:
Authors: Carr M, Saint-Onge K, Blanchette-Carrière C, Paquette T, Nielsen T
Abstract
A recent study reported that individuals recalling frequent idiopathic nightmares (NM) produced more perseveration errors on a verbal fluency task than did control participants (CTL), while not differing in overall verbal fluency. Elevated scores on perseveration errors, an index of executive dysfunction, suggest a cognitive inhibitory control deficit in NM participants. The present study sought to replicate these results using a French-speaking cohort and French language verbal fluency tasks. A phonetic verbal fluency task using three stimulus letters (P, R, V) and a semantic verbal fluency task using two stimulus categories (female and male French first names) were administered to 23 participants with frequent recall of NM (≥2 NM per week, mean age = 24.4 ± 4.0 years), and to 16 CTL participants with few recalled NM (≤ 1 NM per month, mean age = 24.5 ± 3.8 years). All participants were French-speaking since birth and self-declared to be in good mental and physical health apart from their NM. As expected, groups did not differ in overall verbal fluency, i.e. total number of correct words produced in response to stimulus letters or categories (P = 0.97). Furthermore, groups exhibited a difference in fluency perseveration errors, with the NM group having higher perseveration than the CTL group (P = 0.03, Cohen's d = 0.745). This replication suggests that frequent NM recallers have executive inhibitory dysfunction during a cognitive association task and supports a neurocognitive model which posits fronto-limbic impairment as a neural correlate of disturbed dreaming.
PMID: 29171104 [PubMed - as supplied by publisher]
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Randomized, blinded, controlled trial on effectiveness of photobiomodulation therapy and exercise training in the fibromyalgia treatment.
Randomized, blinded, controlled trial on effectiveness of photobiomodulation therapy and exercise training in the fibromyalgia treatment.
Lasers Med Sci. 2017 Nov 23;:
Authors: da Silva MM, Albertini R, de Tarso Camillo de Carvalho P, Leal-Junior ECP, Bussadori SK, Vieira SS, Bocalini DS, de Oliveira LVF, Grandinetti V, Silva JA, Serra AJ
Abstract
This study evaluated the role of the phototherapy and exercise training (EXT) as well as the combined treatment in general symptoms, pain, and quality of life in women suffering from fibromyalgia (FM). A total of 160 women were enrolled and measures were carried out in two sets: it was sought to identify the acute effect for a single phototherapy and EXT session (Set 1); long-term effect (10 weeks) of the interventions (Set 2). Phototherapy irradiation was performed at 11 locations in their bodies, employing a cluster with nine diodes (one super-pulsed infrared 905 nm, four light-emitting diodes [LEDs] of 640 nm, and four LEDs of 875 nm, 39.3 J per location). Algometry and VAS instrument were applied to evaluate pain. The FM symptoms were evaluated with Fibromyalgia Impact Questionnaire (FIQ) and Research Diagnostic Criteria (RDC) instruments. Quality of life was assessed through SF-36 survey. Set 1: pain threshold was improved with the phototherapy, and EXT improved the pain threshold for temporomandibular joint (right and left body side) and occipital site (right body side). Set 2: there was improved pain threshold in several tender points with the phototherapy and EXT. There was an overlap of therapies to reduce the tender point numbers, anxiety, depression, fatigue, sleep, and difficulty sleeping on FIQ/RDC scores. Moreover, quality of life was improved with both therapies. The phototherapy and EXT improved the pain threshold in FM women. A more substantial effect was noticed for the combined therapy, in which pain relief was accomplished by improving VAS and FIQ scores as well as quality of life.
PMID: 29170901 [PubMed - as supplied by publisher]
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Brain Networks are Independently Modulated by Donepezil, Sleep, and Sleep Deprivation.
Brain Networks are Independently Modulated by Donepezil, Sleep, and Sleep Deprivation.
Brain Topogr. 2017 Nov 23;:
Authors: Wirsich J, Rey M, Guye M, Bénar C, Lanteaume L, Ridley B, Confort-Gouny S, Cassé-Perrot C, Soulier E, Viout P, Rouby F, Lefebvre MN, Audebert C, Truillet R, Jouve E, Payoux P, Bartrés-Faz D, Bordet R, Richardson JC, Babiloni C, Rossini PM, Micallef J, Blin O, Ranjeva JP, Pharmacog Consortium
Abstract
Resting-state connectivity has been widely studied in the healthy and pathological brain. Less well-characterized are the brain networks altered during pharmacological interventions and their possible interaction with vigilance. In the hopes of finding new biomarkers which can be used to identify cortical activity and cognitive processes linked to the effects of drugs to treat neurodegenerative diseases such as Alzheimer's disease, the analysis of networks altered by medication would be particularly interesting. Eleven healthy subjects were recruited in the context of the European Innovative Medicines Initiative 'PharmaCog'. Each underwent five sessions of simultaneous EEG-fMRI in order to investigate the effects of donepezil and memantine before and after sleep deprivation (SD). The SD approach has been previously proposed as a model for cognitive impairment in healthy subjects. By applying network based statistics (NBS), we observed altered brain networks significantly linked to donepezil intake and sleep deprivation. Taking into account the sleep stages extracted from the EEG data we revealed that a network linked to sleep is interacting with sleep deprivation but not with medication intake. We successfully extracted the functional resting-state networks modified by donepezil intake, sleep and SD. We observed donepezil induced whole brain connectivity alterations forming a network separated from the changes induced by sleep and SD, a result which shows the utility of this approach to check for the validity of pharmacological resting-state analysis of the tested medications without the need of taking into account the subject specific vigilance.
PMID: 29170853 [PubMed - as supplied by publisher]
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Design and Rationale for a Technology-based Healthy Lifestyle Intervention in Older Adults Grieving the Loss of a Spouse.
Design and Rationale for a Technology-based Healthy Lifestyle Intervention in Older Adults Grieving the Loss of a Spouse.
Contemp Clin Trials Commun. 2017 Dec;8:99-105
Authors: Stahl ST, Emanuel J, Albert SM, Dew MA, Schulz R, Robbins-Welty G, Reynolds CF
Abstract
Introduction: Experiencing the death of a spouse during late life is associated with an increased risk of developing debilitating mental health problems. Healthy lifestyle practices, such as regular exercise, healthy eating, and good sleep hygiene are promising strategies to influence the mental health and associated physical symptoms of late-life spousal bereavement.
Objective: This paper describes the design and rationale of an intervention development study addressing selective and indicated prevention of depression, anxiety, and/or complicated grief disorder(s) among adults 60 years and older who are grieving the recent loss (within 8 months) of a spouse or partner.
Methods: In Phase I, now complete, we developed and standardized behavioral self-monitoring of daily lifestyle choices via an electronic diary (BSM) and the combined BSM + motivational interviewing-based lifestyle coaching (BSM+MI) to be administered to participants grieving the loss of loved one. In Phase II, we have been implementing the interventions in a randomized controlled trial and addressing challenges related to recruitment. Randomization is to one of three cells: BSM, BSM+MI, or an enhanced usual care condition.
Discussion: Several challenges in implementing our lifestyle interventions to older widow(er)s who are at risk for common mental disorders have been identified. Direct outreach to hospice organizations is an effective way to identify older adults in the early months following spousal death. Results from study may advance the field of grief support and promote a healthy adaptation to widowhood.
PMID: 29170758 [PubMed]
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Increased core body temperature in astronauts during long-duration space missions.
Increased core body temperature in astronauts during long-duration space missions.
Sci Rep. 2017 Nov 23;7(1):16180
Authors: Stahn AC, Werner A, Opatz O, Maggioni MA, Steinach M, von Ahlefeld VW, Moore A, Crucian BE, Smith SM, Zwart SR, Schlabs T, Mendt S, Trippel T, Koralewski E, Koch J, Choukèr A, Reitz G, Shang P, Röcker L, Kirsch KA, Gunga HC
Abstract
Humans' core body temperature (CBT) is strictly controlled within a narrow range. Various studies dealt with the impact of physical activity, clothing, and environmental factors on CBT regulation under terrestrial conditions. However, the effects of weightlessness on human thermoregulation are not well understood. Specifically, studies, investigating the effects of long-duration spaceflight on CBT at rest and during exercise are clearly lacking. We here show that during exercise CBT rises higher and faster in space than on Earth. Moreover, we observed for the first time a sustained increased astronauts' CBT also under resting conditions. This increase of about 1 °C developed gradually over 2.5 months and was associated with augmented concentrations of interleukin-1 receptor antagonist, a key anti-inflammatory protein. Since even minor increases in CBT can impair physical and cognitive performance, both findings have a considerable impact on astronauts' health and well-being during future long-term spaceflights. Moreover, our findings also pinpoint crucial physiological challenges for spacefaring civilizations, and raise questions about the assumption of a thermoregulatory set point in humans, and our evolutionary ability to adapt to climate changes on Earth.
PMID: 29170507 [PubMed - in process]
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Daily Time-Use Patterns and Obesity and Mental Health among Primary School Students in Shanghai: A Population-Based Cross-Sectional Study.
Daily Time-Use Patterns and Obesity and Mental Health among Primary School Students in Shanghai: A Population-Based Cross-Sectional Study.
Sci Rep. 2017 Nov 23;7(1):16200
Authors: Zhang Y, Zhang D, Li X, Ip P, Ho F, Jiang Y, Sun W, Zhu Q, Zhu W, Zhang J, Zhao H, Wang G, Shen X, Jiang F
Abstract
Physical activity, screen viewing, sleep, and homework among children have been independently linked to health outcomes. However, few studies have assessed the independent associations between time spent in daily activities and children's physical and mental health. This study describes time spent in four activities among primary school students in Shanghai, and examines the relationship between daily time-use patterns and obesity and mental health. The representative sample consists of 17,318 children aged 6-11 years in Shanghai. Time spent in moderate to vigorous physical activities (MVPA), screen viewing, sleep, and homework was measured by validated questionnaires. Logistic regressions were performed. We also fitted generalized additive models (GAM) and performed two-objective optimization to minimize the probability of poor mental health and obesity. In 2014, 33.7% of children spent ˂1 hour/day on MVPA, 15.6% spent ≥ 2 hours/day on screen viewing, 12.4% spent ˂ 9 hours/day on sleep, and 27.2% spent ≥ 2 hours/day on homework. The optimization results suggest that considering the 24-hour time limit, children face trade-offs when allocating time. A priority should be given to the duration of sleep and MVPA. Screen exposure should be minimized to save more time for sleep and other beneficial activities.
PMID: 29170506 [PubMed - in process]
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Idiopathic REM sleep behaviour disorder and neurodegeneration - an update.
Idiopathic REM sleep behaviour disorder and neurodegeneration - an update.
Nat Rev Neurol. 2017 Nov 24;:
Authors: Högl B, Stefani A, Videnovic A
Abstract
So-called idiopathic rapid eye movement (REM) sleep behaviour disorder (RBD), formerly seen as a rare parasomnia, is now recognized as the prodromal stage of an α-synucleinopathy. Given the very high risk that patients with idiopathic RBD have of developing α-synucleinopathies, such as Parkinson disease (PD), PD dementia, dementia with Lewy bodies or multiple system atrophy, and the outstandingly high specificity and very long interval between the onset of idiopathic RBD and the clinical manifestations of α-synucleinopathies, the prodromal phase of this disorder represents a unique opportunity for potentially disease-modifying intervention. This Review provides an update on classic and novel biomarkers of α-synuclein-related neurodegeneration in patients with idiopathic RBD, focusing on advances in imaging and neurophysiological, cognitive, autonomic, tissue-specific and other biomarkers. We discuss the strengths, potential weaknesses and suitability of these biomarkers for identifying RBD and neurodegeneration, with an emphasis on predicting progression to overt α-synucleinopathy. The role of video polysomnography in providing quantifiable and potentially treatment-responsive biomarkers of neurodegeneration is highlighted. In light of all these advances, and the now understood role of idiopathic RBD as an early manifestation of α-synuclein disease, we call for idiopathic RBD to be reconceptualized as isolated RBD.
PMID: 29170501 [PubMed - as supplied by publisher]
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Publisher Correction: Cortical dendritic activity correlates with spindle-rich oscillations during sleep in rodents.
Publisher Correction: Cortical dendritic activity correlates with spindle-rich oscillations during sleep in rodents.
Nat Commun. 2017 Nov 23;8(1):1838
Authors: Seibt J, Richard CJ, Sigl-Glöckner J, Takahashi N, Kaplan DI, Doron G, de Limoges D, Bocklisch C, Larkum ME
Abstract
In the originally published version of this Article, incorrect references were cited on two occasions in the Results section. Under the subheading 'Ca(2+) activity in single dendrites and somata of L5 neurons', the final sentence of the second paragraph incorrectly cited reference 29 instead of reference 31. Under the subheading 'Spiking of L5 cell bodies is not influenced by spindles', the first sentence cited reference 30 instead of reference 29. These errors have now been corrected in both the PDF and HTML versions of the Article.
PMID: 29170378 [PubMed - in process]
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38 A comparison of two interventions in the treatment of severe ankle sprains and distal fibular avulsion fractures: a patient perspective.
38 A comparison of two interventions in the treatment of severe ankle sprains and distal fibular avulsion fractures: a patient perspective.
Emerg Med J. 2017 Dec;34(12):A886-A887
Authors: Powell S
Abstract
: Stable ankle injuries are highly prevalent in Emergency Departments across the UK. Appropriate management to enable patients to experience a smooth recovery and prevent chronic ankle instability or reoccurrence is a priority. Current literature states that stable ankle fractures and severe ankle sprains can be successfully managed with the below knee plaster or the aircast brace and crutches. The functional brace has proved to be clinically effective in several reports. There has however, been no research to measure patient satisfaction levels between these two treatments.An experimental, mixed method approach to the researching of this issue was performed in a busy, central London Emergency Department; a randomised controlled trial undertaken to compare the two devices and quantitative and qualitative data collection by means of a tailored questionnaire to determine patient satisfaction. Thirty nine patients were recruited during hospital attendance over 9 months. Patients were requested to complete the questionnaire 7 days into their treatment via post; stamped addressed envelopes were provided. Telephone interview was adopted as a secondary measure when postal responses failed. The primary outcome measured was patient satisfaction levels regarding comfort of the device, pain relief, daily activities, sleep, work, care of dependents and social life measured by use of a likert scale; ranging from very unsatisfactory to very satisfactory. The null hypothesis is that there is no significant difference in satisfaction levels between the two devices. Data was analysed using the unrelated t test.31 responses were obtained; 16 participants with avulsion fractures to the distal fibular and 15 severe ankle sprains, 16 allocated to the ankle brace and 15 to the plaster. The findings demonstrate that there were statistically significant higher patient satisfaction levels in patients treated with an aircast brace than with the plaster cast. Using a probability level of 0.01, the critical value was 2.756, the t value 4.996; therefore the null hypothesis was rejected. The main indicators contributing to these findings were in the levels of comfort, daily activities, sleep work and social life. Overall it appears that patients preferred treatment with the aircast brace. Both forms of treatment were clinically equally effective in this study.Evidence indicates that our current department guidelines may need to be re-evaluated. In addition, this a study focused on patient-centred care. The questionnaire developed, could potentially be used to measure patient satisfaction in other fields.
PMID: 29170335 [PubMed - in process]
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SLEEP DISORDER AND ALTERED LOCOMOTOR ACTIVITY AS BIOMARKERS OF THE PARKINSON'S DISEASE CHOLINOPATHY IN RAT.
SLEEP DISORDER AND ALTERED LOCOMOTOR ACTIVITY AS BIOMARKERS OF THE PARKINSON'S DISEASE CHOLINOPATHY IN RAT.
Behav Brain Res. 2017 Nov 20;:
Authors: Ciric J, Lazic K, Kapor S, Perovic M, Petrovic J, Pesic V, Kanazir S, Saponjic J
Abstract
In order to find out the possible earliest biomarkers of Parkinson's disease (PD) cholinopathy, we followed the impact of bilateral pedunculopontine tegmental nucleus (PPT) lesion in rat on: the cortical and hippocampal sleep/wake states architectures, all sleep states related EEG microstructures, sleep spindles, the basal and stimulated locomotor activity. Sleep and basal locomotor activity in adult Wistar rats were followed during their inactive circadian phase, and throughout the same aging period. The bilateral PPT lesions were done by 0.1M ibotenic acid (IBO) during the surgical procedure for implantation of the electroencephalographic (EEG) and electromyographic (EMG) electrodes for chronic sleep recording. The cholinergic neuronal loss was identified by NADPH - diaphorase histochemistry. After all sleep and behavioral recording sessions, the locomotor activity was stimulated by d-amphetamine (d-AMPH) and the neuronal activity of striatum was followed by c-Fos immunolabeling. Impaired cholinergic innervation from the PPT was expressed earlier as sleep disorder then as movement disorder, and it was the earliest and long-lasting at hippocampal and thalamo-cortical level, and followed by a delayed "hypokinesia". This severe impact of a tonically impaired PPT cholinergic innervation was evidenced as the cholinergic interneuronal loss of the caudate putamen and as a suppressed c-Fos expression after stimulation by d-AMPH. In order how they occurred, the hippocampal non rapid eye movement (NREM) sleep disorder, altered high voltage sleep spindle (HVS) dynamics during rapid eye movement (REM) sleep in the hippocampus and motor cortex, and "hypokinesia" may serve as the biomarkers of PD cholinopathy onset and progression.
PMID: 29170000 [PubMed - as supplied by publisher]
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BS12-assisted flotation for the intensification of SNPs separation from CMP wastewater using a novel flotation column.
BS12-assisted flotation for the intensification of SNPs separation from CMP wastewater using a novel flotation column.
J Hazard Mater. 2017 Nov 21;344:788-796
Authors: Hu N, Shu T, Wu Z, Liu G, Li Z, Zhao Y, Yin H, Huang D
Abstract
In view of the extremely small size, high stable dispersion and intricate colloidal nature of silica nanoparticles (SNPs) in chemical mechanical polishing (CMP) wastewater, they might not only have hazards for environment and human health, but also cause low separation efficiency by classical water-treatment processes. Thus, it would be an important challenge to develop an efficient flotation technology for the separation SNPs. For this propose, this paper firstly presented the interaction between SNPs and dodecyl dimethyl betaine (ambient-friendly surfactant). Secondly, a novel flotation column was developed for strengthening interfacial adsorption by micro-bubbles and enhancing foam drainage by internal of regular-decagonal hollow frustum (RHF). One vital finding was that the mixture of micro-bubbles and macro-bubbles was conducive to improving the flotation performance. Under the suitable operating conditions, the enrichment ratio (E) and recovery percentage (R) of SNPs could reach 30.4±1.5 and 90.8±4.5%, respectively. The great E and R were obtained simultaneously, revealing a good participation of RHF in the flotation. Without a doubt, owing to the low chemical reagent addition and the high flotation performance, it was clear that our flotation has huge implications for the separation of nanoparticles from their wastewaters.
PMID: 29172165 [PubMed - as supplied by publisher]
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Genetic characterization, micropropagation, and potential use for arsenic phytoremediation of Dittrichia viscosa (L.) Greuter.
Genetic characterization, micropropagation, and potential use for arsenic phytoremediation of Dittrichia viscosa (L.) Greuter.
Ecotoxicol Environ Saf. 2017 Nov 21;148:675-683
Authors: Guarino F, Conte B, Improta G, Sciarrillo R, Castiglione S, Cicatelli A, Guarino C
Abstract
In the last decade, many scientists have focused their attention on the search for new plant species that can offer improved capacities to reclaim polluted soils and waters via phytoremediation. In this study, seed batches from three natural populations of Dittrichia viscosa, harvested in rural, urban, and industrial areas of central and southern Italy, were used to: (i) evaluate the genetic and morphological diversity of the populations; (ii) develop an efficient protocol for in-vitro propagation from seedling microcuttings; (iii) achieve optimal acclimatization of micropropagated plants to greenhouse conditions; (iv) test the response to arsenic (As) soil contamination of micropropagated plants. The genetic biodiversity study, based on Random Amplification of Polymorphic DNA (RAPD), as well as the morphometric analysis of 20 seedlings from each population revealed some degree of differentiation among populations. Based on these data, the most biodiverse plants from the three populations (10 lines each) were clonally multiplied by micropropagation using microcuttings of in-vitro grown seedlings. Three culture media were tested and Mureshige and Skoog medium was chosen for both seedling growth and micropropagation. The micropropagated plants responded well to greenhouse conditions and over 95% survived the acclimatization phase. Four clones were tested for their capacity to grow on soil spiked with NaAsO2 and to absorb and accumulate the metalloid. All clones tolerated up to 1.0mg As. At the end of the trial (five weeks), As was detectable only in leaves of As-treated plants and concentration varied significantly among clones. The amount of As present in plants (leaves) corresponded to ca. 0.10-1.7% of the amount supplied. However, As was no longer detectable in soil suggesting that the metalloid was taken up, translocated and probably phytovolatilized.
PMID: 29172148 [PubMed - as supplied by publisher]
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A molecularly imprinted electrochemiluminescence sensor based on upconversion nanoparticles enhanced by electrodeposited rGO for selective and ultrasensitive detection of clenbuterol.
A molecularly imprinted electrochemiluminescence sensor based on upconversion nanoparticles enhanced by electrodeposited rGO for selective and ultrasensitive detection of clenbuterol.
Biosens Bioelectron. 2017 Nov 21;102:357-364
Authors: Jin X, Fang G, Pan M, Yang Y, Bai X, Wang S
Abstract
A simple, efficient and sensitive molecularly imprinted electrochemiluminescence sensor (MIECLS) based on reduced graphene oxide (rGO) and upconversion nanoparticles (UCNPs) was developed for determination of clenbuterol (CLB). In this study, rGO generated by electrodeposition of graphene oxide not only acted as carrier for immobilizing UCNPs, but also had a significant impact in boosting electrochemiluminescence (ECL) response of UCNPs thanks to its high conductivity, superior electron transport rate and large specific surface area. UCNPs as an advanced ECL emitter possessed wonderful ECL performance. Furthermore, the introduction of molecularly imprinted polymers (MIP) endowed the ECL sensor a new character of specifically identifying analyte CLB. Under the optimal experimental conditions, the ECL signal was proportional to the logarithm of CLB concentration in the range of 10nM to 100µM with a low detection limit of 6.3nM. The proposed MIECLS combining the advantages of UCNPs-ECL and MIP exhibited good sensitivity, desirable selectivity and favorable stability, indicating enormous potential in the future of food safety detection.
PMID: 29172144 [PubMed - as supplied by publisher]
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Potentiation by potassium iodide reveals that the anionic porphyrin TPPS4 is a surprisingly effective photosensitizer for antimicrobial photodynamic inactivation.
Potentiation by potassium iodide reveals that the anionic porphyrin TPPS4 is a surprisingly effective photosensitizer for antimicrobial photodynamic inactivation.
J Photochem Photobiol B. 2017 Oct 31;178:277-286
Authors: Huang L, El-Hussein A, Xuan W, Hamblin MR
Abstract
We recently reported that addition of the non-toxic salt, potassium iodide can potentiate antimicrobial photodynamic inactivation of a broad-spectrum of microorganisms, producing many extra logs of killing. If the photosensitizer (PS) can bind to the microbial cells, then delivering light in the presence of KI produces short-lived reactive iodine species, while if the cells are added after light the killing is caused by molecular iodine produced as a result of singlet oxygen-mediated oxidation of iodide. In an attempt to show the importance of PS-bacterial binding, we compared two charged porphyrins, TPPS4 (thought to be anionic and not able to bind to Gram-negative bacteria) and TMPyP4 (considered cationic and well able to bind to bacteria). As expected TPPS4+light did not kill Gram-negative Escherichia coli, but surprisingly when 100mM KI was added, it was highly effective (eradication at 200nM+10J/cm(2) of 415nm light). TPPS4 was more effective than TMPyP4 in eradicating the Gram-positive bacteria, methicillin-resistant Staphylococcus aureus and the fungal yeast Candida albicans (regardless of KI). TPPS4 was also highly active against E. coli after a centrifugation step when KI was added, suggesting that the supposedly anionic porphyrin bound to bacteria and Candida. This was confirmed by uptake experiments. We compared the phthalocyanine tetrasulfonate derivative (ClAlPCS4), which did not bind to bacteria or allow KI-mediated killing of E. coli after a spin, suggesting it was truly anionic. We conclude that TPPS4 behaves as if it has some cationic character in the presence of bacteria, which may be related to its delivery from suppliers in the form of a dihydrochloride salt.
PMID: 29172135 [PubMed - as supplied by publisher]
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Synthesis, characterisation, cellular uptake and cytotoxicity of functionalised magnetic ruthenium (II) polypyridine complex core-shell nanocomposite.
Synthesis, characterisation, cellular uptake and cytotoxicity of functionalised magnetic ruthenium (II) polypyridine complex core-shell nanocomposite.
J Photochem Photobiol B. 2017 Nov 03;178:270-276
Authors: Kandibanda SR, Gundeboina N, Das S, Sunkara VM
Abstract
The development of multifunctional nanoparticles comprising of a magnetic core in conjunction with appropriate molecules with capabilities to impart functionalities like luminescent, specific binding sites to facilitate attachment of moieties. This has attracted increasing attention and enables identification of promising candidates using for applications such as diagnostics and cure through early detection and localized delivery. Many studies have been performed on the synthesis and cellular interactions of core-shell nanoparticles, in which a functional inorganic core is coated with a biocompatible polymer layer that should reduce nonspecific uptake and cytotoxicity Here we report the synthesis and characterisation of multifunctional core-shell magnetic, luminescent nanocomposite (Fe3O4@SiO2@[Ru(Phen)3](2+)@SiO2@NH2). Fe3O4 as core and a luminescent ruthenium (II) complex encapsulated with silica shell, and then it is functionalized by an amine group by APTMS. The magnetic, luminescent, and biological activity of this multifunctional nanocomposite have also been studied to prove the nanocomposite is biocompatible, cellular uptake. The synthesized nanocomposite was completely characterized by X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, transmission electron microscopy (TEM), vibrating sample magnetometer (VSM), and emission spectroscopy. MTT assay and cellular uptake by flow cytometry results proved that magnetic ruthenium (II) polypyridine complex - core shell nanocomposite has biocompatibility, minimum cytotoxicity and internalized inside B16F10 cells and confirms the potential biomedical applications.
PMID: 29172134 [PubMed - as supplied by publisher]
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