Photomedicine and Laser Surgery , Vol. 0, No. 0.
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Τρίτη 25 Ιουλίου 2017
Effect of Low-Level Laser Therapy on Bone Regeneration During Osseointegration and Bone Graft
The chemistry and toxicity of discharge waters from copper mine tailing impoundment in the valley of the Apuseni Mountains in Romania
Abstract
Copper mining generates large quantities of waste, tailings, and acid outflows causing long-term environmental impacts and potential threats to human health. Valea Şesei is the largest tailing impoundment in Romania, created by flooding the valley (known as Valea Şesei) of the Metalliferous Mountains (a division of the Apuseni Mountains) with copper mining waste. The present study (i) estimated the total volume of tailings in this area; (ii) screened the concentration of 65 elements (rare earth and platinum group elements, alkali metals and alkali earth metals, transition and post-transition metals and metalloids) and cyanide concentrations in wastewater samples collected from tailing impoundment; (iii) evaluated the toxicity of these water samples using five in vitro bioassays employing human cells isolated from healthy donors and a short-term (1 h) exposure model. The sampled waters were highly acidic (pH 2.1–4.9) and had high electrical conductivity (280–1561 mS cm−1). No cyanides were detected in any sample. Water samples collected from the stream (AMD) inflowing to the tailing impoundment were characterized by the greatest concentrations of alkali metals, alkaline earth metals, transition and post-transition metals, metalloids, rare earth elements, and noble metal group. At other sites, the elemental concentrations were lower but remained high enough to pose a relevant risk. The greatest magnitude of in vitro toxic effects was induced by AMD. Observed alterations included redox imbalance in human neutrophils followed by lipid peroxidation and decreased cell survival, significant aggregation of red blood cells, and increased prothrombin time. The study highlights that Valea Şesei is a large sink for toxic elements, posing environmental and health risks, and requiring action to prevent further release of chemicals and to initiate restoration of the area.
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Altered Biodistribution of 99m Tc-DPD on Bone Scan After Intravenous Iron Supplement
Abstract
We report a case with altered biodistribution of 99mTc-dicarboxypropane diphosphonate (99mTc-DPD) on whole body bone scan after intravenous iron supplement therapy. A 47-year-old male patient who had recently been detected with a hepatic mass suggestive of hepatocellular carcinoma underwent bone scan as staging work-up before surgery. Bone scan images at 3 h after injection of 99mTc-DPD demonstrated unusually increased blood pool activities in the heart, liver, and spleen with usual skeletal uptakes. The patient had been treated for severe anemia from hemorrhoid with two intravenous administration of ferric hydroxide carboxymaltose complex at approximately 22 h and 2 h prior to the 99mTc-DPD injection, which we consider as the most probable cause of altered biodistribution of 99mTc-DPD.
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Can Concurrent Abnormalities in Free Light Chains and Immunoglobulin Concentrations Identify a Target Population for Immunoglobulin Trials in Sepsis?.
Objectives: Light chains [kappa] and [lambda] are immunoglobulin constituents but also circulate independently in blood as free light chains. We investigated whether a concomitant abnormality in free light chain and immunoglobulin levels could identify a high risk of death sepsis subpopulation to inform future IV immunoglobulin trials. We tested whether light chain allelic inclusion occurs in circulating B cells. Design: Prospective cohort study. Setting: Adult general ICUs. Patients: Adult sepsis patients without any documented immune comorbidity. Interventions: None. Measurements and Main Results: Serum total free light chain, immunoglobulin G, immunoglobulin A, and immunoglobulin M were measured on ICU days 1, 3, and 7. Population normal ranges defined normal and abnormal categories. Logistic regression models tested any independent relationship between high free light chain, immunoglobulins and hospital mortality. CD19 B-cell subsets expressing cell surface [kappa] and [lambda] were quantified by flow cytometry; their frequencies were compared against healthy subjects and correlation assessed against free light chain concentrations. On ICU day 1, high free light chain [lambda] and high free light chain [kappa] were seen in 46.5% and 75.3% of the study cohort (n = 101). Low immunoglobulin levels were commonplace (45.5%) at ICU admission. ICU admission day free light chain and immunoglobulin concentrations were significantly correlated. Septic patients had significantly more CD19 B cells expressing both [kappa] and [lambda] compared with healthy controls (median [interquartile range] 4.1% [2.4-11.0] vs 1.3% [1.2-2.9], respectively; p = 0.0001); these correlated with free light chain concentrations. Conclusions: To our knowledge, abnormalities and associations of free light chain in critically ill adults with sepsis have not been previously reported. The additional prognostic value of free light chain [lambda] and the significance of allelic inclusion in B cells in sepsis require further investigation. Copyright (C) by 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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A review of chitosan's effect on oral biofilms: Perspectives from the tube to the mouth
Source:Journal of Oral Biosciences
Author(s): Eduardo Manuel Costa, Sara Silva, Mariana Veiga, Freni Kekhasharú Tavaria, Maria Manuela Pintado
BackgroundThe oral cavity is a propitious environment for bacteria with different tissue tropisms to colonize and grow due to its diverse surfaces. For bacterial survival in the oral cavity, where tissues are continuously bathed in fluids, biofilm formation is necessary. Dental biofilm, i.e. dental plaque, is notoriously hard to inhibit and traditional oral care solutions are either ineffective at managing oral biofilms or cause secondary effects, such as teeth staining, that make them unattractive.HighlightChitosan has high biocompatibility and antimicrobial activity that is heralded by the pharmaceutical industry for its applicability in biofabrication. Therefore, this material is a potential substitute for the antimicrobials traditionally used in oral care.ConclusionCurrently, the body of work on chitosan and the oral cavity ranges from planktonic studies in vitro to biofilm control/removal studies in vivo. With a wide range of topics available for analysis, this review provides a working understanding of chitosan's role in the control and management of oral biofilms.
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Reduced Functional Connectivity between Ventromedial Prefrontal Cortex and Insula Relates to Longer Corrected QT Interval in HIV+ and HIV- Individuals
Despite the widespread availability of antiretroviral therapy, mortality from cardiovascular disease (CVD) has increased for persons infected with human immunodeficiency virus (HIV) (Enakpene et al., 2015). A large proportion of this CVD comorbidity has been attributed to sudden cardiac death (Tseng et al., 2012). The QT interval reflects the latency between the initiation of the QRS-complex and end of the T-wave and is used as a general marker of ventricular repolarization (Drew et al., 2010). Clinical presentation of ventricular arrhythmias (i.e., torsade de pointes) is partially attributed to prolongation of the QT interval (Viskin, 1999).
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Spatial constraints evoke increased number of steps during turning in Parkinsońs disease
A hallmark of parkinsonian gait phenomenology is the patients' difficulty to perform standing or walking turns. Turns require the patients to repeatedly shift their weight, and this frequently contributes to falls (Robinovitch et al., 2013). A recent project evaluated objective home-recorded data which demonstrated that people with Parkinson's disease (PwP) showed reduced performance in turning while the overall activity was similar compared to healthy controls (Mancini et al., 2015). Independently from turning, progressive deterioration of stepping, i.e.
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Impact of novel miR-145-3p regulatory networks on survival in patients with castration-resistant prostate cancer
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Tumour heterogeneity poses a significant challenge to cancer biomarker research
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Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors
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Mitochondria on the move: emerging paradigms of organelle trafficking in tumour plasticity and metastasis
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The role of primary tumour sidedness, EGFR gene copy number and EGFR promoter methylation in RAS/BRAF wild-type colorectal cancer patients receiving irinotecan/cetuximab
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No additional prognostic value for MRE11 in squamous cell carcinomas of the anus treated with chemo-radiotherapy
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Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study
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Embracing model-based designs for dose-finding trials
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Human equilibrative nucleoside transporter 1 gene expression is associated with gemcitabine efficacy in advanced leiomyosarcoma and angiosarcoma
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Post-translational regulation contributes to the loss of LKB1 expression through SIRT1 deacetylase in osteosarcomas
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Comprehensive analysis of copy number aberrations in microsatellite stable colon cancer in view of stromal component
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Characterisation of blood-derived exosomal hTERT mRNA secretion in cancer patients: a potential pan-cancer marker
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A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study
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Microsurgical and Endovascular Treatments for Ruptured Paraclinoid Aneurysms
J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/s-0037-1604078
Background The treatment of paraclinoid aneurysms can be challenging due to their relationship to the cavernous sinus, carotid siphon, and optic nerve. The goal of this retrospective analysis is to compare the efficacy and safety of microsurgical versus endovascular treatments for ruptured paraclinoid aneurysms. Methods Medical records were reviewed to collect information about patient demographics, risk factors, diagnosis (the position and size of aneurysms), Hunt and Hess grade, and surgical method and outcomes, including modified Rankin Scale (mRS) at the time of discharge and 6 months later, complications, and death. Results In total, 15 and 6 patients were recruited into the microsurgery and endovascular groups, respectively. No difference was detected regarding age, sex, risk factors, and Hunt and Hess grade. Most patients had ophthalmic segment aneurysms (87% versus 83%; p = 1.000) and small aneurysms (< 10 mm, 67% versus 100%; p = 0.102). In the microsurgical group, five patients (33%) had large aneurysms (10–25 mm); three patients (20%) had multiple aneurysms (all p > 0.05 compared with the endovascular group). The occlusion rate at 6 months was 93% in the microsurgical group and 100% in the endovascular group (p > 0.05). No difference was found regarding mRS or the complication and mortality rates between the two groups (all p > 0.05). The occurrence of complications was not related to the location and size of aneurysms (all p > 0.05). Conclusions Our retrospective analysis indicates that good clinical outcomes can be achieved with both microsurgical and endovascular approaches. But further prospective randomized multicenter studies are needed to provide more evidence for clinical practice.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Sources and toxicities of phenolic polychlorinated biphenyls (OH-PCBs)
Abstract
Polychlorinated biphenyls (PCBs), a group of 209 congeners that differ in the number and position of chlorines on the biphenyl ring, are anthropogenic chemicals that belong to the persistent organic pollutants (POPs). For many years, PCBs have been a topic of interest because of their biomagnification in the food chain and their environmental persistence. PCBs with fewer chlorine atoms, however, are less persistent and more susceptible to metabolic attack, giving rise to chemicals characterized by the addition of one or more hydroxyl groups to the chlorinated biphenyl skeleton, collectively known as hydroxylated PCBs (OH-PCBs). In animals and plants, this biotransformation of PCBs to OH-PCBs is primarily carried out by cytochrome P-450-dependent monooxygenases. One of the reasons for infrequent detection of lower chlorinated PCBs in serum and other biological matrices is their shorter half-lives, and their metabolic transformation, resulting in OH-PCBs or their conjugates, such as sulfates and glucuronides, or macromolecule adducts. Recent biomonitoring studies have reported the presence of OH-PCBs in human serum. The occurrence of OH-PCBs, the size of this group (there are 837 mono-hydroxyl PCBs alone), and their wide spectra of physical characteristics (pKa's and log P's ranging over 5 to 6 orders of magnitude) give rise to a multiplicity of biological effects. Among those are bioactivation to electrophilic metabolites that can form covalent adducts with DNA and other macromolecules, interference with hormonal signaling, inhibition of enzymes that regulate cellular concentrations of active hormones, and interference with the transport of hormones. This new information creates an urgent need for a new perspective on these often overlooked metabolites.
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Sputum autoantibodies in severe eosinophilic asthma
Publication date: Available online 24 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Manali Mukherjee, David C. Bulir, Katherine Radford, Melanie Kjarsgaard, Chynna Margaret Huang, Elizabeth A. Jacobsen, Sergei I. Ochkur, Ana Catuneanu, Hanah Lamothe-Kipnes, James Mahony, James J. Lee, Paige Lacy, Parameswaran K. Nair
BackgroundThe persistence of eosinophils in sputum despite high doses of corticosteroids indicates disease severity in asthma. Chronic inflamed airways over time may lose tolerance to immunogenic entities released upon frequent eosinophil degranulation, which further contributes to disease severity and necessitates increase in maintenance corticosteroids.ObjectivesTo investigate the possibility of a polyclonal autoimmune event in asthmatic airways, and identify associated clinical and molecular characteristics.MethodsPresence of autoantibodies against eosinophil peroxidase (EPX) and anti-nuclear antibodies (ANAs) was investigated in eosinophilic asthmatics maintained on high dose corticosteroids and/or prednisone. The ability of sputum immunoglobulins to induce eosinophil degranulation in vitro was assessed. In addition, the associated inflammatory micro-environment in patients with detectable autoantibodies was examined.ResultsWe report a "polyclonal" autoimmune event occurring in the airways of prednisone-dependent asthmatics with increased eosinophil activity and/or recurrent pulmonary infections, evident by the concomitant presence of sputum anti-EPX and ANAs of the IgG subtype. Extensive cytokine profiling of the sputum revealed a Th2-dominated micro-environment (eotaxin-2, IL-5, IL-18, IL-13), and increased signalling molecules that support the formation of ectopic lymphoid structures (B-cell activating factor, B-cell attracting chemokine-1). Immunoprecipitated sputum immunoglobulins from patients with increased autoantibodies triggered eosinophil degranulation in vitro, with release of extensive histone-rich extracellular-traps; an event unsuppressed by dexamethasone possibly contributing to the steroid-unresponsive nature of these eosinophilic patients.ConclusionThis study identifies an "autoimmune" endotype of severe asthma that can be identified by the presence of sputum autoantibodies against EPX and autologous cellular components.
Teaser
We report a novel concept of an autoimmune inflammation localised to the airways of severe eosinophilic asthmatics. This is possibly steroid-insensitive, contributing to disease severity, and necessitates identification of these patients for appropriate therapeutic strategies. (35 words)from # & - All via ola Kala on Inoreader http://ift.tt/2tX873t
Idiopathic Intracranial Hypertension Progressing to Venous Sinus Thrombosis, Subarachnoid Hemorrhage, and Stroke.
Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure (ICP), the absence of structural lesions on neuroimaging, and normal cerebrospinal fluid composition. Cerebral venous sinus thrombosis (CVST) is a common cause of increased ICP and can be differentiated from IIH with magnetic resonance venography. We describe a young woman with typical IIH who underwent lumbar puncture and was treated with a short course of high-dose corticosteroids followed by acetazolamide. She subsequently developed CVST, subarachnoid hemorrhage, and stroke. Risk factors that may have resulted in CVST are discussed. (C) 2017 by North American Neuro-Ophthalmology Society
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Supraglottic Atomization of Surfactant in Spontaneously Breathing Lambs Receiving Continuous Positive Airway Pressure.
Objectives: To determine the short-term tolerance, efficacy, and lung deposition of supraglottic atomized surfactant in spontaneously breathing lambs receiving continuous positive airway pressure. Design: Prospective, randomized animal study. Setting: Animal research laboratory. Subjects: Twenty-two preterm lambs on continuous positive airway pressure (132 +/- 1 d gestational age). Interventions: Animals receiving continuous positive airway pressure via binasal prongs at 8 cm H2O were randomized to receive atomized surfactant at approximately 60-minute of life (atom; n = 15) or not (control; n = 7). The atom group received 200 mg/kg of poractant alfa (Curosurf; Chiesi Farmaceutici SpA, Parma, Italy) over 45 minutes via a novel atomizer located in the upper pharynx that synchronized surfactant delivery with the inspiratory phase. Measurements and Main Results: Arterial blood gas, regional distribution of tidal ventilation (electrical impedance tomography), and carotid blood flow were recorded every 15 minutes until 90 minutes after stabilizing on continuous positive airway pressure. Gas exchange, respiratory rate, and hemodynamic variables, including carotid blood flow, remained stable during surfactant treatment. There was a significant improvement in arterial alveolar ratio after surfactant delivery in the atom group (p
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National clinical practice guidelines for food allergy and anaphylaxis: an international assessment
Clinical practice guidelines are important tools to promote evidence-based clinical care, but not all countries have the capacity or infrastructure to develop these in-house. The European Academy of Allergy an...
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La Bri's Body Health Atomic and Xplode Capsules by EZ Weight Loss TX: Recall - Undeclared Drug Ingredient
Audience: Consumer [Posted 07/25/2017] ISSUE: EZ Weight Loss TX is voluntarily recalling all lots of La Bri's Body Health Atomic and Xplode capsules to the consumer level. FDA analysis has found the products to be tainted with sibutramine....
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Role of the Perioperative Surgical Home in Optimizing the Perioperative Use of Opioids.
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose. In the Perioperative Surgical Home model, anesthesiologists and other pain medicine specialists are uniquely qualified and positioned to develop, implement, and coordinate a comprehensive perioperative analgesic plan, which begins with the formal preoperative patient assessment and continues throughout the postdischarge, convalescence period. The scope and practice of pain management within the Perioperative Surgical Home should thus (a) expand to include routine preoperative patient-level pain-risk stratification (including the chronic use of opioid and nonopioid analgesics), (b) address the multitude of biopsychosocial factors that contribute to interpatient pain variability, and (c) extend and be well coordinated across all 4 phases of the surgical pain experience (preoperative, intraoperative, postoperative, and postdischarge). Specifically, safe and effective perioperative pain management should include a plan of care that is tailored to the individual patient's underlying disease(s), presence of a chronic pain condition and preoperative use of opioids, and the specific surgical procedure- with evidence-based, multimodal analgesic regimens being applied in the vast majority of cases. An iteratively evolutionary component of an existing institutional Perioperative Surgical Home program can be an integrated Transitional Pain Service, which is modeled directly after the wellestablished prototype at the Toronto General Hospital in Ontario, Canada. This multidisciplinary, perioperative Transitional Pain Service seeks to modify the pain trajectories of patients who are at increased risk of (a) long-term, increasing, excessive opioid consumption and/or (b) developing chronic postsurgical pain. Like the Perioperative Surgical Home program in which it can be logically integrated, such a Transitional Pain Service can serve as the needed but missing linkage to improve the continuum of care and perioperative pain management for elective, urgent, and emergent surgery. Even if successfully and cost-efficiently embedded within an existing Perioperative Surgical Home, a new perioperative Transitional Pain Service will require additional resources. (C) 2017 International Anesthesia Research Society
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Perioperative Amino Acid Infusion for Preventing Hypothermia and Improving Clinical Outcomes During Surgery Under General Anesthesia: A Systematic Review and Meta-analysis.
Amino acid (AA) infusion is sometimes selected to avoid hypothermia during general anesthesia. However, the widespread clinical use of AA infusion therapy has not been established. This study aimed to clarify the evidence that AA infusion can increase patient body temperature and improve clinical outcomes using the Grading of Recommendations Assessment, Development, and Evaluation system. We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Japana Centra Revuo Medicina) in November 2015. Studies were reviewed by 2 independent assessors to identify randomized controlled trials (RCTs) involving AA infusion compared with placebos during surgery under general or combined general/epidural anesthesia. Study quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system and the Cochrane methodology. The primary outcome was difference in body temperature before and after perioperative AA infusion. Shivering frequency, blood loss volume, postoperative intubation time, and hospitalization period were also assessed as clinical outcomes. We analyzed the outcome data using a random effect model. From 298 screened titles, 14 RCTs met our inclusion criteria, including 626 patients (327 in AA and 299 in placebo groups). In 626 participants from 14 RCTs, AA infusion increased body temperature by a mean difference (MD) of 0.46[degrees]C (95% confidence interval [CI], 0.31-0.62, low-quality evidence). Regarding other outcomes, AA infusion decreased shivering frequency by a risk ratio of 0.34 (95% CI, 0.12-0.94; 7 RCTs, 248 participants, very low-quality evidence), shortened postoperative intubation time by MD of -125 minutes (95% CI, -210 to -38.8; 2 RCTs, 158 participants, moderate-quality evidence), and shortened the hospitalization period by MD of -1.81 days (95% CI, -2.07 to -1.55; 3 RCTs, 230 participants, low-quality evidence) compared with placebo. There was no significant difference in the volume of blood loss between the 2 groups (standardized MD, -0.20, 95% CI, -0.44 to 0.04; low-quality evidence). There was no publication bias. AA infusion in the perioperative period increased patient body temperature and improved clinical outcomes compared with placebo. However, the evidence to support the use of AA infusion is limited, and further large-scale RCTs are required. (C) 2017 International Anesthesia Research Society
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Improving Adherence to Intraoperative Lung-Protective Ventilation Strategies at a University Medical Center.
BACKGROUND: Intraoperative lung-protective ventilation (ILPV) is defined as tidal volumes 65 kg. Surveyed providers demonstrated stronger agreement to having knowledge and practice consistent with ILPV after interventions. CONCLUSIONS: Our interventions improved anesthesia provider adherence to low tidal volume ILPV. IBW was found to be an important factor related to provider adherence to ILPV. Provider attitudes about their knowledge and practice consistent with ILPV also changed with our interventions. (C) 2017 International Anesthesia Research Society
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Estimation of Stroke Volume and Stroke Volume Changes by Electrical Impedance Tomography.
BACKGROUND: Electrical impedance tomography (EIT) is a noninvasive imaging method that identifies changes in air and blood volume based on thoracic impedance changes. Recently, there has been growing interest in EIT to measure stroke volume (SV). The objectives of this study are as follows: (1) to evaluate the ability of systolic impedance variations ([DELTA]Zsys) to track changes in SV in relation to a baseline condition; (2) to assess the relationship of [DELTA]Zsys and SV in experimental subjects; and (3) to identify the influence of body dimensions on the relationship between [DELTA]Zsys and SV. METHODS: Twelve Agroceres pigs were instrumented with transpulmonary thermodilution catheter and EIT and were mechanically ventilated in a random order using different settings of tidal volume (VT) and positive end-expiratory pressure (PEEP): VT 10 mL[middle dot]kg-1 and PEEP 10 cm H2O, VT 10 mL[middle dot]kg-1 and PEEP 5 cm H2O, VT 6 mL[middle dot]kg-1 and PEEP 10 cm H2O, and VT 6 mL[middle dot]kg-1 and PEEP 5 cm H2O. After baseline data collection, subjects were submitted to hemorrhagic shock and successive fluid challenges. RESULTS: A total of 204 paired measurements of SV and [DELTA]Zsys were obtained. The 4-quadrant plot showed acceptable trending ability with a concordance rate of 91.2%. Changes in [DELTA]Zsys after fluid challenges presented an area under the curve of 0.83 (95% confidence interval, 0.74-0.92) to evaluate SV changes. Conversely, the linear association between [DELTA]Zsys and SV was poor, with R2 from linear mixed model of 0.35. Adding information on body dimensions improved the linear association between [DELTA]Zsys and SV up to R2 from linear mixed model of 0.85. CONCLUSIONS: EIT showed good trending ability and is a promising hemodynamic monitoring tool. Measurements of absolute SV require that body dimensions be taken into account. (C) 2017 International Anesthesia Research Society
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Lack of Association Between the Use of Nerve Blockade and the Risk of Persistent Opioid Use Among Patients Undergoing Shoulder Arthroplasty: Evidence From the Marketscan Database.
BACKGROUND: Persistent opioid use following surgery has received increasing attention from policymakers, researchers, and clinicians. Perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. We examined whether nerve blockade was associated with a decreased risk of persistent opioid use among patients undergoing shoulder arthroplasty, a procedure with high rates of persistent postoperative pain. METHODS: Using health care claims data, we constructed a sample of 6695 patients undergoing shoulder arthroplasty between 2002 and 2012 and used billing data to identify the utilization of nerve blockade. We then used a multivariable logistic regression to estimate the association between nerve blockade and 2 measures of opioid use: having filled at least 1 prescription for an opioid between postoperative days (PODs) 0 and 90, and between POD 91 and 365. This regression adjusted for a variety of potential confounders, such as preoperative opioid use and medical history. RESULTS: There was no association between nerve blockade and our 2 measures of persistent opioid use: adjusted odds ratio, 1.12 (97.5% confidence interval, 0.939-1.34; P = .15) for opioid use between POD 0 and 90, and adjusted odds ratio, 0.997 (97.5% confidence interval, 0.875-1.14; P = .95) for opioid use between POD 91 and 365. CONCLUSIONS: Although the use of perioperative nerve blockade may offer short-term benefits, in this study, it was not associated with a reduction in the risk of persistent opioid use for patients undergoing shoulder arthroplasty. (C) 2017 International Anesthesia Research Society
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End-Expiratory Occlusion Test Predicts Fluid Responsiveness in Patients With Protective Ventilation in the Operating Room.
BACKGROUND: End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic variations induced by EEOT could predict the effect of volume expansion in patients with protective ventilation in the operating room. METHODS: Forty-one patients undergoing neurosurgery were included. Stroke volume and pulse pressure variations were continuously recorded using pulse contour analysis before and immediately after a 30-second EEOT and after volume expansion (250 mL saline 0.9% given over 10 minutes). Patients with an increase in stroke volume >= 10% after volume expansion were defined as responders. RESULTS: Twenty patients were responders to fluid administration. EEOT induced a significant increase in stroke volume, which was correlated with the stroke volume changes induced by volume expansion (r2 = 0.55, P
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Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
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Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
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Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
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Endocrine aspects in cystic fibrosis
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
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45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
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Stephen Shortridge, 1951 | Romantic Impressionist painter
Stephen Charles Shortridge is a romantic impressionist who is experiencing much success with his vibrant brush strokes and his hand-enhanced giclees.
Shortridge, the artist, may be more familiar to you as an actor.
Theatrically he has starred as a series regular in "Welcome Back Kotter" as the southern sweathog 'Beau' and co-starred with Debbie Reynolds on the ABC show, "Aloha Paradise".
He spent the year of 1987 playing the role of David Reed as part of the original cast on the CBS daytime soap opera "The Bold and the Beautiful".
It was after this role that Stephen set his priorities toward business and finally to pursue his love of art.
Stephen enjoyed acting but found painting much more creatively satisfying and explains, "...the feeling of being totally free to create as an artist is exciting to me. In acting a large part of the creative process had taken place by the time I was involved. The writer, director, and producer had already made many decisions about the character I would play. In contrast, painting gives me complete control. I may race along in a painting and have a disaster on my hands or something I'm proud of... but, I make the choices and accept the consequences, good or bad. That's freedom... it's precious and the most fulfilling part of being an artist to me".
Amongst Stephen's collectors are celebrities Patty Duke, Donna Summer and Rick Dees.
Also while living in the LA area, Stephen exhibited with fellow actors/artists including accomplished artist Peter Falk.
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