Αρχειοθήκη ιστολογίου

Παρασκευή 18 Αυγούστου 2017

Exploring Planting and Filter Media in Stormwater Bioremediating Landscapes: a Review

Abstract

Filter media recommendations in stormwater bioremediation contain large ratios of sand. Ratios exceeding 75% by volume are supported by research into infiltration rates, physical filtration, reduced clogging, and leaching of nutrients from organics, satisfying engineering specifications. Perhaps, high sand ratios are causing hostile soil ecosystems for a majority of common ornamental landscape plants which are not adapted to such sandy soils. Most sands have lower cation exchange capacities and lower adhesion holding plant available moisture than clay fractions. Clay, however, is not an ideal component in stormwater management due to small physical size and tendency to clog filters causing failure of engineered functions. A number of studies have addressed this issue by seeking plants that are suited to high sand content (thus adapted to low fertility and low plant available moisture). While these studies may provide plants suitable to such gardens, they may not address the need for gardens to appeal esthetically to the general public and remain familiar to the maintenance crews which must service these systems. By highlighting possible shortfalls of high sand content soil blends, this review exposes a need for research in plant performance as well as soil micro- and macro-faunal communities within bioremediation by addressing the whole ecosystem. The filter and planting media used in stormwater management gardens should improve floral and faunal health while maintaining engineered specifications and esthetic requirements. With improved ecosystem health and activity, these gardens could last longer, perform better, and cost less to maintain.



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The dual role of group V secretory phospholipase A 2 in pancreatic β-cells

Abstract

Purpose

Group X (GX) and group V (GV) secretory phospholipase A2 (sPLA2) potently release arachidonic acid (AA) from the plasma membrane of intact cells. We previously demonstrated that GX sPLA2 negatively regulates glucose-stimulated insulin secretion (GSIS) by a prostaglandin E2 (PGE2)-dependent mechanism. In this study we investigated whether GV sPLA2 similarly regulates GSIS.

Methods

GSIS and pancreatic islet-size were assessed in wild-type (WT) and GV sPLA2-knock out (GV KO) mice. GSIS was also assessed ex vivo in isolated islets and in vitro using MIN6 pancreatic beta cell lines with or without GV sPLA2 overexpression or silencing.

Results

GSIS was significantly decreased in islets isolated from GV KO mice compared to WT mice and in MIN6 cells with siRNA-mediated GV sPLA2 suppression. MIN6 cells overexpressing GV sPLA2 (MIN6-GV) showed a significant increase in GSIS compared to control cells. Though the amount of AA released into the media by MIN6-GV cells was significantly higher, PGE2 production was not enhanced or cAMP content decreased compared to control MIN6 cells. Surprisingly, GV KO mice exhibited a significant increase in plasma insulin levels following i.p. injection of glucose compared to WT mice. This increase in GSIS in GV KO mice was associated with a significant increase in pancreatic islet size and number of proliferating cells in β-islets compared to WT mice.

Conclusions

Deficiency of GV sPLA2 results in diminished GSIS in isolated pancreatic beta-cells. However, the reduced GSIS in islets lacking GV sPLA2 appears to be compensated by increased islet mass in GV KO mice.



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Lack of association between interleukin 28B polymorphism and vertical transmission of hepatitis C.

Objectives: Single genetic nucleotide polymorphism (rs12979860) near the gene for Interleukin 28B (IL28B), is known to be of importance for frequency of spontaneous clearance and treatment outcome in interferon based therapies in patients with hepatitis C virus (HCV) infection. The aim of this study was to investigate if IL28B polymorphism in children and/or their mothers plays a role in vertical transmission of HCV (HCV-VT). Methods: Plasma samples from 59 infected women, 76 uninfected children born to infected mothers, and 47 children with known vertically transmitted HCV infection, were analysed for IL28B polymorphism and classified by the IL28B genotype (C/C, C/T and T/T) as well as by viral genotype. Results: The proportion of children with genotype C/C was the same in the vertically infected (36%, 17/47) and the exposed uninfected children (38%, 29/76). No difference was seen when stratifying for viral genotype. There was no association between mothers' IL28B genotype and the risk of vertical transmission. Conclusion: Regardless of viral genotype we found no association between IL28B genotype and the risk of HCV-VT. The IL28B genotype CC, which has been shown to be favourable in other settings, was not protective of HCV-VT. Thus, other factors possibly associated with the risk of HCV-VT need to be explored. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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The dual role of group V secretory phospholipase A 2 in pancreatic β-cells

Abstract

Purpose

Group X (GX) and group V (GV) secretory phospholipase A2 (sPLA2) potently release arachidonic acid (AA) from the plasma membrane of intact cells. We previously demonstrated that GX sPLA2 negatively regulates glucose-stimulated insulin secretion (GSIS) by a prostaglandin E2 (PGE2)-dependent mechanism. In this study we investigated whether GV sPLA2 similarly regulates GSIS.

Methods

GSIS and pancreatic islet-size were assessed in wild-type (WT) and GV sPLA2-knock out (GV KO) mice. GSIS was also assessed ex vivo in isolated islets and in vitro using MIN6 pancreatic beta cell lines with or without GV sPLA2 overexpression or silencing.

Results

GSIS was significantly decreased in islets isolated from GV KO mice compared to WT mice and in MIN6 cells with siRNA-mediated GV sPLA2 suppression. MIN6 cells overexpressing GV sPLA2 (MIN6-GV) showed a significant increase in GSIS compared to control cells. Though the amount of AA released into the media by MIN6-GV cells was significantly higher, PGE2 production was not enhanced or cAMP content decreased compared to control MIN6 cells. Surprisingly, GV KO mice exhibited a significant increase in plasma insulin levels following i.p. injection of glucose compared to WT mice. This increase in GSIS in GV KO mice was associated with a significant increase in pancreatic islet size and number of proliferating cells in β-islets compared to WT mice.

Conclusions

Deficiency of GV sPLA2 results in diminished GSIS in isolated pancreatic beta-cells. However, the reduced GSIS in islets lacking GV sPLA2 appears to be compensated by increased islet mass in GV KO mice.



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Comparison of Combined Spike Detection and Clustering Using Mutual Information

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Publication date: Available online 18 August 2017
Source:Journal of Neuroscience Methods
Author(s): Peter N. Steinmetz
BackgroundSpike sorting techniques involve both detection of spike waveform events and classification of those events into clusters of similar waveform shape. The one existing method of evaluating the combined effects of both detection and classification depends on assignment of cluster correspondence. Other methods of evaluation have focused on either clustering or detection, but not both, although these two steps may interact.New methodThis paper develops an information theoretic measure of agreement between the output of two spike sorting techniques, AMIall, which can be used even when the number of waveform events detected by the two techniques differs.ResultsAMIall is shown to be a useful measure for studying variations of parameters of spike sorting techniques in two examples: comparing outputs for simulated noisy spike sorting and spike sorting of human single neuron recordings.Comparison with existing methods Computing AMIall does not require an explicit assignment of cluster correspondence, thereby eliminating a potential source of variation. By providing a single measure of performance, computing AMIall is very useful when comparing large numbers of algorithmic or parametric variations of spike sorting techniques; prior comparison techniques have often required multiple measures of performance which complicates large scale comparisons.ConclusionsThe use of AMIall to measure agreement between spike sorting techniques facilitates the comparison of the outputs of those techniques, including variations in both spike detection and waveform clustering. This measure should be useful for broad based and large scale comparisons between spike sorting techniques.



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Home-cage anxiety levels in a transgenic rat model for Spinocerebellar Ataxia type 17 measured by an approach-avoidance task: the light spot test

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Publication date: Available online 18 August 2017
Source:Journal of Neuroscience Methods
Author(s): Elisavet I. Kyriakou, Huu Phuc Nguyen, Judith R. Homberg, Johanneke E. Van der Harst
BackgroundMeasuring anxiety in a reliable manner is essential for behavioural phenotyping of rodent models such as the rat model for Spinocerebellar ataxia type 17 (SCA17) where anxiety is reported in patients. An automated tool for assessing anxiety within the home cage can minimize human intervention, stress of handling, transportation and novelty.New methodWe applied the anxiety test "light spot" (LS) (white led directed at the food-hopper) to our transgenic SCA17 rat model in the PhenoTyper 4500® to extend the knowledge of this automated tool for behavioural phenotyping and to verify an anxiety-like phenotype at three different disease stages for use in future therapeutic studies.ResultsLocomotor activity was increased in SCA17 rats at 6 and 9 months during the first 15minutes of the LS, potentially reflecting increased risk assessment. Both genotypes responded to the test with lower duration in the LS zone and higher time spent inside the shelter compared to baseline.Comparison with existing methodsWe present the first data of a rat model subjected to the LS. The LS can be considered more biologically relevant than a traditional test as it measures anxiety in a familiar situation.ConclusionsThe LS successfully evoked avoidance and shelter-seeking in rats. SCA17 rats showed a stronger approach-avoidance conflict reflected by increased activity in the area outside the LS. This home cage test, continuously monitoring pre- and post-effects, provides the opportunity for in-depth analysis, making it a potentially useful tool for detecting subtle or complex anxiety-related traits in rodents.



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Reproducibility of task activation using the Addenbrooke’s cognitive examination in healthy controls: A functional Transcranial Doppler ultrasonography study

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Publication date: Available online 19 August 2017
Source:Journal of Neuroscience Methods
Author(s): L Beishon, C.A.L Williams, R.B Panerai, T.G Robinson, V.J Haunton
IntroductionCerebral blood flow velocity (CBFv) changes occurring with cognitive stimulation can be measured by Transcranial Doppler ultrasonography (TCD). The aim of this study was to assess the reproducibility of CBFv changes to the Addenbrooke's cognitive examination (ACE-III).New Method13 volunteers underwent bilateral TCD (middle cerebral artery), continuous heart rate (HR, 3-lead ECG, Finometer), beat-to-beat mean arterial pressure (MAP, Finometer), and end-tidal CO2 (ETCO2, capnography). After 5minutes baseline, all ACE-III tasks were performed in 3 domains (A/B/C). Data presented are population CBFv peak normalised changes and area under the curve (AUC). Statistical analysis was by 2-way repeated measures (ANOVA), intra-class correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV).Results12 bilateral data sets were obtained (10 right hand dominant, 6 female). Baseline parameters (MAP, HR, ETCO2) did not differ between visits. All tasks increased CBFv. Only domain A on AUC analysis differed significantly on ANOVA, and one task on post hoc testing (p <0.05). ICC values were poor (<0.4) for most tasks, but 3 tasks produced more consistent results on AUC and peak CBFv analysis (range ICC: 0.15-0.73, peak CV: 16.2-56.1(%), AUC CV: 23.2-60.2(%), peak SEM: 2.5–6.0 (%), AUC SEM: 21.8-135.8 (%*s).Comparison with existing methodsThis is the first study to examine reproducibility of CBFv changes to a complete cognitive assessment tool.ConclusionsReproducibility of CBFv measurements to the ACE-III was variable. AUC may provide more reliable estimates than peak CBFv responses. These data need validating in patient populations.



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Microdialysis and its use in behavioural studies: Focus on acetylcholine.

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Publication date: Available online 18 August 2017
Source:Journal of Neuroscience Methods
Author(s): Magdalena König, Anna Thinnes, Jochen Klein
Microdialysis is a technique that allows access to the extracellular space of many tissues. For behavioural studies, microdialysis probes are inserted into the brain under anesthesia, but the experiment can be done in awake and freely moving animals. Microdialysis is a sampling method (not a measuring method), therefore, the analyte(s) under study must be quantified from the dialysate using available analytical methods of high sensitivity. Neurotransmitters and energy metabolites are most commonly measured. Limitations of the microdialysis technique are poor time resolution in the minute range and large diameters of the probe which samples from many thousands of cells and millions of synapses. The article illustrates the use of microdialysis in several behavioural fields and describes uses in motor function, stress research, and novelty and habituation, with an emphasis on its use in cholinergic mechanisms.



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Method of derivation and differentiation of mouse embryonic stem cells generating synchronous neuronal networks

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Publication date: Available online 18 August 2017
Source:Journal of Neuroscience Methods
Author(s): Elena V. Gazina, Emma Morrisroe, Gunarathna D.C. Mendis, Anna E. Michalska, Joseph Chen, Christian M. Nefzger, Benjamin N. Rollo, Christopher A. Reid, Martin F. Pera, Steven Petrou
BackgroundStem cells-derived neuronal cultures hold great promise for in vitro disease modelling and drug screening. However, currently stem cells-derived neuronal cultures do not recapitulate the functional properties of primary neurons, such as network properties. Cultured primary murine neurons develop networks which are synchronised over large fractions of the culture, whereas neurons derived from mouse embryonic stem cells (ESCs) display only partly synchronised network activity and human pluripotent stem cells-derived neurons have mostly asynchronous network properties. Therefore, strategies to improve correspondence of derived neuronal cultures with primary neurons need to be developed to validate the use of stem cell-derived neuronal cultures as in vitro models.New methodBy combining serum-free derivation of ESCs from mouse blastocysts with neuronal differentiation of ESCs in morphogen-free adherent culture we generated neuronal networks with properties recapitulating those of mature primary cortical cultures.ResultsAfter 35days of differentiation ESC-derived neurons developed network activity very similar to that of mature primary cortical neurons. Importantly, ESC plating density was critical for network development.Comparison with existing method(s)Compared to the previously published methods this protocol generated more synchronous neuronal networks, with high similarity to the networks formed in mature primary cortical culture.ConclusionWe have demonstrated that ESC-derived neuronal networks recapitulating key properties of mature primary cortical networks can be generated by optimising both stem cell derivation and differentiation. This validates the approach of using ESC-derived neuronal cultures for disease modelling and in vitro drug screening.



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Hypofractionated stereotactic radiotherapy to the resection bed for intracranial metastases

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Publication date: Available online 19 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Audrey Keller, Mélanie Doré, Hélène Cebula, François Thillays, François Proust, Ioana Darié, Stéphane-André Martin, Gregory Delpon, François Lefebvre, Georges Noël, Delphine Antoni
PurposeWe retrospectively report the outcomes of a large multicenter cohort of patients treated with surgery and hypofractionated stereotactic radiotherapy (HFSRT) to the resection cavities of brain metastases (BMs).Methods and materialsBetween March 2008 and February 2015, 181 patients with no prior whole-brain radiation therapy (WBRT) were treated by HFSRT to the surgical bed of BM at the dose of 33 Gy (3×11 Gy). The primary end-point was local control (LC). Secondary endpoints were distant brain control (DBC), overall survival (OS), risk of radionecrosis (RN) and leptomeningeal disease (LMD).ResultsOf the 189 resected lesions, 44% were metastatic from a non-small cell lung cancer (NSCLC) primary tumor, and 76% of patients had a single BM at the time of treatment. With a median follow up of 15 months, the 6-and 12-month LC rates were 93% and 88%, respectively. On multivariate analysis, PTV (p=0.005), GPA score (p=0.021) and meningeal contact of BM (p=0.032), were predictive of local failure. The 6-and 12-month DBC rates were 70% and 61%. Twenty-six patients (14%) developed signs of LMD at a median time of 3.8 months. The preoperative tumor volume was predictive of LMD (p=0.029). The median OS was 17months. The 6-,12-and 24-month OS rates were 79%, 62% and 39%, respectively. RPA Class 3 (p=0.02), piecemeal resection (p=0.017) and an increasing number of BMs (p<0.01) were independent unfavorable prognostic factors for OS. Fifty-four patients (30%) were subsequently treated with salvage WBRT at a median time of 6.5 months, and 41% were re-irradiated with SRT. RN occurred in 19% of cases at a median time of 15 months and was associated with the infratentorial location of the BM (p=0.0025).ConclusionThis study demonstrated the safety and efficacy of a 3×11 Gy HFSRT regimen for the irradiation of BMs resection cavities. It was an alternative to adjuvant WBRT.

Teaser

We retrospectively report the outcomes of a large multicenter cohort of patients treated with surgery and hypofractionated stereotactic radiotherapy (HFSRT) to the resection cavities of brain metastases (BMs). We analyzed the local control, distant brain control, overall survival, risk of radionecrosis and leptomeningeal disease. This study demonstrated the safety and efficacy of a 3×11Gy HFSRT regimen for the irradiation of BMs resection cavities. It was an alternative to adjuvant whole-brain radiotherapy (WBRT).


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Impact of surgery, adjuvant therapy and other prognostic factors for choroid plexus carcinoma; a systematic review and individual patient data analysis

Publication date: Available online 18 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Supriya Mallick, Rony Benson, Wineeta Melgandi, G.K. Rath
ObjectiveThe optimal management of patients with choroid plexus carcinoma (CPC) is unclear. We conducted a systematic review and meta-analysis of individual patient information to find the impact of surgery, adjuvant therapy and other prognostic factors in this disease.MethodologyA comprehensive search of the PubMed and Google scholar was performed with the following MesH terms: "choroid plexus tumor; choroid plexus carcinoma; choroid plexus carcinoma AND treatment; and choroid plexus carcinoma AND survival" to find all possible publications on CPC. We performed individual patient data analysis, to assess the strength of potential association between different variables and the outcome in patients with CPC.ResultsData from 284 patients was retrieved from 89 publications. The median age of the patients was 2 years with 26% patients diagnosed in the 1st year of their life. 52.8% of patients underwent a gross total resection [GTR] or near total resection. Median follow-up for the entire cohort was 10.8 months. Median progression free survival [PFS] was 13 months [95% CI 8.14-17.8]. PFS was better for patients older than 5 years and GTR. Median overall survival [OS] was 29 months (95% CI 16.3- 41.7). OS was better for patients older than 5 years, GTR, adjuvant treatment and parenchymal site of the tumor.ConclusionCPC is an aggressive tumor, with a median PFS of 13 months and a median OS of 29 months. All patients should undergo a maximal safe resection as GTR is associated with improved survival. Adjuvant radiation and chemotherapy were also associated with improved outcomes.

Teaser

Optimal management of patients with choroid plexus carcinoma (CPC) is not clear. We conducted a systematic review and meta-analysis of individual patient observations to find the impact of surgery, adjuvant therapy and other prognostic factors for CPC. Median overall survival for the entire cohort was 29 months. The overall survival was better for patients older than 5 years, patients undergoing GTR, adjuvant treatment, and parenchymal tumor. A gross total resection and adjuvant treatment need to be advocated for all patients as it improves survival outcome.


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Physiologic Considerations in Trauma Patients Undergoing Resuscitative Endovascular Balloon Occlusion of the Aorta

Resuscitative endovascular balloon occlusion of the aorta is a new procedure for adjunctive management of critically injured patients with noncompressible torso or pelvic hemorrhage who are in refractory hemorrhagic shock, ie, bleeding to death. The anesthesiologist plays a critical role in management of these patients, from initial evaluation in the trauma bay to definitive care in the operating room and the critical care unit. A comprehensive understanding of the effects of resuscitative endovascular balloon occlusion of the aorta is essential to making it an effective component of hemostatic resuscitation.

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A Graphical Guide to the REBOA: Five Life-Saving Steps

imageNo abstract available

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Resuscitative Endovascular Balloon Occlusion of the Aorta: Principles, Initial Clinical Experience, and Considerations for the Anesthesiologist

imageResuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular technique that allows for temporary occlusion of the aorta in patients with severe, life-threatening, trauma-induced noncompressible hemorrhage arising below the diaphragm. REBOA utilizes a transfemoral balloon catheter inserted in a retrograde fashion into the aorta to provide inflow control and support blood pressure until definitive hemostasis can be achieved. Initial retrospective and registry clinical data in the trauma surgical literature demonstrate improvement in systolic blood pressure with balloon inflation and improved survival compared to open aortic cross-clamping via resuscitative thoracotomy. However, there are no significant reports of anesthetic implications and perioperative management in this challenging cohort. In this narrative, we review the principles, technique, and logistics of REBOA deployment, as well as initial clinical outcome data from our level-1 American College of Surgeons–verified trauma center. For anesthesiologists who may not yet be familiar with REBOA, we make several suggestions and recommendations for intraoperative management based on extrapolation from these initial surgical-based reports, opinions from a team with increasing experience, and translated experience from emergency aortic vascular surgical procedures. Further prospective data will be necessary to conclusively guide anesthetic management, especially as potential complications and implications for global organ function, including cerebral and renal, are recognized and described.

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Human neural stem cell transplantation into the corpus callosum of Alzheimer's mice

Abstract

The hippocampus has been the target of stem cell transplantations in preclinical studies focused on Alzheimer's disease, with results showing improvements in histological and behavioral outcomes. The corpus callosum is another structure that is affected early in Alzheimer's disease. Therefore, we hypothesize that this structure is a novel target for human neural stem cell transplantation in transgenic Alzheimer's disease mouse models. This study demonstrates the feasibility of targeting the corpus callosum and identifies an effective immunosuppression regimen for transplanted neural stem cell survival. These results support further preclinical development of the corpus callosum as a therapeutic target in Alzheimer's disease.



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Increased serum levels of fetuin B in patients with coronary artery disease

Abstract

Background

Recent evidence indicates a pivotal role for fetuin B, one of the cystatin superfamily of cysteine protease inhibitors, in the pathogenesis of metabolic diseases. This study investigated whether serum fetuin B levels are associated with the presence of coronary artery disease.

Methods

Serum fetuin B levels were assessed in 87 patients with coronary artery disease (41 with acute coronary syndromes and 46 with stable angina pectoris) and 87 healthy controls using an enzyme-linked immunosorbent assay. The association of serum fetuin B levels with cardiac risk factors was analyzed.

Results

Serum fetuin B levels were significantly higher in patients with coronary artery disease than those in healthy controls (90.7 ± 32.1 vs. 110.0 ± 32.7 μg/ml, P < 0.001), extremely elevated in group with acute coronary syndromes (115.0 ± 35.2 μg/ml). Pearson correlation analysis showed that serum fetuin B levels were positively associated with the levels of total cholesterol (r = 0.276, P < 0.001), low-density lipoprotein cholesterol (r = 0.363, P < 0.001), and fasting blood glucose (r = 0.159, P < 0.05). In addition, multiple logistic regression analyses revealed that fetuin B was independently associated with the presence of coronary artery disease (OR, 1.019; 95% CI, 1.009 to 1.029; P < 0.001) and acute coronary syndromes (OR, 1.017; 95% CI, 1.006 to 1.028; P < 0.01).

Conclusions

Our data revealed that high fetuin B levels are associated with the presence of coronary artery disease and acute coronary syndromes, and that fetuin B may serve as a potential biomarker for coronary artery disease.



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Increased serum levels of fetuin B in patients with coronary artery disease

Abstract

Background

Recent evidence indicates a pivotal role for fetuin B, one of the cystatin superfamily of cysteine protease inhibitors, in the pathogenesis of metabolic diseases. This study investigated whether serum fetuin B levels are associated with the presence of coronary artery disease.

Methods

Serum fetuin B levels were assessed in 87 patients with coronary artery disease (41 with acute coronary syndromes and 46 with stable angina pectoris) and 87 healthy controls using an enzyme-linked immunosorbent assay. The association of serum fetuin B levels with cardiac risk factors was analyzed.

Results

Serum fetuin B levels were significantly higher in patients with coronary artery disease than those in healthy controls (90.7 ± 32.1 vs. 110.0 ± 32.7 μg/ml, P < 0.001), extremely elevated in group with acute coronary syndromes (115.0 ± 35.2 μg/ml). Pearson correlation analysis showed that serum fetuin B levels were positively associated with the levels of total cholesterol (r = 0.276, P < 0.001), low-density lipoprotein cholesterol (r = 0.363, P < 0.001), and fasting blood glucose (r = 0.159, P < 0.05). In addition, multiple logistic regression analyses revealed that fetuin B was independently associated with the presence of coronary artery disease (OR, 1.019; 95% CI, 1.009 to 1.029; P < 0.001) and acute coronary syndromes (OR, 1.017; 95% CI, 1.006 to 1.028; P < 0.01).

Conclusions

Our data revealed that high fetuin B levels are associated with the presence of coronary artery disease and acute coronary syndromes, and that fetuin B may serve as a potential biomarker for coronary artery disease.



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Phonak to Introduce Hearing Aid That Connects to Any Cell Phones and TV

Phonak (http://ift.tt/1TpqSBL) is set to release its new Bluetooth hearing aid Audéo B-Direct, which connects directly to any Bluetooth-enabled cell phones, including Androids, iPhones, and classic cell phones, offering users true hands-free calling and excellent TV sound quality when used with the TV Connector, another new product. Audéo B-Direct users can answer or reject a phone call by pressing the push button on the hearing aid. They will hear the ringing of the phone directly through the hearing aid, and once the call is accepted, the conversation is instantly streamed. All this is done without the hearing aid wearer ever having to physically touch his or her phone. When used in conjunction with the TV Connector, the Audéo B-Direct hearing aid can function as wireless TV headphones. The TV Connector is capable of connecting to multiple Audéo B-Direct hearing aids simultaneously, ideal for watching TV together.

Both the Audéo B-Direct and the TV Connector will be available in the United States at the end of August and in Europe and other countries worldwide from September onwards.​

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Published: 8/18/2017 9:17:00 AM


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Development of the gut microbiota in infancy and its impact on health in later life

Publication date: Available online 18 August 2017
Source:Allergology International
Author(s): Masaru Tanaka, Jiro Nakayama
Gut microbial ecology and function are dynamic in infancy, but are stabilized in childhood. The 'new friends' have a great impact on the development of the digestive tract and host immune system. In the first year of life, especially, the gut microbiota dramatically changes through interactions with the developing immune system in the gut. The process of establishing the gut microbiota is affected by various environmental factors, with the potential to be a main determinant of life-long health. In this review, we summarize recent findings regarding gut microbiota establishment, including the importance of various factors related to the development of the immune system and allergic diseases later in life.



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Telmesani Radiological Classification of the Location of the Vertical Segment of the Facial Nerve: Impact on Surgical Approach in Cochlear Implant Surgery.

Objective: This study was conducted to establish a radiological classification of the location of the vertical segment of the facial nerve (VSFN) and to see if this has implications on the surgical technique needed to access the round window niche (RWN) in cochlear implant (CI) surgery. Study Design: Observational case series study. Setting: Tertiary referral center. Patients: One hundred twenty seven patients underwent CI surgery, and high resolution computed tomography (HRCT) of 140 temporal bones was studied. The data that were collected consisted of the patient's age, sex, radiological inner ear malformations (IEM), and the surgical technique used to access the RWN. Main Outcome Measures: The radiologic location of the VSFN in relation to the lateral semicircular canal in the coronal plane of HRCT and its implication on the surgical approach used to access the RWN in CI surgery. Results: A statistically significant association is present between the radiological location of the VSFN and the surgical approach used (p 0.05. Conclusions: On HRCT (0.6 mm) in the coronal plane, the position of the VSFN in relation to the lateral semicircular canal is correlated with the alternative approaches that must be taken during CI surgery. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Ablation of facial adenoma sebaceum using the Versajet™ Hydrosurgery System

Abstract

Sebaceous adenomas, histologically facial angiofibromas, are closely associated with the tuberous sclerosis complex. The dermatologic disorder constitutes one of the main characteristics for that disease. The lesions commonly involve the central part of the face, including the cheeks, perioral region and nose with predominance in the nasolabial folds, causing a major cosmetic disfigurement. Aesthetic surgery of the face comprises different forms of ablative treatments using mechanical dermabrasion, shave excision, radiofrequency ablation, cryosurgery, laser therapy, and electrocoagulation. The use of Versajet™ Hydrosurgery System has not been previously described in the treatment of adenoma sebaceum so far. In this case report, we present the successful application of this hydrosurgical system in a patient with tuberous sclerosis and multiple facial angiofibromas indicating it as a feasible, effective, reliable, and economical treatment option.

Level of Evidence: Level V, therapeutic study.



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Treatment of Swedish Patients with Graves' Hyperthyroidism Is Associated with Changes in Acylcarnitine Levels

Thyroid , Vol. 0, No. 0.


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Protection against TBI-Induced Neuronal Death with Post-Treatment with a Selective Calpain-2 Inhibitor in Mice

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Journal of Neurotrauma , Vol. 0, No. 0.


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Impaired Baroreflex Function during Orthostatic Challenge in Patients after Spinal Cord Injury

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Journal of Neurotrauma , Vol. 0, No. 0.


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A Season of American Football Is Not Associated with Changes in Plasma Tau

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Journal of Neurotrauma , Vol. 0, No. 0.


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Systemic Administration of Exosomes Released from Mesenchymal Stromal Cells Attenuates Apoptosis, Inflammation, and Promotes Angiogenesis after Spinal Cord Injury in Rats

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Journal of Neurotrauma , Vol. 0, No. 0.


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Transcriptional Changes in the Mouse Retina after Ocular Blast Injury: A Role for the Immune System

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Journal of Neurotrauma , Vol. 0, No. 0.


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Protection against TBI-Induced Neuronal Death with Post-Treatment with a Selective Calpain-2 Inhibitor in Mice

Journal of Neurotrauma , Vol. 0, No. 0.


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Impaired Baroreflex Function during Orthostatic Challenge in Patients after Spinal Cord Injury

Journal of Neurotrauma , Vol. 0, No. 0.


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A Season of American Football Is Not Associated with Changes in Plasma Tau

Journal of Neurotrauma , Vol. 0, No. 0.


from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2v9UrCA

Systemic Administration of Exosomes Released from Mesenchymal Stromal Cells Attenuates Apoptosis, Inflammation, and Promotes Angiogenesis after Spinal Cord Injury in Rats

Journal of Neurotrauma , Vol. 0, No. 0.


from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2uQwtRT

Transcriptional Changes in the Mouse Retina after Ocular Blast Injury: A Role for the Immune System

Journal of Neurotrauma , Vol. 0, No. 0.


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Ablation of facial adenoma sebaceum using the Versajet™ Hydrosurgery System

Abstract

Sebaceous adenomas, histologically facial angiofibromas, are closely associated with the tuberous sclerosis complex. The dermatologic disorder constitutes one of the main characteristics for that disease. The lesions commonly involve the central part of the face, including the cheeks, perioral region and nose with predominance in the nasolabial folds, causing a major cosmetic disfigurement. Aesthetic surgery of the face comprises different forms of ablative treatments using mechanical dermabrasion, shave excision, radiofrequency ablation, cryosurgery, laser therapy, and electrocoagulation. The use of Versajet™ Hydrosurgery System has not been previously described in the treatment of adenoma sebaceum so far. In this case report, we present the successful application of this hydrosurgical system in a patient with tuberous sclerosis and multiple facial angiofibromas indicating it as a feasible, effective, reliable, and economical treatment option.

Level of Evidence: Level V, therapeutic study.



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Analysis of temperature increase in swine gingiva after exposure to a Polywave® LED light curing unit

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Publication date: Available online 18 August 2017
Source:Dental Materials
Author(s): Cristiane Maucoski, Driellen Christine Zarpellon, Fabio Andre dos Santos, Leandro Cavalcante Lipinski, Eduardo Bauml Campagnoli, Frederick Allen Rueggeberg, Cesar Augusto Galvão Arrais
ObjectiveThis study evaluated the temperature increase in swine gingival temperature after exposure to light emitted by a Polywave® LED light curing unit (LCU, Bluephase 20i, Ivoclar Vivadent).MethodsAfter local Ethics Committee approval (protocol 711/2015), 40 pigs were subjected to general anesthesia and the LCU tip was placed 5mm from the buccal gingival tissue (GT) close to lower lateral incisors. A thermocouple probe (Thermes WFI, Physitemp) was inserted into the gingival sulcus before and immediately after exposure to light. Real-time temperature (°C) was measured after the following exposure modes were applied: High Power (20s-H, 40s-H, and 60s-H) or Turbo mode (5s-T), either with or without the presence of rubber dam (RD) interposed between the LCU tip and GT (n=10). The presence of gingival lesions after the exposures was also evaluated. Peak temperature (°C) and the temperature increase during exposure over that of the pre-exposure baseline value (ΔT) data were analyzed using 2-way ANOVA followed by Bonferroni's post-hoc test (α=5%). A binary logistic regression analysis determined the risk of gingival lesion development.ResultsWithout RD, no significant difference in ΔT was observed among 20s-H, 40s-H, and 60s-H groups, which showed the highest temperature values, while the 5s-T exposure showed the lowest ΔT, regardless of RD. RD reduced ΔT only for the 20s-H group (p=0.004). Gingival lesions were predominantly observed using 40s-H, with RD, and 60s-H, with and without RD.SignificanceExposure to a LCU light might be harmful to swine gingiva only when high radiant exposure values are delivered, regardless of the use of RD.



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Primary intraosseous squamous cell carcinoma - A rare odontogenic malignancy

Arush Thakur, Jagdish V Tupkari, Tabita Joy, Ajas A Gogri

Journal of Oral and Maxillofacial Pathology 2017 21(2):320-320

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare epithelial odontogenic malignancy affecting the jaws, especially in elderly population. It is a rare lesion, because very few cases of PIOSCC have been reported in the literature with not much of research done on this particular entity. In the present article, we report a case of PIOSCC with detailed discussion of clinical, radiographic and histopathologic features along with review of literature.

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Ultrastructural changes in cell death

BK Charan Gowda, Ganganna Kokila

Journal of Oral and Maxillofacial Pathology 2017 21(2):299-300



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A rare coexistence of aspergillosis with actinomycosis

B Hari Vinay, Aditya Mohan, P Haritha, K Roja Lakshmi

Journal of Oral and Maxillofacial Pathology 2017 21(2):277-281

Aspergillosis is a common systemic mycosis which affects immunocompromised and immunocompetent hosts. Aspergillus spp. is wide spread in the environment in most countries, which renders an invasive form of disease. The presence conidial heads are pathognomic to aspergillosis in diagnosis. Actinomycosis is a subacute-to-chronic infection that causes sinus fistula, tract or abscess due to the invasion surrounding the soft tissue. Cervicofacial infection accounts for 50%–60% of all actinomycosis cases. The mandible and nasopharynx are the sites of predilection, but maxillary infection is rare. Aspergillosis and Actinomycosis each of them was reported in case, but mixed infection of both organisms is rare, only one case has been reported. This paper discussed about a case report of coexistence of aspergillosis with actinomycosis in 38-year-old male.

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Use of jaggery and honey as adjunctive cytological fixatives to ethanol for oral smears

Deepak Pandiar, Harakh Chand Baranwal, Sandip Kumar, Vellaichamy Ganesan, Piyush Kumar Sonkar, Kausik Chattopadhyay

Journal of Oral and Maxillofacial Pathology 2017 21(2):317-317

Background: Ethanol has satisfactorily been used as cyto-fixative. Owing to its limitations, pathologists have always searched for new fixatives. The present study was conducted to evaluate the efficacy of two natural sweeteners as cyto-fixatives. An attempt has also been made to understand the underlying mechanism by which these fixatives fix the oral mucosal cells. Materials and Methods: Three smears were collected from 25 healthy volunteers. One smear was fixed in ethanol and the other two in 20% aqueous honey solution and 30% aqueous jaggery solution for 15–30 min followed by Papanicolaou staining. Slides were evaluated for nuclear staining, cytoplasmic staining, cell morphology, clarity of staining and uniformity of staining randomly irrespective of the fixatives. Chi-square test and Bonferroni post hoc test were done using SPSS software. P < 0.05 was considered to be statistically significant. In addition, cytological fixatives were analyzed for the pH and amount of reducing sugars. Results: It was found that for all the characteristics studied, no statistically significant difference was seen between the three fixatives. The pH of the both tested fixatives remained acidic even after 1 week. The amount of reducing sugars in 20% aqueous honey solution and 30% aqueous jaggery solution was 19.3 g/100 mL and 2.07 g/100 mL, respectively. Conclusion: Both the test fixatives gave results equivalent to ethanol and thus can be used as alternative fixatives for oral smears. It is proposed that 20% aqueous honey and 30% aqueous jaggery fix the oral smears satisfactorily in a mechanism akin to ethanol by coagulating and denaturing proteins.

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Trends in oral squamous cell carcinoma: Diagnosis for effective, evidence-based treatment 2017

Rooban Thavarajah, Kannan Ranganathan

Journal of Oral and Maxillofacial Pathology 2017 21(2):189-191



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The so-called “combined epithelial odontogenic tumor”: A specific entity or not?

Kunal Sah

Journal of Oral and Maxillofacial Pathology 2017 21(2):192-193



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Small cell neuroendocrine carcinoma of the paranasal sinus with intraoral involvement: Report of a rare case and review of the literature

Anita Spadigam, Anita Dhupar, Shaheen Syed, Shruti U Nagvekar

Journal of Oral and Maxillofacial Pathology 2017 21(2):286-295

The diffuse neuroendocrine system continues to be an enigmatic topic of study in pathology due to its controversial embryologic origins, biology and a variety of tumors engendered. Originally thought to be localized to the classic neuroendocrine organs (pituitary, thyroid, pancreas and adrenal medulla), the neuroendocrine cells are now known to be distributed in every organ system of the body. A number of human diseases have been linked to aberrations in the functioning of the neuroendocrine cells. Neoplasms of the neuroendocrine system can thus occur in myriad primary sites and range in behavior from benign to lethal. Small cell neuroendocrine carcinoma (SNEC) is a high-grade neuroendocrine tumor, rarely presenting in the sinonasal region. This article reports a case of a 68-year-old male patient with primary paranasal SNEC showing intraoral involvement. The diagnosis is based on a thorough clinical, histopathological and immunohistochemical workup to differentiate it from the other small round blue cell tumors.

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Influence of legislations and news on Indian internet search query patterns of e-cigarettes

Rooban Thavarajah, Anusa Arunachalam Mohandoss, Kannan Ranganathan, Srinivas Kondalsamy-Chennakesavan

Journal of Oral and Maxillofacial Pathology 2017 21(2):194-202

Background: There is a paucity of data on the use of electronic nicotine delivery systems (ENDS) in India. In addition, the Indian internet search pattern for ENDS has not been studied. We aimed to address this lacuna. Moreover, the influence of the tobacco legislations and news pieces on such search volume is not known. Given the fact that ENDS could cause oral lesions, these data are pertinent to dentists. Methods: Using a time series analysis, we examined the effect of tobacco-related legislations and news pieces on total search volume (TSV) from September 1, 2012, to August 31, 2016. TSV data were seasonally adjusted and analyzed using time series modeling. The TSV clocked during the month of legislations and news pieces were analyzed for their influence on search pattern of ENDS. Results: The overall mean ± standard deviation (range) TSV was 22273.75 ± 6784.01 (12310–40510) during the study with seasonal variations. Individually, the best model for TSV-legislation and news pieces was autoregressive integrated moving average model, and when influence of legislations and news events were combined, it was the Winter's additive model. In the legislation alone model, the pre-event, event and post-event month TSV was not a better indicator of the effect, barring for post-event month of 2nd legislation, which involved pictorial warnings on packages in the study period. Similarly, a news piece on Pan-India ban on ENDS influenced the model in the news piece model. When combined, no "events" emerged significant. Conclusions: These findings suggest that search for information on ENDS is increasing and that these tobacco control policies and news items, targeting tobacco usage reduction, have only a short-term effect on the rate of searching for information on ENDS.

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Cytological spectrum of salivary gland lesions and their correlation with epidemiological parameters

Vaneet Kaur Sandhu, Upender Sharma, Navtej Singh, Arun Puri

Journal of Oral and Maxillofacial Pathology 2017 21(2):203-210

Background: The role fine-needle aspiration (FNA) in the diagnosis of salivary gland lesions has evolved over the years. Although clinical and radiological parameters help to narrow the differential diagnosis the tissue diagnosis still remains the gold standard. Materials and Methods: This study is from January 2013 to December 2015 in our Department of Pathology where 170 salivary gland lesions were aspirated. The aim of the present study was to analyze adequacy rate in relation to the size of lesion and to evaluate varied cytological spectrum of salivary gland lesions with emphasis on differential diagnosis and to correlate cytological diagnosis with age, gender and anatomical site. Results: The 170 cytological smears were categorized into two groups: Group 1 adequate aspirations (88.2%), Group 2 inadequate aspirations (11.7%). The adequate aspirations were subdivided as neoplastic (53.33%) and nonneoplastic (46.66%). The distribution of the various neoplastic lesions (80; 53.33%) were 66 (82.5%) benign, 12 (15%) were malignant and 2 (2.5%) were suspicious of malignancy. Among benign neoplasms, the pleomorphic adenoma (62; 93.3%) was the most frequent followed by Warthins tumor (4; 6%). The most common malignant neoplasms were adenoid cystic carcinoma (6; 50%), followed by mucoepidermoid carcinoma (4; 33.3%), malignant lymphoma (1; 8.3%) and metastatic carcinomatous deposits (1; 8.3%). In two cases, cytological picture indicated suspicion for malignancy however specific tumor typing could not be done. The neoplasms occurred more frequently in the parotid gland (65%), followed by submandibular gland (21.3%) and minor salivary glands (13.8%). The nonneoplastic lesions (70) included 68.6% cases of chronic sialadenitis, 17.1% cases were reported as mucocele, 11.4% cases of acute sialadenitis 2.9% cases as tubercular granulomas. Conclusion: FNA cytology provides useful information on the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.

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Evaluation of paxillin expression in patients with oral squamous cell carcinoma: An immunohistochemical study

Saurabh Shekhar, Punnya V Angadi

Journal of Oral and Maxillofacial Pathology 2017 21(2):318-319

Background: Oral squamous cell carcinoma (OSCC) is the tenth most common cancer in the world. The diagnosis of OSCC remains problematic, especially in advanced-stage tumors. Aims: The present study was conducted to understand the pattern of expression of paxillin in varying grades of carcinomas and also to ascertain whether its expression has an association with increasing grades. Methods: A total of ninety formalin-fixed paraffin-embedded tissues of OSCC were included in the study comprising thirty cases of each of well-differentiated squamous cell carcinomas, moderately differentiated squamous cell carcinomas (MDSCCs) and poorly differentiated squamous cell carcinomas (PDSCCs). The tissue sections were subjected to immunohistochemical staining of paxillin using super polymer-sensitive polymer 3,3' diaminobenzidine detection kit. All the three groups were analyzed on various parameters including staining intensity, location and percentage of staining. SPSS 19.0 was used to analyze the data. Results: Paxillin stain positivity was observed in 95.5% of the cases. Predominant intense paxillin staining was demonstrated in 17 (56.6%) cases of well-differentiated squamous cell carcinoma, 28 (93.3%) cases of moderately differentiated squamous squamous cell carcinoma and 15 (50%) cases of PDSCC. A predominant cytoplasmic staining was observed in 21 (70%) cases of PDSCC and cytoplasmic plus membrane staining in 14 (46.6%) cases of MDSCC. Conclusion: The present study provides evidence that paxillin may be involved in the development and progression of OSCC. Thus, paxillin could be considered a useful biomarker for patient management and prognosis.

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Validation of immunoexpression of tenascin-C in oral precancerous and cancerous tissues using ImageJ analysis with novel immunohistochemistry profiler plugin: An immunohistochemical quantitative analysis

Deepa Rajesh Mane, Alka D Kale, Chetan Belaldavar

Journal of Oral and Maxillofacial Pathology 2017 21(2):211-217

Background: Immunohistochemistry (IHC) is a molecular technique that has grown tremendously over the years. However, the assessment is only qualitative which is subjective and causes errors. Due to this limitation, several excellent markers have not gained importance and reached clinical trials. Hence, we aimed to quantify IHC by ImageJ analysis with a novel IHC profiler plugin. ImageJ has not been tried in oral precancerous tissues with minimal attempt for matrix markers. Aim: This study aimed to validate the quantification of immunoexpression of tenascin-C (TN-C) in oral precancerous tissues and oral squamous cell carcinoma (OSCC) using ImageJ software with IHC profiler plugin. Materials and Methods: After IHC staining for TN-C and image acquisition, ImageJ analysis was performed as per the standard recommended algorithm. Assessment was done by two observers by blinding the histopathological diagnosis. The immunoscore was assessed for interobserver variability using Kohen's kappa statistics. Results: All our cases were in agreement and found to be statistically significant with P < 0.005. Moderate agreement was for mild dysplasia, moderate dysplasia and oral lichen planus. Substantial agreement was for oral submucous fibrosis and OSCC and almost perfect agreement noted for cases of severe dysplasia. Conclusion: IHC can now be quantified using freely downloadable software ImageJ analysis in oral precancerous tissues and OSCC. This software with good threshold control can quantify matrix marker such as TN-C. Hence, herewith, we propose that IHC markers should be quantified using ImageJ by our entire oral pathology fraternity so as to have a standard immunoscore for all markers.

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Darier disease: A rare genodermatosis

Hema Suryawanshi, Akshay Dhobley, Aparna Sharma, Pramod Kumar

Journal of Oral and Maxillofacial Pathology 2017 21(2):321-321

Darier disease (DD), also known as keratosis follicularis or dyskeratosis follicularis, is a rare autosomal dominant genodermatosis with high penetrance and variable expressivity. It is caused by mutations of ATP2A2 gene which encodes the sarco/endoplasmic reticulum Ca2+ ATPase isoform 2. It is clinically manifested by hyperkeratotic papules primarily affecting seborrheic areas on the head, neck and thorax, with less frequent involvement of the oral mucosa. When oral manifestations are present, they primarily affect the palatal and alveolar mucosa, are usually asymptomatic and are discovered in routine dental examination. Histologically, the lesions show suprabasal clefts with acantholytic and dyskeratotic cells. We present a case of 35-year-old female patient with typical clinical and histological features of DD.

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Immunohistochemical analysis of stromal fibrocytes and myofibroblasts to envision the invasion and lymph node metastasis in oral squamous cell carcinoma

Sowmya J Rao, Jyothi Bellur Madhava Rao, PP Jagadish Rao

Journal of Oral and Maxillofacial Pathology 2017 21(2):218-223

Background: Tumor cells work in close coordination with stromal elements from its stage of emergence to metastasis. The study was designed to assess the presence and distribution pattern of stromal fibrocytes and myofibroblasts in oral squamous cell carcinoma (OSCC). Possibility of using these stromal cells as a marker for invasion and lymphnode metastasis was evaluated. Materials and Methods: A total of 40 cases of OSCC consisting twenty cases of each lymph node positive (pN+) and lymph node negative (pN0) samples and ten normal oral mucosa (NOM) tissues were subjected to double immunostaining using CD34 and alpha-smooth muscle actin (α-SMA) antibodies. Stained sections were evaluated semiquantitatively. Results: CD34 fibrocytes were seen in 70% of NOM and none of OSCC samples. α-SMA myofibroblasts were seen in 80% of OSCC and none of NOM samples. A statistically significant difference was found in fibrocyte values (P < 0.001) and myofibroblast values (P < 0.001) between NOM and OSCC study samples. No statistical significance in myofibroblast values between pN0 and pN+ study groups; however, their distribution pattern appreciably varied. Conclusions: This study suggested that fibrocytes could be used as one of the markers for early invasion. Abrupt loss of fibrocytes at the transition zone toward carcinoma and statistical significance in their values supported this inference. Heterogeneity in the distribution pattern of myofibroblasts in tumor stroma indicates that this variability may predict the tumor behavior toward nodal metastasis rather than their mere presence or absence.

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From the Editor's Desk

T Smitha

Journal of Oral and Maxillofacial Pathology 2017 21(2):185-185



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Hemangiolymphangioma of buccal mucosa: A rare case report

Selvamani Manickam, Prem Sasikumar, B Nanda Kishore, Sheethal Joy

Journal of Oral and Maxillofacial Pathology 2017 21(2):282-285

Vascular anomalies are mainly classified under two headings, i.e. under vascular tumors and vascular malformations. Hemangioma and lymphangioma are examples for such a vascular anomalies. Malformations may be seen in different combinations of vascular elements, and histologically these vessels may be filled with blood and named lymphangiohemangioma or hemangiolymphangioma according to the dominant tissue structure present. It is a rare developmental anomaly. This paper reports a case of lymphangiohemangioma in a 21-year-old female patient.

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Optoacoustic detection of early therapy-induced tumor cell death using a targeted imaging agent

Purpose: The development of new treatments and their deployment in the clinic may be assisted by imaging methods that allow an early assessment of treatment response in individual patients. The C2A domain of Synaptotagmin-I (C2Am), which binds to the phosphatidylserine (PS) exposed by apoptotic and necrotic cells, has been developed as an imaging probe for detecting cell death. Multispectral optoacoustic tomography (MSOT) is a real-time and clinically applicable imaging modality that was used here with a near infrared (NIR) fluorophore-labeled C2Am to image tumor cell death in mice treated with a TNF-related apoptosis-inducing ligand receptor 2 (TRAILR2) agonist and with 5-fluorouracil (5-FU).<br /><br />Experimental Design: C2Am was labeled with a near infrared (NIR) fluorophore and injected intravenously into mice bearing human colorectal TRAIL-sensitive Colo205 and TRAIL-resistant HT-29 xenografts that had been treated with a potent agonist of TRAILR2 and in Colo205 tumors treated with 5-FU.<br /><br />Results: Three dimensional MSOT images of probe distribution showed development of tumor contrast within 3 h of probe administration and a signal-to-background ratio in regions containing dead cells of >10 after 24 h. A site-directed mutant of C2Am that is inactive in PS binding showed negligible binding. Tumor retention of the active probe was strongly correlated (R2=0.97, P value<0.01) with a marker of apoptotic cell death measured in histological sections obtained post mortem.<br /><br />Conclusions: The rapid development of relatively high levels of contrast suggests that NIR fluorophore-labeled C2Am could be a useful optoacoustic imaging probe for detecting early therapy-induced tumor cell death in the clinic.



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p53 non-genotoxic activation and mTORC1 inhibition lead to effective combination for neuroblastoma therapy.

Purpose: mTORC1 inhibitors are promising agents for neuroblastoma therapy, however they have shown limited clinical activity as monotherapy, thus rational drug combinations need to be explored to improve efficacy. Importantly, neuroblastoma maintains both an active p53 and an aberrant mTOR signaling. <br /><br />Experimental Design: Using an orthotopic xenograft model and modulating p53 levels, we investigated the anti-tumor effects of the mTORC1 inhibitor temsirolimus in neuroblastoma expressing normal, decreased, or mutant p53, both as single agent and in combination with first and second generation MDM2 inhibitors to reactivate p53. <p>Results: Non-genotoxic p53 activation suppresses mTOR activity. Moreover, p53 reactivation via RG7388, a second generation MDM2 inhibitor, strongly enhances the in vivo anti-tumor activity of temsirolimus. Single agent temsirolimus does not elicit apoptosis, and tumors rapidly re-grow after treatment suspension. In contrast, our combination therapy triggers a potent apoptotic response in wild-type p53 xenografts and efficiently blocks tumor re-growth after treatment completion. We also found that this combination uniquely led to p53-dependent suppression of survivin whose ectopic expression is sufficient to rescue the apoptosis induced by our combination.</p> <br />Conclusions: Our study supports a novel highly effective strategy that combines RG7388 and temsirolimus in wild-type p53 neuroblastoma, which warrants testing in early-phase clinical trials.



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Defective cyclin B1 induction in trastuzumab-emtansine (T-DM1) acquired resistance in HER2-positive breast cancer

Purpose: Trastuzumab-emtansine (T-DM1) is a standard treatment in advanced HER2 positive breast cancer. However, resistance inevitably occurs. We aimed to identify mechanisms of acquired T-DM1 resistance. <p>Experimental Design: HER2-positive breast cancer cells (HCC1954, HCC1419, SKBR3 and BT474) were treated in a pulse-fashion with T-DM1 to induce a resistant phenotype. Cellular and molecular effects of T-DM1 in parental versus resistant cells were compared. CDK1 kinase activity and cyclin B1 expression were assayed under various conditions. Genetic modifications to up or down regulate cyclin B1 were conducted. Effects of T-DM1 on cyclin B1 levels, proliferation and apoptosis were assayed in human HER2 positive breast cancer explants.</p> <p>Results: We obtained three cell lines with different levels of acquired T-DM1 resistance (HCC1954/TDR, HCC1419/TDR and SKBR3/TDR cells). HER2 remained amplified in the resistant cells. Binding to HER2 and intracellular uptake of T-DM1 were maintained in resistant cells. T-DM1 induced cyclin B1 accumulation in sensitive but not resistant cells. Cyclin B1 knock-down by siRNA in parental cells induced T-DM1 resistance, while increased levels of cyclin B1 by silencing cdc20, partially sensitized resistant cells. In a series of 18 HER2-positive breast cancer fresh explants, T-DM1 effects on proliferation and apoptosis paralleled cyclin B1 accumulation.</p> <p>Conclusion: Defective cyclin B1 induction by T-DM1 mediates acquired resistance in HER2 positive breast cancer cells. These results support the testing of cyclin B1 induction upon         T-DM1 treatment as a pharmacodynamic predictor in HER2 positive breast cancer.



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Dasatinib reversibly disrupts endothelial vascular integrity by increasing non-muscle myosin II contractility in a ROCK-dependent manner

Purpose: Dasatinib is a short-acting dual ABL/SRC family tyrosine kinase inhibitor (TKI), which is frequently used to treat chronic myeloid leukemia. Although very effective, dasatinib often displays severe adverse effects, including pleural effusions and increased risk of bleeding primarily in the gastrointestinal tract. The actual causes of these side effects are currently undetermined. We hypothesize that endothelial cells (ECs) that line the inner walls of blood vessels and control the traffic to the underlying tissues, might be involved. <p>Experimental design: The effects of TKIs on ECs were studied by various assays, such as real-time cell impedance measurements, live-cell microscopy, wound healing, western blot and an in vivo model.</p> <p>Results: Dasatinib uniquely causes a profound, dose-dependent disorganization of the EC monolayers. Dasatinib promoted the disassembly of cell-cell contacts, altered cell-matrix contacts and further altered the wound healing. A key observation is that this effect is fully reversible after drug washout. In line with these in vitro observations, intraperitoneal administration of dasatinib to mice caused significant vascular leakage in the intestine. The underlying molecular mechanism of dasatinib-induced reorganization of the actin involves ROCK activation, which increases the amount of the phosphorylation of myosin light chain and consequently activates the non-muscle myosin II.</p> <p>Conclusions: Our data are consistent with a scenario in which dasatinib triggers a transient increase in vascular leakage that probably contributes to adverse effects such as bleeding diathesis and pleural effusions.



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Selected alkylating agents can overcome drug tolerance of G0-like tumor cells and eradicate BRCA1-deficient mammary tumors in mice.

Purpose: We aimed to characterize and target drug-tolerant BRCA1-deficient tumor cells that cause residual disease and subsequent tumor relapse.<br /><br />Experimental Design: We studied responses to various mono- and bifunctional alkylating agents in a genetically engineered mouse model for BRCA1/p53-mutant breast cancer. Due to the large intragenic deletion of the Brca1 gene, no restoration of BRCA1 function is possible, and therefore no BRCA1-dependent acquired resistance occurs. To characterize the cell cycle stage from which Brca1-/-;p53-/- mammary tumors arise after cisplatin treatment, we introduced the fluorescent ubiquitination-based cell cycle indicator (FUCCI) construct into the tumor cells.<br /><br />Results: Despite repeated sensitivity to the maximum tolerated dose (MTD) of platinum drugs, the Brca1-mutated mammary tumors are not eradicated, not even by a frequent dosing schedule. We show that relapse comes from single nucleated cells delaying entry into S phase. Such slowly cycling cells, which are present within the drug-naïve tumors, are enriched in tumor remnants. Using the FUCCI construct we identified non-fluorescent G0-like cells as the population most tolerant to platinum drugs. Intriguingly, these cells are more sensitive to the DNA crosslinking agent nimustine resulting in an increased number of multinucleated cells that lack clonogenicity. This is consistent with our in vivo finding that the nimustine MTD, among several alkylating agents, is most effective in eradicating Brca1-mutated mouse mammary tumors.<br /><br />Conclusions: Our data show that targeting G0-like cells is crucial for the eradication of BRCA1/p53-deficient tumor cells. This can be achieved with selected alkylating agents such as nimustine.



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Reply: Discussion on "Intraoperative comparison of anatomical versus round implants in breast augmentation: A randomized controlled trial".

No abstract available

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Role of Mitomycin C in Preventing Capsular Contracture in Implant-Based Reconstructive Breast Surgery: A Randomized Controlled Trial.

No abstract available

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Reply: Medial Row Perforators Are Associated with Higher Rates of Fat Necrosis in Bilateral DIEP Flap Breast Reconstruction#8232;.

No abstract available

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Comments on "Should Immediate Autologous Breast Reconstruction be considered in women who require Post-Mastectomy Radiation Therapy?".

No abstract available

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Why Women Request Labiaplasty.

No abstract available

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Reply: Blood Congestion Can be Rescued by Hemodilution in a Random-Pattern Skin Flap.

No abstract available

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Reply: The Impact of Two Operating Surgeons on Microsurgical Breast Reconstruction.

No abstract available

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Comment on: Application of Posterior Thigh Three-Dimensional Profunda Artery Perforator Perforasomes in Refining Next-Generation Flap Designs: Transverse, Vertical, and S-Shaped Profunda Artery Perforator Flaps.

No abstract available

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The Impact of Two Operating Surgeons on Microsurgical Breast Reconstruction.

No abstract available

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Response to Letter by Dr. Ciancio to PRS manuscript 170529.

No abstract available

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"Medial Row Perforators Are Associated with Higher Rates of Fat Necrosis in Bilateral DIEP Flap Breast Reconstruction.".

No abstract available

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Reply to Letter to the Editor: Why Women Request Labiaplasty.

No abstract available

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response letter for "Simplifying the Forehead Flap for Nasal Reconstruction : A review of 420 consecutive cases.

No abstract available

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Telmesani Radiological Classification of the Location of the Vertical Segment of the Facial Nerve: Impact on Surgical Approach in Cochlear Implant Surgery.

Objective: This study was conducted to establish a radiological classification of the location of the vertical segment of the facial nerve (VSFN) and to see if this has implications on the surgical technique needed to access the round window niche (RWN) in cochlear implant (CI) surgery. Study Design: Observational case series study. Setting: Tertiary referral center. Patients: One hundred twenty seven patients underwent CI surgery, and high resolution computed tomography (HRCT) of 140 temporal bones was studied. The data that were collected consisted of the patient's age, sex, radiological inner ear malformations (IEM), and the surgical technique used to access the RWN. Main Outcome Measures: The radiologic location of the VSFN in relation to the lateral semicircular canal in the coronal plane of HRCT and its implication on the surgical approach used to access the RWN in CI surgery. Results: A statistically significant association is present between the radiological location of the VSFN and the surgical approach used (p 0.05. Conclusions: On HRCT (0.6 mm) in the coronal plane, the position of the VSFN in relation to the lateral semicircular canal is correlated with the alternative approaches that must be taken during CI surgery. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Second-Order Peer Reviews of Clinically Relevant Articles for the Physiatrist: “Early Physical Therapy Vs Usual Care in Patients with Recent-Onset Low Back Pain” (Fritz JM, Magel JS, McFadden M, et al, JAMA 2015): “Physical Therapy May Not Help Acute Lower Back Pain Sufferers”

imageNo abstract available

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Grip Strength on the Unaffected Side as an Independent Predictor of Functional Improvement After Stroke

imageObjective: The aim of this study was to investigate the association between grip strength on the unaffected side and post-stroke functional improvement. Design: A total of 127 patients with unilateral stroke were included in this study. Demographic data, clinical data on initial grip strength, initial National Institutes of Health Stroke Scale, admission and discharge Modified Barthel Index (MBI), and stroke profiles were retrospectively reviewed. Results: Univariate and multiple linear regression analyses were carried out to evaluate the predictive values of each variable. In the model for discharge MBI, age, initial National Institutes of Health Stroke Scale, grip strength on the unaffected side, lesion side, and admission MBI were shown to be independent predictors. Meanwhile, grip strength on the unaffected side, lesion side, and admission MBI had significant predictive values in the model for difference between admission and discharge MBI. Conclusion: The current study suggests for the first time that grip strength on the unaffected side is an independent predictor for short-term functional gain and outcome after stroke. This result may change post-stroke rehabilitation strategies to emphasize exercises to prevent loss of muscle strength. In addition, this implies the possibility of a relationship between sarcopenia and post-stroke function. Further research is needed to reveal the effect of sarcopenia on stroke patients and its mechanism.

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Feasibility of Restoring Walking in Multiple Sclerosis with Multichannel Implanted Electrical Stimulation

imageAbstract: A patient with multiple sclerosis–related gait dysfunction was followed over the course of his disease. Despite aggressive treatment, he developed significant weakness in ankle dorsiflexors and hip and knee flexors and was no longer capable of consistently taking a step on his own. With electrical stimulation of hip and knee flexors and ankle dorsiflexors using implanted electrodes, he was able to consistently walk short distances as far as 30 m, thus significantly improving his Expanded Disability Status Scale score. This case study supports further exploration into the potential benefits of an implanted pulse generator to ameliorate gait dysfunction and improve quality of life for people with multiple sclerosis.

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Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial

imageObjective: The aim of this study was to investigate whether isometric neck extension exercise restores physiological cervical lordosis and reduces pain. Design: Sixty-five patients with loss of cervical lordosis were randomly assigned to exercise (27 women, 7 men; mean age, 32.82 ± 8.83 yrs) and control (26 women, 5 men; mean age, 33.48 ± 9.67 yrs) groups. Both groups received nonsteroidal anti-inflammatory drugs for 10 days. The exercise group received additional therapy as a home exercise program, which consisted of isometric neck extension for 3 mos. Neck pain severity and cervical lordosis were measured at baseline and at 3 mos after baseline. Results: Compared with baseline levels, cervical lordosis angle was significantly improved in the exercise group (P

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The State of Disability Awareness in American Medical Schools

imageAbstract: This study was designed to: (1) determine how many American medical schools include disability awareness in their curriculum, (2) explore the format of disability awareness programs in existence, and (3) understand why some schools do not include disability awareness in their curriculum. An online survey was sent to deans of medical education (or equivalent positions) at accredited allopathic and osteopathic American medical schools (N = 167) in 2015. Seventy-five schools (45%) completed surveys. Fifty-two percent (39/75) reported having a disability awareness program. The most common format was people with disabilities or caregivers speaking in a large group setting. Programs were most likely to focus on adults with physical disabilities. Among schools without a program, the top barriers were no one advocating for inclusion in the curriculum and time constraints. Nearly half of schools without a program expressed interest in adopting an awareness curriculum if one was made available. Such results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.

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Efficacy of Radial Extracorporeal Shock Wave Therapy on Lateral Epicondylosis, and Changes in the Common Extensor Tendon Stiffness With Pretherapy and Posttherapy in Real-Time Sonoelastography: Erratum

No abstract available

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Authors' Response to Letter to the Editor “Ultrasound-Guided C7 Cervical Medial Branch Block Using the In-Plane Approach”

imageNo abstract available

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Can Early Rehabilitation on the General Ward After an Intensive Care Unit Stay Reduce Hospital Length of Stay in Survivors of Critical Illness?: A Randomized Controlled Trial

imageObjective: The aim of this study was to evaluate if an early rehabilitation program for survivors of critical illness improves functional recovery, reduces length of stay, and reduces hospital costs. Design: This was a prospective randomized controlled trial. Fifty-three consecutive survivors of critical illness were included in the study. After discharge from the intensive care unit, the intervention group received an early rehabilitation program, and the standard-care group received physical therapy as ordered by the primary care team. Length of stay at the general ward after transfer from the intensive care unit was recorded. In addition, Early Rehabilitation Barthel Index, visual analog scale for pain, 3-minute walk test, Beck Depression Inventory, State-Trait Anxiety Inventory, and Medical Research Council scale were used. Results: In the per-protocol analysis, length of stay at the general ward was a median 14 days (interquartile range [IQR], 12–20 days) in the early rehabilitation and 21 days [IQR, 13–34 days) in the standard-care group. This significant result could not be confirmed by the intention-to-treat analysis (16 days [IQR, 13–23 days] vs. 21 days [IQR, 13–34 days]). Secondary outcomes were similar between the groups. Hospital costs were lower in the intervention group. No adverse effects were detected. Conclusions: An early rehabilitation program in survivors of critical illness led to an earlier discharge from the hospital, improved functional recovery, and was also cost-effective and safe. To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://ift.tt/1l80W45 CME Objectives: Upon completion of this article, the reader should be able to (1) delineate the benefits of early rehabilitation on a general medicine ward after an intensive care unit stay, (2) recognize the safety of appropriately implemented early rehabilitation, and (3) incorporate early rehabilitation on the general medical ward as applicable. Level: Advanced Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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The Magnitude and Time Course of Muscle Cross-section Decrease in Intensive Care Unit Patients

imageObjective: Bedriddenness and immobilization of patients at an intensive care unit may result in muscle atrophy and devaluation in quality of life. The exact effect of immobilization on intensive care unit patients is not known. The aim of this study was to investigate the magnitude and time course of muscle cross-section decrease in acute critically ill patients admitted to the intensive care unit. Design: An observational pilot study was performed in intensive care unit patients. Data of bilateral ultrasound muscle cross-section measurements of the knee extensors and the elbow flexors were collected. Thirty-four intensive care unit patients were included in this study; data are presented from 14 patients who were measured at least three times. Results: Repeated measures analysis of variance shows a significant decrease in muscle cross-section over time (F1,13 = 80.40, P ≤ 0.001).The decrease in muscle cross-section of the arms was significantly higher (F1,13 = 5.38, P = 0.037) than the decrease of the legs. Four weeks after intensive care unit admission, the muscle cross-section decrease had not reached an asymptote yet. Conclusions: The muscle cross-section decrease in bedridden intensive care unit patients is significant for a time of 2 to 4 weeks. The decrease in muscle cross-section of the arms is greater than the decrease of the legs.

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Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials

imageBackground: Massage therapy is gaining interest as a therapeutic approach to managing osteoarthritis and rheumatoid arthritis symptoms. To date, there have been no systematic reviews investigating the effects of massage therapy on these conditions. Design: Systematic review was used. Objectives: The primary aim of this review was to critically appraise and synthesize the current evidence regarding the effects of massage therapy as a stand-alone treatment on pain and functional outcomes among those with osteoarthritis or rheumatoid arthritis. Methods: Relevant randomized controlled trials were searched using the electronic databases Google Scholar, MEDLINE, and PEDro. The PEDro scale was used to assess risk of bias, and the quality of evidence was assessed with the GRADE approach. Results: This review found seven randomized controlled trials representing 352 participants who satisfied the inclusion criteria. Risk of bias ranged from four to seven. Our results found low- to moderate-quality evidence that massage therapy is superior to nonactive therapies in reducing pain and improving certain functional outcomes. It is unclear whether massage therapy is more effective than other forms of treatment. Conclusions: There is a need for large, methodologically rigorous randomized controlled trials investigating the effectiveness of massage therapy as an intervention for individuals with arthritis.

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Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial

imageObjective: This study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache. Design: Individuals (n = 62) with episodic or chronic tension-type headache were randomized to receive 12 twice-weekly 45-min massage or sham ultrasound sessions or wait-list control. Massage focused on trigger point release (ischemic compression) of MTrPs in the bilateral upper trapezius and suboccipital muscles. PPT was measured at MTrPs with a pressure algometer pre and post the first and final (12th) treatments. Results: PPT increased across the study timeframe in all four muscle sites tested for massage, but not sham ultrasound or wait-list groups (P

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Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems

Abstract: A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning—that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems. In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems. Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

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Prospective Evaluation of Postural Control and Gait in Pediatric Patients with Cancer After a 4-Week Inpatient Rehabilitation Program

imageObjective: The aim of the study was to investigate the effects of a 4-wk inpatient rehabilitation program on postural control and gait in pediatric patients with cancer. Design: Eighty-eight patients with brain tumors (n = 59) and bone/soft tissue sarcomas (n = 29) were evaluated. Postural control was assessed examining the velocity of the center of pressure and single-leg stance time on a pressure distribution platform. Walk ratio, a measure of neuromotor control, was used to evaluate intervention effects on gait. Results: Repeated measures analysis of variance showed improvements in postural control measures, indicated by a decrease in velocity of center of pressure of −0.4 cm/sec (F1,80 = 7.175, P = 0.009, ηp2 = 0.082) and increase in single-leg stance time (mean [median] = 1.1 [2.6] sec, respectively; F1,80 = 12.617, P = 0.001, ηp2 = 0.136). Walk ratio increased by 0.2 mm/steps per min (F1,82 = 3.766, P = 0.056, ηp2 = 0.044). Mean changes in dependent variables did not differ between both patient groups (P > 0.05). Conclusions: The results indicate benefits of an inpatient rehabilitation program comprising standard physical therapy as well as aquatic and hippo therapy on postural control and gait after treatment of pediatric patients with cancer.

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Ultrasound-Guided C7 Cervical Medial Branch Block Using the In-Plane Approach

imageNo abstract available

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A Rarely Seen Complication That Causes Increase in Morbidity in Tetraplegic Patients: Zenker Diverticula

imageAbstract: Although spinal cord injury (SCI) damages the spinal cord, physiological changes due to SCI can affect many organs and systems of the human body. While respiratory problems are common following cervical SCI, dysphagia is a relatively uncommon secondary complication that occurs after cervical SCI. We report a case of recurrent aspiration pneumonia due to Zenker diverticulum in 26-year-old tetraplegic patient with a chronic history of silent aspirations and dysphagia contributing to functional disability.

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Another Etiology of Meralgia Paresthetica-Impingement by Bone Spur from Anterior Superior Iliac Spine: A Case Report: Erratum

No abstract available

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Radiopaque Line in Front of the Lumbar Spine During a S1 Transforaminal Epidural Injection: Where Is the Contrast?

imageNo abstract available

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Lessons learnt from incidents involving the airway and breathing reported from Australasian emergency departments.

Related Articles

Lessons learnt from incidents involving the airway and breathing reported from Australasian emergency departments.

Emerg Med Australas. 2017 Aug 16;:

Authors: Crock C, Hansen K, Fogg T, Cahill A, Deakin A, Runciman WB

Abstract
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified.
METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing.
RESULTS: In all, 51 problems were identified among the 36 incidents related to airway and/or breathing. Fourteen involved clinical decision-making, 11 equipment, nine communication, seven intubation, five surgical access and five pneumothorax. Eight incidents involved children and there were nine deaths within hours or days.
CONCLUSIONS: Recommendations for improving preparedness of ED staff and facilities have been made for each of the problem areas identified with respect to clinical practice, equipment, communication and clinical process. Analysis of incidents from the Australasian Emergency Medicine Events Register allows clusters of like-events to be identified and characterised, providing the possibility of getting a better idea of how problems present and progress, with some information about contributing factors, characteristics and context. This will pave the way for earlier and better detection of life-threatening problems and the development and reinforcement of preventive and corrective strategies.

PMID: 28816011 [PubMed - as supplied by publisher]



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Hypo-fractionated SBRT for localized prostate cancer: a German bi-center single treatment group feasibility trial

For prostate cancer treatment, treatment options with minimal side effects are desired. External beam radiation therapy (EBRT) is non-invasive, standard of care and delivered in either conventional fractionati...

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Colorectal cancer patient’s self-efficacy for managing illness-related problems in the first 2 years after diagnosis, results from the ColoREctal Well-being (CREW) study

Abstract

Purpose

There is a growing emphasis on self-management of cancer aftercare. Little is known about patient's self-efficacy (confidence) to manage illness-related problems and how this changes over time. This paper describes the patterns of self-efficacy for managing illness-related problems amongst colorectal cancer patients in the 2 years following diagnosis.

Methods

In this prospective cohort study, questionnaires were administered at baseline (pre-surgery), 3, 9, 15 and 24 months to 872 colorectal cancer patients. Self-efficacy (confidence to manage illness-related problems), anxiety, social support, affect, socio-demographics, physical symptoms and clinical and treatment characteristics were assessed. Group-based trajectory analysis identified trajectories of self-efficacy up to 24 months and predictors.

Results

Four trajectories of self-efficacy were identified: group 1 (very confident) 16.0% (95% confidence interval (CI) 10.7–21.3%), group 2 (confident) 45.6% (95% CI 40.3–51.0%), group 3 (moderately confident) 29.5% (95% CI 25.1–33.8%) and group 4 (low confidence) 8.9% (95% CI 6.4–11.4%). Greater deprivation, domestic status, more co-morbidities, worse fatigue and pain, lower positivity and greater negativity were significantly associated with lower self-efficacy. There was an increase in mean scores for self-efficacy over time for the whole sample, but this did not reach the cut-off for minimally important differences. At 2 years, the lowest level of confidence to manage was for symptoms or health problems.

Conclusion

Around 40% of patients had suboptimal levels of confidence to manage illness-related problems with little change from the time of diagnosis across the four groups.

Implications for cancer survivors

Screening for self-efficacy at diagnosis would enable targeted, early intervention which could in turn enhance health-related quality of life.



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Organic Matter and Nutrients Removal in Tropical Constructed Wetlands Using Cyperus ligularis (Cyperaceae) and Echinocloa colona (Poaceae)

Abstract

In tropical countries like Colombia, a large variety of available aquatic plants have yet to be investigated for phytodepuration processes. The aim of this study was to assess the effect of Cyper-us ligularis and Echinocloa colona¸ two local plants of Colombian Caribbean region, on removal of dissolved organic matter (COD) and nutrients (N-NH4+, N-NO3 and P-PO4−3) from domestic wastewater. Experiments were conducted in replicate pilot-scale Horizontal Subsurface Flow Constructed Wetlands (HSSF CWs) (0.66 m2). Four wetland treatment units were installed in parallel. Two were planted with C. ligularis and the other two remained with E. colona. The experimental system was connected to a 0.76-m3 primary sedimentation tank that fed experimental wetland treatment units. Wetlands were filled with granite gravel (~8 mm and 0.4 of porosity). During a period of 4 months, each treatment unit received a continuous loading at the rate of 42 L day−1 and a hydraulic retention time of 2.3 days approximately. Wastewater samples from influent and effluents were collected three times each week in order to monitor temporal/spatial changes in removals efficiencies of COD, N-NH4+, N-NO3, and P-PO4−3. Results showed that removals of COD, N-NH4+, and N-NO3 were not significantly different between treatments (p > 0.05). Nevertheless, P-PO4−3 removal for E. colona was significantly higher than C. ligularis (p < 0.05), showing that this plant can assimilate important amounts of P. Further investigations must be conducted to evaluate the potential of native aquatic macrophytes for phytodepuration.



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Performance Analysis of Photolytic, Photocatalytic, and Adsorption Systems in the Degradation of Metronidazole on the Perspective of Removal Rate and Energy Consumption

Abstract

The efficiency of the following systems: photolysis (UV-C only), photocatalysis with titanium-dioxide (UV-C/TiO2), photocatalysis with granular-activated carbon (UV-C/GAC), and by adsorption on GAC, was assessed under different initial contaminant concentrations, i.e., 0.1–100 mg L−1. The experiments were conducted in a batch photocatalytic reactor (1.9 L and 32 W UV power). It was found that UV-C/TiO2 and UV-C/GAC systems showed fairly equal removal efficiencies under lower MNZ concentrations (0.1–5 mg L−1) compared to higher concentrations at similar catalyst loading of 2.5 g L−1. A decline in removal rate (based on first-order reaction) was observed with respect to increase in initial MNZ concentration in all systems. MNZ removal by adsorption on GAC was much lesser compared to UV-C only, UV-C/TiO2, and UV-C/GAC systems. The adsorption data well correlated with the Freundlich model indicated that the adsorption was on the heterogeneous surface of the catalyst. The effectiveness of the systems were evaluated by calculating electrical energy consumed per order (E EO). The lowest E EO value was found to be for UV-C/TiO2 (0.03 kWh m−3 order−1) for the degradation of 0.1 mg L−1 of MNZ compared to UV-C/GAC (0.06 kWh m−3 order−1), UV-C only (0.15 kWh m−3 order−1), and adsorption (0.44 kWh m−3 order−1). The total organic carbon and nitrogen ion analyses have confirmed the mineralization of MNZ via aliphatic carboxylic acid compounds in the photocatalytic system. Overall, the photocatalytic system seems to be an energy-efficient treatment option for the removal of MNZ and similar other micropollutants.



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Tumori della ghiandola parotide

Publication date: June 2017
Source:EMC - Otorinolaringoiatria, Volume 16, Issue 2
Author(s): P. Bonfils, O. Laccourreye, P. Giraud, P. Halimi
I tumori della parotide rappresentano il 70-80% dei tumori delle ghiandole salivari. Quasi l'80% dei tumori della parotide è benigno e, per la maggior parte, essi colpiscono l'adulto. Questi tumori sono caratterizzati da un'estrema diversità della loro natura anatomopatologica; la classificazione anatomopatologica dell'Organizzazione Mondiale della Sanità di questi tumori descrive quasi dieci diverse forme di adenomi, dominati dall'adenoma pleomorfo e dal tumore di Warthin, ma anche quasi una ventina di forme di carcinomi, dei tumori non epiteliali, dei linfomi e dei tumori secondari. La clinica varia a seconda del tipo di tumore, in particolare in base alla sua natura benigna o maligna. Gli esami complementari sono dominati dalla risonanza magnetica e dalla biopsia con ago sottile (FNA, Fine Needle Aspiration), spesso ecoguidata. La TC non ha un grande posto nella valutazione di questi tumori parotidei. Il trattamento dei tumori benigni della parotide si basa sulla chirurgia, il cui tipo di exeresi è discusso in letteratura tra procedure di exeresi ampia come una parotidectomia totale con conservazione del nervo faciale e procedure più o meno limitate, come la dissecazione extracapsulare. Il trattamento dei tumori maligni si basa sulla chirurgia e sulla radioterapia; le indicazioni sono discusse in funzione dello stadio del tumore.



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Linfangiomi cervicofacciali: imaging, diagnosi e trattamento

Publication date: June 2017
Source:EMC - Otorinolaringoiatria, Volume 16, Issue 2
Author(s): N. Teissier
I linfangiomi sono malformazioni dei vasi linfatici che si sviluppano principalmente sul viso e sul collo. Essi sono definiti dalla presenza di cisti a pareti sottili, che evolvono per puntate infiammatorie. A seconda delle dimensioni delle cisti, si descrivono principalmente due tipi: i linfangiomi microcistici e macrocistici. Li si distingue secondo le loro caratteristiche topografiche, cliniche e prognostiche. Questa differenza ha un impatto anche sulla loro gestione. Sono proposte diverse opzioni terapeutiche, senza che alcuna abbia dimostrato una superiorità rispetto alle altre, in particolare nella gestione dei linfangiomi microcistici.



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Epistassi

Publication date: June 2017
Source:EMC - Otorinolaringoiatria, Volume 16, Issue 2
Author(s): J.-M. Prades, M. Gavid
L'epistassi è un motivo quotidiano di urgenza in oto-rino-laringoiatria. Le cause sono molteplici e di varia gravità. Le cause locali di epistassi sono rappresentate dal trauma facciale, da un plesso vascolare o da una perforazione settale, più raramente da un fibroma rinofaringeo del ragazzo giovane o da un tumore maligno nasosinusale. Le cause generali di epistassi sono associate a un'alterazione dell'emostasi costituzionale o, più spesso, acquisita in occasione di un trattamento antitrombotico, di una malattia di Rendu-Osler o di una malattia sistemica come la granulomatosi di Wegener. La gestione terapeutica deve, allo stesso tempo, controllare l'emorragia e valutarne le conseguenze. Si devono considerare tre situazioni di gravità differente: l'epistassi è estremamente grave con uno shock emorragico che impone una rianimazione e l'emostasi di un tronco arterioso cefalico principale come l'arteria carotide interna; l'epistassi è grave per il suo contesto, in quanto sono presenti un trauma accidentale o perioperatorio, un disturbo dell'emostasi, più raramente una malattia di Rendu-Osler o un fibroma rinofaringeo; l'epistassi è "benigna" perché risponde rapidamente ai piccoli gesti di emostasi locali, in particolare con il controllo di un plesso vascolare del setto.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wpI5eb

Stimulus Characteristics of Single-Word Tests of Children's Speech Sound Production

Purpose
This clinical focus article provides readers with a description of the stimulus characteristics of 12 popular tests of speech sound production.
Method
Using significance testing and descriptive analyses, stimulus items were compared in terms of the number of opportunities for production of all consonant singletons, clusters, and rhotic and nonrhotic vowels of Standard American English; phonetic/phonological and structural complexity; and the presence of bound morphemes.
Results
The tests varied widely in terms of the number of opportunities for production of consonant singletons, clusters, and rhotic and nonrhotic vowels. Most of the tests included only 1 opportunity, scored or unscored, to produce a majority of the consonant singletons in each word position. Only 3 of the tests included stimulus items with 3-element clusters. The majority contained limited opportunities to produce 3- or 4-syllable stimulus items. The tests provided sufficient opportunities for production of most vowels, although most did not score vowels. The tests differed significantly in the complexity of their stimulus items. Most, however, contained a negligible number of items that, with the addition of a bound morpheme, resulted in a word-final cluster.
Conclusion
Most of the tests elicit an inadequate sample with which to conduct a comprehensive phonological analysis.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://article/doi/10.1044/2017_LSHSS-16-0050/2650813/Stimulus-Characteristics-of-SingleWord-Tests-of