Effect of different wavelengths and dyes on Candida albicans: In vivo study using Galleria mellonella as an experimental model.

Publication date: Available online 24 January 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Elisabetta Merigo, Stefania Conti, Tecla Ciociola, Carlo Fornaini, Luciano Polonelli, Giuseppe Lagori, Maddalena Manfredi, Paolo Vescovi
BackgroundStudies on photodynamic inactivation against microorganisms had a great development in recent years. The aim of this work was to test the application of different laser wavelengths with or without different photosensitizing dyes on Candida albicans cells in vitro and in photodynamic therapy protocols in vivo in larvae of Galleria mellonella.MethodsLaser application was realized on C. albicans cells suspended in saline solution or cultured on solid medium for the in vitro study, and in a model of G. mellonella candidal infection for the in vivo study. Three wavelengths (650, 405, and 532nm) were used in continuous mode with different values of applied fluences: 10, 20 and 30J/cm² for the in vitro study and 10J/cm² for the in vivo study, without and with photosensitizing dyes.ResultsNo growth inhibition was obtained on yeast cells in saline solution without photosensitizers. The maximum inhibition of growth (100%) was obtained with 405nm diode laser and curcumin at any used fluence. No growth inhibition was observed for yeast cells cultured on solid medium after laser application without dyes. An inhibition was observed after laser application when curcumin and erythrosine were added to the medium.The survival curves of G. mellonella larvae infected with C. albicans with or without the different dyes and after laser application showed a statistically significant difference (p<0.001) in comparison with the proper control groups.ConclusionsThese results show the efficacy of photodynamic inactivation exploiting a suitable combination of light and dyes against C. albicans and the potential of photodynamic therapy for the treatment of candidal infections.



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Efficacy of photodynamic therapy in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with denture stomatitis

Publication date: Available online 24 January 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Tariq Abduljabbar, Mansour Al-Askar, Mohammed K. Baig, Zeyad H. AlSowygh, Sergio Varela Kellesarian, Fahim Vohra
ObjectiveThe aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with denture stomatitis (DS).MethodsA questionnaire was used to gather demographic information. Clinical oral examination was performed to determine location of denture in the jaws and oral erythematous lesions. Presence of fungal hyphae in smokers and non-smokers was confirmed using exfoliative cytology. In both groups, aPDT was performed and colony forming units per milliliter (CFU/ml) were assessed im both groups at 3-months follow-up. Level of significance was et at P<0.05.ResultsTwenty-two males with DS (12 smokers and 10 non-smokers) were included. The mean ages of smokers and non-smokers was 73.8±2.5 and 70.5±1.2years, respectively. The duration and daily frequency of cigarette smoking was 20.6±4.5years and 12.3±1.5 cigarettes daily, respectively. Smokers and non-smokers had been wearing complete dentures since 6.2±0.8 and 5.8±0.4years, respectively. At 3-months follow-up, there was a statistically significant decrease in the mean fungal CFU/ml among smokers (25.5±8.3 CFU/ml) compared with their respective baseline values 106.7±6.3 CFU/ml (P <0.01). Among non-smokers, the mean CFU/ml values were 12.7±0.8 CFU/ml compared with their respective baseline values (93.6±8.4 CFU/ml) (P<0.01). At 3-months follow-up, fungal CFU/ml levels were statistically significantly higher among smokers (25.5±8.3 CFU/ml) compared with non-smokers (12.7±0.8 CFU/ml) (P<0.05).ConclusionaPDT is effective in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with. The role of denture is also emphasized.



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Preface: Studies on Understanding and Anti-Tumor Agents of Reproductive Cancer Cells

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Übergewicht und Fettleibigkeit sind Risikofaktoren für die Entwicklung einer Kardiotoxizität durch Anthrazykline oder die sequenzielle Gabe von Anthrazyklinen und Trastuzumab

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Einfluss von Dosis und Fraktionierung auf die kurativ intendierte Strahlentherapie nicht-kleinzelliger Bronchialkarzinome

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DART-bid for loco-regionally advanced NSCLC

Abstract

Background

To report acute and late toxicity with long-term follow-up, and to describe our experiences with pulmonary dose constraints.

Methods

Between 2002 and 2009, 150 patients with 155 histologically/cytologically proven non-small cell lung cancer (NSCLC; tumor stages II, IIIA, IIIB in 6, 55 and 39%, respectively) received the following median doses: primary tumors 79.2 Gy (range 72.0–90.0 Gy), lymph node metastases 59.4 Gy (54.0–73.8 Gy), nodes electively 45 Gy; with fractional doses of 1.8 Gy twice daily (bid). In all, 86% of patients received 2 cycles of chemotherapy previously.

Results

Five treatment-related deaths occurred: pneumonitis, n = 1; progressive pulmonary fibrosis in patients with pre-existing pulmonary fibrosis, n = 2; haemorrhage, n = 2. In all, 8% of patients experienced grade 3 and 1.3% grade 4 pneumonitis; 11% showed late fibrotic alterations grade 2 in lung parenchyma. Clinically relevant acute esophagitis (grade 2 and 3) was seen in 33.3% of patients, 2 patients developed late esophageal stenosis (G3). Patients with upper lobe, middle lobe and central lower lobe tumours (n = 130) were treated with V20 (total lung) up to 50% and patients with peripheral lower lobe tumours (n = 14, basal lateral tumours excluded) up to 42%, without observing acute or late pulmonary toxicity >grade 3. Only patients with basal lateral lower lobe tumours (n = 5) experienced grade 4/5 pulmonary toxicity; V20 for this latter group ranged between 30 and 53%. The mean lung dose was below the QUANTEC recommendation of 20–23 Gy in all patients. The median follow-up time of all patients is 26.3 months (range 2.9–149.4) and of patients alive 80.2 months (range 63.9–149.4.). The median overall survival time of all patients is 26.3 months; the 2-, 5- and 8‑year survival rates of 54, 21 and 15%, respectively. The local tumour control rate at 2 and 5 years is 70 and 64%, the regional control rate 90 and 88%, respectively.

Discussion and conclusion

Grade 4 or 5 toxicity occurred in 7/150 patients (4.7%), which can be partially avoided in the future (e.g. by excluding patients with pre-existing pulmonary fibrosis). Tolerance and oncologic outcome compare favourably to concomitant chemoradiation also in long-term follow-up.

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Prepregnancy Dietary Patterns Are Associated with Blood Lipid Level Changes During Pregnancy: A Prospective Cohort Study inRio de Janeiro, Brazil

Publication date: Available online 24 January 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Ilana Eshriqui, Ana Beatriz Franco-Sena, Dayana Rodrigues Farias, Ana Amélia Freitas-Vilela, Diana Barbosa Cunha, Erica Guimarães Barros, Pauline M. Emmett, Gilberto Kac
BackgroundPhysiologic adaptations lead to an increase in blood lipid levels during pregnancy, yet little is known about the influence of prepregnancy dietary patterns.AimTo identify whether prepregnancy dietary patterns that explain the consumption of fiber, energy, and saturated fat are associated with blood lipid levels throughout pregnancy.DesignProspective cohort study, with data collection at gestational weeks 5 to 13, 20 to 26, and 30 to 36. A food frequency questionnaire was administered at baseline (gestational week 5 to 13).Participants/settingWomen with singleton pregnancy (N=299) aged 20 to 40 years, without infectious/chronic disease (except obesity) were enrolled in the study. One hundred ninety-nine women were included in the final analysis. The study took place at a prenatal service of a public health care center in Rio de Janeiro, Brazil, during the period from 2009 to 2012.Main outcome measuresTotal cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride levels, measured at all trimesters.Statistical analyses performedDietary patterns were derived by reduced rank regression. Fiber density, dietary energy density, and percent energy from saturated fat were response variables. Crude and adjusted longitudinal linear mixed-effects regression models were performed to account for confounders and mediators. Interaction terms between dietary pattern and gestational week were tested.ResultsFast Food and Candies; Vegetables and Dairy; and Beans, Bread, and Fat patterns were derived. Our Fast Food and Candies pattern was positively associated with triglyceride level (β=4.961, 95% CI 0.945 to 8.977; P=0.015). In the HDL-C rate of change prediction, significant interactions were observed between both the Fast Food and Candies and Vegetables and Dairy patterns and gestational week (β=–.053, 95% CI –0.101 to –0.004; P=0.035 and β=.055, 95% CI –0.002 to 0.112; P=0.060, respectively). The Beans, Bread, and Fat pattern was not associated with blood lipid levels.ConclusionsPrepregnancy dietary patterns were associated with gestational blood lipid levels; that is, higher scores for the Fast Food and Candies pattern were associated with higher triglyceride and slower HDL-C rates of change during pregnancy, whereas higher scores for the Vegetables and Dairy dietary patterns were associated with faster HDL-C rates of change over gestational weeks.



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Molecular diversity of corticotropin-releasing hormone mRNA-containing neurons in the hypothalamus

Hormonal responses to acute stress rely on the rapid induction of corticotropin-releasing hormone (CRH) production in the mammalian hypothalamus, with subsequent instructive steps culminating in corticosterone release at the periphery. Hypothalamic CRH neurons in the paraventricular nucleus of the hypothalamus are therefore considered as 'stress neurons'. However, significant morphological and functional diversity among neurons that can transiently produce CRH in other hypothalamic nuclei has been proposed, particularly as histochemical and molecular biology evidence associates CRH to both GABA and glutamate neurotransmission. Here, we review recent advances through single-cell RNA sequencing and circuit mapping to suggest that CRH production reflects a state switch in hypothalamic neurons and thus confers functional competence rather than being an identity mark of phenotypically segregated neurons. We show that CRH mRNA transcripts can therefore be seen in GABAergic, glutamatergic and dopaminergic neuronal contingents in the hypothalamus. We then distinguish 'stress neurons' of the paraventricular nucleus that constitutively express secretagogin, a Ca²⁺ sensor critical for the stimulus-driven assembly of the molecular machinery underpinning the fast regulated exocytosis of CRH at the median eminence. Cumulatively, we infer that CRH neurons are functionally and molecularly more diverse than previously thought.

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Leptin stimulates bone formation in ob/ob mice at doses having minimal impact on energy metabolism

Leptin, the protein product of the ob gene, is essential for normal bone growth, maturation and turnover. Peripheral actions of leptin occur at lower serum levels of the hormone than central actions because entry of leptin into the central nervous system (CNS) is limited due to its saturable transport across the blood–brain barrier (BBB). We performed a study in mice to model the impact of leptin production associated with different levels of adiposity on bone formation and compared the response with well-established centrally mediated actions of the hormone on energy metabolism. Leptin was infused (0, 4, 12, 40, 140 or 400 ng/h) for 12 days into 6-week-old female ob/ob mice (n = 8/group) using sc-implanted osmotic pumps. Treatment resulted in a dose-associated increase in serum leptin. Bone formation parameters were increased at EC₅₀ infusion rates of 7–17 ng/h, whereas higher levels (EC₅₀, 40–80 ng/h) were required to similarly influence indices of energy metabolism. We then analyzed gene expression in tibia and hypothalamus at dose rates of 0, 12 and 140 ng/h; the latter dose resulted in serum leptin levels similar to WT mice. Infusion with 12 ng/h leptin increased the expression of genes associated with Jak/Stat signaling and bone formation in tibia with minimal effect on Jak/Stat signaling and neurotransmitters in hypothalamus. The results suggest that leptin acts peripherally to couple bone acquisition to energy availability and that limited transport across the BBB insures that the growth-promoting actions of peripheral leptin are not curtailed by the hormone's CNS-mediated anorexigenic actions.

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Dissociating the Neural Basis of Conceptual Self-Awareness from Perceptual Awareness and Unaware Self-Processing

Conceptual self-awareness is a mental state in which the content of one's consciousness refers to a particular aspect of semantic knowledge about oneself. This form of consciousness plays a crucial role in shaping human behavior; however, little is known about its neural basis. Here, we use functional magnetic resonance imaging (fMRI) and a visual masked priming paradigm to dissociate the neural responses related to the awareness of semantic autobiographical information (one's own name, surname, etc.) from the awareness of information related to any visual stimulus (perceptual awareness), as well as from the unaware processing of self-relevant stimuli. To detect brain activity that is highly selective for self-relevant information, we used the blood-oxygen-level-dependent (BOLD) adaptation approach, which goes beyond the spatial limitations of conventional fMRI. We found that self-awareness was associated with BOLD adaptation in the medial frontopolar-retrosplenial areas, whereas perceptual awareness and unaware self-processing were associated with BOLD adaptation in the lateral fronto-parietal areas and the inferior temporal cortex, respectively. Thus, using a direct manipulation of conscious awareness we demonstrate for the first time that the neural basis of conceptual self-awareness is neuroanatomically distinct from the network mediating perceptual awareness of the sensory environment or unaware processing of self-related stimuli.

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Heparan Sulfates Support Pyramidal Cell Excitability, Synaptic Plasticity, and Context Discrimination

Heparan sulfate (HS) proteoglycans represent a major component of the extracellular matrix and are critical for brain development. However, their function in the mature brain remains to be characterized. Here, acute enzymatic digestion of HS side chains was used to uncover how HSs support hippocampal function in vitro and in vivo. We found that long-term potentiation (LTP) of synaptic transmission at CA3–CA1 Schaffer collateral synapses was impaired after removal of highly sulfated HSs with heparinase 1. This reduction was associated with decreased Ca²⁺ influx during LTP induction, which was the consequence of a reduced excitability of CA1 pyramidal neurons. At the subcellular level, heparinase treatment resulted in reorganization of the distal axon initial segment, as detected by a reduction in ankyrin G expression. In vivo, digestion of HSs impaired context discrimination in a fear conditioning paradigm and oscillatory network activity in the low theta band after fear conditioning. Thus, HSs maintain neuronal excitability and, as a consequence, support synaptic plasticity and learning.

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Dermatomal Organization of SI Leg Representation in Humans: Revising the Somatosensory Homunculus

Penfield and Rasmussen's homunculus is the valid map of the neural body representation of nearly each textbook of biology, physiology, and neuroscience. The somatosensory homunculus places the foot representation on the mesial surface of the postcentral gyrus followed by the representations of the lower leg and the thigh in superio-lateral direction. However, this strong homuncular organization contradicts the "dermatomal" organization of spinal nerves. We used somatosensory-evoked magnetic fields and source analysis to study the leg's neural representation in the primary somatosensory cortex (SI). We show that the representation of the back of the thigh is located inferior to the foot's representation in SI whereas the front of the thigh is located laterally to the foot's representation. This observation indicates that the localization of the leg in SI rather follows the dermatomal organization of spinal nerves than the typical map of neighboring body parts as depicted in Penfield and Rasmussen's illustration of the somatosensory homunculus.

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Elevated Body Mass Index is Associated with Increased Integration and Reduced Cohesion of Sensory-Driven and Internally Guided Resting-State Functional Brain Networks

Elevated body mass index (BMI) is associated with increased multi-morbidity and mortality. The investigation of the relationship between BMI and brain organization has the potential to provide new insights relevant to clinical and policy strategies for weight control. Here, we quantified the association between increasing BMI and the functional organization of resting-state brain networks in a sample of 496 healthy individuals that were studied as part of the Human Connectome Project. We demonstrated that higher BMI was associated with changes in the functional connectivity of the default-mode network (DMN), central executive network (CEN), sensorimotor network (SMN), visual network (VN), and their constituent modules. In siblings discordant for obesity, we showed that person-specific factors contributing to obesity are linked to reduced cohesiveness of the sensory networks (SMN and VN). We conclude that higher BMI is associated with widespread alterations in brain networks that balance sensory-driven (SMN, VN) and internally guided (DMN, CEN) states which may augment sensory-driven behavior leading to overeating and subsequent weight gain. Our results provide a neurobiological context for understanding the association between BMI and brain functional organization while accounting for familial and person-specific influences.

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Longitudinal Evidence for Increased Functional Response in Frontal Cortex for Older Adults with Hippocampal Atrophy and Memory Decline

The functional organization of the frontal cortex is dynamic. Age-related increases in frontal functional responses have been shown during various cognitive tasks, but the cross-sectional nature of most past studies makes it unclear whether these increases reflect reorganization or stable individual differences. Here, we followed 130 older individuals' cognitive trajectories over 20–25 years with repeated neuropsychological assessments every 5th year, and identified individuals with stable or declining episodic memory. Both groups displayed significant gray matter atrophy over 2 successive magnetic resonance imaging sessions 4 years apart, but the decline group also had a smaller volume of the right hippocampus. Only individuals with declining memory demonstrated increased prefrontal functional responses during memory encoding and retrieval over the 4-year interval. Regions with increased functional recruitment were located outside, or on the borders of core task-related networks, indicating an expansion of these over time. These longitudinal findings offer novel insight into the mechanisms behind age-associated memory loss, and are consistent with a theoretical model in which hippocampus atrophy, past a critical threshold, induces episodic-memory decline and altered prefrontal functional organization.

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Spontaneous eye blink rate (EBR) predicts poor performance in high-stakes situations

Publication date: Available online 24 January 2017
Source:International Journal of Psychophysiology
Author(s): Ilse H. van de Groep, Lucas M. de Haas, Iris Schutte, Erik Bijleveld
Although the existence of 'choking under pressure' is well-supported by research, its biological underpinnings are less clear. In this research, we examined two individual difference variables that may predict whether people are likely to perform poorly in high-incentive conditions: baseline eye blink rate (EBR; reflecting dopamine system functioning) and baseline anterior hemispheric asymmetry (an indicator of goal-directed vs. stimulus driven processing). Participants conducted a switch task under control vs. incentive conditions. People low in EBR were generally capable of improving their performance when incentives were at stake, whereas people high in EBR were not. Hemispheric asymmetry did not predict performance. These findings are consistent with the idea that suboptimal performance in high-stakes conditions may stem from the neuromodulatory effects of dopamine.



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Blunted cardiovascular reactivity during social reward anticipation in subclinical depression

Publication date: Available online 24 January 2017
Source:International Journal of Psychophysiology
Author(s): Kerstin Brinkmann, Jessica Franzen
The present study extends past research about reduced reward responsiveness in depression by assessing effort-related cardiovascular responses during anticipation of a social reward. Dysphoric (i.e., subclinically depressed) and nondysphoric participants worked on a cognitive task. Half the participants in each group expected the possibility to subscribe to a social exchange internet site. Effort mobilization during task performance was assessed by participants' cardiovascular reactivity. Confirming the predictions, nondysphoric participants in the social-reward condition had higher reactivity of pre-ejection period, systolic blood pressure, and heart rate, compared to the other three cells. In contrast, dysphoric participants' cardiovascular reactivity was generally low. These findings indicate that social-reward function is indeed impaired in subclinical depression. Implications for social punishment are discussed.



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Cold flow of three-dimensional confined polymer systems

Publication date: 24 February 2017
Source:Polymer, Volume 111
Author(s): Xiang Li, Chen Zhang, Ye Sha, Linling Li, Dongshan Zhou, Zexin Zhang, Gi Xue, Xiaoliang Wang
Increasing temperature has been widely considered as a primary and effective way to improve the segmental mobility of polymer chains and subsequently cause polymer chains to flow. Here, by confining the morphology of polymers into nanospheres and combining this process with external stress, we present an important new approach to achieve the cold flow of glassy polymers at room temperature, under which the mobility of chain segments are enhanced significantly. The interparticle fusion and the flow of polymer chains under pressure were monitored by utilizing a non-radiative energy transfer (NRET) method. Additionally, we showed that low-temperature processing based on cold flow retains the biological activity of bio-additives.

Graphical abstract

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Auditing access to outpatient rehabilitation services for children with traumatic brain injury and public insurance in Washington State

Publication date: Available online 23 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Molly M. Fuentes, Leah Thompson, D. Alex Quistberg, Wren L. Haaland, Karin Rhodes, Deborah Kartin, Cheryl Kerfeld, Susan Apkon, Ali Rowhani-Rahbar, Frederick P. Rivara
ObjectiveIdentify insurance-based disparities in access to outpatient pediatric neurorehabilitation services.DesignAudit study, with paired calls where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury (TBI) and public or private insurance.SettingOutpatient rehabilitation clinics in Washington StateParticipants195 physical therapy clinics (PTc), 109 occupational therapy clinics (OTc), 102 speech therapy clinics (STc) and 11 rehabilitation medicine clinicsInterventionsNoneMain outcome measuresAcceptance of public insurance, business days until the next available appointment.ResultsTherapy clinics were more likely to accept private versus public insurance (relative risk (RR) for PTc 1.33 (95% confidence interval (CI) 1.22-1.44), OTc 1.40 (95% CI 1.24-1.57), and STc 1.42 (95% CI 1.25-1.62), with no significant difference for rehabilitation medicine (RR 1.10, 95% CI 0.90-1.34). The difference in median wait time between clinics that accepted public versus only private insurance was 4 business days for PTc and 15 days for STc (p ≤ .001) but not significantly different for OTc or rehabilitation medicine. When adjusting for urban and multidisciplinary clinic status, the wait at clinics accepting public insurance was 59% longer for PT (95% CI 39-81%), 18% longer for OT (95% CI 7-30%) and 107% longer for ST (95% CI 87-130%) than at clinics accepting only private insurance. Distance to clinics varied by discipline and area within the state.ConclusionTherapy clinics were less likely to accept public versus private insurance. Therapy clinics accepting public insurance had longer wait times than clinics that accepted only private insurance. Rehabilitation professionals should attempt to implement policy and practice changes to promote equitable access to care.



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Body Image in Patients With Spinal Cord Injury During Inpatient Rehabilitation

Publication date: Available online 24 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Tijn van Diemen, Christel van Leeuwen, Ilse van Nes, Jan Geertzen, Marcel Post
Objectives(1) To investigate the course of body image in patients with spinal cord injury (SCI) during their first inpatient rehabilitation stay; and (2) to explore the association between demographic and injury-related variables and body image and the association between body image and psychological distress.DesignLongitudinal inception cohort study.SettingRehabilitation center.ParticipantsOf the 210 people admitted for their first inpatient SCI rehabilitation program (between March 2011 and April 2015), 188 met the inclusion criteria. Of these, N=150 (80%) agreed to participate.InterventionsNot applicable.Main Outcome MeasureThe Body Experience Questionnaire was used to measure 2 dimensions of body image: alienation and harmony.ResultsMean scores on the Body Experience Questionnaire alienation subscale decreased significantly during the rehabilitation program. Mean scores on the Body Experience Questionnaire harmony subscale did not increase significantly but showed a trend in the hypothesized direction. The 2 subscales showed weak correlations with demographic and injury-related variables. The 2 subscales together explained 16% and 14% of the variance of depression and anxiety, respectively, after correction for demographic and injury-related variables.ConclusionsDuring participants' first inpatient rehabilitation stay after SCI, body image progressed toward a healthier state. Body image explains part of the variance in depression and anxiety, and the entire rehabilitation team should be targeting interventions to improve body image.



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Tissue engineering the mechanosensory circuit of the stretch reflex arc with human stem cells: Sensory neuron innervation of intrafusal muscle fibers

Publication date: April 2017
Source:Biomaterials, Volume 122
Author(s): Xiufang Guo, Alisha Colon, Nesar Akanda, Severo Spradling, Maria Stancescu, Candace Martin, James J. Hickman
Muscle spindles are sensory organs embedded in the belly of skeletal muscles that serve as mechanoreceptors detecting static and dynamic information about muscle length and stretch. Through their connection with proprioceptive sensory neurons, sensation of axial body position and muscle movement are transmitted to the central nervous system. Impairment of this sensory circuit causes motor deficits and has been linked to a wide range of diseases. To date, no defined human-based in vitro model of the proprioceptive sensory circuit has been developed. The goal of this study was to develop a human-based in vitro muscle sensory circuit utilizing human stem cells. A serum-free medium was developed to drive the induction of intrafusal fibers from human satellite cells by actuation of a neuregulin signaling pathway. Both bag and chain intrafusal fibers were generated and subsequently validated by phase microscopy and immunocytochemistry. When co-cultured with proprioceptive sensory neurons derived from human neuroprogenitors, mechanosensory nerve terminal structural features with intrafusal fibers were demonstrated. Most importantly, patch-clamp electrophysiological analysis of the intrafusal fibers indicated repetitive firing of human intrafusal fibers, which has not been observed in human extrafusal fibers.



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Copyright

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2





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Contributors

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2





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Contents

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2





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CME Accreditation Page

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2





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Forthcoming Issues

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2





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Genitourinary Imaging

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2
Author(s): Andrew B. Rosenkrantz




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Dual-Energy Computed Tomography in Genitourinary Imaging

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2
Author(s): Achille Mileto, Daniele Marin

Teaser

Reignited by innovations in scanner engineering and software design, dual-energy computed tomography (CT) has come back into the clinical radiology arena in the last decade. Possibilities for noninvasive in vivo characterization of genitourinary disease, especially for renal stones and renal masses, have become the pinnacle offerings of dual-energy CT for body imaging in clinical practice. This article renders a state-of-the-art review on clinical applications of dual-energy CT in genitourinary imaging.


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The Evidence for and Against Corticosteroid Prophylaxis in At-Risk Patients

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2
Author(s): Matthew S. Davenport, Richard H. Cohan

Teaser

Corticosteroid prophylaxis is commonly used for the prevention of allergiclike reactions to iodinated and gadolinium-based contrast material in patients at highest risk of an allergiclike reaction. However, it has only a weak mitigating effect on allergiclike reactions, probably does not affect the severity of subsequent reactions, and does not prevent all reactions. Breakthrough reactions occur, are usually the same severity as the index reaction, and can occasionally be life threatening. Premedication of inpatients is likely associated with substantial cost and harm because of hospital length-of-stay prolongation; these indirect effects may exceed the benefits of premedication in this population.


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Index

Publication date: March 2017
Source:Radiologic Clinics of North America, Volume 55, Issue 2





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Editorial: Towards Improving the Science of Hormones and Cancer

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Evaluating phytoextraction efficiency of two high-biomass crops after soil amendment and inoculation with rhizobacterial strains

Abstract

We evaluated the effect of compost amendment and/or bacterial inoculants on the growth and metal accumulation of Salix caprea (clone BOKU 01 AT-004) and Nicotiana tabacum (in vitro-bred clone NBCu10-8). Soil was collected from an abandoned Pb/Zn mine and rhizobacterial inoculants were previously isolated from plants growing at the same site. Plants were grown in untreated or compost-amended (5% w/w) soil and were inoculated with five rhizobacterial strains. Non-inoculated plants were also established as a control. Compost addition increased the shoot DW yield of N. tabacum but not S. caprea, while it decreased soil metal availability and lowered shoot Cd/Zn concentrations in tobacco plants. Compost amendment enhanced the shoot Cd/Zn removal due to the growth promotion of N. tabacum or to the increase in metal concentration in S. caprea leaves. Bacterial inoculants increased photosynthetic efficiency (particularly in N. tabacum) and sometimes modified soil metal availability, but this did not lead to a significant increase in Cd/Zn removal. Compost amendment was more effective in improving the Cd and Zn phytoextraction efficiency than bioaugmentation.

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Dental health status in crack/cocaine-addicted men: a cross-sectional study

Abstract

The aim of this study was to evaluate the association between crack/cocaine addiction and dental health in men. Forty crack/cocaine-addicted patients and 120 nonaddicted patients (≥18 years) underwent full-mouth dental examinations. Decayed, missing, and filled teeth (DMFT) were identified using the criteria recommended by the World Health Organization. Crack/cocaine addiction was determined, based on the medical records and interviews of each patient. All drug-addicted patients used both crack and cocaine. The chi-square test and logistic regression analysis were used to assess the association between DMFT and crack/cocaine addiction (p ≤ 0.05). Decayed teeth showed a positive association with crack/cocaine addiction (odds ratio (OR) = 3.65; 95% confidence interval (CI), 1.68–7.92; p = 0.001), whereas filled and missing teeth showed a negative association (filled teeth: OR = 0.37; 95% CI, 0.18–0.76; p = 0.008; missing teeth: OR = 0.33; 95% CI, 0.13–0.81; p = 0.02). The DMFT was only associated with age (OR = 2.12; 95% CI, 1.11–4.08, p = 0.023). In the present population, crack/cocaine addiction was associated with a greater decayed teeth index and a lower filled and missing teeth index. Programs aimed to encourage self-esteem and encourage individuals to seek dental care are required for this population. Further studies using a larger sample size and studies with women are required to confirm the results.

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Removal of phenanthrene in contaminated soil by combination of alfalfa, white-rot fungus, and earthworms

Abstract

The aim of this study was to investigate the removal of phenanthrene by combination of alfalfa, white-rot fungus, and earthworms in soil. A 60-day experiment was conducted. Inoculation with earthworms and/or white-rot fungus increased alfalfa biomass and phenanthrene accumulation in alfalfa. However, inoculations of alfalfa and white-rot fungus can significantly decrease the accumulation of phenanthrene in earthworms. The removal rates for phenanthrene in soil were 33, 48, 66, 74, 85, and 93% under treatments control, only earthworms, only alfalfa, earthworms + alfalfa, alfalfa + white-rot fungus, and alfalfa + earthworms + white-rot fungus, respectively. The present study demonstrated that the combination of alfalfa, earthworms, and white-rot fungus is an effective way to remove phenanthrene in the soil. The removal is mainly via stimulating both microbial development and soil enzyme activity.

http://ift.tt/2jWxNfd

Concurrent panniculectomy in the obese ventral hernia patient: assessment of short-term complications, hernia recurrence, and healthcare utilization

Panniculectomy (PAN) is often performed concurrently with ventral hernia repair (VHR) in the obese patient. However, the effectiveness and safety profile of this common practice have not been fully established in part due to paucity of comparative effectiveness studies. Presented herein is a comparative analysis of early complications, long-term hernia recurrence, and healthcare expenditures between VHR-PAN and VHR-only patients.

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Xanthomatous Hypophysitis Is Associated with Ruptured Rathke’s Cleft Cyst

Abstract

Xanthomatous hypophysitis is a rare inflammatory disease of the pituitary gland that can mimic a neoplastic lesion clinically and radiologically. Its pathogenesis remains largely unknown, although recent evidence suggests that pituitary inflammation may occur as a secondary reaction to mucous content released from a ruptured cyst. In a series of 1221 pituitary specimens, we identified seven cases of xanthomatous hypophysitis. Six patients had complete radiological and biochemical workup preoperatively: a cystic-appearing pituitary mass was identified in all six patients (100%) with a mean size of 2.0 cm (range 1.4–2.5 cm) on imaging, and pituitary endocrine dysfunction was noted in five patients (83.3%). In all cases, the pituitary mass was resected through an endoscopic transsphenoidal approach. Pathological examination revealed the presence of foamy macrophages admixed with variable amounts of giant cells and chronic inflammatory cells, confirming the diagnosis of xanthomatous hypophysitis. Additionally, all cases presented with concurrent findings of ruptured Rathke's cleft cyst, with the exception of one patient who had previous surgery for a Rathke's cleft cyst, followed by recurrence and diagnosis of xanthomatous hypophysitis. While accurate distinction of hypophysitis from a pituitary neoplasm can be problematic in the preoperative setting, the identification of a cystic lesion in the sella turcica should raise the possibility of such an entity in the clinical and radiological differential diagnosis. The current series provides further evidence that xanthomatous hypophysitis predominantly occurs as a secondary reaction to a ruptured Rathke's cleft cyst; thus, it is best classified as a secondary (reactive) hypophysitis.

http://ift.tt/2juM0Nf

Thiazolidine reacts with thioreactive biomolecules

Publication date: Available online 24 January 2017
Source:Free Radical Biology and Medicine
Author(s): Deyuan Su, Yin Nian, Fenglei Zhang, Jinsheng Hu, Jianmin Cui, Ming Zhou, Jian Yang, Shu Wang
The thiazolidine ring is a biologically active chemical structure and is associated with many pharmacological activities. However, the biological molecules that can interact with the thiazolidine ring are not known. We show that thiazolidine causes sustained activation of the TRPA1 channel and chemically reacts with glutathione, and the chemical reactivity of thiazolidine ring is required for TRPA1 activation. Reducing agents reverse thiazolidine-induced TRPA1 activation, and mutagenesis studies show that nucleophilic cysteine residues in TRPA1 are critical, suggesting an activation mechanism involving thioreactive chemical reactions. In vivo studies show that thiazolidine induces acute pain and inflammation in mouse and these responses are specifically dependent on TRPA1. These results indicate that thiazolidine compounds can chemically react with biological molecules containing nucleophilic cysteines, thereby exerting biological activities.



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The Potential for Advanced Neuro MRI Techniques in Pediatric Stroke Research

Publication date: Available online 24 January 2017
Source:Pediatric Neurology
Author(s): Trish Domi, Arastoo Vossough, Nicholas V. Stence, Ryan J. Felling, Jackie Leung, Pradeep Krishnan, Christopher J. Watson, P. Ellen Grant, Andrea Kassner
PurposeThis paper was written to provide clinicians and researchers with an overview of a number of advanced neuroimaging in an effort to promote increased utility, and the design of future studies using advanced neuroimaging techniques in childhood stroke.BackgroundThe current capabilities of advanced magnetic resonance imaging (MRI) techniques provide the opportunity to build on our knowledge of the consequences of stroke on the developing brain. These capabilities include providing information about the physiology, metabolism, structure, and function of the brain that are not routinely evaluated in the clinical setting.MethodsDuring the Proceedings of the Stroke Imaging Laboratory for Children (SILC) Workshop in Toronto in June 2015, a subgroup of clinicians and imaging researchers discussed how the application of advanced neuroimaging techniques could further our understanding of the mechanisms of stroke injury and repair in the pediatric population. This subgroup was established based on their interest and commitment to design collaborative, advanced neuroimaging studies in the pediatric stroke population. In working towards this goal, we first sought to describe here the MRI techniques that are currently available for use, and how they have been applied in other stroke populations (for example, adult and perinatal stroke).ConclusionsWith the continued improvement of advanced neuroimaging techniques, including shorter acquisition times, there is an opportunity to apply these techniques to their full potential in the research setting, and learn more about the effects of stroke in the developing brain.



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Myoclonic Absence Seizures in Dravet Syndrome

Publication date: Available online 24 January 2017
Source:Pediatric Neurology
Author(s): Kenneth A. Myers, Ingrid E. Scheffer
BackgroundDravet syndrome is a developmental and epileptic encephalopathy that occurs due to SCN1A mutations in more than 80% of cases. The core clinical features of Dravet syndrome include febrile and afebrile seizures beginning before 12 months; multiple seizure types, usually medically refractory, including hemiclonic, generalized tonic-clonic, focal impaired awareness, myoclonic, and absence seizures; status epilepticus; and normal early development with plateau or regression by two years. Myoclonic absence seizures have not previously been described.CaseA 20-year-old man had infantile onset epilepsy with the classical clinical features of Dravet syndrome and a de novo A1326P SCN1A mutation. By five years of age, photosensitive myoclonic absence seizures had become his dominant seizure type, occurring up to 20 times per day. The seizures were refractory to multiple anti-epileptic medications and a vagal nerve stimulator.DiscussionAlthough photosensitivity is well recognised in Dravet syndrome, myoclonic absence seizures have not been previously reported. This rare seizure type may be underreported in Dravet as the myoclonic features may be subtle and can be missed if thorough history-taking and video recordings are not available.



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Recurrent focal myositis in childhood: a case report and systematic review of the literature

Publication date: Available online 24 January 2017
Source:Pediatric Neurology
Author(s): Gregorio P. Milani, Marta B.M. Mazzoni, Helga Gatti, Giuseppe Bertolozzi, Emilio F. Fossali
BackgroundRecurrent focal myositis in adulthood has been documented in some case reports and case series. Existing textbooks and reviews do not mention or mention only in passing this entity in childhood. The aim of this study was to report a new paediatric case of recurrent focal myositis and summarise clinical, laboratory, management and outcome available data on this entity in paediatric age.MethodA 9-year-old patient with recurrent myositis of the left biceps is described. Moreover, the terms "myositis" and "relapsing" or "recurrent" or "recurrence" were searched using the United States National Library of Medicine and the Excerpta Medica Database. Pertaining secondary references were also screened.ResultsA total of further 7 paediatric cases (5 males and 2 females, median age 10, interquartile range 7-14 years old) affected with recurrent focal myositis were found. In children, the calf was the most frequently involved muscle and myositis, differently from adults, was usually painful. Episodes presented normal or elevated blood levels of erythrocyte sedimentation rate, C-reactive protein, creatine kinase and aspartate aminotransferase. Abnormalities of creatine kinase value did not seem to be associated with higher risk of recurrences.ConclusionsAs in our case, paediatric focal myositis has a favourable outcome. Recurrent focal myositis is rare and usually benign in childhood. Accumulation of more data is needed to improve the knowledge on this condition.



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Risk assessment in paediatric glioma – time to move on from the binary classification

Publication date: Available online 23 January 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): A.J. DodgshunThe author names have been tagged as given names and surnames (surnames are highlighted in teal color). Please confirm if they have been identified correctly., J.R. Hansford, M.J. Sullivan
BackgroundPaediatric glioma encompasses a wide range of entities with highly variable prognoses. Gliomas are grouped by histopathological features into high- and low-grade glioma but this classification until recently has not taken into account many emerging risk factors in this disease. A comprehensive risk classification has not been published for paediatric glioma despite many risk factors being established in this disease.MethodsA comprehensive literature review was carried out identifying risk factors for paediatric low-grade and high-grade glioma.ResultsThe most consistently described risk factors in high-grade glioma included midline location and extent of surgical resection. For patients with progressive unresectable low-grade glioma, age under 1, neurofibromatosis type I status and location were the most consistently prognostic. Molecular classification shows promise in accurately reassigning diagnosis for some gliomas.ConclusionRisk profiling in paediatric glioma will require a focused multinational effort but will result in a more accurate and nuanced assessment of prognosis.



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A randomized controlled clinical and histopathological trial comparing excisional biopsies of oral fibrous hyperplasias using CO 2 and Er:YAG laser

Abstract

This study was conducted in order to compare clinical and histopathological outcomes for excisional biopsies when using pulsed CO₂ laser versus Er:YAG laser. Patients (n = 32) with a fibrous hyperplasia in the buccal mucosa were randomly allocated to the CO₂ (140 Hz, 400 μs, 33 mJ) or the Er:YAG laser (35 Hz, 297 μs, 200 mJ) group. The duration of excision, intraoperative bleeding and methods to stop the bleeding, postoperative pain (VAS; ranging 0–100), the use of analgesics, and the width of the thermal damage zone (μm) were recorded and compared between the two groups. The median duration of the intervention was 209 s, and there was no significant difference between the two methods. Intraoperative bleeding occurred in 100% of the excisions with Er:YAG and 56% with CO₂ laser (p = 0.007). The median thermal damage zone was 74.9 μm for CO₂ and 34.0 μm for Er:YAG laser (p < 0.0001). The median VAS score on the evening after surgery was 5 for the CO₂ laser and 3 for the Er:YAG group. To excise oral soft tissue lesions, CO₂ and Er:YAG lasers are both valuable tools with a short time of intervention and postoperative low pain. More bleeding occurs with the Er:YAG than CO₂ laser, but the lower thermal effect of Er:YAG laser seems advantageous for histopathological evaluation.

http://ift.tt/2kqaI1A

Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society

Abstract

Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biologic behavior and management strategies. Although Spitz naevi are considered benign tumours, their clinical and dermoscopic morphologic overlap with spitzoid melanoma renders the management of spitzoid lesions particularly difficult. The controversy deepens because of the existence of tumours that cannot be safely histopathologically diagnosed as naevi or melanomas (atypical Spitz tumours). The dual objective of the present study was to provide an updated classification on dermoscopy of Spitz naevi, and management recommendations of spitzoid looking lesions based on a consensus among experts in the field. After a detailed search of the literature for eligible studies, a data synthesis was performed from 15 studies on dermoscopy of Spitz naevi. Dermoscopically, Spitz naevi are typified by 3 main patterns: starburst pattern (50.6%), a pattern of regularly distributed dotted vessels (19.3%) and globular pattern with reticular depigmentation (17.0%). A consensus-based algorithm for the management of spitzoid lesions is proposed. According to it, dermoscopically asymmetric lesions with spitzoid features (both flat/raised and nodular) should be excised to rule out melanoma. Dermoscopically symmetric spitzoid nodules should also be excised or closely monitored, irrespectively of the age, to rule out atypical Spitz tumours. Dermoscopically symmetric flat spitzoid lesions should be managed according to the age of the patient. Finally, the histopathologic diagnosis of atypical Spitz tumour should warrant wide excision but not a sentinel lymph node biopsy.

This article is protected by copyright. All rights reserved.

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Electrochemotherapy in the treatment of metastatic malignant melanoma: A prospective cohort study by InspECT

Abstract

Background

Electrochemotherapy (ECT) is an effective local treatment for cutaneous metastasis. Treatment involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumour. The aim of this study was to investigate the effectiveness of ECT in cutaneous metastases of melanoma and to identify factors which affect (beneficially or adversely) the outcome.

Methods

13 cancer centres in the International Network for Sharing Practices on Electrochemotherapy (INSPECT) consecutively and prospectively uploaded data to a common database. ECT consisted of intratumoural or intravenous injection of bleomycin, followed by application of electric pulses under local or general anaesthesia.

Results

151 patients with metastatic melanoma were identified from the database, 114 of which had follow-up data of 60 days or more. 80 of these patients (73%) experienced an overall response (complete response + partial response = OR). 394 lesions were treated, of which 306 (77%) revealed an OR, 229 a complete response (58%). In multivariate analysis, factors positively associated with overall response were coverage of deep margins, absence of visceral metastases, presence of lymphoedema, treatment of non-irradiated areas were factors significantly influencing treatment efficacy. Factors significant associated to a complete response to ECT treatment were: coverage of deep margins, previous irradiation of treated area, and tumour size (<3 cm). One-year overall survival in this cohort of patients was 67% (C.I. 95%: 57%-77%), whilst melanoma specific survival was 74% (C.I. 95%: 64%-84%). No serious adverse events were reported, and the treatment was in general very well tolerated.

Conclusion

ECT is a highly effective local treatment for melanoma metastases in the skin, with no severe adverse effects. In the presence of certain clinical factors, ECT may be considered for local tumour control as an alternative to established local treatments, or as an adjunct to systemic treatments.

This article is protected by copyright. All rights reserved.

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Nicotinamide reduces COX-2 expression in HaCaT keratinocytes after ultraviolet B irradiation

Abstract

In their interesting research letter, Chen et al. (2016 Apr 8. doi: 10.1111/bjd.14662)¹ described the protective effects of oral nicotinamide (NCT) for chemoprevention of non-melanoma skin cancers (NMSCs) in renal transplant recipients. We totally agree that NCT can represent a new opportunity

for NMSC chemoprevention basing on its capability to preserve cellular energy reserve for ATP-dependent DNA repair as well as UV-induced immunosuppression.² Moreover, we hypothesize that one of the mechanisms through which NCT may act is by modulating the expression of cyclooxygenase (COX)-2, the rate-limiting enzyme in prostaglandin (PG) generation.

This article is protected by copyright. All rights reserved.

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Artifacts Caused by Breast Tissue Markers in a Dedicated Cone-beam Breast CT in Comparison to Full-field Digital Mammography

Publication date: Available online 24 January 2017
Source:Academic Radiology
Author(s): Susanne Wienbeck, Carsten Nowak, Antonia Zapf, Georg Stamm, Christina Unterberg-Buchwald, Joachim Lotz, Uwe Fischer
Rationale and ObjectivesThe purpose of this ex vivo study was to investigate artifacts in a cone-beam breast computed tomography (CBBCT) caused by breast tissue markers.Materials and MethodsBreast phantoms with self-made tissue pork mincemeat were created. Twenty-nine different, commercially available markers with varying marker size, composition, and shape were evaluated. A dedicated CBBCT evaluation of all phantoms was performed with 49 kVp, 50 and 100 mA, and marker orientation parallel and orthogonal to the scan direction. The resultant images were evaluated in sagittal, axial, and coronal view with a slice thickness of 0.5 mm. Additionally, measurements of all markers in the same directions were done with full-field digital mammography.ResultsAll markers were visible in full-field digital mammography without any artifacts. However, all markers caused artifacts on a CBBCT. Artifacts were measured as the length of the resulting streakings. Median length of artifacts was 7.2 mm with a wide range from 0 to 48.3 mm (interquartile range 4.3–11.4 mm) dependent on composition, size, shape, weight, and orientation of the markers. The largest artifacts occurred in axial view with a median size of 12.6 mm, with a range from 0 to 48.3 mm, resulting in a relative artifact length (quotient artifact in mm/real physical length of the marker itself) of 4.1 (interquartile range 2.3–6.1, range 0–8.7).ConclusionsArtifacts caused by markers can significantly influence image quality in a CBBCT, thus limiting primary diagnostics and follow-up in breast cancer. The size of the artifacts depends on the marker characteristics, orientation, and the image plane of reconstruction.



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3D Printing of Preoperative Simulation Models of a Splenic Artery Aneurysm

Publication date: Available online 24 January 2017
Source:Academic Radiology
Author(s): Hidemasa Takao, Shiori Amemiya, Eisuke Shibata, Kuni Ohtomo
Rationale and ObjectivesThree-dimensional (3D) printing is attracting increasing attention in the medical field. This study aimed to apply 3D printing to the production of hollow splenic artery aneurysm models for use in the simulation of endovascular treatment, and to evaluate the precision and accuracy of the simulation model.Materials and MethodsFrom 3D computed tomography (CT) angiography data of a splenic artery aneurysm, 10 hollow models reproducing the vascular lumen were created using a fused deposition modeling-type desktop 3D printer. After filling with water, each model was scanned using T2-weighted magnetic resonance imaging for the evaluation of the lumen. All images were coregistered, binarized, and then combined to create an overlap map. The cross-sectional area of the splenic artery aneurysm and its standard deviation (SD) were calculated perpendicular to the x- and y-axes.ResultsMost voxels overlapped among the models. The cross-sectional areas were similar among the models, with SDs <0.05 cm². The mean cross-sectional areas of the splenic artery aneurysm were slightly smaller than those calculated from the original mask images. The maximum mean cross-sectional areas calculated perpendicular to the x- and y-axes were 3.90 cm² (SD, 0.02) and 4.33 cm² (SD, 0.02), whereas those calculated from the original mask images were 4.14 cm² and 4.66 cm², respectively. The mean cross-sectional areas of the afferent artery were, however, almost the same as those calculated from the original mask images.ConclusionThe results suggest that 3D simulation modeling of a visceral artery aneurysm using a fused deposition modeling-type desktop 3D printer and computed tomography angiography data is highly precise and accurate.



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Attending Radiologist Variability and Its Effect on Radiology Resident Discrepancy Rates

Publication date: Available online 24 January 2017
Source:Academic Radiology
Author(s): Joseph C. Wildenberg, Po-Hao Chen, Mary H. Scanlon, Tessa S. Cook
Rationale and ObjectivesDiscrepancy rates for interpretations produced in a call situation are one metric to evaluate residents during training. Current benchmarks, reported in previous studies, do not consider the effects of practice pattern variability among attending radiologists. This study aims to investigate the impact of attending variability on resident discrepancy rates to determine if the current benchmarks are an accurate measure of resident performance and, if necessary, update discrepancy benchmarks to accurately identify residents performing below expectations.Materials and MethodsAll chest radiographs, musculoskeletal (MSK) radiographs, chest computed tomographies (CTs), abdomen and pelvis CTs, and head CTs interpreted by postgraduate year-3 residents in a call situation over 5 years were reviewed for the presence of a significant discrepancy and composite results compared to prior findings. Simulations of the expected discrepancy distribution for an "average resident" were then performed using Gibbs sampling, and this distribution was compared to the actual resident distribution.ResultsA strong inverse correlation between resident volume and discrepancy rates was found. There was wide variability among attendings in both overread volume and propensity to issue a discrepancy, although there was no significant correlation. Simulations show that previous benchmarks match well for chest radiographs, abdomen and pelvis CTs, and head CTs but not for MSK radiographs and chest CTs. The simulations also demonstrate a large effect of attending practice patterns on resident discrepancy rates.ConclusionsThe large variability in attending practice patterns suggests direct comparison of residents using discrepancy rates is unlikely to reflect true performance. Current benchmarks for chest radiographs, abdomen and pelvis CTs, and head CTs are appropriate and correctly flag residents whose performance may benefit from additional attention, whereas those for MSK radiographs and chest CTs are likely too strict.



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Automated and Manual Measurements of the Aortic Annulus with ECG-Gated Cardiac CT Angiography Prior to Transcatheter Aortic Valve Replacement

Publication date: Available online 24 January 2017
Source:Academic Radiology
Author(s): David Guez, Gilda Boroumand, Nicholas J. Ruggiero, Praveen Mehrotra, Ethan Joseph Halpern
Rationale and ObjectivesMultimodality evaluation of the aortic annulus is generally advocated to plan for transcatheter aortic valve replacement (TAVR). We compared aortic annular measurements by cardiac computed tomography angiography (cCTA) to three-dimensional transesophageal echocardiography (3D-TEE), and also evaluated the use of semi-automated software for cCTA annular measurements.Materials and MethodsA retrospective cohort of 74 patients underwent 3D-TEE and electrocardiogram-gated cCTA of the heart within 30 days for TAVR planning. 3D-TEE measurements were obtained during mid-systole; cCTA measurements were obtained during late-systole (40% of R-R interval) and mid-diastole (80% of R-R interval). Annular area was measured independently by manual planimetry and with semi-automated software.ResultscCTA measurements in systole and diastole were highly correlated for short-axis diameter (r = 0.91), long-axis diameter (r = 0.92), and annular area (r = 0.96), although systolic measurements were significantly larger (P < 0.001), most notably for the short-axis diameter. Good correlation was observed between 3D-TEE and cCTA for short-axis diameter (r = 0.84–0.90), long-axis diameter (r = 0.77–0.79), and annular area (r = 0.89–0.90). As compared to 3D-TEE, annular area is overmeasured by 28 mm² on systolic phase cCTA (P < 0.008), but nearly identical with 3D-TEE on diastolic phase cCTA. Semi-automated and manual cCTA annulus measurements were highly correlated in systole (r = 0.94) and diastole (r = 0.93), although the semi-automated annular area measured 11–30 mm² greater than manual planimetry. Of note, the 95% limits of agreement in our Bland-Altman analysis suggest that the variability in annular area estimates for individual patients between cCTA and 3D-TEE (−100.9 to 99.6 mm²), as well as the variability between manual and automated measurements with cCTA (−105.9 to 45.2 mm²), may be sufficient to alter size selection for an aortic prosthesis.ConclusionsAlthough all cCTA measurements are highly correlated with measurements by 3D-TEE, diastolic phase cCTA measurements tend to be closer to standard mid-systolic 3D-TEE measurements. Semi-automated measurement of the aortic annulus with cCTA is highly correlated with manual planimetry. Nonetheless, annular contours derived by semi-automated software should be visually inspected, as the variability in area estimates for individual cases between manual and automated measurements may alter the sizing of an aortic prosthesis.



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Purification and immunochemical characterization of Pla l 2, the profilin from Plantago lanceolata

Publication date: March 2017
Source:Molecular Immunology, Volume 83
Author(s): Raquel Moya, Virginia Rubio, Juan Mª. Beitia, Jerónimo Carnés, M. Angeles López-Matas
Profilins are small actin-binding proteins found in eukaryotes and involved in cell development, cytokinesis, membrane trafficking, and cell motility. From an allergenic point of view, profilins are panallergens usually involved in allergic polysensitization, although they are generally recognized as minor allergens.The objectives of this study were to identify and characterize the profilin from Plantago lanceolata pollen and to investigate the cross-reactivity between profilins from different pollen allergenic sources.Profilins from P. lancelolata (Pla l 2) and palm tree pollen (Pho d 2) were purified by affinity chromatography, deeply characterized and identified by mass spectrometry. Pla l 2 allergenicity was confirmed by immunoblot with serum samples from a patient population sensitized to profilin. Immunoblot inhibition was performed to study IgG reactivity between different pollen profilins. IgE cross-reactivity was demonstrated by ImmunoCAP inhibition.Pla l 2 is the second P. lanceolata allergen included in the IUIS Allergen Nomenclature database. Four peptides from purified Pla l 2 were identified with percentages of homology with other pollen profilins between 73 and 86%. Eighty-six percent (21/24) of the patient population recognized Pla l 2. The allergenic relatedness between Pla l 2, Pho d 2 and six pollen profilins was confirmed, and IgE cross-reactivity of Pla l 2 with rBet v 2 and rPhl p 12 was demonstrated.Pla l 2 is the profilin from P. lanceolata. The demonstrated allergenicity of this protein and its cross-reactivity with other pollen profilins support its use in profilin diagnostic assays.



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Inflammasomes in the lung

Publication date: Available online 24 January 2017
Source:Molecular Immunology
Author(s): James W. Pinkerton, Richard Y. Kim, Avril A.B. Robertson, Jeremy A. Hirota, Lisa G. Wood, Darryl A. Knight, Matthew A. Cooper, Luke A.J. O'Neill, Jay C. Horvat, Philip M. Hansbro
Innate immune responses act as first line defences upon exposure to potentially noxious stimuli. The innate immune system has evolved numerous intracellular and extracellular receptors that undertake surveillance for potentially damaging particulates. Inflammasomes are intracellular innate immune multiprotein complexes that form and are activated following interaction with these stimuli. Inflammasome activation leads to the cleavage of pro-IL-1β and release of the pro-inflammatory cytokine, IL-1β, which initiates acute phase pro-inflammatory responses, and other responses are also involved (IL-18, pyroptosis). However, excessive activation of inflammasomes can result in chronic inflammation, which has been implicated in a range of chronic inflammatory diseases. The airways are constantly exposed to a wide variety of stimuli. Inflammasome activation and downstream responses clears these stimuli. However, excessive activation may drive the pathogenesis of chronic respiratory diseases such as severe asthma and chronic obstructive pulmonary disease. Thus, there is currently intense interest in the role of inflammasomes in chronic inflammatory lung diseases and in their potential for therapeutic targeting. Here we review the known associations between inflammasome-mediated responses and the development and exacerbation of chronic lung diseases.



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Effects of pasireotide (SOM230) on protein turnover and p70S6 kinase-S6 ribosomal protein signaling pathway in rat skeletal muscle cells

http://ift.tt/2jUVNPL

Expression of YAP1 in aggressive thyroid cancer

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Studying the influence of formulation and process variables on Vancomycin-loaded polymeric nanoparticles as potential carrier for enhanced ophthalmic delivery

Publication date: 30 March 2017
Source:European Journal of Pharmaceutical Sciences, Volume 100
Author(s): Carol Yousry, Seham A. Elkheshen, Hanan M. El-laithy, Tamer Essam, Rania H. Fahmy
Ocular topically applied Vancomycin (VCM) suffers poor bioavailability due to its high molecular weight and hydrophilicity. In the present investigation, VCM-loaded polymeric nanoparticles (PNPs) were developed aiming to enhance its ocular bioavailability through prolonging its release pattern and ophthalmic residence. PNPs were prepared utilizing double emulsion (W/O/O), solvent evaporation technique. 2³×4¹ full factorial design was applied to evaluate individual and combined influences of polymer type, Eudragit® RS100, sonication time, and Span®80 concentration on PNPs particle size, encapsulation efficiency, and zeta potential. Further, the optimized formulae were incorporated in 1% Carbopol®-based gel. In-vivo evaluation of the optimized formulae was performed via Draize test followed by microbiological susceptibility testing on albino rabbits. Results revealed successful formulation of VCM-loaded PNPs was achieved with particle sizes reaching 155nm and up to 88% encapsulation. Draize test confirmed the optimized formulae as non-irritating and safe for ophthalmic administration. Microbiological susceptibility testing confirmed prolonged residence, higher Cmax. with more than two folds increment in the AUC(0.25–24) of VCM-PNPs over control groups. Thus, VCM-loaded PNPs represent promising carriers with superior achievements for enhanced Vancomycin ophthalmic delivery over the traditional use of commercially available VCM parenteral powder after constitution into a solution by the ophthalmologists.

Graphical abstract

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Twenty-year follow-up using a postal survey of childhood vitiligo treated with narrowband ultraviolet-B phototherapy

Vitiligo is a depigmenting skin disorder with an estimated prevalence of 1%.¹ Childhood-onset vitiligo occurs in approximately a third of all cases.² Early-onset childhood vitiligo tends to be a more extensive and progressive type of vitiligo.³ Narrowband ultraviolet-B (NB-UVB) phototherapy is an effective treatment option in active vitiligo and leads to >75% repigmentation in 14-75% of childhood cases.^4,5 Unfortunately, no evidence is available whether this repigmentation is long-lasting. To date, no data are available on the long-term efficacy and safety of NB-UVB in childhood vitiligo.

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Siramesine causes preferential apoptosis of mast cells in skin biopsies from psoriatic lesions

Summary

Background

Skin mast cells are implicated as detrimental effector cells in various inflammatory skin diseases such as contact eczema, atopic dermatitis and psoriasis. Selective reduction of cutaneous mast cells, e.g. by inducing targeted apoptosis, might prove a rational and efficient therapeutic strategy in dermatoses negatively influenced by mast cells.

Objectives

The objective of the present study was to evaluate whether a lysosomotropic agent such as siramesine can cause apoptosis of mast cells present in psoriatic lesions.

Methods

Punch biopsies were obtained from lesional and uninvolved skin in 25 patients with chronic plaque psoriasis. After incubation with siramesine, the number of tryptase-positive mast cells, and their expression of IL-6 and IL-17 was analyzed. Skin biopsies were digested to allow flow cytometry analysis of the drug's effect on cutaneous fibroblasts and keratinocytes.

Results

Siramesine caused a profound reduction in the total number of mast cells in both lesional and uninvolved psoriatic skin biopsies without affecting the gross morphology of the tissue. The drug reduced the density of IL-6- and IL-17-positive mast cells, and showed antiproliferative effects on epidermal keratinocytes but had no apparent cytotoxic effect on keratinocytes or dermal fibroblasts.

Conclusions

Considering the pathophysiology of psoriasis, the effects of siramesine on cutaneous mast cells may prove favourable from the therapeutic aspect. The results encourage further studies to assess the usefulness of siramesine and other lysosomotropic agents in the treatment of cutaneous mastocytoses and inflammatory skin diseases aggravated by dermal mast cells.

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Antipruritic effect of pretreatment with 8% topical capsaicin on histamine- and cowhage-evoked itch in healthy volunteers – a randomized placebo-blinded proof-of-concept trial

Abstract

Background

Chronic itch is difficult to treat and associated with significantly decreased life quality. Topical low-concentration capsaicin (0.006-0.05%) has previously been investigated and applied in therapy of itch but contradictory evidence exits regarding its efficacy.

Objectives

This placebo-controlled, double-blinded study investigated the effect of 8% topical capsaicin applied for 1 and 24 hours on evoked itch, neurogenic inflammation and itch-associated dysesthesia.

Methods

Sixteen healthy volunteers (22±0.5 years, 9F) were treated with capsaicin for 1h and 24hrs, and vehicle for 24hrs on each volar forearm. After capsaicin/vehicle application, histamine (1%, administered prick test lancets) and cowhage (40-45 spicules) were applied in pretreated areas. Evoked itch and pain intensities were recorded for 10 minutes using a visual analog scale (0-10 cm), while Sensitivity To Touch-evoked Itch (STTI) was evaluated using von Frey filaments before/after itch provocations (as a measure of punctuate hyperknesis). Neurogenic inflammation was assessed using perfusion-imaging.

Results

In the vehicle-pretreated areas peak itch responses to histamine and cowhage were 4.67±0.58 and 5.15±0.71, respectively. Capsaicin-pretreatment reduced peak itch responses to both histamine and cowhage, after 24-hour pretreatment to 1.41±0.58 (p=0.003) and 0.81±0.18, (p<0.001), respectively. 1-hour capsaicin-pretreatment only reduced cowhage-induced itch (p=0.023). Furthermore, 24-hours capsaicin-pretreatment abolished punctuate hyperknesis and lowered histamine-induced neurogenic inflammation but did not affect wheal reactions.

Conclusions

Twenty-four hours of topical 8% capsaicin-pretreatment reduced histaminergic and non-histaminergic itch by ≈75%, while only significant reduction was achieved for non-histaminergic itch in a standard 1-hour treatment. Further investigations are needed to elucidate the clinical potential of high-concentration capsaicin as an antipruritic.

This article is protected by copyright. All rights reserved.

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IFC (editorial board)

Publication date: February 2017
Source:Peptides, Volume 88





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The International Neuropeptide society pages

Publication date: February 2017
Source:Peptides, Volume 88





http://ift.tt/2jtqYyG

Gayle & Richard Olson prize pages

Publication date: February 2017
Source:Peptides, Volume 88





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Physical Therapy Treatments for Chronic Non-Cancer Pain: A Review of Guidelines [Internet].

Examples of physical therapies used in the management of chronic pain include exercise and active physical therapy, yoga, manual therapies (such as spinal manipulation therapy and mobilization), acupuncture and massage. Physical and exercise therapies are varied and may include exercises to improve range of motion and muscle conditioning to increase the degree of stability and function and improve pain control. Exercises can be passive, during which external force is applied and there is no voluntary muscle contraction or can be active, assisted with partial contraction and external force applied. Acupuncture is an intervention that involves the insertion of needles at specific acupuncture points. In the management of chronic pain it has been hypothesized that acupuncture induces changes in the perception and memory of pain and may induce changes in the sympathetic nervous system. Massage therapy has been defined as "as soft tissue and joint manipulation using the hands or a handheld device" for therapeutic purposes and is another example of a physical therapy used to help control pain. Massage therapy is thought to have a broad range of benefits related to relaxation and circulation.

http://ift.tt/2j1eAK9

Vein Illumination Devices for Vascular Access: A Review of Clinical Effectiveness [Internet].

The purpose of this report is to retrieve and review the existing evidence on the efficacy of vascular transillumination devices for pediatric patients in acute care settings.

http://ift.tt/2kek5lu

Rural Healthcare Workforce: A Systematic Review [Internet].

Approximately 20 percent of the US total population lives in rural areas. Patients living in rural areas are often underserved with regard to healthcare access. The complexity of rural healthcare provision requires careful and systematic evaluation of individual contributing factors. The purpose of this review is to examine the current literature quantifying current and projected health provider need, to explore geographic provider choices, to synthesize evidence on interventions to increase rural provider recruitment and provider retention, and to document the efficacy of student training for current rural healthcare in the US.

http://ift.tt/2j18Yzt

Ceftolozane and Tazobactam for the Treatment of Bacterial Infections: A Review of Clinical Effectiveness, Cost-effectiveness, and Guidelines [Internet].

Health Canada issued a Notice of Compliance for Zerbaxa in September 2015 and the date of first sale was in January 2016. Given the recent introduction of IV ceftolozane/tazobactam into clinical practice, evidence is required to support its broader use and to better understand its place in therapy relative to existing antimicrobial treatment options. The purpose of this report is to evaluate the clinical effectiveness, cost-effectiveness, and evidence-based guidelines for the use of ceftolozane/tazobactam for patients with bacterial infections.

http://ift.tt/2kerOQA

Metformin Use in Patients with Historical Contraindications or Precautions [Internet].

Metformin is a biguanide oral hypoglycemic used primarily for treating type 2 diabetes mellitus (T2D). Evidence suggests that, in addition to improving glycemic control, metformin is associated with improved all-cause and cardiovascular mortality and decreased risk of some cancers. However, clinicians have been advised by the U.S. Food and Drug Administration (FDA) to exercise caution in prescribing metformin to individuals with chronic kidney disease (CKD), unstable congestive heart failure (CHF), chronic liver disease (CLD), and older age due to perceived risk of side effects, including lactic acidosis (LA).

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A community-based primary prevention programme for type 2 diabetes mellitus integrating identification and lifestyle intervention for prevention: a cluster randomised controlled trial.

The study found that a relatively low-resource pragmatic screening programme fit for implementation in the UK NHS may lead to a reduction in type 2 diabetes mellitus and is cost-effective.

http://ift.tt/2j1gYAx

Long and Short Duration Inpatient Treatment Programs for the Treatment of Post-Traumatic Stress Disorder: Comparative Effectiveness and Guidelines [Internet].

Patients can be treated for post-traumatic stress disorder (PTSD) in numerous services, programs, and settings for varying durations. There are usually four levels of care for patients with mental illness: inpatient hospitalization (i.e., 24-hour care in a structured setting, usually for patients who are severely depressed, traumatized, or suicidal), residential treatment (i.e., similar to inpatient hospitalization but in a more home-like environment, medical staff not available on a 24-hour basis, for residents who are declared medically stable), partial hospitalization (i.e., day treatment, for patients who need structured treatment program but do not need 24-hour supervision), or outpatient treatment.

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An evidence-based approach to the use of telehealth in long-term health conditions: development of an intervention and evaluation through pragmatic randomised controlled trials in patients with depression or raised cardiovascular risk.

Two linked telehealth trials found small benefits with increased costs and raised questions about the most appropriate methods for future development and evaluation of telehealth.

http://ift.tt/2j1bGVD

Behavioural and Psychological Interventions for Chronic Non-Cancer Pain: A Review of Guidelines [Internet].

The aim of this report is to review the guidelines regarding the behavioural and psychological interventions for chronic non-cancer pain.

http://ift.tt/2keihcl

Denosumab versus Zoledronic Acid for Men with Osteoporosis: A Review of Clinical Effectiveness and Guidelines [Internet].

There is a need to determine if there is a preferred non-oral agent to increase bone mineral density (BMD) in men with osteoporosis, particularly for cases when patients have failed on or cannot tolerate oral bisphosphonates, for patients with comorbidities that may affect choice of therapy, or for men with early prostate cancer undergoing androgen-deprivation therapy (ADT). In 2015, denosumab (Prolia) was evaluated by the CADTH Common Drug Review (CDR) for the treatment of osteoporosis in men, but zoledronic acid has not been reviewed by CDR for this indication. The Canadian Drug Expert Committee (CDEC) noted that at the time of the CDR review, there were no direct comparisons of denosumab with other therapeutic agents approved for the treatment of men with osteoporosis. The purpose of this report is to evaluate the comparative clinical effectiveness of denosumab and zoledronic acid for the treatment of men with osteoporosis, including men with non-metastatic prostate cancer who are receiving ADT, and to identify evidence-based guidelines for the use of these agents for these indications.

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Interventions to improve contact tracing for tuberculosis in specific groups and in wider populations: an evidence synthesis.

The evidence on interventions to improve contact tracing for TB was primarily descriptive rather than evaluative, so a high priority for future research is empirical evaluation.

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Supplemental Project To Assess the Transparency of Reporting for Strategies To Improve Mental Health Care for Children and Adolescents [Internet].

The RTI International–University of North Carolina Evidence-based Practice Center (RTI-UNC EPC) used an ongoing review, Strategies to Improve Mental Health Care for Children and Adolescents (SIMHC), to generate a report on the additional information gained by including data from clinicaltrials.gov. The purpose of the report was to summarize the evidence on strategies to improve mental health for children, through quality improvement (QI) strategies and interventions with proven effectiveness (e.g., evidence-based practices [EBPs]). The rationale for the topic was to understand how to bridge the gap between observed and achievable processes and outcomes, through strategies that target changes in the organization and delivery of mental health services

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Dialysis Modalities for the Treatment of End-Stage Kidney Disease: A Health Technology Assessment — Project Protocol [Internet].

An increasing number of patients with end-stage kidney disease (ESKD) are being initiated on long-term dialysis every year in Canada. Hemodialysis (HD) and peritoneal dialysis (PD) are the two main types of dialysis provided under Canadian renal care programs. In HD, the patient's blood is circulated to an external dialysis machine, which filters wastes and extra water from the blood before returning it to the body. In PD, a permanent catheter affixed to the abdomen is used to fill the peritoneal cavity with a dialysis solution. The peritoneal membrane functions as a filter for wastes and extra water, and the dialysis solution is exchanged, either intermittently or continuously.

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Computed Tomography Angiography for Diagnosis of Stroke or Transient Ischemic Attack: A Review of the Clinical Effectiveness [Internet].

The objective of this report is to review the evidence with respect to clinical effectiveness of computed tomography angiogram (CTA) in the diagnosis of patients presenting with symptoms of stroke or transient ischemic attacks (TIA).

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Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care.

The researchers explored the processes through which, and the circumstances in which, feeding back data from patient-reported outcome measures (PROMs) improved patient care, at the aggregate and individual level.

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Microstructure statistics–property relations of silver particle-based interconnects

Publication date: 15 March 2017
Source:Materials & Design, Volume 118
Author(s): A. Gillman, M.J.G.H. Roelofs, K. Matouš, V.G. Kouznetsova, O. van der Sluis, M.P.F.H.L. van Maris
This paper presents a novel approach for establishing microstructure statistics-property relations for a silver particle-based thermal interface material (TIM). Several sintered silver TIMs have been prepared under different processing conditions, generating samples with distinct microstructures. The 3D microstructure is revealed and visualized using the combination of Focussed Ion Beam (FIB) milling and Scanning Electron Microscopy (SEM) imaging. Representative synthetic model microstructures have been generated based on Gaussian random field models, having well defined analytical descriptions. The statistical characteristics of the samples and the synthetic models are shown to have a good correspondence, indicating that the linear effective properties of these complex materials can be predicted based on analytical estimates available for the synthetic models. This is verified by computing the effective elastic and thermal material properties using the computational homogenization approach based on the finite element models of the real samples. The computational homogenization, providing the reference solution, and the higher-order statistical estimates for the synthetic models are in very good agreement. These results can be used in the development of new silver particle-based materials, whereby the expensive and time consuming effective material property characterization can be replaced by efficient estimation based on the synthetic random field models.

Graphical abstract

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Modeling of bake-hardening effect for fine grain bainite-aided dual phase steel

Publication date: 15 March 2017
Source:Materials & Design, Volume 118
Author(s): N. Ormsuptave, V. Uthaisangsuk
Bake hardening (BH) effects of dual phase (DP) steels with consideration of grain size and bainitic phase were investigated. Basically, after BH process, DP steels exhibited complex microstructure characteristic including Cottrell atmosphere, precipitation in ferrite and tempered martensite. Firstly, severe plastic deformation, namely, constrained groove pressing (CGP) was applied to a ferrite–pearlite low carbon steel for producing fine grain microstructure with submicron size. Subsequently, DP steel and DP steel with bainite were generated by intercritical annealing following by water and oil quenching, respectively. The BH at the temperature of 160°C for 20min was performed for steel samples with different microstructures after pre-straining to 2, 6 and 10%. Obviously, fine grain structure and bainite could effectively increase the bake hardenability of the examined steels. Additionally, micromechanics based modeling for describing flow stress behavior of the DP steels after BH was done. Hereby, influences of carbon accumulation, occurred carbides and softened martensite were incorporated. Accordingly, the flow curves of the investigated DP steels before and after BH were fairly predicted by means of representative volume element (RVE) finite element (FE) simulations. The increased yield strengths, BH values and resulting strain hardening curves could be accurately described.

Graphical abstract

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Ataxia-telangiectasia: Immunodeficiency and survival

Publication date: Available online 24 January 2017
Source:Clinical Immunology
Author(s): Nienke J.H. van Os, Anne F.M. Jansen, Marcel van Deuren, Asgeir Haraldsson, Nieke T.M. van Driel, Amos Etzioni, Michiel van der Flier, Charlotte A. Haaxma, Tomohiro Morio, Amit Rawat, Michiel H.D. Schoenaker, Annarosa Soresina, Alexander M.R. Taylor, Bart P.C. van de Warrenburg, Corry M.R. Weemaes, Nel Roeleveld, Michèl A.A.P. Willemsen
Ataxia-telangiectasia (AT) is a neurodegenerative disorder characterized by ataxia, telangiectasia, and immunodeficiency. An increased risk of malignancies and respiratory diseases dramatically reduce life expectancy. To better counsel families, develop individual follow-up programs, and select patients for therapeutic trials, more knowledge is needed on factors influencing survival. This retrospective cohort study of 61 AT patients shows that classical AT patients had a shorter survival than variant patients (HR 5.9, 95%CI 2.0–17.7), especially once a malignancy was diagnosed (HR 2.5, 95%CI 1.1–5.5, compared to classical AT patients without malignancy). Patients with the hyper IgM phenotype with hypogammaglobulinemia (AT-HIGM) and patients with an IgG2 deficiency showed decreased survival compared to patients with normal IgG (HR 9.2, 95%CI 3.2–26.5) and patients with normal IgG2 levels (HR 7.8, 95%CI 1.7–36.2), respectively. If high risk treatment trials will become available for AT, those patients with factors indicating the poorest prognosis might be considered for inclusion first.



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Obesity, physical activity and cancer risks: Results from the Cancer, Lifestyle and Evaluation of Risk Study (CLEAR)

Publication date: April 2017
Source:Cancer Epidemiology, Volume 47
Author(s): Carlos Nunez, Adrian Bauman, Sam Egger, Freddy Sitas, Visalini Nair-Shalliker
IntroductionPhysical activity (PA) has been associated with lower risk of cardiovascular diseases, but the evidence linking PA with lower cancer risk is inconclusive. We examined the independent and interactive effects of PA and obesity using body mass index (BMI) as a proxy for obesity, on the risk of developing prostate (PC), postmenopausal breast (BC), colorectal (CRC), ovarian (OC) and uterine (UC) cancers.MethodsWe estimated odds ratios (OR) and 95% confidence intervals (CI), adjusting for cancer specific confounders, in 6831 self-reported cancer cases and 1992 self-reported cancer-free controls from the Cancer Lifestyle and Evaluation of Risk Study, using unconditional logistic regression.ResultsFor women, BMI was positively associated with UC risk; specifically, obese women (BMI≥30kg/m²) had nearly twice the risk of developing UC compared to women with healthy-BMI-range (<25kg/m²) (OR=1.99;CI:1.31–3.03). For men, BMI was also positively associated with the risk of developing any cancer type, CRC and PC. In particular, obese men had 37% (OR=1.37;CI:1.11–1.70), 113% (OR=2.13;CI:1.55–2.91) and 51% (OR=1.51;CI:1.17-1.94) higher risks of developing any cancer, CRC and PC respectively, when compared to men with healthy-BMI-range (BMI<25kg/m²).Among women, PA was inversely associated with the risks of CRC, UC and BC. In particular, the highest level of PA (versus nil activity) was associated with reduced risks of CRC (OR=0.60;CI:0.44–0.84) and UC (OR=0.47;CI:0.27–0.80). Reduced risks of BC were associated with low (OR=0.66;CI:0.51–0.86) and moderate (OR=0.72;CI:0.57–0.91) levels of PA. There was no association between PA levels and cancer risks for men.We found no evidence of an interaction between BMI and PA in the CLEAR study.ConclusionThese findings suggest that PA and obesity are independent cancer risk factors.



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Title page / Editorial Board

Publication date: February 2017
Source:Cancer Epidemiology, Volume 46





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Table of contents

Publication date: February 2017
Source:Cancer Epidemiology, Volume 46





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Fluid Therapy Management in Hospitalized Patients: Results From a Cross-sectional Study

Publication date: Available online 23 January 2017
Source:Clinical Therapeutics
Author(s): Anna Brugnolli, Federica Canzan, Anita Bevilacqua, Oliva Marognolli, Giuseppe Verlato, Silvia Vincenzi, Elisa Ambrosi
PurposeIntravenous (IV) fluid therapy is widely used in hospitalized patients. It has been internationally studied in surgical patients, but little attention to date has been dedicated to medical patients within the Italian context. The aims of the present study were to describe the prevalence of fluid therapy and associated factors among Italian patients admitted to medical and surgical units, describe the methods used to manage fluid therapy, and analyze the monitoring of patients by clinical staff.MethodsIn this cross-sectional study of 7 hospitals in northern Italy, data on individual and monitoring variables were collected, and their associations with in-hospital fluid therapy were analyzed by using logistic regression analysis. Patients aged ≥18 years who were admitted to medical and surgical units were included. Patients who received at least 500 mL of continuous fluids were included in the fluid therapy group.FindingsIn total, 785 (median age, 72 years; women, 52%) patients were included in the study, and 293 (37.3%) received fluid therapy. Maintenance was the most frequent reason for prescribing IV fluid therapy (59%). The mean (SD) volume delivered was 1177 (624) mL/d, and the highest volume was infused for replacement therapy (1660 [931] mL/d). The mean volume infused was 19.55 (13) mL/kg/d. The most commonly used fluid solutions were 0.9% sodium chloride (65.7%) and balanced crystalloid without glucose (32.9%). The proportion of patients assessed for urine output (52.6% vs 36.8%; P < 0.001), serum electrolyte concentrations (74.4% vs 65.0%; P = 0.005), and renal function (70.0% vs 58.7%; P = 0.002) was significantly higher in patients who did receive fluid therapy versus those who did not. In contrast, the use of weight and fluid assessments was not significantly different between the 2 groups (P = 0.216 and 0.256, respectively). Patients admitted for gastrointestinal disorders (odds ratio [OR], 3.5 [95% CI, 1.8–7.05) and for fluid/electrolyte imbalances (OR, 3.35 [95% CI, 1.06–10.52) were more likely to receive fluids. However, the likelihood of receiving fluids was lower for patients admitted to a surgical unit (OR, 0.36 [95% CI, 0.22–0.59]) and with cardiovascular diseases (OR, 0.37 [95% CI, 0.17–0.79).ImplicationsOnly one third of the study patients received fluid therapy. Crystalloid fluids, are the fluids of choice for maintaining plasma volume. During fluid therapy, measurement of the serum electrolyte concentrations, renal function, and urine output was largely used while weight and fluid balance were rarely assessed.



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Receptor-based screening assays for the detection of antibiotics residues – A review

Publication date: 1 May 2017
Source:Talanta, Volume 166
Author(s): Saeed Ahmed, Jianan Ning, Guyue Cheng, Ijaz Ahmad, Jun Li, Liu Mingyue, Wei Qu, Mujahid Iqbal, M.A.B. Shabbir, Zonghui Yuan
Consumer and regulatory agencies have a high concern to antibiotic residues in food producing animals, so appropriate screening assays of fast, sensitive, low cost, and easy sample preparation for the identification of these residues are essential for the food-safety insurance. Great efforts in the development of a high-throughput antibiotic screening assay have been made in recent years. Concerning the screening of antibiotic residue, this review elaborate an overview on the availability, advancement and applicability of antibiotic receptor based screening assays for the safety assessment of antibiotics usage (i.e. radio receptor assay, enzyme labeling assays, colloidal gold receptor assay, enzyme colorimetry assay and biosensor assay). This manuscript also tries to shed a light on the selection, preparation and future perspective of receptor protein for antibiotic residue detection. These assays have been introduced for the screening of numerous food samples. Receptor based screening technology for antibiotic detection has high accuracy. It has been concluded that at the same time, it can detect a class of drugs for certain receptor, and realize the multi-residue detection. These assays offer fast, easy and precise detection of antibiotics.

Graphical abstract

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Attention to pain! A neurocognitive perspective on attentional modulation of pain in neuroimaging studies

Publication date: Available online 23 January 2017
Source:Cortex
Author(s): D.M. Torta, V. Legrain, A. Mouraux, E. Valentini
Several studies have used neuroimaging techniques in an attempt to characterize brain correlates of the attentional modulation of pain. Although these studies have advanced the knowledge in the field, important confounding factors such as imprecise theoretical definitions of attention, incomplete operationalization of the construct under exam, and limitations of techniques relying on measuring regional changes in cerebral blood flow have hampered the potential relevance of the conclusions. Here, we first provide an overview of the major theories of attention and of attention in the study of pain to bridge theory and experimental results. We conclude that load and motivational/affective theories are particularly relevant to study the attentional modulation of pain and should be carefully integrated in functional neuroimaging studies. Then, we summarize previous findings and discuss the possible neural correlates of the attentional modulation of pain. We discuss whether classical functional neuroimaging techniques are suitable to measure the effect of a fluctuating process like attention, and in which circumstances functional neuroimaging can be reliably used to measure the attentional modulation of pain. Finally, we argue that the analysis of brain networks and spontaneous oscillations may be a crucial future development in the study of attentional modulation of pain, and why the interplay between attention and pain, as examined so far, may rely on neural mechanisms shared with other sensory modalities.



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Holistic versus feature-based binding in the medial temporal lobe

Publication date: Available online 23 January 2017
Source:Cortex
Author(s): Rebecca N. van den Honert, Gregory McCarthy, Marcia K. Johnson
A central question for cognitive neuroscience is how feature-combinations that give rise to episodic/source memories are encoded in the brain. Although there is much evidence that the hippocampus is involved in feature binding, and some evidence that other brain regions are as well, there is relatively little evidence about the nature of the resulting representations in different brain regions. We used multivoxel pattern analysis (MVPA) to investigate how feature combinations might be represented, contrasting two possibilities, feature-based versus holistic. Participants viewed stimuli that were composed of three source features – a person (face or body), a scene (indoor or outdoor), and an object (bike or luggage) – which were combined to make eight unique stimulus identities. We reasoned that regions that can classify the eight identities (a multiclass classification) but not the individual features (a binary classification) likely have a holistic representation of each identity. In contrast, regions that can classify the eight identities and can classify each feature are likely to contain feature-based representations of these identities. To further probe the extent of feature-based or holistic classification in each region, we developed and validated a novel approach that directly compares binary and multiclass classification. We found clear evidence for holistic representation in the parahippocampal cortex, consistent with theories that posit that pattern-separation-like binding mechanisms are not unique to the hippocampus. Further clarifying the mechanisms of feature binding should benefit from systematic comparisons of multi-feature representations and whether they vary with task, type of stimulus, and/or experience.



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The dorsal visual stream revisited: stable circuits or dynamic pathways?

Publication date: Available online 23 January 2017
Source:Cortex
Author(s): Claudio Galletti, Patrizia Fattori
In both macaque and human brain, information regarding visual motion flows from the extrastriate area V6 along two different paths: a dorsolateral one towards areas MT/V5, MST, V3A, and a dorsomedial one towards the visuomotor areas of the superior parietal lobule (V6A, MIP, VIP). The dorsolateral visual stream is involved in many aspects of visual motion analysis, including the recognition of object motion and self motion. The dorsomedial stream uses visual motion information to continuously monitor the spatial location of objects while we are looking and/or moving around, to allow skilled reaching for and grasping of the objects in structured, dynamically changing environments. Grasping activity is present in two areas of the dorsal stream, AIP and V6A. Area AIP is more involved than V6A in object recognition, V6A in encoding vision for action. We suggest that V6A is involved in the fast control of prehension and plays a critical role in biomechanically selecting appropriate postures during reach to grasp behaviors.In everyday life, numerous functional networks, often involving the same cortical areas, are continuously in action in the dorsal visual stream, with each network dynamically activated or inhibited according to the context. The dorsolateral and dorsomedial streams represent only two examples of these networks. Many others streams have been described in the literature, but it is worthwhile noting that the same cortical area, and even the same neurons within an area, are not specific for just one functional property, being part of networks that encode multiple functional aspects. Our proposal is to conceive the cortical streams not as fixed series of interconnected cortical areas in which each area belongs univocally to one stream and is strictly involved in only one function, but as interconnected neuronal networks, often involving the same neurons, that are involved in a number of functional processes and whose activation changes dynamically according to the context.



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Toddlers later diagnosed with autism exhibit multiple structural abnormalities in temporal corpus callosum fibers

Publication date: Available online 23 January 2017
Source:Cortex
Author(s): Noa Fingher, Ilan Dinstein, Michal Ben-Shachar, Shlomi Haar, Anders M. Dale, Lisa Eyler, Karen Pierce, Eric Courchesne
Interhemispheric functional connectivity abnormalities are often reported in autism and it is thus not surprising that structural defects of the corpus callosum (CC) are consistently found using both traditional MRI and DTI techniques. Past DTI studies however, have subdivided the CC into 2 or 3 segments without regard for where fibers may project to within the cortex, thus placing limitations on our ability to understand the nature, timing and neurobehavioral impact of early CC abnormalities in autism. Leveraging a unique cohort of 97 toddlers (68 autism; 29 typical) we utilized a novel technique that identified seven CC tracts according to their cortical projections. Results revealed that younger (<2.5 years old), but not older toddlers with autism exhibited abnormally low mean, radial, and axial diffusivity values in the CC tracts connecting the occipital lobes and the temporal lobes. Fractional anisotropy and the cross sectional area of the temporal CC tract were significantly larger in young toddlers with autism. These findings indicate that water diffusion is more restricted and unidirectional in the temporal CC tract of young toddlers who develop autism. Such results may be explained by a potential overabundance of small caliber axons generated by excessive prenatal neural proliferation as proposed by previous genetic, animal model, and postmortem studies of autism. Furthermore, early diffusion measures in the temporal CC tract of the young toddlers were correlated with outcome measures of autism severity at later ages. These findings regarding the potential nature, timing, and location of early CC abnormalities in autism add to accumulating evidence, which suggests that altered inter-hemispheric connectivity, particularly across the temporal lobes, is a hallmark of the disorder.



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