Publication date: Available online 17 April 2017
Source:Practical Radiation Oncology
Author(s): David J. Sher, David J. Adelstein, Gopal K. Bajaj, David M. Brizel, Ezra E.W. Cohen, Aditya Halthore, Louis B. Harrison, Charles Lu, Benjamin J. Moeller, Harry Quon, James W. Rocco, Erich M. Sturgis, Roy B. Tishler, Andy Trotti, John Waldron, Avraham Eisbruch
PurposeTo present evidence-based guidelines for the treatment of oropharyngeal squamous cell carcinoma (OPSCC) with definitive or adjuvant radiation therapy (RT).Methods and materialsThe American Society for Radiation Oncology convened the OPSCC Guideline Panel to perform a systematic literature review investigating the following key questions: (1) When is it appropriate to add systemic therapy to definitive RT in the treatment of OPSCC? (2) When is it appropriate to deliver postoperative RT with and without systemic therapy following primary surgery for OPSCC? (3) When is it appropriate to use induction chemotherapy in the treatment of OPSCC? (4) What are the appropriate dose, fractionation, and volume regimens with and without systemic therapy in the treatment of OPSCC?ResultsPatients with stage IV and stage T3 N0-1 OPSCC treated with definitive RT should receive concurrent high-dose intermittent cisplatin. Patients receiving adjuvant RT following surgical resection for positive surgical margins or extracapsular extension should be treated with concurrent high-dose intermittent cisplatin, and individuals with these risk factors who are intolerant of cisplatin should not routinely receive adjuvant concurrent systemic therapy. Induction chemotherapy should not be routinely delivered to patients with OPSCC. For patients with stage IV and stage T3 N0-1 OPSCC ineligible for concurrent chemoradiation therapy, altered fractionation RT should be used.ConclusionThe successful management of OPSCC requires the collaboration of radiation, medical, and surgical oncologists. When high-level data are absent for clinical decision-making, treatment recommendations should incorporate patient values and preferences to arrive at the optimal therapeutic approach.
http://ift.tt/2oGGfja
Δευτέρα 17 Απριλίου 2017
Radiation therapy for oropharyngeal squamous cell carcinoma: Executive summary of an ASTRO Evidence-Based Clinical Practice Guideline
Nasal ala reconstruction: Tunnelled island pedicle melolabial flap; jigsaw puzzle advancement flap; spiral flap; dog-ear island pedicle flap and banner melolabial transposition flap.
Skin tumours of the nasal ala are common and surgery is the treatment
of choice. Nasal ala reconstruction is challenging due to the reduced
mobility and unique features of its thick and sebaceous skin. The
natural arc of the ala and its boundary with the cheek are difficult
features to reproduce. One should bear in mind the functional and
cosmetic risks of nasal ala reconstruction. A distorted nasal contour
may impair the nasal valve; the alar rim may notch or elevate; facial
symmetry may be disrupted by blunting of the alar crease, trapdooring,
bridging of the nasofacial sulcus and poor colour and texture match.
Our aim is to review and compare the functional and cosmetic results
of different local flaps used to correct intermediate-thickness
defects on the nasal ala after surgical excision of cutaneous tumours.
We present representative patients who were treated at our
Dermatological Surgery Unit from June 2015 to September 2016.
The choice of the flap was adapted to the patients' physiognomy and
the defects' size: tunnelled island pedicle melolabial flap [Figure
1]; jigsaw puzzle advancement flap [Figure 2]; spiral flap [Figure 3];
dog-ear island pedicle flap [Figure 4] and banner melolabial
transposition flap [Figure 5]. Surgery was performed under
loco-regional anaesthesia, in an outpatient basis, followed by
prophylactic antibiotic therapy. There were neither immediate
complications nor subsequent flap necrosis. The tumours were
completely excised.
Figure 1: Female, 86-year-old, nodular ulcerated basal cell carcinoma
in the nasal ala: tunnelled island pedicle melolabial flap. (a)
Surgical plan, (b) primary defect, (c) secondary defect after
tunnelling of the flap, (d) immediate post-operative, (e and f) result
after healing (10 months after surgery).
Click here to view
Figure 2: Male, 76-year-old, nodular basal cell carcinoma on the nasal
ala: jigsaw puzzle advancement flap. (a) surgical plan, (b) primary
and secondary defects, (c) anchoring sutures secure the flap in place;
(d) immediate post-operative, (e) result after healing (3 months after
surgery).
Click here to view
Figure 3: Female, 76-year-old, nodular basal cell carcinoma on the
nasal ala: spiral flap, a combination of advancement and rotation. (a)
Surgical plan, (b) immediate post-operative, (c) result after healing
(2 months after surgery).
Click here to view
Figure 4: Female, 76-year-old, basal cell carcinoma on the nasal ala:
dog-ear island flap, combining two flaps: cheek advancement and
rotated island pedicle. (a) Surgical plan, (b) primary defect, (c)
immediate post-operative, (d) day 7 post-operative, (e) result after
healing (1 month after surgery).
Click here to view
Figure 5: Male, 83-year-old, two nodular basal cell carcinomas on the
nasal ala and dorsum: Banner's melolabial transposition flap. (a)
Surgical plan, (b) primary defect, (c) immediate post-operative, (d)
result after healing (7 months after surgery)
Click here to view
Facial symmetry was well preserved by the spiral and jigsaw puzzle
flaps [Figure 2] and [Figure 3]. The nasal sulcus was left intact by
the spiral flap as well as the tunnelled melolabial island flap
[Figure 1] and [Figure 3]. The melolabial flaps and the dog-ear island
flap allowed for the correction of larger defects on the nasal ala
[Figure 1], [Figure 4] and [Figure 5]. The dog-ear island flap [Figure
4] obtained a good result despite the large size of the primary
defect. Banner's melolabial transposition flap [Figure 5] was used to
correct a complex defect involving not only the nasal ala but also the
nasal dorsum and resulted in facial asymmetry due to trapdooring.
The small size of the defects that can be addressed by the spiral and
puzzle flaps may explain their superior cosmetic results.[1],[2] The
tunnelled melolabial island flap, although technically demanding, may
produce excellent results; compared to the cheek-to-nose interpolation
flap, the tunnelling technique offers the advantage of being one-stage
procedure. The dog-ear island flap is an adaptation of the cheek
advancement flap; despite its apparent complexity, it offers a viable
alternative to the melolabial flaps,[3] with a lower risk of trapdoor
effect and with proper preservation of the alar contour. The discussed
flaps are useful alternatives to the bilobed transposition flap and
the skin graft for the surgical reconstruction of the nasal ala.
When planning the surgery, it is important to assess the primary
defect on the nasal ala: size and location (medial or lateral), depth,
involvement of other cosmetic units/subunits and extension to the alar
rim, nasal tip or adjacent cheek. Several techniques have been
developed that are useful for the reconstruction of defects of the
nasal ala. Based on our experience and a review of the literature, we
present an algorithm [Table 1] to optimise the choices in the
reconstruction of intermediate-thickness defects in nasal ala. In
[Table 2], we review the main advantages and caveats of some of the
most useful surgical techniques for nasal ala
reconstruction.[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14]
Table 1: Nasal ala reconstruction: What is the optimal approach
according to the defects' size and location?
Click here to view
Table 2: Nasal ala reconstruction: major advantages and potential
caveats of different surgical techniques
Click here to view
In the nasal ala, given the paucity of surrounding skin and the
importance of minimising nasal ala distortion, flaps that recruit skin
from a distant site should be considered. Mastering different
techniques is essential for a surgeon to optimise treatment for each
patient. At the end of the day, the best choice depends on many
factors and should be adapted on a case-by-case basis and to the
surgeon's expertise.
--
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
alsfakia@gmail.com
CAD/CAM Removable Dental Prostheses: a Review of Digital Impression Techniques for Edentulous Arches and Advancements on Design and Manufacturing Systems
Abstract
Purpose of Review
The aim of this article is to provide an overview of CAD/CAM removable dental prostheses in the treatment of completely edentulous patients.
Recent Findings
Computer-aided design/computer-aided manufacturing protocols continue to evolve in many areas in dentistry including removable complete dentures. Current protocols are advantageous in decreasing the number of clinical appointments needed, which may reduce the distress in elderly with limited access to care. In addition, CAD/CAM complete dentures are fabricated using standardized techniques using high-value quality controlled materials. Laboratory tabletop scanners are being used predominantly for the digitization of conventional impressions or dental casts. Further research is needed to further advance existing intra-oral scanners in digital impressioning of the completely edentulous jaws.
Summary
Use of digital technology in complete denture manufacturing provides prostheses with improved quality such as reduced porosity, polymerization shrinkage, and improved retention. Presence of digital depository data allows replacement dentures to be fabricated in case they are lost or damaged.
http://ift.tt/2omQ4AF
Taste Sensing Systems Influencing Metabolic Consequences
Abstract
Recent Findings
The taste information contributes to evaluate the quality and nutritional value of food before it is ingested, and thus, is essential for maintaining nutritive homeostasis within the body. Recent studies revealed that taste sensitivity is modulated by humoral factors such as hormones. Angiotensin II is a key hormone regulating sodium and water balance. Investigations of its involvement in the taste system revealed that angiotensin II suppresses the gustatory NaCl responses (amiloride-sensitive component) and enhances sweet taste sensitivity without affecting umami, sour, and bitter responses in mice.
Summary
These results suggest that taste modulation by angiotensin II may play important roles in maintaining electrolyte and glucose homeostasis.
Purpose of Review
This review focuses on the molecular mechanisms of salty taste perception and its modulation through the angiotensin II signaling to work out novel strategies to control food intake influencing metabolic consequences.
http://ift.tt/2nUUOlQ
Root Coverage Procedures for Multiple Recession Defects
Abstract
Purpose of Review
The demand for root coverage in multiple gingival recession defects has increased in recent years. Compared to isolated recession, multiple gingival recession defects are much more challenging due to various limiting factors and require more sophisticated surgical techniques. This review aims to address recent progress in the management of multiple recession defects.
Recent Findings
The subepithelial connective tissue graft (SCTG) procedure, while effective, is limited due to tissue availability and patient preference to avoid a donor harvest site. Different surgical techniques and biological materials have been studied in an attempt to find ideal alternatives.
Summary
Based on the studies reviewed, the SCTG procedure still remains the gold standard in terms of percent root coverage. Acellular dermal matrix allograft in conjunction with different flap designs has shown comparable, satisfactory results up to 1 year postoperatively. Other materials such as porcine collagen matrix and enamel matrix derivative also show some promise. Well-designed studies with long-term outcomes are still needed.
http://ift.tt/2omQjMi
Well-Differentiated Neuroendocrine Tumors in Skin: Terminology and Diagnostic Utility of Cytokeratin 5/6 and p63
Abstract
Background
Well-differentiated neuroendocrine tumors (WDNETs) in skin include metastases from visceral primary sites and very uncommonly, primary cutaneous carcinoid tumors. Cutaneous WDNET may present a diagnostic challenge and in particular can be mistaken for a benign skin adnexal tumor. In contrast to cutaneous adnexal tumors, metastatic adenocarcinomas to the skin are cytokeratin 5/6 (CK 5/6) and p63 negative in the majority of cases. It is unclear if failure to stain with CK 5/6 and p63 would be helpful in differentiating WDNETs from cutaneous adnexal neoplasms.
Methods
We reviewed ten cases of cutaneous WDNETs (8 cases of metastatic disease and 2 presumed primary carcinoid tumors of the skin) and performed immunohistochemical stains for CK 5/6 and p63 on all cases.
Results
All ten cases were negative with both CK 5/6 and p63.
Conclusion
Negative staining for cytokeratin 5/6 and p63 can be helpful to distinguish WDNETs from cutaneous adnexal neoplasms. It is important to consider WDNETs in the differential diagnosis of cutaneous adnexal neoplasms as low grade tumors may be first sign of aggressive metastatic disease.
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The multiple genetic causes of central hypothyroidism
Publication date: Available online 17 April 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Luca Persani, Marco Bonomi
An insufficient stimulation by thyrotropin (TSH) of an otherwise normal thyroid gland represents the cause of Central Hypothyrodism (CeH). CeH is about 1,000-folds rarer than Primary Hypothyroidism and often represents a real challenge for the clinicians, mainly because they cannot rely on adequately sensitive parameters for diagnosis or management, as it occurs with circulating TSH in PH. Therefore, CeH diagnosis can be frequently missed or delayed in patients with a previously unknown pituitary involvement. A series of genetic defects have been described to account for isolated CeH or combined pituitary hormone defects (CPHDs) with variable clinical characteristics and degrees of severity. The recently identified candidate gene IGSF1 appears frequently involved. This review provides an updated illustration of the different genetic defects accounting for CeH.
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Hormonal and reproductive risk factors of papillary thyroid cancer: A population-based case-control study in France
Source:Cancer Epidemiology, Volume 48
Author(s): Emilie Cordina-Duverger, Christophe Leux, Monica Neri, Catherine Tcheandjieu, Anne-Valérie Guizard, Claire Schvartz, Thérèse Truong, Pascal Guénel
The three times higher incidence of thyroid cancer in women compared to men points to a role of female sex hormones in its etiology. However the effects of these factors are poorly understood. We analyzed the association between thyroid cancer and hormonal and reproductive factors among women enrolled in CATHY, a population-based case-control study conducted in France. The study included 430 cases of papillary thyroid cancer and 505 controls frequency-matched on age and area of residence. The odds ratios for thyroid cancer increased with age at menarche (p trend 0.05). Postmenopausal women were at increased risk, as compared to premenopausal women, particularly if menopause followed an ovariectomy, and for women with age at menopause <55years. In addition, use of oral contraceptives and menopausal hormone therapy reduced the association with thyroid cancer by about one third, and breastfeeding by 27%. Overall, these findings provide evidence that the risk of thyroid cancer increases with later age at menarche and after menopause, and decreases with use of oral contraceptives and menopausal hormone therapy. These findings confirm an implication of hormonal factors in papillary thyroid cancer risk, whose mechanisms need to be elucidated.
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Overall survival in elderly patients with colorectal cancer: A population-based study in the Caribbean
Source:Cancer Epidemiology, Volume 48
Author(s): Clarisse Joachim, Lidvine Godaert, Moustapha Dramé, Jacqueline Véronique-Baudin, Jonathan Macni, Juliette Smith-Ravin, Jean-Luc Novella, Rachid Mahmoudi
BackgroundPopulation-based Cancer registries (PBCR) play an important role in cancer surveillance and research. The aim of this study was to examine overall survival in elderly patients with colorectal cancer (CRC) by analysing data from the Martinique PBCR between 1993 and 2012.MethodsThe log-rank test was used to assess the statistical differences of the survival curves by each categorical variable: age at diagnosis, sex, histology, zone of residence, subsite, stage at diagnosis, and chemotherapy. A multivariable Cox model was performed to identify independent prognostic factors for overall survival in elderly patients with colorectal cancer.ResultsAmong 2230 patients included in the study, 60.8% were aged≥65years; mean age at diagnosis of these patients was 75.7±7.2years. For the period 2008–2012, 532 elderly patients were analysed; mean age of those receiving chemotherapy was 73.0±0.4 versus 77.9±0.4years for those not receiving chemotherapy (p<0.0001). Stage at diagnosis was evaluated in 87.8% (467/532) of patients; 63.0% (294/467) had stage III–IV and 49.3% of these patients (145/294) received chemotherapy. Chemotherapy was less frequently prescribed in patients aged 75–84 and ≥85 years as compared to those aged 65–74 years (41.1% and 15.0% versus 64.6% respectively; p<0.0001). Stage III–IV at diagnosis (HR=5.25; 3.70–7.45; p<0.0001), and not receiving chemotherapy (HR=3.05; 2.23–4.16; p<0.0001), were independent prognostic factors for overall survival.ConclusionOur study highlights the role of PBCR in evaluating cancer survival and patterns of care in elderly people of the French West- Indies. Chemotherapy was less frequently prescribed among the elderly
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A modification on Brook formula in calculating the misfit of Ni-based superalloys
Publication date: 15 July 2017
Source:Materials & Design, Volume 126
Author(s): Haibo Long, Shengcheng Mao, Sisi Xiang, Yanhui Chen, Hua Wei, Yizhou Zhou, JinLai Liu, Yinong Liu
The validity of the Brooke formula in estimating the lattice misfit based on dislocation network structure in Ni-based superalloys is investigated. The misfit value of a sample subjected to prolonged thermal exposure as derived from the popular Brooke formula is below that determined by X-ray diffraction (XRD) method, whereas the misfit estimated using the Brooke formula for a sample subjected to creep is greater than that determined by XRD method. These discrepancies imply the invalidity of the popular Brooke formula in two aspects: that a dislocation network is not always mature to fully relax the lattice misfit leading underestimate the misfit and that using the full magnitude of the Burgers vector overestimates the misfit. To overcome this problem, a modified Brook formula using the {100} projection of the edge component of a Burgers vector as the effective magnitude to relieve the misfit is proposed. The misfit derived from the modified Brook formula is in good agreement with the values determined by XRD method for a number of Ni-based superalloys studied.
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Time in the Therapeutic Range for Patients Taking Warfarin in Clinical Trials: Useful, but Also Misleading, Misused, and Overinterpreted.
http://ift.tt/2ptcbdE
Engagement, Research, and Evidence: Leveraging the National Patient-Centered Clinical Research Network for Better Cardiovascular Health.
http://ift.tt/2oGkQGP
Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease.
http://ift.tt/2pt7U9Z
Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): The Past, Present, and Future Management.
http://ift.tt/2oGpBQw
High-Sensitive Cardiac Troponin T as an Early Biochemical Signature for Clinical and Subclinical Heart Failure: MESA (Multi-Ethnic Study of Atherosclerosis).
http://ift.tt/2psPExC
High-Sensitive Cardiac Troponin for Prediction of Clinical Heart Failure: Are We Ready for Prime Time?.
http://ift.tt/2oGr9Kq
Impact of Practice-Based Management of Pulmonary Artery Pressures in 2000 Patients Implanted With the CardioMEMS Sensor.
http://ift.tt/2pt3ujm
Measuring Pulmonary Artery Pressures in Heart Failure: A New Useful Diagnostic Tool?.
http://ift.tt/2oGtYLe
Range of Risk Factor Levels: Control, Mortality, and Cardiovascular Outcomes in Type 1 Diabetes Mellitus.
http://ift.tt/2pt1sjc
Nicotinamide Phosphoribosyltransferase Promotes Pulmonary Vascular Remodeling and Is a Therapeutic Target in Pulmonary Arterial Hypertension.
http://ift.tt/2oGpx3e
Treatment of Patients With Atrial Fibrillation and Heart Failure With Reduced Ejection Fraction.
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Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.
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Some Common Ground Emerges in Debate Over ECGs for Athletes.
http://ift.tt/2pt2GLz
Physical Activity Guided by Pulse Pressure in Patients With Continuous Flow Left Ventricular Assist Devices: A Pilot Study.
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Letter by Irfan Regarding Article, "Assessment of the European Society of Cardiology 0-Hour/1-Hour Algorithm to Rule-Out and Rule-In Acute Myocardial Infarction".
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Letter by Mueller and Roffi Regarding Article, "Assessment of the European Society of Cardiology 0-Hour/1-Hour Algorithm to Rule-Out and Rule-In Acute Myocardial Infarction".
http://ift.tt/2oG5QJ2
Response by Than et al to Letter Regarding Article, "Assessment of the European Society of Cardiology 0-Hour/1-Hour Algorithm to Rule-Out and Rule-In Acute Myocardial Infarction".
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Letter by Hermida et al Regarding Article, "The Heart's Circadian Rhythms Point to Potential Treatment Strategies".
http://ift.tt/2ptbmkO
Determination of veterinary penicillin antibiotics by fast high-resolution liquid chromatography and luminescence detection
Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): M.L. Castillo-García, M.P. Aguilar-Caballos, A. Gómez-Hens
A chromatographic method based on the use of a fused-core column and luminescence detection is described for the determination of six penicillin antibiotics used in veterinary practice, namely amoxicillin, ampicillin, penicillin G, oxacillin, cloxacillin and nafcillin. The use of this column provides the separation of these antibiotics with retention times lower than 4.5min. The tris(2,2′-bipyridyl)ruthenium(II) [Ru(bpy)32+] – Ce(IV) system has been used as post-column derivatization reagent, obtaining a luminescence signal (λem 610nm) proportional to the analyte concentration when the system is excited at 450nm.The dynamic ranges of the calibration graphs are 100–10,000ngmL−1 for all the antibiotics assayed and the limits of detection are in the range of 44–51ngmL−1. The precision, established at two concentration levels of each analyte and expressed as the percentage of the relative standard deviation is in the range of 6.9–9.8%. The method has been satisfactorily applied to the analysis of water and pharmaceutical samples, with recoveries ranging from 88.6% to 108.5%.
Graphical abstract
http://ift.tt/2nXnN8P
Determination of stability characteristics for electrochemical biosensors via thermally accelerated ageing
Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): Peter Panjan, Vesa Virtanen, Adama Marie Sesay
Biosensors are devices that are prone to ageing; this phenomenon can be characterized as a decrease in signal over time. Biosensor stability is of a crucial importance for commercial success and as biosensors are presently being applied to an increasing and variety of applications. Stability characteristics related to shelf life, reusability and/or continuous use stability are often poorly investigated or unreported in literature, yet are important factors. Instability or ageing can be accelerated at an elevated temperature; Arrhenius (exponential) and linear models were investigated in order to propose a novel method for rapid ageing characteristics determination. Linear correlation proved more suitable with higher coefficients of determination than exponential correlation. Degradation rate is linearly dependent on temperature and by utilizing the proposed models, long term shelf life of a biosensor can be determined in 4 days and continuous use stability in less than 24h. Reusability studies are found to correlate poorly due to the unpredictable nature of biosensor handling. Basic constructed screen printed electrode glucose oxidase biosensors were used as a model biosensor in order to propose models for shelf life, reusability and continuous use stability.
Graphical abstract
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A voltammetry sensor platform for baicalein and baicalin simultaneous detection in vivo based on Ta2O5-Nb2O5@CTS composite
Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): Zhengkun Xie, Wang Lu, Lingxi Yang, Gaiping Li, Baoxian Ye
Baicalein and baicalin are the major flavonoids found in Scutellariae Radix, an essential herb which has had a presence in traditional Chinese medicine (TCMs) for more than two thousands of years. Owing to their similar characteristics and physiochemical properties, sensitive, it is a great challenge to detect both of them simultaneously. In this work, a novel, facile and sensitive electrochemical method was proposed based on tantalum oxide (Ta2O5), niobium oxide (Nb2O5) particles and antiseptic chitosan modified carbon paste electrode (Ta2O5-Nb2O5@CTS-CPE). Scanning electron microscope (SEM), X-ray diffraction spectroscopy (XRD), Fourier transform infrared spectroscopy (FTIR), cyclic voltammetry (CV) and electrochemical impedance spectrum (EIS) were used to characterize the properties and investigate the electrochemical response of the sensor. The electrochemical behaviors and redox mechanisms of two analytes were investigated at the target electrode. Under the optimum conditions, the highly sensitive and simultaneous determination of baicalein and baicalin was successfully achieved with a linear response range of 0.08–8.0μM for both of them. The obtained detection limits for baicalein and baicalin were of 0.05 and 0.03μM (S/N=3), respectively. Furthermore, the proposed sensor displayed high sensitivity, excellent stability and satisfactory results in Scutellariae Radix samples analysis and hydrolysis process analysis of baicalin in vivo.
Graphical abstract
http://ift.tt/2nXnKKb
Electrochemically deposited conductive composite sorbent for highly efficient online solid-phase microextraction of jasmonates in plant samples
Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): Xu Ling, Zilin Chen
Conductive composite films composed of poly (3, 4-ethylenedioxythiophene) (PEDOT) and sulfonated graphene were electrochemically deposited on carbon fiber bundle in aqueous solutions for solid phase microextraction (SPME). During the electro-polymerization process, negatively charged sulfonated graphene were doped in PEDOT layer and uniformly dispersed in the composite. The modified carbon fiber bundle worked as sorbent was then successfully applied to online SPME-HPLC-UV analysis of jasmonates in wintersweet flowers. High extraction efficiency (over 420-fold), low limits of detection (0.1ngmL−1 for jasmonic acid and 0.01ngmL−1 for methyl jasmonate) and wide linear ranges (0.5–5000 and 0.05–5000ngmL−1, R>0.9997) have been obtained. It has been demonstrated that this method can be well used for jasmonates analysis in fresh wintersweet flowers with good recoveries (92.4–98.9%). The results were confirmed by HPLC-MS method.
Graphical abstract
http://ift.tt/2nXfbPo
Detection of Aβ oligomers based on magnetic-field-assisted separation of aptamer-functionalized Fe3O4 magnetic nanoparticles and BaYF5:Yb,Er nanoparticles as upconversion fluorescence labels
Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): Ling-Feng Jiang, Bo-Cheng Chen, Ben Chen, Xue-Jian Li, Hai-Lin Liao, Hong-Miao Huang, Zhan-Jing Guo, Wen-Yan Zhang, Lin Wu
A sensitive and stable bioassay for the detection of Aβ oligomer (Aβo), a potentially promising candidate biomarker for Alzheimer's disease (AD) diagnosis, was developed using Fe3O4 magnetic nanoparticles (MNPs) as the recognition and concentration elements and BaYF5:Yb,Er upconversion nanoparticles (UCNPs) as highly sensitive labels, conjugated with the Aβo aptamer (DNA1) and the complementary oligonucleotide of the Aβo aptamer (DNA2), respectively. The DNA1 hybridized with DNA2 to form the duplex structure on the surface of the MNPs/UCNPs nanocomposites probe. When the target Aβo was introduced, the aptamer DNA1 preferentially bound with Aβo and caused the dissociation of some complementary DNA2, liberating some UCNP-labeled complementary DNA2 and leading to a decreased upconversion fluorescent intensity on the surface of MNPs. The decreased fluorescence intensity of UCNPs was related to the concentration of Aβo in the range of 0.2–15nM with a detection limit of 36 pM. The developed method then was successfully applied to measure Aβo in artificial cerebrospinal fluid. Benefiting from the magnetic separation and concentration effect of MNPs, the high sensitivity of UCNPs, as well as the selectivity and stability of the aptamer, the present strategy offered valuable information related to early diagnosis of AD process.
Graphical abstract
http://ift.tt/2pvB9Gs
In-line moisture monitoring in fluidized bed granulation using a novel multi-resonance microwave sensor
Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): Johanna Peters, Kathrin Bartscher, Claas Döscher, Wolfgang Taute, Michael Höft, Reinhard Knöchel, Jörg Breitkreutz
Microwave resonance technology (MRT) is known as a process analytical technology (PAT) tool for moisture measurements in fluid-bed granulation. It offers a great potential for wet granulation processes even where the suitability of near-infrared (NIR) spectroscopy is limited, e.g. colored granules, large variations in bulk density. However, previous sensor systems operating around a single resonance frequency showed limitations above approx. 7.5% granule moisture. This paper describes the application of a novel sensor working with four resonance frequencies. In-line data of all four resonance frequencies were collected and further processed. Based on calculation of density-independent microwave moisture values multiple linear regression (MLR) models using Karl-Fischer titration (KF) as well as loss on drying (LOD) as reference methods were build. Rapid, reliable in-process moisture control (RMSEP≤0.5%) even at higher moisture contents was achieved.
Graphical abstract
http://ift.tt/2pvCKvP
Motivation to change, coping, and self-esteem in adolescent anorexia nervosa: a validation study of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)
Abstract
Background
Understanding motivation to change is a key issue in both the assessment and the treatment of eating disorders. Therefore, sound instruments assessing this construct are of great help to clinicians. Accordingly, the present study analysed the psychometric properties of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), including its relation to coping style and self-esteem.
Methods
N = 92 adolescents referred to an eating disorders outpatient clinic meeting criteria for anorexia nervosa gave written informed consent to participate in this study and completed the ANSOCQ, the Eating Disorder Inventory, the Eating Attitudes Test, the Body Image Questionnaire, two questionnaires measuring Self-Related Cognitions and the Coping Across Situations Questionnaire. After a treatment period of nine months, clinical anorexia nervosa diagnosis and the body mass index were re-assessed. In addition to exploratory factor analysis, correlational analysis was used to test for the convergent validity of the ANSOCQ and logistic regression analysis was used to test its predictive validity.
Results
The ANSOCQ had good psychometric properties. Factor analysis yielded two meaningful factors labelled as 'weight gain and control' and 'attitudes and feelings'. Internal consistencies of the two factors amounted to Cronbach's alpha = .87 and .76, respectively. Significant correlations with other scales measuring eating disorder psychopathology were indicative of meaningful construct validity. Higher motivation to change was related to higher self-esteem and a more active coping style. Higher (positive) ANSOCQ total scores predicted remission of anorexia nervosa after nine months of treatment. A higher score on 'attitudes and feelings' was a protective factor against drop-out from intervention.
Conclusions
The ANSOCQ is a clinically useful instrument for measuring motivation to change in adolescents with AN. Two factorial dimensions explain most of the variation. Self-esteem and coping style are relevant additional constructs for the understanding of the motivation to change in anorexia nervosa.
Trial registration
NCT02828956. Retrospectively registered July 2016
http://ift.tt/2oGOtJv
Simulation-based instruction for pharmacy practice skill development: A review of the literature
Archives of Pharmacy Practice 2017 8(2):43-50
Background: Simulation is attractive for its potential for applying a control over learning environment, content complexity, teacher time, costs and risk. Simulation-based instruction (SBI) is poised to expand in pharmacy practice and education. This systematic review synthesises published, SBI in first-degree pharmacy programmes, especially those pertaining to psychomotor or cognitive skill development. Materials and Methods: MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and some education journals were searched for relevant articles published between January 2000 and December 2015. Results: Of 108 articles identified, 12 were included, which were covering four major simulation-based interventions. These simulation-based interventions were diverse, and they covered a range of competencies and outcome measures. Nine studies included medication, and five studies included physical examination/procedure-related competencies as outcome measures. The evidence from nine studies suggested that skills could be improved through interventions involving human patient simulation. Conclusion: Despite improvements in students' ability to perform, there is a lack of evidence on how this translates to real settings and to patient satisfaction.
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Awareness, perception, attitude, and knowledge regarding complementary and alternative medicines (cams) among the pharmacy and medical students of a public university in Saudi Arabia
Archives of Pharmacy Practice 2017 8(2):51-63
Introduction: The use of natural products, that is, herbs for clinical and domestic purposes, is quite common in Saudi Arabia. Studies have reported an increasing use of complementary and alternative medicines (CAMs). This study aims to investigate the perception, attitude, and knowledge of the students regarding CAMs and their use. Materials and Methods: A quantitative, cross-sectional study targeting the students of the pharmacy and medical colleges at the University of Dammam, Saudi Arabia was conducted for a 6-month duration. It employed a survey questionnaire termed as CAMs inventory. Results: The majority of the respondents were females (N = 180, 60.8%), and a major segment (N = 170, 57.4%) belonged to the age group between 21 and 23 years. Nearly half of the students (N = 121, 40.9%) strongly agreed on the need for integration of CAMs-related courses in medical and allied health education, and a similar proportion (N = 129, 43.6%) of the target population acknowledged using CAMs, based on family recommendations (N = 134, 45.3%). Half of the students (N = 142, 48%) had no knowledge about CAMs. Some of the CAMs were more prevalent in males and vice versa (P value <0.05). Conclusion: A positive perception and attitude toward CAMs was observed. It is influenced by their traditional use and partly by the recent induction of CAMs-related education in pharmacy. The majority of the students agreed on integrating CAMs-related courses in their curriculum. It was also observed that the knowledge regarding the subject was inadequate. Lastly, gender has the potential to influence the use of particular CAMs.
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Unusual case of lamivudine-associated skin rashes in an HIV/AIDS patient: a case presentation
Archives of Pharmacy Practice 2017 8(2):82-83
In patients with human immunodeficiency virus (HIV) infection, lamivudine is used as a first-line drug for antiretroviral therapy. Lamivudine is relatively nontoxic in nature, and it can also be used during pregnancy. Herein, we describe a 43-year-old, HIV-positive female hospitalized with maculopapular, pruritic rash that appeared first on the extremities and gradually spread with systemic symptoms such as fever and myalgia after lamivudine therapy.
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Translation and psychometric analysis of the Malaysian version of medication understanding and use self-efficacy scale (m-muse) for diabetes mellitus
Archives of Pharmacy Practice 2017 8(2):64-69
Introduction: Enhancing diabetes self-efficacy (SE) level can improve the self-management behaviour in patients living with diabetes mellitus (DM). This study aimed to translate and assess the psychometric properties of Malaysian version of diabetes Medication Understanding and Use Self-Efficacy Scale (M-MUSE). Methods: Following the translation of English version of MUSE to Malay language using established international standard translation guidelines, 252 adult diabetics (≥ 18 years old; DM type 1 or 2) attending the Endocrine Clinic at Hospital Kuala Lumpur, Malaysia, were recruited in this cross-sectional study. After testing the face and content validity, the psychometric properties of the final M-MUSE were evaluated using the Classical Test Theory (CTT) for reliability (Cronbach's alpha (α) and intra-class correlation coefficient (ICC)) and construct validity (factor analysis (FA)). Results: The semantic and conceptual problems in M-MUSE were identified and modified by a qualified professional translation committee. The final version showed good reliability values for internal consistency (Cronbach's α = 0.89) and one month test-retest reliability (ICC = 0.72). The Bartlett's test of sphericity and the Kaiser-Meyer-Olkin tests proved the suitability of M-MUSE for factor analysis. The extracted single component M-MUSE (eigenvalue > 1) explained a total variance of 57.58% with an eigenvalue of 4.60. The two factor structures; namely taking medication (item # 1, 6, 7 and 8) and learning about medication (item # 2, 3, 4 and 5) explained a total variance of 59.25% with good factor loading values (ranged from 0.63 to 0.89 for taking medication, and 0.66 to 0.83 for learning about medication). Conclusion: The M-MUSE appears to be a linguistically reliable and valid measure that is conceptually equivalent to the original version. The M-MUSE can be used in Malaysian healthcare settings to evaluate the SE in understanding and using prescribed diabetes medications.
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Quality of methodological reporting of randomized clinical trials of sodium-glucose cotransporter-2 (sglt2) inhibitors
Archives of Pharmacy Practice 2017 8(2):78-81
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new class of medicines approved recently for the treatment of type 2 diabetes. To improve the quality of randomized clinical trial (RCT) reports, the Consolidated Standards of Reporting Trials (CONSORT) statement for methodological features was created. For achieving our objective in this study, we assessed the quality of methodological reporting of RCTs of SGLT2 inhibitors according to the 2010 CONSORT statement. We reviewed and analyzed the methodology of SGLT2 inhibitors RCTs that were approved by the Food & Drug Administration (FDA). Of the 27 trials, participants, eligibility criteria, and additional analyses were reported in 100% of the trials. In addition, trial design, interventions, and statistical methods were reported in 96.3% of the trials. Outcomes were reported in 93.6% of the trials. Settings were reported in 85.2% of the trials. Blinding and sample size were reported in 66.7 and 59.3% of the trials, respectively. Sequence allocation and the type of randomization were reported in 63 and 74.1% of the trials, respectively. Besides those, a few methodological items were inadequate in the trials. Allocation concealment was inadequate in most of the trials. It was reported only in 11.1% of the trials. The majority of RCTs have high percentage adherence for more than half of the methodological items of the 2010 CONSORT statement.
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The impact of risk factors on ECG parameters and quality of life in post-myocardial infarct patients
Archives of Pharmacy Practice 2017 8(2):70-77
Introduction: Many epidemiological studies have shown that there are numerous risk factors for acute coronary disease. The aim is to determine the effect of risk factors on the echocardiographic changes and quality of life in patients treated with different methods 1 year after myocardial infarction. Methods: The research was a prospective–retrospective, clinical, epidemiological study and was conducted at the Clinic of Cardiology, University Clinical Center Sarajevo. Patients were divided into four groups based on the therapy treatment they got. The patients were divided into four groups based on the therapy treatment they received. The first group consisted of 40 patients who had had myocardial infarction and were treated with medications. The patients in the groups II and III were treated with percutaneous coronary intervention (PCI) [who immediately after incident underwent primary PCI or delayed PCI], and each group consisted of 40 patients. The group IV consisted of 40 patients, who underwent surgical revascularization (coronary artery bypass surgery). After the treatments have finished, an echocardiogram was performed on every patient. The Short Form (SF)-36 health survey was used for testing the life quality. Echocardiogram and the quality of life (QoL) testing were repeated a year after the treatment. Results: The study included 160 patients with a history of myocardial infarction, of which 130 (81.3%) were men, and 30 (18.8%) were women. The average age in the total sample was 54.9 ± 8.8 years. The review of risk factors' presence showed that in the total sample, most present was hypertension with 134 (83.8%), smoking with 120 (75.0%), and hypercholesterolemia with 110 or 68.8% of patients. Hypertension showed a statistically significant negative effect on the SF-scales only in the group III according to the mental health (P = 0.020), social functioning (P = 0.013), and pain (P = 0.011). A statistically significant effect of smoking was observed in the group III according to left ventricular internal dimension in end-diastole (P = 0.000) and left ventricular internal dimension in end-systole (P = 0.001) in the sense that smokers have the higher values of these parameters, and negative to ejection fraction (EF) (P = 0.001) in the sense that smokers have lower EF. In the group IV, positive correlation was observed to EF (P = 0.038), and negative toward the mitral regurgitation (P = 0.032). Conclusion: High blood pressure negatively affected the QoL. Smoking is negatively associated with all observed echocardiographic parameters in all the groups except with the size of the left atrium.
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Pharmacy without pharmacist: Body without soul
Archives of Pharmacy Practice 2017 8(2):84-84
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Extreme lightweight structures: avian feathers and bones
Publication date: Available online 17 April 2017
Source:Materials Today
Author(s): Tarah N. Sullivan, Bin Wang, Horacio D. Espinosa, Marc A. Meyers
Flight is not the exclusive domain of birds; mammals (bats), insects, and some fish have independently developed this ability by the process of convergent evolution. Birds, however, greatly outperform other flying animals in efficiency and duration; for example the common swift (Apus apus) has recently been reported to regularly fly for periods of 10 months during migration. Birds owe this extraordinary capability to feathers and bones, which are extreme lightweight biological materials. They achieve this crucial function through their efficient design spanning multiple length scales. Both feathers and bones have unusual combinations of structural features organized hierarchically from nano- to macroscale and enable a balance between lightweight and bending/torsional stiffness and strength. The complementary features between the avian bone and feather are reviewed here, for the first time, and provide insights into nature's approach at creating structures optimized for flight. We reveal a novel aspect of the feather vane, showing that its barbule spacing is consistently within the range 8–16μm for birds of hugely different masses such as Anna's Hummingbird (Calypte anna) (4g) and the Andean Condor (Vultur gryphus) (11,000g). Features of the feather and bone are examined using the structure-property relationships that define Materials Science. We elucidate the role of aerodynamic loading on observed reinforced macrostructural features and efficiently tailored shapes adapted for specialized applications, as well as composite material utilization. These unique features will inspire synthetic structures with maximized performance/weight for potential use in future transportation systems.
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LALF 32-51 -E7 therapeutic vaccine induces antitumor immunity against human papillomavirus type 16 E7-expressing murine tumor metastases in the lungs
Abstract
One important goal of cancer immunotherapy is to prevent and treat tumor metastasis. We have previously reported the significant antitumor effect induced by the immunization with our human papillomavirus therapeutic protein-based vaccine (LALF32-51-E7) without adjuvant and admixed with clinically relevant adjuvants in the subcutaneous TC-1 tumor challenge model. In the present study, we evaluated the efficacy of the above mentioned vaccine formulations in controlling the hematogenous spread of TC-1 tumor cells using a more tumourigenic clone named TC-1* and other intravenous injection site less stressful than the tail vein. We generated a lung metastasis model by injecting TC-1* cells into the retro-orbital venous sinus and this is the first study describing it. Also, this is the first study that demonstrates the efficacy of the immunization with LALF32-51-E7 without adjuvant and admixed with VSSP or Al(OH)3 in controlling metastatic tumors increasing the survival of the mice. Our TC-1 lung metastasis model can be used to test the efficacy of other immunotherapeutic strategies based on E6/E7 antigens.
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Nasal ala reconstruction: Surgical conundrum
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):55-58
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Should advertising by aesthetic surgeons be permitted?
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):48-48
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Autologous platelet-rich fibrin matrix in non-healing trophic ulcers in patients with Hansen's disease
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):3-7
Background: Non-healing trophic ulcers in Hansen's disease patients is one of the major causes for disability. It has been shown that autologous platelet-rich fibrin matrix (PRFM) is effective in healing chronic non-healing leg ulcers. Aim: The objective of this study is to demonstrate the efficacy of autologous platelet-rich fibrin matrix (PRFM) in non-healing trophic ulcers in patients treated for Hansen's disease. Design: A prospective study. Setting: An institution-based clinic. Participants: Seven treated patients with Hansen's disease, with a mean age of 38.33 years, with nine non-healing trophic ulcer of more than 6 weeks duration. Measurements: Photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and every subsequent sitting till the closure was achieved. Materials and Methods: The healthy ulcers were treated with PRFM at weekly intervals, repeated once a week for a maximum of five sittings as per requirement. Results: The mean percentage improvement in the area was 93.52%, and volume was 97.74% at the end of the second sitting. All ulcers closed by a maximum of five sittings. No adverse events were noted. Conclusion: PRFM for the treatment of trophic ulcers in treated patients with Hansen's disease is a feasible, safe, simple and inexpensive method.
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Accelerated wound healing: Harnessing the power of platelets, biomaterials, stem cells and gene therapy
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):1-2
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Comparison of efficacy of autologous platelet-rich fibrin versus saline dressing in chronic venous leg ulcers: A randomised controlled trial
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):8-12
Background: Venous leg ulcer is a chronic condition, and various treatment modalities are available. Platelet-rich fibrin (PRF) is one of the newer modalities and it contains fibroblast growth factor (GF), vascular endothelial GF, angiopoitin and platelet-derived GF which enhances the wound healing. Hence, we conducted a randomised controlled trial to compare the efficacy of PRF versus saline dressing in chronic venous leg ulcers. Aim: This study aims to compare the efficacy of autologous PRF with saline dressing in patients with chronic venous leg ulcer and to compare the mean reduction in ulcer area at the end of 4 weeks. Materials and Methods: Fifteen patients with chronic venous leg ulcers of >6 months duration having an ulcer area of 1 cm × 1 cm to 5 cm × 5 cm were taken into the study and were randomly divided into two groups. Group 1: Patients received PRF dressing. Ten millilitres of patient's blood was taken and centrifuged at 3000 rpm for 15 min. A fibrin clot obtained in the middle of the tube was removed and used for dressing over the wound surface. It was repeated every week for 4 weeks. Group 2: Patients received saline dressings once a week for 4 weeks. The assessment of the ulcer size was done with the help of photographs, and ulcer area was measured. Results: The mean reduction in the area of the ulcer size in PRF group was 85.51%, and the mean reduction in the area of the ulcer size in Saline group was 42.74% which was statistically significant with a P< 0.001 and t = 4.11. Conclusion: We conclude that PRF dressing can be used as it is effective, inexpensive, safe and an outpatient procedure.
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Plaque like giant dermatofibroma: A case report
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):51-53
Dermatofibroma, also known as benign fibrous histiocytoma, is a soft-tissue tumour that usually occurs in the mid-adult life and shows a slight female predominance. Giant dermatofibroma, a very rare clinical variant, is characterised by its unusually large size, benign biological behaviour despite its large size and same histopathological characteristics as conventional dermatofibroma. We report a 63-year-old woman who presented with a large tumour on the scapular region which showed histopathological features of benign dermatofibroma.
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Using amniotic membrane as a novel method to reduce post-burn hypertrophic scar formation: A prospective follow-up study
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):13-17
Background: Several studies have shown that the application of amniotic membrane as a biological dressing in the management of burns is accompanied by rapid re-epithelialisation. In this follow-up study, we aimed to evaluate the possible role of amniotic membrane as an adjunct to split thickness skin grafting on reducing itching and severity of hypertrophic scar formation. Materials and Methods: From October 2013 to January 2015, in a prospective follow-up study, 54 patients (108 limbs) with second and third degree burns, covering 4%–15% of total body surface area (TBSA), were included in the study. All patients needed split-thickness skin grafts for burn-wound coverage. Selected patients had symmetric burns on two (upper or lower) extremities. Then, in every patient, the extremities were randomly divided into two groups: In one limb, the skin graft was traditionally fixed with skin staples (control group) and in the other limb, the skin graft was covered with an amniotic membrane (amnion group). Therefore, in every patient, the graft was covered with an amniotic membrane in one extremity and fixed with skin staples in the other extremity. Finally, after 6 months, the degree of itching and hypertrophic scar formation was compared between the two groups. Results: The study group was composed of 108 limbs in 54 patients (27 males and 27 females) with a mean age of 23.54 % 4.9 years and burn 9.03 % 2.69% TBSA. The patients were divided into two groups: 54 limbs in amnion group and 54 limbs in control group. In 59.25% of the cases, patient had less itching in the extremity covered with amniotic membrane. Furthermore, in 64.81% of the cases, patients had less hypertrophic scar formation in the extremity covered with amniotic membrane. These differences were statistically significant (P < 0.001). Conclusions: Amniotic membrane used as an adjunct in split thickness skin grafting is a novel modality which significantly reduces scar formation and itching that can be greatly distressing to burn patients. However, still more prospective well designed studies are needed to prove it.
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Successful management of dowling-degos disease with combination of Q-switched Nd: YAG and fractional carbon dioxide laser
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):60-62
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A comparative study of collagen dressing versus petrolatum gauze dressing in reducing pain at the donor area
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):18-21
Background: Skin graft is one of the commonly done procedures by plastic surgeons, dermato surgeons and general surgeons. Pain at the donor area is a common complaint by the patient. The skin graft donor site area is usually covered with petrolatum dressing dermatosurgeons. Aim: This study was done to compare collagen dressing with petroleum gauze dressing in control of post-operative pain on skin graft donor area. Materials and Methods: The study was done on forty patients, twenty as study group who received collagen dressing and twenty as control group who received petroleum gauze dressing. The procedure was randomly selected by permutated block size of four. The post-operative pain was assessed with numerical pain rating scale 0 to 10. Nursing staff did the recording of pain scale. The nursing staff was not aware whether patient had collagen or petroleum gauze dressing. Statistics: Statistical analysis used was independent 't'-test (two-sample test) and Levene's test. Results: Statistics proved that study group (collagen dressing) had lesser pain than control group (petroleum gauze dressing). Conclusion: The collagen sheet dressing on skin graft donor area reduces pain in post-operative period.
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Should advertising by aesthetic surgeons be permitted?
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):45-47
Cosmetic, aesthetic and cutaneous surgical procedures require qualified specialists trained in the various procedures and competent to handle complications. However, it also requires huge investments in terms of infrastructure, trained staff and equipment. To be viable advertising is essential to any establishment which provides cosmetic and aesthetic procedures. Business men with deep pockets establish beauty chains which also provide these services and advertise heavily to sway public opinion in their favour. However, these saloons and spas lack basic medical facilities in terms of staff or equipment to handle any complication or medical emergency. To have a level playing field ethical advertising should be permitted to qualified aesthetic surgeons as is permitted in the US and UK by their respective organisations.
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Nasolabial perforator flap for one-stage reconstruction of nasal defects
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):22-27
Background: The excellent freedom of movement and range of this flap when based on a the nasolabial perforator flap have not been sufficiently explored. In this study, along with demonstrating the other key advantages of this flap over its traditional counterpart, we will endeavour to fill these lacunae in the available literature. Materials and Methods: From February 2009 to February 2012, twenty patients with nasal defects were repaired with a nasolabial perforator flap in the Department of Plastic and Cosmetic Surgery at Sir Ganga Ram Hospital, New Delhi. Of these, two patients (10%) underwent the procedure bilaterally. Thus, a total of 22 nasolabial perforator flap procedures were carried out. Prospectively, collected clinical records and data of each patient were retrospectively retrieved and reviewed to study the nasal defect and surgery done. Results: All the twenty (100%) patients had good functional and aesthetic outcome. All patients who had nasal stenosis preoperatively had very good improvement in the patency of the nasal passages, breathing and nasal blockage with complete recovery of symptoms. The patients were entirely satisfied with the functional recovery. Conclusions: The reliability and versatility of the nasolabial perforator flap exceed its recognised application in reconstruction of nasal defects and it must form a part of every plastic surgeon's armamentarium.
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Spring-loaded syringe for multiple rapid injections
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):49-50
Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage.
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Intra-individual right-left comparative study of medium depth peels in superficial nail abnormalities
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):28-32
Background: Superficial nail abnormalities include conditions which produce nail surface changes such as trachyonychia, pitting and ridging. Mostly, this is a neglected area due to the dearth of treatment options. Glycolic acid peeling has been reported to be effective in such cases. Aim: This study aims to assess the safety and efficacy of medium depth peels (70% glycolic acid versus phenol combination peel [8% phenol with 15% trichloroacetic acid]) in patients with superficial nail abnormalities. Materials and Methods: A right-left comparative study in patients with superficial nail abnormalities was done. On the right finger or toenails phenol combination peels and on the left side 70% glycolic acid was used in a predefined protocol over 12 weeks. The severity was assessed objectively by a new devised index (Nail Surface abnormality Index (NSI]). Patient's subjective perception of severity was assessed by Visual Analogue Scale (VAS), and that of the physician was assessed by Physician's Global Assessment (PGA) scores. Results: A total of 17 patients were enrolled, two dropped out and 15 patients were included in the final analysis (mean age 19.2 years, total 120 nails treated). The mean NSI score declined from 7.88 % 0.45 to 4.02 % 0.45 on the right side; and from 8.0 % 0.45 to 4.32 % 0.44 on left side, at the end of 12 weeks. The VAS declined from 6.57 % 0.26 to 3.87 % 0.33 on right side and from 6.32 % 0.28 to 3.78 % 0.32 on left side. According to PGA score, five patients showed good improvement, seven showed moderate improvement and three responded poorly. Conclusion: Both the medium depth peels were found to be safe and equally efficacious modalities for treatment of superficial nail abnormalities.
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Reconstruction with dorsal nasal flap after excision of basal cell carcinoma of the nose
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):54-55
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Comparative study of efficacy and safety of botulinum toxin a injections and subcutaneous curettage in the treatment of axillary hyperhidrosis
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):33-39
Background: Primary focal axillary hyperhidrosis is a chronic distressing disorder affecting both the sexes. When the condition is refractory to conservative management, we should go for more promising therapies like intradermal botulinum toxin A (BtxA) injections in the axilla, and surgical therapies like subcutaneous curettage of sweat glands. Aims and Objectives: The aim of this study is to compare the efficacy, safety and duration of action of intradermal BtxA injections in one axilla and subcutaneous curettage of sweat glands in the other axilla of the same patient with axillary hyperhidrosis. Materials and Methods: Twenty patients (40 axillae) received intradermal BtxA injections on the right side (20 axillae) and underwent tumescent subcutaneous curettage of sweat glands on the left side (20 axillae). Sweat production rate was measured using gravimetry analyses at baseline and at 3 months after the procedure. Subjective analyses were done using hyperhidrosis disease severity scale (HDSS) score at baseline, at 3rd and 6th month after the procedure. Results: At 3 months post-treatment, the resting sweat rate in the toxin group improved by 80.32% versus 79.79% in the subcutaneous curettage method (P = 0.21). Exercise-induced sweat rate in the toxin group improved by 88.76% versus 88.8% in the subcutaneous curettage group (P = 0.9). There was a significant difference in the HDSS score after treatment with both the modalities. There were no adverse events with BtxA treatment compared to very minor adverse events with the surgical method. Conclusion: Both intradermal BtxA injections and tumescent subcutaneous curettage of sweat glands had a significant decrease in the sweat rates with no significant difference between the two modalities. Hence, in resource poor settings where affordability of BtxA injection is a constraint, subcutaneous curettage of sweat glands can be preferred which has been found equally effective with no or minimal adverse events.
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Squamous cell carcinoma of the nail bed: The great mimicker
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):59-60
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Long-pulsed Nd: YAG laser and intense pulse light-755 nm for idiopathic facial hirsutism: A comparative study
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):40-44
Background: Hirsutism means excessive terminal hair growth in a female in male pattern distribution. Perception of hirsutism is subjective. Permanent laser hair reduction is a slow process taking many sessions and tracking of improvement parameters is tedious. Hence, a lot of confusion still exists regarding the type of laser most beneficial for treatment. Aim: The aim of this study was to compare the effectiveness and safety profile of long-pulsed Nd: YAG laser (1064 nm) and intense pulse light (IPL)-755 nm in management of idiopathic facial hirsutism. Settings and Design: Open-labelled, randomly allocated experimental study. Subjects and Methods: The study included 33 cases of idiopathic facial hirsutism. Patients were randomly divided into Group A, treated with long-pulsed Nd: YAG laser and Group B, treated with IPL-755 for a total of six sessions at 1 month interval. Statistical Analysis: Chi-square test was used in Medcalc® version 9.0 and the test of significance was taken to be P< 0.05. Results: Average percentage of improvement in Group A, according to patients at each sessions were 46.33%, 70.66%, 81.66%, 84.67%, 85.33%, 87.33% and that in Group B were 28.06%, 39.72%, 52.22%, 64.72%, 67.78%, 71.11%, respectively. Excellent response (>75% reduction in hair) after six sessions in Group A was seen in fourteen (93.33%) out of fifteen patients, whereas in Group B, it was seen only in three (16.66%) out of eighteen patients. In Group A, erythema was seen in 26.67%, perifollicular edema and hyperpigmentation in 13.33% each. In Group B, erythema was seen in 50% patients, perifollicular edema in 16.67% and hyperpigmentation in 38.89% patients. Conclusions: Long-pulsed Nd: YAG Laser (1064 nm) is better than IPL-755 nm in terms of safety and effectiveness in the management of idiopathic facial hirsutism.
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Erratum: Recurrent adult nasal dermoid cyst
Journal of Cutaneous and Aesthetic Surgery 2017 10(1):63-63
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The reliability and criterion validity of 2D video assessment of single leg squat and hop landing
Publication date: Available online 17 April 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Lee Herrington, Faisal Alenezi, Msaad Alzhrani, Hasan Alrayani, Richard Jones
The objective was to assess the intra-tester, within and between day reliability of measurement of hip adduction (HADD) and frontal plane projection angles (FPPA) during single leg squat (SLS) and single leg landing (SLL) using 2D video and the validity of these measurements against those found during 3D motion capture. 15 healthy subjects had their SLS and SLL assessed using 3D motion capture and video analysis. Inter-tester reliability for both SLS and SLL when measuring FPPA and HADD show excellent correlations (ICC2,1 0.97-0.99). Within and between day assessment of SLS and SLL showed good to excellent correlations for both variables (ICC3,1 0.72-91). 2D FPPA measures were found to have good correlation with knee abduction angle in 3-D (r = 0.79, p = 0.008) during SLS, and also to knee abduction moment (r = 0.65, p =0.009). 2D HADD showed very good correlation with 3D HADD during SLS (r = 0.81, p = 0.001), and a good correlation during SLL (r = 0.62, p =0.013). All other associations were weak (r<0.4). This study suggests that 2D video kinematics have a reasonable association to what is being measured with 3D motion capture.
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Prevalence and Descriptive Epidemiology of Atopic Dermatitis and Its Impact on Quality of Life in Singapore
Abstract
Atopic dermatitis (AD) is a common, chronic, pruritic skin condition that is known to negatively impact the quality of life (QOL) of patients1,2. Due to its increasing prevalence, AD can impose a substantial economic burden on a country's healthcare system.3 A study in 2002 found a prevalence of 20.8% of AD in Singapore schoolchildren aged between 7 and 12 years4.
This article is protected by copyright. All rights reserved.
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Label-free electrochemical biosensing of small-molecule inhibition on O-GlcNAc glycosylation
Source:Biosensors and Bioelectronics, Volume 95
Author(s): Yu Yang, Yuxin Gu, Bin Wan, Xiaomin Ren, Liang-Hong Guo
O-linked N-acetylglucosamine (O-GlcNAc) transferase (OGT) plays a critical role in modulating protein function in many cellular processes and human diseases such as Alzheimer's disease and type II diabetes, and has emerged as a promising new target. Specific inhibitors of OGT could be valuable tools to probe the biological functions of O-GlcNAcylation, but a lack of robust nonradiometric assay strategies to detect glycosylation, has impeded efforts to identify such compounds. Here we have developed a novel label-free electrochemical biosensor for the detection of peptide O-GlcNAcylation using protease-protection strategy and electrocatalytic oxidation of tyrosine mediated by osmium bipyridine as a signal reporter. There is a large difference in the abilities of proteolysis of the glycosylated and the unglycosylated peptides by protease, thus providing a sensing mechanism for OGT activity. When the O-GlcNAcylation is achieved, the glycosylated peptides cannot be cleaved by proteinase K and result in a high current response on indium tin oxide (ITO) electrode. However, when the O-GlcNAcylation is successfully inhibited using a small molecule, the unglycosylated peptides can be cleaved easily and lead to low current signal. Peptide O-GlcNAcylation reaction was performed in the presence of a well-defined small-molecule OGT inhibitor. The results indicated that the biosensor could be used to screen the OGT inhibitors effectively. Our label-free electrochemical method is a promising candidate for protein glycosylation pathway research in screening small-molecule inhibitors of OGT.
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Lateral hypothalamic circuits for sleep–wake control
Source:Current Opinion in Neurobiology, Volume 44
Author(s): Takayuki Yamashita, Akihiro Yamanaka
The lateral hypothalamic area (LHA) of the diencephalon is crucially involved in controlling instinctive behavior such as sleep–wake cycle and feeding behavior. LHA is a heterogeneous structure that contains spatially intermingled, genetically distinct cell populations. Among LHA neurons, orexin/hypocretin (OX) neuron is the key cell type that promotes waking, and specific loss of OX neurons results in narcolepsy. Melanin-concentrating hormone (MCH) containing neurons are known to be active during rapid eye movement (REM) sleep and stimulation of these neurons promotes REM sleep. Here we review the classical and more recent findings in this field and discuss the molecular and cellular network organization of LHA neurons that could ultimately regulate the switch between wakefulness and general states of sleep.
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Editorial overview: Neurobiology of learning and plasticity 2017
Source:Current Opinion in Neurobiology
Author(s): Tim P Vogels, Leslie C Griffith
http://ift.tt/2nVV2Jk
Acute Noncardiovascular Illness in the Cardiac Intensive Care Unit
AbstractBackground
Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality.
ObjectivesThe authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission.
MethodsWe studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center. Through systematic inspection of individual charts, we identified primary and secondary diagnoses, vital sign measurements, length of stay (LOS), hospital readmissions, and mortality.
ResultsThe most common primary diagnosis was acute coronary syndrome (25%), which consisted of both non–ST-segment elevation acute coronary syndrome (14%) and ST-segment elevation myocardial infarction (11%). Sepsis was the most frequent noncardiovascular primary diagnosis (5%), but it only occurred in 16% of all admissions. Acute kidney injury and acute respiratory failure each occurred in 30% of admissions. One-half of all admissions (n = 524; 50%) were marked by acute respiratory failure, acute kidney injury, or sepsis. Median LOS in the CICU and the hospital were 2 days (interquartile range [IQR]: 1 to 5 days) and 6 days (IQR: 3 to 11 days). Mortality was 7% in the CICU and 12% in the hospital. Of the 920 patients who survived to hospital discharge, 171 (19%) were readmitted within 30 days. Sepsis, acute kidney injury, and acute respiratory failure were associated with mortality. Acute kidney injury, acute respiratory failure, and new-onset subclinical atrial fibrillation, which occurred in 8% of admissions, were all associated with CICU LOS.
ConclusionsMany patients in the modern CICU have acute noncardiovascular illnesses that are associated with mortality and increased LOS.
http://ift.tt/2oPNZBb
Clinical Trial Principles and Endpoint Definitions for Paravalvular Leaks in Surgical Prosthesis: An Expert Statement
Abstract
The VARC (Valve Academic Research Consortium) for transcatheter aortic valve replacement set the standard for selecting appropriate clinical endpoints reflecting safety and effectiveness of transcatheter devices, and defining single and composite clinical endpoints for clinical trials. No such standardization exists for circumferentially sutured surgical valve paravalvular leak (PVL) closure. This document seeks to provide core principles, appropriate clinical endpoints, and endpoint definitions to be used in clinical trials of PVL closure devices. The PVL Academic Research Consortium met to review evidence and make recommendations for assessment of disease severity, data collection, and updated endpoint definitions. A 5-class grading scheme to evaluate PVL was developed in concordance with VARC recommendations. Unresolved issues in the field are outlined. The current PVL Academic Research Consortium provides recommendations for assessment of disease severity, data collection, and endpoint definitions. Future research in the field is warranted.
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Bleeding-Related Deaths in Relation to the Duration of Dual-Antiplatelet Therapy After Coronary Stenting
AbstractBackground
Although some randomized controlled trials (RCTs) and meta-analyses have suggested that prolonged dual-antiplatelet therapy (DAPT) may be associated with increased mortality, the mechanistic underpinnings of this association remain unclear.
ObjectivesThe aim of this study was to analyze the associations among bleeding, mortality, and DAPT duration after drug-eluting stent implantation in a meta-analysis of RCTs.
MethodsRCTs comparing different DAPT durations after drug-eluting stent placement were sought through the MEDLINE, Embase, and Cochrane databases and the proceedings of international meetings. Deaths were considered possibly bleeding related if occurring within 1 year of the episodes of bleeding. Primary analysis was by intention-to-treat. Secondary analysis was performed in a modified intention-to-treat population in which events occurring when all patients were on DAPT were excluded.
ResultsIndividual patient data were obtained for 6 RCTs, and aggregate data were available for 12 RCTs. Patients with bleeding had significantly higher rates of mortality compared with those without, and in a time-adjusted multivariate analysis, bleeding was an independent predictor of mortality occurring within 1 year of the bleeding episode (hazard ratio: 6.93; 95% confidence interval: 4.53 to 10.60; p < 0.0001). Shorter DAPT was associated with lower rates of all-cause death compared with longer DAPT (hazard ratio: 0.85; 95% confidence interval: 0.73 to 1.00; p = 0.05), which was driven by lower rates of bleeding-related deaths with shorter DAPT compared with prolonged DAPT (hazard ratio: 0.65; 95% confidence interval: 0.43 to 0.99; p = 0.04). Mortality unrelated to bleeding was comparable between the 2 groups. Similar results were apparent in the modified intention-to-treat population.
ConclusionsBleeding was strongly associated with the occurrence of mortality within 1 year after the bleeding event. Shorter compared with longer DAPT was associated with lower risk for bleeding-related death, a finding that may underlie the lower all-cause mortality with shorter DAPT in the RCTs of different DAPT durations after DES.
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Implantable Cardioverter-Defibrillators With Versus Without Resynchronization Therapy in Patients With a QRS Duration >180 ms
AbstractBackground
More than 20% of Medicare beneficiaries receiving cardiac resynchronization therapy defibrillators (CRT-D) have a very wide (≥180 ms) QRS complex duration (QRSD). Outcomes of CRT-D in these patients are not well-established because they have been underrepresented in clinical trials.
ObjectivesThis study examined outcomes in patients with CRT-D in a very wide QRSD with left bundle branch block (LBBB) versus those without LBBB.
MethodsMedicare patients from the Implantable Cardioverter Defibrillator Registry (January 1, 2005, through April 30, 2006) with a CRT-D and confirmed Class I or IIa indications for CRT-D were matched to implantable cardioverter-defibrillator (ICD) patients without CRT despite having Class I or IIa indications for CRT. Mortality and heart failure hospitalizations longer than 4 years with CRT-D versus standard ICDs based on a QRSD and morphology were analyzed.
ResultsWe analyzed 24,960 patients. Among those with LBBB, patients with a QRSD ≥180 ms had a greater adjusted survival benefit with CRT-D versus standard ICD (hazard ration [HR] for death: 0.65; 95% confidence interval [CI]: 0.59 to 0.72) compared with those having a QRSD 120 to 149 ms (HR: 0.85; 95% CI: 0.80 to 0.92) and 150 to 179 ms (HR: 0.87; 95% CI: 0.81 to 0.93). CRT-D versus ICD was associated with an improvement in survival in those with LBBB and a QRSD ≥180 ms (adjusted HR for death: 0.78; 95% CI: 0.68 to 0.91), but not in those with LBBB and a QRSD 150 to 179 ms (adjusted HR for death: 1.06; 95% CI: 0.95 to 1.19).
ConclusionsImprovements in both survival and heart failure hospitalizations with CRT-D were greatest in patients with a QRSD ≥180 ms with or without LBBB, whereas patients with a QRSD 150 to 179 ms without LBBB had no improvement in survival with CRT-D, and those with a QRSD 150 to 179 ms and LBBB had only a modest improvement.
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Improving Atrial Fibrillation Therapy: Is There a Gene for That?
Abstract
Atrial fibrillation (AF) is an all-too-common and often challenging reality of clinical care. AF leads to significant morbidity and mortality; however, currently available treatments for AF have modest efficacy and high recurrence rates. In recent years, genetic therapy approaches have been explored in preclinical models of AF, and offer potential as a treatment modality with targeted delivery, tissue specificity, and therapy tailored to address mechanisms underlying the arrhythmia. However, many challenges remain before gene therapy can advance to a clinically relevant AF treatment. In this review, we summarize the available published data on gene therapy and discuss the challenges, opportunities, and limitations of this approach.
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Quality of Life After Surgery or DES in Patients With 3-Vessel or Left Main Disease
AbstractBackground
In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization.
ObjectivesThis study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD.
MethodsBetween 2005 and 2007, the SYNTAX trial randomized 1,800 patients with 3-vessel or left main CAD to either CABG or DES-PCI. Health status was assessed at baseline and at 1, 6, 12, 36, and 60 months by using the Seattle Angina Questionnaire (SAQ) and the 36-Item Short Form Health Survey.
ResultsAt 5-year follow-up, CABG was superior to DES-PCI on several SAQ domains including angina frequency and physical function, as well as the role physical and role emotional scales of the 36-Item Short Form Health Survey. Subgroup analysis demonstrated a significant interaction between angiographic complexity (as assessed by the SYNTAX score) and angina relief (mean difference in the SAQ angina frequency score for CABG vs. PCI of –0.9, 3.3, and 3.9 points for low, intermediate, and high SYNTAX score patients, respectively; p = 0.048 for interaction).
ConclusionsAmong patients with 3-vessel or left main CAD, both CABG and DES-PCI were associated with substantial and sustained quality-of-life benefits over 5 years of follow-up. In general, CABG resulted in greater angina relief, although the absolute treatment benefit was small. Angina relief at 5 years was enhanced with CABG among patients with high SYNTAX scores, a finding reinforcing the recommendation that CABG should be strongly preferred for such patients. (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery [SYNTAX]; NCT00114972)
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ANGPTL3 Deficiency and Protection Against Coronary Artery Disease
AbstractBackground
Familial combined hypolipidemia, a Mendelian condition characterized by substantial reductions in all 3 major lipid fractions, is caused by mutations that inactivate the gene angiopoietin-like 3 (ANGPTL3). Whether ANGPTL3 deficiency reduces risk of coronary artery disease (CAD) is unknown.
ObjectivesThe study goal was to leverage 3 distinct lines of evidence—a family that included individuals with complete (compound heterozygote) ANGPTL3 deficiency, a population based-study of humans with partial (heterozygote) ANGPTL3 deficiency, and biomarker levels in patients with myocardial infarction (MI)—to test whether ANGPTL3 deficiency is associated with lower risk for CAD.
MethodsWe assessed coronary atherosclerotic burden in 3 individuals with complete ANGPTL3 deficiency and 3 wild-type first-degree relatives using computed tomography angiography. In the population, ANGPTL3 loss-of-function (LOF) mutations were ascertained in up to 21,980 people with CAD and 158,200 control subjects. LOF mutations were defined as nonsense, frameshift, and splice-site variants, along with missense variants resulting in <25% of wild-type ANGPTL3 activity in a mouse model. In a biomarker study, circulating ANGPTL3 concentration was measured in 1,493 people who presented with MI and 3,232 control subjects.
ResultsThe 3 individuals with complete ANGPTL3 deficiency showed no evidence of coronary atherosclerotic plaque. ANGPTL3 gene sequencing demonstrated that approximately 1 in 309 people was a heterozygous carrier for an LOF mutation. Compared with those without mutation, heterozygous carriers of ANGPTL3 LOF mutations demonstrated a 17% reduction in circulating triglycerides and a 12% reduction in low-density lipoprotein cholesterol. Carrier status was associated with a 34% reduction in odds of CAD (odds ratio: 0.66; 95% confidence interval: 0.44 to 0.98; p = 0.04). Individuals in the lowest tertile of circulating ANGPTL3 concentrations, compared with the highest, had reduced odds of MI (adjusted odds ratio: 0.65; 95% confidence interval: 0.55 to 0.77; p < 0.001).
ConclusionsANGPTL3 deficiency is associated with protection from CAD.
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Impact of season and different vitamin D thresholds on prevalence of vitamin D deficiency in epidemiological cohorts—a note of caution
Abstract
Purpose
We investigated the impact of different cut-offs on the prevalence of 25-hydroxyvitamin D [25-(OH)D] deficiency.
Methods
We used baseline data of 4149 participants (45–75 years, 50% women) of the population-based Heinz Nixdorf Recall study. Serum 25-(OH)D was measured with the Roche Cobas assay. Quartiles (p25, p50, and p75) were calculated. Data were stratified by months, sex, and age. According to the recommendations of 'Dachverband Osteologie', Endocrine Society and National Institute of Health we used 25-(OH)D thresholds of 12, 20, and 30 ng/ml to estimate vitamin D deficiency.
Results
Overall the median of 25-(OH)D was 19.8 ng/ml (p25 = 14.4 ng/ml, p75 = 26.6 ng/ml), with highest concentrations in July (p50 = 23.8 ng/ml, p25 = 18.2 ng/ml, and p75 = 31.2 ng/ml) and lowest in March (p50 = 15.8 ng/ml, p25 = 11.5 ng/ml, and p75 = 20.6 ng/ml). Prevalence of vitamin D deficiency rose from 16, 51 up to 83% using the cut-offs of <12, <20 ng/ml, and <30 ng/ml, respectively. With respect to seasonal variance, prevalence of vitamin D deficiency rose to 92% in February/March using the cut-off <30 ng/ml (<12: 28%, <20 ng/ml: 71%) whereas in June/July prevalence of vitamin D deficiency decreased to 71% (<12: 6%, <20 ng/ml: 30%). The chance to attest the diagnosis of vitamin D deficiency for cut-off 12 ng/ml in March is 6.4-fold higher than in June, for cut-off 20 ng/ml, 5.5-fold higher and for cut-off 30 ng/ml, 3.1-fold higher.
Conclusions
Guidelines to define vitamin D deficiency revealed extremely different prevalence rates ranging between 6 and 92%. Accounting for collection time and antecedent sun exposure are important to reduce bias in research studies and improve decision-making in clinical care. Vitamin D thresholds have to be rethought.
http://ift.tt/2pqkdE6
Characterization and pyrolysis of Chlorella vulgaris and Arthrospira platensis: potential of bio-oil and chemical production by Py-GC/MS analysis
Abstract
Biofuels have been seen as potential sources to meet future energy demand as a renewable and sustainable energy source. Despite the fact that the production technology of first-generation biofuels is consolidated, these biofuels are produced from foods crops such as grains, sugar cane, and vegetable oils competing with food for crop use and agricultural land. In recent years, it was found that microalgae have the potential to provide a viable alternative to fossil fuels as source of biofuels without compromising food supplies or arable land. On this scenario, this paper aims to demonstrate the energetic potential to produce bio-oil and chemicals from microalgae Chlorella vulgaris and Arthrospira platensis. The potential of these biomasses was evaluated in terms of physical-chemical characterization, thermogravimetric analysis, and analytical pyrolysis interfaced with gas chromatograph (Py-GC/MS). The results show that C. vulgaris and A. platensis are biomasses with a high heating value (24.60 and 22.43 MJ/kg) and low ash content, showing a high percentage of volatile matter (72.49 and 79.42%). These characteristics confirm their energetic potential for conversion process through pyrolysis, whereby some important aromatic compounds such as toluene, styrene, and phenol were identified as pyrolysis products, which could turn these microalgae a potential for biofuels and bioproduct production through the pyrolysis.
http://ift.tt/2pulh6W
Effect of Home and Community-Based Physical Activity Interventions on Physical Function among Cancer Survivors: A Systematic Review and Meta-analysis
Publication date: Available online 17 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Maria C. Swartz, Zakkoyya H. Lewis, Elizabeth J. Lyons, Kristofer Jennings, Addie Middleton, Rachel R. Deer, Demi Arnold, Kaitlin Dresser, Kenneth J. Ottenbacher, James S. Goodwin
ObjectiveWe reviewed randomized trials to examine the effect of home and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures.Data SourcesFive electronic databases—Medline Ovid, Pubmed, CINAHL, Web of Science, and PsychINFO—were searched from inception to March 2016 for relevant articles.Study SelectionSearch terms included: community-based interventions, physical functioning, and cancer survivors. A reference librarian trained in systematic reviews conducted the final search. Detail protocol is registered on PROSPERO (http://ift.tt/W2LRof) CRD42016036730.Data ExtractionFour reviewers evaluated eligibility and two reviewers evaluated methodological quality. Data were abstracted from studies that used the most prevalent physical function measurement tools—Medical Outcomes Study Short Form-36, Late Life Function and Disability Instrument, European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire, and six minute walk test. Random or fixed effects models were conducted to obtain overall effect size per physical function measure.Data SynthesisFourteen studies met inclusion criteria and were used to compute standardized mean differences using inverse variance statistical method. The median sample size was 83 participants. The majority of the studies were conducted among breast cancer survivors (n = 7). The interventions produced short-term positive effects on physical functioning with overall effect sizes ranging from small (0.17, 95% CI: 0.07, 0.27) to medium (0.45, 95% CI: 0.23, 0.67). Community-based interventions that met in groups and used behavioral change strategies produced the largest effect sizes.ConclusionsHome and community-based physical activity interventions may be a potential tool to combat functional deterioration among aging cancer survivors. More studies are needed among other cancer types using clinically relevant objective functional measures (e.g., gait speed) to accelerate translation into the community and clinical practice.
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Development and Preliminary Psychometrics of the Exercise Therapy Burden Questionnaire for Patients with Chronic Conditions
Source:Archives of Physical Medicine and Rehabilitation
Author(s): William Martin, Clémence Palazzo, Serge Poiraudeau
http://ift.tt/2pJnPNO
Impact of season and different vitamin D thresholds on prevalence of vitamin D deficiency in epidemiological cohorts—a note of caution
Abstract
Purpose
We investigated the impact of different cut-offs on the prevalence of 25-hydroxyvitamin D [25-(OH)D] deficiency.
Methods
We used baseline data of 4149 participants (45–75 years, 50% women) of the population-based Heinz Nixdorf Recall study. Serum 25-(OH)D was measured with the Roche Cobas assay. Quartiles (p25, p50, and p75) were calculated. Data were stratified by months, sex, and age. According to the recommendations of 'Dachverband Osteologie', Endocrine Society and National Institute of Health we used 25-(OH)D thresholds of 12, 20, and 30 ng/ml to estimate vitamin D deficiency.
Results
Overall the median of 25-(OH)D was 19.8 ng/ml (p25 = 14.4 ng/ml, p75 = 26.6 ng/ml), with highest concentrations in July (p50 = 23.8 ng/ml, p25 = 18.2 ng/ml, and p75 = 31.2 ng/ml) and lowest in March (p50 = 15.8 ng/ml, p25 = 11.5 ng/ml, and p75 = 20.6 ng/ml). Prevalence of vitamin D deficiency rose from 16, 51 up to 83% using the cut-offs of <12, <20 ng/ml, and <30 ng/ml, respectively. With respect to seasonal variance, prevalence of vitamin D deficiency rose to 92% in February/March using the cut-off <30 ng/ml (<12: 28%, <20 ng/ml: 71%) whereas in June/July prevalence of vitamin D deficiency decreased to 71% (<12: 6%, <20 ng/ml: 30%). The chance to attest the diagnosis of vitamin D deficiency for cut-off 12 ng/ml in March is 6.4-fold higher than in June, for cut-off 20 ng/ml, 5.5-fold higher and for cut-off 30 ng/ml, 3.1-fold higher.
Conclusions
Guidelines to define vitamin D deficiency revealed extremely different prevalence rates ranging between 6 and 92%. Accounting for collection time and antecedent sun exposure are important to reduce bias in research studies and improve decision-making in clinical care. Vitamin D thresholds have to be rethought.
http://ift.tt/2pqkdE6
The Blood Brain Barrier and Neuropsychiatric Lupus: New perspectives in light of advances in understanding the neuroimmune interface
Source:Autoimmunity Reviews
Author(s): Ariel D. Stock, Sivan Gelb, Ofer Pasternak, Ayal Ben-Zvi, Chaim Putterman
Experts have previously postulated a linkage between lupus associated vascular pathology and abnormal brain barriers in the immunopathogenesis of neuropsychiatric lupus. Nevertheless, there are some discrepancies between the experimental evidence, or its interpretation, and the working hypotheses prevalent in this field; specifically, that a primary contributor to neuropsychiatric disease in lupus is permeabilization of the blood brain barrier. In this commonly held view, any contribution of the other known brain barriers, including the blood-cerebrospinal fluid and meningeal barriers, is mostly excluded from the discussion. In this review we will shed light on some of the blood brain barrier hypotheses and try to trace their roots. In addition, we will suggest new research directions to allow for confirmation of alternative interpretations of the experimental evidence linking the pathology of intra-cerebral vasculature to the pathogenesis of neuropsychiatric lupus.
http://ift.tt/2pqbdi8
Timing of high-efficacy therapy in relapsing-remitting multiple sclerosis: A systematic review
Source:Autoimmunity Reviews
Author(s): Bernd Merkel, Helmut Butzkueven, Anthony L. Traboulsee, Eva Havrdova, Tomas Kalincik
BackgroundImmunotherapy initiated early after first presentation of relapsing-remitting multiple sclerosis is associated with improved long-term outcomes. One can therefore speculate that early initiation of highly effective immunotherapies, with an average efficacy that is superior to the typical first-line therapies, could further improve relapse and disability outcomes. However, the most common treatment strategy is to commence first-line therapies, followed by treatment escalation in patients who continue to experience on-treatment disease activity. While this monitoring approach is logical, the current lack of effective regenerative or remyelinating therapies behoves us to consider high-efficacy treatment strategies from disease onset (including induction therapy) in order to prevent irreversible disability.ObjectiveIn this systematic review, we evaluate the effect of high-efficacy immunotherapies at different stages of MS.MethodsA systematic review of literature reporting outcomes of treatment with fingolimod, natalizumab or alemtuzumab at different stages of MS was carried out.Results and conclusionsTwelve publications reporting relevant information were included in the systematic review. The literature suggests that treatment with high-efficacy immunotherapies is more potent in suppressing relapse activity when initiated early vs. with a delay after the MS diagnosis. The evidence reported for disability and MRI outcomes is inconclusive.
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Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an un...
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