Ιατρικά Άρθρα: 06/14/17

Τετάρτη 14 Ιουνίου 2017

Familial hypocalciuric hypercalcemia type 1 due to a novel homozygous mutation of the calcium-sensing receptor gene

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Effect of primary recrystallization microstructure on abnormal growth of Goss grains in a twin-roll cast grain-oriented electrical steel

Publication date: 5 October 2017
Source:Materials & Design, Volume 131
Author(s): Hong-Yu Song, Hai-Tao Liu, John J. Jonas, Guo-Dong Wang
Various primary recrystallization microstructures and textures were produced in a twin-roll cast grain-oriented electrical steel by employing different routes. The relationship between the primary recrystallization microstructure and texture and the abnormal growth of secondary Goss grains was investigated. The results show that the cold rolling reductions have a significant influence on secondary recrystallization by changing the primary recrystallization microstructure. Sheet processed by single-stage cold rolling with 88.3% reduction displayed the poorest secondary recrystallization microstructure as it contained many small equiaxed grains. By contrast, the employment of two-stage cold rolling markedly improved the secondary recrystallization microstructure. In the case of two moderate reductions of 65.2% and 66.3%, dense deformation substructures formed during both the first and second cold rolling, leading to a homogeneous primary recrystallization microstructure together with a strong γ-fiber texture. In this way, a suitable secondary recrystallization microstructure consisting of large Goss grains was produced. In the case of the inappropriate reductions, many large λ- and α-grains in the primary recrystallization matrix blocked the growth of secondary Goss grains along the transverse direction, resulting in a poor secondary recrystallization microstructure.

Graphical abstract

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Organic aerogel-impregnated low-density carbon/carbon composites: Preparation, properties and response under simulated atmospheric re-entry conditions

Publication date: 5 October 2017
Source:Materials & Design, Volume 131
Author(s): Chonghai Wang, Xiangyu Jin, Haiming Cheng, Changqing Hong, Xinghong Zhang
A novel lightweight organic aerogel-impregnated low-density carbon/carbon (C/C) composite was produced through vacuum impregnation using carbon-bonded carbon fibre (CBCF) as substrate and resorcinol-furfural (RF) aerogel as infiltrant. Microstructural analysis showed that fibres in CBCF were uniformly coated with a thin layer of aerogels, acting as the supporting skeletons, to strengthen the aerogel matrix. The as prepared RF-C/C possessed low densities between 0.26 and 0.37g/cm³, relatively high compressive strength, ranging from 0.45 to 3.27MPa, and low thermal conductivities of 0.105 to 0.350W/(mK) at room temperature. Furthermore, good thermal ablative and insulative properties (recession rates as low as 0.082mm/s and internal temperature peaks below 90°C at 38mm in-depth position as the surface temperature exceeded 2000°C) under an atmospheric re-entry condition. From mentioned above, RF-C/C present huge application prospects in heat preservation and thermal protection field, especially in energy-saving and aerospace.

Graphical abstract

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Microstructure evolution and thermostability of bondline based on Cu@Sn core-shell structured microparticles under high-temperature conditions

Publication date: 5 October 2017
Source:Materials & Design, Volume 131
Author(s): Tianqi Hu, Hongtao Chen, Mingyu Li, Chunqing Wang
Cu@Sn core-shell structured particles with different coating layer thicknesses were fabricated and used as bonding materials. The microstructure evolution and thermostability of the bondline were studied under high-temperature conditions; the minimum thickness of the Sn coating layer required to consume all the inner Cu cores when forming ε-Cu3Sn was determined; and the accompanying volume shrinkage was verified. The phase transformation pathway for particles with a thin Sn coating layer was Cu6Sn5→ε-Cu3Sn→δ-Cu41Sn11→γ-phase→β-phase upon heating to 600°C. Thermal instability occurs at 520°C and 586°C due to the formation of the Cu-rich phases. High-temperature shearing tests were conducted at 500°C and 550°C to verify the existence of a critical point for brittle rupture and tough rupture at approximately 520°C. For particles with a thick Sn coating layer, the outer Sn shell completely consumes the inner Cu core when forming a ε-Cu3Sn intermetallic phase, and no other Cu-rich phases formed when heating to 600°C.

Graphical abstract

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Defect induced magnetism and super spin glass state in reactive ion beam deposited nano-structured AlN thin films

Publication date: 5 October 2017
Source:Materials & Design, Volume 131
Author(s): Shilpam Sharma, E.P. Amaladass, Awadhesh Mani
Defect induced magnetism is reported in undoped aluminium nitride thin films deposited using reactive ion beam sputtering of aluminium in nitrogen plasma. The films have been deposited on silicon substrate at different temperatures. Existence of the defects in the films has been verified using room temperature photo-luminescence measurements. Owing to nano-crystalline nature of the films, super-magnetic ground states have been observed. A cross-over from super paramagnetic to super spin glass state has been observed as the grain density increases. Detailed magnetisation measurements along with AC susceptibility measurements have been used to determine the ground states in these AlN thin films.

Graphical abstract

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Mixed-mode (I/II) interlaminar fracture of glued-laminated timber

Publication date: 5 October 2017
Source:Materials & Design, Volume 131
Author(s): Yanhua Zhao, Zheng Li, Bohan Xu
Mixed-mode bending (MMB) tests, together with double cantilever beam (DCB) and end-notched flexure (ENF) tests were conducted on Mongolian Scots pine to investigate the initial interlaminar fracture toughness of glued-laminated timber (glulam) under various mixed mode I/II conditions. By changing the loading lever location, a wide range of apparent ratios between mode I and mode II fracture were covered for MMB tests. Using the recorded critical load, interlaminar fracture toughness in terms of energy release rate was determined using compliance combination method (CCM), where the influence of growth ring orientations of adjacent laminae of glulam was highlighted. The results reveal the initial interlaminar fracture toughness was influenced by the growth ring orientation when mode II fracture component is larger. And an empirical power criterion was proven to be applicable to the mixed mode I/II interlaminar fracture toughness envelope of glulam.

Graphical abstract

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Multiuse of Disposable Microsurgical Instruments as a Cost-Efficient Alternative for Training and Research

Summary: Microsurgery demands significant preclinical training, often hampered by the high costs of the required microsurgery instruments. We hypothesized that recently available disposable microsurgery instruments provide sufficient quality and significantly reduced costs. In a comparative analysis with standard reusable instruments, participants performed equally with both instrument sets and recommended the disposable instruments for microsurgery training and research applications.

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Immediate Regrafting of the Split Thickness Skin Graft Donor Site Assists Healing

Background: Delayed or even lack of healing of a split-thickness skin graft (STSG) donor site is a potential problem with elderly patients or those with poor wound healing capabilities. A proactive solution that may minimize this risk is to regraft that donor site using otherwise discarded skin graft remnants. Methods: A prospective, nonrandomized, consecutive study was designed to compare the time to healing of the commonly used anterior thigh STSG donor site in patients who had routine dressings (n = 113) versus those with comorbidities known to adversely affect wound healing and had planned regrafting (n = 204). Those comorbidities included age (≥65 years), diabetes mellitus, peripheral vascular disease, chronic renal disease, and chronic steroid use. Results: The average number of comorbidities in the regrafted subgroup versus those not regrafted was 1.41 and 0.31, respectively. This was considered to be a significant difference (P

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The influence of antidepressants on restless legs syndrome and periodic limb movements: A systematic review

Restless legs syndrome is commonly co-morbid with medical conditions that are treated with antidepressant medications, such as depression, anxiety, fibromyalgia, and chronic insomnia disorder. Evidence from case reports and cross-sectional studies suggests that antidepressants may induce or worsen restless legs syndrome and increase periodic limb movements. We undertook a systematic review of the literature to identify and collate all prospective studies that measured restless legs syndrome symptoms and/or periodic limb movements following the introduction of an antidepressant.

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Sleep quality during pregnancy: A meta-analysis

Women's sleep quality has been reported to change during pregnancy; prevalence estimates of poor sleep quality during pregnancy vary widely. To further understand the observed variation of findings, we conducted a meta-analysis to quantify the prevalence of poor sleep quality during pregnancy. Articles (N = 24) that reported prevalence of poor sleep quality as captured by the Pittsburgh sleep quality index (PSQI) ≥ 5 were included, with a total of 11,002 participants contributing data. PubMed, PsycINFO, and Web of Science databases were systematically searched.

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Comparison of G protein sequences of South African street rabies viruses showing distinct progression of the disease in a mouse model of experimental rabies

Publication date: Available online 13 June 2017
Source:Microbes and Infection
Author(s): Wonhyo Seo, Alexandre Servat, Florence Cliquet, Jenkins Akinbowale, Christophe Prehaud, Monique Lafon, Claude Sabeta
Rabies is a fatal zoonotic disease and infections generally lead to a fatal encephalomyelitis in both humans and animals. In South Africa, domestic (dogs) and the wildlife (yellow mongoose) host species maintain the canid and mongoose rabies variants respectively. In this study, pathogenicity differences of South African canid and mongoose rabies viruses were investigated in a murine model, by assessing the progression of clinical signs and survivorship. Comparison of glycoprotein gene sequences revealed amino acid differences that may underpin the observed pathogenicity differences. Cumulatively, our results suggest that the canid rabies virus may be more neurovirulent in mice than the mongoose rabies variant.

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Quality of Life and Dysphagia Following Palliative Stenting in Esophageal Cancer

Condition: Esophageal Cancer
Intervention:
Sponsor: Centre hospitalier de l'Université de Montréal (CHUM)
Recruiting - verified June 2017

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Cysteine-rich whey protein isolate (Immunocal®) ameliorates deficits in the GFAP.HMOX1 mouse model of schizophrenia

Publication date: September 2017
Source:Free Radical Biology and Medicine, Volume 110
Author(s): Wei Song, Ayda Tavitian, Marisa Cressatti, Carmela Galindez, Adrienne Liberman, Hyman M. Schipper
Schizophrenia is a neuropsychiatric disorder that features neural oxidative stress and glutathione (GSH) deficits. Oxidative stress is augmented in brain tissue of GFAP.HMOX1 transgenic mice which exhibit schizophrenia-relevant characteristics. The whey protein isolate, Immunocal® serves as a GSH precursor upon oral administration. In this study, we treated GFAP.HMOX1 transgenic mice daily with either Immunocal (33mg/ml drinking water) or equivalent concentrations of casein (control) between the ages of 5 and 6.5 months. Immunocal attenuated many of the behavioral, neurochemical and redox abnormalities observed in GFAP.HMOX1 mice. In addition to restoring GSH homeostasis in the CNS of the transgenic mice, the whey protein isolate augmented GSH reserves in the brains of wild-type animals. These results demonstrate that consumption of whey protein isolate augments GSH stores and antioxidant defenses in the healthy and diseased mammalian brain. Whey protein isolate supplementation (Immunocal) may constitute a safe and effective modality for the management of schizophrenia, an unmet clinical imperative.

Graphical abstract

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Imiquimod-induced cutaneous lupus erythematosus with antinuclear antibodies showing a homogenous pattern

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Lichen striatus following yellow fever vaccination in an adult woman

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Development of a solid-phase extraction method with simple MEKC-UV analysis for simultaneous detection of indole metabolites in human urine after administration of indole dietary supplement

Publication date: 1 November 2017
Source:Talanta, Volume 174
Author(s): Apichai Phonchai, Prapin Wilairat, Rattikan Chantiwas
This work presents the development of a solid phase extraction method with simple MEKC-UV analysis for the simultaneous determination of indole-3-carbinol (I3C) and its metabolites (3, 3′-diindolylmethane (DIM), indole-3-carboxaldehyde (I3CAL), indole-3-acetonitrile (I3A)) in human urine after oral administration of an indole dietary supplement. Solid phase extraction (SPE) method was applied for the first time for simultaneous analysis of these indole metabolites. The MEKC separation method was developed in a previous work. Three commercial SPE cartridges, each with different sorbent materials, were investigated: Sep-Pak^® C18, Oasis^® HLB and Oasis^® WCX. The Sep-Pak^® C18 material provided the highest extraction recovery of 88–113% (n = 9), for the four target indole metabolites (I3C, DIM, I3CAL and I3A). The optimal washing and elution solutions were 40% methanol/water (v/v) and 100% methanol, respectively, and optimal elution volume was 2.0mL. The specificity of the proposed SPE method was evaluated with negative control urine samples (n = 10) from healthy volunteers who had not taken the dietary supplement or vegetables known to contain indole compounds. Linear calibration curves were in the range of 0.2–25μgmL⁻¹ (r² > 0.998) using diphenylamine (DPA) as the internal standard. Intra-day and inter-day precisions were 3.5–12.3%RSD and 2.7–14.1%RSD, respectively. Limits of detection and quantification were 0.05–0.10μgmL⁻¹ and 0.10–0.50μgmL⁻¹, respectively. The four target indole compounds were separated within only 5min by MEKC-UV analysis. Urine from 5 subjects who had taken a dietary supplement containing I3C and DIM were found to contain only the DIM metabolite at concentrations ranging from 0.10 to 0.35µgmL⁻¹. Accuracy of the proposed method based on the percentage recovery of spiked urine samples were 70–108%, 82–116%, 82–132% and 80–100% for I3C, I3CAL, I3A and DIM, respectively. The Sep-Pak^®C18 cartridge was highly effective in extraction and sample cleanup for the downstream simultaneous detection of urinary indole metabolites by MEKC-UV method.

Graphical abstract

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Ordered mesoporous silica film as a novel fiber coating for solid-phase microextraction

Publication date: 1 November 2017
Source:Talanta, Volume 174
Author(s): Hui Jiang, Jiansheng Li, Xingru Hu, Jinyou Shen, Xiuyun Sun, Weiqing Han, Lianjun Wang
Ordered mesoporous silica (OMS) film supported on anodized titanium wire was fabricated as a new solid phase microextraction (SPME) fiber for the extraction of chlorophenols (CPs) from aqueous media followed by the determination with gas chromatography flame ionization detection (GC-FID). The supported OMS film was prepared via a solvent evaporation-induced self-assembly approach (EISA) combined with dip-coating technology. Commonly used fragile fused silica fiber was replaced by anodized titanium wire. The coating materials were characterized by N2 adsorption-desorption, Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM) and thermogravimetric (TG) analysis. The N2 adsorption-desorption results show the OMS material has well-ordered mesostructure with uniform pore diameter. The SEM images verify that the OMS film was successfully grafted onto the surface of anodized titanium wire. The resultant method based on the OMS fiber exhibited wide linear ranges (0.2-200μgL⁻¹), low detection limits (0.03-0.12μgL⁻¹) and good repeatabilities (6.2–9.8% for one fiber, 8.9–13.2% for fiber-to-fiber). No significant change was observed after being subjected into high temperature or immersed in organic solvents. The new fiber was successfully applied to the extraction and determination of three CPs compounds in the natural water samples. Thus, the OMS fiber is a promising alternative to the commercial fiber as it is easily and inexpensively prepared with high extraction capacity and good stability.

Graphical abstract

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Patterns of multimorbidity in people with severe or profound intellectual and motor disabilities

Publication date: August 2017
Source:Research in Developmental Disabilities, Volume 67
Author(s): E.A. van Timmeren, A. Waninge, H.M.J. van Schrojenstein Lantman-de, A.A.J. van der Putten, C.P. van der Schans
BackgroundPeople with severe or profound intellectual and motor disabilities (SPIMD) experience multimorbidity and have complex health needs. Multimorbidity increases mortality, decreases functioning, and negatively influences quality of life. Information regarding patterns of multimorbidity in people with SPIMD may lead to proactive prevention, specifically detection and treatment of physical health problems at an early stage and prevention of secondary complications.AimThe aim of this study was to explore patterns of multimorbidity in individuals with SPIMD.Methods and proceduresData from medical records and care plans on reported physical health problems of 99 adults with SPIMD were analysed. To explore the co-occurrence of physical health problems, cross tabulations and a 5-set Venn Diagram were used.Outcomes and resultsThe most common combination of two physical health problems comprise the most prevalent physical health problems, which included visual impairment, constipation, epilepsy, spasticity, and scoliosis. These five issues occurred as a multimorbidity combination in 37% of the participants. In 56% of the participants a multimorbidity combination of four health problems emerged, namely constipation, visual impairment, epilepsy, and spasticity.Conclusions and implicationsPeople experiencing SPIMD have interrelated health problems. As a consequence, a broad variety of potential interactions between physical health problems and their treatments may occur. Identifying multimorbidity patterns can provide guidance for accurate monitoring of persistent health problems and, early detection of secondary complications. However, the results require confirmation with larger samples in further studies.

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Exogenous deoxyribonuclease has a protective effect in a mouse model of sepsis

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Lucia Lauková, Barbora Konečná, Janka Bábíčková, Alexandra Wagnerová, Veronika Melišková, Barbora Vlková, Peter Celec
Sepsis is associated with the activation of white blood cells (WBCs) that leads to the production of extracellular traps. This process increases extracellular DNA (ecDNA) that can be recognized by the innate immune system and leads to inflammation. Previous studies have shown that by cleaving ecDNA deoxyribonuclease (DNase) prevents the antibacterial effects of extracellular traps, but also has beneficial effects in sepsis. The aim of our study was to analyze the effects of DNase on WBCs in vitro and on ecDNA in a mouse model of sepsis. Our results confirmed that DNase decreases ecDNA by 70% and prevents the antibacterial effects of WBCs in vitro. Sepsis was induced in mice by intraperitoneal injection of E. coli. DNase was subsequently administered intravenously. In comparison to untreated septic mice DNase treatment improved the survival of septic mice by 60%, reduced their weight loss as well as inflammatory markers. Increased plasma DNase activity led to ecDNA concentrations in plasma comparable with the control group. In conclusion, the study showed that intravenous DNase improves survival of septic mice by cleavage of ecDNA, especially of nuclear origin. Further mechanistic studies are needed to prove the potential of DNase in the treatment or prevention of septic complications.

Graphical abstract

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Targeting proinflammatory cytokines, oxidative stress, TGF-β1 and STAT-3 by rosuvastatin and ubiquinone to ameliorate trastuzumab cardiotoxicity

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Ahmed M. Kabel, Abeer A. Elkhoely
The aim of this study was to assess the possible modulatory effects of rosuvastatin and/or ubiquinone on trastuzumab (TRZ)-induced cardiotoxicity in mice. One hundred and twenty mice were divided into six equal groups as follows: control group; TRZ group; TRZ+carboxymethyl cellulose group; TRZ+rosuvastatin group; TRZ+Ubiquinone group and TRZ+rosuvastatin+Ubiquinone group. Serum creatine kinase (CK-MB), lactate dehydrogenase (LDH), troponin I and N-terminal pro-B-type natriuretic peptide (NT-pro BNP) were measured. Also, tissue malondialdehyde (MDA), catalase (CAT), glutathione peroxidase (GPx), interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-β1) and signal transducers and activators of transcription-3 (STAT-3) were determined. Also, echocardiography was performed. Parts of the heart were subjected to histopathological, immunohistochemical and electron microscopic examination. Administration of rosuvastatin and/or ubiquinone to TRZ-treated mice induced significant increase in tissue GPx, CAT and STAT-3 with significant decrease in serum CK-MB, LDH, troponin I, NT-pro BNP, tissue MDA, TGF-β1 and IL-6 and improved the histopathological, immunohistochemical, echocardiographic and electron microscopic changes compared to the group that received TRZ alone. These changes were significant in rosuvastatin/ubiquinone combination group compared to the use of each of these drugs alone. In conclusion, rosuvastatin/ubiquinone combination may represent a new therapeutic modality to ameliorate TRZ-induced cardiotoxicity.

Graphical abstract

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Second generation H1 - antihistamines interaction with food and alcohol—A systematic review

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Paweł Paśko, Tomasz Rodacki, Renata Domagała-Rodacka, Krzysztof Palimonka, Monika Marcinkowska, Danuta Owczarek
Histamine is a mediator of many physiological processes. It plays an important role in modulating allergy reactions and immune system responses. H1 receptor is a therapeutic target for drugs applied in allergic diseases such as allergic rhinoconjunctivitis, urticarial, or atopic dermatitis. H1‐antihistamines display different chemical structures, pharmacokinetics and a potential for drug–drug and drug-food interactions. Drug-food interactions are known to reduce therapeutic effects of the medicine, as well as to induce a potent adverse drug reactions. Considering it all, a systematic review was conducted to investigate the importance of drug-food interaction for H1-antihistamine drugs. As non-sedating second generation H1-antihistamines remain to be drugs of choice in treating allergic conditions, the review has been focused on this particular class of medicines.The aim of this paper is to examine the evidence of food-drug and food-alcohol interactions for second generation H1-antihistamine drugs.A systematic literature queries were performed in the following databases: Medline (via PubMed), Cochrane Library, Embase and Web of Science (all from their inception date till October 2016). The queries covered nine specific names of second generation anthistamine drugs, namely bilastine, cetirizine, desloratadine, ebastine, fexofenadine, levocetirizine, loratadine, mizolastine, and rupatadine, in combinations with such terms as "food", "juice", "grapefruit", "fruits", "alcohol", "pharmacokinetics", and "meal". Additional publications were found by checking all the reference lists. Where none data on drug-food interaction could be found within the investigated databases, a specific drug prescribing information was used. 2326 publications were identified with the database queries. Articles were subjected to analysis by reviewing their title, abstract and full text; duplicated papers were removed. Having collected a complete set of data, a critical review was undertaken.For selected H1-antihistamines food, fruit juices or alcohol consumption may significantly impact the efficacy and safety of the therapy. This issue shall be well understood to educate patients properly, as it provides the major therapeutic element in allergic diseases.

Graphical abstract

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Long noncoding RNA linc00462 promotes hepatocellular carcinoma progression

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): JianDe Gong, XuFei Qi, Yi Zhang, YingCong Yu, XiZhou Lin, HongLiang Li, YiRen Hu
BackgroundHepatocellular carcinoma (HCC) represents one of the most common malignancies worldwide. In two pubic long noncoding RNA (lncRNA) profiling studies of HCC, linc00462 was consistently upregulated. We analyzed the clinical significance and biological role of linc00462 in HCC.MethodsWe performed quantitative real-time PCR analysis to determine the levels of linc00462 in HCC tissues from 49 patients. Functional analysis was performed in cell lines and in an animal model to support clinical findings.ResultsOur data showed that linc00462 was significantly upregulated in HCC tissues compared with matched normal tissues. The knockdown of linc00462 in HCC cells resulted in a much less aggressive oncogenic phenotype, and linc00462 downregulation contribute to the inactivation of the PI3K/AKT signaling pathway.Conclusionslinc00462 may be a potential therapeutic target in HCC.

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The role of apitoxin in alleviating propionic acid-induced neurobehavioral impairments in rat pups: The expression pattern of Reelin gene

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Maha H. Daghestani, Manar E. Selim, Yasmina M. Abd-Elhakim, Enas N. Said, Noura E. Abd El-Hameed, Samah R. Khalil, Osama S. El-Tawil
The efficacy of apitoxin (bee venom; BV) in ameliorating propionic acid (PPA) −induced neurobehavioral impacts was studied. Sixty rat pups were enrolled in a split litter design to six groups: a control group, a PPA-treated group, a BV-treated group, a BV/PPA protective group, a PPA/BV therapeutic group, and a BV/PPA/BV protective and therapeutic group. Exploratory, social, locomotor, and repetitive/stereotype-like activities were assessed and prosocial, empathy, and acquired behavior were evaluated. Levels of neurotransmitter including serotonin, dopamine, and gamma-aminobutyric acid (GABA) were determined and a quantitative analysis of Reelin gene expression was performed. PPA treatment induced several behavioral alterations, as reduced exploratory activity and social behaviors, increased repetitive/stereotypic behaviors, and hyperactivity. In addition, a marked decline of neurotransmitters and down-regulation of Reelin mRNA expression were observed. BV exhibited high efficiency in ameliorating the PPA-induced neurobehavioral alterations, particularly when applied both before and after PPA administration. Overall, the results implied that BV has merit as a candidate therapeutic treatment to alleviate PPA-induced neurobehavioral disorders.

Graphical abstract

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Non-surgical wound closure—a simple inexpensive technique

Abstract

Background

Primary suture closure of wounds is often the optimal solution for soft tissue defect closure because of its simplicity and satisfactory outcome, yet it may be impeded by high -tension closure. The customary application of skin grafts, flaps, free tissue transfer, or tissue expansion is often associated with relatively more complex surgical reconstructive procedures, significant morbidity and extended hospitalization and prolonged recovery period.

Methods

We retrospectively investigated all patients who underwent wound closure using a mechanical wound closure device between 2014 and 2016 in a tertiary hospital center. The device consisted of stainless steel hooks, sutured over the opposite wound edges, and rubber bands for generating tension which is gradually increased. Approximated wound margins were sutured or allowed to heal by secondary intention.

Results

The mechanical device was applied in 50 patients. There were 38 males and 12 females. Wound size ranged from 3 to 25 cm. In most of the patients there was a satisfactory wound margin approximation. However, in 6 patients skin hook cut through from wound margins occurred due to excessive rubber band tension. In 5 patients, it was decided to also apply negative-pressure wound therapy along with the device. After application of the wound closure device, a residual raw area remained in other 4 patients in whom a split thickness graft was applied. During follow-up, hypertrophic scar and wound dehiscence were found in 5 patients.

Conclusions

The mechanical wound closure device herein presented is a simple and inexpensive technique that allows a significant reduction in surgical costs and surgery-related morbidity.

Level of Evidence: Level IV, therapeutic study.

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Wind-induced flow velocity effects on nutrient concentrations at Eastern Bay of Lake Taihu, China

Abstract

Shallow lakes are highly sensitive to respond internal nutrient loading due to wind-induced flow velocity effects. Wind-induced flow velocity effects on nutrient suspension were investigated at a long narrow bay of large shallow Lake Taihu, the third largest freshwater lake in China. Wind-induced reverse/compensation flow and consistent flow field probabilities at vertical column of the water were measured. The probabilities between the wind field and the flow velocities provided a strong correlation at the surface (80.6%) and the bottom (65.1%) layers of water profile. Vertical flow velocity profile analysis provided the evidence of delay response time to wind field at the bottom layer of lake water. Strong wind field generated by the west (W) and west-north-west (WNW) winds produced displaced water movements in opposite directions to the prevailing flow field. An exponential correlation was observed between the current velocities of the surface and the bottom layers while considering wind speed as a control factor. A linear model was developed to correlate the wind field-induced flow velocity impacts on nutrient concentration at the surface and bottom layers. Results showed that dominant wind directions (ENE, E, and ESE) had a maximum nutrient resuspension contribution (nutrient resuspension potential) of 34.7 and 43.6% at the surface and the bottom profile layers, respectively. Total suspended solids (TSS), total nitrogen (TN), and total phosphorus (TP) average concentrations were 6.38, 1.5, and 0.03 mg/L during our field experiment at Eastern Bay of Lake Taihu. Overall, wind-induced low-to-moderate hydrodynamic disturbances contributed more in nutrient resuspension at Eastern Bay of Lake Taihu. The present study can be used to understand the linkage between wind-induced flow velocities and nutrient concentrations for shallow lakes (with uniform morphology and deep margins) water quality management and to develop further models.

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Hypoparathyroidism should always be checked in papilledema

Peter Gradisnik

Journal of Neurosciences in Rural Practice 2017 8(3):329-329

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Primary paraspinal hydatidosis causing acute paraplegia

Srihari Sridharan, GS Jagan Narayana, Kalyanasundarabharathi Chidambaram, Anand Prasath Jayachandiran

Journal of Neurosciences in Rural Practice 2017 8(3):472-474

The zoonotic infection hydatidosis is caused by the tapeworm cestode, Echinococcus granulosus. Though considered endemic in India where association of humans with sheep and dogs form part of the livelihood, primary skeletal muscle involvement of the disease is an extremely rare event. We report a case of primary paraspinal hydatidosis with extradural extension causing acute paraplegia. Excision of the cyst and decompression of the cord was done along with albendazole therapy. Paraspinal hydatid disease is a rare entity, and in regions where hydatid disease is endemic, it can be involved in the differential diagnosis of acute compressive myelopathy. Although antihelminthic chemotherapy forms the mainstay of the treatment, surgical intervention forms a major part of the management.

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Symptomatic vertebral hemangioma in a young child

William Martin, Ravi Rajmohan, Muhittin Belirgen

Journal of Neurosciences in Rural Practice 2017 8(3):458-460

Vertebral hemangiomas (VHs) are the most common benign vertebral neoplasm and typically are asymptomatic, only to be discovered incidentally on imaging from the fourth to fifth decade of life. Seldom do they enlarge to a point of compression, causing pain and focal neurologic deficits. We present the rare case of an 8-year-old female who presented with paraparesis after a fall. Imaging revealed a pathological fracture of the T8 vertebra with retropulsion and spinal cord compression from both fracture and epidural tumor tissue. The patient underwent an anterior and posterior removal of the tumor, decompression, and fusion. Pathological report of specimen biopsy confirmed a benign hemangioma. To the best of our knowledge, this is the same age as the youngest previously reported case of symptomatic VH and it is the longest to be recurrence-free at follow-up. The hemangioma was successfully treated with tumor removal, decompression, and fusion. No adjuvant treatment was required, and she remained asymptomatic without recurrence at her 4-year follow-up.

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Epidermoid cysts of the quadrigeminal cistern: Neuropsychiatric symptoms and management

Daniel de Araujo Paz

Journal of Neurosciences in Rural Practice 2017 8(3):327-328

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How to improve adherence to medication and follow-up in chronic mental illnesses: Stakeholder views

Kaliaperumal Mathan, Siddharth Sarkar, Shivanand Kattimani, Arun Kumar Vivek, V Muthukrishnan, P Venkatlakshmi

Journal of Neurosciences in Rural Practice 2017 8(3):496-498

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Anterior pituitary hormonal disturbances in patients suffering with traumatic brain injury

Guru Dutta Satyarthee, Kanwaljit Garg

Journal of Neurosciences in Rural Practice 2017 8(3):481-483

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Commentary

G Lakshmi Prasad

Journal of Neurosciences in Rural Practice 2017 8(3):446-447

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Surgically relevant bony anatomical variations in paraclinoid aneurysms-three-dimensional multi-detector row computed tomography-based study

K Suprasanna, Ashvini Kumar

Journal of Neurosciences in Rural Practice 2017 8(3):330-334

Objective: To evaluate the proportion of surgically relevant anatomical variations such as caroticoclinoid foramen, interclinoid osseous bridge, and anterior clinoid pneumatization in patients with paraclinoid aneurysms based on computed tomography (CT) cerebral angiography studies. Materials and Methods: Fifty-four CT cerebral angiography studies showing paraclinoid aneurysms involving the cavernous, clinoid, and supraclinoid internal carotid artery (ICA) were retrospectively evaluated. Source images were processed for three-dimensional reconstructions to evaluate the presence and type of caroticoclinoid foramen, interclinoid osseous bridge, and multiplanar reconstructions with bone algorithm to study the type of pneumatization. Results: The study included 30 female and 24 male patients with mean age of 45.61 (10.47) years. Among the 108 sides studied in 54 patients, caroticoclinoid foramen was seen in 24 cases (22.22%), interclinoid osseous bridge was seen unilaterally in 1 case (0.9%), and pneumatization of anterior clinoid process occurred in 12 cases (11.11%). Incomplete caroticoclinoid foramen (11 cases) and Type I pneumatization (7 cases) were seen to be predominant subtypes. There was no statistically significant gender difference in the occurrence of caroticoclinoid foramen and anterior clinoid pneumatization. Seventy-four aneurysms were detected in 54 patients. Based on their location, 46 aneurysms involved supraclinoid ICA, 18 aneurysms in the clinoid segment, and 10 aneurysms in the cavernous segment. Caroticoclinoid foramen was most prevalent in clinoid aneurysms with 12 cases occurring in the clinoid segment. Conclusion: Notable proportions of caroticoclinoid foramen and pneumatization occur in cases of paraclinoid aneurysm. Radiological reports should emphasize on these surgically relevant bony anatomical variations.

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Environmental arsenic contamination and its effect on intelligence quotient of school children in a historic gold mining area Hutti, North Karnataka, India: A pilot study

R Manju, Amitha M Hegde, Paul Parlees, Anisha Keshan

Journal of Neurosciences in Rural Practice 2017 8(3):364-367

Context: Arsenic is a rare crystal element that naturally occurs in all environmental media. A combination of regional and site-specific biogeochemical and hydrological factors governs its dispersion in the environment. It has far reaching consequences on human health. Exposure to arsenic in drinking water has been associated with a decline in intellectual function in children. Aim: The aim of this study is to assess the relationship between exposure to arsenic by drinking water and children's intelligence in Karnataka state, India. Settings and Design: Twenty school children of age 10–14 years from Sandur, Bellary, Karnataka, and from Hutti, Raichur, Karnataka, were categorized as control and study group, respectively. Subjects and Methods: Water samples were collected from both the villages for the analysis of arsenic and fluoride levels. Hair and nail samples were collected from the participants, and the arsenic levels were determined. Intelligence quotient (IQ) assessment was done using the Raven's Standard Progressive Matrices. Statistical Analysis Used: Chi-square test, Mann–Whitney U-test, and Fisher's exact test. P< 0.05 was considered statistically significant. Results: There was a significant increase in the arsenic content in the hair and nail samples of children in the study group. The mean IQ tests score in the control group and study group was 30.55 and 17.95, respectively, and this difference was statistically significant. Conclusion: Chronic arsenic exposure could be a possible cause for the reduced IQ scores seen in children residing in Hutti, Raichur District, North Karnataka.

http://ift.tt/2rta1ws

Role of biofilm in cerebrospinal fluid shunt infections: A study at tertiary neurocare center from South India

Kirtilaxmi K Benachinmardi, R Ravikumar, B Indiradevi

Journal of Neurosciences in Rural Practice 2017 8(3):335-341

Introduction: Biofilms are the source of persistent infections of many pathogenic microbes. They are responsible for nosocomial infection and also associated with many surgical conditions including indwelling medical devices such as ventriculoperitoneal shunt. A significant problem encountered in shunt procedures is obstruction followed by infection, with infection rate ranging from 2% to 27%, often with poor outcome. Materials and Methods: This study was conducted in the Department of Neuromicrobiology at a tertiary neuroinstitute for 6 months from July 1 to December 31, 2014. The samples comprised cerebrospinal fluid (CSF) from suspected cases of shunt infections. Laboratory diagnosis of causative agent was established by adopting standard procedures. Then, isolates were evaluated for production of biofilm by tissue culture plate (TCP) method and tube method. Results: Of the 1642 shunt CSF samples obtained from neurosurgery, 14.79% were culture positive which yielded 254 isolates. About 51.97% were Gram-negative bacilli (GNB), 46.46% were Gram-positive cocci (GPC), and 1.57% were Candida albicans. Among GNB, nonfermenters were the most common (51.52%) followed by Pseudomonas aeruginosa (15.9%). Among GPC, coagulase-negative Staphylococci were 88.13%, out of which 43.26% were methicillin-resistant. Other GPC were Enterococcus spp. (4.24%), Staphylococcus aureus (5.08%), and Streptococcus spp. (2.54%). Among all isolates, 120 were tested for biofilm production, out of which 57.5% were biofilm producers and 42.5% were nonproducers. Conclusions: TCP was the better method to detect biofilm. Most of the biofilm producers were resistant pathogens.

http://ift.tt/2rtfJyi

Headache, facial palsy, and diplopia: An unusual presentation of ruptured distal anterior cerebral artery aneurysm

Sushant Sahoo, Chhitij Srivastava

Journal of Neurosciences in Rural Practice 2017 8(3):487-488

http://ift.tt/2scg6dH

Comparison of efficacy of intraoperative indocyanine green videoangiography in clipping of anterior circulation aneurysms with postoperative digital subtraction angiography

Vikas Kumar, Anita Jagetia, Daljit Singh, Arvind Kumar Srivastava, Monica Sehgal Tandon

Journal of Neurosciences in Rural Practice 2017 8(3):342-345

Introduction: The aim of this study is to assess the efficacy of intraoperative indocyanine green videoangiography (ICG-VA) using postoperative digital subtraction angiography (DSA) in clipped anterior circulation aneurysms. Materials and Methods: A prospective study was conducted for 1 year which included thirty patients of anterior circulation aneurysm treated by clipping of aneurysm. Intraoperative ICG-VA was performed on all the patients. Postoperative DSA was performed to assess the efficacy of ICG-VA. Results: Intraoperative ICG-VA revealed the occlusion of aneurysm in all the thirty patients. Postoperative DSA revealed aneurysm neck remnant in two patients and demonstrated no branch occlusion. Conclusions: Intraoperative ICG-VA is useful in assessing the completeness of clipping of cerebral aneurysms and ensures patency of branch vessels, thus providing a better postoperative outcome. It replaces the need for invasive postoperative angiographic imaging in a selected group of patients and is also cost effective.

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Acute disseminated encephalomyelitis presenting as an isolated mesodiencephalic junction lesion

Kondanath Saifudheen, VV Ashraf, R Praveenkumar

Journal of Neurosciences in Rural Practice 2017 8(3):441-442

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Depression as a manifestation of obstructive sleep apnea

Sheikh Shoib, Javid A Malik, Shariq Masoodi

Journal of Neurosciences in Rural Practice 2017 8(3):346-351

Background: Obstructive sleep apnea (OSA) often results in a wide range of comorbid conditions, predominantly of the cardiovascular/respiratory, endocrine/metabolic, and neuropsychiatric symptoms. In view of the ambiguity of literature regarding the association between OSA and depression, we conducted this study to show any association between the two disorders. Objective: The aim of the study was to see the association between OSA and depression and to study the prevalence of OSA in patients suffering from depression. Methods: We performed polysomnography (PSG) studies of patients that were referred from various subspecialty clinics from July 2011 to August 2013. Psychiatric diagnosis was done using mini international neuropsychiatric interview plus scale. This was followed by application of Hamilton Depression Rating Scale (HAM-D). Standard methods of statistical analysis were used for data analysis. Results: Out of 182 patients who underwent PSG, 47 were suffering from depression with a mean age significantly more (P < 0.001) than that of other population (58.60 years vs. 53.60 years). In our 47 depressed patients, 44 (93.6%) had abnormal PSG. Based on apnea-hypopnea index score, 3 (6.8%) patients had mild, 18 (40.9%) had moderate, and 23 (52.3%) had severe OSA. The mean HAM-D score was significantly more in depression patients, (17. 35 ± 5.45) as compared to non depressive patents (8.64 ± 6.24) (P = 0.0001). Conclusion: This study demonstrates significant overlap between the sleep apnea and depression. Health specialists need more information about screening for patients with OSA to ensure proper diagnosis and treatment of those with the condition. Most of the clinicians do not suspect this important comorbidity of depression in the beginning resulting in delayed diagnosis.

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Facial diplegia as initial manifestation of acute, myelomonocytic leukemia with isolated trisomy 47, XY,+11[14]/46, XY[6]

Josef Finsterer, Michael Panny

Journal of Neurosciences in Rural Practice 2017 8(3):451-454

Bilateral peripheral facial palsy (facial diplegia) has been repeatedly reported as a neurologic manifestation of acute myeloid leukemia but has not been reported as the initial clinical manifestation of myelomonocytic leukemia. A 71-year-old male developed left-sided peripheral facial palsy being interpreted and treated as Bell's palsy. C-reactive protein (CRP) and leukocyte count 4 days later were 2.5 mg/l and 16 G/l, respectively. Steroids were ineffective. Seven days after onset, he developed right-sided peripheral facial palsy. Three days later, CRP and leukocyte count were 234.3 mg/l and 59.5 G/l, respectively. Cerebrospinal fluid investigations revealed pleocytosis (62/3) and elevated protein (54.9 mg/dl). Two days later, pleocytosis and leukocytosis were attributed to myelomonocytic leukemia. Leukemic meningeosis was treated with cytarabine and methotrexate intrathecally. In addition, cytarabine and idarubicin were applied intravenously. Under this regimen, facial diplegia gradually improved. Facial diplegia may be the initial clinical manifestation of myelomonocytic leukemia, facial diplegia obligatorily requires lumbar puncture, and unilateral peripheral facial palsy is not always Bell's palsy. Patients with alleged unilateral Bell's palsy and slightly elevated leukocytes require close follow-up and more extensive investigations than patients without abnormal blood tests.

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Cerebral and coronary vasculature in disease associations and dissociations in the South Indian population

Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, GS Ravi

Journal of Neurosciences in Rural Practice 2017 8(3):352-356

Introduction: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. Patients and Methods: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors. Results: 91% of patients who had undergone CABG had radiological evidence of CVD. The most common risk associated with CAD and CVD was Hypertension (HT), DM, dyslipidemia and combined HT and DM in that order. Neck vessels were normal in 59%. Significant disease was found in only 7.2%. Internal carotids were abnormal in 82%. Infarcts were seen in 82.1%. Discussion: This study reveals patients with CAD have a high degree of asymptomatic CVD. It is mostly due to small vessel disease including internal carotids but not so much with large vessels. Therefore, patients with CAD carry a high risk of vascular cognitive dysfunction. This can be reduced by effective management of the systemic risk factors. Screening for large vessel disease which is commonly done is likely to give a false sense of security. Conclusion: As against western population Indians seem to have small and medium sized vessels disease in the setting of CAD.

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Isolated intracranial myeloid sarcoma occurring as relapse in acute myeloid leukemia

Geetha Narayanan, Lali V Soman, Lakshmi Haridas, Harish Sugathan

Journal of Neurosciences in Rural Practice 2017 8(3):466-468

Myeloid sarcoma (MS) or chloroma is a rare extramedullary tumor composed of extramedullary proliferation of blasts of granulocytic, monocytic, erythroid, or megakaryocytic lineage occurring at sites outside the bone marrow. MS occurs in 2%–8% of patients with acute myeloid leukemia (AML), sometimes it occurs as the presenting manifestation of relapse in a patient in remission. We describe the case of a young male with AML in remission for 6 years presenting with central nervous system symptoms. Magnetic resonance imaging showed an extra-axial altered intensity lesion in the parasagittal parietal region, infiltrating anterosuperiorly into anterior falx, and posterosuperior aspect of the superior sagittal sinus. A biopsy from the lesion was diagnostic of MS which was positive for myeloperoxidase. He did not have any other sites of disease. He has received chemotherapy with FLAG ( Fludarabine, Cytosine arabinoside) followed by cranial irradiation and is in complete remission.

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Cognitive and functional outcomes following inpatient rehabilitation in patients with acquired brain injury: A prospective follow-up study

Maitreyi Patil, Anupam Gupta, Meeka Khanna, Arun B Taly, Amit Soni, J Keshav Kumar, K Thennarasu

Journal of Neurosciences in Rural Practice 2017 8(3):357-363

Objectives: To study the effects of cognitive retraining and inpatient rehabilitation to study the effects of cognitive retraining and inpatient rehabilitation in patients with acquired brain injury (ABI). Design and Setting: This was a prospective follow-up study in a neurological rehabilitation department of quaternary research hospital. Patients and Methods: Thirty patients with ABI, mean age 36.43 years (standard deviation [SD] 12.6, range 18–60), mean duration of illness 77.87 days (SD 91.78, range 21–300 days) with cognitive, physical, and motor-sensory deficits underwent inpatient rehabilitation for minimum of 14 sessions over a period of 3 weeks. Nineteen patients (63%) reported in the follow-up of minimum 3 months after discharge. Type of ABI, cognitive status (using Montreal Cognitive assessment scale [MoCA] and cognitive Functional Independence Measure [Cog FIM]®), and functional status (motor FIM®) were noted at admission, discharge, and follow-up and scores were compared. Results: Patients received inpatient rehabilitation addressing cognitive and functional impairments. Baseline MoCA, motor FIM, and Cog FIM scores were 15.27 (SD = 7.2, range 3–30), 31.57 (SD = 15.6, range 12–63), and 23.47 (SD = 9.7, range 5–35), respectively. All the parameters improved significantly at the time of discharge (MoCA = 19.6 ± 7.4 range 3–30, motor FIM® = 61.33 ± 18.7 range 12–89, Cog FIM® =27.23 ± 8.10 range 9–35). Patients were discharged with home-based programs. Nineteen patients reported in follow-up and observed to have maintained cognition on MoCA (18.8 ± 6.8 range 6–27), significantly improved (P < 0.01) on Cog FIM® (28.0 ± 7.7 range 14–35) and motor FIM® =72.89 ± 16.2 range 40–96) as compare to discharge scores. Conclusions: Cognitive and functional outcomes improve significantly with dedicated and specialized inpatient rehabilitation in ABI patients, which is sustainable over a period.

http://ift.tt/2rsZ2TJ

Medicine revisited: Safeguard yourself against “oblivious to the obvious”

Sachin A Adukia, Gopal Krishna Dash

Journal of Neurosciences in Rural Practice 2017 8(3):478-479

http://ift.tt/2sc0ve4

Using of open biopsy microseparator in the fresh cadaveric cow brain for the evaluation of clinical usability

Cengiz Cokluk

Journal of Neurosciences in Rural Practice 2017 8(3):485-486

http://ift.tt/2rtjDHg

Ecological risk assessment of an open dumping site at Mehmood Booti Lahore, Pakistan

Abstract

A robust risk assessment of Mehmood Booting Open Dumping (MBOD) site has been carried out by developing holistic risk assessment framework. Framework mainly comprises on baseline study, hazard identification, and risk quantification and evaluation. Physico-chemical analysis of groundwater and leachate, health risk assessment, and estimation of gas emissions from the site were carried out for risk evaluation. LandGEM 3.02 modelling software was used to measure the gas emissions. Analysis of leachate showed that all parameters were exceeding the WHO standard limit. Water samples were found polluted with heavy metals and total coliform contamination. Health survey inferred that problems which were faced by the majority of respondents were respiratory problems (80%). LandGEM model estimated that total landfill gas (TLG) emitted from the site for the year 2014 was 1.760E+05 Mg/year, CH₄ emission was 5.445E+06 Mg/year, CO₂ emission was 1.290E+05 Mg/year and for non-methane organic compound emission was 2.021E+03 Mg/year. It can be concluded that in the near future, almost all the water locations are possibly threatened with leachate contamination due to the continued accumulation of solid waste at MBOD site. The study recommends that new sanitary landfill sites should be designed to minimize the adverse effects associated with solid waste disposal and to preclude further pollution to surface water, groundwater, soil, and air.

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Different exposure levels of fine particulate matter and preterm birth: a meta-analysis based on cohort studies

Abstract

The previous studies estimated the association between PM_2.5 (particulate matter with aerodynamic diameter less than or equal to 2.5 μm) exposure during pregnancy and preterm birth, only considered and highlighted the hazard effects of high levels of air pollutant exposure, and underestimated that low levels of pollutant exposure might also affect pregnancy outcome. We conducted a meta-analysis of 11 cohort studies, a total of more than 1,500,000 subjects. The results of these studies were pooled by exposure levels and study periods. PM_2.5 exposure during pregnancy was positively associated with preterm birth (OR = 1.15, 95% CI = 1.07–1.23), and during the first trimester of pregnancy, low levels of PM_2.5 exposure were also positively associated with preterm birth (OR = 1.17, 95% CI = 1.04–1.30). It is important to protect pregnant women from PM_2.5 exposures, especially during their first trimester of pregnancy even when the ambient PM_2.5 concentration is relatively low. More relevant health policy should be carried out to prevent hazard effect of air pollutants.

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