Conditions: Head and Neck Cancer; Xerostomia
Intervention: Other: Acupuncture
Sponsor: M.D. Anderson Cancer Center
Recruiting - verified August 2017
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Δευτέρα 14 Αυγούστου 2017
Reflections of the Editor-in-Chief.
Author: Hill, Joseph A. MD, PhD
Page: 613-614
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Charting Our Future Together: Turning Discovery Science Into Cardiovascular Health.
Author: Gibbons, Gary H. MD
Page: 615-617
http://ift.tt/2vDXW6o
Particulate Matter Exposure and Stress Hormone Levels: A Randomized, Double-Blind, Crossover Trial of Air Purification.
Author: Li, Huichu MS *; Cai, Jing PhD *; Chen, Renjie PhD; Zhao, Zhuohui PhD; Ying, Zhekang PhD; Wang, Lin PhD; Chen, Jianmin PhD; Hao, Ke ScD; Kinney, Patrick L. ScD; Chen, Honglei MD, PhD; Kan, Haidong MD, PhD
Page: 618-627
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"Stressed" About Air Pollution: Time for Personal Action.
Author: Brook, Robert D. MD; Rajagopalan, Sanjay MD
Page: 628-631
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Predictors and Association With Clinical Outcomes of the Changes in Exercise Capacity After Transcatheter Aortic Valve Replacement.
Author: Abdul-Jawad Altisent, Omar MD; Puri, Rishi MBBS, PhD; Regueiro, Ander MD; Chamandi, Chekrallah MD; Rodriguez-Gabella, Tania MD; del Trigo, Maria MD; Campelo-Parada, Francisco MD; Couture, Thomas MS; Marsal, Josep Ramon MSc; Cote, Melanie MSc; Paradis, Jean-Michel MD; DeLarochelliere, Robert MD; Doyle, Daniel MD; Mohammadi, Siamak MD; Dumont, Eric MD; Rodes-Cabau, Josep MD
Page: 632-643
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Walking as a Window to Risk and Resiliency.
Author: Alexander, Karen P. MD
Page: 644-645
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Potent Thrombolytic Effect of N-Acetylcysteine on Arterial Thrombi.
Author: Martinez de Lizarrondo, Sara PhD; Gakuba, Clement MD, PhD; Herbig, Bradley A. PhD; Repesse, Yohann PhD; Ali, Carine PhD; Denis, Cecile V. PhD; Lenting, Peter J. PhD; Touze, Emmanuel MD, PhD; Diamond, Scott L. PhD; Vivien, Denis PhD; Gauberti, Maxime PhD
Page: 646-660
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Thrombolytic Potential of N-Acetylcysteine: Evidence for Significant Benefit in Mitigating Arterial Thrombosis.
Author: Lillicrap, David MD
Page: 661-663
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Plasminogen Activator Inhibitor Type I Controls Cardiomyocyte Transforming Growth Factor-[beta] and Cardiac Fibrosis.
Author: Flevaris, Panagiotis MD, PhD; Khan, Sadiya S. MD, MS; Eren, Mesut PhD; Schuldt, Adam J. T. MD, PhD; Shah, Sanjiv J. MD; Lee, Daniel C. MD; Gupta, Sweta MD, MS; Shapiro, Amy D. MD; Burridge, Paul W. PhD; Ghosh, Asish K. PhD; Vaughan, Douglas E. MD
Page: 664-679
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Cardiomyocyte Regeneration: A Consensus Statement.
Author: Eschenhagen, Thomas MD *; Bolli, Roberto MD; Braun, Thomas MD; Field, Loren J. PhD; Fleischmann, Bernd K. MD; Frisen, Jonas MD, PhD; Giacca, Mauro MD, PhD; Hare, Joshua M. MD; Houser, Steven PhD *; Lee, Richard T. MD; Marban, Eduardo MD; Martin, James F. MD, PhD; Molkentin, Jeffery D. PhD; Murry, Charles E. MD, PhD; Riley, Paul R. PhD; Ruiz-Lozano, Pilar PhD; Sadek, Hesham A. MD, PhD *; Sussman, Mark A. PhD; Hill, Joseph A. MD, PhD *
Page: 680-686
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Acute Coronary Syndrome: What Is the Affected Artery? Where Is the Occlusion Located? And How Important Is the Myocardial Mass Involved?.
Author: Fiol-Sala, Miguel MD; Bayes de Luna, Antonio MD
Page: 691-693
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Letter by Rowshani et al Regarding Article, "Gene Expression Profiling for the Identification and Classification of Antibody-Mediated Heart Rejection".
Author: Rowshani, Ajda T. MD, PhD; Caliskan, Kadir MD, PhD; von der Thusen, Jan H. MD, PhD
Page: 694-695
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Letter by Moayedi et al Regarding Article, "Gene Expression Profiling for the Identification and Classification of Antibody-Mediated Heart Rejection".
Author: Moayedi, Yasbanoo MD; Duero Posada, Juan MD; Alhussein, Mosaad MD; Ross, Heather Joan MD, MHSc
Page: 696-697
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Response by Loupy et al to Letters Regarding Article, "Gene Expression Profiling for the Identification and Classification of Antibody-Mediated Heart Rejection".
Author: Loupy, Alexandre MD, PhD; Hidalgo, Luis PhD; Duong, Jean Paul MD, PhD; Bruneval, Patrick MD, PhD; Jouven, Xavier MD, PhD; Halloran, Philip F. MD, PhD
Page: 698-699
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American Heart Association's Call to Action for Payment and Delivery System Reform.
Author: Bufalino, Vincent J. MD, FAHA, Chair; Berkowitz, Scott A. MD, MBA; Gardner, Timothy J. MD, FAHA; Pina, Ileana L. MD, MPH, FAHA; Konig, Madeleine MPH; On behalf of the AHA Expert Panel on Payment and Delivery System Reform
Page: e162-e171
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Are Disagreements in Caregiver and Patient Assessment of Patient Health Associated with Increased Caregiver Burden in Caregivers of Older Adults with Cancer?
AbstractBackground.As patients age, caregivers increasingly provide essential support and patient information. We sought to determine if patient‐caregiver assessments of patient health differ and if differences contribute to burden in caregivers of older adults with cancer.Materials and Methods.One hundred patients, aged ≥65, and their caregivers independently assessed patient function, comorbidity, nutrition, social activity, social support, and mental health. Caregivers completed the Caregiver Strain Index (CSI). Patient‐caregiver assessments were compared using the Wilcoxon signed rank test and paired t test. Association between caregiver burden and differences between patient‐caregiver assessments was examined using generalized linear regression.Results.Median patient age was 70 (range 65–91) and 70% had advanced disease. Sixty percent of patients reported requiring help with instrumental activities of daily living (IADLs); most had good social support (median Medical Outcomes Study [MOS]‐Social Support Survey score 92) and mental health (median Mental Health Inventory score 85).Caregivers were a median age of 66 (range 28–85), 73% female, 68% spousal caregivers, and 79% lived with the patient. Caregivers rated patients as having poorer physical function (more IADLs dependency [p = .008], lower Karnofsky Performance Status [p = .02], lower MOS‐Physical Function [p < .0001]), poorer mental health (p = .0002), and having more social support (p = .03) than patients themselves. Three‐quarters of caregivers experienced some caregiver burden (mean CSI score 3.1). Only differences in patient‐caregiver assessment of the patient's need for help with IADLs were associated with increased caregiver burden (p = .03).Conclusion.Patient‐caregiver assessments of patient function, mental health, and social support differ. However, only differences in assessment of IADLs dependency were associated with increased caregiver burden.Implications for Practice.As patients age, there is a higher incidence of frailty and cognitive impairments. As a result, caregivers play an increasingly vital role in providing information about patient health to healthcare providers, which is used to help healthcare providers tailor treatments and optimize patient health. These findings highlight that caregiver reporting in older adults with cancer may not replace patient reporting in those older adults who are otherwise able to self‐report. Furthermore, clinicians should check for caregiver burden in caregivers who report providing more help with instrumental activities of daily living than patients themselves report and provide appropriate support as needed.
http://ift.tt/2wZoNZU
Influence of ignited sediments on external phosphorus adsorption and sedimentary phosphorus forms
Abstract
Phosphorus (P) adsorpted by sediments, when covered by and mixed with ignited sediments from Meiliang Bay in Tai Lake, was analyzed in the laboratory. Potassium dihydrogen phosphate (KH2PO4) was added to the parallel experimental units to simulate periodic external P input. Based on the Langmuir model, the sediments after ignition had a greater Smax (maximum P adsorption), a lower equilibrium phosphorus concentration at zero adsorption (EPC0), and a lower degree of phosphorus saturation in comparison with sediments without ignition. This was confirmed by the variation in the dissolved inorganic phosphorus in the overlying water. When sediments were mixed with or covered by the ignited sediments, 5.985 and 5.978 mg of input P disappeared from the overlying water, respectively. However, when the sediments were mixed with the ignited sediments, 84.18% of the input P was converted to HCl-P, whereas when they were covered by the ignited sediments, sedimentary P was released, mainly from Fe/Al-P (up to 87.50%). This was attributed to differences in the microenvironments where less-intense anaerobic conditions were formed in the mixed sediments than in the sediments covered by the ignited sediments. This suggests that the injection of ignited sediments into existing sediments enhances their P adsorption and retention. It is favor of the control of the eutrophication with a simple technology.
http://ift.tt/2w4Y4yI
Chest circumference and birth weight are good predictors of lung function in preschool children from an e-waste recycling area
Abstract
The purpose of this study was to investigate the associations between birth weight, chest circumference, and lung function in preschool children from e-waste exposure area. A total of 206 preschool children from Guiyu (an e-waste recycling area) and Haojiang and Xiashan (the reference areas) in China were recruited and required to undergo physical examination, blood tests, and lung function tests during the study period. Birth outcome such as birth weight and birth height were obtained by questionnaire. Children living in the e-waste-exposed area have a lower birth weight, chest circumference, height, and lung function when compare to their peers from the reference areas (all p value <0.05). Both Spearman and partial correlation analyses showed that birth weight and chest circumference were positively correlated with lung function levels including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). After adjustment for the potential confounders in further linear regression analyses, birth weight, and chest circumference were positively associated with lung function levels, respectively. Taken together, birth weight and chest circumference may be good predictors for lung function levels in preschool children.
http://ift.tt/2wZ2hAy
Physicochemical and adsorptive characteristics of activated carbons from waste polyester textiles utilizing MgO template method
Abstract
Activated carbons with high specific surface areas were produced, utilizing waste polyester textiles as carbon precursor by magnesium oxide (MgO) template method. Magnesium chloride (MgCl2), magnesium citrate (MgCi), and MgO were employed as MgO precursors to prepare activated carbons (AC-MgCl2, AC-MgCi, and AC-MgO). Thermogravimetry-differential scanning calorimetry was conducted to investigate the pore-forming mechanism, and N2 adsorption/desorption isotherms, XRD, SEM-EDS, TEM, FTIR and pHpzc were achieved to analyze physicochemical characteristics of the samples. The specific surface areas of AC-MgCl2 (1173 m2/g) and AC-MgCi (1336 m2/g) were much higher than that of AC-MgO (450 m2/g), and the pores sizes of which were micro-mesoporous, mesoporous, and macropores, respectively, due to the formation of MgO crystal with different sizes. All activated carbons had abundant acidic oxygen groups. In addition, batch adsorption experiments were carried out to investigate the adsorptive characteristics of the prepared activated carbons toward Cr(VI). The adsorption kinetics fitted well with the pseudo-second order, and the adsorptive capacity of AC-MgCl2 (42.55 mg/g) was higher than those of AC-MgCi (40.93 mg/g) and AC-MgO (35.87 mg/g).
http://ift.tt/2uIOGMI
A pilot study comparing T-regulatory cell function among healthy children in different areas of Gansu, China
Abstract
Immune system is critical to protecting human health from toxic substances. Our previously published research had found an important link between polycyclic aromatic hydrocarbons (PAHs) in ambient air and changes at the DNA level in immune cells that led to impaired function of regulatory T (Treg) cells in children living in California, USA. But molecular and cellular pathways of these changes remain unclear. The present study aims to explore whether exposure to PAHs leads to changes in Treg cells functions of children living in Gansu, China, where ambient air pollution levels are much higher than those in California, and to explore potential mechanisms of PAH-induced immunological dysfunctions. Air pollutions in Lanzhou and Lintao, Gansu Province, were measured from December 2015 to June 2016. Healthy children were recruited from both cities and enrolled in this pilot study. Demographic information was collected by questionnaires. Blood samples were collected. Peripheral blood Treg cells were analyzed for Treg cells percentage by flow cytometry. Gene expression of forkhead box transcription factor 3 (Foxp3), transforming growth factor-β (TGF-β), and interleukin 35 (IL35) were examined by reverse transcription-polymerase chain reaction (RT-PCR). The results indicated PAH concentration (as sum of 16 PAHs) in Lintao was over two times higher than that was in Lanzhou (707 vs. 326 ng/m3), whereas PM2.5 concentration was comparable in two cities (55.3 in Lintao vs. 65.7 μg/m3 in Lanzhou). Notably, we observed lower gene expressions for Foxp3 (P < 0.05), IL35 (P < 0.05), and TGF-β, in children living in Lintao, suggesting an impairment of Treg cells function potentially associated with higher PAH exposure in Lintao. However, no significant difference was observed in Treg cells % among CD4+ T cells between Lanzhou and Lintao groups.
http://ift.tt/2w7KwSo
Assessing landscape and contaminant point-sources as spatial determinants of water quality in the Vermilion River System, Ontario, Canada
Abstract
The Vermilion River and major tributaries (VRMT) are located in the Vermilion watershed (4272 km2) in north-central Ontario, Canada. This watershed not only is dominated by natural land-cover but also has a legacy of mining and other development activities. The VRMT receive various point (e.g., sewage effluent) and non-point (e.g., mining activity runoff) inputs, in addition to flow regulation features. Further development in the Vermilion watershed has been proposed, raising concerns about cumulative impacts to ecosystem health in the VRMT. Due to the lack of historical assessments on riverine-health in the VRMT, a comprehensive suite of water quality parameters was collected monthly at 28 sites during the ice-free period of 2013 and 2014. Canadian water quality guidelines and objectives were not met by an assortment of water quality parameters, including nutrients and metals. This demonstrates that the VRMT is an impacted system with several pollution hotspots, particularly downstream of wastewater treatment facilities. Water quality throughout the river system appeared to be influenced by three distinct land-cover categories: forest, barren, and agriculture. Three spatial pathway models (geographical, topographical, and river network) were employed to assess the complex interactions between spatial pathways, stressors, and water quality condition. Topographical landscape analyses were performed at five different scales, where the strongest relationships between water quality and land-use occurred at the catchment scale. Sites on the main stem of Junction Creek, a tributary impacted by industrial and urban development, had above average concentrations for the majority of water quality parameters measured, including metals and nitrogen. The river network pathway (i.e., asymmetric eigenvector map (AEM)) and topographical feature (i.e., catchment land-use) models explained most of the variation in water quality (62.2%), indicating that they may be useful tools in assessing the spatial determinants of water quality decline.
http://ift.tt/2uIaOao
Comparison of Live Rat Femoral Artery Model with Intraoperative Microvascular Anastomosis
J reconstr Microsurg
DOI: 10.1055/s-0037-1605378
Background The live rat femoral artery model is the gold standard in high-fidelity simulation for microvascular anastomosis worldwide. Despite widespread use, there is a paucity of evidence for its validity. This study aims to determine the correlation between microvascular anastomosis in the live rat femoral artery model and clinical performance. Methods Twenty-nine microsurgical fellows were included in the study. At the beginning and end of the 1-year fellowship, fellows were assessed performing arterial microvascular anastomoses in the laboratory in a live rat femoral artery model. Each procedure was digitally video recorded and blinded. Fellows were also assessed in the operating room at the beginning and end of training performing microvascular anastomoses in multiple free flap cases. Validated tools were used for assessment, and duration of procedure was also recorded. The results from the evaluations were compared and interfellow comparisons were performed. Results At both the beginning and end of the fellowship, there was no significant correlation between clinical performance evaluations during operating room cases and laboratory evaluations. In the laboratory, higher performance scores were associated with faster times at both the beginning and end of the fellowship. Conclusion Contrary to conventional wisdom, microsurgical skill in the live rat femoral artery model in the laboratory does not correlate with clinical performance in the operating room. This calls into question the utility of this model for training purposes. Further research is necessary to corroborate these results and potentially establish experimental models with greater validity and reliability.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Effect of Monopolar Cutting Mode against Bipolar Diathermy on Surgical Dissection of Microvessels
J reconstr Microsurg
DOI: 10.1055/s-0037-1604438
Background An ideal vessel dissection will be to maximize bleeding control through coagulation while minimizing vessel damage. Among the diathermy methods, there has been no report comparing the effect on vessels. This study aims to verify the effect of bipolar diathermy against monopolar diathermy cutting mode for vessel dissection. Methods A total of 18 Sprague–Dawley rats were divided into three groups according to the method of pedicle dissection for 6 × 6 cm sized abdominal flap; (group 0) surgical scissors, (group 1) monopolar diathermy cutting mode and (group 2) bipolar diathermy. They were evaluated for the temperature of device tip and the radiating heat to the surrounding tissue, change in vessel diameter, flow velocity, and perfusion to the skin flap during dissection. Final flap survival rate and pathology of the vessels were also evaluated. Results Significantly higher radiating heat was observed using bipolar diathermy (average: 37.5°C) compared with group using monopolar diathermy (average: 34.4°C) (p value 0.045). However, there were no differences in vessel diameter, skin flap perfusion, flow velocity, and flap survival rate among the groups. Conclusions Both monopolar diathermy cutting mode and bipolar diathermy are safe to use to dissect the pedicle vessels when used adequately. Although it has no significant difference in relations to flap survival, vessel spasm, and perfusion/velocity to the flap, the extent of histologic damage may be less in monopolar diathermy cutting mode. Using monopolar diathermy cutting mode may provide efficiency to achieve ligation in small vessels during pedicle dissection but requires finesse technique and a learning curve.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults
AbstractBackground
Previous studies have revealed inconsistent findings regarding the association of light to moderate alcohol consumption with cardiovascular disease (CVD) and cancer mortality.
ObjectivesThe aim of this study was to examine the association between alcohol consumption and risk of mortality from all causes, cancer, and CVD in U.S. adults.
MethodsData were obtained by linking 13 waves of the National Health Interview Surveys (1997 to 2009) to the National Death Index records through December 31, 2011. A total of 333,247 participants ≥18 years of age were included. Self-reported alcohol consumption patterns were categorized into 6 groups: lifetime abstainers; lifetime infrequent drinkers; former drinkers; and current light, moderate, or heavy drinkers. Secondary exposure included participants' binge-drinking status. The main outcome was all-cause, cancer, or CVD mortality.
ResultsAfter a median follow-up of 8.2 years (2.7 million person-years), 34,754 participants died of all causes (including 8,947 CVD deaths and 8,427 cancer deaths). Compared with lifetime abstainers, those who were light or moderate alcohol consumers were at a reduced risk of mortality for all causes (light—hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.76 to 0.82; moderate—HR: 0.78; 95% CI: 0.74 to 0.82) and CVD (light—HR: 0.74; 95% CI: 0.69 to 0.80; moderate—HR: 0.71; 95% CI: 0.64 to 0.78), respectively. In contrast, there was a significantly increased risk of mortality for all causes (HR: 1.11; 95% CI: 1.04 to 1.19) and cancer (HR: 1.27; 95% CI: 1.13 to 1.42) in adults with heavy alcohol consumption. Binge drinking ≥1 d/week was also associated with an increased risk of mortality for all causes (HR: 1.13; 95% CI: 1.04 to 1.23) and cancer (HR: 1.22; 95% CI: 1.05 to 1.41).
ConclusionsLight and moderate alcohol intake might have a protective effect on all-cause and CVD-specific mortality in U.S. adults. Heavy or binge drinking was associated with increased risk of all-cause and cancer-specific mortality.
http://ift.tt/2uDnuTT
Risk of Arterial Thromboembolism in Patients With Cancer
AbstractBackground
The risk of arterial thromboembolism in patients with cancer is incompletely understood.
ObjectivesThe authors aimed to better define this epidemiological relationship, including the effects of cancer stage.
MethodsUsing the Surveillance Epidemiology and End Results–Medicare linked database, the authors identified patients with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, pancreatic, or gastric cancer or non-Hodgkin lymphoma from 2002 to 2011. They were individually matched by demographics and comorbidities to a Medicare enrollee without cancer, and each pair was followed through 2012. Validated diagnosis codes were used to identify arterial thromboembolism, defined as myocardial infarction or ischemic stroke. Cumulative incidence rates were calculated using competing risk survival statistics. Cox hazards analysis was used to compare rates between groups at discrete time points.
ResultsThe authors identified 279,719 pairs of patients with cancer and matched control patients. The 6-month cumulative incidence of arterial thromboembolism was 4.7% (95% confidence interval [CI]: 4.6% to 4.8%) in patients with cancer compared with 2.2% (95% CI: 2.1% to 2.2%) in control patients (hazard ratio [HR]: 2.2; 95% CI: 2.1 to 2.3). The 6-month cumulative incidence of myocardial infarction was 2.0% (95% CI: 1.9% to 2.0%) in patients with cancer compared with 0.7% (95% CI: 0.6% to 0.7%) in control patients (HR: 2.9; 95% CI: 2.8 to 3.1). The 6-month cumulative incidence of ischemic stroke was 3.0% (95% CI: 2.9% to 3.1%) in patients with cancer compared with 1.6% (95% CI: 1.6% to 1.7%) in control patients (HR: 1.9; 95% CI: 1.8 to 2.0). Excess risk varied by cancer type (greatest for lung), correlated with cancer stage, and generally had resolved by 1 year.
ConclusionsPatients with incident cancer face a substantially increased short-term risk of arterial thromboembolism.
http://ift.tt/2uDzzbB
Geometry as a Confounder When Assessing Ventricular Systolic Function: Comparison Between Ejection Fraction and Strain
AbstractBackground
Preserved left ventricular (LV) ejection fraction (EF) and reduced myocardial strain are reported in patients with hypertrophic cardiomyopathy, ischemic heart disease, diabetes mellitus, and more.
ObjectivesThe authors performed a combined mathematical and echocardiographic study to understand the inconsistencies between EF and strains.
MethodsAn analytical equation showing the relationship between EF and the 4 parameters, global longitudinal strain (GLS), global circumferential strain (GCS), wall thickness, and short-axis diameter, was derived from an elliptical LV model. The equation was validated by measuring the 4 parameters by echocardiography in 100 subjects with EF ranging from 16% to 72% and comparing model-predicted EF with measured EF. The effect of the different parameters on EF was explored in the model and compared with findings in the patients.
ResultsCalculated EF had very good agreement with measured EF (r = 0.95). The model showed that GCS contributes more than twice as much to EF than GLS. A significant reduction of GLS could be compensated by a small increase of GCS or wall thickness or reduced diameter. The model further demonstrated how EF can be maintained in ventricles with increased wall thickness or reduced diameter, despite reductions in both longitudinal and circumferential shortening. This was consistent with similar EF in 20 control subjects and 20 hypertrophic cardiomyopathy patients with increased wall thickness and reductions in both circumferential and longitudinal shortening (all p < 0.01).
ConclusionsReduced deformation despite preserved EF can be explained through geometric factors. Due to geometric confounders, strain better reflects systolic function in patients with preserved EF.
http://ift.tt/2uDssQk
Aortic Bioprosthetic Valve Durability: Incidence, Mechanisms, Predictors, and Management of Surgical and Transcatheter Valve Degeneration
Abstract
In recent times, there has been a considerable increase in the use of aortic bioprostheses (vs. mechanical prostheses) for treating aortic valve disease, and this tendency is likely to continue in the near future. However, the occurrence of structural valve degeneration, limiting valve durability, remains an important drawback of surgical and transcatheter bioprostheses. In this paper, we provide an overview of bioprosthetic valve durability, focusing on the definition, incidence, mechanisms, predictive factors, and management of structural degeneration of aortic bioprostheses.
http://ift.tt/2uVIobX
Pharmacological and Activated Fibroblast Targeting of G{beta}{gamma}-GRK2 After Myocardial Ischemia Attenuates Heart Failure Progression
AbstractBackground
Cardiac fibroblasts are a critical cell population responsible for myocardial extracellular matrix homeostasis. Upon injury or pathological stimulation, these cells transform to an activated myofibroblast state and play a fundamental role in myocardial fibrosis and remodeling. Chronic sympathetic overstimulation, a hallmark of heart failure (HF), induces pathological signaling through G protein β (Gβ) subunits and their interaction with G protein–coupled receptor kinase 2 (GRK2).
ObjectivesThis study investigated the hypothesis that Gβ-GRK2 inhibition and/or ablation after myocardial injury would attenuate pathological myofibroblast activation and cardiac remodeling.
MethodsThe therapeutic potential of small molecule Gβ-GRK2 inhibition, alone or in combination with activated fibroblast- or myocyte-specific GRK2 ablation—each initiated after myocardial ischemia–reperfusion (I/R) injury—was investigated to evaluate the possible salutary effects on post-I/R fibroblast activation, pathological remodeling, and cardiac dysfunction.
ResultsSmall molecule Gβ-GRK2 inhibition initiated 1 week post-injury was cardioprotective in the I/R model of chronic HF, including preservation of cardiac contractility and a reduction in cardiac fibrotic remodeling. Systemic small molecule Gβ-GRK2 inhibition initiated 1 week post-I/R in cardiomyocyte-restricted GRK2 ablated mice (also post-I/R) still demonstrated significant cardioprotection, which suggested a potential protective role beyond the cardiomyocyte. Inducible ablation of GRK2 in activated fibroblasts (i.e., myofibroblasts) post-I/R injury demonstrated significant functional cardioprotection with reduced myofibroblast transformation and fibrosis. Systemic small molecule Gβ-GRK2 inhibition initiated 1 week post-I/R provided little to no further protection in mice with ablation of GRK2 in activated fibroblasts alone. Finally, Gβ-GRK2 inhibition significantly attenuated activation characteristics of failing human cardiac fibroblasts isolated from end-stage HF patients.
ConclusionsThese findings suggested consideration of a paradigm shift in the understanding of the therapeutic role of Gβ-GRK2 inhibition in treating HF and the potential therapeutic role for Gβ-GRK2 inhibition in limiting pathological myofibroblast activation, interstitial fibrosis, and HF progression.
http://ift.tt/2uDssji
Catecholamine-Dependent {beta}-Adrenergic Signaling in a Pluripotent Stem Cell Model of Takotsubo Cardiomyopathy
AbstractBackground
Takotsubo syndrome (TTS) is characterized by an acute left ventricular dysfunction and is associated with life-threating complications in the acute phase. The underlying disease mechanism in TTS is still unknown. A genetic basis has been suggested to be involved in the pathogenesis.
ObjectivesThe aims of the study were to establish an in vitro induced pluripotent stem cell (iPSC) model of TTS, to test the hypothesis of altered β-adrenergic signaling in TTS iPSC-cardiomyocytes (CMs), and to explore whether genetic susceptibility underlies the pathophysiology of TTS.
MethodsSomatic cells of patients with TTS and control subjects were reprogrammed to iPSCs and differentiated into CMs. Three-month-old CMs were subjected to catecholamine stimulation to simulate neurohumoral overstimulation. We investigated β-adrenergic signaling and TTS cardiomyocyte function.
ResultsEnhanced β-adrenergic signaling in TTS-iPSC-CMs under catecholamine-induced stress increased expression of the cardiac stress marker NR4A1; cyclic adenosine monophosphate levels; and cyclic adenosine monophosphate–dependent protein kinase A–mediated hyperphosphorylation of RYR2-S2808, PLN-S16, TNI-S23/24, and Cav1.2-S1928, and leads to a reduced calcium time to transient 50% decay. These cellular catecholamine-dependent responses were mainly mediated by β1-adrenoceptor signaling in TTS. Engineered heart muscles from TTS-iPSC-CMs showed an impaired force of contraction and a higher sensitivity to isoprenaline-stimulated inotropy compared with control subjects. In addition, altered electrical activity and increased lipid accumulation were detected in catecholamine-treated TTS-iPSC-CMs, and were confirmed by differentially expressed lipid transporters CD36 and CPT1C. Furthermore, we uncovered genetic variants in different key regulators of cardiac function.
ConclusionsEnhanced β-adrenergic signaling and higher sensitivity to catecholamine-induced toxicity were identified as mechanisms associated with the TTS phenotype. (International Takotsubo Registry [InterTAK Registry] [InterTAK]; NCT01947621)
http://ift.tt/2uD83e9
Differential effect of TGFβ on the proteome of cancer associated fibroblasts and cancer epithelial cells in a co-culture approach - a short report
Abstract
Background
Solid tumors contain various components that together form the tumor microenvironment. Cancer associated fibroblasts (CAFs) are capable of secreting and responding to signaling molecules and growth factors. Due to their role in tumor development, CAFs are considered as potential therapeutic targets. A prominent tumor-associated signaling molecule is transforming growth factor β (TGFβ), an inducer of epithelial-to-mesenchymal transition (EMT). The differential action of TGFβ on CAFs and ETCs (epithelial tumor cells) has recently gained interest. Here, we aimed to investigate the effects of TGFβ on CAFs and ETCs at the proteomic level.
Methods
We established a 2D co-culture system of differentially fluorescently labeled CAFs and ETCs and stimulated this co-culture system with TGFβ. The respective cell types were separated using FACS and subjected to quantitative analyses of individual proteomes using mass spectrometry.
Results
We found that TGFβ treatment had a strong impact on the proteome composition of CAFs, whereas ETCs responded only marginally to TGFβ. Quantitative proteomic analyses of the different cell types revealed up-regulation of extracellular matrix (ECM) proteins in TGFβ treated CAFs. In addition, we found that the TGFβ treated CAFs exhibited increased N-cadherin levels.
Conclusions
From our data we conclude that CAFs respond to TGFβ treatment by changing their proteome composition, while ETCs appear to be rather resilient.
http://ift.tt/2uVwejt
BioXmark for high-precision radiotherapy in an orthotopic pancreatic tumor mouse model
Abstract
Background and purpose
High-precision radiotherapy (RT) requires precise positioning, particularly with high single doses. Fiducial markers in combination with onboard imaging are excellent tools to support this. The purpose of this study is to establish a pancreatic cancer mouse model for high-precision image-guided RT (IGRT) using the liquid fiducial marker BioXmark (Nanovi, Kongens Lyngby, Denmark).
Methods
In an animal-based cancer model, different volumes of BioXmark (10–50 µl), application forms, and imaging modalities—cone-beam computer tomography (CBCT) incorporated in either the Small Animal Radiation Research Platform (SARRP) or the small-animal micro-CT Scanner (SkyScan; Bruker, Brussels, Belgium)—as well as subsequent RT with the SARRP system were analyzed to derive recommendations for BioXmark.
Results
Even small volumes (10 µl) of BioXmark could be detected by CBCT (SARRP and Skyscan). Larger volumes (50 µl) led to hardening artefacts. The position of BioXmark was monitored at least weekly by CBCT and was stable over 4 months. BioXmark was shown to be well tolerated; no changes in physical condition or toxic side effects were observed in comparison to control mice. BioXmark enabled an exact fusion with the original treatment plan with less hardening artefacts, and minimized the application of contrast agent for fractionated RT.
Conclusion
An orthotopic pancreatic tumor mouse model was established for high-precision IGRT using a fiducial marker. BioXmark was successfully tested and provides the perfect basis for improved imaging in high-precision RT. BioXmark enables a unique application method and optimal targeted precision in fractionated RT. Therefore, preclinical trials evaluating novel fractionation regimens and/or combination treatment with high-end RT can be performed.
http://ift.tt/2w6lPFY
Nongenetically modified Lactococcus lactis-adjuvanted vaccination enhanced innate immunity against Helicobacter pylori
Abstract
Background
Gram-positive enhancer matrix particles (GEM) produced by Lactococcus lactis can enhance vaccine-induced immune response. However, the mechanism under which this adjuvant mounts the efficacy of orally administered vaccines remains unexplored.
Materials and Methods
We used a prophylactic mice model to investigate the mechanism of GEM-adjuvanted vaccination. Helicobacter pylori urease-specific antibody response was monitored and detected in murine serum by ELISA. Urease-specific splenic cytokine profile was examined. Gastric inflammatory responses were measured on day 43 or 71 by quantitative real-time PCR, flow cytometry and histology.
Results
We found that GEM enhanced the efficiency of oral H. pylori vaccine by promoting innate immunity. The vaccine CUE-GEM composed of GEM particles and recombinant antigen CTB-UE provided protection of immunized mice against H. pylori insult. The protective response was associated with induction of postimmunization gastritis and local Th1/Th17 cell-medicated immune response. We showed that innate inflammatory responses including neutrophil chemokines CXCL1-2, neutrophils, and antimicrobial proteins S100A8 and MUC1 were significantly elevated. Within all infected mice, S100A8 and MUC1 levels were negatively correlated with H. pylori burden. Strikingly, mice receiving GEM also show reduction of colonization, possibly through natural host response pathways to recruit CD4+ T cells and promote S100A8 expression.
Conclusions
These findings suggest that GEM-based vaccine may impact Th1/Th17 immunity to orchestrate innate immune response against H. pylori infection.
http://ift.tt/2uHdULE
Cosmetics, Vol. 4, Pages 29: Evaluation of the Effect of Plant Mixture Ethanol Extracts Containing Biota orientalis L. Extract on Suppression of Sebum in Cultured Sebocytes and on Stimulation of Growth of Keratinocytes Co-cultured with Hair Papilla Cells
Cosmetics, Vol. 4, Pages 29: Evaluation of the Effect of Plant Mixture Ethanol Extracts Containing Biota orientalis L. Extract on Suppression of Sebum in Cultured Sebocytes and on Stimulation of Growth of Keratinocytes Co-cultured with Hair Papilla Cells
Cosmetics doi: 10.3390/cosmetics4030029
Authors: Haifeng Zeng Lihao Gu Kazuhisa Maeda
Biota orientalis L. leaf extract (BOLE) is used medically to improve strength and arrest hemorrhage. In China, BOLE has been used in traditional medicine for its antibacterial properties and for hair restoration. In this study, we investigated the mechanism of hair restoration by BOLE from the point of view of the sebum suppressant effect and hair loss prevention. BOLE at 25 or 50 μg/mL final concentrations, a hair growth plant ethanol extract (HGPEE), and a hair growth plant water extract (HGPWE) (the latter two each containing BOLE and other plant compounds), were used to study: (1) the sebum suppressant effect in sebocytes from normal golden hamster ear pinna origin; (2) the effect on the growth of human fetal epidermal keratinocytes; and (3) the effect on gene expression related to hair growth stimulation, with (2) and (3) studied in human fetal epidermal keratinocytes and hair papilla cells. BOLE had a sebum depletion effect in cultured sebocytes; moreover, the amounts of mRNA of the hair growth factors, KGF, VEGF, and G3PDH analyzed by real-time polymerase chain reaction in human hair papilla cells were increased by HGPEE. The amount of mRNA of Wnt10b in cultured epidermal keratinocytes was increased by the addition of BOLE, and the growth of the cultured epidermal keratinocytes was promoted by HGPEE in a two-layer culture system of hair papilla cells and epidermal keratinocytes. HGPEE had a hair growth promotion/hair restoration effect and a sebum suppression effect. Hair restorers containing HGPEE may be useful for stimulating hair growth and suppressing excess scalp sebum in males and females.
http://ift.tt/2vBPsMQ
Neoadjuvant Immunoradiotherapy in Head & Neck Cancer
Conditions: Head and Neck Cancer; Head and Neck Squamous Cell Carcinoma
Interventions: Drug: Nivolumab; Procedure: Surgical Resection; Radiation: Radiation
Sponsors: Providence Health & Services; Providence Cancer Center, Earle A. Chiles Research Institute
Not yet recruiting - verified August 2017
http://ift.tt/2vBFSK0
Interventions: Drug: Nivolumab; Procedure: Surgical Resection; Radiation: Radiation
Sponsors: Providence Health & Services; Providence Cancer Center, Earle A. Chiles Research Institute
Not yet recruiting - verified August 2017
http://ift.tt/2vBFSK0
Heavy metal pollutants in selected organs of African giant rats from three agro-ecological zones of Nigeria: evidence for their role as an environmental specimen bank
Abstract
An assessment of the concentration of heavy metals in the liver, brain, kidney, bone, and lungs of African giant rats (AGRs) from three agro-ecological zones of Nigeria having different industrial activities was carried out using atomic absorption spectrophotometer. Twenty adult AGRs from cities in mangrove/freshwater swamp, rainforest, and woodland/tall grass savanna agro-ecological zones of Nigeria were used for this study. AGRs were euthanized, carefully dissected, and the brains, liver, lungs, bone, and kidneys were harvested, digested, and analyzed for concentrations of vanadium (V), lead (Pb), cadmium (Cd), zinc (Zn), selenium (Se), copper (Cu), and iron (Fe). All data generated were evaluated for statistical significance using one-way ANOVA with Tukey's multiple post-test comparison. Results showed the major environmental heavy metal pollutants of the mangrove/freshwater swamp to be vanadium and selenium while those of woodland/tall grass savanna agro-ecological zones were lead, selenium, and zinc. The vanadium concentration was more than twofold higher in the observed tissues of AGR from the mangrove/freshwater swamp, and this may be related to increased exploitation of minerals and the activities of militants in pipeline vandalization in this zone. Interestingly, the highest concentration of this metal was seen in the lungs suggestive of a respiratory route of exposure. Among the potential adverse effects derived from exposure to metals, developmental toxicity is a serious risk. This type of investigation can assist in knowing the level of animal and human exposure to environmental pollutants both in highly industrialized and non-industrialized areas and is more ideal in environmental monitoring. This study therefore suggests AGR as model for ecotoxicological research and environmental specimen banks (ESBs) in this part of Africa.
http://ift.tt/2vTM8PU
A survey on monopolar radiofrequency treatment
Abstract
This questionnaire-based study was aimed to measure the level of appreciation, awareness of the special tips, and practice patterns of monopolar radiofrequency among Korean dermatologists practicing a specific monopolar radiofrequency device (Thermage® Inc., Hayward, CA). A total of 82 surveys were analyzed to show that the majority of participants (78.8%) were highly satisfied with the outcomes of monopolar radiofrequency treatment. All respondents were aware of the Eye Tip 0.25 cm2, and the majority knew the difference between the Face tip (blue) and the Total tip (orange). Most (86.3%) agreed to the statement that 900 shots were appropriate for facial tightening in those between the ages of 35 and 65 years. 66.2% of participants reported to have perform monopolar radiofrequency to extra-facial sites within the past year. As for the tips, the Total tip was most popular for all body sties and the Big tip was favored for the abdomen, thighs and buttock. We hope our data allow dermatologists to better utilize monopolar radiofrequency.
http://ift.tt/2wX23to
Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma
Vetrivel Chezian Sengodan, Sajith Kurian, Raghupathy Ramasamy
Journal of Clinical Imaging Science 2017 7(1):32-32
Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.
http://ift.tt/2wIfkHj
Journal of Clinical Imaging Science 2017 7(1):32-32
Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.
http://ift.tt/2wIfkHj
Postpartum glucose intolerance: an updated overview
Abstract
The prevalence of type 2 diabetes mellitus has increased worldwide over the past three decades, as a consequence of the more westernized lifestyle, which is responsible for the increasing obesity rate in the modern adult's life. Concomitant with this increase there has been a gradual rise in the overall prevalence of gestational diabetes mellitus, a condition that strongly predisposes to overt diabetes later in life. Many women with previous gestational diabetes mellitus show glucose intolerance in the early postpartum period. Although the best screening strategy for postpartum glucose intolerance is still debated, numerous evidences indicate that identification of these women at this time is of critical importance, as efforts to initiate early intensive lifestyle modification, including hypocaloric diet and physical activity, and to ameliorate the metabolic profile of these high-risk subjects can prevent or delay the onset of type 2 diabetes mellitus. Nevertheless, less than one fifth of women attend the scheduled postpartum screening following gestational diabetes mellitus and they are at increased risk to develop type 2 diabetes mellitus later in their lives. Unsatisfying results have also come from early intervention strategies and tools that have been developed during the last few years to help improving the rate of adherence to postpartum glycemic testing, thereby indicating that more effective strategies are needed to improve women's participation in postpartum screening.
http://ift.tt/2vBE9nO
Scholar : These new articles for Advanced Robotics are available online
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Postpartum glucose intolerance: an updated overview
Abstract
The prevalence of type 2 diabetes mellitus has increased worldwide over the past three decades, as a consequence of the more westernized lifestyle, which is responsible for the increasing obesity rate in the modern adult's life. Concomitant with this increase there has been a gradual rise in the overall prevalence of gestational diabetes mellitus, a condition that strongly predisposes to overt diabetes later in life. Many women with previous gestational diabetes mellitus show glucose intolerance in the early postpartum period. Although the best screening strategy for postpartum glucose intolerance is still debated, numerous evidences indicate that identification of these women at this time is of critical importance, as efforts to initiate early intensive lifestyle modification, including hypocaloric diet and physical activity, and to ameliorate the metabolic profile of these high-risk subjects can prevent or delay the onset of type 2 diabetes mellitus. Nevertheless, less than one fifth of women attend the scheduled postpartum screening following gestational diabetes mellitus and they are at increased risk to develop type 2 diabetes mellitus later in their lives. Unsatisfying results have also come from early intervention strategies and tools that have been developed during the last few years to help improving the rate of adherence to postpartum glycemic testing, thereby indicating that more effective strategies are needed to improve women's participation in postpartum screening.
http://ift.tt/2vBE9nO
The interplay of epigenetic marks during stem cell differentiation and development
Nature Reviews Genetics. doi:10.1038/nrg.2017.57
Authors: Yaser Atlasi & Hendrik G. Stunnenberg
http://ift.tt/2wW7adJ
Settling the score: variant prioritization and Mendelian disease
Nature Reviews Genetics. doi:10.1038/nrg.2017.52
Authors: Karen Eilbeck, Aaron Quinlan & Mark Yandell
http://ift.tt/2wW9S2H
Phase II study of bi-weekly temozolomide plus bevacizumab for adult patients with recurrent glioblastoma
Abstract
Purpose
Bevacizumab is an active anti-angiogenic agent in the treatment of recurrent glioblastoma. Temozolomide can prolong survival in patients with newly diagnosed glioblastoma. At recurrence, alternate dosing of temozolomide has shown to further deplete methyl-guanine-methyltransferase (MGMT) conferring added activity for patients who have progressed on the standard dosing regimen. In this study, bevacizumab plus biweekly temozolomide was evaluated for efficacy in adult patients with recurrent glioblastoma.
Methods
Thirty patients with recurrent glioblastoma were treated with bevacizumab on (10 mg/kg i.v.) days 1 and 15 of a 28-day cycle combined with temozolomide (100 mg/m2) on days 1–5 and 15–19 on a 28-day cycle. Responses were assessed at week 4 and then every 8 weeks. MGMT status and quality of life measures were also assessed.
Results
Overall response rate from diagnosis was 51 weeks, the 6-month progression-free survival was 52%, and median time to tumor progression was 5.5 months.
Conclusion
Bevacizumab plus bi-weekly temozolomide was well tolerated and may be a salvage regimen to be considered in a subset of patients with recurrent glioblastoma.
http://ift.tt/2vwtNqU
Scholar : These new articles for Aging, Neuropsychology, and Cognition are available online
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Scholar : These new articles for International Journal of Environmental Analytical Chemistry are available online
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First Evaluation of the Behavioral Addiction Indoor Tanning Screener (BAITS) in a nationwide representative sample
Abstract
Background
Evidence suggests that indoor tanning (IT) may have addictive properties. However, many instruments for measuring IT addiction show poor validity and reliability. Recently, a new instrument, the Behavioral Addiction Indoor Tanning Screener (BAITS), has been developed.
Objectives
Our aim was to test validity and reliability of the BAITS by using a multi-method approach.
Methods
We used data of the first wave of the National Cancer Aid Monitoring on Sunbed Use (NCAM), which includes a cognitive pretest (08/2015) and a Germany-wide representative survey (10-12/2015). In the cognitive pretest 10 participants were interviewed, while 3,000 individuals aged 14 to 45 years were included in the representative survey. Potential symptoms of IT addiction were measured via the BAITS, a brief screening survey including seven items (answer categories: yes vs. no). Criterion validity was assessed by comparing the results of BAITS with usage parameters. Additionally, we tested internal consistency and construct validity.
Results
19.7% of current and 1.8% of former IT users were screened positive for symptoms of a potential IT addiction. We found significant associations between usage parameters and the BAITS (criterion validity). Internal consistency (reliability) was good (Kuder-Richardson-20=0.854). The BAITS was shown to be a homogenous construct (construct validity).
Conclusions
Compared to other short instruments measuring symptoms of a potential IT addiction, the BAITS seems to be a valid and reliable tool. With its short lengths and the binary items the BAITS is easy to use in large surveys.
This article is protected by copyright. All rights reserved.
http://ift.tt/2w5gL4x
Scholar : These new articles for Bulletin of Spanish Studies are available online
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Scholar : These new articles for Australian Journal of International Affairs are available online
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Scholar : These new articles for AIDS Care are available online
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Rhinoplasty Setsquare Device: A Novel Instrument to Verify Columellar and Nasal Dorsal Position at the Midsagittal Line
Summary: Even a mild degree of postoperative deviation of the nasal dorsum and/or columella from the midsagittal plane could be enough to displease a patient. Postoperative judgment of the nasal dorsum and the columellar positioning on the midsagittal plane is somewhat of a subjective decision determined by the surgeons' naked eye. Most innovations tend to evolve from necessities. The risk and reality of misjudging the positioning for both the nasal dorsum and/or the columella led me to develop a device for the objective measurement of the midsagittal axis of the nose. I have called it the rhinoplasty setsquare device. This device is made from 316 quality stainless chrome. It is completely sterilizable. It consists of 4 main parts. During the finishing touches of the operation, the correct placement of the rhinoplasty setsquare device will provide the surgeon with an objective decision that will help make the positioning of the nasal dorsum and the columella more precise. When I conducted my research on literature and device catalogs for possible devices designed for measurement in rhinoplasty operations, I ran into devices such as the Castroviejo caliper, calibrated lateral crus stabilizer, Joseph measuring rod, and Thorpe Marchac caliper. All of them are unique in their function and design. However, as far as I could see, there is no device similar in form and function to my rhinoplasty setsquare device. I have been using this device for 8 months for all my rhinoplasty patients. I am more confident now in my postoperative results due to its objective measurement of the midsagittal line.http://ift.tt/2wsJzl6
Donor-Site Morbidity After DIEAP Flap Breast Reconstruction—A 2-Year Postoperative Computed Tomography Comparison
Background: The study was undertaken to provide a more complete picture of donor-site morbidity following the deep inferior epigastric artery perforator (DIEAP) flap harvest in breast reconstruction. Most studies evaluating this subject have been performed using ultrasonography. Computed tomography (CT) might provide valuable information. Methods: In 14 patients who were reconstructed with a DIEAP flap, donor-site morbidity was assessed by comparing routine preoperative CT abdomen with CT abdomen performed 2 years postoperatively. The anteroposterior diameter and transverse diameter (TD) of the rectus muscle were measured bilaterally within 4 standardized zones. Diastasis recti abdominis (DRA) was measured in the same zones. The abdominal wall was assessed for hernias, bulging, and seromas. Results: The operated rectus muscle had a significantly increased anteroposterior diameter in 2 zones and decreased TD in 1 zone compared with preoperative measurements. Comparing the operated and nonoperated rectus muscles, the former had a significantly decreased TD in 1 zone. Supraumbilical DRA was significantly decreased with surgery, whereas infraumbilical DRA was significantly increased. No new hernias or bulging were found. Two patients had seroma formation in the abdominal wall. Conclusions: Symmetry of the 2 hemiabdomens is well preserved after DIEAP flap harvest; however, significant changes to the rectus muscles and DRA were observed. Hernia formation does not seem to be a postoperative complication of importance. The study indicates that DIEAP flaps result in limited donor-site morbidity, which for most patients does not outweigh the benefits of free perforator flap breast reconstruction.http://ift.tt/2vMs7u7
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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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