Ιατρικά Άρθρα: 08/17/17

Πέμπτη 17 Αυγούστου 2017

Status and progress of treatment methods for root caries in the last decade: a literature review

Abstract

The aim of this literature review is to explore the treatment methods for root caries in laboratory and clinical research in the last decade. A systematic search of publications in PubMed and Web of Science databases was performed. The time-span was limited to the last 10 years and English language. Further retrieval was conducted using the search terms of specific therapies or treatments. Titles and abstracts of identified publications were screened. Reviews; case reports; conference abstracts; letters to editor; dissertation and theses; non-English articles; epidemiological studies, diagnostic methods or decision-making process for root caries treatment without assessment of its efficacy; deep carious lesions with inflamed pulp and require pulp capping or endodontic treatment and research on root cementum were excluded. The remaining papers were retrieved with full-texts. Cross-referencing was performed to identify other relevant articles in addition to manual screening of the bibliographies of the remaining papers. Eighty-two articles were included in this systematic review and full texts were retrieved. Types of studies included laboratory studies and clinical trials. Therapeutic approaches for root caries without risk of pulp exposure can be categorised into non-invasive and restorative treatment. Non-invasive treatments which targeted different causative factors of root caries have been developed in the last decade. Accordingly, several artificial caries model systems have been proposed for the study of root caries in the laboratory. Carious tissue excavation techniques and restorative materials and procedures have been modified to improve the prognosis of invasive treatment. It is of importance to determine the most appropriate therapy for root caries and further clinical trials are needed to draw firm conclusions concerning the efficacy and consistency of the various treatment methods proposed.

http://ift.tt/2wfJfJU

External Beam Radiation Therapy for Amyloidosis of the Urinary Bladder

Publication date: Available online 16 August 2017
Source:Practical Radiation Oncology
Author(s): Christopher T. Cooper, Bruce D. Greene, Jeffrey E. Fegan, Douglas Rovira, Morie A. Gertz, David M. Marcus

http://ift.tt/2uVUi6E

A multi-institutional phase II trial of prostate stereotactic body radiation therapy (SBRT) utilizing continuous real-time evaluation of prostate motion with patient reported quality of life

Publication date: Available online 16 August 2017
Source:Practical Radiation Oncology
Author(s): William C. Jackson, Robert T. Dess, Dale W. Litzenberg, Pin Li, Matthew Schipper, Seth A. Rosenthal, Garrick C. Chang, Eric M. Horwitz, Robert A. Price, Jeff M. Michalski, Hiram A. Gay, John T Wei, Mary Feng, Felix Y. Feng, Howard M. Sandler, Robert E. Wallace, Daniel E. Spratt, Daniel A. Hamstra
PurposeThe use of stereotactic body radiation therapy (SBRT) for prostate cancer has been reported predominantly from single institutional studies while concerns for broader adoption exist.Methods and MaterialsFrom 2011–2013, 66 men were accrued to a phase II trial at five centers. SBRT consisted of 5 fractions of 7.4 Gy to 37 Gy using conventional linear accelerators. Electromagnetic transponders were utilized for motion management. Health-related quality of life (HRQOL) was evaluated via the EPIC-26 questionnaire. Acute and late toxicities were collected by common terminology criteria for adverse events (CTCAE) version 4.0. Linear mixed modeling was performed to assess changes in HRQOL over time.ResultsMedian follow-up was 36 months. All men had low or intermediate-risk disease. There have been zero biochemical recurrences. No grade 3 urinary or bowel toxicity was reported. Twenty-three percent of patients had acute grade 2 urinary toxicity, with 9% late grade 2 urinary toxicity. Four and 5% experienced acute or late grade 2+ bowel toxicity, respectively. Urinary bother and bowel HRQOL transiently decreased during the first 6–12 months post-SBRT, and then returned to baseline. In men with good erectile function at baseline, sexual HRQOL declined during the first 6 months and stabilized thereafter. On linear mixed modeling the strongest predictor of sustained bowel and sexual HRQOL was baseline HRQOL.ConclusionsIn this multi-institutional phase II clinical trial utilizing continuous real-time evaluation of prostate motion, prostate SBRT has excellent intermediate-term tumor control with mild and expected treatment-related side effects.

http://ift.tt/2wlDQA1

Measuring Safety Culture: Application of The Hospital Survey on Patient Safety Culture to Radiotherapy Departments Worldwide

Publication date: Available online 16 August 2017
Source:Practical Radiation Oncology
Author(s): Sarah Leonard, Anita O'Donovan
BackgroundMinimising errors and improving patient safety has gained prominence worldwide in high risk disciplines such as radiotherapy. Patient safety culture has been identified as an important factor in reducing the incidence of adverse events and improving patient safety in the healthcare setting.PurposeThe aim of distributing the Hospital Survey on Patient Safety Culture (HSPSC) to radiotherapy departments worldwide was to assess the current status of safety culture, identify areas for improvement and areas that excel, examine factors which influence safety culture and to raise staff awareness.Materials and MethodsThe safety culture in radiotherapy departments worldwide was evaluated by distributing the HSPSC. A total of 266 participants were recruited worldwide from radiotherapy departments and included radiation oncologists, radiation therapists, physicists and dosimetrists.ResultsThe positive percent scores for the 12 dimensions of the HSPSC varied from 50% to 79%. The highest composite score amongst the 12 dimensions was teamwork within units and the lowest composite score was handoffs and transitions.ConclusionThe results indicated that health care professionals in radiotherapy departments felt positively towards patient safety. The HSPSC was successfully applied to radiotherapy departments and provided a valuable insight into areas of potential improvement such as teamwork across units, staffing and handoffs and transitions. Managers and policy makers in radiotherapy may use this assessment tool for focused improvement efforts towards patient safety culture.

http://ift.tt/2uW6013

Super pulse CO2 laser therapy for benign eyelid tumors

Summary

Background

Benign eyelid tumors occur commonly in daily outpatient services.

Objectives

The aim of this study was to evaluate the treatment of benign eyelid lesions with a super pulse CO₂ laser as an alternative to surgical excision.

Methods

This retrospective clinical study included 80 patients with 99 benign eyelid lesions treated with super pulse CO₂ laser photocoagulation. The following areas were involved: the upper eyelid in 38 cases, the lower eyelid in 39 cases, and the angulus oculi in seven cases (the eyelid margin was included in 18 cases). The laser spot size ranged from 120 to 200 μm and the super pulse CO₂ laser power density varied between 0.6 and 21.1 W/mm². The mean follow-up period was 14.0±7.1 months (range five to 30). Histological diagnoses were obtained in 62 of the 80 patients.

Results

The cosmetic outcomes of all of the patients were satisfactory after treatment, and the wounds formed dry scabs, with no infections. They were epithelialized within 2-4 weeks with normal-appearing epithelium. Temporarily, the treated area had less hyperpigmentation than the surrounding normal skin, showing no obvious scars or notches. No complications were observed, with no relapses during the follow-up.

Conclusions

The super pulse CO₂ laser therapy of the benign eyelid tumors provided satisfactory cosmetic results in this study. It is a convenient, cheap, accessible, and well-tolerated alternative to traditional surgery, especially for diffuse tumors, or those positioned close to the lacrimal papillae.

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Myricetin protects keratinocyte damage induced by UV through IκB/NFκb signaling pathway

Summary

Objective

The aim of this study was to evaluate the potential molecular mechanism of myricetin that protecting cells from photodamage.

Methods

Myricetin had broadly chemopreventive effects and anti-inflammatory properties. The effect of myricetin was assessed on HaCaT cells. Cell viability assay was carried out. Reactive oxygen species (ROS) level was measured. The expression of pro-inflammatory factor COX2 was determined by real-time PCR and Western blot. The protein levels of p-IκBa and IκBa were determined by Western blot.

Results

Myricetin attenuated UV-induced keratinocyte death in a dose-dependent manner as determined by cell viability assay. Pretreatment with myricetin also reduced the UV-induced ROS levels. Myricetin suppresses the upregulation of COX2 induced by UV in keratinocyte as demonstrated by real-time PCR and Western blot. Furthermore, signal transduction studies confirmed that myricetin attenuates the upregulation of COX2 induced by UV via suppression of IκB/NFκB pathways.

Conclusion

These results showed that antioxidant property of myricetin can effectively attenuate UV-caused cell damage and suppress the expression of COX2 through the IκB/NFκB signaling pathways. Myricetin had potential protective effects on UV-induced skin cell damages, which might be used in cosmetic and pharmaceutical industries.

http://ift.tt/2vNIX9P

Association between serum osteocalcin and body mass index: a systematic review and meta-analysis

Abstract

Purpose

Osteocalcin is considered as a bone-derived hormone affecting on the body fat distribution and body mass index. Several cross-sectional studies have investigated the association between serum osteocalcin and body mass index. The aim of this study was to summarize the evidence on the relationship between serum osteocalcin and body mass index.

Methods

We conducted a complete search up to November 2016 in PubMed and SCOPUS and reviewed reference list of all relevant articles and reviews. The DerSimonian–Laird method were used to pool effect sizes of eligible studies. The potential sources of heterogeneity were assessed using the standard χ ² test.To find possible the sources of between-study heterogeneity, we carried out subgroup analyses based on sex, and type of study population.

Results

There was a significant inverse association in the overall result of this study between serum osteocalcin levels and BMI(r = −0.161; 95% CI: −0.197, −0.124, p < 0.000). In the subgroup analysis to find the sources of significant heterogeneity between-study, we observed that the type of the study population may be the source of between-study heterogeneity and the most correlation was seen in metabolic syndrome studies (r = −0.265; p = 0.000).

Conclusion

Findings from the available data indicated an overall significant inverse association between serum osteocalcin and body mass index. Further studies based on the type of study population are needed to better clarify these associations.

http://ift.tt/2fQfXKM

Antagonistic Activities of Sox2 and Brachyury Control the Fate Choice of Neuro-Mesodermal Progenitors

Publication date: Available online 17 August 2017
Source:Developmental Cell
Author(s): Frederic Koch, Manuela Scholze, Lars Wittler, Dennis Schifferl, Smita Sudheer, Phillip Grote, Bernd Timmermann, Karol Macura, Bernhard G. Herrmann
The spinal cord and mesodermal tissues of the trunk such as the vertebral column and skeletal musculature derive from neuro-mesodermal progenitors (NMPs). Sox2, Brachyury (T), and Tbx6 have been correlated with NMP potency and lineage choice; however, their exact role and interaction in these processes have not yet been revealed. Here we present a global analysis of NMPs and their descending lineages performed on purified cells from embryonic day 8.5 wild-type and mutant embryos. We show that T, cooperatively with WNT signaling, controls the progenitor state and the switch toward the mesodermal fate. Sox2 acts antagonistically and promotes neural development. T is also involved in remodeling the chromatin for mesodermal development. Tbx6 reinforces the mesodermal fate choice, represses the progenitor state, and confers paraxial fate commitment. Our findings refine previous models and establish molecular principles underlying mammalian trunk development, comprising NMP maintenance, lineage choice, and mesoderm formation.

Teaser

The mammalian trunk arises from neuro-mesodermal progenitors (NMPs) giving rise to two fundamentally different cell lineages, one forming the spinal cord and the other mesodermal tissues. Analyzing the lineages derived from NMPs, Koch et al. find antagonistic roles for Sox2 and Brachyury in the specification of neural and mesodermal fates.

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A Real-Time Biosensor for ERK Activity Reveals Signaling Dynamics during C. elegans Cell Fate Specification

Publication date: Available online 17 August 2017
Source:Developmental Cell
Author(s): Claire de la Cova, Robert Townley, Sergi Regot, Iva Greenwald
Kinase translocation reporters (KTRs) are genetically encoded fluorescent activity sensors that convert kinase activity into a nucleocytoplasmic shuttling equilibrium for visualizing single-cell signaling dynamics. Here, we adapt the first-generation KTR for extracellular signal-regulated kinase (ERK) to allow easy implementation in vivo. This sensor, "ERK-nKTR," allows quantitative and qualitative assessment of ERK activity by analysis of individual nuclei and faithfully reports ERK activity during development and neural function in diverse cell contexts in Caenorhabditis elegans. Analysis of ERK activity over time in the vulval precursor cells, a well-characterized paradigm of epidermal growth factor receptor (EGFR)-Ras-ERK signaling, has identified dynamic features not evident from analysis of developmental endpoints alone, including pulsatile frequency-modulated signaling associated with proximity to the EGF source. The toolkit described here will facilitate studies of ERK signaling in other C. elegans contexts, and the design features will enable implementation of this technology in other multicellular organisms.

Teaser

A genetically encoded biosensor for ERK activity allows qualitative or quantitative assessment by analysis of individual nuclei during development and neural function in diverse cell contexts in C. elegans. In-depth analysis of ERK activity over time in the vulval precursor cells has identified dynamic features including pulsatile frequency-modulated signaling.

http://ift.tt/2vNNCZj

A Novel Absorbable Radiopaque Hydrogel Spacer to Separate the Head of the Pancreas and Duodenum in Radiotherapy of Pancreatic Cancer

Publication date: Available online 14 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Avani D. Rao, Ziwei Feng, Eun Ji Shin, Jin He, Kevin M. Waters, Stephanie Coquia, Robert DeJong, Lauren M. Rosati, Lin Su, Dengwang Li, Juan Jackson, Stephen Clark, Jeffrey Schultz, Danielle Hutchings, Seong-Hun Kim, Ralph H. Hruban, John Wong, Amol Narang, Joseph M. Herman, Kai Ding
Purpose/Objectives: We assessed the feasibility and theoretical dosimetric advantages of an injectable hydrogel to increase space between the head of the pancreas (HOP) and duodenum in a human cadaveric model.Materials/MethodsUsing three human cadaveric specimens, an absorbable radiopaque hydrogel was injected between the HOP and duodenum via open laparotomy in one case and endoscopic-ultrasound (EUS) guidance in two cases. Cadavers were subsequently imaged using computed tomography and dissected for histologic confirmation of hydrogel placement. The duodenal dose reduction and planning target volume (PTV) coverage were characterized using pre- and post-spacer injection stereotactic body radiotherapy (SBRT) plans of the two cadavers with EUS, the delivery method which appears to be most clinically desirable. Modeling studies were performed using 60 SBRT plans consisting of 10 previously treated unresectable pancreatic cancer patients each with 6 different HOP-duodenum separation distances. Duodenal volume receiving 15 Gy (V15), 20 Gy (V20) and 33 Gy (V33) was assessed for each iteration.ResultsIn the three cadaveric studies, an average of 0.9 cm, 1.1 cm, and 0.9 cm HOP-duodenum separation was achieved, respectively. In the two EUS cases, V20 decreased from 3.86 cc→0.36 cc and 3.75 cc→1.08 cc (treatment constraint: <3 cc), and V15 decreased from 7.07 cc→2.02 cc and 9.12 cc→3.91 cc (treatment constraint: <9 cc), respectively. PTV coverage improved or was comparable between the pre- and post-injection studies. Modeling studies demonstrated that separation of 8 mm was sufficient to consistently reduce V15, V20 and V33 to acceptable clinical constraints.ConclusionsCurrently, dose-escalation is limited due to radiosensitive structures adjacent to the pancreas. We demonstrated the feasibility of hydrogel separation of the HOP and duodenum. Future studies will evaluate the safety and efficacy of this technique with the potential for more effective dose-escalation using SBRT or intensity-modulated radiotherapy to improve outcomes in unresectable pancreatic cancer patients.

Teaser

We demonstrated the feasibility of an endoscopic ultrasound-guided injectable hydrogel separation technique using a cadaveric model to increase the space between the head of the pancreas and duodenum. Using modeling studies, we identified the minimum distance of this separation for optimal sparing of the duodenum, setting the foundation for future clinical trials utilizing this technique to enable dose-escalation with either stereotactic or intensity-modulated radiotherapy for patients with unresectable pancreatic cancer.

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Association between serum osteocalcin and body mass index: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

http://ift.tt/2fQfXKM

Editorial Board and Contents

Publication date: September 2017
Source:Trends in Cell Biology, Volume 27, Issue 9

http://ift.tt/2w7wnFg

Spatial and Temporal Control of Senescence

Publication date: Available online 17 August 2017
Source:Trends in Cell Biology
Author(s): Yoko Ito, Matthew Hoare, Masashi Narita
Cellular senescence is an autonomous tumor suppressor mechanism leading to stable cell cycle arrest. Senescent cells are highly secretory, driving a range of different functions through the senescence-associated secretory phenotype (SASP). Recent findings have suggested that the composition of the SASP is dynamically and spatially regulated and that the changing composition of the SASP can determine the beneficial and detrimental aspects of the senescence program, tipping the balance to either an immunosuppressive/profibrotic environment or proinflammatory/fibrolytic state. Here, we discuss the current understanding of the temporal and spatial regulation of the SASP and the novel finding of NOTCH signaling as a regulator of SASP composition.

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Zika-Virus-Encoded NS2A Disrupts Mammalian Cortical Neurogenesis by Degrading Adherens Junction Proteins

Publication date: Available online 17 August 2017
Source:Cell Stem Cell
Author(s): Ki-Jun Yoon, Guang Song, Xuyu Qian, Jianbo Pan, Dan Xu, Hee-Sool Rho, Nam-Shik Kim, Christa Habela, Lily Zheng, Fadi Jacob, Feiran Zhang, Emily M. Lee, Wei-Kai Huang, Francisca Rojas Ringeling, Caroline Vissers, Cui Li, Ling Yuan, Koeun Kang, Sunghan Kim, Junghoon Yeo, Yichen Cheng, Sheng Liu, Zhexing Wen, Cheng-Feng Qin, Qingfeng Wu, Kimberly M. Christian, Hengli Tang, Peng Jin, Zhiheng Xu, Jiang Qian, Heng Zhu, Hongjun Song, Guo-li Ming
Zika virus (ZIKV) directly infects neural progenitors and impairs their proliferation. How ZIKV interacts with the host molecular machinery to impact neurogenesis in vivo is not well understood. Here, by systematically introducing individual proteins encoded by ZIKV into the embryonic mouse cortex, we show that expression of ZIKV-NS2A, but not Dengue virus (DENV)-NS2A, leads to reduced proliferation and premature differentiation of radial glial cells and aberrant positioning of newborn neurons. Mechanistically, in vitro mapping of protein-interactomes and biochemical analysis suggest interactions between ZIKA-NS2A and multiple adherens junction complex (AJ) components. Functionally, ZIKV-NS2A, but not DENV-NS2A, destabilizes the AJ complex, resulting in impaired AJ formation and aberrant radial glial fiber scaffolding in the embryonic mouse cortex. Similarly, ZIKA-NS2A, but not DENV-NS2A, reduces radial glial cell proliferation and causes AJ deficits in human forebrain organoids. Together, our results reveal pathogenic mechanisms underlying ZIKV infection in the developing mammalian brain.

Graphical abstract

Teaser

Zika virus infects neural stem cells and causes microcephaly. In this study, Yoon et al. showed that NS2A protein encoded by Zika virus, but not by Dengue virus, impairs proliferation of radial glial cells in both embryonic mouse cortex and human forebrain organoids. Mechanistically, ZIKV-NS2A disrupts adherens junction formation.

http://ift.tt/2w6rM65

Scholar : Chinese Archives of Otolaryngology-Head and Neck Surgery, Year 2017, Issue 02 -New Issue Alert.

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Owlready: Ontology-oriented programming in Python with automatic classification and high level constructs for biomedical ontologies

Publication date: Available online 14 August 2017
Source:Artificial Intelligence in Medicine
Author(s): Jean-Baptiste Lamy
ObjectiveOntologies are widely used in the biomedical domain. While many tools exist for the edition, alignment or evaluation of ontologies, few solutions have been proposed for ontology programming interface, i.e. for accessing and modifying an ontology within a programming language. Existing query languages (such as SPARQL) and APIs (such as OWLAPI) are not as easy-to-use as object programming languages are. Moreover, they provide few solutions to difficulties encountered with biomedical ontologies. Our objective was to design a tool for accessing easily the entities of an OWL ontology, with high-level constructs helping with biomedical ontologies.MethodsFrom our experience on medical ontologies, we identified two difficulties: (1) many entities are represented by classes (rather than individuals), but the existing tools do not permit manipulating classes as easily as individuals, (2) ontologies rely on the open-world assumption, whereas the medical reasoning must consider only evidence-based medical knowledge as true. We designed a Python module for ontology-oriented programming. It allows access to the entities of an OWL ontology as if they were objects in the programming language. We propose a simple high-level syntax for managing classes and the associated "role-filler" constraints. We also propose an algorithm for performing local closed world reasoning in simple situations.ResultsWe developed Owlready, a Python module for a high-level access to OWL ontologies. The paper describes the architecture and the syntax of the module version 2. It details how we integrated the OWL ontology model with the Python object model. The paper provides examples based on Gene Ontology (GO). We also demonstrate the interest of Owlready in a use case focused on the automatic comparison of the contraindications of several drugs. This use case illustrates the use of the specific syntax proposed for manipulating classes and for performing local closed world reasoning.ConclusionOwlready has been successfully used in a medical research project. It has been published as Open-Source software and then used by many other researchers. Future developments will focus on the support of vagueness and additional non-monotonic reasoning feature, and automatic dialog box generation.

http://ift.tt/2we5aAX

Correlation between adrenal function, growth hormone secretion, and insulin sensitivity in children with idiopathic growth hormone deficiency

Abstract

Purpose

Patients with growth hormone deficiency (GHD) demonstrate an increased cortisol/cortisone ratio which could potentially explain the metabolic features of GHD, while GH treatment (GHT) could increase the cortisol metabolism.

Methods

In 35 children (27 M, mean age 10.1 years) with idiopathic GHD at baseline and after 12 months of GHT and in 25 controls, in addition to metabolic parameters, we assessed adrenal function by morning serum cortisol, its peak, and its area under the curve (AUC_COR) during insulin tolerance test (ITT).

Results

A cortisol peak <18 µg/dl was shown in 22 and 31% of GHD children at baseline and after GHT, respectively. At baseline, GHD children had lower fasting glucose (p < 0.001) and ISI-Matsuda (p = 0.042), with concomitant higher Homa-IR (p = 0.006) and morning cortisol (p = 0.012) than controls. Morning cortisol was negatively correlated with GH (p < 0.001), fasting glucose (p < 0.001) and ISI-Matsuda (p < 0.001) and positively with Homa-IR (p = 0.010). Both cortisol peak and AUC_COR were negatively correlated with GH (all p < 0.001) and ISI-Matsuda (p = 0.016 and p = 0.001, respectively). After 12 months of GHT, a significant increase in fasting glucose (p < 0.001), and Homa-IR (p = 0.011) was documented, with a concomitant decrease in morning cortisol (p = 0.002), AUC_COR (p = 0.038), total (p = 0.003) and LDL-cholesterol (p = 0.016). No significant correlations were found among cortisol levels and all parameters were investigated.

Conclusions

Cortisol levels correlate with GH secretion and with many metabolic parameters in GHD children, while the metabolic effects during GHT are mainly due to GHT per se and less to cortisol reduction.

http://ift.tt/2vImYmu

Mobile Phones—An asset or a liability: A study based on characterization and assessment of metals in waste mobile phone components using leaching tests

Publication date: 15 January 2018
Source:Journal of Hazardous Materials, Volume 342
Author(s): Meenakshi Hira, Sudesh Yadav, P. Morthekai, Anurag Linda, Sushil Kumar, Anupam Sharma
The prolonged use of old fashioned gadgets, especially mobile phones, is declining readily with the advancement in technology which ultimately lead to generation of e-waste. The present study investigates the concentrations of nine metals (Ba, Cd, Cr, Cu, Fe, Ni, Pb, Sn, and Zn) in various components of the mobile phones using Toxicity Characteristic Leaching Procedure (TCLP), Waste Extraction Test (WET) and Synthetic Precipitation Leaching Procedure (SPLP). The results were compared with the threshold limits for hazardous waste defined by the California Department of Toxic Substances Control (CDTSC) and United States Environmental Protection Agency (USEPA). The average concentrations of metals were found high in PWBs. WET was found relatively aggressive as compared to TCLP and SPLP. Redundancy analysis (RDA) suggests that part of mobile, extraction test, manufacturer, mobile model and year of manufacturing explain 34.66% of the variance. According to the present study, waste mobile phones must be considered as hazardous due to the potential adverse impact of toxic metals on human health and environment. However, mobile phones can be an asset as systematic extraction and recycling could reduce the demand of primary metals mining and conserve the natural resources.

http://ift.tt/2fNtd2C

Theoretical and experimental insight into zinc loading on mesoporous silica

Publication date: 15 January 2018
Source:Microporous and Mesoporous Materials, Volume 256
Author(s): Tomasz Siodla, Izabela Sobczak, Maria Ziolek, Frederik Tielens
Zinc oxide species grafted on mesostructured cellular foam (MCF) silica are investigated using a combination of experimental and theoretical techniques. MCF is modelled using a realistic amorphous silica surface model surface slab. The most energetically favorable complexes grafted on the silica surface were identified and characterized at the molecular level. The Zn metal center was found in tetrahedral coordination. Moreover, the Si-O-Zn-OH species is found to be stabilized in a 5 fold coordinated silicon with an unusual trigonal bipyramidal geometry. A mechanism for the grafting process of the metal species on the support is proposed.

Graphical abstract

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In vitro bioaccessibility and health risk assessment of heavy metals in atmospheric particulate matters from three different functional areas of Shanghai, China

Publication date: 1 January 2018
Source:Science of The Total Environment, Volumes 610–611
Author(s): Huang Huang, Ying Jiang, Xiaoyun Xu, Xinde Cao
The bioaccessibility and human health risks of heavy metals in PM2.5 and PM10 samples from three functional areas of Shanghai, China including a commercial area (CA), a residential area (RA), and an industrial area (IA), were investigated. Gamble's solution and physiologically based extraction test were employed to simulate human respiratory and digestive system, respectively. Both PM2.5 and PM10 concentration in the three areas exceeded the guideline of WHO, and followed the order of IA>CA≈RA. Zinc and Pb were the most abundant metals with a concentration range of 0.19–0.44 and 0.05–0.42μgm⁻³, respectively. In respiratory system, heavy metal bioaccessibility for PM2.5 and PM10 varied within the range of 5.3%–71.4% and 4.8%–51.5%, respectively. Heavy metals in RA showed higher bioaccessibility than those in CA and IA in the respiratory system. In digestive system, heavy metal bioaccessibility for PM2.5 and PM10 reached 24.6%–90.9% and 28.5%–88.9% in the gastric phase and was reduced to 8.7%–85.5% and 8.5%–81.8% in the intestinal phase, respectively. The bioaccessibility of heavy metals in CA was highest among three areas in the digestive system. Based on the bioaccessibility analysis, the hazard quotient values of heavy metals in PMs via inhalation exposure were far below 1, the safe level, for both adults and children. However, potential risks via ingestion exposure resulted from Pb existed for children of three areas and for adults of RA as their hazard quotient values could reach up to 11. The obtained results indicated that the air quality in Shanghai need to be improved and the health risks to humans via ingestion exposure to atmospheric Pb must be considered.

Graphical abstract

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Peristomal leakage of enteroatmospheric fistulas treated with lipotransfer combined to minimal-invasive scar release technique

Abstract

Lipografting is emerging as a "rescue" treatment for postoperative sequelae, soft tissue volume defects and refractory fistulas. After complicated laparotomies or colostomies, also peristomal soft tissue volume deficiencies and scarring can occur and lead to severe care problems. Currently, no satisfactory treatment is available for these sequelae resulting in general surgery. In this case report, we applied the operative approach by means of a minimal-invasive scar release combined to waterjet-assisted lipotransfer and sculpturing on the abdominal wall as a treatment of peristomal irregularities. We applied one procedure on a patient with insufficient stoma sealing on large enteroatmospheric fistulas in "frozen" open abdomen (Björk 4 classification). Clinical and aesthetic outcome were measured and evaluated via digital photographs and CT scan pre- and postoperatively. Size reduction, complete sealing of the stoma appliance and total healing of the peristomal skin damage were accomplished within 5 weeks.

Level of Evidence: Level V, therapeutic study.

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Cover 2/Editorial Board

Publication date: September 2017
Source:Journal of Anthropological Archaeology, Volume 47

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Interferon-γ-Driven iNOS: A Molecular Pathway to Terminal Shock in Arenavirus Hemorrhagic Fever

Publication date: Available online 17 August 2017
Source:Cell Host & Microbe
Author(s): Melissa M. Remy, Mehmet Sahin, Lukas Flatz, Tommy Regen, Lifen Xu, Mario Kreutzfeldt, Benedict Fallet, Camille Doras, Toni Rieger, Lukas Bestmann, Uwe-Karsten Hanisch, Beat A. Kaufmann, Doron Merkler, Daniel D. Pinschewer
Arenaviruses such as Lassa virus (LASV) cause hemorrhagic fever. Terminal shock is associated with a systemic cytokine storm, but the mechanisms are ill defined. Here we used HLA-A2-expressing mice infected with a monkey-pathogenic strain of lymphocytic choriomeningitis virus (LCMV-WE), a close relative of LASV, to investigate the pathophysiology of arenavirus hemorrhagic fever (AHF). AHF manifested as pleural effusions, edematous skin swelling, and serum albumin loss, culminating in hypovolemic shock. A characteristic cytokine storm included numerous pro-inflammatory cytokines and nitric oxide (NO) metabolites. Edema formation and terminal shock were abrogated in mice lacking inducible nitric oxide synthase (iNOS), although the cytokine storm persisted. iNOS was upregulated in the liver in a T cell- and interferon-γ (IFN-γ)-dependent fashion. Accordingly, blockade of IFN-γ or depletion of T cells repressed hepatic iNOS and prevented disease despite unchecked high-level viremia. We identify the IFN-γ-iNOS axis as an essential and potentially druggable molecular pathway to AHF-induced shock.

Graphical abstract

Teaser

Viral hemorrhagic fevers (VHF) are characterized by a cytokine storm, culminating in vascular leak and shock. In a model of arenavirus hemorrhagic fever, Remy et al. identify inducible nitric oxide synthase (iNOS) as a key mediator of VHF. Interferon-γ blockade prevents iNOS induction, abrogating vascular leak and terminal shock.

http://ift.tt/2fPuKFs

Broad Targeting Specificity during Bacterial Type III CRISPR-Cas Immunity Constrains Viral Escape

Publication date: Available online 17 August 2017
Source:Cell Host & Microbe
Author(s): Nora C. Pyenson, Kaitlyn Gayvert, Andrew Varble, Olivier Elemento, Luciano A. Marraffini
CRISPR loci are a cluster of repeats separated by short "spacer" sequences derived from prokaryotic viruses and plasmids that determine the targets of the host's CRISPR-Cas immune response against its invaders. For type I and II CRISPR-Cas systems, single-nucleotide mutations in the seed or protospacer adjacent motif (PAM) of the target sequence cause immune failure and allow viral escape. This is overcome by the acquisition of multiple spacers that target the same invader. Here we show that targeting by the Staphylococcus epidermidis type III-A CRISPR-Cas system does not require PAM or seed sequences, and thus prevents viral escape via single-nucleotide substitutions. Instead, viral escapers can only arise through complete target deletion. Our work shows that, as opposed to type I and II systems, the relaxed specificity of type III CRISPR-Cas targeting provides robust immune responses that can lead to viral extinction with a single spacer targeting an essential phage sequence.

Graphical abstract

Teaser

Exploring the target specificity of type III-A CRISPR-Cas systems, Pyenson et al. find that most point mutations in the target region still allow robust immunity. As a consequence, viral escape from the type III-A CRISPR-Cas immune response requires the full deletion of the target, which is a very rare event.

http://ift.tt/2iatqxP

Utilization of waste bittern from saltern as a source for magnesium and an absorbent for carbon dioxide capture

Abstract

During solar salt production, large quantities of bittern, a liquid by-product containing high inorganic substance concentrations, are produced. The purpose of this research was to examine the utilization of waste bittern generated from salterns as a source for Mg production and as an absorbent for carbon dioxide (CO₂) capture. The study was conducted in a sequential two-step process. At NaOH/Mg molar ratios of 2.70–2.75 and pH 9.5–10.0, > 99% Mg precipitation from the bittern was achieved. After washing with water, 100–120 g/L of precipitate containing 94% Mg(OH)₂ was recovered from the bittern. At the optimum NH₄OH concentration of 5%, 120 g of sodium bicarbonate precipitate per liter of bittern were recovered, which was equivalent to 63 g CO₂ captured per liter of bittern. These results can be used to support the use of bittern as a resource and reduce economic losses during solar salt production.

http://ift.tt/2v6fCWq

Biodiversity variability and metal accumulation strategies in plants spontaneously inhibiting fly ash lagoon, India

Abstract

Out of 29 plant species taken into consideration for biodiversity investigations, the present study screened out Cyperus rotundus L., Calotropis procera (Aiton) W.T. Aiton, Croton bonplandianus Baill., Eclipta prostrata (L.) L., and Vernonia cinerea (L.) Less. as the most suitable metal-tolerant plant species (high relative density and frequency) which can grow on metal-laden fly ash (FA) lagoon. Total (aqua-regia), residual (HNO₃) and plant available (CaCl₂) metal concentrations were assessed for the clean-up of metal-contaminated FA disposal site using naturally colonized plants. The total metal concentration (in mg kg⁻¹) in FA followed an order of Mn (229.8) > Ni (228.4) > Zn (89.4) > Cr (61.2) > Pb (56.6) > Cu (51.5) > Co (41.9) > Cd (9.7). The HNO₃- and CaCl₂-extracted metals were 0.57–15.68% and 0.03–7.82% of the total metal concentration, respectively. The concentration of Ni and Cr in FA in the present study was highest among the previously studied Indian and average world power plants and Cd, Ni, and Cr were above soil toxicity limit. The variation in total, residual, and plant-available metal (single extraction) concentration indicated the presence of different proportions of metals in FA lagoon which affects the metal uptake potential of the vegetation growing on it. It has been reported that plant-available metal extractant (CaCl₂) is the most suitable extractant for assessment of metal transfer from soil to plant. However in the present study, Spearman's correlation showed best significant correlation between total metal concentration in FA and shoot metal concentration (r = 0.840; p < 0.01) which suggest aqua-regia as the best extractant for understanding the bioavailability and transfer of metal, and in calculation of BCF for moderately contaminated site. It can be stated that plant-available extractant is not always suitable for understanding the availability of metal, but total metal concentration can provide a better insight especially for moderate or low metal-contaminated sites. Principle component analysis revealed that all the plants showed positive correlation with Co and Cd which suggest its subsequent uptake in root and shoot. The biological indices (BCF, BAF, and TF) revealed that E. prostrata (10 mg Cd kg⁻¹) and C. procera (3.5 mg Cd kg⁻¹) can be utilized efficiently for the phytoextraction of Cd and phytostabilization of other potentially toxic metals (Pb, Cr, and Co) from FA lagoon. All the plants were tolerant to Pb pollution (TF > 1, BAF > 1, and BCF > 1); hence, there was a negligible translocation of Pb to the aerial tissues of these plants which shows their suitability in phytostabilization. In addition, V. cinerea accumulated elevated concentration of potentially toxic Cr (50 mg Cr kg⁻¹) and Ni (67 mg Ni kg⁻¹) which could also help in the phytoremediation of FA lagoon.

http://ift.tt/2uNm6xX

In situ remediation of chlorinated solvent-contaminated groundwater using ZVI/organic carbon amendment in China: field pilot test and full-scale application

Abstract

Chlorinated solvents in groundwater pose threats to human health and the environment due to their carcinogenesis and bioaccumulation. These problems are often more severe in developing countries such as China. Thus, methods for chlorinated solvent-contaminated groundwater remediation are urgently needed. This study presents a technique of in situ remediation via the direct-push amendment injection that enhances the reductive dechlorination of chlorinated solvents in groundwater in the low-permeability aquifer. A field-based pilot test and a following real-world, full-scale application were conducted at an active manufacturing facility in Shanghai, China. The chlorinated solvents found at the clay till site included 1,1,1-trichloroethane (1,1,1-TCA), 1,1-dichloroethane (1,1-DCA), 1,1-dichloroethylene (1,1-DCE), vinyl chloride (VC), and chloroethane (CA). A commercially available amendment (EHC^®, Peroxychem, Philadelphia, PA) combining zero-valent iron and organic carbon was used to treat the above pollutants. Pilot test results showed that direct-push EHC injection efficiently facilitated the in situ reductive remediation of groundwater contaminated with chlorinated solvents. The mean removal rates of 1,1,1-TCA, 1,1-DCA, and 1,1-DCE at 270 days post-injection were 99.6, 99.3, and 73.3%, respectively, which were obviously higher than those of VC and CA (42.3 and 37.1%, respectively). Clear decreases in oxidation-reduction potential and dissolved oxygen concentration, and increases in Fe²⁺ and total organic carbon concentration, were also observed during the monitoring period. These indicate that EHC promotes the anaerobic degradation of chlorinated hydrocarbons primarily via long-term biological reductive dechlorination, with instant chemical reductive dechlorination acting as a secondary pathway. The optimal effective time of EHC injection was 0–90 days, and its radius of influence was 1.5 m. In full-scale application, the maximum concentrations of 1,1,1-TCA and 1,1-DCA in the contaminate plume fell below the relevant Dutch Intervention Values at 180 days post-injection. Moreover, the dynamics of the target pollutant concentrations mirrored those of the pilot test. Thus, we have demonstrated that the direct-push injection of EHC successfully leads to the remediation of chlorinated solvent-contaminated groundwater in a real-world scenario. The parameters determined by this study (e.g., effectiveness, injection amount, injection depth, injection pressures, and radius of influence) are applicable to other low-permeability contaminated sites where in situ remediation by enhanced reductive dechlorination is required.

http://ift.tt/2v6qgw5

CO2: Editorial Board/Subscription info.

Publication date: September 2017
Source:Progress in Neurobiology, Volume 156

http://ift.tt/2vNnJZE

Reproductive factors and risk of Parkinson’s disease in women: A meta-analysis of observational studies

Publication date: 29 September 2017
Source:Behavioural Brain Research, Volume 335
Author(s): Menglian Lv, Ying Zhang, Guo-chong Chen, Guowei Li, Yehua Rui, Liqiang Qin, Zhongxiao Wan
Evidence on the relationship between reproductive factors, use of oral contraceptives (OCs) and the incidence of Parkinson's disease (PD) remain inconclusive. The aim of this meta-analysis is to evaluate whether relevant reproductive factors including age at menarche, age at menopause, fertile lifespan, parity, type of menopause (surgical versus natural), and use of OCs are associated with risk of PD in women via random-effects model. PubMed and EMBASE database were used to search for case-control or cohort studies published before February17, 2017. 6 case-control and 5 cohort studies were included in the meta-analysis. The pooled relative risks (RRs) of PD risk were 1.00 (95% CI: 0.79–1.28) for use of OCs (ever versus never), 1.03 (95% CI: 0.84–1.26) for age at menarche, 0.98 (95% CI: 0.75–1.29) for age at menopause, 0.98(95% CI: 0.77–1.25) for fertile lifespan, 0.99(95% CI:0.0.79–1.25) for parity, 0.93 (95% CI:0.68–1.29) for type of menopause (surgical versus natural). In the subgroup analysis stratified by study design, age, caffeine intake and smoking, an inverse association was found between surgical menopause and risk of PD for those adjusting for caffeine intake (RR: 0.67, 95% CI: 0.45–0.99) and smoking (RR: 0.77, 95% CI: 0.63–0.94); while a positive association was found between surgical menopause and PD risk for those not adjusting for smoking (RR: 1.91, 95% CI: 1.29–2.83). In conclusion, our meta-analysis provided little epidemiological support for the role of reproductive factors in the incidence of PD. Whether surgical menopause is inversely associated with the risk of PD requires further explorations.

http://ift.tt/2uVyYy5

Effects of curcumin on short-term spatial and recognition memory, adult neurogenesis and neuroinflammation in a streptozotocin-induced rat model of dementia of Alzheimer’s type

Publication date: 29 September 2017
Source:Behavioural Brain Research, Volume 335
Author(s): Taysa B. Bassani, Joelle M. Turnes, Eric L.R. Moura, Jéssica M. Bonato, Valentín Cóppola-Segovia, Silvio M. Zanata, Rúbia M.M.W. Oliveira, Maria A.B.F. Vital
Curcumin is a natural polyphenol with evidence of antioxidant, anti-inflammatory and neuroprotective properties. Recent evidence also suggests that curcumin increases cognitive performance in animal models of dementia, and this effect would be related to its capacity to enhance adult neurogenesis. The aim of this study was to test the hypothesis that curcumin treatment would be able to preserve cognition by increasing neurogenesis and decreasing neuroinflammation in the model of dementia of Alzheimer's type induced by an intracerebroventricular injection of streptozotocin (ICV-STZ) in Wistar rats. The animals were injected with ICV–STZ or vehicle and curcumin treatments (25, 50 and 100mg/kg, gavage) were performed for 30days. Four weeks after surgery, STZ-lesioned animals exhibited impairments in short-term spatial memory (Object Location Test (OLT) and Y maze) and short-term recognition memory (Object Recognition Test – ORT), decreased cell proliferation and immature neurons (Ki-67- and doublecortin-positive cells, respectively) in the subventricular zone (SVZ) and dentate gyrus (DG) of hippocampus, and increased immunoreactivity for the glial markers GFAP and Iba-1 (neuroinflammation). Curcumin treatment in the doses of 50 and 100mg/kg prevented the deficits in recognition memory in the ORT, but not in spatial memory in the OLT and Y maze. Curcumin treatment exerted only slight improvements in neuroinflammation, resulting in no improvements in hippocampal and subventricular neurogenesis. These results suggest a positive effect of curcumin in object recognition memory which was not related to hippocampal neurogenesis.

http://ift.tt/2wl9AoY

Developmental suppression of forebrain trkA receptors and attentional capacities in aging rats: A longitudinal study

Publication date: 29 September 2017
Source:Behavioural Brain Research, Volume 335
Author(s): Brittney Yegla, Vinay Parikh
Basal forebrain (BF) cholinergic neurons innervating the cortex regulate cognitive, specifically attentional, processes. Cholinergic atrophy and cognitive decline occur at an accelerated pace in age-related neurodegenerative disorders such as Alzheimer's disease; however, the mechanism responsible for this phenomenon remains unknown. Here we hypothesized that developmental suppression of nerve growth factor signaling, mediated via tropomyosin-related kinase A (trkA) receptors, would escalate age-related attentional vulnerability. An adeno-associated viral vector expressing trkA shRNA (AAV-trkA) was utilized to knockdown trkA receptors in postnatal rats at an ontogenetic time point when cortical cholinergic inputs mature, and the impact of this manipulation on performance was assessed in animals maintained on an operant attention task throughout adulthood and until old (24 months) age. A within-subject comparison across different time points illustrated a gradual age-related decline in attentional capacities. However, the performance under baseline and distracted conditions did not differ between the AAV-trkA-infused and animals infused with a vector expressing shRNA against the control protein luciferase at any time point. Additional analysis of cholinergic measures conducted at 24 months showed that the capacity of cholinergic terminals to release acetylcholine following a depolarizing stimulus, cortical cholinergic fiber density and BF cholinergic cell size remained comparable between the two groups. Contrary to our predictions, these data indicate that developmental BF trkA disruption does not impact age-related changes in attentional functions. It is possible that life-long engagement in cognitive activity might have potentially rescued the developmental insults on the cholinergic system, thus preserving attentional capacities in advanced age.

http://ift.tt/2wl87PG

Elucidating the functions of brain GSK3α: Possible synergy with GSK3β upregulation and reversal by antidepressant treatment in a mouse model of depressive-like behaviour

Publication date: 29 September 2017
Source:Behavioural Brain Research, Volume 335
Author(s): Dmitrii Pavlov, Nataliia Markova, Lucien Bettendorff, Vladimir Chekhonin, Igor Pomytkin, Viktoria Lioudyno, Andrei Svistunov, Eugene Ponomarev, Klaus-Peter Lesch, Tatyana Strekalova
Glycogen synthase kinase 3 (GSK3) has been linked to the mechanisms of stress, mood regulation, and the effects of antidepressants. The functions of the GSK3β isoform have been extensively investigated, but little is known about the α-isoform, although they may functionally related. In a recently established modified swim test with a third delayed swim exposure, brain GSK3β mRNA expression positively correlated with floating behaviour on the third test. A two-week-long pretreatment regime with imipramine (7.5mg/kg/day) or thiamine (200mg/kg/day), which is known to have antidepressant properties, reduced the GSK3β over-expression and decreased floating behaviour on Day 5. GSK3α mRNA levels were measured in the hippocampus and prefrontal cortex on Days 1, 2 and 5. GSK3α expression was decreased in the prefrontal cortex on Day 2 and increased on Day 5. In this model, GSK3α mRNA changes were prevented by imipramine or thiamine treatment. There was a significant correlation between the expression of the two isoforms in the prefrontal cortex on Day 2 in untreated group. These results provide the first evidence for the potential involvement of GSK3α in depressive-like behaviours and as a target of anti-depressant therapy. Furthermore, the correlations suggest some cross-talk may exist between the two GSK3 isoforms.

http://ift.tt/2uVIbX6

Clinical multi-omics strategies for the effective cancer management

Publication date: Available online 15 August 2017
Source:Journal of Proteomics
Author(s): Byong Chul Yoo, Kyung-Hee Kim, Sang Myung Woo, Jae Kyung Myung
Cancer is a global health issue as a multi-factorial complex disease, and early detection and novel therapeutic strategies are required for more effective cancer management. With the development of systemic analytical -omics strategies, the therapeutic approach and study of the molecular mechanisms of carcinogenesis and cancer progression have moved from hypothesis-driven targeted investigations to data-driven untargeted investigations focusing on the integrated diagnosis, treatment, and prevention of cancer in individual patients. Predictive, preventive, and personalized medicine (PPPM) is a promising new approach to reduce the burden of cancer and facilitate more accurate prognosis, diagnosis, as well as effective treatment. Here we review the fundamentals of, and new developments in, -omics technologies, together with the key role of a variety of practical -omics strategies in PPPM for cancer treatment and diagnosis.Biological significanceIn this review, a comprehensive and critical overview of the systematic strategy for predictive, preventive, and personalized medicine (PPPM) for cancer disease was described in a view of cancer prognostic prediction, diagnostics, and prevention as well as cancer therapy and drug responses. We have discussed multi-dimensional data obtained from various resources and integration of multisciplinary –omics strategies with computational method which could contribute the more effective PPPM for cancer. This review has provided the novel insights of the current applications of each and combined -omics technologies, which showed their powerful potential for the establishment of PPPM for cancer

http://ift.tt/2ib58nd

Preventive effects of interleukin-6 in lipopolysaccharide/d-galactosamine induced acute liver injury via regulating inflammatory response in hepatic macrophages

Publication date: October 2017
Source:International Immunopharmacology, Volume 51
Author(s): Long Li, Chaoli Duan, Yan Zhao, Xiaofang Zhang, Hongyan Yin, Tianxi Wang, Caoxin Huang, Suhuan Liu, Shuyu Yang, Xuejun Li
Lipopolysaccharide/d-Galactosamine (LPS/d-Gal)-induced acute liver injury is characterized by significant inflammatory responses including TNF-α and interleukin-6 (IL-6) and is a widely applied experimental model for inflammation research. TNF-α is critical in the progression of LPS/d-Gal-induced liver injury. However, the role of IL-6 in this model is still unknown. In the present study, we aim to elucidate the involvement of IL-6 in the pathogenesis of acute liver injury induced by LPS/d-Gal in mice and its underlying mechanism. To induce acute liver injury, LPS (50μg/kg body weight) and d-Gal (400mg/kg body weight) were injected intraperitoneally in the C57BL/6 mice. The vehicle (saline) or a single dose of recombinant IL-6 (200μg/kg body weight) was administered 2h prior to LPS/d-Gal injection. Mice were sacrificed 2h and 6h after LPS/d-Gal injection. The results indicated that IL-6 treatment could protect mice from LPS/d-Gal-induced tissue damage, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation, as well as hepatocyte apoptosis and inflammation. Furthermore, in vitro study showed that IL-6 treatment could significantly suppress LPS-triggered expression of proinflammatory cytokines and chemokines, TNF-α, RANTES and MCP-1 in macrophages while promoting the expression of M2 markers, such as Arg-1 and Mrc-1 in macrophages. Taken together, these findings revealed a novel and unexpected role of IL-6 in ameliorating LPS/d-Gal-induced acute liver injury via regulating inflammatory responses in hepatic macrophages.

http://ift.tt/2vNtrLi

Activity-guided isolation and structural identification of immunomodulating substances from Pleurotus eryngii byproducts

Publication date: October 2017
Source:International Immunopharmacology, Volume 51
Author(s): Yanan Sun, Wenxiang Li
A two-step extraction process was used to investigate the bioactive substances from the byproducts of the fungus Pleurotus eryngii. Methanol extraction followed by extraction using different polar solvents coupled with silica column chromatography was carried out to separate the bioactive components. The immunomodulating activity of the extracts was investigated using Ana-1 mouse macrophage cells. At 25μg/mL, the butyl alcohol extract showed the highest enhancement of Ana-1 cell proliferative activity and secretion of cytokines. Using silica-gel column chromatography, the butyl alcohol extract was purified to seven elution fractions. Fr. 2 showed the highest promotion of Ana-1 macrophage cell proliferation and TNF-α, IL-6 secretion. HPLC-QTOF-MS/MS was used to determine the structure of the active substance in Fr. 2. Adenosine was identified as the primary active component in Fr. 2 with a chemical formula of C10H13N5O4. Adenosine may be useful as a natural immunostimulatory agent and anti-tumor agent.

http://ift.tt/2w6PPlh

Immunomodulatory effects of M2000 (β-D-Mannuronic acid) on TNF-α, IL-17 and FOXP3 gene expression in patients with inflammatory bowel disease

Publication date: October 2017
Source:International Immunopharmacology, Volume 51
Author(s): Hussaini Alhassan Mohammed, Ali Akbar Saboor-Yaraghi, Homayoun Vahedi, Mir Saeed Yekaninejad, Ghodratollah Panahi, Gholamreza Hemmasi, Mostafa Lakzaei, Abbas Mirshafiey
IntroductionInflammatory bowel diseases (IBD) are immune-mediated disorders that result from an aberrant immunological response to the gut luminal antigen in genetically susceptible patients. IBD is categorized into two serotype, Crohn's diseases (CD) and ulcerative colitis (UC), both subtype are important cause of gastrointestinal diseases. The increasing rate of hospitalization, with the high economic burden experienced by the IBD patients, calls for more concerted research efforts to design a potent and affordable treatment option for the treatment of http://ift.tt/2vNz7Fb research was designed to test the efficacy and potency of β-D Mannuronic acid (M2000) and assess if it could serve as a better therapeutic option in the treatment of IBD.MethodologyTen (10)ml of blood was aseptically collected into an EDTA container, from 24 IBD patients and 24 normal healthy controls. PBMC was isolated and stimulated with 1μg/ml of LPS in cell culture plate and incubated for 4h. The cells were later treated with 10μg/ml and 50μg/ml of β-D Mannuronic acid (M2000) and incubated for 24h at 37°C under 5% CO2 and 100% humidity. The RNA extractions, cDNA synthesis, and QRT-PCR were performed.ResultsOur findings showed a significant down-regulation of TNF-α and IL-17 gene expression, while the expression of FOXP3 gene was significantly up-regulated.ConclusionThis result has indicated that β-D Mannuronic acid (M2000) have immunoregulatory and anti-inflammatory effects on these cytokines that are pivotal in the pathogenesis of IBD.

http://ift.tt/2w70JaW

Corrigendum to “Functional quantum dot-siRNA nanoplexes to regulate chondrogenic differentiation of mesenchymal stem cells” [Acta Biomater. 46 (2016) 165–176]

Publication date: Available online 12 August 2017
Source:Acta Biomaterialia
Author(s): Yang Wu, Bo Zhou, Fuben Xu, Xiaoyong Wang, Gang Liu, Li Zheng, Jinmin Zhao, Xingdong Zhang

http://ift.tt/2v6syLF

Tissue-Specific Extracellular Matrix Promotes Myogenic Differentiation of Human Muscle Progenitor Cells on Gelatin and Heparin Conjugated Alginate Hydrogels

Publication date: Available online 17 August 2017
Source:Acta Biomaterialia
Author(s): Hualin Yi, Steven Forsythe, Yunyan He, Qiang Liu, Xiong Geng, Shicheng Wei, Guodong Li, Anthony Atala, Aleksander Skardal, Yuanyuan Zhang
Myogenic differentiation, cell fusion, and myotube formation of skeletal muscle progenitor cells (SMPCs) have key roles during skeletal muscle development and repair. However, after isolation from living tissue and transition to culture dishes, SMPCs gradually lose their function and stop propagating due to the absence of extracellular matrix (ECM). Despite encouraging results of experiments using ECM components in cell culture for maintenance and propagation of some tissue types, the benefits of this approach on SMPC culture are limited, because the bioactive molecules and proteins instantly release and are degraded during culture. In this study, we developed a novel approach to enhance the proliferation and differentiation of human skeletal muscle progenitor cells (hSMPCs) in vitro with skeletal muscle ECM in combination with a modified alginate hydrogel conjugated with gelatin and heparin (Alg-G-H) as a substrate. This Alg-G-H substrate, together with skeletal muscle ECM, significantly enhanced cell expansion, differentiation, and maturation of hSMPCs compared with individual substrata (i.e. gelatin, Matrigel^®, or ECM alone). In Western-blot and immunocytochemical analyses, the Alg-G-H-ECM predominantly enhanced expression of skeletal myogenesis markers (MyoD, Myf5, Myogenin, Desmin and Myosin) and myotube formation in hSMPCs. This study demonstrated that combining Alg-G-H substrates with skeletal muscle ECM modulated homeostasis of cell proliferation, differentiation, and maturation of hSMPCs by releasing signaling molecules and growth factors. This technique could be a cost-effective tool for in vitro skeletal muscle cell differentiation and maturation, with potential applications in tissue regeneration and drug development.Statement of SignificanceAlginate based biomaterials are commonly used in tissue engineering and regenerative medicine field, however, the inefficient sequestration of growth factors restricted its utilization. In this study, a novel alginate based substrates was produced covalently modified with gelatin and heparin, in order to capture more effective cytokines and proteins in the culture milieu, keep homeostasis for cell survival and tissue regeneration with growth factor sequestration and long-term release capacities. Combining with skeletal muscle derived ECM, the modified Alginate-Gelatin-Heparin gel could most effectively mimic the tissue specific microenvironment to support skeletal muscle progenitor cells proliferation, differentiation and myotube formation. Additionally, the economical and practical features will make it more promising in high-throughput application for regenerative medicine research.

Graphical abstract

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Study on the Mg-Li-Zn ternary alloy system with improved mechanical properties, good degradation performance and different responses to cells

Publication date: Available online 17 August 2017
Source:Acta Biomaterialia
Author(s): Yang Liu, Yuanhao Wu, Dong Bian, Shuang Gao, Sander Leeflang, Hui Guo, Yufeng Zheng, Jie Zhou
Novel Mg-(3.5, 6.5 wt.%)Li-(0.5, 2, 4 wt.%)Zn ternary alloys were developed as a new kind of biodegradable metallic materials with potential for stent applications. Their mechanical properties, degradation behavior, cytocompatibility and hemocompatibility were studied. These potential biomaterials showed higher ultimate tensile strength than those of previously reported binary Mg-Li alloys and ternary Mg-Li-X (X=Al, Y, Ce, Sc, Mn and Ag) alloys. Among the alloys studied, the Mg-3.5Li-2Zn and Mg-6.5Li-2Zn alloys exhibited comparable corrosion resistance in Hank's solution to pure magnesium and better corrosion resistance in a cell culture medium than pure magnesium. Corrosion products observed on the corroded surface were composed of Mg(OH)2, MgCO3 and Ca-free Mg/P inorganics and Ca/P inorganics. In vitro cytotoxicity assay revealed different behaviors of Human Umbilical Vein Endothelial Cells (HUVECs) and Human Aorta Vascular Smooth Muscle Cells (VSMCs) to material extracts. HUVECs showed increasing nitric oxide (NO) release and tolerable toxicity, whereas VSMCs exhibited limited decreasing viability with time. Platelet adhesion, hemolysis and coagulation tests of these Mg-Li-Zn alloys showed different degrees of activation behavior, in which the hemolysis of the Mg-3.5Li-2Zn alloy was lower than 5%. These results indicated the potential of the Mg-Li-Zn alloys as good candidate materials for cardiovascular stent applications.

Graphical abstract

http://ift.tt/2uNplFy

Smart activatable and traceable dual-prodrug for image-guided combination photodynamic and chemo-therapy

Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Fang Hu, Youyong Yuan, Duo Mao, Wenbo Wu, Bin Liu
Activatable photosensitizers (PSs) and chemo-prodrugs are highly desirable for anti-cancer therapy to reduce systemic toxicity. However, it is difficult to integrate both together into a molecular probe for combination therapy due to the complexity of introducing PS, singlet oxygen quencher, chemo-drug, chemo-drug inhibitor and active linker at the same time. To realize activatable PS and chemo-prodrug combination therapy, we develop a smart therapeutic platform in which the chemo-prodrug serves as the singlet oxygen quencher for the PS. Specifically, the photosensitizing activity and fluorescence of the PS (TPEPY-SH) are blocked by the chemo-prodrug (Mitomycin C, MMC) in the probe. Meanwhile, the cytotoxicity of MMC is also inhibited by the electron-withdrawing acyl at the nitrogen position next to the linker. Upon glutathione activation, TPEPY-S-MMC can simultaneously release active PS and MMC for combination therapy. The restored fluorescence of TPEPY-SH is also used to report the activation for both PS and MMC as well as to guide the photodynamic therapy.

http://ift.tt/2fPUoKg

Regulating cancer associated fibroblasts with losartan-loaded injectable peptide hydrogel to potentiate chemotherapy in inhibiting growth and lung metastasis of triple negative breast cancer

Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Chunhua Hu, Xiaoyu Liu, Wei Ran, Jia Meng, Yihui Zhai, Pengcheng Zhang, Qi Yin, Haijun Yu, Zhiwen Zhang, Yaping Li
Preoperative chemotherapy is effective in improving the prognosis of patients, but its efficacy is impeded by cancer associated fibroblasts (CAFs) that enhance the survival, growth, and metastasis of cancer cells. To inhibit the activity of CAFs, prolonged and localized drug exposure is necessary. Here, we report on the rational design, screening, and evaluation of an injectable peptide hydrogel as a local losartan depot aiming to inhibit CAFs and potentiate chemotherapy. We synthesized a set of peptide derivatives and found that C16-GNNQQNYKD-OH (C16-N) surpassed the others in hydrogel formation and drug encapsulation, due to its flexible hydrocarbon tail and interpeptide hydrogen bonding that allowed supramolecular self-assembly into long filaments with hydrophobic cores. C16-N co-assembled with losartan to form hydrogel from which losartan was sustainably released over 9 days. After intratumoral injection, the hydrogel could be retained in the tumor for more than 9 days, significantly inhibited the CAFs and collagen synthesis in orthotopic 4T1 tumors, and enhanced the efficacy of PEGylated doxorubicin-loaded liposomes (Dox-L) in inhibiting the tumor growth (64% vs. Dox-L alone) and lung metastasis (80% vs. Dox-L alone). These results provide important guiding principles for the rational design of injectable peptide hydrogels aiming to regulate CAFs and improve chemotherapy.

Graphical abstract

http://ift.tt/2iadsna

Role of Digital Breast Tomosynthesis in Screening and Diagnostic Breast Imaging

Publication date: Available online 14 August 2017
Source:Seminars in Ultrasound, CT and MRI
Author(s): Stamatia Destounis
Digital Breast Tomosynthesis (DBT) is quickly becoming the standard of care in breast cancer screening and diagnosis. Since its introduction to the clinical landscape in 2011, radiologists specializing in breast disease diagnosis around the country have made the decision to adopt the technology for both screening and diagnostic applications; with adoption growing substantially in present day. Users of the technology have attested to the benefits the technology affords, both in screening and the diagnostic evaluation of patients, through recent years of peer-reviewed publications and scientific presentations. This review article will describe the history of DBT and its implementation; from the early days of research, through Food and Drug Administration (FDA) approval, to integration into the clinical workflow, in the setting of screening and diagnostic evaluation.

http://ift.tt/2vI7jn8

Deciphering the breast density inform law movement: implications for practice

Publication date: Available online 14 August 2017
Source:Seminars in Ultrasound, CT and MRI
Author(s): Sean D. Raj, Valerie Fein-Zachary, Priscilla J. Slanetz
While dense breast tissue is a normal and routine finding on screening mammography, dense breast tissue is associated with an independent increased risk for breast cancer. It is well known that screening mammography has a decreased sensitivity for cancer detection in women with dense breasts. Over the past decade, there has been increased interest generated among patients, physicians, and legislators regarding how best to screen dense-breasted women culminating in 2009 with the passage of a breast density notification law in Connecticut. Since that time, over half the United States has passed similar notification laws. Despite this, controversy remains as to the optimal supplemental screening modality to complement mammography as each imaging modality (digital breast tomosynthesis, whole breast ultrasound, magnetic resonance imaging, contrast enhanced mammography, and molecular breast imaging) has variable benefits and limitations.

http://ift.tt/2wVgY8C

Role of anesthesiologist in the management of a child with cerebral palsy

Safiya Imtiaz Shaikh, Ganapati Hegade

Anesthesia: Essays and Researches 2017 11(3):544-549

Cerebral palsy (CP) refers to a spectrum of nonprogressive neurological disorders with disturbances in posture and movement, resulting from perinatal intrauterine insult to developing infant brain. Many conditions associated with CP require surgery. Such cases pose important gastrointestinal, respiratory, and other perioperative considerations. Anesthetic management in these cases is delicate. Intraoperative complications including hypovolemia, hypothermia, muscle spasms, seizures, and delayed recovery might complicate the anesthetic management. A thorough preanesthetic evaluation allows for a better intra- and post-operative care. Postoperative analgesia is important, particularly in orthopedic surgeries one for pain relief. This review highlights the clinical manifestations in CP and anesthetic considerations in such child presenting for various surgeries.

http://ift.tt/2wfjwB7

A comparative study for the analgesic efficacy and safety profile of fentanyl versus clonidine as an adjuvant to epidural ropivacaine 0.75% in lower abdominal surgeries

Shuchi Nigam, Shivani Rastogi, Amit Tyagi, Rajlakshmi Bhandari

Anesthesia: Essays and Researches 2017 11(3):692-696

Context: Different adjuvants are coadministered with local anesthetics to improve the speed of onset and duration of analgesia, and to reduce the dose, the selection of which is often left to the choice of an anesthesiologist. Aim: The aim of this study was to compare the analgesic efficacy and safety profile of fentanyl and clonidine as an adjuvant to epidural ropivacaine anesthesia. Setting and Design: With institutional ethical committee clearance, a prospective, randomized, placebo-controlled double-blind clinical study was conducted at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow. Material and Methods: Two groups with thirty patients each were randomly allocated to receive 15–20 ml of 0.75% ropivacaine with 75 μg clonidine or 15–20 ml of 0.75% ropivacaine with 75 μg fentanyl, respectively. Block characteristics such as onset of analgesia, maximum level of sensory blockade, complete motor blockade, hemodynamic, time to two-segment regressions, time for rescue analgesia, time to complete motor recovery, and side effects were analyzed. Results: Results showed that the onset of blockade is faster when fentanyl is used as additives. Time for two-segment regression was earlier in fentanyl group but time for rescue analgesia was longer in clonidine group. Statistical Analysis: Two groups were compared by Student's t-test and Chi-square test; ANOVA and significance of mean difference bet were done by Newman–Keuls test. Conclusion: Addition of clonidine to epidural ropivacaine provides superior analgesia than the addition of fentanyl to epidural ropivacaine without much difference in side effect profile.

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Laparoscopic cholecystectomy under segmental thoracic spinal anesthesia: A feasible economical alternative

Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal

Anesthesia: Essays and Researches 2017 11(3):781-783

Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial.We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient.We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml−1 mixed with 0.5 ml of fentanyl 50 μg ml−1. Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension,or pruritus during or after surgery. The patient was reviewed 2 days postoperatively in ward.The thoracic spinal anesthetia was performed easily in the patient.Some discomfort which was readily treated with 1mg midazolam and 20 mg ketamine intravenously.There was no neurological deficit and hemodynamic parameters were in normal range intra and post-operatively and recovery was uneventful. We used a narrow gauze (26G) spinal needle which minimized the trauma to the patient and the chances of PDPH, which was more if 16 or 18G epidural needle had been used and could have increased further if there have been accidental dura puncture. Also using spinal anesthesia was economical although it should be done cautiously as we are giving spinal anesthesia above the level of termination of spinal cord.

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A comparative study of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to laryngoscopy and endotracheal intubation

Ekta Ratnani, Om Prakash Sanjeev, Abhishek Singh, Manoj Tripathi, Hemant Kumar Chourasia

Anesthesia: Essays and Researches 2017 11(3):745-750

Background: Direct layngoscopy and endotracheal intubation is a noxious stimuli and induces sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients. Esmolol, Labetalol and Lignocaine attenuate these responses but are associated with side effects of bradycardia, hypotension etc. In lower doses, chances of these side effects are comparatively low. So we designed this prospective clinical trial to assess the efficacy of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to endotracheal intubation. Materials and Methods: Seventy-five consenting patients of ASA physical status I or II of age range 20 to 60 years, scheduled for different general surgical procedures were randomly assigned to one of the three groups; group ES, group LB and group LG. Participants of group ES, group LB and group LG was given esmolol HCL 0.5 mg/Kg, labetalol HCL 0.25 mg/kg and lignocaine HCL 1 mg/Kg body weight respectively. Outcome variables were HR, SBP, DBP, MAP and RPP. These variables were recorded just after intubation and thereafter at 1,3,5, 7 and 10 minutes of intubation. Results: There was no statistically significant difference regarding the demographic characteristics of the groups. Heart rate and systolic blood pressure was lower throughout the study period in labetalol group. But the values of study parameters were always higher than the baseline in esmolol and lignocaine group. Values of mean arterial pressure was slightly higher in labetalol group but it was much higher in two other groups throughout the study period. Diastolic blood pressure was higher in all the groups. Values of rate pressure product was higher during intubation and at 1minute after intubation in labetalol group but thereafter it was always lower than baseline values. Conclusion: Labetalol 0.25 mg Kg-1 is an effective and safe drug to be used for attenuation of sympathomimetic responses to endotracheal intubation. Esmolol 0.5 mg Kg-1 and lignocaine 1 mg Kg-1 are also effective to some extent and are safe.

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Nasogastric tube insertion in anesthetized intubated patients undergoing laparoscopic hysterectomies: A comparative study of three techniques

B S. Vijay Siddhartha, N G. Anish Sharma, Shashank Kamble, P Shankaranarayana

Anesthesia: Essays and Researches 2017 11(3):550-553

Background: Insertion of a nasogastric tube (NGT) in an anesthetized, comatose intubated patient is not always as easy as in a conscious, cooperative patient. Various techniques have been tried with varying success. The aim of this randomized study was to compare and evaluate the two techniques of NGT insertion with the conventional technique of insertion with respect to success rate, time taken for insertion and adverse effects. Materials and Methods: Patients admitted for laparoscopic hysterectomy were chosen and then were divided into three equal groups of forty each, by randomized technique. Group C included patients in whom conventional method was used to insert NGT. Group R where reverse Sellick's technique was used. Group F where neck flexion with lateral pressure was used. Results: Both the techniques were better than the conventional method. Among both the techniques, reverse Sellick's technique was the best method but not without adverse effects. The required insertion time was very less and success in the first attempt was more in the group where reverse Sellick's was used. Conclusion: Modified techniques of NGT insertion were better than the conventional method. Further studies after eliminating major limitations are required to really find a superior technique.

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Hyperparathyroid crisis: It's not all about calcium!

Abinash Patro, Rameez Riaz, Vansh Priya, Aruna Bharti

Anesthesia: Essays and Researches 2017 11(3):804-806

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Influence of addition of dexmedetomidine or fentanyl to bupivacaine lumber spinal subarachnoid anesthesia for inguinal hernioplasty

Ayman Eskander T Saadalla, Osama Yehia A Khalifa

Anesthesia: Essays and Researches 2017 11(3):554-557

Background: No drug, used as adjuvant to spinal bupivacaine, has yet been identified that specifically inhibits nociception without its associated side effects. Aim of the Work: The purpose of this study is to compare the efficacy of dexmedetomidine and fentanyl with spinal bupivacaine in inguinal hernioplasty. Patients and Methods: Sixty patients of inguinal hernioplasty were randomly allocated to one of three groups, Group C (n = 20) – the patients received 15 mg hyperbaric bupivacaine + 0.5 ml saline. Group D – (n = 20) the patients received 15 mg hyperbaric bupivacaine + 10 μg dexmedetomidine diluted with 0.5 ml saline. Group F (n = 20) – the patients received 15 mg hyperbaric bupivacaine + 25 μg fentanyl (0.5 ml). Onset, duration of anesthesia, degree of sedation, and side effects were recorded. Results: The onset of anesthesia was shorter in Groups D and F as compared with the control Group C, but it was shorter in Group D than in Group F. The duration of sensory and motor block was prolonged in Group D and F as compared with the control Group C, but it was longer in Group D than in Group F. The postoperative analgesic consumption in the first 24 h was lower in Groups D and F than in Group C, and it was lower in Group D than in Group F. Conclusion: Onset of anesthesia is more rapid and duration is longer with less need for postoperative analgesia in patients undergoing inguinal hernioplasty under spinal anesthesia with dexmedetomidine and fentanyl than those with spinal alone with tendency of dexmedetomidine to produce faster onset, longer duration, and less analgesic need than fentanyl with similar safety profile.

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A prospective, observational study to evaluate the role of gabapentin as preventive analgesic in thyroidectomy under general anesthesia

Vadakkoot Raghavan Hema, Konnanath Thekkethil Ramadas, Kannammadathy Poulose Biji, Suseela Indu, Aravind Arun

Anesthesia: Essays and Researches 2017 11(3):718-723

Background: Effective management of postoperative pain is a part of well-organized perioperative care, which helps in reduced morbidity and improved patient satisfaction. Preventive analgesia can reduce acute and chronic pain by blocking the noxious inputs to pain pathways, preventing sensitization. Studies have reported efficacy of gabapentin as a preventive analgesic in perioperative pain. In this study, we aimed to determine whether preoperative gabapentin reduced postoperative pain and tramadol consumption after thyroidectomy under general anesthesia. Materials and Methods: Sixty patients scheduled for thyroidectomy were allocated to two groups of thirty each for this prospective, observational study. Patients in Group A and Group B received oral gabapentin 600 mg (6 × 10−4 kg) and diazepam 10 mg (1 × 10−5 kg), respectively, 2 h prior to surgery. Tramadol was given as rescue analgesic for postoperative pain with a verbal rating score of two. The analgesic efficacy of preoperative gabapentin was assessed in terms of postoperative pain scores at rest or swallowing, time to first rescue analgesic, and total tramadol consumption for 24 h. Ramsay sedation score and side effects of drug were also looked into. Results: Postoperative pain scores and total tramadol consumption were significantly lower in Group A during 24 h (P = 0.00). Time to first rescue analgesic was significantly prolonged in Group A (P = 0.001). Side effects were comparable. Conclusion: Oral gabapentin is effective as a preventive analgesic in reducing postoperative pain and tramadol consumption after thyroidectomy under general anesthesia.

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A prospective comparative observational study of clinical efficacy of isobaric ropivacaine 0.75% with of isobaric bupivacaine 0.5% intrathecally in elective inguinal hernia repair surgeries

Shivam Bipin Parekh, Suchita Shailesh Parikh, Harsha Patel, Malini Mehta

Anesthesia: Essays and Researches 2017 11(3):561-566

Aims: To evaluate the efficacy of intrathecal isobaric Ropivacaine and its comparison with intrathecal isobaric Bupivacaine in elective inguinal hernia repair surgeries. Settings and Design: A prospective, randomized study was conducted in a tertiary care hospital with 80 patients of ASA grade I-III undergoing elective inguinal hernia repair surgery under spinal anaesthesia .Ethical committee clearance and written consent taken. The patients were randomly divided into two equal groups to the Ropivicaine group (Group R) and to theBupivicaine group (Group B). Parameters observed were onset and duration of sensory and motor block, maximum sensory level achieved degree of motor blockade, two segment regression, and haemodynamic changes. Results: The development of sensory block was faster with Isobaric Ropivicaine (12.1 ± 4.9 minutes) as than isobaric Bupivicaine (13.94 ± 4.52 minutes) but the difference was not statistically significant. Onset of Grade III Motor block was longer with Isobaric Ropivicaine (8.51 ± 3.39 minutes) as compared to isobaric Bupivicaine ( 8.51 ± 3.39 minutes), but the difference was not statistically significant. Time of Complete Sensory Regression was significantly shorter with Isobaric Ropivicaine (212.69 ± 27.31 minutes) with statistical significance. Time to complete motor recovery was significantly shorter in Ropivacaine group (253.38 ± 27.13 minutes)as compared to Bupivacaine group (258.55 ± 35.81min), with statistical significance.Time to achieve discharge criteria was relatively shorter with Isobaric Ropivicaine. Haemodynamic Parameters did not differ significantly in both the groups during the entire study period. Conclusion: Intrathecal administration of isobaric Ropivacaine (0.75%) 15 mg provides similar quality of spinal anaesthesia but of significantly shorter duration, maintaining similar hemodynamic stability and discharge criteria without significant adverse effects when compared to isobaric Bupivicaine (0.5%) 10 mg.

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Postoperative analgesic efficacy of bilateral transversus abdominis plane block in patients undergoing midline colorectal surgeries using ropivacaine: A randomized, double-blind, placebo-controlled trial

Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool

Anesthesia: Essays and Researches 2017 11(3):767-772

Background: Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine. Materials and Methods: Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial. Group A received TAP block with 20 ml of 0.2% ropivacaine on either side of the abdominal wall, and Group B received 20 ml of normal saline. The time to request for rescue analgesia, total analgesic consumption in 24 h, and satisfaction with the anesthetic technique were assessed. Results: The mean visual analog scale scores at rest and on coughing were higher in control group (P > 0.05). Time (min) to request for the first rescue analgesia was prolonged in study group compared to control group (P < 0.001). The total tramadol consumption in 24 h postoperatively was significantly high in control group (P < 0.001). Nausea/vomiting was more common in control group (P > 0.05). The level of satisfaction concerning postoperative pain control/anesthetic technique was higher in study group (P < 0.001). Conclusion: TAP block produces effective and prolonged postoperative analgesia in patients undergoing midline colorectal surgery. It is a technically simple block to perform with a high margin of safety. It produces a considerable reduction in mean intravenous postoperative tramadol requirements, reduction in postoperative pain scores, and increased time to first request for further analgesia, both at rest and on movement.

http://ift.tt/2x9pRuy

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Πέμπτη 17 Αυγούστου 2017

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