Publication date: Available online 9 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): T Mark Campbell, Bahareh Bahram Ghaedi, Elizabeth Tanjong Ghogomu, Vivian Welch
ObjectiveTo determine whether shoe lifts effectively treat leg length discrepancy (LLD)-associated morbidities in adults with common painful musculoskeletal conditions.Data SourcesTRIP, CENTRAL, PubMed, PEDro and National Guideline Clearinghouse databases. The search was performed in September 2017, limited to English-only, and had no time constraints.Study SelectionTwo reviewers independently determined study eligibility. Inclusion criteria were: (1) participants ≥18 years-old with musculoskeletal-related complaints and LLD, (2) a shoe lift intervention was used, and (3) the study reported on pain, function, range of motion, patient satisfaction, quality of life, or adverse events. Randomized controlled trials (RCTs), controlled intervention, cohort, before-and-after, case-series and case report studies were included. Three-hundred-and-nineteen articles were screened and nine guidelines reviewed.Data ExtractionWe extracted data pertaining to participant demographic characteristics, study setting, recruitment, randomization, method of LLD measurement, shoe lift characteristics, treatment duration, and outcome measures. We included ten studies, including one RCT.Data SynthesisLLD was associated with low back pain, scoliosis, and osteoarthritis of the hip and knee. Description of LLD correction strategy was often inadequate. Study quality was very low or poor. In non-RCT studies reporting on the proportion of participants who improved with a shoe lift, 88±3% of 349 participants treated had partial or complete pain relief (effect size range 66.7-100%). All 22 RCT participants receiving treatment experienced pain relief (mean pain reduction 27±9mm on a 150mm visual analogue scale). Two of nine guidelines recommended shoe lift use based on consensus, and were of moderate-to-high quality.ConclusionsThere is low-quality evidence that shoe lifts reduce pain and improve function in patients with LLD and common painful musculoskeletal conditions. High quality research evaluating a threshold LLD to correct and a strategy to do so is necessary. Developing an appropriate comparison group to test clinically-relevant outcome measures would make a valuable contribution in this regard.
http://ift.tt/2B10oJ3
Παρασκευή 8 Δεκεμβρίου 2017
Shoe Lifts for Leg Length Discrepancy in Adults with Common Painful Musculoskeletal Conditions: A Systematic Review of the Literature
Post procedural complications of cardiac implants done in a resource limited setting under ‘C’ arm: A single centre experience
Source:Medical Journal Armed Forces India
Author(s): A. Jayachandra, Vivek Aggarwal, Sandeep Kumar, I.V. Nagesh
BackgroundCardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm.MethodsThis study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities. Consecutive patients reporting to cardiology center, between Jan 2015 and Oct 2016, with a definite indication for cardiac device implant were included in the study. All the procedure of implantation was done in the operation theatre under 'C' arm under local anesthesia with continuous cardiac monitoring and critical care back up.ResultsTotal 58 device implantations were done from Jan 2015 to Oct 2016. The mean age of the patients was 67.15±10.85 years. Males constituted almost two third (68.9%) of patients. The commonest indication for device implantation was sinus node dysfunction in 60.34% followed by complete heart block in 25.86% and ventricular tachycardia in 12.06%. No post procedure infection was observed in our study.ConclusionDevice implantation constitute a major group of life saving interventions in cardiology practice. Our study has emphasised that when appropriate aseptic measures are taken during device implantation at peripheral centres, the complications rate are comparable to interventions done at advance cardiac centres.
http://ift.tt/2AGIwk3
Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC): A Review
Publication date: January 2018
Source:Neoplasia, Volume 20, Issue 1
Author(s): Bryan Oronsky, Patrick Ma, Tony R. Reid, Pedro Cabrales, Michelle Lybeck, Arnold Oronsky, Neil Oronsky, Corey A. Carter
As the leading cause of cancer-related mortality, lung cancer is a worldwide health issue that is overwhelmingly caused by smoking. However, a substantial minority (~25%) of patients with non–small cell lung cancer (NSCLC) has never smoked. In these patients, activating mutations of the epidermal growth factor receptor (EGFR) are more likely, which render their tumors susceptible for a finite period to treatment with EGFR tyrosine kinase inhibitors (TKIs) and confer a better prognosis than EGFR wild-type NSCLC. On progression, due to the inevitable insurgence of resistance, TKIs are generally followed by second- or third-line salvage chemotherapy until treatment failure, after which no standard treatment options are available, resulting in a poor prognosis and a high risk of death. With the focus of clinical attention on treatment with TKIs, few studies on optimal salvage therapies, including cytotoxic chemotherapy, after failure of EGFR TKIs have been reported. Despite a paucity of available data, the aim of this review is to summarize the "no-man's land" of TKI-failed EGFR-mutated NSCLC and expand on alternative strategies as well as potential future directions.
http://ift.tt/2y9vqt2
Health-related quality of life in elderly hearing aid users vs. non-users
Publication date: Available online 8 December 2017
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Eman A. Said
Background and aimPresbycusis, is usually a harbinger of aging. The negative consequences are not limited to an auditory impairment but influences a range of psychosocial and physical health concerns. The cornerstone of audiologic intervention is the use hearing aids. Optimal management should include an evaluation of quality of life (QoL) status and its assessment. Aim of this work: To quantify the quality of life of hearing impaired elderly individuals (HIEI) and to assess hearing aids impact on QoL.SubjectsElderly patients (1 2 7) above 60 years had sensorineural hearing loss ranged from mild to severe degree of hearing loss, only 24 of them (21.1%) were fitted with monaural hearing aid.MethodsEach subject of this study underwent basic audiologic evaluation, speech perception in noise, aided tonal sound field threshold and aided speech tests. Generic WHOQOL-BREF and hearing handicap inventory for the elderly (HHIE).ResultsThere were significant lower aided tonal sound field thresholds (ATSFTs) at 0.5, 1, 2 and 4 kHz of hearing aid users when compared with values of non-users at all tested frequencies. Hearing aid users perform better in all domains of WHO QOL-BREF with significant reductions in emotional, social and total scores of HHIE in users group compared with non-users indicated improvement in their QOL. There were no significant differences between scores of males and scores of females. The severity of the hearing loss had statistically significant effects on these scores for non-users but not in users group.
http://ift.tt/2kI8Iqx
Differential distribution patterns of Fonsecaea agents of chromoblastomycosis, exemplified by the first case due to F. monophora from Argentina
Publication date: Available online 8 December 2017
Source:Medical Mycology Case Reports
Author(s): Marcelo Label, Luciana C. Karayan, Sybren De Hoog, Javier Afeltra, Togo Bustamante, Roxana G. Vitale
Chromoblastomycosis is a mutilating infection of the skin and subcutaneous tissues caused by melanized fungi belonging to the order Chaetothyriales. Proven cases of the main agent, Fonsecaea pedrosoi are mainly limited to (sub)tropical, humid climates of Latin and Central America and the Caribbean. Fonsecaea monophora has a global distribution along the equator. Cases outside the (sub)tropics have thus far mostly been considered to have been imported, but here we report the first endemic case by F. monophora from Argentina. Patient was a 82-year-old rural female worker from Corrientes, a province with a dry continental climate.
http://ift.tt/2A6zMTo
Dosimetric effects of saline- versus water-filled balloon applicators for IORT using the model S700 electronic brachytherapy source
Source:Brachytherapy
Author(s): Gage Redler, Alistair Templeton, Heming Zhen, Julius Turian, Damian Bernard, James C.H. Chu, Katherine L. Griem, Yixiang Liao
PurposeThe Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT. However, Xoft recommends saline for balloon applicator filling. This study investigates dosimetric differences due to increased effective atomic number (Zeff) for saline (Zeff = 7.56) versus water (Zeff = 7.42).MethodsBalloon applicator diameters range from 3 to 6 cm. Monte Carlo N-Particle software is used to calculate dose at the surface (Ds) of and 1 cm away (D1cm) from the water-/saline-filled balloon applicator using a single dwell at the applicator center as a simple estimation of the dosimetry and multiple dwells simulating the clinical dose distributions for the atlas plans.ResultsSingle-dwell plans show a 4.4–6.1% decrease in Ds for the 3- to 6-cm diameter applicators due to the saline. Multidwell plans show similar results: 4.9% and 6.4% Ds decrease, for 4-cm and 6-cm diameter applicators, respectively. For the single-dwell plans, D1cm decreases 3.6–5.2% for the 3- to 6-cm diameter applicators. For the multidwell plans, D1cm decreases 3.3% and 5.3% for the 4-cm and 6-cm applicators, respectively.ConclusionsThe dosimetric effect introduced by saline versus water filling for Xoft balloon applicator–based IORT treatments is ∼5%. Users should be aware of this in the context of both treatment planning and patient outcome studies.
http://ift.tt/2iL1Y73
Outcomes of Spontaneous Isolated Superior Mesenteric Artery Dissection Without Antithrombotic Use
Publication date: Available online 8 December 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Hyangkyoung Kim, Hojong Park, Sang Jun Park, Bong Won Park, Jae Chol Hwang, Young Woo Seo, Hong Rae Cho
ObjectivesThis study aimed to show the intention to treat results of treatment for spontaneous isolated superior mesenteric artery dissection (SISMAD) without anticoagulation or antiplatelet agents and the follow-up results of SISMAD according to the configuration on computed tomography (CT) scans.DesignRetrospective, observational single centre studyMethodsAll cases of SISMAD were enrolled consecutively from 2006 onwards. There were 25 symptomatic and four asymptomatic patients in whom SISMAD was found incidentally. The SISMAD patients were treated using a consistent therapeutic strategy without antithrombotics. SISMAD was categorized into four types based on the configuration on CT scans by Yun's classification. Follow-up CT was performed at 3 months, 6 months, and yearly thereafter.ResultsThe median follow-up duration was 57 months (13–129 months). Improvement or complete resolution on CT scans, with no symptom recurrence, was seen in 27 patients. The non-invasive approach failed in three cases and two patients underwent further intervention. No patient died during the follow-up.ConclusionsWeighing the risks versus benefits of antithrombotics and considering the benign nature of SISMAD, conservative treatment without antithrombotics might be sufficient in patients without evidence of bowel ischaemia or infarction on initial CT scan.
http://ift.tt/2A84cEY
Association of HLA-DQB1*03:03 with pityriasis rosea in Chinese patients
Summary
Background
The association of human leucocyte antigen (HLA) with a variety of diseases has been described, especially with various autoimmune diseases. However, there are few studies on the association between HLA and pityriasis rosea (PR).
Aim
To investigate the relevance of HLA II alleles with the development of PR.
Methods
Typing for HLA-DRB1, HLA-DQA1 and HLA-DQB1 typing was performed in 55 patients with PR and 90 healthy controls (HCs), using sequence-based typing (SBT) and PCR with sequence-specific primers (PCR-SSP), respectively.
Results
We found that the frequency of HLA-DQB1*03:03 was significantly higher in the PR compared with the HC group [P = 0.001; relative risk (RR) = 2.24; 95% CI 1.38–3.6], while suggestive evidence for a protective effect of HLA-DQB1*06:06 was observed in the study cohort (P < 0.02; RR = 0.40; 95% CI 0.17–0.90).
Conclusions
The HLA-DQB1*03:03 allele may be a susceptible factor in patients with PR. In addition, the association of HLA-DQB1*03:03 with PR suggests participation of immunity in the pathogenesis of PR.
http://ift.tt/2yQM43S
Effects of acrylamide on oxidant/antioxidant parameters and CYP2E1 expression in rat pancreatic endocrine cells
Source:Acta Histochemica
Author(s): Jelena Marković, Milena Stošić, Danijela Kojić, Milica Matavulj
Oxidative stress is one of the principle mechanism of acrylamide-induced toxicity. Acrylamide is metabolized by cytochrome P450 2E1 (CYP2E1) to glycidamide or by direct conjugation with glutathione. Bearing in mind that up to now the effects of acrylamide on oxidative stress status and CYP2E1 level in endocrine pancreas have not been studied we performed qualitative and quantitative immunohistochemical evaluation of inducible nitric oxide synthase (iNOS), superoxide dismutase 1 (SOD1), superoxide dismutase 2 (SOD2), catalase (CAT) and CYP2E1 expression in islets of Langerhans of rats subchronically treated with 25 or 50mg/kg bw of acrylamide. Since the majority of cells (>80%) in rodent islets are beta cells, in parallel studies, we employed the Rin-5F beta cell line to examine effects of acrylamide on redox status and the activity of CAT, SOD and glutathione-S-transferase (GST), their gene expression, and CYP2E1, NF-E2 p45-related factor 2 (Nrf2) and iNOS expression. Immunohistochemically stained pancreatic sections revealed that acrylamide induced increase of iNOS and decrease of CYP2E1 protein expression, while expression of antioxidant enzymes was not significantly affected by acrylamide in islets of Langerhans. Analysis of Mallory-Azan stained pancreatic sections revealed increased diameter of blood vessels lumen in pancreatic islets of acrylamide-treated rats. Increase in the GST activity, lipid peroxidation and nitrite level, and decrease in GSH content, CAT and SOD activities was observed in acrylamide-exposed Rin-5F cells. Level of mRNA was increased for iNOS, SOD1 and SOD2, and decreased for GSTP1, Nrf2 and CYP2E1 in acrylamide-treated Rin-5F cells. This is the first report of the effects of acrylamide on oxidant/antioxidant parameters and CYP2E1 expression in pancreatic endocrine cells.
http://ift.tt/2AqQvos
Neurons and satellite glial cells in adult rat lumbar dorsal root ganglia express connexin 36
Source:Acta Histochemica
Author(s): E. Martha Pérez Armendariz, Monica Norcini, Beatriz Hernández-Tellez, Andrés Castell-Rodríguez, Cristina Coronel-Cruz, Raquel Guerrero Alquicira, Alexandra Sideris, Esperanza Recio-Pinto
Previous studies have shown that following peripheral nerve injury there was a downregulation of the gap junction protein connexin 36 (Cx36) in the spinal cord; however, it is not known whether Cx36 protein is expressed in the dorsal root ganglia (DRGs), nor if its levels are altered following peripheral nerve injuries. Here we address these aspects in the adult rat lumbar DRG. Cx36 mRNA was detected using qRT-PCR, and Cx36 protein was identified in DRG sections using immunohistochemistry (IHC) and immunofluorescence (IF). Double staining revealed that Cx36 co-localizes with both anti-β-III tubulin, a neuronal marker, and anti-glutamine synthetase, a satellite glial cell (SGC) marker. In neurons, Cx36 staining was mostly uniform in somata and fibers of all sizes and its intensity increased at the cell membranes. This labeling pattern was in contrast with Cx36 IF dots mainly found at junctional membranes in islet beta cells used as a control tissue. Co-staining with anti-Cx43 and anti-Cx36 showed that whereas mostly uniform staining of Cx36 was found throughout neurons and SGCs, Cx43 IF puncta were localized to SGCs. Cx36 mRNA was expressed in normal lumbar DRG, and it was significantly down-regulated in L4 DRG of rats that underwent sciatic nerve injury resulting in persistent hypersensitivity. Collectively, these findings demonstrated that neurons and SGCs express Cx36 protein in normal DRG, and suggested that perturbation of Cx36 levels may contribute to chronic neuropathic pain resulting from a peripheral nerve injury.
http://ift.tt/2jyNwA1
Neutrophil-lymphocyte ratio kinetics in patients with advanced solid tumours on phase I trials of PD-1/PD-L1 inhibitors
Source:European Journal of Cancer, Volume 89
Author(s): Malaka Ameratunga, Maxime Chénard-Poirier, Irene Moreno Candilejo, Manuel Pedregal, Andrew Lui, David Dolling, Caterina Aversa, Alvaro Ingles Garces, Joo Ern Ang, Udai Banerji, Stan Kaye, Hui Gan, Bernard Doger, Victor Moreno, Johann de Bono, Juanita Lopez
BackgroundAlthough the neutrophil-lymphocyte ratio (NLR) is prognostic in many oncological settings, its significance in the immunotherapy era is unknown. Mechanistically, PD-1/PD-L1 inhibitors may alter NLR. We sought to characterise NLR kinetics in patients with advanced solid tumours treated with PD-1/PD-L1 inhibitors.MethodsElectronic records of patients treated with PD-1/PD-L1 inhibitors on phase I trials across three sites were reviewed. A high NLR (hNLR) was predefined as >5. Univariate logistic regression models were used for toxicity, response analyses and Cox models for overall survival (OS) and progression-free survival analyses. Landmark analyses were performed (cycle two, three). Longitudinal analysis of NLR was performed utilising a mixed effect regression model.ResultsThe median OS for patients with hNLR was 8.5 months and 19.4 for patients with low NLR, (hazard ratio [HR] = 1.85, 95% confidence interval [CI] 1.15–2.96, p = 0.01). On landmark analysis, hNLR was significantly associated with inferior OS at all time points with a similar magnitude of effect over time (p < 0.05). On multivariate analysis, NLR was associated with OS (HR 1.06, 95% CI 1.01–1.11, p = 0.01). NLR did not correlate with increased immune toxicity. Longitudinally, NLR correlated with response: NLR decreased by 0.09 (95% CI: −0.15 to −0.02; p = 0.01) per month in responders compared with non-responders.ConclusionshNLR at baseline and during treatment is adversely prognostic in patients with advanced malignancies receiving PD-1/PD-L1 blockade. Importantly, NLR reduced over time in responders to immunotherapy. Taken together, these data suggest that baseline and longitudinal NLR may have utility as a unique biomarker to aid clinical decision-making in patients receiving immunotherapy.
http://ift.tt/2kf8Zh8
The use of breast imaging for predicting response to neoadjuvant lapatinib, trastuzumab and their combination in HER2-positive breast cancer: Results from Neo-ALTTO
Source:European Journal of Cancer, Volume 89
Author(s): S. Di Cosimo, C. Campbell, H.A. Azim, G. Galli, G. Bregni, G. Curigliano, C. Criscitiello, M. Izquierdo, L. de la Pena, D. Fumagalli, L. Fein, J. Vinholes, W.M.J. Ng, M. Colleoni, A. Ferro, B.J. Naume, A. Patel, J. Huober, M.J. Piccart-Gebhart, J. Baselga, E. de Azambuja
AimTo determine the value of mammography and breast ultrasound (US) in predicting outcomes in HER2 positive breast cancer patients (pts) within Neo-ALTTO trial.Patients and methodsMammography and US were required at baseline, week 6 and surgery. Two independent blinded investigators reviewed the measurements and assigned the corresponding response category. Pts showing complete or partial response according to RECIST (v1.1) were classified as responders. The association between imaging response at week 6 or prior to surgery was evaluated with respect to pathological complete response (pCR) and event-free Survival (EFS).ResultsOf the 455 pts enrolled in the trial, 267 (61%) and 340 (77%) had evaluable mammography and US at week 6; 248 (56%) and 309 (70%) pts had evaluable mammography and US prior to surgery. At week 6, 32% and 43% of pts were classified as responders by mammography and US, respectively. pCR rates were twice as high for responders than non-responders (week 6: 46% versus 23% by US, p < 0.0001; 41% versus 24% by mammography, p = 0.007). Positive and negative predictive values of mammography and US prior to surgery were 37% and 35%, and 82% and 70%, respectively. No significant correlation was found between response by mammography and/or US at week 6/surgery and EFS.ConclusionsMammography and US were underused in Neo-ALTTO although US had the potential to assess early response whereas mammography to detect residual disease prior to surgery. Our data still emphasise the need for further imaging studies on pts treated with neoadjuvant HER2-targeted therapy.
http://ift.tt/2BkyfNU
Comparing granulocyte colony–stimulating factor filgrastim and pegfilgrastim to its biosimilars in terms of efficacy and safety: A meta-analysis of randomised clinical trials in breast cancer patients
Source:European Journal of Cancer, Volume 89
Author(s): Edoardo Botteri, Andriy Krendyukov, Giuseppe Curigliano
BackgroundGranulocyte colony–stimulating factors (G-CSFs) are widely used to prevent neutropenia in cancer patients undergoing myelosuppressive chemotherapy. Several biosimilar medicines of G-CSF are now available, with their development involving a step-wise series of comparisons to demonstrate similarity to reference biologics. Randomised clinical trials (RCTs) are considered confirmatory, and for G-CSF biosimilars, patients with breast cancer (BC) undergoing myelosuppressive chemotherapy are the most sensitive population in which to confirm similarity. This meta-analysis aimed to compare the clinical efficacy and safety of approved or proposed G-CSF biosimilars (filgrastim or pegfilgrastim) with reference G-CSF in patients with BC.MethodsA Medline literature search up to March 2017 identified RCTs comparing biosimilar G-CSF to reference in BC patients. The primary efficacy end-point was mean difference in duration of severe neutropenia (DSN). Secondary efficacy end-points were differences in depth of absolute neutrophil count (ANC) nadir, time to ANC recovery and incidence of febrile neutropenia. Safety analyses included calculation of risk ratios for bone pain events, myalgia events and serious adverse events. Random effect models were fitted to obtain the pooled estimates of the mean difference for continuous outcomes and the risk ratio for dichotomous outcomes and their corresponding 95% confidence intervals (CIs).FindingsEight eligible RCTs were included in this meta-analysis. Overall difference in DSN between reference and biosimilar medicines was not statistically significant (0·06 d [95% CI −0·05, 0·17]). The analysis of secondary efficacy end-points showed no significant differences between reference biologics and biosimilar medicines, as well as the analysis of bone pain events, myalgia events and serious adverse events.
http://ift.tt/2kbKeCo
Positron emission tomography/computed tomography evaluation of oncolytic virus therapy efficacy in melanoma
Source:European Journal of Cancer
Author(s): Viola Franke, Bernies van der Hiel, Bart A. van de Wiel, Willem M.C. Klop, Sylvia ter Meulen, Alexander C.J. van Akkooi
http://ift.tt/2BmmW7N
Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitian Nutritionists
Publication date: Available online 22 November 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Denise Andersen, Shari Baird, Tracey Bates, Denise L. Chapel, Alana D. Cline, Shyamala N. Ganesh, Margaret Garner, Barbara L. Grant, Kathryn K. Hamilton, Krista Jablonski, Sherri L. Jones, Alexandra G. Kazaks, Susan H. Konek, Kelly K. Leonard, Kimi G. McAdam, Beth N. Ogata, Egondu M. Onuoha, Gretchen Y. Robinson, Darrin W. Schmidt, Nancy G. Walters, Pauline Williams, Pamela Wu, Karen Hui, Carol Gilmore, Mujahed Khan, Dana Buelsing, Sharon M. McCauley
Registered dietitian nutritionists (RDNs) face complex situations every day. Competently addressing the unique needs of each situation and applying standards appropriately are essential to providing safe, timely, patient-/client-/customer-centered, quality nutrition and dietetics care and services. The Academy of Nutrition and Dietetics (Academy) leads the profession by developing standards that can be used by RDNs (who are credentialed by the Commission on Dietetic Registration) for self-evaluation to assess quality of practice and performance. The Standards of Practice reflect the Nutrition Care Process and workflow elements as a method to manage nutrition care activities with patients/clients/populations that include nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention/plan of care, nutrition monitoring and evaluation, and discharge planning and transitions of care. The Standards of Professional Performance consist of six domains of professional performance: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The Academy's Revised 2017 Standards of Practice and Standards of Professional Performance for RDNs, along with the Academy's Code of Ethics and the Revised 2017 Scope of Practice for the RDN, provide minimum standards and tools for demonstrating competence and safe practice and are used collectively to gauge and guide an RDN's performance in nutrition and dietetics practice.
http://ift.tt/2Bj6m8R
Food Insecurity and the Nutrition Care Process: Practical Applications for Dietetics Practitioners
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Marianna S. Wetherill, Kayla Castleberry White, Christine Rivera
http://ift.tt/2kanliC
December 2017 Classified Advertisements
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2kbxqfl
Table of Contents
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2Bj5P6R
What's New Online
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2kcGwYY
Consider Making Public Policy a Part of Your New Year
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Donna S. Martin
http://ift.tt/2Bj9Hox
Prevalence of and Differences in Salad Bar Implementation in Rural Versus Urban Arizona Schools
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Michelle Blumenschine, Marc Adams, Meg Bruening
BackgroundRural children consume more calories per day on average than urban children, and they are less likely to consume fruit. Self-service salad bars have been proposed as an effective approach to better meet the National School Lunch Program's fruit and vegetable recommendations. No studies have examined how rural and urban schools differ in the implementation of school salad bars.ObjectiveTo compare the prevalence of school-lunch salad bars and differences in implementation between urban and rural Arizona schools.DesignSecondary analysis of a cross-sectional web-based survey.Participants/settingSchool nutrition managers (N=596) in the state of Arizona.Main outcomes measuredNational Center for Education Statistics locale codes defined rural and urban classifications. Barriers to salad bar implementation were examined among schools that have never had, once had, and currently have a school salad bar. Promotional practices were examined among schools that once had and currently have a school salad bar.Statistical analyses performedGeneralized estimating equation models were used to compare urban and rural differences in presence and implementation of salad bars, adjusting for school-level demographics and the clustering of schools within districts.ResultsAfter adjustment, the prevalence of salad bars did not differ between urban and rural schools (46.9%±4.3% vs 46.8%±8.5%, respectively). Rural schools without salad bars more often reported perceived food waste and cost of produce as barriers to implementing salad bars, and funding was a necessary resource for offering a salad bar in the future, as compared with urban schools (P<0.05). No other geographic differences were observed in reported salad bar promotion, challenges, or resources among schools that currently have or once had a salad bar.ConclusionsAfter adjustment, salad bar prevalence, implementation practices, and concerns are similar across geographic settings. Future research is needed to investigate methods to address cost and food waste concerns in rural areas.
http://ift.tt/2Bj1H6I
VegPlate: A Mediterranean-Based Food Guide for Italian Adult, Pregnant, and Lactating Vegetarians
Publication date: Available online 21 November 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Luciana Baroni, Silvia Goggi, Maurizio Battino
http://ift.tt/2keYYAy
Prepare for a New Year with Real Solutions You Can Use
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Barbara Jirka, Corey Holland
http://ift.tt/2Bk22WK
From Neighborhood to Genome: Three Decades of Nutrition-Related Research from the Atherosclerosis Risk in Communities Study
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Margaret R. Savoca, Lyn M. Steffen, Alain G. Bertoni, Lynne E. Wagenknecht
http://ift.tt/2kbqO0s
Dietary Energy Density in the Australian Adult Population from National Nutrition Surveys 1995 to 2012
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Amanda Lee Grech, Anna Rangan, Margaret Allman-Farinelli
BackgroundIt is hypothesized that the observed proliferation of energy-dense, nutrient-poor foods globally is an important contributing factor to the development of the obesity epidemic. However, evidence that the population's dietary energy density has increased is sparse. The World Cancer Research Fund recommends that dietary energy density be <1.25 kcal/g to prevent weight gain.ObjectiveThe aim of this research was to determine whether the dietary energy density of the Australian population has changed between 1995 and 2012.DesignA secondary analysis of two cross-sectional Australian national nutrition surveys from 1995 and 2011/2012 was conducted.Participants/settingParticipants of the surveys included adults aged 18 years and older (1995 n=10,986 and 2011/2012 n=9,435) completing 24-hour dietary recalls, including a second recall for a subset of the population (10.4% in 1995 and 64.6% in 2011/2012).Main outcome measuresOutcome measures included the change in dietary energy density (calculated as energy/weight of food [kcal/g] for food only) between surveys.Statistical analysisThe National Cancer Institute method for "estimating ratios of two dietary components that are consumed nearly every day" was used to determine the usual distribution and the percentage of participants reporting energy density <1.25 kcal/g.ResultsThe mean (standard deviation) dietary energy density was 1.59 (0.26) kcal/g and 1.64 (0.32) kcal/g (P<0.0001) in 1995 and 2011/2012, respectively, with 13% and 5% (P<0.0001) of the population meeting dietary energy-density recommendations. For those aged 70 years and older, the percentage with energy density <1.25 kcal/g decreased from 22% to 6% (P<0.0001) for men and from 33% to 11% (P<0.0001) for women in 1995 and 2011/2012, respectively. Among those aged 18 to 29 years, 1% of men in both surveys (P=0.8) and 4% of women in 1995 and 2% in 2011/2012 (P=0.01) reported energy density <1.25 kcal/g.ConclusionsDietary energy density has increased between the two surveys and few people consumed low energy-dense diets in line with recommendations. The change was largely due to increased energy density of older adult's diets, while young adults had high dietary energy density at both time points. These data suggest efforts now focus on the evaluation of the role of modifying energy density of the diet to reduce the risk of weight gain in adults.
http://ift.tt/2BlmzKT
Use of Added Sugars Instead of Total Sugars May Improve the Capacity of the Health Star Rating System to Discriminate between Core and Discretionary Foods
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Hannah Menday, Bruce Neal, Jason H.Y. Wu, Michelle Crino, Surinder Baines, Kristina S. Petersen
BackgroundThe Australian Government has introduced a voluntary front-of-package labeling system that includes total sugar in the calculation.ObjectiveOur aim was to determine the effect of substituting added sugars for total sugars when calculating Health Star Ratings (HSR) and identify whether use of added sugars improves the capacity to distinguish between core and discretionary food products.DesignThis study included packaged food and beverage products available in Australian supermarkets (n=3,610). The product categories included in the analyses were breakfast cereals (n=513), fruit (n=571), milk (n=309), non-alcoholic beverages (n=1,040), vegetables (n=787), and yogurt (n=390). Added sugar values were estimated for each product using a validated method. HSRs were then estimated for every product according to the established method using total sugar, and then by substituting added sugar for total sugar. The scoring system was not modified when added sugar was used in place of total sugar in the HSR calculation. Products were classified as core or discretionary based on the Australian Dietary Guidelines. To investigate whether use of added sugar in the HSR algorithm improved the distinction between core and discretionary products as defined by the Australian Dietary Guidelines, the proportion of core products that received an HSR of ≥3.5 stars and the proportion of discretionary products that received an HSR of <3.5 stars, for algorithms based upon total vs added sugars were determined.ResultsThere were 2,263 core and 1,347 discretionary foods; 1,684 of 3,610 (47%) products contained added sugar (median 8.4 g/100 g, interquartile range=5.0 to 12.2 g). When the HSR was calculated with added sugar instead of total sugar, an additional 166 (7.3%) core products received an HSR of ≥3.5 stars and 103 (7.6%) discretionary products received a rating of ≥3.5 stars. The odds of correctly identifying a product as core vs discretionary were increased by 61% (odds ratio 1.61, 95% CI 1.26 to 2.06; P<0.001) when the algorithm was based on added compared to total sugars.ConclusionsIn the six product categories examined, substitution of added sugars for total sugars better aligned the HSR with the Australian Dietary Guidelines. Future work is required to investigate the impact in other product categories.
http://ift.tt/2kbPmGt
December 2017 Sites in Review
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
http://ift.tt/2BkcldE
Gardening Experience Is Associated with Increased Fruit and Vegetable Intake among First-Year College Students: A Cross-Sectional Examination
Publication date: Available online 1 December 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jennifer Loso, Daniel Staub, Sarah E. Colby, Melissa D. Olfert, Kendra Kattelmann, Melissa Vilaro, James Colee, Wenjun Zhou, Lisa Franzen-Castle, Anne E. Mathews
BackgroundGardening interventions have been shown to increase fruit and vegetable (F/V) intake among school-aged children. It is unknown whether these effects persist into later adolescence or adulthood, and little is known about whether gardening in later adolescence is related to F/V intake.ObjectiveTo identify the relationship between both childhood and recent (within the past 12 months) gardening experiences and current F/V intake among college students.Design/participantsA cross-sectional evaluation of 1,121 college freshmen with suboptimal F/V consumption from eight US universities.Main outcome measuresParticipants completed the National Cancer Institute Fruit and Vegetable Screener and questions about gardening experiences. Respondents were grouped as having gardened or not gardened during childhood and recently.Statistical analyses performedA linear mixed model was used to evaluate the relationship between childhood and recent gardening and current F/V intake.ResultsOf the student participants, 11% reported gardening only during childhood, 19% reported gardening only recently, 20% reported gardening both as a child and recently, and 49% of students reported never having gardened. Students who gardened both during childhood and recently had a significantly higher mean current intake of F/V compared with students who never gardened (2.5±0.6 vs 1.9±0.5 cup equivalents [CE], respectively; P<0.001). In addition, F/V intake increased with frequency of recent gardening engagement when comparing students who did not garden with those who gardened monthly or weekly (2.1±0.5 CE, 2.4±0.6 CE, and 2.8±0.7 CE, respectively; P<0.001).ConclusionsThis analysis suggests that the combination of childhood and recent gardening experience is associated with greater current F/V intake among first-year college students not currently meeting national F/V recommendations. In addition, a greater frequency of gardening experience may further enhance this effect.
http://ift.tt/2kdTB4u
Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers’ Perspectives
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): Dipti A. Dev, Virginia Carraway-Stage, Daniel J. Schober, Brent A. McBride, Car Mun Kok, Samantha Ramsay
BackgroundNational childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited.ObjectiveUsing the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years).DesignUsing a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached.Participants/settingThe study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois.Main outcome measureChild-care providers' perspectives regarding implementation of NE.Statistical analyses performedThematic analysis to derive themes using NVivo software.ResultsThree overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods.ConclusionsPresent study findings offer insights regarding providers' perspectives on implementing NE in child care. Drawing from these perspectives, registered dietitian nutritionists can train providers about the importance of NE for encouraging healthy eating in children, integrating NE with mealtime conversations, and practicing low-cost, hands-on NE activities that meet the food safety standards for state licensing. Such strategies may improve providers' ability to deliver NE in child-care settings.
http://ift.tt/2BlIyRO
Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Denise Andersen, Shari Baird, Tracey Bates, Denise L. Chapel, Alana D. Cline, Shyamala N. Ganesh, Margaret Garner, Barbara L. Grant, Kathryn K. Hamilton, Krista Jablonski, Sherri L. Jones, Alexandra G. Kazaks, Susan H. Konek, Kelly K. Leonard, Kimi G. McAdam, Beth N. Ogata, Egondu M. Onuoha, Gretchen Y. Robinson, Darrin W. Schmidt, Nancy G. Walters, Pauline Williams, Pamela Wu, Karen Hui, Carol Gilmore, Mujahed Khan, Dana Buelsing, Sharon M. McCauley
The Academy of Nutrition and Dietetics (Academy) is the world's largest organization of food and nutrition professionals and the association that represents credentialed nutrition and dietetics practitioners—registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs). RDNs integrate research, professional development, and practice to stimulate innovation and discovery; collaborate to solve the greatest food and nutrition challenges now and in the future; focus on systemswide impact across the food, wellness, and health sectors; have a global impact in eliminating all forms of malnutrition; and amplify the contribution of nutrition and dietetics practitioners and expand workforce capacity and capability. The Revised 2017 Scope of Practice for the RDN reflects the position of the Academy on the essential role of the RDN in the direction and delivery of food and nutrition services. The scope of practice for the RDN is composed of education and credentialing, practice resources, Academy Standards of Practice and Professional Performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, and organizational policy and procedures. The Revised 2017 Scope of Practice for the RDN is used in conjunction with the Revised 2017 Standards of Practice (SOP) in Nutrition Care and the Standards of Professional Performance (SOPP) for RDNs. The SOP address activities related to direct patient and client care. The SOPP address behaviors related to the professional role of RDNs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for RDNs. A companion document addresses the scope of practice for the NDTR.
http://ift.tt/2ke6oUn
Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States
Publication date: December 2017
Source:Journal of the Academy of Nutrition and Dietetics, Volume 117, Issue 12
Author(s): David H. Holben, Michelle Berger Marshall
It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.
http://ift.tt/2Bjql7t
Presurgical language mapping using event-related high-gamma activity: The Detroit procedure
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Toshimune Kambara, Sandeep Sood, Zahraa Alqatan, Christine Klingert, Diksha Ratnam, Akane Hayakawa, Yasuo Nakai, Aimee F. Luat, Rajkumar Agarwal, Robert Rothermel, Eishi Asano
A number of investigators have reported that event-related augmentation of high-gamma activity at 70–110 Hz on electrocorticography (ECoG) can localize functionally-important brain regions in children and adults who undergo epilepsy surgery. The advantages of ECoG-based language mapping over the gold-standard stimulation include: (i) lack of stimulation-induced seizures, (ii) better sensitivity of localization of language areas in young children, and (iii) shorter patient participant time. Despite its potential utility, ECoG-based language mapping is far less commonly practiced than stimulation mapping. Here, we have provided video presentations to explain, point-by-point, our own hardware setting and time–frequency analysis procedures. We also have provided standardized auditory stimuli, in multiple languages, ready to be used for ECoG-based language mapping. Finally, we discussed the technical aspects of ECoG-based mapping, including its pitfalls, to facilitate appropriate interpretation of the data.
http://ift.tt/2iFwsaD
Human subthalamic oscillatory dynamics following somatosensory stimulation
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Saskia Elben, Carlos Trenado, Jan Vesper, Alfons Schnitzler, Lars Wojtecki
ObjectiveElectrical median nerve somatosensory stimulation leads to a distinct modulation of cortical oscillations. Initial high frequency and gamma augmentation, as well as modulation of beta and alpha oscillations have been reported. We aimed at investigating the involvement of the subthalamic nucleus in somatosensory processing by means of local field potential recordings, since recordings during passive movements and peripheral somatosensory stimulation have suggested a prominent role.MethodsRecordings of subthalamic neuronal activity following median nerve stimulation in 11 Parkinson's disease patients were performed. Time-frequency analysis from 1 to 500 Hz was averaged and analyzed.ResultsSeveral oscillatory components in response to somatosensory stimulation were revealed in the time-frequency analysis: (I) prolonged increase in alpha band power, followed by attenuation; (II) initial suppression of power followed by a subsequent rebound in the beta band; (III) early broad-frequency increase in gamma band power; (IV) and sustained increase of 160 Hz frequency oscillations throughout the trial.ConclusionsThese results further corroborate the involvement of the subthalamic nucleus in somatosensory processing.SignificanceThe present results not only support the notion of somatosensory processing in the subthalamic nucleus. Moreover, an improvement of somatosensory processing during subthalamic deep brain stimulation in Parkinson's disease might be accounted for by enhancement of prevailing high frequency oscillations.
http://ift.tt/2yP31vB
Erol Başar, 1938–2017
Source:Clinical Neurophysiology
Author(s): Bahar Güntekin, Görsev Yener, Ahmet Ademoğlu, Tamer Demiralp, Canan Başar-Eroğlu
http://ift.tt/2iIe0OR
Abnormal functional connectivity of high-frequency rhythms in drug-naïve schizophrenia
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Tetsuya Takahashi, Takashi Goto, Sou Nobukawa, Yuji Tanaka, Mitsuru Kikuchi, Masato Higashima, Yuji Wada
ObjectiveThe "dysconnection hypothesis" has been proposed as a core neural basis for schizophrenia. Although growing neuroimaging-based evidence suggests atypical functional connectivity in patients with schizophrenia, the results are inconsistent and the effects of antipsychotic treatment remain elusive.MethodsWe performed resting-state electroencephalography (EEG) in 21 drug-naïve patients with schizophrenia (14 patients were re-evaluated after administration of antipsychotic treatment) and 31 age-matched healthy control subjects. We estimated functional connectivity, using the phase lag index (PLI), which captures the true synchronization of EEG signals.ResultsThe patients had reduced functional connectivity of the beta band across frontal regions and of the gamma band throughout the scalp when compared to the control subjects. In the schizophrenia group, symptom severity did not seem associated with functional connectivity. Antipsychotic treatment led to no alterations in functional connectivity.ConclusionsSynchronous activity within and across brain areas over multiple frequencies reflect the integration of various types of information processing. Our findings of abnormal frequency- and region-specific functional connectivity patterns may provide further insight into the "dysconnection hypothesis" of schizophrenia.SignificanceThe PLI may serve as a useful measure for the characterization and understanding of the intrinsic pathophysiological mechanisms of schizophrenia, and as a reliable biomarker for this disease.
http://ift.tt/2yPW79x
Cramps frequency and severity are correlated with small and large nerve fiber measures in type 1 diabetes
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Alon Abraham, Carolina Barnett, Leif E. Lovblom, Bruce A. Perkins, Vera Bril, Hans D. Katzberg
ObjectivesTo explore the correlations between different muscle cramp characteristics including cramp frequency and severity and clinical and large and small nerve fiber measures in patients with diabetes type 1 (DM 1) and 2 (DM 2).MethodsProspective cross sectional study of healthy controls and patients with DM 1 and DM 2 recruited between April 2009 and November 2012. Participants underwent clinical evaluation and large and small nerve fiber studies, and the frequency and correlations of muscle cramps were explored.Results37 controls, 51 patients with DM 1, and 69 patients with DM 2 were studied. Muscle cramps were the most frequent symptom captured by the Toronto Clinical Neuropathy Score (TCNS) in all groups, up to 78% in patients with DM 2. In patients with DM 1, but not DM 2, muscle cramp frequency and severity were correlated with clinical (TCNS) and both large (electrophysiology and vibration perception thresholds) and small nerve fiber measures.ConclusionsMuscle cramps are frequent in diabetes and are correlated with clinical and both small and large nerve fiber measures in DM 1, suggesting that their origin and propagation might extend beyond the motor nerve.SignificanceMuscle cramps correlate with nerve fiber measures in DM 1.
http://ift.tt/2iJmS6C
Clinical features of otolith organ-specific vestibular dysfunction
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Chisato Fujimoto, Sayaka Suzuki, Makoto Kinoshita, Naoya Egami, Keiko Sugasawa, Shinichi Iwasaki
ObjectiveTo elucidate the clinical features and vestibular symptoms of patients with otolith organ dysfunction in the presence of normal function of the semicircular canals.MethodsWe reviewed the clinical records of 277 consecutive new patients with balance disorders who underwent testing of cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) as well as caloric testing and video head impulse testing (vHIT).ResultsWe identified 76 patients who showed normal caloric responses and normal vHIT findings in each SCC plane, but abnormal responses in cVEMP and/or oVEMP testing. Benign paroxysmal positional vertigo (BPPV) was the most common diagnosis. 37% of patients could not be categorized into any of the established clinical entities that could cause a balance disorder and did not show sensorineural hearing loss. The most common clinical manifestation in the idiopathic cases was recurrent rotatory vertigo with a duration of 1–12 h.ConclusionsThe most common diagnosis of otolith organ-specific vestibular dysfunction was BPPV. The most common clinical manifestation in the idiopathic cases was recurrent rotatory vertigo.SignificanceSpecific dysfunction of the otolith organs occurs in association with some of the undiagnosed patients with recurrent rotatory vertigo.
http://ift.tt/2iIdSPn
What is the optimal frequency range for quantifying slow EEG activity in neonates? Insights from power spectra
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Simon Finnigan, Paul B. Colditz
http://ift.tt/2kC389c
Four-dimensional map of the human early visual system
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Yasuo Nakai, Akari Nagashima, Akane Hayakawa, Takuya Osuki, Jeong-won Jeong, Ayaka Sugiura, Erik C. Brown, Eishi Asano
ObjectiveWe generated a large-scale, four-dimensional map of neuronal modulations elicited by full-field flash stimulation.MethodsWe analyzed electrocorticography (ECoG) recordings from 63 patients with focal epilepsy, and delineated the spatial-temporal dynamics of visually-elicited high-gamma70-110 Hz amplitudes on a standard brain template. We then clarified the neuronal events underlying visual evoked potential (VEP) components, by correlating with high-gamma amplitude measures.ResultsThe medial-occipital cortex initially revealed rapid neural activation followed by prolonged suppression, reflected by augmentation of high-gamma activity lasting up to 100 ms followed by attenuation lasting up to 1000 ms, respectively. With a number of covariate factors incorporated into a prediction model, the eccentricity representation independently predicted the magnitude of post-activation suppression, which was more intense in regions representing more parafoveal visual fields compared to those of more peripheral fields. The initial negative component on VEP was sharply contoured and co-occurred with early high-gamma augmentation, whose offset then co-occurred with a large positive VEP peak. A delayed negative VEP peak was blunt and co-occurred with prolonged high-gamma attenuation.ConclusionsEccentricity-dependent gradient in neural suppression in the medial-occipital region may explain the functional difference between peripheral and parafoveal/central vision. Early negative and positive VEP components may reflect neural activation, whereas a delayed negative VEP peak reflecting neural suppression.SignificanceOur observation provides the mechanistic rationale for transient scotoma or mild flash-blindness, characterized by physiological afterimage preferentially formed in central vision following intense but non-injurious light exposure.
http://ift.tt/2y8K6bz
Short-term intraindividual variability of the posterior dominant alpha frequency in the electroencephalogram
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): A. Khan, W. Paulus, C. Stephani
http://ift.tt/2y91tsO
Diagnosing Kernohan-Woltman notch phenomenon by somatosensory evoked potentials in intensive care unit
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Florent Gobert, Jan H. Baars, Thomas Ritzenthaler, Mehdi Afathi, Sébastien Boulogne, Nathalie André-Obadia, Fréderic Dailler
http://ift.tt/2kESgaK
Social involvement issues in patients with Becker muscular dystrophy: A questionnaire survey of subjects from a patient registry
Source:Brain and Development
Author(s): Madoka Mori-Yoshimura, Yukio Mizuno, Sumiko Yoshida, Narihiro Minami, Naohiro Yonemoto, Fumi Takeuchi, Ichizo Nishino, Miho Murata, Shin'ichi Takeda, Yuji Takahashi, En Kimura
BackgroundLittle is known about the relationship between Becker Muscular Dystrophy (BMD) and developmental problems, school life, employment, and mental problems. We aimed to clarify whether BMD is a risk factor for developmental disorders, problematic behavior, psychiatric diseases, and other social difficulties in school life and employment.MethodsAdults with genetically or immunohistochemically confirmed BMD from the Registry of Muscular Dystrophy in Japan (REMUDY) were asked to complete a questionnaire regarding patient history, school life, employment, and mental problems.ResultsIn total, 125 (68.3%) of 183 participants with BMD (median age, 37.2 years) completed the questionnaire. Of these, ten had developmental disorders (mental retardation, autism, and speech disturbance). Fifty-eight (44%) experienced bullying in school, and 39 felt the reason for bullying was physical handicap. Sixteen participants experienced problematic behavior such as cutting class, domestic violence, violent incidents, suicide attempts, or self-mutilation. Employment histories were noted by 92 (73%), of whom 15 could not continue to work due to physical handicaps. Fifteen participants had psychiatric disorders, with 5, 3 and 1 having neurosis, depression, and bipolar disorder, respectively. The other 6 participants with psychiatric disorders did not specify their diagnoses. Patients carrying a Dp140 expression change had significantly more incidences of developmental disorders, but not bullying, problematic behavior, workplace difficulties, or psychiatric disorders.ConclusionsPatients with BMD risk bullying and workplace difficulties, as well as developing psychiatric disorders. Parents, teachers, and supporters should be mindful of the daily environment of BMD patients and provide support to help them cope with stress.
http://ift.tt/2AIi2ku
Epileptic spasms secondary to acute cerebral and cerebellar encephalitis
Source:Brain and Development
Author(s): Tohru Okanishi, Ayataka Fujimoto, Risa Hashimoto, Mitsuyo Nishimura, Sotaro Kanai, Miho Ogawa, Takayuki Suzuki, Hirotaka Motoi, Yukitoshi Takahashi, Hideo Enoki
BackgroundPatients with infection-related acute encephalitis sometimes develop epilepsy in the chronic phase of the disease. Patients with postencephalitic epilepsy usually develop partial seizures due to the lesions generated by the encephalitis. We report a case who developed late-onset epileptic spasms after acute cerebral and cerebellar encephalitis.Case report: A 5-year-old girl showed severe tremor, gait ataxia, partial or generalized tonic-clonic seizures, hyperactivity, and panic attacks after a mild enterocolitis. Her cerebellar symptoms disappeared until 3 months after onset, and her seizures were controlled with carbamazepine. However, the seizures reappeared as epileptic spasms 5 months after onset. The anti-NMDA-type glutamate receptor antibody concentration was significantly elevated in her cerebrospinal fluid at 8 days, 10 months, and 15 months after onset. The spasms were resistant to multiple antiepileptic drugs. High-dose methylprednisolone and high-dose immunoglobulin therapies did not show any benefits. Oral pranlukast hydrate was started 17 months after onset. After 3 weeks of the medication, her seizures disappeared, and her behavior also dramatically improved.ConclusionWe presented a rare case of post-encephalitic epilepsy that manifested as epileptic spasms. Pranlukast significantly improved her seizures.
http://ift.tt/2Bj0Va3
Histopathological proof of the pathogenicity of a rare GFAP mutation in a patient with flaccid paraparesis
Source:Brain and Development
Author(s): Florian Brackmann, Roland Coras, Karl Rössler, Cornelia Kraus, Oliver Rompel, Regina Trollmann
Infantile Alexander disease is a rare progressive leukodystrophy caused by autosomal dominant mutations in the (GFAP) gene typically presenting with psychomotor retardation, progressive macrocephaly and refractory epilepsy. Neuroradiological hallmarks are extensive white matter lesions with frontal preponderance as well as signal intensity changes of basal ganglia and medulla oblongata with variable contrast enhancement. Here, we report an atypical manifestation in a 21-month-old boy presenting with flaccid paraparesis and areflexia. Cognitive, visual as well as fine motor skills and muscular strength of the upper extremities were appropriate for age. Weight and height as well as head circumference were within normal range. Clinical or electroencephalographic signs of seizures were absent. Cranial MRI demonstrated bifrontal cystic tumorous lesions with partial contrast rims, as well as space-occupying focal lesions of the caudate nuclei. Spinal MRI revealed swelling of the lumbar and cervical spinal cord. CSF and blood chemistry showed normal results. Histopathology of a subcortical lesion showed large amounts of Rosenthal fibers and protein droplets characteristic of Alexander disease. Sequencing detected a heterozygous mutation of the GFAP gene (c.205G > A; p.(Glu69Lys)) that has been reported before as probably pathogenetic in another case of lower spinal involvement.This well documented case draws attention to atypical spinal manifestations of Alexander disease and gives histopathological proof of the pathogenetic role of a rare GFAP mutation with marked spinal involvement.
http://ift.tt/2AHpVql
Ketogenic diet using a Japanese ketogenic milk for patients with epilepsy: A multi-institutional study
Source:Brain and Development
Author(s): Tomohiro Kumada, Katsumi Imai, Yukitoshi Takahashi, Shin Nabatame, Hirokazu Oguni
BackgroundIn Japan, Meiji 817-B (M817-B), a powdered ketogenic milk, has been available since the ketogenic diet was introduced to infants and tube-fed children with medication-resistant epilepsy in the 1980s.MethodsWe retrospectively evaluated the efficacy, tolerability, and side effects of the ketogenic diet using M817-B as the main source of daily food intake for patients with epilepsy by sending questionnaires to the members of a subcommittee of the Japan Epilepsy Society that focuses on the proper use of M817-B.ResultsA total of 42 patients were enrolled. Age at the initiation of the diet therapy ranged from 3 to 244 months (median, 32.5 months). Thirty-four patients were fed via tube, and the remaining 8 were fed orally. About 93% of patients were able to continue the diet for 1 month, 74% for 3 months, and 64% for 6 months. The median period of continuation was 16 months. One patient was able to continue as long as 7 years. The ketogenic ratio was maintained at about 3.0. The seizure-free rate and responder (>50% seizure reduction) rate were about 10% and 30–40%, respectively during the 12 months on the diet. Mean serum beta-hydroxybutyrate increased to almost 4 mM at 1 month and was maintained during the diet period. Side effects, which required discontinuation of the diet therapy, occurred in 11 of 42 patients and included hypertonia, weight loss, vomiting, hypoglycemia, metabolic acidosis, and hypokalemia.ConclusionM817-B could be used long-term with demonstrated efficacy in seizure reduction, although there are some side effects that may require cessation of the diet therapy.
http://ift.tt/2Borgn0
Duchenne muscular dystrophy with platypnea-orthodeoxia from Chilaiditi syndrome
Source:Brain and Development
Author(s): Masashi Ogasawara, Akihiko Ishiyama, Akira Sugiura, Kazuhiko Segawa, Ikuya Nonaka, Eri Takeshita, Yuko Shimizu-Motohashi, Hirofumi Komaki, Masayuki Sasaki
IntroductionChilaiditi syndrome is a rare pathophysiology in which the colon or other organs are interposed between the diaphragm and liver, and respiratory or digestive symptoms sometimes manifest. Although there have been some cases of Chilaiditi syndrome complicating neuromuscular disorders, none have described resulting respiratory or digestive symptoms.Case presentationOur patient was a 20-year-old man with DMD who had been receiving noninvasive positive-pressure ventilation during the night. He experienced respiratory distress when changing from a supine to sitting position. Ventilator adjustment did not relieve the respiratory distress. Abdominal computed tomography revealed marked constipation and interposition of the transverse colon between the diaphragm and liver, indicating Chilaiditi syndrome. The right side of the diaphragm was elevated by the interposed transverse colon when the respiratory distress was present on chest radiograph, but not when symptoms were absent. The patient was diagnosed with platypnea-orthodeoxia attributed to Chilaiditi syndrome. The respiratory distress was improved by the relief of constipation, in addition to the usage of the ventilator throughout the day.ConclusionThe rare symptoms and pathophysiology of DMD complicated by Chilaiditi syndrome are reported and discussed herein.
http://ift.tt/2AHy8uB
Arima syndrome caused by CEP290 specific variant and accompanied with pathological cilium; clinical comparison with Joubert syndrome and its related diseases
Source:Brain and Development
Author(s): Masayuki Itoh, Shuhei Ide, Yuji Iwasaki, Takashi Saito, Keishi Narita, Hongmei Dai, Shinji Yamakura, Takeki Furue, Hirotsugu Kitayama, Keiko Maeda, Eihiko Takahashi, Kiyoshi Matsui, Yu-ichi Goto, Sen Takeda, Masataka Arima
ObjectiveArima syndrome (AS) is a rare disease and its clinical features mimic those of Joubert syndrome or Joubert syndrome-related diseases (JSRD). Recently, we clarified the AS diagnostic criteria and its severe phenotype. However, genetic evidence of AS remains unknown. We explored causative genes of AS and compared the clinical and genetic features of AS with the other JSRD.Patients and methodsWe performed genetic analyses of 4 AS patients of 3 families with combination of whole-exome sequencing and Sanger sequencing. Furthermore, we studied cell biology with the cultured fibroblasts of 3 AS patients.ResultsAll patients had a specific homozygous variant (c.6012-12T>A, p.Arg2004Serfs*7) or compound heterozygous variants (c.1711+1G>A; c.6012-12T>A, p.Gly570Aspfs*19;Arg2004Serfs*7) in centrosomal protein 290 kDa (CEP290) gene. These unique variants lead to abnormal splicing and premature termination. Morphological analysis of cultured fibroblasts from AS patients revealed a marked decrease of the CEP290-positive cell number with significantly longer cilium and naked and protruded ciliary axoneme without ciliary membrane into the cytoplasm.ConclusionAS resulted in cilia dysfunction from centrosome disruption. The unique variant of CEP290 could be strongly linked to AS pathology. Here, we provided AS specific genetic evidence, which steers the structure and functions of centrosome that is responsible for normal ciliogenesis. This is the first report that has demonstrated the molecular basis of Arima syndrome.
http://ift.tt/2Blk5vW
Streptomyces puniceus strain AS13. Production, characterization and evaluation of bioactive metabolites: a new face of dinactin as an antitumor antibiotic
Source:Microbiological Research
Author(s): Aehtesham Hussain, Muzafar Ahmad Rather, Mohd Saleem Dar, N.A. Dangroo, Mushtaq A. Aga, Arem qayum, Aabid Manzoor Shah, Zahoor Ahmad, Mohd Jamal Dar, Qazi Parvaiz Hassan
A highly active actinobacterial strain isolated from untapped areas of Northwestern Himalayas and characterised as Streptomyces puniceus strain AS13 by 16S rRNA gene sequencing was selected for production of bioactive metabolites. The bioassay-guided fractionation of microbial cultured ethyl acetate extract of the strain, led to isolation of macrotetrolide compound 1 (Dinactin) and compound 2 (1-(2,4-dihydroxy-6-methylphenyl)-ethanone). Structures of the isolated compounds were elucidated interpretation of NMR and other spectroscopic data including HR-ESI-MS, FT-IR. These compounds are reported for first time from Streptomyces Puniceus. Compound 1 exhibited strong anti-microbial activity against all tested bacterial pathogens including Mycobacterium tuberculosis. The MIC values of compound 1 against Gram negative and Gram positive bacterial pathogens ranged between 0.019 − 0.156μgml−1 and 1μgml−1 against Mycobacterium tuberculosis H37Rv. Dinactin exhibited marked anti-tumor potential with IC50 of 1.1- 9.7μM in various human cancerous cell lines and showed least cytotoxicity (IC50∼80μM) in normal cells (HEK-293). Dinactin inhabited cellular proliferation in cancer cells, reduced their clonogenic survival as validated by clonogenic assay and also inhabited cell migration and invasion characteristics in colon cancer (HCT-116) cells. Our results expressed the antimicrobial potential of dinactin and also spotted its prospective as an antitumor antibiotic.
http://ift.tt/2BjymcC
Evaluation of fungal community involved in the bioderioration process of wooden artworks and canvases in Montefeltro area (Marche, Italy)
Source:Microbiological Research
Author(s): Luigia Sabatini, Maurizio Sisti, Raffaella Campana
Microbiological monitoring represents one of the most useful methods to assess potential risks related to the integrity of cultural heritage. The objective of this work was to evaluate the fungal community prevalent in 64 different artworks of Montefeltro area (Marche, central Italy). A total of 293 swabs were collected and, among these, 2.3% resulted negative to cultural method, while 87.7% were positive for the presence of filamentous fungi, yeasts and Actinomycetes. Totally, 11 genera and 12 different species were recovered from Sabouraud Dextrose Agar (SDA), Czapek Dox Agar (CDA), Malt Extract Agar (MEA), including 73 strains of Mycelia sterilia. Penicillium spp. was isolated mostly from canvases (28.8%), while Aspergillus spp. was most present in wooden artworks (25.3%). SDA was the best performing medium with 57.1% of isolations, followed by CDA and MEA with percentages of 24.8 and 18.1% respectively.This study could be useful to better understand the microorganism-related phenomena in cultural heritage of Marche region, identifying the potential risks and defining preventive protecting such as climate control, frequent cleaning and environmental monitoring.
http://ift.tt/2AIfSkS
Revealing the inhibitory potential of Yersinia enterocolitica on cysteine proteases of the papain family
Source:Microbiological Research
Author(s): Mateusz Kędzior, Aleksandra Pawlak, Rafał Seredyński, Jacek Bania, Aleksandra Platt-Samoraj, Magdalena Czemplik, Elżbieta Klausa, Gabriela Bugla-Płoskońska, Jan Gutowicz
Cysteine proteases of the papain family, including mammalian cathepsins, play important physiological roles, however, their excessive activity may contribute to the development of various pathologies. Therefore, cysteine cathepsin inhibitors are being considered as promising drugs to treat cathepsin-driven diseases. Diverse saprophytic and parasitic microbes produce such inhibitors, which target the host's proteases playing pivotal roles in immune responses, thus leading to the survival of microbes within their host. Yersinia enterocolitica is a Gram-negative zoopathogenic coccobacillus, which has developed several mechanisms to evade the host's immune system. Nevertheless, the bacterium has not yet been shown to produce any cysteine protease inhibitors. Here we demonstrate that Y. enterocolitica strains of different bioserotypes and genotypes synthesize papain and human cathepsin L inhibitors, but not bovine cathepsin B inhibitors. By employing fluorimetry and zymography, the cell-surface inhibitors were shown to associate peripherally with the outer membrane, while the inhibitors present in cell-free extracts proved to: interact reversibly with their target enzymes, exhibit thermolability and stability in a range of pH values (5–9), and have high molecular weights. Batch affinity chromatography on papain–agarose resin was then undertaken to isolate putative inhibitors of cysteine proteases from the bacterial extract. The isolated 18kDa protein was identified by LC-MS/MS as the periplasmic chaperone Skp. The Skp-containing eluate inhibited the activity of cysteine cathepsins produced by human dermal fibroblasts. The homologous Skp protein was also isolated from the extract of Escherichia coli. Our results point to a possible new biological role of the bacterial chaperone Skp.
http://ift.tt/2Bjqtnc
Fusarium species as pathogen on orchids
Source:Microbiological Research
Author(s): Shikha Srivastava, Chris Kadooka, Janice Y. Uchida
The recent surge in demand for exotic ornamental crops such as orchids has led to a rise in international production, and a sharp increase in the number of plant and plant products moving between countries. Along with the plants, diseases are also being transported and introduced into new areas. Fusarium is one of the major diseases causing pathogens infecting orchids that is spreading through international trade. Studies have identified several species of Fusarium associated with orchids, some are pathogenic and cause symptoms such as leaf and flower spots, leaf or sheath blights, pseudostem or root rots, and wilts. Infection and damage caused by Fusarium reduces the quality of plants and flowers, and can cause severe economic losses. This review documents the current status of the Fusarium-orchid interaction, and illustrates challenges and future perspectives based on the available literature. This review is the first of Fusarium and orchid interactions, and integrates diverse results that both furthers the understanding and knowledge of this disease complex, and will enable the development of effective disease management practices.
http://ift.tt/2AIfJOm
Language processing in age-related macular degeneration associated with unique functional connectivity signatures in the right hemisphere
Source:Neurobiology of Aging, Volume 63
Author(s): Jie Zhuang, David J. Madden, Xuan Duong-Fernandez, Nan-kuei Chen, Scott W. Cousins, Guy G. Potter, Michele T. Diaz, Heather E. Whitson
Age-related macular degeneration (AMD) is a retinal disease associated with significant vision loss among older adults. Previous large-scale behavioral studies indicate that people with AMD are at increased risk of cognitive deficits in language processing, particularly in verbal fluency tasks. The neural underpinnings of any relationship between AMD and higher cognitive functions, such as language processing, remain unclear. This study aims to address this issue using independent component analysis of spontaneous brain activity at rest. In 2 components associated with visual processing, we observed weaker functional connectivity in the primary visual cortex and lateral occipital cortex in AMD patients compared with healthy controls, indicating that AMD might lead to differences in the neural representation of vision. In a component related to language processing, we found that increasing connectivity within the right inferior frontal gyrus was associated with better verbal fluency performance across all older adults, and the verbal fluency effect was greater in AMD patients than controls in both right inferior frontal gyrus and right posterior temporal regions. As the behavioral performance of our patients is as good as that of controls, these findings suggest that preservation of verbal fluency performance in AMD patients might be achieved through higher contribution from right hemisphere regions in bilateral language networks. If that is the case, there may be an opportunity to promote cognitive resilience among seniors with AMD or other forms of late-life vision loss.
http://ift.tt/2BkguhE
Dysregulation of C-X-C motif ligand 10 during aging and association with cognitive performance
Source:Neurobiology of Aging, Volume 63
Author(s): Steven Bradburn, Jamie McPhee, Liam Bagley, Michael Carroll, Mark Slevin, Nasser Al-Shanti, Yoann Barnouin, Jean-Yves Hogrel, Mati Pääsuke, Helena Gapeyeva, Andrea Maier, Sarianna Sipilä, Marco Narici, Andrew Robinson, David Mann, Antony Payton, Neil Pendleton, Gillian Butler-Browne, Chris Murgatroyd
Chronic low-grade inflammation during aging (inflammaging) is associated with cognitive decline and neurodegeneration; however, the mechanisms underlying inflammaging are unclear. We studied a population (n = 361) of healthy young and old adults from the MyoAge cohort. Peripheral levels of C-X-C motif chemokine ligand 10 (CXCL10) was found to be higher in older adults, compared with young, and negatively associated with working memory performance. This coincided with an age-related reduction in blood DNA methylation at specific CpGs within the CXCL10 gene promoter. In vitro analysis supported the role of DNA methylation in regulating CXCL10 transcription. A polymorphism (rs56061981) that altered methylation at one of these CpG sites further associated with working memory performance in 2 independent aging cohorts. Studying prefrontal cortex samples, we found higher CXCL10 protein levels in those with Alzheimer's disease, compared with aged controls. These findings support the association of peripheral inflammation, as demonstrated by CXCL10, in aging and cognitive decline. We reveal age-related epigenetic and genetic factors which contribute to the dysregulation of CXCL10.
http://ift.tt/2AJBjBS
Neocortical origin and progression of gray matter atrophy in nonamnestic Alzheimer's disease
Publication date: March 2018
Source:Neurobiology of Aging, Volume 63
Author(s): Jeffrey S. Phillips, Fulvio Da Re, Laynie Dratch, Sharon X. Xie, David J. Irwin, Corey T. McMillan, Sanjeev N. Vaishnavi, Carlo Ferrarese, Edward B. Lee, Leslie M. Shaw, John Q. Trojanowski, David A. Wolk, Murray Grossman
Amnestic Alzheimer's disease (AD) is characterized by early atrophy of the hippocampus and medial temporal lobes before spreading to the neocortex. In contrast, nonamnestic Alzheimer's patients have relative sparing of the hippocampus, but the pattern in which the disease spreads is unclear. We examined spreading disease in nonamnestic AD using a novel magnetic resonance imaging–based analysis adapted from pathologic staging studies, applied here to cross-sectional imaging data. We selected 240 T1-weighted scans from 129 patients with pathology confirmed by autopsy or cerebrospinal fluid, and atrophy maps were computed relative to 238 scans from 115 elderly controls. For each phenotype, the frequency of atrophy in 116 brain regions was used to infer the anatomical origin of disease and its progression across 4 phases of atrophy. Results from the amnestic cohort were used to determine appropriate parameter settings for the phase assignment algorithm, based on correspondence to Braak pathology staging. Phase 1 regions, which represent the origin of disease, included the hippocampus for the amnestic group (comprising 33 scans); left lateral temporal lobe for logopenic-variant primary progressive aphasia (88 scans); occipitoparietal cortex for posterior cortical atrophy (51 scans); temporoparietal cortex for corticobasal syndrome (31 scans); and frontotemporal cortex for behavioral/dysexecutive variant AD (37 scans). In nonamnestic patients, atrophy spread to other neocortical areas in later phases, but the hippocampus exhibited only late-phase atrophy in posterior cortical atrophy and corticobasal syndrome. Region-specific phase values were also associated with regional measures of tau, beta amyloid, neuronal loss, and gliosis for the subset of patients (n = 17) with neuropathology findings; this comparison represented a first validation of the phase assignment algorithm. We subsequently assigned a phase to each patient scan based on the similarity of regional atrophy patterns with atrophy predicted for the corresponding phenotype at each phase. Scan-specific phases were correlated with disease duration as well as global and domain-specific cognition, supporting these phase values as global estimates of patients' disease progression. Logistic regression models based on spatial overlap with model-predicted atrophy patterns reliably discriminated nonamnestic phenotypes from each other and from amnestic AD. The frequency-based phase assignment algorithm used in the present study thus represents a promising approach for studying the neocortical origin and spread of disease in nonamnestic AD.
Graphical abstract
http://ift.tt/2BjqOGy
Subacromial Impingement Syndrome: An Electromyographic Study of Shoulder Girdle Muscle Fatigue
Source:Journal of Electromyography and Kinesiology
Author(s): Omid Alizadehkhaiyat, Margaret M. Roebuck, Ahmed T. Makki, Simon P. Frostick
Muscle fatigue affecting glenohumeral and/or scapular muscles is suggested as one of the contributing factors to the development of subacromial impingement syndrome (SAIS). Nonetheless, the fatigability of shoulder girdle muscles in association with the pathomechanics of SAIS has not been reported. This study aimed to measure and compare fatigue progression within the shoulder girdle musculature of patients and healthy controls. 75 participants including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) participated in the study. Study evaluated the progression of muscle fatigue in 15 shoulder girdle muscles by means of surface and fine-wire EMG during submaximal contraction of four distinct movements (abduction, flexion, internal and external rotation). Shoulder strength, subjective pain experience (McGill Pain Questionnaire), and psychological status (Hospital Anxiety and Depression Scale) were also assessed. The results were compared between patient and control groups according to the gender. Despite marked fatigue observed in the majority of muscles particularly during flexion and abduction at 90°, overall results indicated a lower tendency of fatigue progression in the impingement group across the tests (0.05< p <0.05). Shoulder Strength, pain experience, and psychological status were significantly different between the two groups (P<0.05). Lower tendency to fatigue progression in the impingement group can be attributed to the presence of fear avoidance and pain-related muscle inhibition, which in turn lead to adaptations in motor programme to reduce muscle recruitment and activation. The significantly higher levels of pain experience and anxiety/depression in the impingement group further support this proposition.
http://ift.tt/2kG5Avs
Orthodontic Class II:1 treatment—efficiency and outcome quality of Herbst-multibracket appliance therapy
Abstract
Objectives
The aim of this retrospective investigation was to assess the efficiency and outcome quality of Class II:1 treatment (Tx).
Material and methods
The investigation is based on the evaluation of all Class II:1 patients that ever (1986–2014) started Tx with a Herbst appliance and subsequently a multibracket appliance (MBA) at the study center. Study casts from before Tx, after Herbst-MBA Tx, and (if available) after ≥ 24 months of retention were evaluated using the Peer Assessment Rating (PAR) index, the Ahlgren scale, and standard occlusal variables.
Results
In total, 526 Class II:1 patients with a mean pre-Tx age of 14.4 years (range 9.8–44.4) had received Herbst-MBA Tx; 18 patients discontinued Tx before completion. For 240 patients, data from ≥ 24 months of retention were available. The pre-Tx PAR score of 32.4 ± 8.83 was reduced to 8.0 ± 4.51 during Tx. A slight increase to 8.8 ± 5.11 occurred during retention. The percentage of patients which could be assigned to the category "greatly improved" was 62% after Tx and 57% after retention; only 2–3% had to be assigned to the category "worse/no different." The outcome ratings according to the Ahlgren scale revealed 17% excellent, 35% good, 45% satisfactory, and 3% unsuccessful results.
Conclusions
Class II:1 Tx using Herbst-MBA is an efficient approach in orthodontic care. During a mean active Tx period of 2 years, high-quality results can be obtained in the majority of patients.
Clinical relevance
The present investigation is the first to investigate a large unselected cohort of consecutive Herbst-MBA patients to determine representative data on the efficiency and the outcome quality of this Tx approach.
http://ift.tt/2C0MzYP
Vemurafenib for BRAF V600-Mutant Erdheim-Chester Disease and Langerhans Cell Histiocytosis
http://ift.tt/2AIb9Aw
Restaging Computed Tomography After Chemoradiotherapy in Patients With Rectal Cancer
http://ift.tt/2iV9Q6A
Overall Survival vs Disease-Specific Survival—Reply
http://ift.tt/2iHZc2S
Incident Cancer in Cancer Survivors
http://ift.tt/2B3VZSh
The MACRA Quality Payment Program and Oncology Clinicians
http://ift.tt/2iHZqae
Overall Survival vs Disease-Specific Survival
http://ift.tt/2iHZEOC
Prior Cancer Among Persons Newly Diagnosed With Cancer
http://ift.tt/2iGT0IF
Open Access Information Added
http://ift.tt/2B3ztbX
Primary Tumor Location and RAS and BRAF Mutations in Colon Cancer
http://ift.tt/2B17XMn
Critical Lessons From High-Value Oncology Practices
http://ift.tt/2jwPkMC
Strategies to Achieve High-Value Oncology Care
http://ift.tt/2yP4XSH
Ipilimumab in Women With Human Papillomavirus–Related Cervical Carcinoma
http://ift.tt/2jyu09P
Immune Checkpoint Inhibition and Targeted Therapy in Stage IV Melanoma
http://ift.tt/2jweyuT
Rethinking Extended Adjuvant Antiestrogen Therapy for Breast Cancer
http://ift.tt/2hFJNmH
Incorrect Percentages in the Abstract
http://ift.tt/2hEMm8y
Gradually Worsening Pruritic Plaques
http://ift.tt/2AVtUx1
Men’s Awareness of Human Papillomavirus Positivity—Reply
http://ift.tt/2yp0pBZ
Spending Changes for Oral Anticancer Therapy After State Parity Laws
http://ift.tt/2yn1omo
Testing for High-Level Microsatellite Instability/Deficient Mismatch Repair
http://ift.tt/2Avtzkm
Regulation of the kynurenine metabolism pathway by Xiaoyao San and the underlying effect in the hippocampus of the depressed rat
Publication date: 25 March 2018
Source:Journal of Ethnopharmacology, Volume 214
Author(s): Jiajia Wang, Xiaofang Li, Shugui He, Lijun Hu, Jiewen Guo, Xiangning Huang, Jinqing Hu, Yaoqun Qi, Bin Chen, Dewei Shang, Yuguan Wen
Ethnopharmacological relevanceXiaoyao San (XYS) is a classic Chinese herbal formula for treatment of depression. The present study aimed to investigate the antidepressant effects of XYS in a rat model of chronic unpredictable mild stress (CUMS) and the underlying mechanisms.Materials and methodsA CUMS rat model of depression was established via 4 weeks of unpredictable stimulation. Then the rats were orally administered paroxetine and XYS for 2 weeks with continued stress. Behavioral assessments, including an open field test (OFT), sucrose preference test (SPT) and forced swim test (FST), were conducted to evaluate the antidepressant effects of XYS. The concentrations in rat plasma of tryptophan (Trp) and its metabolic products, including kynurenine (Kyn) and quinolinic acid (QUIN), were determined using high performance liquid chromatography tandem mass spectrometry with electrochemical detection (HPLC-MS/MS). The mRNA and protein levels in rat hippocampus of depression-related brain derived neurotrophic factor (BDNF), cyclic AMP response element binding protein (CREB) and nerve cell adhesion molecule (NCAM) were determined by real-time qPCR and Western blot, respectively. Enzyme Linked Immunosorbent Assay (ELISA) was used to detect the activities of indoleamine 2,3-dioxygenase (IDO) and kynurenine-3-monooxygenase (KMO) in rat plasma.ResultsThe results showed that a successful CUMS rat model was established through 4 weeks of continuous unpredictable stimulation, as indicated by the significant decrease in locomotor activity and increase in immobility time in the OFT, reduction in body weight and food intake etc. Compared with the normal group, the concentrations of Kyn and QUIN had significantly (p < 0.05) decreased at day 28 in the control group, but then improved after drug treatment with paroxetine and XYS. There were no obvious changes in the activities of IDO and KMO. Compared with the normal group, the mRNA of NCAM, CREB and BDNF were significantly down-regulated (p < 0.001) in the control group, BDNF gene was up-regulated by paroxetine or XYS treatment, NCAM and CREB gene did not change in XYS group, protein expressions of BDNF and CREB were significantly increased, and NCAM was significantly reduced (p < 0.05).ConclusionsXYS reversed the abnormalities of the tryptophan-kynurenine metabolic pathways in depressed rats and achieved an excellent antidepressant effect. Its direct impact may be observed as changes in biological indicators in rat hippocampus tissue.
Graphical abstract
http://ift.tt/2iDH4aa
Assessment of the laxative activity of an ethanolic extract of Bambusa arundinacea (Retz.) Willd. shoot
Publication date: 25 March 2018
Source:Journal of Ethnopharmacology, Volume 214
Author(s): S.M. Neamul Kabir Zihad, Sanjib Saha, Md. Sifujjaman Rony, Hasna Banu, Shaikh J. Uddin, Jamil A. Shilpi, I. Darren Grice
Ethnobotanical relevanceBambusa arundinacea (Retz.) Willd., commonly known as Kanta Bans, plays an important ethnobotanical role, especially in Asia. In traditional medicine it has reportedly been used for the treatment of constipation, blood-diseases, leucodema, inflammation and urinary discharges. A number of ethnomedicinal records exist regarding the use of B. arundinaceae shoots as a laxative, however, there are no scientific studies reported on its laxative activity. Therefore, the aim of this present study was to evaluate the laxative activity of an ethanolic B. arundinaceae shoot extract in mice.Materials and methodsB. arundinacea shoots were collected from Dhaka, Bangladesh in July 2015. An ethanolic shoot extract was obtained and its laxative activity was evaluated by faecal consistency, gastrointestinal transit and entero-pooling assays in a mouse model. Furthermore, a phytochemical investigation of the extract was conducted by UHPLC-ESI-QqQ MS and UHPLC-ESI-Orbitrap MS analysis.ResultsThe ethanolic shoot extract of B. arundinacea showed significant laxative activity in our mouse model, with significant increases in (i) the amount of wet faeces, with the maximum effect at 2h for 500mg/kg (47.92%), (ii) gastrointestinal transit (67.18% and 60.03% for doses of 250 and 500mg/kg, respectively), and (iii) small intestine content at the test doses of 250 and 500mg/kg p.o. Phytochemical investigation identified a total of thirty compounds in the ethanolic shoot extract of B. arundinacea using UHPLC-ESI-QqQ MS and UHPLC-ESI-Orbitrap MS analysis.ConclusionsThe results of this study provide support for the traditional use of B. arundinacea shoot as a laxative.
Graphical abstract
http://ift.tt/2y8Oh7j
-
Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an un...
-
The online platform for Taylor & Francis Online content New for Canadian Journal of Remote Sen...
