Effects of thymol on amyloid-β-induced impairments in hippocampal synaptic plasticity in rats fed a high-fat diet

Publication date: Available online 13 January 2018
Source:Brain Research Bulletin
Author(s): Masoumeh Asadbegi, Alireza Komaki, Iraj Salehi, Parichehreh Yaghmaei, Azadeh Ebrahim-Habibi, Siamak Shahidi, Abdolrahman Sarihi, Sara Soleimani Asl, Zoleikha Golipoor
Obesity and a high-fat diet (HFD) are known to increase the incidence of Alzheimer's disease (AD). Oxidative stress, a major risk factor for AD, is increased with HFD consumption. Thymol (Thy) has antioxidant properties. Therefore, in the present study, we examined the protective and therapeutic effects of Thy on amyloid-β (Aβ)-induced impairments in the hippocampal synaptic plasticity of HFD-fed rats. In this study, 72 adult male Wistar rats were randomly assigned to 9 groups (n = 8 rats/group): Group 1 (control; standard diet); Group 2: Control + phosphate-buffered saline (PBS) + Oil (Thy vehicle); Group 3 (HFD + PBS); Group 4: (HFD + Aβ); Group 5: Control + PBS + Thy; Group 6: (HFD + Aβ + Oil); Group 7: Control + Aβ + Thy; Group 8: HFD + PBS + Thy; Group 9: (HFD + Aβ + Thy). After stereotaxic surgery, the field potentials were recorded after the implantation of the recording and stimulating electrodes in the dentate gyrus (DG) and perforant pathway, respectively. Following high-frequency stimulation, the long-term potentiation (LTP) of the population spike (PS) amplitude and the slope of the excitatory postsynaptic potentials (EPSPs) were measured in the DG. The HFD rats that received Aβ exhibited a significant decrease in their EPSP slope and PS amplitude as compared to the control group. In contrast, Thy administration in the HFD + Aβ rats reduced the decrease in the EPSP slope and PS amplitude. Thy decreased the Aβ-induced LTP impairments in HFD rats. The HFD significantly increased serum malondialdehyde levels and decreased total antioxidant capacity and total glutathione levels; whereas, Thy supplementation significantly reversed these parameters. Therefore, these results suggest that Thy, a natural antioxidant, can be therapeutic against high risk factors for AD, such as HFD.



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Editorial Board

Publication date: January 2018
Source:Brain Research Bulletin, Volume 136





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Normative distribution of substance P and its tachykinin neurokinin-1 receptor in the medullary serotonergic network of the human infant during postnatal development

Publication date: Available online 11 January 2018
Source:Brain Research Bulletin
Author(s): Fiona M. Bright, Roger W. Byard, Robert Vink, David S. Paterson
Substance P (SP) and its tachykinin NK1 receptor (NK1R) function within key medullary nuclei to regulate cardiorespiratory and autonomic control. We examined the normative distribution of SP and NK1R in the serotonergic (5-Hydroxytryptamine, [5-HT]) network of the human infant medulla during postnatal development, to provide a baseline to facilitate future analysis of the SP/NK1R system and its interaction with 5-HT within pediatric brainstem disorders in early life. [¹²⁵I] labelled Bolton Hunter SP (BH-SP) tissue receptor autoradiography (n = 15), single label immunohistochemistry (IHC) and double label immunofluorescence (IF) (n = 10) were used to characterize the normative distribution profile of SP and NK1R in the 5-HT network of the human infant medulla during postnatal development. Tissue receptor autoradiography revealed extensive distribution of SP and NK1R in nuclei intimately related to cardiorespiratory function and autonomic control, with significant co-distribution and co-localization with 5-HT in the medullary network in the normal human infant during development. A trend for NK1R binding to decrease with age was observed with significantly higher binding in premature and male infants. We provide further evidence to suggest a significant role for SP/NK1R in the early postnatal period in the modulation of medullary cardiorespiratory and autonomic control in conjunction with medullary 5-HT mediated pathways and provide a baseline for future analysis of the potential consequences of abnormalities in these brainstem neurotransmitter networks during development.



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Retinal Arterio-Arterial Collaterals in Susac Syndrome

Background: The ophthalmic findings of Susac syndrome (SS) consist of visual field defects related to branch retinal artery occlusion (BRAO), and fluorescein angiography (FA) reveals a unique staining pattern. To date, retinal arterial collateral development has been described only in a single patient. Given that the immunopathological process in SS induces retinal ischemia, it is conceivable that abnormal blood vessel development may occur in affected individuals. Methods: This is a retrospective observational study. The medical records including fundus photography and FA of all patients with SS were reviewed, and those with any type of retinal arterial collateral were identified. Results: A total of 11 patients were identified with retinal collaterals. Five were men. Age ranged from 20 to 50 years. Ten patients had arterio-arterial (A-A) collaterals and 1 had arterio-venous (A-V) collaterals, and all had collaterals remote from the optic disc. No collaterals were present at onset of illness and the first developed at 9 months. Conclusions: The literature reveals scant evidence for the association between BRAO and retinal arterial collaterals. Our findings indicate that retinal arterial collaterals in SS are usually A-A and not A-V and may be more common in this disorder than previously believed. Collaterals do not develop early in the disease, and there may be a predilection toward development in men. The chronic inflammatory state of SS may be the stimulus for the development of these arterial collaterals. Address correspondence to Robert A. Egan, MD, Department of Neurology, Rockwood Clinic, 910 W. 5th Avenue, Suite 1000, Spokane, WA 99204; E-mail: Eganr8@gmail.com The authors report no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society

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Literature Commentary

In this issue of Journal of Neuro-Ophthalmology, M. Tariq Bhatti, MD and Mark L. Moster, MD will discuss the following 6 articles: Nachev P, Rose GE, Verity DH, Manohar SG, MacKenzie K, Adams G, Theodorou M, Pankhurst QA, Kennard C. Magnetic oculomotor prosthetics for acquired nystagmus. Ophthalmology. 2017;124:1556–1564.Vestergaard N, Rosenberg T, Torp-Pedersen C, Vorum H, Andersen CU, Aasbjerg K. Increased mortality and comorbidity associated with Leber's hereditary optic neuropathy: a nationwide cohort study. Invest Ophthalmol Vis Sci. 2017;58:4586–4592.Roberts DR, Albrecht MH, Collins HR, Asemani D, Chatterjee AR, Spampinato MV, Zhu X, Chimowitz MI, Antonucci MU. Effects of space flight on astronaut brain structure as indicated on MRI. N Engl J Med. 2017;377:1746–1753.Klawiter EC, Bove R, Elsone L, Alvarez E, Borisow N, Cortez M, Mateen F, Mealy MA, Sorum J, Mutch K, Tobyne SM, Ruprecht K, Buckle G, Levy M, Wingerchuk D, Paul F, Cross AH, Jacobs A, Chitnis T, Weinshenker B. High risk of postpartum relapses in neuromyelitis optica spectrum disorder. Neurology. 2017;89:2238–2244.Ahle G, Touitou V, Cassoux N, Bouyon M, Humbrecht C, Oesterlé H, Baraniskin A, Soussain C, Nguyen-Them L, Gaultier C, Hoang-Xuan K, Houillier C. Optic nerve infiltration in primary central nervous system lymphoma. JAMA Neurol. 2017;74:1368–1373.Gelfand JM, Bradshaw MJ, Stern BJ, Clifford DB, Wang Y, Cho TA, Koth LL, Hauser SL, Dierkhising J, Vu N, Sriram S, Moses H, Bagnato F, Kaufmann JA, Ammah DJ, Yohannes TH, Hamblin MJ, Venna N, Green AJ, Pawate S. Infliximab for the treatment of CNS sarcoidosis: a multi-institutional series. Neurology. 2017;89:2092–2100. © 2018 by North American Neuro-Ophthalmology Society

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Risk of Acute Ischemic Stroke in Patients With Monocular Vision Loss of Vascular Etiology

Background: To evaluate the risk of concurrent acute ischemic stroke and monocular vision loss (MVL) of vascular etiology. Design: Retrospective, cross-sectional study. Subjects: Patients aged 18 or older diagnosed with MVL of suspected or confirmed vascular etiology who had no other neurologic deficits and who received brain MRI within 7 days of onset of visual symptoms were included. Methods: A medical record review was performed from 2013 to 2016 at Yale New Haven Hospital. Patients were included if vision loss was unilateral and due to transient monocular vision loss (TMVL), central retinal artery occlusion (CRAO), or branch retinal artery occlusion (BRAO). Any patients with neurologic deficits other than vision loss were excluded. Other exclusion criteria were positive visual phenomena, nonvascular intraocular pathology, and intracranial pathology other than ischemic stroke. Main Outcome Measures: The presence or absence of acute stroke on diffusion-weighted imaging (DWI) on brain MRI. Results: A total of 641 records were reviewed, with 293 patients found to have MVL. After excluding those with focal neurologic deficits, there were 41 patients who met the inclusion criteria and received a brain MRI. Eight of the 41 subjects (19.5%) were found to have findings on brain MRI positive for acute cortical strokes. The proportion of lesion positive MRI was 1/23 (4.3%) in TMVL subjects, 4/12 (33.3%) in CRAO subjects, and 2/5 (40%) in BRAO subjects. Brain computed tomography (CT) scans were not able to identify the majority of acute stroke lesions in this study. Conclusions: Patients with MVL of vascular etiology such as TMVL, CRAO, or BRAO may have up to 19.5% risk of concurrent ischemic stroke, even when there are no other neurologic deficits. These strokes were detected acutely with brain MRI using DWI but were missed on CT. Address correspondence to Jason Zhang, MD, Department of Ophthalmology and Visual Sciences, Yale University School of Medicine, 40 Temple Street, Suite 3D, New Haven, CT 06510; E-mail: jason.zhang@yale.edu Presented at the American Academy of Ophthalmology Annual Meeting, November 14–17, 2015, Las Vegas, NV. The authors report no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the full text and PDF versions of this article on the journal's Web site (http://ift.tt/2BFTkP1). © 2018 by North American Neuro-Ophthalmology Society

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Serum irisin concentrations in lean adolescents with polycystic ovary syndrome

Summary

Objective

To explore differences in irisin concentrations between lean adolescents with PCOS and age- and body mass index (BMI)-matched controls and examine the associations of irisin with core features of the syndrome.

Design

Cross-sectional study.

Patients

Lean females with PCOS, aged 13-21 years.

Measurements

Physical, hormonal and sonographic assessment. Irisin concentrations were measured with ELISA.

Results

Participants included in total 39 sedentary females (mean±SD; age 17.3±2.1 years, BMI 20.7±1.3 Kg/m²); 23 adolescents with PCOS and 16 controls. Adolescents with PCOS compared to controls, had significantly elevated concentrations of fasting serum irisin (mean±SD; PCOS, 1.7±1.0 μg/mL vs. controls, 1.0±0.4 μg/mL; P=.007), luteinizing hormone (LH), estradiol, testosterone, Δ4-androstenedione, 17-hydroxyprogesterone, glucose, as well as free-androgen index, Ferriman-Gallwey score and mean ovarian volume (MOV).

For the total sample, circulating irisin was positively correlated with MOV (r=.593, P=.020), glucose (r=.428, P=.007), insulin (r_s=.369, P=.021), HOMA-IR (r_s=.422, P=.007) and negatively correlated with QUICKI (r=-.329, P=.041). Follicle-stimulating hormone (B=0.295, Beta=.342, P=.042) and MOV (B=0.182, Beta=.821, P=.001) were positive predictors and LH (B=-0.108, Beta=-.523, P=.010) and testosterone (B=-0.431, Beta=-.457, P=.032) negative predictors of irisin concentrations, whereas irisin positively predicted fasting glucose (B=4.728, Beta=.428, P=.007).

In the PCOS group, irisin concentrations were positively correlated with HOMA-IR (r_s=.416, P=.048) but negatively correlated with LH (r_s=-.499, P=.015), testosterone (r=-.585, P=.003), free-androgen index (r=-.426, P=.048) and Ferriman-Gallwey score (r=-.533, P=.015).

Conclusions

Irisin was associated with the adolescents' metabolic and reproductive characteristics and the hyperandrogenic phenotype of the syndrome. More research is needed to ascertain mechanisms of elevated serum irisin in adolescent PCOS.

This article is protected by copyright. All rights reserved.

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Genetic Influences on the Development of Cerebral Cortical Thickness During Childhood and Adolescence in a Dutch Longitudinal Twin Sample: The Brainscale Study

Abstract

Previous studies have demonstrated that cortical thickness (CT) is under strong genetic control across the life span. However, little is known about genetic influences that cause changes in cortical thickness (ΔCT) during brain development. We obtained 482 longitudinal MRI scans at ages 9, 12, and 17 years from 215 twins and applied structural equation modeling to estimate genetic influences on (1) cortical thickness between regions and across time, and (2) changes in cortical thickness between ages. Although cortical thickness is largely mediated by the same genetic factor throughout late childhood and adolescence, we found evidence for influences of distinct genetic factors on regions across space and time. In addition, we found genetic influences for cortical thinning during adolescence that is mostly due to fluctuating influences from the same genetic factor, with evidence of local influences from a second emerging genetic factor. This fluctuating core genetic factor and emerging novel genetic factor might be implicated in the rapid cognitive and behavioral development during childhood and adolescence, and could potentially be targets for investigation into the manifestation of psychiatric disorders that have their origin in childhood and adolescence.

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Subthreshold Activity Underlying the Diversity and Selectivity of the Primary Auditory Cortex Studied by Intracellular Recordings in Awake Marmosets

Abstract

Extracellular recording studies have revealed diverse and selective neural responses in the primary auditory cortex (A1) of awake animals. However, we have limited knowledge on subthreshold events that give rise to these responses, especially in non-human primates, as intracellular recordings in awake animals pose substantial technical challenges. We developed a novel intracellular recording technique in awake marmosets to systematically study subthreshold activity of A1 neurons that underlies their diverse and selective spiking responses. Our findings showed that in contrast to predominantly transient depolarization observed in A1 of anesthetized animals, both transient and sustained depolarization (during or beyond the stimulus period) were observed. Comparing with spiking responses, subthreshold responses were often longer lasting in duration and more broadly tuned in frequency, and showed narrower intensity tuning in non-monotonic neurons and lower response threshold in monotonic neurons. These observations demonstrated the enhancement of stimulus selectivity from subthreshold to spiking responses in individual A1 neurons. Furthermore, A1 neurons classified as regular- or fast-spiking subpopulation based on their spike shapes exhibited distinct response properties in frequency and intensity domains. These findings provide valuable insights into cortical integration and transformation of auditory information at the cellular level in auditory cortex of awake non-human primates.

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Genetic Complexity of Cortical Structure: Differences in Genetic and Environmental Factors Influencing Cortical Surface Area and Thickness

Abstract

Quantifying the genetic architecture of the cerebral cortex is necessary for understanding disease and changes to the brain across the lifespan. Prior work shows that both surface area (SA) and cortical thickness (CT) are heritable. However, we do not yet understand the extent to which region-specific genetic factors (i.e., independent of global effects) play a dominant role in the regional patterning or inter-regional associations across the cortex. Using a population sample of young adult twins (N = 923), we show that the heritability of SA and CT varies widely across regions, generally independent of measurement error. When global effects are controlled for, we detected a complex pattern of genetically mediated clusters of inter-regional associations, which varied between hemispheres. There were generally weak associations between the SA of different regions, except within the occipital lobe, whereas CT was positively correlated within lobar divisions and negatively correlated across lobes, mostly due to genetic covariation. These findings were replicated in an independent sample of twins and siblings (N = 698) from the Human Connectome Project. The different genetic contributions to SA and CT across regions reveal the value of quantifying sources of covariation to appreciate the genetic complexity of cortical structures.

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Correction to: Effect of 1064-nm Q-switched Nd:YAG laser on invasiveness and innate immune response in keratinocytes infected with Candida albicans

Abstract

In the published online version of the article, the authors' given and family names were incorrectly captured. The corrected names are shown in the author group section above.

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Visualization of viscoelastic behavior in skin equivalent using optical coherence tomography-based straingraphy

Abstract

Background/Purpose

The relationships between the skin components and these mechanical roles are still unclear. To clarify these relationships, we investigated spatial mapping of the mechanical behavior of cultured skin equivalents (SEs) using optical coherence tomography (OCT)-based straingraphy.

Methods

We built a strain relaxation test system combined with OCT and developed an algorithm that could visualize a time-dependent strain distribution, named dynamic-optical coherence straingraphy (D-OCSA). Using this system, we analyzed how the spatial mechanical changes in the SEs depended on the culture duration. For quantitative analysis of viscoelastic behavior, we defined a relaxation attenuation coefficient of strain rate, which indicates the ratio of viscosity and elasticity in the Klevin-Voight model.

Results

By culturing for 4 days in comparison to culturing for 1 day, the strain relaxation attenuation coefficient of the whole skin, especially at the region of the dermal-epidermal junction (DEJ), significantly increased in the negative direction. In tissue slices taken for microscopy, several cracks were observed in the SEs cultured for 4 days.

Conclusion

This study is the first to provide quantified evidence that the DEJ is a dynamically specialized region. An OCT-based straingraphy system (D-OCSA) would be beneficial for evaluating the quality of SEs, as well as functional analysis of their mechanics.

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Wrinkle and roughness measurement by the Antera 3D and its application for evaluation of cosmetic products

Abstract

Background

Skin topographic measurements are of paramount importance in the field of dermo-cosmetic evaluation. The aim of this study was to investigate how the Antera 3D, a multi-purpose handheld camera, correlates with other topographic techniques and changes in skin topography following the use of a cosmetic product.

Methods

Skin topographic measurements were collected on 26 female volunteers aged 45-70 years with the Antera 3D, the DermaTOP and image analysis on parallel-polarized pictures. Different filters for analysis from the Antera 3D were investigated for repeatability, correlations with other imaging techniques and ability to detect improvements of skin topography following application of a serum.

Results

Most of Antera 3D parameters were found to be strongly correlated with the DermaTOP parameters. No association was found between the Antera 3D parameters and measurements on parallel-polarized photographs. The measurements repeatability was comparable among the different filters for analysis, with the exception of wrinkle max depth and roughness Rt. Following a single application of a tightening serum, both Antera 3D wrinkles and texture parameters were able to record significant improvements, with the best improvements observed with the large filter.

Conclusion

The Antera 3D demonstrated its relevance for cosmetic product evaluation. We also provide recommendations for the analysis based on our findings.

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Neural signatures for active maintenance and interference during working memory updating

Publication date: Available online 12 January 2018
Source:Biological Psychology
Author(s): Adrià Vilà-Balló, Juha Salmi, Anna Soveri, Antoni Rodríguez-Fornells, Minna Lehtonen, Matti Laine
Although working memory (WM) is amongst the most studied neurocognitive functions, temporal patterns of its component processes are not fully understood. We examined the neural underpinnings of active maintenance and interference management in the n-back task by manipulating load (1-back vs 3-back) and including so-called lure stimuli. ERPs of 27 young adults revealed that the 1-back condition enabling active maintenance showed a positive slow wave (PSW) prior to the next stimulus (-600–0 ms) and augmented P2 (190–290 ms) and P3b (330–430 ms) responses after the stimulus appeared, albeit the latter effects were driven by the initial PSW. Moreover, PSW amplitude correlated negatively with reaction time in the 1-back condition. Responses to lures showed interference, accompanied with different ERP effects for the two load levels. Our results support the view that PSW reflects efficient WM maintenance and suggest two distinct neuronal correlates for interference in WM.



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A profile of Propionibacterium acnes resistance and sensitivity at a tertiary dermatological centre in Singapore

Propionibacterium acnes (P. acnes) is a key component in the pathogenesis of acne. Both topical and oral antibiotics are key therapeutic options. Unfortunately, antibiotic resistance is rapidly increasing globally. Many countries have reported greater than 50% of P.acnes strains acquiring resistance to topical macrolides^1-3. In Singapore, antibiotic resistance rates of 8% in 1999⁴ rising to 14.9%⁵ in 2007 were reported. We aimed to update the local prevalence of antibiotic resistance and identify features which may distinguish patients demonstrating antibiotic resistance from those who are pan-sensitive.

This article is protected by copyright. All rights reserved.

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Pulsed-dye laser therapy for carcinoma in situ of the penis

Carcinoma in situ (CIS) of the penis is a precancerous condition with a 5 to 10% risk for progression into an invasive penile squamous cell carcinoma (SCC)¹. Clinical variants of genital CIS encompass bowenoid papulosis, erythroplasia of Queyrat and Bowen's disease. Treatment options of penile CIS include topical application of 5-fluorouracil (5-FU) or imiquimod, photodynamic therapy (PDT), ablative laser therapy, cryotherapy and surgery² .

This article is protected by copyright. All rights reserved.

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Omalizumab updosing allows disease activity control in refractory patients with chronic spontaneous urticaria

Omalizumab has been shown to be a very effective drug in chronic spontaneous urticaria (CSU) improving patients' quality of life.¹ Phase III clinical trials ASTERIA I/II and GLACIAL showed respectively 58.8-52.4% of patients achieving a twice daily average Urticaria Activity Score 7 (UAS7td)≤6 at week 12.² Outside of clinical trials, the response varies between 77-83%.³ However, some patients do not achieve well-controlled activity of the disease with the licensed dose of omalizumab (300mg/4 weeks).

This article is protected by copyright. All rights reserved.

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Dermoscopic features of pilar leiomyomas

Cutaneous pilar leiomyomas are benign smooth muscle neoplasms that usually present as painful firm erythematous to brown coloured papules and nodules.¹ Dermoscopy has been used as an auxiliary tool in the diagnosis of various cutaneous tumors. Herein we report the various dermoscopic features of 48 cutaneous pilar leiomyomas in five patients.

This article is protected by copyright. All rights reserved.

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Evaluation of the cognitive effect of newborn resuscitation training on health-care workers in selected states in Northern Nigeria

Lawal Waisu Umar, Hafsat Rufa'I Ahmad, Abdulkadir Isah, Hafsat Wasagu Idris, Laila Hassan, Fatima Laraba Abdullahi, Ishaku Hassan, Abubakar Yakubu, Abubakar Muhammad Zubairu, Jane Alison Jobling

Annals of African Medicine 2018 17(1):33-39

Background: Neonatal deaths contribute significantly to slower progress in under-5 mortality reduction. Lack of sufficiently trained birth assistants partly contributes to early neonatal deaths. Resuscitation training equips frontline health-care workers (HCWs) with requisite knowledge and skills to prevent birth asphyxia. Objective: The objective of this study was to evaluate the immediate impact of newborn resuscitation training on cognitive ability of HCWs. Materials and Methods: This is a descriptive observational study using pre- and posttraining scores obtained by HCWs who were participants in 1-day training on emergency newborn resuscitation. The Newborn Resuscitation Manual of the UK Resuscitation Council (2006) was used to train HCWs. The course included lectures, skill and scenario demonstrations using mannequins, and basic resuscitation equipment. Cognitive knowledge was evaluated using a pre- and post-training questionnaire. Participants' scores were collated, analyzed, and results were presented as tables, charts, and descriptive statistics with P < 0.05 considered statistically significant. Results: A total of 293 HCWs completed the course (81 doctors and 212 nurse/midwives), with variable improvements of mean posttraining marks over the pretraining scores. Resident doctors obtained significantly higher mean pre- and post-training marks with lower mean difference than senior doctors and medical officers. The junior nurses obtained significantly higher mean pretraining scores compared to the senior nursing cadre, while the intermediate nursing cadre obtained significantly higher mean posttraining scores compared to senior nurses. Conclusion: Resuscitation training improved the knowledge of HCWs. Further evaluation could ascertain impacts on knowledge/skills' retention and neonatal survival. Preservice training and continuing education for frontline HCWs who conduct deliveries are recommended.

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Indications and outcome of tracheostomy in Ilorin, North Central Nigeria: 10 years review

BS Alabi, OA Afolabi, AD Dunmade, HK Omokanye, IO Ajayi, SO Ayodele, NO Busari

Annals of African Medicine 2018 17(1):1-6

Background: The study aims to highlight common indications as well as outcome of treatment among patients with tracheostomy in Ilorin, North-Central Nigeria. Methods: A review of clinical records of all patients with tracheostomy over a period of ten years (2002-2011), using the Theatre, Ward, ICU and the emergency register after approval from the ethical review committee. Data retrieved included; demographic profile, primary diagnosis, indication for tracheostomy, surgical technique, hospital admission and care outcome of management. All information retrieved input and analysed using an SPSS version 17.0 and data analyzed descriptively. Results: Seventy-six patients had complete data for analysis, age range from 1-89yrs, and mean age of 41.9yrs. There are 48males and 28 females with M:F ratio of 1.6:1. Majority of the patients were in the 3rd–5th decade. About 47.4% had temporary tracheostomy. The commonest indication for tracheostomy is upper airway obstruction secondary to aerodigestive tract tumors in 60.5%, then trauma in 26.3%. The complications are higher among the under tens'. Out of the 36 temporary tracheostomy only 18 were successfully decannulated. The mean hospital stay was 22±2days. Overall 15% mortality was recorded. Conclusion: Common reason for tracheostomy is essentially same earlier documentation in developing countries, common among males, emergency type still most common, neoplasm, prolonged intubation and trauma are the commonest indications, its complication is still high among the under tens'. The outcome is good with 15% mortality due to the primary disease and not from tracheostomy.

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The astigmatic effect of pterygium in a Tertiary Hospital in Kano, Nigeria

Abdu Lawan, Sadiq Hassan, Ebisike Philips Ifeanyichukwu, Hadi Bala Yahaya, Rabi Yahaya Sani, Saudat Garba Habib, Abdulsalam Shuaib, Okpo Eme

Annals of African Medicine 2018 17(1):7-10

Aim: This study aims to determine the effect of pterygium excision on the degree of corneal induced astigmatism and visual acuity. Patients and Methods: This was a prospective interventional study conducted between September 2012 and June 2013. Consecutive patients with pterygium who met the inclusion criteria were recruited into the study. They had a basic eye examination, and those with existing comorbidity were excluded. Selected patients had pterygium excision using the bare sclera technique with intraoperative application of Mitomycin C. Detailed pre- and post-operative evaluation and refraction was done. Results: There were 45 eyes of 33 patients aged 28–75 years. The mean age was 56.12 + 12.38 years. Six eyes had Grade I, 29 eyes had Grade II and 10 eyes had Grade III pterygium. The mean value for preoperative astigmatism was 2.12 ± 1.09 diopter cylinder (DC) while that for postoperative astigmatism was 0.72 ± 0.50 DC (P = 0.000). Surgery was associated with statistically significant increase in postoperative visual acuity. (P = 0.000).Conclusion: This study has shown that the degree of pterygium-induced astigmatism reduces significantly following surgical excision. Pterygium excision was associated with improvement in visual acuity.

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Drug-induced oral erythema multiforme: A diagnostic challenge

Syed Ahmed Taqi

Annals of African Medicine 2018 17(1):43-45

Trimethoprim-sulfamethoxazole (cotrimoxazole or TMP/SMX) is commonly used for the treatment of urinary or lower respiratory tract infections. A comprehensive review is presented of the world literature on adverse reactions to TMP/SMX since its first use in 1968, when concern was expressed about possible hematologic toxicity. The adverse reactions to TMP/SMX occur in approximately 1%–3% of persons in general population. Here, we report a case of oral erythema multiforme (EM) secondary to TMP/SMX that presented with oral and lip ulcerations typical of EM without any skin lesions and highlights the importance of distinguishing them from other ulcerative disorders involving oral cavity. The patient was treated symptomatically and given tablet prednisolone. The condition improved with stoppage of TMP/SMX therapy. It has been reported that primary attacks of oral EM is confined to the oral mucosa, but the subsequent attacks can produce more severe forms of EM involving the skin. Hence, it is important to identify for early diagnosis and management. Although EM is quite common with TMP/SMX, there are no reports of oral EM appearing after intake of this drug.

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Assessment of some indicators of oxidative stress in nigerian sickle cell anemic patients

CP Okorie, Theresa Nwagha, Fidelis Ejezie

Annals of African Medicine 2018 17(1):11-16

Background: Oxidative stress, the imbalance between the productive of reactive species and antioxidant defences notably plays an important role in the pathogenesis of sickle cell disease. Generating the necessary data about oxidative stress in patients with sickle cell anemia (SCA) would help in developing cost-effective and accessible treatment interventions of SCA in resource-poor countries. Aim: The aim of this study is to evaluate the levels plasma lipid peroxidation product, malondialdehyde (MDA), serum nitric oxide (NO), and total antioxidant activity (TAOA) as indicators of oxidative stress in sickle cell individuals. Materials and Methods: In this pilot study, 52 patients; homozygous (Hb SS) sickle cell patients confirmed by cellulose electrophoresis and 20 age- and sex-matched healthy (Hb AA) controls were subjected to analysis of NO, MDA, and TAOA. The plasma MDA was measured by a thiobarbituric reaction, (NO) was evaluated by the method described by Guevara et al. using Griess reagent and the TAOA of serum was determined by the method of Koracevic et al. Results: The results showed a statistically significant decrease and increase in baseline levels of NO and MDA, respectively, in Hb SS group when compared with the control Hb AA (P = 0.000 and 95% confidence interval [CI] of 0.10–0.18 and −9.67–−5.57, respectively). A slight decrease in the TAOA level between the groups was observed although not statistically significant (P = 0.15 95% CI was −0.28–2.90). Conclusion: The results showed of imbalance between oxidant and antioxidant status in patients with SCA. Antioxidant supplementation may be a cheap assessable intervention for in sickle cell individuals (in the steady state or in crisis) to prevent further oxidative damage to the erythrocytes.

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Prescribing pattern and antibiotic use for hospitalized children in a Northern Nigerian Teaching Hospital

Lawal Waisu Umar, Abdulmuminu Isah, Shuaibu Musa, Bilkisu Umar

Annals of African Medicine 2018 17(1):26-32

Background: Assessment of patterns of drug to detect performance problems and compliance with standards facilitates objective comparisons and impact evaluation. Children are at higher risk of consequences of irrational prescribing and antibiotic misuse. Objective: The objective of the study was to evaluate the prescribing pattern and utilization of antibiotics for children using standard prescribing indicators and indices of rational drug prescribing. Materials and Methods: This was a retrospective study of prescriptions for pediatric inpatients at a teaching hospital in Northern Nigeria. Information was obtained from eligible prescriptions received over 24-month period using a modified WHO prescribing indicator form. The WHO prescribing indicators and the Index of Rational Drug Prescribing (IRDP) were used to evaluate prescriptions. Data were analyzed and presented as proportions, means, tables, and charts, comparing with WHO standards and with findings of similar studies. Results: There were 3908 eligible prescription orders, with a mean patient age of 3.1 (±2.7) years. With an average of 2.1 drugs per prescription, 66.8% were written with generic names, whereas a single antibiotic was included among 63% of prescriptions with antibiotics. Antibiotics and injections were contained in 49.5% and 67.7% of prescriptions, respectively. Medications were available in the Essential Medicines List in 95.5% of cases. The IRDP obtained is 2.99, against a standard of 5. Aminoglycosides, cephalosporins, and penicillins were the most common choices, whereas ampicillin/cloxacillin was the most common combination. Conclusion: Drug prescribing and antibiotic use were generally inappropriate compared with ideal standards. Continuous training/retraining on rational drug use, periodic monitoring, and use of treatment protocols in tertiary hospitals are recommended.

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Human immunodeficiency virus seroprevalence in patients with invasive cervical cancer in Zaria, North-Western Nigeria

Adamu Abdullahi, Muhammad Inuwa Mustapha, Dawotola Ayorinde David, Olasinde Tajudeen Ayodeji

Annals of African Medicine 2018 17(1):17-21

Background: Cervical cancer is the commonest gynecological malignancy in our environment and is an Acquired Immuno-Deficiency Syndrome (AIDS)-associated malignancy. Documented data on the Human Immune-deficiency Virus (HIV) seroprevalence among patients with cervical cancer in our environment are scarce. Objective: The aim of this study is to determine the prevalence of HIV infection in women with cancer of the cervix. Study Design: The work is a descriptive survey by design, concentrating in frequency of occurrences of prevalence of the dissease in either cases for a number of years retrospectively carried out at the Radiotherapy and Oncology Centre of Ahmadu Bello University Teaching Hospital (ABUTH) Zaria. Setting: The study was carried out at the Radiotherapy and Oncology Centre of ABUTH, Zaria. Materials and Methods: A 5 years retrospective review of patients with histologically-proven cancer of the cervix seen in the Radiotherapy and Oncology Centre, ABUTH, Zaria, North-Western Nigeria was undertaken. Data such as age, clinical stage of disease and HIV seropositivity at presentation were retrieved from the case files. Data analysis was done using the SPSS statistical package version IBM 23 and results presented in frequencies and percentages and charts for graphical presentation. Results: A total of 1,639 patients seen over a period of 5 years were reviewed. The age range of both groups of patients was from 28 years to 92 years with a mean age of 50.5 years. One thousand five hundred and seventy-three of the patients (96%) were seronegative to the HIV tests while 66 (4%) were seropositive. The age range of the seropositive patients was 28 - 49 years with a mean age of 38.1 years. Their peak age at presentation was 30 - 39 years. Similarly, the age range of the seronegative patients was 30 – 92 years with a peak at 40-49 years. 51 (89.5%) of the HIV seropositive patients presented with advanced clinical stage disease, i.e, International Federation of Obstetrics and Gynecology (FIGO) stage 2B and above. 1,363 (93%) of the HIV seronegative patients presented with FIGO 2B disease and above, both scenario illustrating the general trend of late presentation of cancer patients to hospital in our environment. Conclusion: The study shows that the prevalence of HIV infection among cervical cancer patients is low in Zaria, with earlier age of development of cervical cancer among HIV seropositive patients compared to HIV seronegative counterparts. Both group of patients present with cervical cancer at an advanced stage. More studies therefore needed to be done to identify the predisposing factors to the high incidence of invasive cervical cancer in our environment and introduction of cervical cancer screening at an earlier age among HIV seropositive patients.

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Sparfloxacin-induced nail pigmentation: A case of fixed drug eruption?

Husain Yahya

Annals of African Medicine 2018 17(1):40-42

Sparfloxacin, a synthetic, second generation, broad spectrum aminodifluoroquinolone antibiotic, has excellent penetration into respiratory tissues and has good activity against Gram-positive, Gram-negative, and atypical bacteria. Although it is indicated for the treatment of adult community-acquired pneumonia and acute exacerbation of chronic bronchitis, its use has been limited by phototoxicity which is more common with it than with other quinolones. We report a case of a 20-year-old Nigerian woman who developed a diffuse blue-black nail pigmentation of thumb and big toe nails, 2 weeks after completing therapy with sparfloxacin, and a recurrence of the pigmentation in the same nails 1 year after taking the drug again. We think this is likely a case of subungual fixed drug eruption. We briefly discuss the causes and mechanisms of drug-induced nail pigmentation in general.

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Current indications for extremity amputations in Maiduguri, North-East Nigeria: A 6-year retrospective review

Theophilus Maksha Dabkana, Friday Titus Nyaku, Stanley Tella Bwala

Annals of African Medicine 2018 17(1):22-25

Objective: To know the the commonest cause for extremity amputation in UMTH in recent times, following the result of two previous studies citing malignancy and later trauma, at the University of Maiduguri Teaching Hospital, a tertiary hospital in North East Nigeria. Method: We retrieved folders of all patients who had extremity amputation from January 2010 to December 2016 in our center. There were one hundred and sixty three case notes, accounting for one hundred and sixty five amputations. Results: Of the 165 amputations in 163 patients, 94 (57.0%) were as a result of this problem. It was also noted that the affected patients were regular with their medications, bringing into question the efficacy of these medications. Trauma however remains the second common cause for amputation, accounting for 22 (13.3%), followed by complications from splints of traditional bone setters (TBS) which accounted for 20 (12.2%). Conclusion: Complicated diabetes mellitus is the commonest cause oa amputations in recent times in our center.

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Neglected Type III growing skull fracture in a 65-Year-Old female

Sonal Saran, Sameer R Verma, Vineet Tomar

Annals of African Medicine 2018 17(1):46-47



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Adaptation and micro-structure of Co-Cr alloy maxillary complete denture base plates fabricated by selective laser melting technique

Abstract

The purpose of the study was to evaluate the adaptation and micro-structure of Co-Cr alloy maxillary complete denture base plates fabricated by the selective laser melting (SLM) technique. Twenty pairs of edentulous casts were randomly and evenly divided into two groups, and manufacturing of the Co-Cr alloy maxillary complete denture base was conducted either by the SLM technique or by the conventional method. The base-cast sets were transversally sectioned into three sections at the distal canines, mesial of the first molars and the posterior palatal zone. The gap between the metal base and cast was measured in these three sections with a stereoscopic microscope, and the data were analysed using t tests. A total of five specimens of 5 mm diameter were fabricated with the Co-Cr alloy by SLM and the traditional casting technology. A scanning electron microscope (SEM) was used to evaluate the differences in microstructure between these specimens. There was no statistical difference between the three sections in all four groups (P > 0.05). At the region of the canines, the clearance value for the SLM Co-Cr alloy group was larger than that of the conventional method group (P < 0.05). At the mesial of the first molar region and the posterior palatal zone, there was no statistical difference between the gaps observed in the two groups (P > 0.05). The SLM Co-Cr alloy has a denser microstructure behaviour and less casting defect than the cast Co-Cr alloy. The SLM technique showed initial feasibility for the manufacture of dental bases of complete dentures, but large sample studies are needed to prove its reliability in clinical applications. The mechanical properties and microstructure of the denture frameworks prepared by selective laser melting indicate that these dentures are appropriate for clinical use.

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Antidepressant effects of focused ultrasound induced blood-brain-barrier opening

Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Skyler J. Mooney, José N. Nobrega, Anthony J. Levitt, Kullervo Hynynen
In many cases, hippocampal neurogenesis appears to be a hallmark of antidepressant treatments. One novel technique for inducing this type of neurogenesis is using focused ultrasound waves, in conjunction with circulating microbubbles, to open the blood-brain-barrier. The present experiment aimed to test whether this technique has antidepressant effects in a rodent model. Rats were subjected to 1, 2 or 3 weekly treatments of magnetic resonance-guided focused ultrasound in order to open the blood-brain-barrier in the hippocampal region. Before and after treatments, animals went through modified forced swim tests. 1 week after the final treatment, animals that received 2 weekly treatments showed antidepressant-like effects on behavioural measures in comparison to untreated controls. This was not the case for animals that received 1 or 3 weekly treatments. Effects had disappeared by 5 weeks following the first ultrasound treatment. These results suggest that focused ultrasound may be used for inducing short-term antidepressant effects.



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A synergetic biomineralization strategy for immobilizing strontium during calcification of the coccolithophore Emiliania huxleyi

Abstract

The coccolithophore species Emiliania huxleyi has one of the most global distributions in the modern oceans. They are characteristically covered with calcite scales called coccoliths. In this study, stable strontium immobilization during the calcification process was investigated to indirectly assess a proposed bioremediation approach for removing Sr²⁺ contamination from marine environments. Results indicate that E. huxleyi has high Sr²⁺ tolerance and removal efficiency in response to Sr²⁺ stress ranging from 5.6 to 105.6 ppm. Sr²⁺ immobilization during E. huxleyi calcification indicates a concentration-dependent synergistic mechanism. At lower concentrations of Sr²⁺ (25.6 ppm), Sr²⁺ is incorporated into coccoliths through competitive supply between Sr²⁺ and Ca²⁺. In addition, calcite productivity decreases with increased Sr²⁺ removal efficiency due to crystallographic transformation of coccoliths from hydrated calcite into aragonite at 55.6 ppm Sr²⁺. Further formation of strontianite at 105.6 ppm Sr²⁺ is due to precipitation of Sr²⁺ on the edge of the rims and radial arrays of the coccoliths. Our study implies that coccolithophores are capable of significant removal of Sr²⁺ from the marine environment.

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Effects of Coenzyme Q10 Supplementation on Serum Values of Gamma-glutamyl transferase, Pseudocholinesterase, Bilirubin, Ferritin, and High-Sensitivity C-Reactive Protein in Women with Type 2 Diabetes

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-124183

Background Type 2 diabetes mellitus (T2DM) is a disease associated with increased oxidative stress which results from mitochondrial dysfunction. Coenzyme Q10 (CoQ10) is an essential antioxidant for energy production in mitochondria. The purpose of this randomized double-blind clinical trial study was to evaluate the effects of CoQ10 supplementation on serum values of gamma-glutamyl transferase (GGT), pseudocholinesterase (PchE), bilirubin, ferritin, and high-sensitivity c-reactive protein (hs-CRP) and metabolic syndrome biomarkers in women with T2DM. Material & Methods Eighty women with T2DM enrolled in this study. Thirty six of them were randomized in the drug group (receiving 100 mg/day of CoQ10) and 44 women were randomized in placebo group. Intervention was continued for 12 weeks. In both groups 35 subjects finished the study and were included in the analysis. Serum levels of the variables were measured before and after supplementation. Results Serum values of FBS (P=0.039), HOMA-IR (P=0.01), ferritin (P<0.001), total cholesterol (TC) (P=0.006), LDL-C (P=0.007) decreased and HDL-C (P=0.02) increased significantly in the drug group after intervention. Serum levels of triglyceride (P=0.09) decreased marginally in CoQ10 group. Conclusions The results of the current study had shown that after supplementation with 100 mg/day of CoQ10 for 12 weeks, serum values of FBS, HOMA-IR, TC, LDL-C and ferritin were decreased and values of HDL-C were increased in women with T2DM.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Cardiovascular Risk Factors in Acromegaly: What's the Impact of Disease Control?

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-124668

Objective Cardiovascular disease is one of the most important causes of death in acromegalic patients. The aim of this study is to compare the prevalence of cardiovascular risk factors among acromegalic patients and to evaluate the impact of disease control on these factors. Material and Methods 11 acromegalic patients with active disease and 12 controlled patients were evaluated for blood pressure, body mass index, glucose, coagulation status, and lipid profile. A group of 11 patients with non-functioning pituitary adenomas was used as control population. Results Significant differences were found in lipid profile, glucose and coagulation status in both active and controlled patients. Higher levels of fasting glucose (151.2±102.5 mg/dL, p=0.05 and 108.3±23.4 mg/dL, p=0.02 for active and controlled patients respectively) and fibrinogen (427.1±61.9 mg/dL, p=0.02 and 437.3±106.6 mg/dL, p=0.04 for active and controlled patients respectively) were present in both acromegalic groups. Active patients had higher levels of antithrombin III (1.1±0.1 U/mL, p=0.005) and the controlled ones had higher levels of high density lipoprotein cholesterol (56.1±12.5 mg/dL, p=0.05), compared with the non-functioning group. The differences between active and controlled acromegalic patients are that the latter have reduced total cholesterol (170.4±31.7 vs 201.7±34.6 mg/dL, p=0.02), lower density lipoprotein cholesterol (96,8±25,2 vs 130.8±31.5 mg/dL, p=0.01) and antithrombin III (1.0±0.2 vs 1.1±0.1 U/mL, p=0.05). Conclusion There is some reduction in cardiovascular risk factors with control of the disease, but possibly without the return to basal levels.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Berberine Modulates Gut Microbiota and Reduces Insulin Resistance via the TLR4 Signaling Pathway

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-125066

Berberine, a natural compound extracted from several Chinese herbs including Coptis chinensis, has been shown to have anti-obesity effects and prevents insulin resistance in high-fat diet (HFD)-fed obese rats by modulating the gut microbiota; however, the molecular mechanisms underlying these activities remain unknown. We investigated the effects of berberine on obesity and insulin resistance by examining the lipopolysaccharide (LPS)/toll-like receptor 4 (TLR4)/tumor necrosis factor (TNF)-α signaling pathway in livers of HFD-fed obese rats. Our results showed that 8-week berberine (200 mg/kg) treatment significantly reduced fasting blood glucose, triglyceride, low-density lipoprotein-cholesterol and insulin resistance in HFD-fed obese rats. However, berberine had no significant effects on body weight, visceral fat mass or the visceral fat to body weight ratio. Berberine also attenuated HFD-induced hepatic steatosis. A prolonged HFD altered the gut microbiota composition by reducing protective bacteria like Bifidobacterium and increasing gram negative bacteria like Escherichia coli, which resulted in increased LPS release into plasma. Berberine reversed these effects and inhibited LPS-induced TLR4/TNF-α activation, resulting in increased insulin receptor and insulin receptor substrate-1 expression in the liver. These findings suggested that berberine may reduce insulin resistance, at least in part by modulating the gut microbiota along with inhibiting LPS/TLR4/TNF-α signaling in the liver.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Screening for Hypogonadism in Primary Healthcare: How to do this Effectively

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-114866

Background Testosterone, the most important androgen produced by the testes, plays an integral role in male health. Testosterone levels are increasingly being checked in primary healthcare as awareness of the risks of male hypogonadism grows. Aim To investigate what tests are performed to screen for hypogonadism and to exclude secondary hypogonadism. Design and Setting All participants attended general practices in the UK. Methods Data search was performed using the EMIS® clinical database (provider of the majority of GP operating systems in Cheshire). The anonymised records of male patients aged 18–98 years who had undergone a check of serum testosterone during a 10-year period were analysed. Results Overall screening rate was 4.3%. Of 8 788 men with a testosterone result, 1 924 men (21.9%) had a total testosterone level <10 nmol/L. Just 689 of 8 788 men (7.8%) had a sex hormone-binding globulin (SHBG) result, corresponding to 30.5% of those potentially hypogonadal. Estimated free testosterone was negatively associated with BMI (Spearman's rho -0.2, p<0.001) as was total testosterone in the over 50 s. Of 1 924 potentially hypogonadal men with a serum testosterone <10 nmol/L, 588 of 1 924 (30.6%) had a check of serum prolactin. 46.3% and 41.7% had LH and FSH measured, respectively. Only 19.1% of 1 924 men with a hypogonadal total testosterone level were subsequently put on testosterone replacement. The percentage of men in the relatively socially disadvantaged category was similar for both eugonadal and hypogonadal men with a much higher rate of screening for hypogonadism in more socially advantaged men. Conclusions Screening in primary healthcare identified a significant minority of men who had potential hypogonadism. Interpretation of a low serum testosterone requires measurement of serum prolactin, LH and FSH in order to rule out secondary hypogonadism. We suggest that this becomes part of routine screening with a balanced screening approach across the socioeconomic spectrum.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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A Big Thank You to Our Reviewers in The Past Year!

Exp Clin Endocrinol Diabetes 2018; 126: 4-6
DOI: 10.1055/s-0043-124476

© Georg Thieme Verlag KG Stuttgart · New York

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Submaximal Normalizing Methods to Evaluate Load Sharing Changes in the Shoulder During Repetitive Work

Publication date: Available online 9 January 2018
Source:Journal of Electromyography and Kinesiology
Author(s): Alison C. McDonald, Daanish M. Mulla, Paul W. Stratford, Peter J. Keir
The EMG-force relationship changes with muscle fatigue, making interpretation of load sharing between muscles challenging. The purpose of this investigation was to evaluate the efficacy of normalizing EMG to repeated, static, submaximal exertions to mitigate fatigue artifacts in EMG amplitude (increased amplitude without muscle force change). Participants completed repetitive work tasks, in 60-second cycles, until exhaustion. Surface EMG was recorded from 11 shoulder muscles (anterior, middle and posterior deltoids, infraspinatus, upper, middle and lower trapezius, latissimus dorsi, serratus anterior, sternal and clavicular heads of pectoralis major). Every 12 minutes, participants completed 4 submaximal reference exertions. Reference exertion EMG data were used in 6 normalizing methods including 1 standard (normalized to initial reference exertion) and 5 novel methods: (i) Fatigue Only, (ii) Linear, (iii) Cubic, (iv) Points Forward, and (v) Points Forward/Backward. Data normalized with each novel method were compared to the Standard Method using mixed effects modelling. Significant differences depended on the muscle and the number of time points included (p<0.05). The cubic model correlated better to the actual data points than linear predicted values. The novel cubic normalizing method created muscle activity ratios that appear to mitigate the fatigue effects and better reflect muscular loads during fatiguing work.



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Effects of lighting illuminance levels on stair negotiation performance in individuals with visual impairment

Publication date: Available online 16 January 2018
Source:Journal of Electromyography and Kinesiology
Author(s): Aliah F. Shaheen, Alexandros Sourlas, Khim Horton, Christopher McLean, David Ewins, David Gould, Salim Ghoussayni
BackgroundStair-related falls of older people cause a substantial financial and social burden. Deterioration of the visual system amongst other factors put older people at a high risk of falling. Improved lighting is often recommended. The aim of this study was to investigate the effect of lighting illuminance on stair negotiation performance in older individuals with visual impairment.MethodsEleven participants aged 60 or over with a vision of 6/18 or worse ascended and descended a staircase under: 50lx, 100lx, 200lx, 300lx and distributed 200lx lighting. A motion capture system was used to measure movements of the lower limb. Clearance, clearance variability, temporal and spatial parameters and joint/segment kinematics were computed.FindingsThere was no effect on clearance or clearance variability. Participants had lower speed, cadence, increased cycle time and stance time in the 50lx compared to 300lx and distributed 200lx lighting in descent. The minimum hip angle in ascent was increased in the 200lx lighting. Clearance was found to be moderately correlated with balance scores.InterpretationIndividuals with visual impairment adopt precautionary gait in dim lighting conditions. This does not always result in improvements in the parameters associated with risk of falling (e.g. clearance).



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Competitive swimmers with hypermobility have strength and fatigue deficits in shoulder medial rotation

Publication date: Available online 10 January 2018
Source:Journal of Electromyography and Kinesiology
Author(s): Behnam Liaghat, Birgit Juul-Kristensen, Thomas Frydendal, Camilla Marie Larsen, Karen Søgaard, Aki Ilkka Tapio Salo




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Effect of a Mat Pilates Program with TheraBand on Dynamic Balance in Patients with Parkinson's Disease: Feasibility Study and Randomized Controlled Trial

Rejuvenation Research , Vol. 0, No. 0.


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Use of statistical analysis to validate ecogenotoxicology findings arising from various comet assay components

Abstract

Cirrhinus mrigala, Labeo rohita, and Catla catla are economically important fish for human consumption in Pakistan, but industrial and sewage pollution has drastically reduced their population in the River Chenab. Statistics are an important tool to analyze and interpret comet assay results. The specific aims of the study were to determine the DNA damage in Cirrhinus mrigala, Labeo rohita, and Catla catla due to chemical pollution and to assess the validity of statistical analyses to determine the viability of the comet assay for a possible use with these freshwater fish species as a good indicator of pollution load and habitat degradation. Comet assay results indicated a significant (P < 0.05) degree of DNA fragmentation in Cirrhinus mrigala followed by Labeo rohita and Catla catla in respect to comet head diameter, comet tail length, and % DNA damage. Regression analysis and correlation matrices conducted among the parameters of the comet assay affirmed the precision and the legitimacy of the results. The present study, therefore, strongly recommends that genotoxicological studies conduct appropriate analysis of the various components of comet assays to offer better interpretation of the assay data.

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Differential distribution of metals in tree tissues growing on reclaimed coal mine overburden dumps, Jharia coal field (India)

Abstract

Opencast bituminous coal mining invariably generates huge amount of metal-polluted waste rocks (stored as overburden (OB) dumps) and reclaimed by planting fast growing hardy tree species which accumulate metals in their tissues. In the present study, reclaimed OB dumps located in Jharia coal field (Jharkhand, India) were selected to assess the accumulation of selected metals (Pb, Zn, Mn, Cu and Co) in tissues (leaf, stem bark, stem wood, root bark and root wood) of two commonly planted tree species (Acacia auriculiformis A.Cunn. ex Benth. and Melia azedarach L.). In reclaimed mine soil (RMS), the concentrations of pseudo-total and available metals (DTPA-extractable) were found 182–498 and 196–1877% higher, respectively, than control soil (CS). The positive Spearman's correlation coefficients between pseudo-total concentration of Pb and Cu (r = 0.717; p < 0.05), Pb and Co (r = 0.650; p < 0.05), Zn and Mn (0.359), Cu and Co (r = 0.896; p < 0.01) suggested similar sources for Pb-Cu-Co and Mn-Zn. Among the five tree tissues considered, Pb selectively accumulated in root bark, stem bark and leaves; Zn and Mn in leaves; and Cu in root wood and stem wood. These results suggested metal accumulation to be "tissue-specific". The biological indices (BCF, TF_leaf, TF_{stem bark} and TF_{stem wood}) indicated variation in metal uptake potential of different tree tissues. The study indicated that A. auriculiformis could be employed for Mn phytoextraction (BCF, TF_leaf, TF_{stem bark} and TF_{stem wood} > 1). The applicability of both the trees in Cu phytostabilization (BCF > 1; TF_leaf, TF_{stem bark} and TF_{stem wood} < 1) was suggested. The study enhanced knowledge about the selection of tree species for the phytoremediation of coal mine OB dumps and specific tree tissues for monitoring metal pollution.

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Enhanced removal performance of Cr(VI) by the core-shell zeolites/layered double hydroxides (LDHs) synthesized from different metal compounds in constructed rapid infiltration systems

Abstract

Nine kinds of LDHs were synthesized by the co-precipitation method under alkaline conditions with different combinations of trivalent metal compounds (FeCl₃, AlCl₃, CoCl₃) and divalent metal compounds (CaCl₂, MgCl₂, ZnCl₂), which were then coated in situ on the surface of zeolites to synthesize core-shell zeolites/LDHs composites. The zeolites before and after modification were characterized by SEM and X-ray fluorescence spectrometry. Using the different core-shell zeolites/LDHs and original zeolite substrates, the constructed rapid infiltration systems (CRIS) simulated test columns were set to treat the municipal sewage containing hexavalent chromium, Cr(VI). Isothermal adsorption tests were subsequently performed. The average removal efficiencies of the small-sized zeolites were much higher than those of the large-sized zeolites. For the small-sized zeolites, the Cr(VI) removal performances of the Mg-LDHs- and Al-LDHs-modified zeolite substrates were efficiently enhanced in particular, which could reach over 90%. And the removal rate of core-shell zeolites/ZnAl-LDHs reached 94.5%. Meanwhile, the maximum adsorption capacity of ZnAl-LDHs-modified zeolites could reach 51.0 mg/kg, indicating that the adsorption properties could be enhanced by ZnAl-LDHs coating. During the purification experiments, most of the LDHs-modified zeolites maintained their predominant chemical adsorption ability for the removal of Cr(VI). Therefore, the small-sized core-shell zeolites/ZnAl-LDHs composites could be used as potential substrates for the efficient removal of Cr(VI) in CRIS.

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Fraction distribution and leaching behavior of heavy metals in dredged sediment disposal sites around Meiliang Bay, Lake Taihu (China)

Abstract

The objectives of this study were to characterize the heavy metal contamination status of surface soils sampled at two dredged sediment land disposal sites (the Baimao and Kongwan landfills) in Meiliang Bay, Lake Taihu, China, as well as to investigate the effect on their leaching behaviors due to acid rain. Among all the metals, only the nickel content in the Baimao landfill was higher than the Chinese reference value, and all metal contents were below the limit values for agricultural soils. The fraction distribution of metals by sequential extraction was similar at both sites. Cadmium had a relatively high proportion of exchangeable-carbonate fractions, while the other metals were mainly classified as residue fractions. The metals released from soils by simulated rainwater comprised less than 1% of the total soil metal content, and the effect of acid rain on heavy metal release from dredged sediments in land disposal sites was found to be negligible at both sites. All results indicate no environmental concern for the land disposal of dredged sediments and support the feasibility of beneficially reusing dredged sediment soils as a supplement to agricultural soils.

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What you should know about third nipples

A look a third (sometimes called supernumary) nipples, a rare condition where a person has an extra one. Included is detail on causes and diagnosis.

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Trace metal occurrence in Mediterranean seaweeds

Abstract

Seaweeds have been used as animal feed since a long time and are consumed as food in several cultures. In fact, macroalgae are a source of protein, fiber, polyunsaturated fat, and minerals. The concentration of trace elements was determined in dominant macroalga species from three sites of the northwestern Mediterranean Sea. A high interspecies variability was observed, with higher metal levels in brown and green than those in red seaweeds. The maximum values set by European regulations for arsenic, mercury, and cadmium in food and feed were never exceeded, but a few samples were very close to limits set for mercury. Conversely, the maximum limit for lead in feed was exceeded in all species from one of the considered sites. Analogously, lead in seaweeds could constitute a potential risk for human health, due to the exceeding of the maximum value set for food supplements.

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Studies on biogas-fuelled compression ignition engine under dual fuel mode

Abstract

Experimental investigation has been carried out to utilize biogas as an alternative source of energy in compression ignition (CI) engine under dual fuel operational mode. Biogas was inducted into the inlet manifold at different flow rates along with fresh air through inlet manifold and diesel was injected as a pilot fuel to initiate combustion under dual fuel mode. The engine performance and emission characteristics of dual fuel operational mode were analyzed at different biogas flow rates and compared with baseline conventional diesel fuel. Based upon the improved performance and lower emission characteristics under the dual fuel operation, the optimum flow rate of biogas was observed to be 2.2 kg/h. The lower brake thermal efficiency (BTE) and higher brake-specific energy consumption (BSEC) were noticed with biogas-diesel fuel under dual fuel mode when compared with neat diesel operation. Test results showed reduced NO_x emissions and smoke opacity level in the exhaust tailpipe emissions. However, higher hydrocarbon (HC) and carbon monoxide (CO) emissions were noticed under dual fuel mode at entire engine loads when compared with baseline fossil petro-diesel. Hence, the use of low-cost gaseous fuel such as biogas would be an economically viable proposition to address the current and future problems of energy scarcity and associated environmental concerns.

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Comparison of Urticaria Activity Score Over 7 Days (UAS7) Values Obtained from Once-Daily and Twice-Daily Versions: Results from the ASSURE-CSU Study

Abstract

Background

The Urticaria Activity Score summed over 7 days (UAS7) assesses the itch severity and hive count in chronic spontaneous urticaria (CSU) using once- or twice-daily diary-based documentation.

Objective

The aim of this study was to evaluate the comparability of twice-daily versus once-daily versions of the UAS and the resulting UAS7 values.

Methods

Data came from the ASSURE-CSU study. The twice-daily and once-daily UAS7 was calculated from morning and evening ratings, as well as from exact 24-h evening ratings of hive count and itch severity, respectively. Three UAS7 scores were computed: UAS7 twice daily (UAS7_TD), UAS7 once daily for maximum itch (UAS7_OD1MAX), and UAS7 once daily for average itch (UAS7_OD2AVG). UAS7 values were assigned to five score bands (0, 1–6, 7–15, 16–27, 28–42), reflecting urticaria-free to severe disease activity. The score values and score band ratios of the UAS7_TD and UAS7_OD versions were compared and assessed for correlation by weighted Cohen's kappa statistics.

Results

Data from 614 patients were analyzed. All three versions of the UAS7 yielded very similar results, with a mean (standard deviation) UAS7_TD, UAS7_OD1MAX, and UAS7_OD2AVG of 17.3 (10.49), 17.7 (8.90), and 16.2 (8.68), respectively. Correlation coefficients between UAS7_TD and UAS7_OD1MAX, UAS7_TD and UAS7_OD2AVG, and UAS7_OD1MAX and UAS7_OD2AVG were 0.94, 0.95, and 0.99, respectively, showing very high positive pairwise correlation. The weighted kappa coefficient, κ (95% confidence interval) was 0.78 (0.75–0.82) for UAS7_TD versus UAS7_OD1MAX, and 0.82 (0.78–0.85) for UAS7_TD versus UAS7_OD2AVG, demonstrating substantial agreement.

Conclusions

The once- and twice-daily UAS7 scores were highly consistent, supporting the use of either version when evaluating CSU activity.

http://ift.tt/2ryKsKF

Anxiety in Children [Internet].

To evaluate the comparative effectiveness and safety of treatments for childhood anxiety disorders, including panic disorder, social anxiety disorder, specific phobias, generalized anxiety disorder, and separation anxiety.

http://ift.tt/2n9glnx

Immediate Health Consequences of Female Genital Mutilation/Cutting (FGM/C) [Internet].

Female genital mutilation/cutting (FGM/C) has been performed in various forms for millennia and involves the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. In this systematic review we addressed harm occurring during the cutting or alteration modification process and the short-term period.

http://ift.tt/2DEvkko

TNFα-Inhibitors in Inflammatory Bowel Disease [Internet].

Background Patients with the inflammatory bowel diseases ulcerative colitis and Crohn's disease need lifelong treatment and care. Effect of traditional treatments is varied and may cause serious adverse events. Biological drugs aimed at blocking specific molecular steps in the inflammatory process have been developed. Tumor necrosis factor (TNF)α is a proinflammatory cytokine with a role in the inflammatory process associated with inflammatory bowel disease. Hence, a drug blocking this cytokine might be useful for patients with ulcerative colitis and Crohn's disease. This report includes knowledge of the TNFα-inhibitors infliximab (Remicade®), adalimumab (Humira®), etanercept (Enbrel®) and certolizumab pegol (Cimzia®).

http://ift.tt/2naXcls

Prevention of Suicide. Part 1: Psychotherapy, Drug Treatment and Electroconvulsive Treatment [Internet].

Background The Norwegian Directorate for Health and Social Affairs requested the Norwegian Knowledge Centre for the Health Service (NOKC) to do a health technology assessment (HTA) of the effects of interventions by the psychiatric health services for the prevention of suicide. The HTA will be part of the basis for national guidelines for suicide prevention.

http://ift.tt/2r1UtzA

Ipilimumab or FOLFOX in Combination With Nivolumab and Trastuzumab in HER2 Positive EsophagoGastric Adenocarcinoma

Conditions:   Gastric Cancer;   Esophageal Cancer;   Adenocarcinoma Gastric;   HER2 Positive Gastric Cancer;   Metastatic Gastric Cancer;   GastroEsophageal Cancer
Interventions:   Drug: Nivolumab;   Drug: Ipilimumab
Sponsors:   AIO-Studien-gGmbH;   Bristol-Myers Squibb
Not yet recruiting

http://ift.tt/2G8Idku

Effect of the Neck Extension on Blind Intubation Via Ambu® AuraGain™

Conditions:   Intubation; Difficult or Failed;   Intubation Complication
Interventions:   Device: Ambu® AuraGain™;   Procedure: neck extension
Sponsor:   Seoul National University Hospital
Not yet recruiting

http://ift.tt/2rzTcjF

A Dose Escalation and Confirmation Study of PT-112 in Advanced Solid Tumors in Combination With Avelumab

Conditions:   Non Small Cell Lung Cancer (NSCLC);   Urothelial Carcinoma (UC);   Squamous Cell Carcinoma of the Head and Neck (SCCHN);   Metastatic Breast Cancer (mBC);   Castration-resistant Prostate Cancer (CRPC)
Interventions:   Drug: PT-112;   Biological: avelumab
Sponsors:   Phosplatin Therapeutics;   Pfizer;   EMD Serono
Not yet recruiting

http://ift.tt/2G9Mcxj

TH17 cell plasticity: The role of dendritic cells and molecular mechanisms

Publication date: Available online 19 January 2018
Source:Journal of Autoimmunity
Author(s): Theodora Agalioti, Eduardo J. Villablanca, Samuel Huber, Nicola Gagliani
Upon interaction with dendritic cells (DCs), naïve CD4 T cells differentiate into distinct subsets and orchestrate the development of a physiological immune response. When uncontrolled by cellular and molecular mechanisms, CD4 T cells can also lead to immune mediated inflammatory diseases (IMIDs). Initially, these distinct CD4 T-cell subsets were defined according to the expression of a limited number of cytokines. Later it was revealed that CD4 T cells can acquire much more complex functional phenotypes than previously thought. Experimental data showed that the CD4 T-cell subset TH17 can secrete IFN-γ and IL-4, which are signature molecules of other T-cell subsets. Furthermore, some TH17 cells can also explore an anti-inflammatory fate and participate in the resolution of the immune response. A more flexible theory has therefore evolved with the scope to better represent the plastic biology of CD4 T cells. In this context, several aspects still remain unclear. The goal of this review is to discuss the role of extrinsic and intrinsic cellular and molecular mechanisms, which can drive the plasticity of TH17 cells. In particular, we will outline the role of DCs and the function of transcriptional factors in shaping the fate of TH17 cells towards either a pathogenic or a regulatory phenotype. Finally, we will discuss whether TH17 cell plasticity could be a target for new therapies for IMIDs. We indeed envision that when the cellular and molecular mechanisms controlling TH17 plasticity are known, new therapies, which aim to reset the immune system, will be developed. This will be achieved by either selectively depleting only the pathogenic TH17 cells or, if possible, re converting these cells from pathogenic to regulatory. This will overcome the challenge posed by the immune suppressive side effects caused by the current therapies, which impair the function of CD4 cells or delete all of them, to the detriment of the patient.



http://ift.tt/2Dz677e

Current concerns and perspectives on Zika virus co-infection with arboviruses and HIV

Publication date: Available online 17 January 2018
Source:Journal of Autoimmunity
Author(s): Hussin A. Rothan, Mehdi R.M. Bidokhti, Siddappa N. Byrareddy
Dissemination of vector-borne viruses, such as Zika virus (ZIKV), in tropical and sub-tropical regions has a complicated impact on the immunopathogenesis of other endemic viruses such as dengue virus (DENV), chikungunya virus (CHIKV) and human immunodeficiency virus (HIV). The consequences of the possible co-infections with these viruses have specifically shown significant impact on the treatment and vaccination strategies. ZIKV is a mosquito-borne flavivirus from African and Asian lineages that causes neurological complications in infected humans. Many of DENV and CHIKV endemic regions have been experiencing outbreaks of ZIKV infection. Intriguingly, the mosquitoes, Aedes Aegypti and Aedes Albopictus, can simultaneously transmit all the combinations of ZIKV, DENV, and CHIKV to the humans. The co-circulation of these viruses leads to a complicated immune response due to the pre-existence or co-existence of ZIKV infection with DENV and CHIKV infections. The non-vector transmission of ZIKV, especially, via sexual intercourse and placenta represents an additional burden that may hander the treatment strategies of other sexually transmitted diseases such as HIV. Collectively, ZIKV co-circulation and co-infection with other viruses have inevitable impact on the host immune response, diagnosis techniques, and vaccine development strategies for the control of these co-infections.



http://ift.tt/2E5WAFs

Expression level of risk genes of MHC class II is a susceptibility factor for autoimmunity: New insights

Publication date: Available online 10 January 2018
Source:Journal of Autoimmunity
Author(s): Carmen Gianfran, Laura Pisapia, Stefania Picascia, Maria Strazzullo, Giovanna Del Pozzo
To date, the study of the impact of major hystocompatibility complex on autoimmunity has been prevalently focused on structural diversity of MHC molecules in binding and presentation of (auto)antigens to cognate T cells. Recently, a number of experimental evidences suggested new points of view to investigate the complex relationships between MHC gene expression and the individual predisposition to autoimmune diseases. Irrespective of the nature of the antigen, a threshold of MHC-peptide complexes needs to be reached, as well as a threshold of T cell receptors engaged is required, for the activation and proliferation of autoantigen-reactive T cells. Moreover, it is well known that increased expression of MHC class II molecules may alter the T cell receptor repertoire during thymic development, and affect the survival and expansion of mature T cells. Many evidences confirmed that the level of both transcriptional and post-transcriptional regulation are involved in the modulation of the expression of MHC class II genes and that both contribute to the predisposition to autoimmune diseases. Here, we aim to focus some of these regulative aspects to better clarify the role of MHC class II genes in predisposition and development of autoimmunity.



http://ift.tt/2E5DkIq

Serum microRNA screening and functional studies reveal miR-483-5p as a potential driver of fibrosis in systemic sclerosis

Publication date: Available online 20 January 2018
Source:Journal of Autoimmunity
Author(s): Eleni Chouri, Nila H. Servaas, Cornelis P.J. Bekker, Alsya J. Affandi, Marta Cossu, Maarten R. Hillen, Chiara Angiolilli, Jorre S. Mertens, Lucas L. van den Hoogen, Sandra Silva-Cardoso, Maarten van der Kroef, Nadia Vazirpanah, Catharina G.K. Wichers, Tiago Carvalheiro, Sofie L.M. Blokland, Barbara Giovannone, Laura Porretti, Wioleta Marut, Barbara Vigone, Joel A.G. van Roon, Lorenzo Beretta, Marzia Rossato, Timothy R.D.J. Radstake
ObjectiveMicroRNAs (miRNAs) are regulatory molecules, which have been addressed as potential biomarkers and therapeutic targets in rheumatic diseases. Here, we investigated the miRNA signature in the serum of systemic sclerosis (SSc) patients and we further assessed their expression in early stages of the disease.MethodsThe levels of 758 miRNAs were evaluated in the serum of 26 SSc patients as compared to 9 healthy controls by using an Openarray platform. Three miRNAs were examined in an additional cohort of 107 SSc patients and 24 healthy donors by single qPCR. MiR-483-5p expression was further analysed in the serum of patients with localized scleroderma (LoS) (n = 22), systemic lupus erythematosus (SLE) (n = 33) and primary Sjögren's syndrome (pSS) (n = 23). The function of miR-483-5p was examined by transfecting miR-483-5p into primary human dermal fibroblasts and pulmonary endothelial cells.Results30 miRNAs were significantly increased in patients with SSc. Of these, miR-483-5p showed reproducibly higher levels in an independent SSc cohort and was also elevated in patients with preclinical-SSc symptoms (early SSc). Notably, miR-483-5p was not differentially expressed in patients with SLE or pSS, whereas it was up-regulated in LoS, indicating that this miRNA could be involved in the development of skin fibrosis. Consistently, miR-483-5p overexpression in fibroblasts and endothelial cells modulated the expression of fibrosis-related genes.ConclusionsOur findings showed that miR-483-5p is up-regulated in the serum of SSc patients, from the early stages of the disease onwards, and indicated its potential function as a fine regulator of fibrosis in SSc.



http://ift.tt/2E5cm3C

Application of Strict Criteria for Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features and Encapsulated Follicular Variant Papillary Thyroid Carcinoma: a Retrospective Study of 50 Tumors Previously Diagnosed as Follicular Variant PTC

Abstract

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently proposed as a designation for a subset of follicular variant papillary thyroid carcinoma (FVPTC). Encapsulated FVPTC has been shown to be a fairly indolent tumor, and NIFTP are expected to represent the most indolent subset of these tumors. Many of the exclusion criteria for NIFTP related to architecture and a lack of psammoma bodies are designed to preclude the inclusion of more aggressive non-FVPTC tumors in this indolent group and also exclude the diagnosis of FVPTC. In addition to strict application of histologic features to ensure that NIFTP represents a subset of encapsulated FVPTC without invasion, other exclusion criteria including high mitotic activity and necrosis may also lead to a lack of one-to-one correlation between the diagnosis of NIFTP and encapsulated FVPTC without invasion. In this series, 50 cases previously diagnosed as FVPTC over a 2-year period from a large academic center are retrospectively reviewed for reclassification as NIFTP. Additionally, cases not meeting criteria for NIFTP are more accurately classified using the most up to date WHO criteria. Prior BRAF V600E mutation testing was examined for these tumors when available. Seventeen of 50 (34%) tumors met criteria for classification as NIFTP and, 17 (34%) were classified as encapsulated FVPTC with invasion. Strict application of architectural features led to classification of 12 (24%) tumors as non-FVPTC with a variety of more aggressive designations. Tumors classified as NIFTP and encapsulated FVPTC with invasion lacked lymph node metastases (0/4; 0/7, respectively) and BRAF mutations (0/12; 0/13, respectively). In contrast, infiltrative FVPTC, encapsulated PTC with or without invasion, and conventional PTC showed more aggressive features with lymph node metastases and BRAF V600E mutations. One case not meeting criteria for NIFTP maintained the diagnosis of encapsulated FVPTC without invasion but demonstrated significant mitotic activity (three mitoses/ten HPF) and lacked lymph node metastases and BRAF V600E mutation. These findings demonstrate the importance of using strict criteria, especially the lack of true papillary architecture, for the diagnosis of NIFTP and encapsulated FVPTC to ensure that only truly indolent tumors will be included in these diagnoses and to allow tumors with potential for more aggressive behavior to be appropriately treated.

http://ift.tt/2DC69PO

Hypertensive disorders during pregnancy and 3 years after delivery in women with gestational hyperglycemia

Abstract

Aims

Women with gestational hyperglycemia commonly experience hypertensive disorders during pregnancy. More information is needed about how hypertension develops in these patients over time. We investigated the prevalence of hypertension during and 3 years after pregnancy in Caucasian women with gestational hyperglycemia. We also investigated metabolic syndrome presence, glucose tolerance status, insulin sensitivity and insulin secretion levels in the follow-up period.

Methods

In a prospective longitudinal study with a 3-year follow-up, we assessed hypertension status and clinical-related characteristics of 103 consecutive women with gestational hyperglycemia sub-grouped according to their hypertensive status during and after pregnancy.

Results

Overall, 29 (28.1%) women had hypertension during pregnancy (24 gestational hypertension; 4 chronic hypertension; 1 preeclampsia). At follow-up 16 (15.5%) women were diagnosed as having hypertension (11 with hypertension in pregnancy; 5 with a normotensive pregnancy). Women with hypertension after pregnancy had higher BMI, metabolic syndrome rate and worse insulin resistance indexes than normotensive women. Weight increase at follow-up (OR 1.17, 95% CI 1.00–1.35) and hypertension in pregnancy (OR 6.72, 95% CI 1.17–38.64) were associated with hypertension after pregnancy.

Conclusions

Women with gestational hyperglycemia should undergo regular monitoring during and after pregnancy to detect metabolic and clinical impairments and to prevent cardiovascular harm.

http://ift.tt/2n5Sh60

State of Plastic Surgery in Brazil

No abstract available

http://ift.tt/2n7FyQ0

Combining Autologous and Prosthetic Techniques: The Breast Reconstruction Scale Principle

Background: The latissimus dorsi (LD) flap remains a good option for immediate or delayed breast reconstruction. The main limitation of this flap is the small volume provided. To improve the reconstructed breast volume, the LD flap is usually combined with a breast implant. Recently, fat grafting to the LD flap was described to maximize flap volume and obtain a totally autologous breast reconstruction. We report our experience with hybrid breast reconstruction using both breast implants and fat-enriched latissimus dorsi (FELD) flaps. Methods: Between 2013 and 2016, 74 patients underwent breast reconstruction with FELD flaps only or FELD flaps combined with a breast implant. The LD flap was harvested as previously described. Donor sites for fat harvesting were chosen according to each patient's natural fat distribution. Fat was harvested, centrifuged, and injected into the LD flap. After fat grafting, breast sizers were employed to determine the final breast volume when the addition of an implant was indicated. Results: Good cosmetic outcomes were achieved in all cases, with a mean follow-up of 2.1 years. No patients had cancer reoccurrences. Four patients experienced a seroma of the LD donor site, 1 had a breast hematoma, and 1 developed Baker grade III capsular contracture. One year postoperatively, a clinically relevant area of fat necrosis was observed in 1 patient and was surgically treated. Additional fat grafting sessions were required in 3 cases. Conclusion: In elected cases, a FELD flap alone or in combination with a small implant is a valuable technique for breast reconstruction surgery.

http://ift.tt/2BqmIrE

Effect of low-level laser therapy on the healing process of donor site in patients with grade 3 burn ulcer after skin graft surgery (a randomized clinical trial)

Abstract

Skin graft is a standard therapeutic technique in patients with deep ulcers, but managing donor site after grafting is very important. Although several modern dressings are available to enhance the comfort of donor site, using techniques that accelerate wound healing may enhance patient satisfaction. Low-level laser therapy (LLLT) has been used in several medical fields, including healing of diabetic, surgical, and pressure ulcers, but there is not any report of using this method for healing of donor site in burn patients. The protocols and informed consent were reviewed according to Medical Ethics Board of Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1394.363) and Iranian Registry of Clinical Trials (IRCT2016020226069N2). Eighteen donor sites in 11 patients with grade 3 burn ulcer were selected. Donor areas were divided into 2 parts, for laser irradiation and control randomly. Laser area was irradiated by a red, 655-nm laser light, 150 mW, 2 J/cm², on days 0 (immediately after surgery), 3, 5, and 7. Dressing and other therapeutic care for both sites were the same. The patients and the person who analyzed the results were blinded. The size of donor site reduced in both groups during the 7-day study period (P < 0.01) and this reduction was significantly greater in the laser group (P = 0.01). In the present study, for the first time, we evaluate the effects of LLLT on the healing process of donor site in burn patients. The results showed that local irradiation of red laser accelerates wound healing process significantly.

http://ift.tt/2n6oxWx

Sinomenine inhibits fibroblast-like synoviocyte proliferation by regulating α7nAChR expression via ERK/Egr-1 pathway

Publication date: March 2018
Source:International Immunopharmacology, Volume 56
Author(s): Lang Yi, Yan-jun Lyn, Chong Peng, Rui-li Zhu, Sha-sha Bai, Liang Liu, Pei-xun Wang, Hua Zhou, Yan Dong
Fibroblast like synoviocyte (FLS) is a crucial in the pathogenesis of rheumatoid arthritis (RA), and involved in inflammation and joint destruction. Sinomenine (SIN), an alkaloid derived from the plant Sinomenium acutum, has anti-inflammatory and analgesic effect and been used for RA treatment in China. Alpha 7 nicotinic acetylcholine receptors (α7nAChR), as the key receptor in cholinergic anti-inflammatory pathway (CAP) to inhibit inflammation, has been detected in RA patients synovium, but its role is still unclear. Here we investigated the association between the aggressive proliferation of FLS and α7nAChR expression and the effect of sinomenine. FLS was isolated from synovial tissues of adjuvant-induced-arthritis (AIA) rat. Tumor necrosis factor(TNF)-α was used to induce the aggressive proliferation of FLS. MTT assay was applied to evaluate the proliferation of FLS. The messenger RNA (mRNA) and protein levels of α7nAChR and early growth response gene-1 (Egr-1) were measured. The results showed that TNF-α induced FLS proliferation in vitro (P < .01) and increased the phosphorylation of ERK1/2 and the expression of Egr-1 and α7nAChR (P < .05 or P < .01). U0126, the inhibitor of ERK1/2 inhibited α7nAChR expression and FLS proliferation significantly (P < .05 or P < .01). Specific short interference RNA(siRNA) of α7nAChR decreased α7nAChR expression and inhibited FLS proliferation as well. SIN inhibited the proliferation of FLS and decreased the phosphorylation of ERK1/2, and the expression of Egr-1 and α7nAChR induced by TNF-α (P < .05). In conclusion, the expression of α7nAChR involved in the aggressive proliferation of FLS induced by TNF-α and was regulated by ERK/Egr-1 signal pathway. SIN inhibited FLS proliferation and α7nAChR expression through inhibiting ERK/Egr-1 signal pathway, this may contribute to the anti-inflammatory and anti-arthritic effect of SIN.



http://ift.tt/2DE2II0

Cortisol inhibits NF-κB and MAPK pathways in LPS activated bovine endometrial epithelial cells

Publication date: March 2018
Source:International Immunopharmacology, Volume 56
Author(s): Junsheng Dong, Yang Qu, Jianji Li, Luying Cui, Yefan Wang, Jiaqi Lin, Heng Wang
The bovine uterus is subject to infection after calving, which may lead to endometritis. Elevated cortisol levels have been observed in postpartum cattle. However, the role of cortisol in the inflammatory response of the uterus has not been reported. The aim of this study was to investigate the anti-inflammatory effects of cortisol on lipopolysaccharide (LPS)-induced primary bovine endometrial epithelial cells (BEECs). BEECs were treated with various concentrations of cortisol (5, 15 and 30 ng/mL) in the presence of LPS. The mRNA expression of TLR4 and proinflammatory cytokines was measured with qPCR. The activation of NF-κB and MAPK signalling pathways was detected with Western blotting and immunofluorescence. Cortisol induced the down-regulation of the mRNA expression of toll-like receptor 4 (TLR4) and proinflammatory cytokines, including interleukin (IL)-1β, IL-6, IL-8, tumour necrosis factor–α (TNF-α), cyclooxygenase-2 (COX-2) and inducible NO synthase (iNOS). Cortisol inhibited the activity of nuclear factor-κB (NF-κB) via blocking the phosphorylation and degradation of IκB. Cortisol suppressed the phosphorylation of mitogen-activated protein kinase (MAPK), including extracellular signal-regulated kinase (ERK1/2), p38MAPK and c-Jun N-terminal kinase/stress-activated protein kinase (JNK). These results demonstrated that cortisol may exert its anti-inflammatory actions by regulating NF-κB activation and MAPK phosphorylation.



http://ift.tt/2n5ZNgk

Chrysophanol demonstrates anti-inflammatory properties in LPS-primed RAW 264.7 macrophages through activating PPAR-γ

Publication date: March 2018
Source:International Immunopharmacology, Volume 56
Author(s): Quan Wen, Liyan Mei, Sen Ye, Xia Liu, Qin Xu, Jifei Miao, Shaohui Du, Dongfeng Chen, Chun Li, Hui Li
Sepsis is a life-threatening disease. Inflammation is a major concomitant symptom of sepsis Chrysophanol, an anthraquinone derivative isolated from the rhizomes of rheumpalmatum, has been reported to have a protective effect against lipopolysaccharide(LPS)-induced inflammation. However, the underlying molecular mechanisms are not well understood. The aim of this study was to explore the effect and mechanism of chrysophanol on lipopolysaccharide (LPS)-induced anti-inflammatory effect of RAW264.7 cells and its involved potential mechanism. The mRNA and protein expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and inducible nitric oxide synthase (iNOS), nuclear factor kappa B (NF-κB) and PPAR-γ were measured by qRT-PCR and western blotting, the production of TNF-α, IL-1β was evaluated by ELISA. Then, the phosphorylation of NF-κB p65 was also detected by western blotting. And NF-κB p65 promoter activity was analyzed by the Dual-Luciferase reporter assay system as well. Meanwhile, PPAR-γ inhibitor GW9662 was performed to knockdown PPAR-γ expression in cells. Our data revealed that LPS induced the up-regulation of TNF-α, IL-1β, iNOS and NF-κB p65, the down-regulation of PPAR-γ were substantially suppressed by chrysophanol in RAW264.7 cells. Furthermore, our data also figured out that these effects of chrysophanol were largely abrogated by PPAR-γ inhibitor GW9662. Taken together, our results indicated that LPS-induced inflammation was potently compromised by chrysophanol very likely through the PPAR-γ-dependent inactivation of NF-κB in RAW264.7 cells.



http://ift.tt/2DzEL4D

Heavy Water Shedding Light on Antigen-Specific T Cell Responses

Publication date: Available online 24 January 2018
Source:Trends in Immunology
Author(s): Liv Eidsmo, Carmen Gerlach
CD8 T cells are crucial for long-term immunity. Nevertheless, the in vivo differentiation of human naïve CD8 T cells into effector and memory populations remains ill-defined. A recent study assesses the in vivo turnover of human antigen-specific CD8 T cells and suggests that long-lived memory cells arise from effector cells.



http://ift.tt/2DGUe2i

Advanced treatment of petrochemical wastewater by combined ozonation and biological aerated filter

Abstract

The secondary effluent from a petrochemical wastewater treatment plant was treated by biological aerated filter (BAF) before and after ozonation, namely BAF1 and BAF2, respectively. The results showed that BAF2 fed with the ozonized secondary effluent exhibited a high efficiency in degrading organic pollutants. The removal efficiency of COD and NH₄-N was 6.0 ± 3.2 and 48.2~18.6% for BAF1 and 12.5 ± 5.8 and 62.1~40.9% for BAF2, respectively, during the whole operation. The integration system of ozonation and BAF could tolerate a higher organic loading rate. When HRT decreased from 4 to 1 h, COD removal efficiency decreased from 12 to 4% for the BAF1 system, but it kept almost unchanged at high levels of 27–32% for the ozonation-BAF2 system, with around 20% removal by ozonation. The biomass in BAF2 exhibited a higher activity of protease, DHA, and SOUR than that in BAF1. The organic pollutants in influent and effluent of BAF were mainly ester compounds, which were difficult to biodegrade by BAF. The predominant genera in BAF1 were Gemmatimonadaceae uncultured, Thauera, and Thiobacillus, while the dominant genera in BAF2 were Nitrospira, Gemmatimonadaceae uncultured, and Flexibacter, respectively. Overall, BAF2 performed better than BAF1 in organic pollutant removal and microbial activity. The ozonation process was vital for BAF to treat petrochemical secondary effluent.

http://ift.tt/2Dwdzjr