Ιατρικά Άρθρα: 08/18/18

Σάββατο 18 Αυγούστου 2018

Proximal carpal crease incision for carpal tunnel release: a pilot study

Abstract

Background

Limited palmar incision (PI) is the standard approach for treatment of carpal tunnel syndrome. Proximal carpal crease incision (CI) is an investigated alternative. The aim of our study was to evaluate safety and results of PI and CI approaches.

Methods

A prospective, randomised, open label pilot study was carried out in the period of November 2011–November 2017. A total of 104 patients were randomised into two groups according to the incision: group 1 (CI) had 33 patients and group 2 (PI) had 71 patients. Measured characteristics are the following: safety, severity of pain, DASH score, hand grip and pinch strength, two-point discrimination test and Semmes-Weinstein monofilament test. Data were collected 1 h before surgery, in the early (2–3 weeks after surgery) and late (3–4 months after surgery) post-operative periods. A significance level of 0.05 was considered for testing statistical hypotheses.

Results

We found that CI results in lower early (p = 0.064) and late (p = 0.033) post-operative period pain and better hand function: lower DASH score in early (p = 0.005) and late (p = 0.047) post-operative period and stronger hand pinch in early post-operative period (p = 0.037). However, hand grip strength, two-point discrimination and Semmes-Weinstein monofilament test did not reveal any significant differences between the study groups. No major complications appeared in both study groups; thus, both incisions were considered safe.

Conclusions

Pilot study suggests that CI is a safe alternative treatment method of the carpal tunnel syndrome resulting in faster patient recovery after carpal tunnel release.

Level of Evidence: Level I, therapeutic study.

https://ift.tt/2vRTKku

Use of Vascularized Fibular Free Flap in the Reconstruction of the Femur in Pediatric and Adolescent Bone Sarcomas: Complications and Functional Outcome

J reconstr Microsurg
DOI: 10.1055/s-0038-1668142

Background Most reports on skeletal reconstruction using vascularized fibular free flap include patients with varying age groups and anatomic locations. This study has limited the inclusion criteria to pediatric and adolescent patients diagnosed with bone sarcoma of the femoral shaft. Methods Forty-one patients, diagnosed with a malignant bone tumor of the femoral shaft (21 Ewing's sarcomas and 20 osteosarcomas), were locally treated by joint sparing wide resection and reconstruction using a vascularized fibular free flap. All clinical and radiographic data were reviewed for graft healing and hypertrophy as well as oncologic and functional outcome. Results The mean follow-up period was 48.7 months (12–104 months). The mean age at presentation was 10.3 years (5–17 years). The average length of the resected femoral shaft was 19.2 cm (15–24 cm) and the average length of the harvested fibula was 17.4 cm (15–21 cm). The mean time to union was 4.8 months (1–6 months) and the mean hypertrophy index was 78% (15.5–184%). Complications included 12 fractures (33.3%), 5 non-unions (13.8%), and 5 failures of graft hypertrophy (13.8%). At the latest clinical evaluation, the mean MSTS score was 81% (56–100%) and the mean limb length inequality was 4.75 cm (3–11 cm). Conclusion Despite the high functional demand and deleterious effect of chemotherapy on bone healing, reconstruction of the femur by vascularized fibular free flap in pediatric bone sarcomas can lead to a good functional outcome. Complications, such as fracture and non-union, can be successfully treated by revision of fixation and autologous iliac crest grafting. Level of Evidence IV.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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Precise One-Suture Needle-Guided Technique for Window Creation in Supermicrosurgical End-to-Side Anastomosis

J reconstr Microsurg
DOI: 10.1055/s-0038-1667361

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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Patient Reported Outcomes Following Lower Extremity Soft Tissue Sarcoma Resection with Microsurgical Preservation of Ambulation

J reconstr Microsurg
DOI: 10.1055/s-0038-1668116

Background Lower extremity soft tissue sarcoma treatment has evolved from primarily amputation procedures toward limb salvage. This series assesses whether soft tissue sarcoma tissue defects, extensive enough to require microsurgical reconstruction, can reliably result in preservation of ambulation, as well as objectively evaluate functional outcomes utilizing a patient-reported validated scale. It will also look at whether immediate functional muscle reconstructions and tendon transfers can be successful at restoring ambulation, potentially expanding the indications for limb salvage procedures. Methods A retrospective review of all microsurgical reconstructions for limb salvage in lower extremity sarcoma patients was completed at our institution (2009–2013). Patients were additionally asked to complete the Toronto Extremity Salvage Score(TESS) quality of life survey. Results Over a 5-year period, 23 patients (mean age: 53 years) underwent free flap reconstructions for 23 sarcomas (mean follow-up: 14 months). Seventy-eight percent of patients received neoadjuvant radiation. The thigh was the most common tumor site (61%) and three muscles were resected on average. Perforator flaps were most frequently used (61%), and functional muscle transfers or immediate tendon transfers were used in four patients. There were no flap take-backs or failures, and 22 patients achieved independent ambulation. Three patients in the series died, two from metastatic disease found postoperatively and one from local recurrence. A 74% response rate was achieved for the TESS survey, with a mean score of 83. Conclusions Microsurgical reconstruction of lower extremity sarcoma defects enables preservation of independent ambulation. Restoration of function utilizing immediate functional microsurgical reconstructions and tendon transfers should be considered.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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Microsurgery Training Resource Variation among US Integrated Plastic Surgery Residency Programs

J reconstr Microsurg
DOI: 10.1055/s-0038-1668160

Background Given emerging focus on competency-based surgical training and work-hour limitations, surgical skills laboratories play an increasingly important role in resident education. This study was designed to investigate educational opportunities in microsurgery across integrated residency programs. Methods Senior residents (PGY 4–6) at integrated plastic surgery programs were surveyed during the 2016 to 2017 academic year to determine each program's access to: training microscopes and anastomosis models, video-based skills assessment, pre-requisite skills exams, flap courses, or a formal microsurgical training curriculum. Programs were stratified based on large size (>18 residents) and presence of microsurgery fellows. Chi-squared analysis was performed with p < 0.05 to assess statistical significance. Results Survey responses were collected from 32 of 60 eligible programs (53% response rate). Sixty-nine percent provide access to one to two training microscopes, 25% provide three or more, and 6% provide none. Sixty-nine percent of programs train anastomosis with nonliving prosthetics, 66% with living biologics, and 50% with nonliving biologics. Large program size or having microsurgical fellows was not associated with increased access to training microscopes or specific anastomosis models. Programs without microsurgery fellows reported more often that a formal microsurgery curriculum would be helpful (90 vs. 58% of programs with fellows, p = 0.0003). Respondents who indicated that creating a formal curriculum would not be helpful elaborated that their program already has a formal curriculum or a high volume of microsurgery cases. Conclusion This study demonstrates the current variation in microsurgery training at integrated plastic surgery residency programs. A formal microsurgical training curriculum is commonly viewed as being helpful, particularly at programs without microsurgery fellows.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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The content of dioxins and furans in soils, bottom sediments of water bodies, and tissues of small mammals near the landfill site with municipal solid wastes (Moscow, Russia)

Abstract

For the first time, the levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were characterized in the tissues of wild small mammals living in contaminated sites near a municipal solid waste landfill (Moscow, Russia). The Ural field mice Sylvaemus uralensis, the bank voles Clethrionomys glareolus, and the common shrews Sorex araneus were trapped at 1- and 5-km distances from the landfield "Salariyevo." High-resolution chromatography-mass spectrometry was used to measure the levels of 17 PCDD/Fs congeners in the animal organisms and natural objects (soils, bottom sediments). The values of the total toxic equivalencies (WHO-TEQ₀₅) for animals were many times higher than those for soils and bottom sediments. The octo-substituted congeners dominated in the samples from the habitat, whereas the highly toxic 2,3,7,8-substituted ones — in the mammalian tissues. The levels of WHO-TEQ₀₅ were comparable in the soil samples collected at 1- and 5-km distances from the dump body. The levels of WHO-TEQ₀₅ in tissues of mammals caught 1 km from the dump were much higher than those of the distant territory inhabitants. The maximum WHO-TEQ₀₅ levels were found in the shrews, and this has been considered in terms of nutrition characteristics. The data obtained will be used to assess the risks of chronic exposure to low doses of PCDD/Fs contaminating the environment near landfills.

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Detection of tris(2,3-dibromopropyl) phosphate and other organophosphorous compounds in Arctic rivers

Abstract

The flame-retardant tris(2,3-dibromopropyl) phosphate (TDBrPP) was in the 1970s banned for uses in textiles that may be in contact with the skin, owing to strong suspicions that the substance was a human carcinogen. The substance is looked for but rarely detected in samples from the built and natural environments, but there are indications that TDBrPP is still in use. Here, we report the measurement of a polymer-water partition coefficient (K_pw) for two types of silicone rubber (SR), allowing quantitative estimation of freely dissolved concentrations of TDBrPP by passive sampling in water. We found levels of 100 to 200 pg/L in two Arctic rivers that were sampled during a 2014–2015 survey of contamination using passive samplers in Norwegian and Russian rivers draining into the Barents Sea. We also report the widespread presence of other organophosphorus flame retardants in this survey of eight rivers that drain into the Barents Sea.

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Application of paclobutrazol: a strategy for inducing lodging resistance of wheat through mediation of plant height, stem physical strength, and lignin biosynthesis

Abstract

Lodging is a major constraint contributing to poor grain yield and quality of wheat (Triticum aestivum L.) worldwide. The use of plant growth regulators is becoming a foremost agro-chemical approach for minimizing the risk of lodging in cereal crops. The present study was conducted to examine the effects of the paclobutrazol application on culm physical strength, lignin content, and lodging resistance of wheat. Wheat seeds were soaked in paclobutrazol at the concentrations of 0 (CK, as control), 200 (PB1), 300 (PB2), and 400 (PB3) mg L⁻¹. Our results showed that paclobutrazol resulted in a dose-dependent decrease of plant height, internode length, and center of gravity height. Paclobutrazol treatments evidently increased the culm diameter, culm filling degree, and wall thickness of basal internodes, resulting in greater stalk-breaking strength and lodging resistance index (CLRI), where their maximum values were obtained with PB1 treatment. In addition, the activities of lignin-related enzymes were improved by paclobutrazol, particularly at low concentration, which increased the lignin accumulation of the basal internodes of wheat, subsequently improving the capability of stalk lodging resistance. Moreover, the correlation analysis revealed significant correlations between stem diameter, culm filling degree, and lignin with stalk bending strength and CLRI. The paclobutrazol concentration ≥ 300 mg L⁻¹ (PB2 and PB3 treatments) showed inhibitive effects on various culm morphological traits. These results suggest that not only the plant height, but also the lignin contents and physical strength of internodes are closely related with the lodging resistance of wheat, and reduction in plant height along with improved culm morphological characteristics and higher lignin accumulation in basal internodes could effectively relieve the risk of lodging.

https://ift.tt/2vVRQiR

Role of Innate Immune Signaling in Non-Alcoholic Fatty Liver Disease

Publication date: Available online 18 August 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Jingjing Cai, Xiao-Jing Zhang, Hongliang Li

Non-alcoholic fatty liver disease (NAFLD) has become the most epidemic liver disease worldwide owing to rapid changes in lifestyle over the past few decades. This chronic condition intertwines with low-grade inflammation and metabolic disequilibrium, and potentiates the onset and progression of devastating hepatic and extrahepatic complications. In addition to an integral role in promoting host defense, recent studies also implicate innate immune signaling in a multitude of processes that control the progression of NAFLD. The focus of this review is to highlight emerging evidence regarding the role of innate immunity in NAFLD and the integration of different pathways that affect both inflammation and metabolism across the spectrum of this liver morbidity.

https://ift.tt/2nPGfNO

Quantitative analysis of susceptibility-weighted magnetic resonance imaging in chronic hepatitis in rats

Publication date: Available online 18 August 2018

Source: Magnetic Resonance Imaging

Author(s): Yu Cai, Meng-ping Huang, Xiao-feng Wang, Xin Lu, Li Luo, Jian Shu

Abstract

Purpose

To assess the value of susceptibility-weighted imaging (SWI) for staging of liver fibrosis (F), necroinflammatory activity (A), and steatosis (S) of chronic hepatitis.

Methods

100 Sprague-Dawley (SD) male rats were randomly divided into a chronic hepatitis model group (n = 88) and a control group (n = 12). The chronic hepatitis model rats were induced by intraperitoneal injection of 40% (v/v) of carbon tetrachloride (CCl₄) diluted in olive oil. All rats were examined by magnetic resonance imaging (MRI) and then killed immediately to detect pathologic staging as liver fibrosis (F), necroinflammatory activity (A), and steatosis (S). Liver-to-muscle signal intensity ratios (SIRs) of SWI were analyzed and associated with histopathologic findings.

Results

There were ultimately 11 normal control rats and 60 chronic hepatitis model rats. Statistical data were as follows: F0 (n = 11), F1 (n = 18), F2 (n = 16), F3 (n = 13), F4 (n = 13); A0 (n = 11), A1 (n = 29), A2 (n = 21), A3 (n = 10); S0 (n = 11), S1 (n = 12), S2 (n = 12), S3 (n = 18), and S4 (n = 18). The liver-to-muscle SIR of the SWI was related to hepatic fibrosis (P < 0.05) and liver steatosis (P < 0.05) but not to necroinflammatory activity (P > 0.05). By partial correlation analysis, a significant negative correlation was shown between the liver-to-muscle SIR and staging of liver fibrosis (r = −0.68, P < 0.05) as well as a low correlation with liver steatosis (r = 0.30, P < 0.05). Except for F0–F1 and F1–F2, there were statistical differences between each of the stages of hepatic fibrosis (P < 0.05), with an area under the ROC of 0.87 for F3 or above and of 0.96 for F4.

Conclusion

SWI can be a reliable method for staging hepatic fibrosis.

https://ift.tt/2Bp8KvI

Effect of Bacillus cereus peptide conjugated with nanoporous silica on inactivation of Listeria monocytogenes in apple juice, as an ecofriendly preservative

Abstract

Bacteriocins are ribosomally synthesized antimicrobial proteins/peptides. They are of great interest in the food processing industries as potential natural preservative agent to control food-borne pathogens. Bacillus spp. are one among the potential probiotics receiving more attention since they produce a broad spectrum of antimicrobial bioactive peptides. In this study, a small-scale medium composition and bioprocessing parameters were statistically optimized to increase the yield of bacteriocin namely cerein from Bacillus cereus NS02 showing antagonism against a wide range of food-borne pathogens. The cerein was partially purified, characterized, and evaluated for their optimal reaction condition. It was subjected to surface adsorption onto food-grade silica to evaluate its maximal adsorption, reached at 4 h, 40 °C, pH 6–7, and at the initial concentration of 200 AU mL⁻¹. The effectiveness of silica-adsorbed and silica-free cerein was checked in Listeria monocytogenes inoculated fresh apple juice and demonstrated biopreservative activity. In juice treated with silica-cerein, the colony forming unit (CFU) was found to be less in count on the 15th day of storage at 4 °C whereas, free-cerein was found to contain 3.8 log CFU mL⁻¹. While, on the same day of storage, the control juice contained the strength of 14.6 log CFU mL⁻¹. Based on the above, this study concludes that the identified heat stable low molecular weight peptide cerein from B. cereus NS02 could serve as a potential biopreservative with effective antilisterial activity in the food system. However, a more detailed study is required to determine if their quality change especially the effect of cerein in organoleptic and nutritional properties of food beyond their addition is necessary, before it is to be exploited as an ecofriendly biopreservative.

https://ift.tt/2L54iSj

A preliminary comparison between the effects of red and infrared laser irradiation on viability and proliferation of SHED

Abstract

The aim of this preliminary study was to compare the effects of different energy densities from red and infrared low-level laser (LLL) on viability and proliferation of stem cells from human exfoliated deciduous teeth (SHED). SHED were irradiated with red laser (R) or infrared laser (IR) set with the following dosimetry: 1.2 J/cm² (0.05 J), 2.5 J/cm² (0.1 J), 5.0 J/cm² (0.2 J), and 7.5 J/cm² (0.3 J). Positive (C+) and negative (C−) control groups comprised non-irradiated cells. Data were analyzed by two-way ANOVA followed by Tukey's test (P < 0.05). At 24- and 48-h period, group R5.0 showed significantly higher cell viability rates than R1.2 and R2.5. At 48 h, R2.5 also revealed lower proliferation than R5.0. Comparing to the C+ group, R2.5 exhibited lower viability at 72 h, and proliferation at 24 and 48 h. Groups R1.2, IR1.2, and IR5.0 were less viable at 24 h, while R1.2, IR2.5, and IR5.0 revealed lower proliferative capacity at 48 h. Overall, our results showed that LLL can favor viability and proliferation of SHED, especially when cells receive red laser irradiation at 5.0 J/cm². Therefore, according to this preliminary investigation, 5 J/cm² applied by red LLL induced high rates of cell viability and proliferation, while the same irradiation dose using infrared laser led to negative effects. LLL irradiation with 1.2 and 2.5 J/cm² was deleterious to metabolic activity and proliferation of SHED regardless of the type of laser. Further studies are necessary to gain in-depth knowledge about the effects of different wavelengths of LLL on SHED viability and proliferation.

https://ift.tt/2PisTGx

Effects of combined exposure to perfluoroalkyl acids and heavy metals on bioaccumulation and subcellular distribution in earthworms ( Eisenia fetida ) from co-contaminated soil

Abstract

The effects of combined exposure to perfluoroalkyl acids (PFAAs) and heavy metals (HMs) including cadmium (Cd), copper (Cu), zinc (Zn), nickel (Ni), and lead (Pb) on earthworms (Eisenia fetida) were investigated. The results have demonstrated that the concentrations of labile acid exchangeable Cd, Zn, Ni, Pb, and Cu in soil were enhanced in addition of PFAAs. With PFAAs, the uptake of Cd, Zn, Ni, Pb, and Cu in earthworms was increased compared to those without PFAAs with the order of Cd > Zn > Pb > Ni > Cu. In the presence of HMs, the average biota-to-soil accumulation factors (BSAFs) of PFAAs in earthworms were decreased by 0.498–0.729 times for perfluorooctane sulfonate (PFOS) and 0.606–0.978 times for perfluorooctanoic acid (PFOA), indicating decrease rates of PFOS were higher than those of PFOA. And different levels of HMs led to insignificant different responses on the inhibiting effects of PFAAs uptake in earthworms. The increase of Cd in fraction C (associated with cytosol) and decrease of PFAAs in fraction C and fraction P (associated with tissue fragments, cell membranes, and intact cells) especially for fraction C were revealed when they were combined, suggesting cytosolic PFAAs and Cd were susceptibly mutual effected. This study indicated that PFAAs and metals mutually affected their bioaccumulation and subcellular distribution in earthworms, which will help to understand the fate and risks of PFAAs and metals in co-contaminated soil.

https://ift.tt/2wcPMCC

A new approach for excess sludge reduction by manganese dioxide oxidation: performance, kinetics, and mechanism studies

Abstract

A considerable amount of excess sludge, a kind of hazardous waste, is produced from the conventional wastewater treatment systems such as activated sludge process, and efficient sludge reduction processes are needed. A new chemical method for sludge reduction was proposed by using manganese dioxide as oxidant in this study. A favorable condition for sludge reduction is determined as manganese dioxide dosage of 0.165 g g⁻¹ wet sludge, sulfuric acid concentration of 3 mol L⁻¹, and reduction temperature of 90 °C for 90 min, where the sludge reduction efficiency can reach 73.30%. Reaction kinetic study revealed that the sludge reduction rate was controlled by the surface chemical reaction and the reaction followed a shrinking core kinetic model with apparent activation energy of 37.76 kJ mol⁻¹. Furthermore, reaction process analysis indicated that the sludge hydrolysis included two steps, i.e., floc destruction and microbial cell disruption. Considering the high efficiency and short treatment time, manganese dioxide oxidation is suggested to be a feasible method for disintegration of excess activated sludge.

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Trend of the environmental supervision on submarine pipeline installation

https://ift.tt/2Pmhohw

Crude oil removal from aqueous solution using raw and carbonized Xanthoceras sorbifolia shells

Abstract

Fruit shell residue from Xanthoceras sorbifolia was investigated as a potential biosorbent to remove crude oil from aqueous solution. The shell powder and its carbonized material were compared while assessing various factors that influenced oil removal capacity. The structure and sorption mechanism were characterized using scanning electron microscopy and Fourier-transform infrared spectroscopy. The oil removal capacity of the raw material (75.1 mg g⁻¹) was better than the carbonized material (49.5 mg g⁻¹). The oil removal capacity increased with greater saponin content, indicating that hydrophobic and lipophilic surface characteristics of the saponins improved adsorption by the raw X. sorbifolia shell. An orthogonal experimental design was used to optimize the adsorption. Using 4 g L⁻¹ of raw X. sorbifolia shell (particle size of < 0.15 mm), the highest crude oil removal efficiency was obtained using an initial oil concentration of 400 mg L⁻¹, adsorption temperature of 30 °C, adsorption time of 10 min at a shaking speed of 150 rpm. The adsorption of crude oil onto X. sorbifolia shell was best described using a pseudo-second-order kinetic model. Raw X. sorbifolia shell material was more efficient than the carbonized material at crude oil removal from aqueous solution. This was attributable to the functional groups of saponins in raw X. sorbifolia shell. This study highlights that some agricultural and forest residues could be a promising source of low-cost biosorbents for oil contaminants from water—without requiring additional processing such as carbonization.

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People with diabetes do not learn and recall their diabetes foot education: a cohort study

Abstract

Purpose

Diabetes education for those patients at risk of diabetes complications remains a mainstay of diabetes treatment. This study aimed primarily to determine the retention of foot health information 6 months post delivery of education. The secondary aim was to determine the type and delivery method of diabetes-specific foot health information during a podiatry consultation.

Methods

This study was a prospective cohort study with two groups: patients with diabetes and their treating podiatrist. Baseline data collection included educational topics and delivery methods discussed during the consultation. The Problem Areas in Diabetes Questionnaire (PAID) and perceived key educational message were collected from each group's perspective at baseline and 6 months afterwards.

Results

Three podiatrists and 24 participants with diabetes provided information at the two time points. At baseline, the key messages of 14 (58%) patient participant responses differed from their podiatrists and 15 (63%) differed 6 months later. Education covered up to seven separate topics, including neurological impact of diabetes, vascular supply and general foot care. The majority of consultations (n = 23, 96%) covered three or more topics.

Conclusions

Education is vital to effective treatment of people with diabetes. Current common approaches used in individual consultations such as verbal explanations appear ineffective in aiding the learning and retention of podiatry-specific diabetes education. This study highlights the need for research investigating more effective methods to deliver key education to this population to aid retention and therefore assist behaviour change.

https://ift.tt/2vS7bRG

Cause-specific risk of major adverse cardiovascular outcomes and hypoglycemic in patients with type 2 diabetes: a multicenter prospective cohort study

Abstract

Purpose

Glycated hemoglobin A1_c (HbA1_c) and fasting plasma glucose (FPG) was identified to account for the risk of cardiovascular diseases in type 2 diabetic patients, but no study evaluated the risk based on both HbA1_c and FPG levels. We described the risk of major adverse cardiovascular events (MACE) and hypoglycemic in type 2 diabetic patients according to both HbA1_c and FPG levels.

Methods

With the usage of databases of Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE), 1815 patients from 61 centers in China was identified and grouped according to the criterion value of HbA1_c and FPG: Good glycemic control (HbA1_c < 6.5%, FPG < 6.1 mmol/L); Insufficient glycemic control (HbA1_c < 6.5%, FPG ≥ 6.1 mmol/L or HbA1_c ≥ 6.5%, FPG < 6.1 mmol/L); Poor glycemic control (HbA1_c ≥ 6.5%, FPG ≥ 6.1 mmol/L). Time-varying multivariable Cox proportional hazards models were employed.

Results

Average age was 64.8 ± 5.8 years, with a median of 4.8 years of follow-up. Overall, the incidence rates of MACE were 20.6 per 1000-person-years in Good glycemic control compared with 45.9 per 1000-person-years in Insufficient glycemic control (adjusted hazard ratio (aHR): 1.99; 95% CI 1.11–3.56; p = 0.02) and 54.7 per 1000-person-years in Poor glycemic control (aHR: 2.46; 95% CI 1.38–4.40; p = 0.002), respectively. The risk of hypoglycemic was highest in Insufficient glycemic control; 67.3 per 1000-person-years compared with 46.3 per 1000-person-years in Good glycemic control (aHR: 1.62; 95% CI 1.03–2.56; p = 0.04). Apart from this, we also observed that both MACE (aHR:1.41; 95% CI 1.13–1.77; p = 0.003) and hypoglycemic episodes (aHR: 1.82; 95% CI 1.48–2.24; p < 0.001) were sufficiently more frequent in the insulin-exposed group than the non-exposed group. In a post-hoc analysis, the risk of MACE (aHR:1.43; 95% CI 1.09–1.86; p = 0.01) and hypoglycemic (aHR: 1.99; 95% CI 1.46–2.69; p < 0.001) were more pronounced in Insufficient glycemic control with insulin exposure.

Conclusions

We observed a significant association of cause-specific risk of MACE and hypoglycemic with Insufficient glycemic control, particularly with insulin exposure.

https://ift.tt/2L4MTsJ

People with diabetes do not learn and recall their diabetes foot education: a cohort study

Abstract

Purpose

Methods

Results

Conclusions

https://ift.tt/2vS7bRG

Cause-specific risk of major adverse cardiovascular outcomes and hypoglycemic in patients with type 2 diabetes: a multicenter prospective cohort study

Abstract

Purpose

Methods

Results

Conclusions

We observed a significant association of cause-specific risk of MACE and hypoglycemic with Insufficient glycemic control, particularly with insulin exposure.

https://ift.tt/2L4MTsJ

Clinicopathological and immunohistochemical analysis of autoimmune regulator expression in patients with osteosarcoma

Abstract

Autoimmune regulator (AIRE) is a transcription factor that is expressed in medullary thymic epithelial cells. It plays an essential role in central tolerance by eliminating self-reactive T cells. Recently, extrathymic AIRE-expressing cells have been revealed, which are associated with peripheral tolerance. Moreover, AIRE expression has been demonstrated in skin tumors and breast cancer. However, the expression of AIRE in osteosarcoma is unknown. We used immunohistochemistry to investigate AIRE expression in biopsy samples from 43 patients with conventional osteosarcoma and statistically analyzed the association between AIRE expression and clinicopathological characteristics. High AIRE expression was detected in 25 patients (58.1%), and significantly associated with the presence of lung metastasis (P = 0.014) and an increased number of forkhead box P3-positive tumor-infiltrating lymphocytes (regulatory T cells) (P = 0.014). The overall survival rate for all osteosarcoma patients with high AIRE expression was significantly shorter than that for those with low AIRE expression (P = 0.046). In a subgroup analysis of American Joint Committee on Cancer stage II patients who underwent complete surgical resection and conventional chemotherapy, the overall survival and metastasis-free survival rates were significantly shorter for patients with high AIRE expression than for those with low AIRE expression (P = 0.019 and P < 0.01, respectively). High AIRE expression was confirmed to be an independent poor prognostic factor for both overall survival (hazard ratio: 3.841, P = 0.038) and metastasis-free survival (hazard ratio: 4.348, P = 0.022) in the multivariate analysis. The evaluation of AIRE expression may be useful for stratifying osteosarcoma patients for more effective clinical follow-up.

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Short-course regimen of palliative radiotherapy in complicated bone metastases: a phase i–ii study (SHARON Project)

Abstract

Metastases with soft tissues invasion, impending fractures or spinal cord compression (complicated bone metastases) represent a common clinical problem in advanced cancers and frequently lead to deterioration of patients' quality of life (QoL). A phase I–II study was planned to define the maximum tolerated dose (MTD) of a short-course radiotherapy (RT) and its efficacy in palliation of complicated bone metastases. A phase I trial was designed with three dose-escalation steps: 16, 18, and 20 Gy. Total dose at each level was delivered in 2 days, twice daily. Eligibility criteria were painful complicated bone metastases and ECOG performance status ≤ 3. The presence of acute toxicity ≥ Grade 3 (RTOG scale) was considered the dose limiting toxicity. The MTD was used to plan a phase II trial with pain response as the primary outcome. Pain was recorded using a Visual Analogic Scale (VAS), and QoL using CLAS scales. Forty-five patients were enrolled in this trial. In phase I no Grade ≥ 2 acute toxicities were recorded. Thus 20 Gy was established as MTD. In phase II, with a median follow-up of 4 months, rates of complete symptom remission, partial response, no symptomatic change, and symptoms progression were 32.0%, 52.0%, 8.0%, and 8.0%, respectively. This RT protocol tested in our study is effective and tolerable with comparable results to traditional RT treatments delivered in 5–10 daily fractions.

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Scholar : Myringotomy and tubes - νέα αποτελέσματα

Throat dam suction device and methods of use

A MESSER - US Patent App. 15/834,795, 2018

… US20060052662A1 (en), 2006-03-09, Hygiene protection for endoscopes.
US6245077B1 (en), 2001-06-12, Universal myringotomy tube/aural grommet inserter
and methods. US5551872A (en), 1996-09-03, Dental impression device …

Primary Middle Ear Mucosal Melanoma: Case Report and Comprehensive Literature Review of 21 Cases of Primary Middle Ear and Eustachian Tube Melanoma

AK Maxwell, H Takeda, SP Gubbels - Annals of Otology, Rhinology & Laryngology, 2018

Objective: To present a case of primary middle ear mucosal melanoma and perform a
comprehensive literature review of middle ear and eustachian tube mucosal mela...

Capture-tool for manipulating and entubulating nerves

J Faleris, A Engemann, C Deister - US Patent App. 15/416,290, 2018

… US4883474A (en), 1989-11-28, Thoracic catheter. US5466239A (en), 1995-11-14,
Myringotomy ventilation tube and associated method. US6663641B1 (en),
2003-12-16, Endoscopic surgical instrument for rotational manipulation …

Fiber-based mode mixing techniques for surgical laser illumination

C Dos Santos, GD Bacher, R Smith, A Mirsepassi… - US Patent App. 15/882,758, 2018

… Also, second section of optical fiber 304-2 is shown passing through a
hand piece 306, which may include a sheath or tube around optical fiber
304-2 to enable … US5893828A (en), 1999-04-13, Contact laser surgical …

Focusing optics for mixed mode surgical laser illumination

C Dos Santos, GD Bacher, R Smith, A Mirsepassi… - US Patent App. 15/882,790, 2018

… Optical fiber 304 is shown passing through a hand piece 306, which may
include a sheath or tube around optical fiber 304 to enable … US6475138B1
(en), 2002-11-05, Apparatus and method as preparation for performing a …

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Получение и использование водорастворимого прополиса в стоматологии: аннотация

НМ Манастырная - 2018

… water-soluble propolis, dentistry, gingivitis, periodontitis, herpetic stomatitis,
candidiasis. Objective: to analyze the ways of obtaining water-soluble
propolis, and also … The lowest efficiency was observed in the treatment of …

[PDF] Oral Health Status And Treatment Needs In Rural Population Of Punjab: Hospital Based Descriptive Cross-Sectional Study

S Acharya, K Gauba, P Singla, A Dhareula - Journal of Medical and Dental Science …, 2018

… Maximum patients reported with Recurrent Apthous stomatitis with 46.37%,
followed by smoker's palate with 17.39%, then leukoplakia with 15.94%,
then lichen planus with 14.49% and burning mouth syndrome with 5.79 …

The Role of Targeted Agents and Immunotherapy in Older Patients with Non-small Cell Lung Cancer

F Gomes, R Tay, J Chiramel, R Califano - Drugs & Aging, 2018

… Elderly patients were more likely to experience grade 3/4 AEs (35 vs.
18%; p ≤0.001), including rash, fatigue, stomatitis and dehydration … 8.2
months, HR 0.64; LL6: 13.7 vs. 4.1 months, HR 0.16). The most frequent …

[HTML] Antibody Repertoires to the Same Ebola Vaccine Antigen Are Differentially Affected by Vaccine Vectors

M Meyer, A Yoshida, P Ramanathan, EO Saphire… - Cell Reports, 2018

… Leading vaccine candidates, including vesicular stomatitis virus (VSV) and various
adenovirus-based vectors, which demonstrated complete protection in non-human
primates (NHPs), have advanced into clinical trials (Kennedy et al., 2017) …

Painful Oral Lesions

IA Hargitai - Dental Clinics, 2018

… Painful oral vesiculoerosive diseases (OVD) include lichen planus,
pemphigus vulgaris, mucous membrane pemphigoid, erythema multiforme,
and recurrent aphthous stomatitis … Stomatitis Management of oral …

[HTML] Genotoxic evaluation of subcytotoxic concentration of cathine-rich Catha edulis in human peripheral blood lymphocytes

S Mohan, MME Taha, YA Kaabi, SI Abdelwahab - Pharmacognosy Magazine, 2018

… conditions. [6] One of the studies suggests the elevation of systolic blood pressure
in khat consumers due to stimulant effect in β1 adrenoceptor in the heart. [7] Khat
has shown stomatitis, esophagitis, and gastritis in the GIT. Apart …

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Σάββατο 18 Αυγούστου 2018

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[PDF] Oral Health Status And Treatment Needs In Rural Population Of Punjab: Hospital Based Descriptive Cross-Sectional Study

[HTML] Antibody Repertoires to the Same Ebola Vaccine Antigen Are Differentially Affected by Vaccine Vectors

[HTML] Genotoxic evaluation of subcytotoxic concentration of cathine-rich Catha edulis in human peripheral blood lymphocytes

[PDF] Dr. Umarji, tablets in the management of Recurrent Aphthous Ulcers"

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