Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Πέμπτη 27 Σεπτεμβρίου 2018
Diabetic Pulmopathy: A New Clinical Challenge for Diabetology
Exp Clin Endocrinol Diabetes 2018; 126: 590-591
DOI: 10.1055/a-0715-2743
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Reduced Anterolateral Thigh Flap Donor-Site Morbidity Using Incisional Negative Pressure Therapy
J reconstr Microsurg
DOI: 10.1055/s-0038-1672126
Background Primary closure of the donor-site after harvest of a large anterolateral thigh flap (ALT) is associated with significant morbidity. Incisional negative pressure therapy (INPT) may decrease complications in high-risk incisions. This study assessed if the incidence of complications after primary closure of the ALT flap donor-site decreases with INPT. Methods Retrospective cohort study of a prospectively maintained database including patients who underwent upper and lower limb reconstruction, using an ALT free flap with primary closure of the donor-site. Two groups were defined: primary closure and INPT (study group) and primary closure with traditional dressings (control group). Nonparametric statistics were employed to identify prognostic factors, p < 0,05. Results Fifty-eight free ALT flaps in 58 patients (study group n = 28; control group n = 30) were included. Median flap width and length were 9 cm (range: 5–14) and 25 cm (range: 10–48), respectively. Median follow-up was 19 months (range: 3–78 months). No significant differences in age or flap size were identified in both groups (p > 0.05). The global complication rate was 7.14% (n = 2) in the INPT group, and 37% (n = 11) in the control group (p = 0.007). The study group had a lower dehiscence and skin necrosis rate (p < 0.05). Multivariate logistic regression analysis showed IPNT was associated with a significant reduction of donor-site complications (p = 0.006), especially in patients with defects > 8 cm (p = 0.003). Conclusions In this cohort study the use of INPT significantly reduced the donor-site morbidity after ALT flap harvest.
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Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Psychological Wellbeing Outcomes of Nonpharmacological Interventions for Older Persons with Insomnia Symptoms: A Systematic Review and Meta-Analysis
Nonpharmacological treatment of insomnia in older persons has been associated with reduced insomnia symptoms and increased psychological wellbeing. This systematic review and meta-analysis examined whether nonpharmacological interventions can promote wellbeing indicators in older persons who experience insomnia symptoms and investigated the components of these interventions. Twenty studies met inclusion criteria. Psychological wellbeing outcomes included symptoms of depression, anxiety, mental health-related quality of life, and fatigue.
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The anatomy of the superficial temporal artery in patients with unilateral microtia.
This is a retrospective study that evaluated the anatomical distribution of the superficial temporal artery (STA) in supply of the temporoparietal fascial (TPF) flap for use in unilateral microtia patients undergoing reconstruction. We aimed to determine if embryologic arrest of pharyngeal arch development would lead to aberrant STA which impedes reliable harvest of the TPF flap in patients requiring microtia repair.
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Photobiomodulation therapy before futsal matches improves the staying time of athletes in the court and accelerates post-exercise recovery
Abstract
This study aimed to analyze PBMT effects on futsal player's performance and recovery in a non-controlled field environment. It is a randomized, triple-blinded, placebo-controlled, crossover clinical trial. The research included six professional athletes and in each match phototherapy treatments were performed before matches (40 minutes), blood samples were collected before treatments, and samples immediately after the end of the matches and 48 h after. Furthermore, videos were analyzed to quantify the time athletes spent on the pitch and the distance they covered. PBMT was performed at 17 sites of each lower limb (40 mins before matches), employing a cluster with 12 diodes (4 laser diodes of 905 nm, 4 LEDs of 875 nm, and 4 LEDs of 640 nm, 30 J per site). The performance of the athlete could be quantified considering the time on the pitch and the distance covered; the biochemical markers evaluated were creatine kinase, lactate dehydrogenase, blood lactate, and oxidative damage to lipids and proteins. PBMT significantly increased the time of staying in the pitch and a significant improvement in all the biochemical markers evaluated. No statistically significant difference was found for the distance covered. Pre-exercise PBMT can enhance performance and accelerate recovery of high-level futsal players.
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Surface electromyography after lower level laser therapy application on skeletal muscles in individuals with heart failure
Abstract
The purpose of this study was to investigate the effects of low-level laser therapy (LLLT) applied before a fatigue protocol through the effects on the electrical activation in the quadriceps muscle in patients with HF. Fourteen patients with the diagnosis of heart failure (HF) were selected for this double-blind, crossover type clinical trial. These participants have attended to a familiarization, LLLT, and placebo sessions, totaling three visits. The LLLT was applied in the quadriceps muscle (850 nm, 5 J per diode). The fatigue protocol consisted of concentric and eccentric isokinetic contractions (cc/ec) until exhaustion or up to 50 cc/ec. The muscular fatigue was evaluated with surface electromyography, by the analysis of integral, median frequency, and entropy. Only one application of LLLT is not able to decrease skeletal muscle activation in patients with HF. There was no reduction of muscle fatigue among the proposed protocols. Single LLLT session has no effect on the reduction of skeletal muscle fatigue in patients with HF.
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Risk of Hepatocellular Carcinoma After Treatment With Entecavir vs Tenofovir for Chronic Hepatitis B
https://ift.tt/2R5oo3a
Clinical Benefit of Cancer Drugs With FDA Approval Based on Single-Arm Trials
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Tenofovir vs Entecavir for Hepatocellular Carcinoma Prevention in Patients With Chronic Hepatitis B
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Immune Checkpoint Blockade and Tumor-Specific Vaccine for Patients With Incurable HPV-16 Cancer
https://ift.tt/2N4oaWE
Scholar : Archives of Physiology and Biochemistry, Volume 124, Issue 4, October 2018 is now available online on Taylor & Francis Online
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Photobiomodulation with single and combination laser wavelengths on bone marrow mesenchymal stem cells: proliferation and differentiation to bone or cartilage
Abstract
Tissue engineering aims to take advantage of the ability of undifferentiated stem cells to differentiate into multiple cell types to repair damaged tissue. Photobiomodulation uses either lasers or light-emitting diodes to promote stem cell proliferation and differentiation. The present study aimed to investigate single and dual combinations of laser wavelengths on mesenchymal stem cells (MSCs). MSCs were derived from rabbit iliac bone marrow. One control and eight laser irradiated groups were designated as Infrared (IR, 810 nm), Red (R, 660 nm), Green (G, 532 nm), Blue (B, 485 nm), IR–R, IR–B, R–G, and B–G. Irradiation was repeated daily for 21 days and cell proliferation, osseous, or cartilaginous differentiation was then measured. RT-PCR biomarkers were SOX9, aggrecan, COL 2, and COL 10 expression for cartilage and ALP, COL 1, and osteocalcin expression for bone. Cellular proliferation was increased in all irradiated groups except G. All cartilage markers were significantly increased by IR and IR–B except COL 10 which was suppressed by IR–B combination. ALP expression was highest in R and IR groups during osseous differentiation. ALP was decreased by combinations of IR with B and with R, and also by G alone. R and B–G groups showed stimulated COL 1 expression; however, COL 1 was suppressed in IR–B, IR–R, and G groups. IR significantly increased osteocalcin expression, but in B, B–G, and G groups it was reduced. Cartilage differentiation was stimulated by IR and IR–B laser irradiation. The effects of single or combined laser irradiation were not clear-cut on osseous differentiation. Stimulatory effects on osteogenesis were seen for R and IR lasers, while G laser had inhibitory effects.
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Heterogeneity of Astrocytic and Neuronal GLT-1 at Cortical Excitatory Synapses, as Revealed by its Colocalization With Na+/K+-ATPase α Isoforms
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Scholar : Journal of Natural History, Volume 52, Issue 31-32, August - August 2018 is now available online on Taylor & Francis Online
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TAS 102 in Combination With Ramucirumab in Advanced, Refractory Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Interventions: Drug: TAS 102; Drug: Ramucirumab 10 MG/ML Intravenous Solution [CYRAMZA]
Sponsor: H. Lee Moffitt Cancer Center and Research Institute
Not yet recruiting
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Diagnostic Accuracy of Human Transcriptional Activator(MYB) Expression by ELISA Technique Versus Immmunohistochemistry in Detecting Salivary Gland Carcinomas
Intervention: Device: enzyme linked immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R1Qe05
Laser-assisted photodynamic therapy for actinic keratosis: A systematic review and meta-analysis
Publication date: Available online 27 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Theresa Steeb, Justin Gabriel Schlager, Christoph Kohl, Thomas Ruzicka, Markus V. Heppt, Carola Berking
Abstract
Background
Photodynamic therapy (PDT) is an effective intervention for actinic keratosis (AK) and field-cancerization. Ablative fractional laser may facilitate the delivery of photosensitizers and thereby improve the effects of PDT.
Objective
To summarize the current evidence on the efficacy and safety of laser-assisted PDT.
Methods
We performed a systematic literature research in Medline, Embase, and CENTRAL and hand-searched pertinent trial registers for eligible randomized controlled trials (RCTs). Results from individual studies were pooled using a random-effects model. The risk of bias was estimated with the Cochrane Risk of Bias Tool and the quality of evidence of the outcomes with the GRADE approach.
Results
Out of 817 records initially identified, 7 RCTs were included in the qualitative analysis and 4 in the meta-analysis. Laser-assisted PDT showed significantly higher clearance rates compared to PDT monotherapy (risk ratio 1.33, 95% CI 1.24 to 1.42, I2=25%, p<0.01). There was no difference in pain intensity between laser-assisted PDT and other interventions (mean difference 0.31, 95% CI to 0.12 to 0.74, I2=0%, p=0.16). The included studies showed a high risk of bias.
Limitations
The clinical heterogeneity of included studies.
Conclusion
Laser-assisted PDT is more efficient but not more painful than PDT or laser treatment only.
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Results of a nationwide epidemiologic survey of autosomal recessive congenital ichthyosis and ichthyosis syndromes in Japan
Publication date: Available online 26 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Michiko Kurosawa, Ritei Uehara, Atsushi Takagi, Yumi Aoyama, Keiji Iwatsuki, Masayuki Amagai, Masaki Nagai, Yosikazu Nakamura, Yutaka Inaba, Kazuhito Yokoyama, Shigaku Ikeda
Background
Autosomal recessive congenital ichthyosis (ARCI) and ichthyosis syndrome (IS) are rare genetic skin disorders.
Objective
To estimate the number of patients with ARCI and IS in Japan and clarify the clinicoepidemiologic features of these diseases.
Methods
We performed a nationwide survey of patients treated for ARCI or IS during January 2005-December 2009. We developed diagnostic criteria and conducted a primary survey in a stratified random sample of Japanese hospitals to quantify the number of outpatients and inpatients with ARCI or IS. We performed a secondary survey of clinicoepidemiologic features in positive cases.
Results
The estimated number of patients receiving treatment for ARCI and IS during 2005-2009 was 220 (95% confidence interval [CI] 180-260). The estimated disease distribution was as follows: 95 (95% CI 80-110) patients with nonbullous congenital ichthyosiform erythroderma, 30 (95% CI 20-40) with lamellar ichthyosis, 15 (95% CI 10-20) with harlequin ichthyosis, and 85 (95% CI 50-120) with IS.
Limitations
Patients with a mild case of the disease might not have visited a dermatology department, potentially causing underestimation of affected patients.
Conclusion
We report the estimated number of patients with ARCI and IS in Japan and sex differences in the age distribution.
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Attenuating anger and aggression with neuromodulation of the vmPFC: a simultaneous tDCS-fMRI study
Publication date: Available online 27 September 2018
Source: Cortex
Author(s): Gadi Gilam, Rany Abend, Guy Gurevitch, Alon Erdman, Halen Baker, Ziv Ben-Zion, Talma Hendler
Abstract
Angry outbursts during interpersonal provocations may lead to violence and prevails in numerous pathological conditions. In the anger-infused Ultimatum Game (aiUG), unfair monetary offers accompanied by written provocations induce anger. Rejection of such offers relates to aggression, whereas acceptance to anger regulation. We previously demonstrated the involvement of the ventro-medial prefrontal cortex (vmPFC) in accepting unfair offers and attenuating anger during an aiUG, suggestive of its role in anger regulation. Here, we aimed to enhance anger regulation by facilitating vmPFC activity during anger induction, using anodal transcranial direct current stimulation (tDCS) and simultaneously with functional Magnetic Resonance Imaging to validate modulation of vmPFC activity. In a cross-over, sham-controlled, double-blind study, participants (N=25) were each scanned twice, counterbalancing sham and active tDCS applied during administration of the aiUG. Outcome measures included the effect of active vs. sham stimulation on vmPFC activity, unfair offers' acceptance rates, self-reported anger, and aggressive behavior in a subsequent reactive aggression paradigm. Results indicate that active stimulation led to increased vmPFC activity during the processing of unfair offers, increased acceptance rates of these offers, and mitigated the increase in self-reported anger following the aiUG. We also noted a decrease in subsequent aggressive behavior following active stimulation, but only when active stimulation was conducted in the first experimental session. Finally, an exploratory finding indicated that participants with a stronger habitual tendency to use suppression as an emotion regulation strategy, reported less anger following the aiUG in the active compared to sham stimulation conditions. Findings support a potential causal link between vmPFC functionality and the experience and expression of anger, supporting vmPFC's role in anger regulation, and providing a promising avenue for reducing angry and aggressive outbursts during interpersonal provocations in various psychiatric and medical conditions.
https://ift.tt/2xGgq8w
Rest on it: Awake quiescence facilities insight
Publication date: Available online 27 September 2018
Source: Cortex
Author(s): Michael Craig, Georgina Ottaway, Michaela Dewar
Abstract
Many scientific discoveries have been explained by a sudden gaining of insight with regards to an ongoing problem. Insight is characterised by a mental restructuring of acquired information, from which new explicit knowledge can be drawn, leading to qualitative changes in behaviour. Extended sleep facilitates the gaining of insight, possibly because it is conducive to the stabilisation and restructuring of new memory representations via consolidation. Research shows that a brief period of awake quiescence (quiet resting), too, can support consolidation: people remember more new memories if they quietly rest for several minutes after encoding than if they engage in a task involving ongoing sensory input after encoding. However, it remains unknown whether awake quiescence inspires insight. Using a number-based problem-solving task (the Number Reduction Task – 'NRT'), we reveal that, like sleep, awake quiescence facilitates the rapid gaining of insight: young adults were more than twice as likely to demonstrate new explicit knowledge of a hidden solution to the NRT if initial exposure to this task was followed by 10 minutes of awake quiescence than an unrelated perceptual task. These findings indicate that, at least for the NRT, the development of insight is not restricted to sleep but can be achieved via a brief period of awake quiescence. Thus, contrary to conventional wisdom and theories, when faced with a novel problem we may not always need to 'sleep on it' to find a novel solution, simply 'resting on it' may be enough.
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Regeneration of Pancreatic β-Islet Cells in a Type-II Diabetic.
Related Articles |
Regeneration of Pancreatic β-Islet Cells in a Type-II Diabetic.
Case Rep Endocrinol. 2018;2018:6147349
Authors: Jones EC, Rylands JC, Jardet CL
Abstract
A case report is presented in which a type-II diabetic patient significantly improved his dysfunctional β-islet cells using a combination of a strenuous exercise program, cyclical ketogenic diet, and oral GABA/probiotic supplementation. The patient was diagnosed with type-II diabetes at the age of 41 which then progressed through a typical series of treatment changes over 14 years. Treatment periods consisted of metformin therapy alone for 4 years followed by a metformin/glyburide combination therapy for 6 years, and eventually an insulin/metformin combination therapy for 4 years. One year after the initiation of insulin, the patient increased the level of strenuous physical activity (hiking and weight lifting) and adopted a ketogenic diet. Oral GABA and probiotic supplementation were also initiated at the age of 52.7. By the age of 55, the patient no longer required any insulin and is currently being managed with metformin alone. C-peptide values indicate a functional improvement of the β-islet cells during the time of insulin/GABA/probiotic treatment.
PMID: 30254769 [PubMed]
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Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an un...
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