No abstract availablehttps://ift.tt/2Oz1GSl
Τετάρτη 3 Οκτωβρίου 2018
The role of pre-operative α-blockade in patients with normotensive phaeochromocytoma or paraganglioma: A retrospective cohort study
No abstract availablehttps://ift.tt/2Oz1GSl
Comparison of a novel clinical score to estimate the risk of REsidual neuromuscular block Prediction Score and the last train-of-four count documented in the electronic anaesthesia record: A retrospective cohort study of electronic data on file
BACKGROUND Residual neuromuscular block (rNMB) after surgery is not difficult to identify if proper neuromuscular monitoring is used, but many clinicians do not use quantitative neuromuscular monitoring. OBJECTIVE The aim of this study was to develop a REsidual neuromuscular block Prediction Score (REPS) to predict postoperative rNMB and compare the predictive accuracy of the prediction score with train-of-four count (TOFC) measurement at the end of a surgical case. DESIGN Retrospective cohort study of data on file. DATA SOURCE Electronic patient data and peri-operative data on vital signs, administered medications, and train-of-four ratio (TOFR) obtained in the postoperative recovery rooms [postanaesthesia care unit (PACU)] at Massachusetts General Hospital in Boston, Massachusetts, USA. PATIENTS Quantitative TOFR measurements obtained on admission to the PACU were available from 2144 adult noncardiac surgical patients. MAIN OUTCOME MEASURE Presence of rNMB at PACU admission, defined as a TOFR of less than 0.9. RESULTS In the score development cohort (n=2144), rNMB occurred in 432 cases (20.2%). Ten independent predictors for residual paralysis were identified and used for the score development. The final model included: hepatic failure, neurological disease, high-neostigmine dose, metastatic tumour, female sex, short time between neuromuscular blocking agent administration and extubation, aminosteroidal neuromuscular blocking agent, BMI more than 35, absence of nurse anaesthetist and having an experienced surgeon. The model discrimination by C statistics was 0.63, 95% confidence interval (0.60 to 0.66), and risk categories derived from the REPS had a higher accuracy than the last documented intra-operative TOFC for predicting rNMB (net reclassification improvement score 0.26, standard error 0.03, P https://ift.tt/2IBhwGR
Association of pre-operative troponin levels with major adverse cardiac events and mortality after noncardiac surgery: A systematic review and meta-analysis
BACKGROUND Circulating cardiac troponin levels are powerful predictors of prognosis in many clinical settings, but their association with outcomes after noncardiac surgery is unclear. OBJECTIVES The aim of this systematic review was to summarise current evidence on the association of pre-operative troponin elevation with postoperative major adverse cardiac events (MACE) and mortality in patients undergoing noncardiac surgery. DESIGN Systematic review of observational studies with meta-analysis. DATA SOURCES PubMed, EMBASE and Science Citation Index Expanded (ISI Web of Science) from their inception to 1 October 2017. ELIGIBILITY CRITERIA Observational studies reporting the associations between pre-operative troponin levels and MACE and all-cause mortality after noncardiac surgeries were included. RESULTS Ten studies met the eligibility criteria. The entire body of evidence addressing the research question was based on a total of 10 371 patients: 4.7 to 68.3% (median 23.8%) of patients had elevated troponin levels before surgery. Elevated pre-operative troponin was significantly associated with short-term MACE (seven studies, 5180 patients: odds ratio (OR) 6.92, 95% confidence interval (CI) 3.85 to 12.42), short-term mortality (five studies, 6103 patients: OR 4.23, 95% CI 2.27 to 7.89) and long-term mortality (two studies, 760 patients: OR 2.51, 95% CI 1.47 to 4.29). The associations remained significant when only multivariate-adjusted results were analysed. Overall, the reviewers' certainty about the summary estimates of the associations was very low. CONCLUSION Current evidence suggests that pre-operative high troponin levels are significantly associated with adverse cardiac events and mortality after noncardiac surgery. TRIAL REGISTRATION This systematic review was registered in the International Prospective Register of Systematic Reviews (Centre for Reviews and Dissemination 42017077837).https://ift.tt/2OyuxWX
Deep vs. moderate neuromuscular blockade during laparoscopic surgery: A systematic review and meta-analysis
BACKGROUND Previous studies have reported that deep neuromuscular block (posttetanic-count 1 to 2 twitches) improves surgical conditions during laparoscopy compared with moderate block (train-of-four count: 1 to 2 twitches). However, comparisons of surgical conditions were made using different scales and assessment intervals with variable results. OBJECTIVE To explore the heterogeneity of previous comparisons between deep and moderate neuromuscular block. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched from inception to October 2017. ELIGIBILITY CRITERIA Our meta-analysis included RCTs comparing the effects of deep with moderate neuromuscular block on surgical field conditions during laparoscopic surgery. The frequency of excellent or good operating conditions on a surgical rating scale was compared. Heterogeneity was assessed by subgroup analyses. RESULTS Eleven RCTs involving 844 patients were included. On the surgical rating scale, the frequency of excellent or good operating conditions was higher with deep block compared with a moderate block (odds ratio 2.83, 95% confidence interval 1.34 to 5.99, P = 0.007, I2 = 59%). We analysed surgical rating according to the number of assessments made. There was a significant difference in surgical rating with multiple assessments, but no difference when the assessment was made on only one occasion. A significant difference in rating was noted with variable abdominal pressures; there was no significant difference with the same fixed abdominal pressure. Trial sequential analysis demonstrated that the cumulative z-curve crossed the O′Brien–Fleming significance boundary. However, required information size was not achieved. CONCLUSION Deep block was associated with excellent or good surgical rating more frequently than moderate block. However, this finding was not consistent on subgroup analyses based on frequencies of assessment of surgical conditions and abdominal pressure. Further studies are required to address the heterogeneity and power shortage demonstrated by the trial sequential analysis.https://ift.tt/2IBhm2d
Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study
BACKGROUND Continuous monitoring of core temperature is essential during major surgery as a way of improving patient safety. Oesophageal probes or specific arterial catheters are invasive methods used in this setting. A new noninvasive device based on zero-heat-flux (ZHF) technique (SpotOn) seems promising but has been poorly investigated during rapid core temperature changes (RCTC). OBJECTIVE To assess the accuracy of a SpotOn sensor vs. an oesophageal probe or specific arterial catheter during a slow change in core temperature of less than 1 °C within 30 min and RCTC ≥ 1 °C within 30 min. DESIGN Prospective observational study. SETTING Operating rooms at the University Hospital of Poitiers, France. PATIENTS Fifty patients scheduled for major abdominal surgery under general anaesthesia were enrolled from June 2015 to March 2016. Data from 49 patients were finally analysed. Among these, 15 patients were treated with hyperthermic intraperitoneal chemotherapy. INTERVENTION Each patient had a ZHF sensor placed on the skin surface of the forehead (TempZHF) and an oesophageal probe (TempEso) used as a reference method. Twenty-two patients also had a thermodilution arterial catheter (TempArt) placed in the axillary artery. MAIN OUTCOME MEASURES Core temperature was continuously recorded from the three devices after induction of anaesthesia. Comparison of temperature measurements between methods was made using the Bland and Altman method during two separate periods according to the speed of core temperature changes. RESULTS Compared with TempEso, bias and limits of agreement for TempZHF were 0.1 ± 0.5 °C during slow core temperature changes periods and 0.6 ± 1.8 °C during RCTC periods (P = 0.0002). Compared with TempArt, these values were −0.1 ± 0.4 and 0.5 ± 1.7 °C, respectively (P = 0.0039). The ZHF sensor was well tolerated. CONCLUSION A SpotOn sensor using the ZHF method seems reliable for core temperature monitoring during abdominal surgery when variations in core temperature are slow rather than rapid. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02869828.https://ift.tt/2Oxxfw0
Comparison of noninvasive and minimally invasive pulse contour analysis to measure stroke volume during major surgery: A prospective observational study
No abstract availablehttps://ift.tt/2IBhbnz
Diagnostic accuracy of inferior vena caval respiratory variation in detecting fluid unresponsiveness: A systematic review and meta-analysis
BACKGROUND The accuracy of respiratory variation of the inferior vena cava (rvIVC) in predicting fluid responsiveness, particularly in spontaneously breathing patients is unclear. OBJECTIVES To consider the evidence to support the accuracy of rvIVC in identifying patients who are unlikely to benefit from fluid administration. DESIGN Systematic review and meta-analysis. DATA SOURCE We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILCAS and WHO Clinical Trial Registry from inception to June 2017. ELIGIBILITY CRITERIA Case–control or cohort studies that evaluated the accuracy of rvIVC in living adult humans were included. A study was included in the meta-analysis if data enabling construction of 2 × 2 tables were reported, calculated or could be obtained from authors and met the above cited criteria. RESULT A total of 23 studies including 1574 patients were included in qualitative analysis. The meta-analysis involved 20 studies and 761 patients. Pooled sensitivity and specificity of rvIVC in 330 spontaneously breathing patients were 0.80 [95% confidence interval (CI) 0.68 to 0.89] and 0.79 (95% CI 0.60 to 0.90). Pooled sensitivity and specificity of rvIVC in 431 mechanically ventilated patients were 0.79 (95% CI 0.67 to 0.86) and 0.70 (95% CI 0.63 to 0.76). CONCLUSION Decreased inferior vena caval respiratory variation is moderately accurate in predicting fluid unresponsiveness both in spontaneous and mechanically ventilated patients. The findings of this review should be used in the appropriate clinical context and in conjunction with other clinical assessments of fluid status. IDENTIFIER CRD 42017068028.https://ift.tt/2OwOM7D
Device or target? A paradigm shift in airway management: Implications for guidelines, clinical practice and teaching
No abstract availablehttps://ift.tt/2IBpm3g
Haemodilution and head-down tilting induce functional injury in the rat optic nerve: A model for peri-operative ischemic optic neuropathy
BACKGROUND Mechanisms of peri-operative ischaemic optic neuropathy remain poorly understood. Both specific pre-operative and intra-operative factors have been examined by retrospective studies, but no animal model currently exists. OBJECTIVES To develop a rodent model of peri-operative ischaemic optic neuropathy. In rats, we performed head-down tilt and/or haemodilution, theorising that the combination damages the optic nerve. DESIGN Animal study. SETTING Laboratory. ANIMALS A total of 36 rats, in four groups, completed the functional examination of retina and optic nerve after the interventions. INTERVENTIONS Anaesthetised groups (n>8) were supine (SUP) for 5 h, head-down tilted 70° for 5 h, head-down tilted/haemodiluted for 5 h or SUP/haemodiluted for 5 h. We measured blood pressure, heart rate, intra-ocular pressure and maintained constant temperature. MAIN OUTCOME MEASUREMENTS Retinal function (electroretinography), scotopic threshold response (STR) (for retinal ganglion cells) and visual evoked potentials (VEP) (for transmission through the optic nerve). We imaged the optic nerve in vivo and evaluated retinal histology, apoptotic cells and glial activation in the optic nerve. Retinal and optic nerve function were followed to 14 and 28 days after experiments. RESULTS At 28 days in head down tilted/haemodiluted rats, negative STR decreased (about 50% amplitude reduction, P = 0.006), VEP wave N2-P3 decreased (70% amplitude reduction, P = 0.01) and P2 latency increased (35%, P = 0.003), optic discs were swollen and glial activation was present in the optic nerve. SUP/haemodiluted rats had decreases in negative STR and increased VEP latency, but no glial activation. CONCLUSION An injury partly resembling human ischaemic optic neuropathy can be produced in rats by combining haemodilution and head-down tilt. Significant functional changes were also present with haemodilution alone. Future studies with this partial optic nerve injury may enable understanding of mechanisms of peri-operative ischaemic optic neuropathy and could help discover preventive or treatment strategies.https://ift.tt/2OzA7Z3
Deep neuromuscular blockade and surgical conditions during laparoscopic ventral hernia repair: A randomised, blinded study
BACKGROUND Laparoscopic ventral hernia repair is a common surgical procedure. However, muscle contractions and general muscle tension may impair the surgical view and cause difficulties suturing the hernial defect. Deep neuromuscular blockade (NMB) paralyses the abdominal wall muscles and may help to create better surgical conditions. OBJECTIVES The current study investigated if deep compared with no NMB improved the surgical view during laparoscopic ventral hernia repair. DESIGN Crossover study. SETTING The study was carried out at Herlev and Gentofte Hospital, University of Copenhagen, Denmark and conducted from May 2015 until February 2017. PARTICIPANTS A total of 34 patients were randomised in an investigator-initiated, assessor-blinded crossover design of deep vs. no NMB during laparoscopic ventral hernia repair. INCLUSION CRITERIA Adults scheduled for elective laparoscopic ventral hernia repair. EXCLUSION CRITERIA Known allergy to any study medication, known homozygous variants in the butyrylcholinesterase gene, severe renal disease, neuromuscular disease, lactating or pregnant women, any indication for rapid sequence induction. INTERVENTIONS Deep NMB was established with rocuronium and reversed with sugammadex. Anaesthesia was conducted with propofol and remifentanil. MAIN OUTCOME MEASURES The primary outcome was evaluation of surgical view assessed on a five-point rating scale. Other outcomes included the surgical conditions during laparoscopic suturing of the hernia defect. RESULTS We found no difference in ratings for the surgical view when comparing deep with no NMB: mean −0.1 (95% confidence interval −0.4 to 0.2) (P = 0.521, paired t test). However, deep compared with no NMB improved the rating score for surgical conditions while suturing the hernia defect (P = 0.012, Mann–Whitney U test). No differences were found in either total length of surgery (P = 0.76) or hernia suturing time (P = 0.81). CONCLUSION Deep compared with no NMB did not change the rating score of the surgical view immediately after introduction of trocars during laparoscopic ventral hernia repair, but the surgical condition were improved during suturing of the hernia. TRIAL REGISTRATION ClinicalTrials.gov, NCT02247466.https://ift.tt/2IDAX1w
End-tidal carbon dioxide monitoring improves patient safety during propofol-based sedation for breast lumpectomy: A randomised controlled trial
BACKGROUND The use of sedation is becoming more commonplace. Although pulse oximetry is a standard monitoring procedure during sedation, it cannot accurately detect early hypoventilation. End-tidal carbon dioxide (EtCO2) monitoring can be an earlier indicator of airway compromise; however, the existing literature is limited to a few studies with varying outcomes. OBJECTIVES To evaluate whether EtCO2 monitoring decreases the incidences of CO2 retention and apnoeic events in propofol-based sedation. DESIGN Randomised controlled study. SETTING A tertiary hospital. PATIENTS Two hundred women (aged 18 to 65 years, ASA physical status 1 or 2) who were scheduled for breast lumpectomy between June 2017 and August 2017. INTERVENTIONS Patients were allocated randomly to receive either standard monitoring or standard monitoring and EtCO2 monitoring. MAIN OUTCOME MEASURES The primary outcome was the incidence of CO2 retention. The secondary outcomes were the number of actions taken to restore ventilation, variations in PaCO2 and pH, the frequency of apnoea and the recovery time. RESULTS CO2 retention occurred significantly less often in the EtCO2 monitoring group (10 vs. 87%; P https://ift.tt/2OF9XVa
Haemodynamic evaluation and optimisation of brain-dead donors with oesophageal Doppler during organ harvesting: A feasibility study
No abstract availablehttps://ift.tt/2IzQcIV
Dexamethasone concentration affecting rocuronium-induced neuromuscular blockade and sugammadex reversal in a rat phrenic nerve-hemidiaphragm model: An ex vivo study
BACKGROUND The concentration range of dexamethasone that inhibits neuromuscular blockade (NMB) and sugammadex reversal remains unclear. OBJECTIVE To evaluate the effects of dexamethasone on rocuronium-induced NMB and sugammadex reversal. DESIGN Ex vivo study. SETTING Asan Institute for Life Sciences, Asan Medical Center, Korea, from July 2015 to November 2015. ANIMALS One hundred sixty male Sprague–Dawley rats. INTERVENTIONS We assessed the effect of four concentrations of dexamethasone [0, 0.5, 5 (clinical concentrations) and 50 μg ml−1 (experimental concentration)] on partial NMB on 40 phrenic nerve–hemidiaphragm preparations (n=10 per concentration). Once the first twitch of train-of-four (TOF) had been depressed by 50% with rocuronium, dexamethasone was administered. To assess the effect of dexamethasone on sugammadex reversal, 120 phrenic nerve–hemidiaphragm preparations were used in three subexperiments (n=40 per experiment), using three administration regimens of rocuronium–equimolar sugammadex: a single dose, a split-dose (split 1/2 and 1/2) and a reduced split-dose (split 1/2 and 1/4). After complete NMB was achieved, dexamethasone and sugammadex were administered. MAIN OUTCOME MEASURES The change in the first twitch height, the recovery time to a TOF ratio at least 0.9, and the TOF ratio at 30 min were evaluated. RESULTS There were no significant differences in the first twitch height among groups (P = 0.532). With a single dose of sugammadex, dexamethasone did not affect the recovery time to a TOF ratio at least 0.9 (P = 0.070). After using a split-dose of sugammadex, the recovery time to a TOF ratio at least 0.9 was delayed only at a concentration of 50 μg ml−1 of dexamethasone. With a reduced split-dose of sugammadex, the TOF ratio at 30 min was lowered only by a concentration of 50 μg ml−1 of dexamethasone (P https://ift.tt/2OtK1f5
Duration of the action of rocuronium in patients with BMI of less than 25: An observational study
BACKGROUND The duration of rocuronium in patients with BMI more than 30 kg m−2 is prolonged. Whether the reverse is true when BMI is less than 18.5 kg m−2 is unclear. OBJECTIVE The objective of this study was to investigate whether a BMI less than 25 kg m−2 affects the duration of rocuronium in doses adjusted for actual body weight. DESIGN A prospective, observational, single-centre study. SETTING The operating room of a teaching hospital from 1 June 2008 to 30 June 2015. PATIENTS Thirty patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo elective surgery (BMI https://ift.tt/2OGNs29
Effect of biodiesel on PAH, OPAH, and NPAH emissions from a direct injection diesel engine
Abstract
Polycyclic aromatic hydrocarbon (PAH), oxy- and nitro-derivate PAH (OPAH and NPAH) emissions from a direct injection diesel engine fueled with conventional fossil diesel (D), waste cooking oil biodiesel (B100), and their two blends (B20 and B50) were compared. The results show that B100 can reduce low molecular weight PAHs such as naphthalene, acenaphthylene, and fluorene as much as 90% compared with diesel. However, the emissions of high molecular weight PAHs including benzo[b]fluoranthene, benzo[k]fluoranthene, and benzo[a]pyrene decrease slightly when using B100. The emission levels for PAHs and OPAHs present comparable, while NPAH emission levels are five to ten times lower than those of PAHs and OPAHs. Compared with diesel, PAH and NPAH emissions significantly decrease. On the contrary, an increase trend of OPAH emission has been observed with adding biodiesel. For the specific parent PAHs and its oxygenated and nitrated derivatives, the fractions of parent PAHs gradually decrease with increasing biodiesel content in the blends, while the corresponding oxygenated and nitrated derivative fractions observably increase, especially for the high molecular weight compounds. Considering the increase of OPAH and NPAH fractions in total particle-phase PAHs when using biodiesel, in-depth biodiesel cytotoxicity assessment should be conducted.
https://ift.tt/2IAnvvn
The content of the potentially toxic elements, iron and manganese, in the grapevine cv Tamjanika growing near the biggest copper mining/metallurgical complex on the Balkan peninsula: phytoremediation, biomonitoring, and some toxicological aspects
Abstract
Plants growing in areas polluted by heavy metals represent excellent models for the investigations related to their potentials for hazardous metals accumulation which further may help in the estimation of plant practical biomonitoring and phytoremediation potentials. In this study, the potentials of the grapevine cultivar Tamjanika from a highly polluted region in Eastern Serbia, with intensive copper mining and metallurgical activities, were estimated in regard to the potentially toxic elements such as iron and manganese; the potential danger from these metals through fruit consummation is also considered. Used methods were the following: ICP-OES analysis, calculation of biological coefficients, the Pearson correlation study, one-way ANOVA, and hierarchical cluster analysis. The results revealed that a great majority of the recorded concentrations in different plant organs were in the range of normal concentrations, as well as that the calculated accumulation rates for both metals were very low. The data also pointed to generally minimal to moderate enrichment by these metals which represents totally dissimilar situation in comparison with other heavy metals detected in the very same plant samples. The results of this study suggested that the investigated plants of the grapevine cv Tamjanika assimilated iron and manganese predominately according to their individual needs, and confirmed that the utilization of this plant species can be very effective in different biomonitoring procedures and also in the phytoremediation procedure known as phytostabilization. At the same time, it was obvious that even in aggressive circumstances its fruit was protected from some serious contamination and kept pretty safe for consummation.
https://ift.tt/2O3PUA4
The use of rituximab in treatment of epidermolysis bullosa acquisita: Three new cases and a review of the literature
Dermatologic Therapy, EarlyView.
https://ift.tt/2DTLbvZ
Anterior, frontal congenital triangular alopecia, redundancy in therapy without improvement
Dermatologic Therapy, EarlyView.
https://ift.tt/2O22cJ6
Correction to: Adsorption and removal of chromium (VI) contained in aqueous solutions using a chitosan-based hydrogel
The original publication of this paper contains an error. The correct 4th heading in Table 1 should be "Non-linear sips isotherm". The original article has been corrected.
https://ift.tt/2PaNE6K
Clinical Thyroidology®for the Public – Highlighted Article
From Clinical Thyroidology® for the Public: Thyroid nodules are very common, occurring in up to 50% of patients. The best imaging method for evaluation of thyroid nodules is ultrasound. The American Thyroid Association guidelines for management of thyroid nodule offers a system for classifying thyroid nodules from benign to very low, low, intermediate and highly suspicious for thyroid cancer depending on the findings of ultrasound. Read More…
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Feedback & SuggestionsThe post Clinical Thyroidology<sup>®</sup>for the Public – Highlighted Article appeared first on American Thyroid Association.
https://ift.tt/2P9kyVc
Impact of route of administration on genotoxic estrogens concentrations using oral vs. transdermal estradiol in girls with turner syndrome
Clinical Endocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2OwOHk7
Enhanced photocatalytic activity of BiVO 4 powders synthesized in presence of EDTA for the decolorization of rhodamine B from aqueous solution
Abstract
Bismuth vanadate (BiVO4) powders were successfully synthesized in presence of EDTA via microwave irradiation and used as photocatalysts in the oxidation reaction of rhodamine B (rhB) under visible light. Different concentrations of EDTA (0.5 to 10%) to chelate Bi3+ ions were employed on the BiVO4 synthesis. Under the presence of EDTA, a monoclinic crystalline structure was obtained, whereas a mixture of monoclinic and tetragonal phases was observed in the absence of EDTA. In addition, the use of different EDTA concentrations promoted the formation the different shapes of particles. The BiVO4 sample synthesized with low concentration of EDTA (0.5%) exhibited about 85% of rhB decolorization in 300 min at pH 7.5. Therefore, this high efficiency can be attributed to a combination of intrinsic properties such as the morphology type and monoclinic structure of BiVO4 particles.
https://ift.tt/2yaYUIJ
Effective industrial regeneration of arsenic poisoning waste selective catalytic reduction catalyst: contaminants removal and activity recovery
Abstract
In this work, an environmental friendly industrial regeneration approach has been proposed to remove the surface poisoning and recover the catalytic activity of waste V2O5-WO3/TiO2 catalyst. Alkaline treatment and acid wash are combined for the waste catalyst regeneration process, which is applied for the arsenic and alkali metal removal, respectively. The crystal structure was well maintained as anatase phase and the surface area was increased during the regeneration, which is favorable for the following active component addition step and regenerated process. The XPS results illustrated that the surface contaminants (arsenic and sodium) were removed and V(IV) was loaded on the regenerated catalyst. Based on the deNOx evaluations, the catalytic activity of the regenerated sample is increased to the level of commercial fresh catalyst. The present industrial regeneration process provides a promising method for the comprehensive recovery of waste catalyst and further understanding in the field of secondary resource recycle.
https://ift.tt/2xXD64b
Photobiomodulation effect on the proliferation of adipose tissue mesenchymal stem cells
Abstract
The use of mesenchymal stem cells (MSCs) in tissue engineering has been extensively investigated. The greater the proliferation of this cellular group, the greater the regenerative and healing capacity of the tissue to which they belong. In this context, photobiomodulation (PBM) is an efficient technique in proliferation of distinct cell types. However, its parameters and mode of action are still unclear and require further investigation. This study aimed to evaluate the PBM action with different energies in MSCs of adipose tissue (hASCs). We used hASCs, seeded in 24-well plates, with 3 × 104 cells per well, in culture media. We used a total of four experimental groups, one with hASCs and simulated PBM and three other groups, which received PBM irradiation at 24, 48, and 72 h, with a 660-nm laser and power of 40 mW and energy of 0.56, 1.96, and 5.04 J. We performed analyses of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromidefor) and trypan blue to evaluate cell proliferation and viability, 1 h after PBM irradiation. Software Graph PadPrism 7.0 was used. Intergroup comparisons were performed with ANOVA two-way and we used the Tukey post hoc test. Mitochondrial activity evaluated by MTT revealed the statistical difference in the first 24 h for group with more high energy when compared to control group; and in the 72 h for two irradiated groups when compared to the control group. The trypan blue test showed significant differences at the end of the experiment for two irradiated groups LG1 (4.52 × 104 ± 0.2) and LG2 (4.85 × 104 ± 0.8), when compared to the control group (1.87 × 104 ± 0.7). Both tests failed to be statistically different at the end of the experiment for groups LG1 and LG2 and observed a reduction in cellular mitochondrial growth and activity for group LG3. We conclude that PBM with energy close to 0.56 and 1.96 J promote proliferation of hASCs, and higher energy, such as 5.04 J, can be harmful.
https://ift.tt/2yf2x0i
Fasting glucagon-like peptide 1 concentration is associated with lower carbohydrate intake and increases with overeating
Abstract
Purpose
Glucagon-like peptide 1 (GLP-1) is an incretin hormone that appears to play a major role in the control of food intake. The aim of this investigation was to evaluate and quantify the association of circulating GLP-1 concentration with ad libitum total calorie and macronutrient intake.
Methods
One-hundred and fifteen individuals (72 men) aged 35 ± 10 years were admitted for an inpatient study investigating the determinants of energy intake. Ad libitum food intake was assessed during 3 days using a reproducible vending machine paradigm. Fasting plasma GLP-1 concentrations were measured on the morning of the first day and on the morning of the fourth day after ad libitum feeding.
Results
Plasma GLP-1 concentrations increased by 14% after 3 days of ad libitum food intake. Individuals overate on average 139 ± 45% of weight-maintaining energy needs. Fasting plasma GLP-1 on day 1 was negatively associated with carbohydrate intake (r = − 0.2, p = 0.03) and with daily energy intake from low fat–high simple sugar (r = − 0.22, p = 0.016).
Conclusion
Higher plasma GLP-1 concentrations prior to ad libitum food intake were associated with lower carbohydrate intake and lower simple sugar ingestion, indicating a possible role of the GLP-1 in the reward pathway regulating simple sugar intake.
Trial registration
ClinicalTrials.gov identifier: NCT00342732.
https://ift.tt/2OvQrKr
T1–D–T2 correlation of porous media with compressed sensing at low-field NMR
Publication date: Available online 2 October 2018
Source: Magnetic Resonance Imaging
Author(s): Yan Zhang, Lizhi Xiao, Xin Li, Guangzhi Liao
Abstract
3D Laplace NMR can distinguish different components of confined fluid in sedimentary rocks, which is important to oil industry. However, the measurement time for such experiments is very long, which hinders the application in some cases such as NMR well logging. In this research, we accelerated T1–D–T2 experiment with compressed sensing (CS) method at low-field NMR. Simulation was first performed to examine the CS reconstruction method. The experiments were subsequently implemented on a 2 MHz spectrometer (Oxford instrument), which has a similar magnetic field strength to well logging tool. The T1, D and T2 information are obtained by the inversion recovery, pulsed field gradients and Carr–Purcell–Meiboom–Gill (CPMG) method, respectively. The subsampling is applied in T1 and D dimensions with pseudo-random sampling. The measurement time reduced from 3 h to 0.6 h with CS method and a relative error of around 5% is achieved for data with signal-to-noise ratio of 28. The water and oil peaks are clearly distinguished in the correlation maps from subsampled data. The samples with different oil-water ratio and glass bead volume fraction were measured to examine the sensitivity of this method. In addition, diffusion and relaxation properties of the correlation maps are discussed.
https://ift.tt/2DRXE3i
Evaluation of benchtop NMR Diffusion Ordered Spectroscopy for small molecule mixture analysis
Publication date: Available online 2 October 2018
Source: Magnetic Resonance Imaging
Author(s): Evan R. McCarney, Robin Dykstra, Petrik Galvosas
Abstract
Diffusion Ordered Spectroscopy (DOSY) is an attractive method for analyzing chemical mixtures in the liquid state because it separates spectra by the molecular weight of the associated molecule. It has been compared with hyphenated chromatographic and analytical methods such LC-MS and has broad potential in servicing those same applications including forensics, reaction analysis, quality control, and fraud detection. Benchtop NMR can collect quality spectra on small molecules, however, lacks the chemical shift dispersion of high field instruments, can suffer from spectral overlap common in mixtures, and the diminished sensitivity of the lower field compounds these problems. In this work, we show that existing high field pulse sequences and processing methods perform well at 43 MHz. Spectra from molecular mixtures where the constituents had 20% differences in diffusion coefficients and significant overlap were able to be matched to a bespoke spectral library and identified correctly. In addition, spectra from mixtures with constituents that have severe overlap in the spectrum and differ by 50% in diffusion coefficients were also able to be match and identified correctly. The combination of benchtop NMR and easy implementation of modern pulse sequences and processing show promise of bringing these useful methods to chemistry laboratories in research and industrial environments.
https://ift.tt/2zNZ5M9
Antimicrobial and antifouling properties of versatile PPSU/carboxylated GO nanocomposite membrane against Gram-positive and Gram-negative bacteria and protein
Abstract
Biofouling is a serious issue in membrane-based water and wastewater treatment as it critically compromises the efficacy of the water treatment processes. This investigation demonstrates the antimicrobial and antifouling properties of a nanocomposite membrane system composed of carboxyl-functionalized graphene oxide (COOH-GO) and polyphenylsulfone (PPSU). The PPSU/COOH-GO nanocomposite membrane exhibited excellent antimicrobial properties, achieving maximum bacteriostasis rates of 74.2% and 81.1% against the representative Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa, respectively) and 41.9% against the representative Gram-positive bacterium (Staphylococcus aureus). The PPSU/COOH-GO nanocomposite membrane inhibited the attachment, colonization, and the biofilm formation of three species. Antifouling was assessed through filtration experiments using a model foulant bovine serum albumin (BSA). The fouling mechanisms were investigated by Hermia's models (complete blocking, intermediate blocking, standard blocking, and cake formation), and the analysis involved fitting the volumetric flux decline experimental data to models. The fouling study revealed a less irreversible fouling and increased flux recovery ratio for the PPSU/COOH-GO nanocomposite membrane. Complete blocking of pores and cake formation were the major fouling mechanisms for the membrane.
https://ift.tt/2O3Ndyg
Ifetroban in Treating Patients With Malignant Solid Tumors at High Risk of Metastatic Recurrence
Conditions: Anatomic Stage II Breast Cancer; Anatomic Stage IIA Breast Cancer; Anatomic Stage IIB Breast Cancer; Anatomic Stage III Breast Cancer; Anatomic Stage IIIA Breast Cancer; Anatomic Stage IIIB Breast Cancer; Anatomic Stage IIIC Breast Cancer; Clinical Stage II Esophageal Adenocarcinoma; Clinical Stage II Esophageal Squamous Cell Carcinoma; Clinical Stage II Gastric Cancer; Clinical Stage II Gastroesophageal Junction Adenocarcinoma; Clinical Stage IIA Esophageal Adenocarcinoma; Clinical Stage IIA Gastric Cancer; Clinical Stage IIA Gastroesophageal Junction Adenocarcinoma; Clinical Stage IIB Esophageal Adenocarcinoma; Clinical Stage IIB Gastric Cancer; Clinical Stage IIB Gastroesophageal Junction Adenocarcinoma; Clinical Stage III Esophageal Adenocarcinoma; Clinical Stage III Esophageal Squamous Cell Carcinoma; Clinical Stage III Gastric Cancer; Clinical Stage III Gastroesophageal Junction Adenocarcinoma; Distal Esophagus Squamous Cell Carcinoma; Esophageal Carcinoma; Estrogen Receptor Negative; HER2/Neu Negative; Limited Stage Small Cell Lung Carcinoma; Malignant Solid Neoplasm; Non-Small Cell Lung Carcinoma; Pancreatic Adenocarcinoma; Pathologic Stage II Esophageal Adenocarcinoma; Pathologic Stage II Esophageal Squamous Cell Carcinoma; Pathologic Stage II Gastric Cancer; Pathologic Stage II Gastroesophageal Junction Adenocarcinoma; Pathologic Stage IIA Esophageal Adenocarcinoma; Pathologic Stage IIA Esophageal Squamous Cell Carcinoma; Pathologic Stage IIA Gastric Cancer; Pathologic Stage IIA Gastroesophageal Junction Adenocarcinoma; Pathologic Stage IIB Esophageal Adenocarcinoma; Pathologic Stage IIB Esophageal Squamous Cell Carcinoma; Pathologic Stage IIB Gastric Cancer; Pathologic Stage IIB Gastroesophageal Junction Adenocarcinoma; Pathologic Stage III Esophageal Adenocarcinoma; Pathologic Stage III Esophageal Squamous Cell Carcinoma; Pathologic Stage III Gastric Cancer; Pathologic Stage III Gastroesophageal Junction Adenocarcinoma; Pathologic Stage IIIA Esophageal Adenocarcinoma; Pathologic Stage IIIA Esophageal Squamous Cell Carcinoma; Pathologic Stage IIIA Gastric Cancer; Pathologic Stage IIIA Gastroesophageal Junction Adenocarcinoma; Pathologic Stage IIIB Esophageal Adenocarcinoma; Pathologic Stage IIIB Esophageal Squamous Cell Carcinoma; Pathologic Stage IIIB Gastric Cancer; Pathologic Stage IIIB Gastroesophageal Junction Adenocarcinoma; Pathologic Stage IIIC Gastric Cancer; Postneoadjuvant Therapy Stage II Esophageal Adenocarcinoma; Postneoadjuvant Therapy Stage II Esophageal Squamous Cell Carcinoma; Postneoadjuvant Therapy Stage II Gastric Cancer; Postneoadjuvant Therapy Stage II Gastroesophageal Junction Adenocarcinoma; Postneoadjuvant Therapy Stage III Esophageal Adenocarcinoma; Postneoadjuvant Therapy Stage III Esophageal Squamous Cell Carcinoma; Postneoadjuvant Therapy Stage III Gastric Cancer; Postneoadjuvant Therapy Stage III Gastroesophageal Junction Adenocarcinoma; Postneoadjuvant Therapy Stage IIIA Esophageal Adenocarcinoma; Postneoadjuvant Therapy Stage IIIA Esophageal Squamous Cell Carcinoma; Postneoadjuvant Therapy Stage IIIA Gastroesophageal Junction Adenocarcinoma; Postneoadjuvant Therapy Stage IIIB Esophageal Adenocarcinoma; Postneoadjuvant Therapy Stage IIIB Esophageal Squamous Cell Carcinoma; Postneoadjuvant Therapy Stage IIIB Gastroesophageal Junction Adenocarcinoma; Progesterone Receptor Negative; Prognostic Stage II Breast Cancer; Prognostic Stage IIA Breast Cancer; Prognostic Stage IIB Breast Cancer; Prognostic Stage III Breast Cancer; Prognostic Stage IIIA Breast Cancer; Prognostic Stage IIIB Breast Cancer; Prognostic Stage IIIC Breast Cancer; Stage I Pancreatic Cancer; Stage IA Pancreatic Cancer; Stage IB Pancreatic Cancer; Stage II Lung Cancer; Stage II Pancreatic Cancer; Stage IIA Lung Cancer; Stage IIA Pancreatic Cancer; Stage IIB Lung Cancer; Stage IIB Pancreatic Cancer; Stage III Lung Cancer; Stage IIIA Lung Cancer; Stage IIIB Lung Cancer; Stage IIIC Lung Cancer; Triple-Negative Breast Carcinoma
Interventions: Drug: Ifetroban Sodium; Other: Placebo
Sponsors: Vanderbilt-Ingram Cancer Center; Cumberland Pharmaceuticals
Not yet recruiting
https://ift.tt/2IySZ5f
Interventions: Drug: Ifetroban Sodium; Other: Placebo
Sponsors: Vanderbilt-Ingram Cancer Center; Cumberland Pharmaceuticals
Not yet recruiting
https://ift.tt/2IySZ5f
GSK3359609 Plus Tremelimumab for the Treatment of Advanced Solid Tumors
Condition: Neoplasms
Interventions: Drug: GSK3359609; Drug: Tremelimumab; Drug: Docetaxel; Drug: Paclitaxel; Drug: Cetuximab
Sponsors: GlaxoSmithKline; MedImmune LLC
Not yet recruiting
https://ift.tt/2Ox7onJ
Interventions: Drug: GSK3359609; Drug: Tremelimumab; Drug: Docetaxel; Drug: Paclitaxel; Drug: Cetuximab
Sponsors: GlaxoSmithKline; MedImmune LLC
Not yet recruiting
https://ift.tt/2Ox7onJ
Concurrent Neoadjuvant Chemoradiotherapy Plus Durvalumab (MEDI4736) in Resectable Stage II/IIIa NSCLC
Condition: Potentially Resectable Stage II/IIIa NSCLC
Intervention: Drug: durvalumab
Sponsor: Yonsei University
Not yet recruiting
https://ift.tt/2Iz3gOT
Intervention: Drug: durvalumab
Sponsor: Yonsei University
Not yet recruiting
https://ift.tt/2Iz3gOT
Increased frequency of impaired fasting glucose and isolated systolic hypertension in Paget’s disease of bone
Abstract
Purpose
Scanty data about glucose metabolism and hypertension have been reported in Paget's disease of bone (PDB) to be related with increased cardiovascular mortality. The aim of the present study was to evaluate glucose and blood pressure levels in PDB, looking for their association with disease severity.
Methods
We performed an observational cross-sectional study in 54 patients with PDB and 54 age, sex and BMI-matched controls. Glucose and blood pressure levels and parameters of bone and mineral metabolism were assessed.
Results
Patients with PDB showed increased glucose levels (6.3 ± 1.7 vs 5.3 ± 1.4 mmol/l, p < 0.001) and prevalence of impaired fasting glucose (14.8%, 5.3–24.3 vs 1.9%, 0–5.4, p < 0.02) as well as enhanced systolic blood pressure (145.9 ± 21.3 vs 132.9 ± 18.9 mmHg, p < 0.005), pulse pressure (69.6 ± 20.0 vs 56.0 ± 16.9 mmHg, p < 0.01) and prevalence of isolated systolic hypertension (46.3%, 33.0–59.6 vs 16.7%, 6.7–26.6, p < 0.003) in comparison to controls. Moreover, we found a positive association of (1) glucose levels with ionized calcium and bone alkaline phosphatase; (2) both systolic and pulse pressure with total and bone alkaline phosphatase (p < 0.05). By multiple linear regression analysis (R2 = 0.26; p < 0.05) serum ionized calcium correlated with glucose levels (β = 0.44; p < 0.04), after adjusting for age and BMI.
Conclusions
Our study shows increased fasting glucose, systolic and pulse pressure levels as well as enhanced prevalence of impaired fasting glucose and isolated systolic hypertension in PDB, potentially accounting for increased cardiovascular mortality. Furthermore, our findings suggest high serum calcium and/or increased bone alkaline phosphatase as a link between PDB and cardio-metabolic disorders.
https://ift.tt/2E24lQK
A rare case of finger ischemia following bypass procedure with autologous vein graft for thumb revascularization: a case report and brief review of the literature
Abstract
This case report aims to point out the importance of having in mind anatomical variation in the blood supply to the hand even in emergency settings. A 39-year-old patient presented at our emergency department with a wound on the distal anterolateral third of the left forearm with skin loss, degloving injury of the thumb starting from the 1st metacarpal, exposure of the proximal two thirds of the 1st metacarpal bone, and both radial and ulnar digital arteries of the thumb damaged. A 10-cm-long vein graft was anastomosed in termino-later fashion between the dorsal branch of the radial artery and the uninjured distal part of the ulnar collateral digital artery of the thumb, successfully re-establishing its blood supply. Starting from the 1st postoperative day, the thumb was warm and pink while the other fingers were pale and capillary filling was absent. An urgent arteriography of the left upper extremity demonstrated the presence of normal radial artery, hypoplastic ulnar artery, dominant median artery, and absence of vascularization of the 2nd, 3rd, 4th, and 5th fingers. By the end of 2nd week, the patient underwent amputation of the four fingers at the distal metacarpal level. Anatomical anomalies of hand arterial blood supply are not uncommon, even though rarely reported in literature. Therefore, an instrumental study should be performed before attempting any arterial intervention even in emergency settings. Nevertheless, further studies should be performed to identify ready-to-use tools to make surgeons aware of any anatomic variations in order to avoid such complications.
Level of Evidence: Level V, therapeutic study.
https://ift.tt/2P4Mppq
Increased frequency of impaired fasting glucose and isolated systolic hypertension in Paget’s disease of bone
Abstract
Purpose
Scanty data about glucose metabolism and hypertension have been reported in Paget's disease of bone (PDB) to be related with increased cardiovascular mortality. The aim of the present study was to evaluate glucose and blood pressure levels in PDB, looking for their association with disease severity.
Methods
We performed an observational cross-sectional study in 54 patients with PDB and 54 age, sex and BMI-matched controls. Glucose and blood pressure levels and parameters of bone and mineral metabolism were assessed.
Results
Patients with PDB showed increased glucose levels (6.3 ± 1.7 vs 5.3 ± 1.4 mmol/l, p < 0.001) and prevalence of impaired fasting glucose (14.8%, 5.3–24.3 vs 1.9%, 0–5.4, p < 0.02) as well as enhanced systolic blood pressure (145.9 ± 21.3 vs 132.9 ± 18.9 mmHg, p < 0.005), pulse pressure (69.6 ± 20.0 vs 56.0 ± 16.9 mmHg, p < 0.01) and prevalence of isolated systolic hypertension (46.3%, 33.0–59.6 vs 16.7%, 6.7–26.6, p < 0.003) in comparison to controls. Moreover, we found a positive association of (1) glucose levels with ionized calcium and bone alkaline phosphatase; (2) both systolic and pulse pressure with total and bone alkaline phosphatase (p < 0.05). By multiple linear regression analysis (R2 = 0.26; p < 0.05) serum ionized calcium correlated with glucose levels (β = 0.44; p < 0.04), after adjusting for age and BMI.
Conclusions
Our study shows increased fasting glucose, systolic and pulse pressure levels as well as enhanced prevalence of impaired fasting glucose and isolated systolic hypertension in PDB, potentially accounting for increased cardiovascular mortality. Furthermore, our findings suggest high serum calcium and/or increased bone alkaline phosphatase as a link between PDB and cardio-metabolic disorders.
https://ift.tt/2E24lQK
Effect of anaerobic cure of self-etch adhesive on degree of conversion and shear bond strength
Abstract
Objective
The main aim was to evaluate the effect of postponing the curing of the adhesive layer until the first layer of composite resin is applied—hereby oxygen-inhibited layer (OIL) formation and its detrimental effect on the degree of conversion (DC) of self-etch adhesives should be prevented. For this purpose, the degree of conversion and shear bond strength of four current market self-etch adhesives were evaluated, assessing the effect of curing the adhesives anaerobically and then under two different thicknesses of composite resin, and compare this to the samples cured alone and in air.
Materials and methods
The degrees of conversion were obtained by attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, after the samples were prepared on a glass slide. The samples were either light-cured in air or anaerobically under a clear matrix strip alone, under 2 mm of cured composite resin or under 4 mm of cured composite resin. To determine the shear bond strength (SBS), extracted molars were halved and set in acrylic. Prefabricated cured cylinders of composite resin (TPH 3, 2.4 mm in diameter) of two different lengths are placed over the adhesives under the following conditions: light-cured conventionally (2-mm-long cylinder) and light-cured anaerobically under the uncured end of the piece of composite resin (using both 2- and 4-mm-long cylinders as separate treatments). After another incubation for 24 h at 37 °C, the samples were subjected to shearing using the Bisco Shear Bond Strength Tester.
Results
The degree of conversion of the one-step self-etch adhesives was not statistically different when cured anaerobically under a clear matrix strip or cured anaerobically under 2 mm of composite resin. These results were greater than those cured under 4 mm. Shear bond strength between samples cured in air and anaerobically were similar under 2 mm of composite resin tubes, while those cured anaerobically under 4 mm of resin showed lower shear bond strength.
Conclusion
When cured anaerobically, one-step self-etch adhesives show a greater degree of conversion and no significant difference in degree of conversion and shear bond strength when compared to those cured in air under the same thickness of composite resin.
Clinical relevance
The results obtained from DC and SBS analysis show promise in placing the uncured adhesive under the composite resin and curing both the adhesive and restoration material simultaneously.
https://ift.tt/2Rh2ERM
Comparison of linear and volumetric measurements obtained from periodontal defects by using cone beam-CT and micro-CT: an in vitro study
Abstract
Objectives
To assess linear and volumetric measurement accuracy of periodontal defects (class 2 furcation, fenestration, dehiscence, and three-wall intrabony defect) by using CBCT and micro-CT images obtained at different voxel sizes.
Material and methods
We created 66 periodontal defects in human dry mandibles. Images of teeth with defects were taken by Planmeca Promox 3D Max (CBCT) at voxel sizes of 0.2 and 0.075 mm and super-argus PET/CT (micro-CT) at voxel sizes of 0.12 and 0.06 mm. All defects were then linearly (depth, width, and height) and volumetrically measured by 3D-DOCTOR software. Differences between voxels were assessed by Wilcoxon signed rank test. Bland-Altman limits of agreement and ICCs were calculated to assess agreement between the methods. Significance was set at p < 0.05.
Results
Volumes measured by micro-CT (0.12–0.06 mm) were higher than those of CBCT (0.2–0.075 mm) measurements regardless of the voxel size. ICC between micro CT and CBCT methods was found to be statistically significant for all types of defects in terms of volume (p < 0.001), height (p < 0.05), width (p < 0.001), and depth measurements (p < 0.001).
Conclusion
CBCT provides useful information regarding linear and volumetric measurement of periodontal defects in vitro.
Clinical relevance
Size and volume of periodontal defects may play an important role in the determination of the most appropriate treatment plan and disease prognosis along with outcome assessment.
https://ift.tt/2ybHDPJ
Scholar : Asian Security, Volume 14, Issue 3, September-December 2018 is now available online on Taylor & Francis Online
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Genome-wide association analysis suggests novel loci for Hashimoto’s thyroiditis
Abstract
Purpose
Hashimoto's thyroiditis (HT) is the most common form of autoimmune thyroid diseases. Current knowledge of HT genetics is limited, and not a single genome-wide association study (GWAS) focusing exclusively on HT has been performed to date. In order to decipher genetic determinants of HT, we performed the first GWAS followed by replication in a total of 1443 individuals from Croatia.
Methods
We performed association analysis in a discovery cohort comprising 405 cases and 433 controls. We followed up 13 independent signals (P < 10−5) in 303 cases and 302 controls from two replication cohorts and then meta-analyzed results across discovery and replication datasets.
Results
We identified three variants suggestively associated with HT: rs12944194 located 206 kb from SDK2 (P = 1.8 × 10−6), rs75201096 inside GNA14 (P = 2.41 × 10−5) and rs791903 inside IP6K3 (P = 3.16 × 10−5). Genetic risk score (GRS), calculated using risk alleles of these loci, accounted for 4.82% of the total HT variance, and individuals from the top GRS quartile had 2.76 times higher odds for HT than individuals from the lowest GRS quartile.
Conclusions
Although discovered loci are implicated with susceptibility to HT for the first time, genomic regions harboring these loci exhibit good biological candidacy due to involvement in the regulation of the thyroid function and autoimmunity. Additionally, we observe genetic overlap between HT and several related traits, such as hypothyroidism, Graves' disease and TPOAb. Our study adds a new knowledge of underlying HT genetics and sets a firm basis for further research.
https://ift.tt/2xVPCkw
Treating varicocele in 2018: current knowledge and treatment options
Abstract
Purpose
Varicocele is defined as a state of varicosity and tortuosity of the pampiniform plexus around the testis caused by retrograde blood flow through the internal spermatic vein. The prevalence of clinically relevant varicocele ranges from 5 to 20% in the male population and is often associated with infertility and reduction of sperm quality. In this review, the pathophysiology and clinical aspects of varicocele are reviewed along with therapeutic options and treatment effects on sperm parameters and fertility both in adult and in pediatric/adolescent subjects.
Methods
We conducted a Medline and a PubMed search from 1965 to 2018 to identify publications related to varicocele clinical aspects, treatment procedures and treatment outcomes. Keywords used for the search were: "varicocele", "varicocelectomy", "sclerotherapy", "male infertility", "subfertility", and "semen abnormalities".
Results
Data from a large number of studies in adolescent and adult males indicate that varicocele correction improves semen parameters in the majority of patients, reducing oxidative stress and improving sperm nuclear DNA integrity either with surgical or percutaneous approach.
Conclusions
Varicocele repair seems to represent a cost-effective therapeutic option for all males (both adolescent and adults) with a clinical varicocele in the presence of testicular hypotrophy, worsening sperm alterations or infertility. On the other hand, some investigators questioned the role of varicocelectomy in the era of assisted reproduction. Thus, a better understanding of the pathophysiology of varicocele-associated male subfertility is of paramount importance to elucidating the deleterious effects of varicocele on spermatogenesis and possibly formulating new treatment strategies.
https://ift.tt/2Iy1ihu
Quantitative proteomics analysis of sporadic parathyroid adenoma tissue samples
Abstract
Objective
Molecular pathogenesis of parathyroid tumors is incompletely understood. Identification of novel molecules and understanding their role in parathyroid tumorigenesis by proteomics approach would be informative with potential clinical implications.
Method
Adenomatous (n = 5) and normal (n = 2) parathyroid tissue lysates were analyzed for protein profile by LC–MS/MS method and the proteins were classified using bioinformatics tools such as PANTHER and toppfun functional enrichment tool. Identified proteins were further validated by western blotting and qRT-PCR (n = 20).
Result
Comparative proteomics analysis revealed that a total of 206 proteins (74 upregulated and 132 downregulated) were differentially expressed (≥ twofold change) in adenomas. Bioinformatics analysis revealed that 48 proteins were associated with plasma membrane, 49 with macromolecular complex, 39 were cytoplasm, 38 were organelle related, 21 were cell junction and 10 were extracellular proteins. These proteins belonged to a diverse protein family such as enzymes, transcription factors, cell signalling, cell adhesion, cytoskeleton proteins, receptors, and calcium-binding proteins. The major biological processes predicted for the proteins were a cellular, metabolic and developmental process, cellular localization, and biological regulation. The differentially expressed proteins were found to be associated with MAPK, phospholipase C (PLC) and phosphatidylinositol (PI) signalling pathways, and with chromatin organization. Western blot and qRT-PCR analysis of three proteins (DNAJC2, ACO2, and PRDX2) validated the LC–MS/MS findings.
Conclusion
This exploratory study demonstrates the feasibility of proteomics approach in finding the dysregulated proteins in benign parathyroid adenomas, and our preliminary results suggest that MAPK, PLC and PI signalling pathways and chromatin organization are involved in parathyroid tumorigenesis.
https://ift.tt/2y3msjR
Biochar amendment immobilizes arsenic in farmland and reduces its bioavailability
Abstract
This study aimed to determine effects of biochar derived from wheat straw at 500 °C on arsenic immobilization in a soil-Brassica campestris L system. When the soils amended with 4% modified biochar (MBC), 0.5% Fe grit as zero-valent iron (ZVI), 0.5% Fe grit + 4% MBC (ZMBC), 0.5% ZVI + 4% biochar (ZBC), 4% biochar (BC), and control (without amendments), it confirmed that available arsenic concentration in soils occurred in the following order: ZMBC < MBC < ZVI < ZBC < Control < BC. Water-soluble As (WSAs) was reduced by 89.74% and 92.30% in MBC- and ZMBC-amended soils, respectively, compared to the control. When MBC applied into soil, As uptake of shoot and root decreased by 44.55% and 45.40%, respectively, and ZMBC resulted in 74.92% and 71.80% reduction in shoot and root As of Brassica campestris L. Immobilization effect of As in ZBC was also observed though BC elevated plant As uptake significantly. The immobilization effect of MBC was mainly attributed to Fe2O3 impregnation illustrated by x-ray diffraction (XRD) and scanning electron microscopy (SEM) images through sorption, precipitation, and coprecipitation. Such Fe containing complexes might impede As translocation from root to shoot and subsequently reduce As accumulation in the plant with modified biochar amendment.
https://ift.tt/2OC5ORS
Occurrence and risk assessment of heavy metals in water, sediment, and fish from Dongting Lake, China
Abstract
In this study, 15 representative surface waters and sediments and seven typical fish were collected during the wet season in 2016 to explore the occurrence, chemical fractionation, and ecological risk of heavy metals (Cu, Zn, Pb, Cd, Cr, Hg, As, and Ni) in aquatic ecosystems of Dongting Lake in China. In surface water, the concentrations of all elements were lower than the third grade of the surface water quality standards (GB3838-2002). The highest concentrations of Zn, Pb, Cd, Ni, and Cu were found in the outlet of Dongting Lake, whereas As and Cr were highest in the Xiangjiang River Delta area. In surface sediments, the concentration decreased in the order of Zn > Cr > Pb > Cu > Ni > As>Cd > Hg; the highest concentration of all elements, except for Hg, was located in the Xiangjiang River Delta area; for chemical fractionation, Cr, Hg, Zn, As, Ni, and Cu were mainly residual fractionation; and Pb and Cd were mainly in a reducible state and fraction soluble in acid, respectively. In fish muscle, the concentrations of all elements were lower than relevant standards; the highest concentration appeared in fish living in the middle-lower and demersal layers. As for the feeding habits of fish, the average concentration decreased in the order of carnivorous > omnivorous > herbivorous fish. The potential ecological risk and the ratio of secondary phase to primary phase assessment showed that Cd and Hg had the highest ecological risk and that Cd and Pb had a high risk of secondary release. A health risk assessment showed that drinking water and fish for consumption in urban and rural areas around Dongting Lake were in the acceptable level.
https://ift.tt/2y9FnIF
The Importance of CYP19A1 in Estrogen Receptor-Positive Cholangiocarcinoma
Abstract
CYP19A1, also called aromatase, is a key enzyme for converting androgens to estrogens of estrogen synthesis. Elevated serum estrogen and high expression levels of estrogen-related proteins are found in cholangiocarcinoma (CCA; bile duct cancer). However, the expression of CYP19A1 in relation to estrogen-related proteins, including estrogen receptors (ERα, ERβ, and GPR30) and an estrogen response protein (TFF1), has never been explored in CCA. In this study, we investigated the expressions of CYP19A1 and estrogen-related proteins in CCA tissues (n = 74; 51 males and 23 females) using immunohistochemistry. The results showed that CYP19A1 was overexpressed in CCA cells compared with that in normal bile duct cells in the adjacent tissues. High expression of CYP19A1 was correlated with the metastatic status of the patients. High CYP19A1 expression was also positively correlated with GPR30 expression. Correlation between high CYP19A1 expression in the tumor tissues and shorter survival time was more prominent in male than in female CCA patients. To elucidate further, the effect of CYP19A1 knockdown on a CCA cell line was examined using a specific siRNA. When CYP19A1 gene expression was suppressed, migration and proliferation activities of CCA cells were significantly reduced. Moreover, the cell proliferation of high CYP19A1-expressing KKU-213 cells was more profoundly suppressed by CYP19A1 inhibitors (exemestane and letrozole) than low CYP19A1-expressing KKU-100 cells. Thus, CYP19A1 promotes CCA progression with aggressive clinical outcomes via increased migration and proliferation activities of cancer cells. CYP19A1 can be a potential chemotherapeutic target for CCA, especially in male patients.
https://ift.tt/2E3gxAL
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