Ιατρικά Άρθρα

Δευτέρα 12 Σεπτεμβρίου 2016

TRANSDERMAL UNANI FEMALE CONTRACEPTIVE FORMULATION: DESIGNING AND IN-VITRO TRANSDERMAL ACTIVITY EVALUATION

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Tarannum*, Mohammad Idris.
The transdermal drug delivery system has an important place in the medical field. This delivery system has several advantages over the oral and parental route of drug administration. The concept of transdermal drug delivery system was already exists in the Unani system of medicine. Several dosage forms for transdermal drug delivery system in single as well as in compound formulation were mentioned in the classical literature of Unani system. Unani medicine is enriched with several drugs honored to possess antifertility property. Unani antifertility agents are recommended for both- male and female as oral and/or local application. Several single drugs as well as compound formulations are mentioned in Unani classical literature to control the fertility. With this background an effort was made with two objectives. First was to design a transdermal Unani female contraceptive formulation (TUFCF) based on four ingredients i.e. Leaves of Henna (Lawsonia inermis), rhizome of Pakhanbed (Bergenia ciliata), Sibr (Latex of Aloe barbadensis) and Khar-e-Chirchita (Achyranthes aspera). Secondly to evaluate in-vitro transdermal penetration potential of the TUFCF by Franz diffusion cell method, qualitatively and quantitatively. Qualitatively the test formulation reveals significant presence of phytochemicals by chemical test method. Quantitatively it showed 35.07% release across the membrane. Hence, it was concluded that the test formulation possessed the transdermal activity.

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LOCAL INFILTRATION TECHNIQUE IN UNILATERAL TOTAL KNEE REPLACEMENT

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Ardeshna A Nishita, Bashwanth Pasupulati, Dr. Basavaraj CM, Dr. Vinay Pawar.
INTRODUCTION: The most effective treatment for osteoarthritis is TKR and THR but sizeable patient experience chronic pain causing discomfort. There has been shift in the usage of local anesthesia technique (LIA) over the general anesthesia in orthopedic surgeries mainly TKR. Pain control is important post surgery which includes opioid use, and other analgesics. LIA technique has taken increased focus due to early rehabilitation in patients with TKR and THR. METHOD: It was prospective, non-interventional and observational study. RESULTS: Outcomes were assessed with regards to the pain score and analgesic use post LIA. Patients with this technique experienced early mobilization and better pain control after surgery. There was decreased in the opioid usage and increased patient satisfaction. Break-through pain was also found to have decreased with LIA comparatively with only analgesic usage. CONCLUSION: The use of preoperative patient education as an important component in their fast-track recovery program. LIA protocol can achieve meaningful results and can be easily implemented both in tertiary care centers & community hospitals.

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“EVALUATION OF ANTIBACTERIAL AND ANTIFUNGAL ACTIVITY OF RUTIN AND BERBERINE”

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
S. Viswanth Reddy*, Kappera Swetha, G. Avinash.
The aim of study is to investigate the antibacterial and antifungal activity of natural compounds like Rutin (bioflavonoid) and Berberine (isoquinoline alkaloid) by using disc diffusion method. Antibacterial activity was determined using two gram positive cultures (Bacillus subtilis, Staphylococcus aureus) and two gram negative cultures (Pseudomonas aeruginosa, Escherichia coli). Antifungal activity was evaluated against Aspergillus flavus and Fusarium verticillioides fungal cultures. Both Rutin and Berberine were tested at concentration of 50 μg/ml and 100 μg/ml. The isoquinoline alkaloid Berberine at 50μg/ml has significant antibacterial activity against Pseudomonas aeruginosa, Escherichia coli, Bacillus subtilis and Staphylococcus aureus. At 100 μg/ml it has highly significant antibacterial activity against all cultures compared to control group. Rutin has no significant antibacterial activity at 50 μg/ml however at 100 μg/ml it has shown significant activity against Bacillus subtilis. Rutin has no significant antifungal activity at both the doses. Berberine at 50 μg/ml did not show any significant activity against Aspergillus flavus but it was shown lower significant activity against Fusarium verticillioides however at higher concentration (100 μg/ml) it has shown highly significant activity against both the cultures. Berberine has shown higher anti-bacterial and antifungal against all cultures and the activity was better when compared to Rutin. It was concluded that the antibacterial and antifungal potential of these natural products might be due to interference of microbial protein synthesis, so these natural compounds might be better therapeutic targets for bacteria and fungi clinically for development of safe and efficacious antimicrobials.

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“EVALUATION OF ANTIDEPRESSANT ACTIVITY OF RUTIN AND BERBERINE IN DIFFERENT BEHAVIORAL MODELS”

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
S. Viswanth Reddy*, Kappera Swetha.
Depression is one of the most common psychiatric disorders reported in all the parts of Globe. The existing pharmacological therapy with N-methyl D-aspartate antagonists and tricyclic antidepressants has shown good efficacy in increasing neurotransmission in the brain but they are also associated with various unwanted effects. Hence, alternative therapeutics such as nutraceuticals with low side effect profile were investigated as new safe antidepressant agents. In the present study nutraceutical products Rutin and Berberine were screened for in vitro antioxidant activity by DPPH free radical scavenging assay and NBT superoxide scavenging assay. These compounds have shown good inhibitory activity in all in vitro assays, based on these results in vivo studies were conducted. Antidepressant activity of Rutin and Berberine was evaluated by using forced swim test in mice, tail suspension test in rats. These compounds (250, 500 mg/kg bd. wt.) decreased the immobility periods in dose dependent manner in both tail suspension test (TST) and forced swim test (FST). The expected mechanism of action the activity probably through increased monoamine transmission in the brain. From the results it was found that Rutin and Berberine have significant antidepressant activity.

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GASTRORETENTIVE IN SITU GEL FORMULATION SYSTEM

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Mrs. Sushma Singh, Ragini L. Tandle*.
The design of controlled drug delivery systems (DDS) should be primarily subjected to aim and to achieve more predictable and increased bioavailability. In-situ gel refers to polymer solution which can be administered as liquid & undergoes a phase transition to semisolid gel upon exposure to physiological environment. The oral gastro-retentive in-situ gel forming polymeric drug delivery systems are designed with an objective to retain in stomach for an extended time period and also for achieving systemic drug effects over than other pharmaceutical dosage forms. The formulation is introduced to overcome the rapidly increasing cost and to reduce the time required in the development works over than the other pharmaceutical dosage forms. Many natural, biodegradable, biocompatible and synthetic polymers like alginic acid, pluronic F127, xyloglucan, gellan gum, carbopol, pectin, chitosan, poly (DL lactic acid), poly (DL-lactide-coglycolide) and poly-caprolactone etc. are used in the preparation of in situ gelling system. The present study was based on the development of stomach specific drug delivery systems using various approaches like gastro-retentive oral in-situ gel formulation. [1, 2]

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ABC –VED ANALYSIS OF DRUG STORE IN TERTIARY CARE HOSPITAL FOR YEAR 2013-14

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Dr. Amrita Singam, Dr. S. Dudhgaonkar, Dr.Abhishek Mamarde* Dr.Kartik J Salwe*, Dr. Huma Khan*.
Introduction- In government hospital, about one-third of the annual budget is spent on buying medicines. Effective inventory management is required to balance inventory expenditure against demands for medicines. In hospital inventory management, VED analysis has been commonly used together with ABC analysis. So our aim is to analyze the annual drug expenditure (ADE) & Identification of the drug categories requiring greater supervisory monitoring using ABC and VED analysis. Material and Method-Study was conducted in Indira Gandhi Government Medical Collage and Hospital Nagpur of central India, a 594 bed tertiary care hospital. The data of annual consumption and cost on each drug from Medical store, for financial year 2013- 2014 was obtained. ABC analysis done. The data was arranged in Excel sheet. The ABC-VED matrix (combination) was formed by cross tabulating ABC and VED. Results are expressed as %. Result- On ABC analysis it was found that category A consisted 26 drugs i.e.(13.19%) similarly we calculated for categories B and C which came out as, in category B 36 drugs i.e. (18.2%) and for category C 135 drugs i.e.(68.52%).On VED analysis it was found that ,Vital drugs (V)were 60 i.e. (30.96%), Essential drugs (E) were 79 that was (39.08%) and Desirable drugs(D) were 58 (29.94%) were found out of 197 total drugs. On vital drugs (V) the expenditure was 1,07,75,813 (61.63%),Essential drugs (E) expenditure was 51,64,273.52 (29.53%)and on Desirable (D) expenditure was 1544434.03 (8.83%) of the total budget. Conclusion From present study we may conclude that there is a need for conducting such analysis regularly, and applying the inventory management tools for effective and efficient management of the medical stores.

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PHYSIO CHEMICAL STANDARDIZATION OF THE SIDDHA HERBO MINERAL DRUG – AMIRTHARASA MATHIRAI

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Kumar S., Paechiyammal. S. Maanickha chelvi K S.
The standardization of any drug before administration to human beings is mandatory in nowadays Amirtharasa mathirai (AM) is one of the drug belongs to siddha system of medicine which is made up of herbals and metals. The aim of the study is to standardize this preparation. The physio chemical properties are black colour solid material, Total ash value is 9.73%w/w , moisture content is 8.82%w/w and pH value is 7.7% which yield 45%w/w. Inductively coupled plasma optical emission spectrometry (ICP-OES) revealed that toxic metals like mercury, arsenic, cadmium and lead were below detective limit.(BDL). Scanning Electron Microscope (SEM) analysis shows that particles of size 0.25 -0.50μm.

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KNOWLEDGE AND ATTITUDE OF HEALTH PROFESSIONALS TOWARDS SAFE INDUCED ABORTION IN PUBLIC HEALTH FACILITIES IN ILU ABABORA ZONE, OROMIYA, ETHIOPIA

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Ebissa Negera.
Background: In Ethiopia, in 2005, even though, abortion law has been revised to include provision for conducting abortion, it remained in accessible for large majority of women. Provider attitude, stigma and passive resistance remain insidious barriers to the full realization of reproductive equality. Objective: To assess knowledge and attitude of health professionals towards safe induced abortion at public health facilities of Ilu Ababora zone. Methods: A cross-sectional study was conducted from December 15, 2011- February 29, 2012. A total of 395 health professionals (General practitioners, mid-wifery, health officers and nurses) selected by simple random sampling method were involved in the study. Data were collected using structured Afan Oromo Version self administered questionnaire. Analysis was done using bivariate and multi-variate techniques. Results: The proportions of health professionals knowledgeable about safe induced abortion were (58%) and fifty one percent (51%) had favorable attitude towards safe induced abortion. Only (28.4%) of health professionals were trained on safe termination of pregnancy. Knowledge about safe induced abortion was significantly associated with marital status (OR= 1.73; 95% CI 1.07-2.8) and training on safe induced abortion (OR=0.31; 95% CI 0.17-0.5). Attitude towards safe induced abortion was significantly associated with sex (OR=0.32; 95% CI 0.2-0.53), marital status (OR=2.32; 95% CI 1.4-3.88) and training on safe induced abortion (OR=0.26; 95% CI 0.14-0.4). Conclusion: The present study revealed that, while overall awareness on safe induced abortion was high (81.8%), the actual knowledge and attitude towards safe induced abortion is low among health professionals in Ilu Ababora zone.

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INTEGRATION OF FAMILY PLANING SERVICES WITH ABORTION CARE AT PUBLIC AND PRIVATE HEALTH FACILITIES IN METTU TOWN, SOUTH WEST ETHIOPIA

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Ebissa Negera, Geremew Tolesa.
Complications of unsafe abortion contribute to 13% of global maternal mortality and have received less attention than other obstetric emergencies discourses. Timely and appropriate treatment of unsafe abortions and incomplete spontaneous abortions can prevent maternal death and morbidity. Counseling post-abortion care patients on family planning and facilitating their access to family planning methods help to prevent unwanted pregnancies and repeat abortions. The objective of this study was to assess the integration of Family planning services with abortion care at public and private health facilities that provided abortion care service in Mettu town. Facility based cross sectional study was employed. The study was conducted at public and private health facilities those providing abortion care service in Mettu town from February to March 2014. A total of 274 women who got services were interviewed. The response rate was 94.2%. One hundred ninety three (70.44%) of the respondents reported that they have got contraceptive counseling/ information from the service providers .Among them 113 (41.24%) left the health facility with contraceptive methods. Significant proportion of women who got abortion services left the health facility without getting family planning counseling and contraceptive methods. Due attention should be given the ways to integrating women who got abortion services at each health facilities.

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FORMULATION AND CHARACTERIZATION OF THEOPHYLLINE HYDRO GELS USING FREEZE THAW AND CHEMICAL POLYMERIZATION METHODS

2016-09-12T01-57-19Z
Source: Indo American Journal of Pharmaceutical Research
Nagamani Bolla*, V. Ramalingeswa Rao, GSN Koteswara Rao T. Amruta Rai, P. Uma Devi.
The development of topical formulations has been a challenge to formulation scientists because solubility, permeability, half life of the drug etc governs the absorption of the drug. Hydrogels are three-dimensional, hydrophilic, polymeric networks capable of imbibing large amounts of water or biological fluids and are held together by chemical or physical bonds. Theophylline is used as a bronchodilator but in lower concentrations it can be used as an analgesic. Theophylline hydrogels were formulated using two different techniques, Chemical Polymerization (crosslinking agent - borax in different concentrations) and Freeze thaw technique. Sodium hyaluronate and polyvinyl alcohol as polymers with gelatin base and PEG 600 as a permeation enhancer. This was the first report on Theophylline anti inflammatory hydrogels formulated using sodium hyaluronate using different methods, Sodium hyaluronate, one of the polymers which is a safer polymer present in the connective tissue of human body and can be used without causing any toxic effect to the skin.

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Evidence for feasibility of fetal trophoblastic cell-based noninvasive prenatal testing

Abstract

Objective

The goal was to develop methods for detection of chromosomal and subchromosomal abnormalities in fetal cells in the mother's circulation at 10-16 weeks gestation using analysis by array comparative genomic hybridization (CGH) and/or next-generation sequencing (NGS).

Method

Nucleated cells from 30 ml of blood collected at 10-16 weeks gestation were separated from red cells by density fractionation and then immunostained to identify cytokeratin positive and CD45 negative trophoblasts. Individual cells were picked and subjected to whole genome amplification, genotyping, and analysis by array CGH and NGS.

Results

Fetal cells were recovered from most samples as documented by Y chromosome PCR, short tandem repeat analysis, array CGH, and NGS including over 30 normal male cells, one 47,XXY cell from an affected fetus, one trisomy 18 cell from an affected fetus, nine cells from a trisomy 21 case, three normal and one trisomy 13 cells from a case with confined placental mosaicism, and two chromosome 15 deletion cells from a case known by CVS to have a 2.7 Mb de novo deletion.

Conclusion

We believe that this is the first report of using array CGH and NGS whole genome sequencing to detect chromosomal abnormalities in fetal trophoblastic cells from maternal blood. This article is protected by copyright. All rights reserved.

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Markers associated with Alzheimer’s and Parkinson’s diseases are present in Mexico City children chronically exposed to concentrations of fine particulate matter PM2.5 above the current EPA USA standards

Mexico City (MC) children have lifetime exposures to concentrations of air pollutants above the current USA standards, including fine particulate matter (PM 2.5). Metropolitan Mexico City is an example of extreme urban growth and serious environmental pollution including high exposures to PM 2.5, ozone, polycyclic aromatic hydrocarbons (PAH), metals, endotoxins, tobacco smog, open waste dumps, highly polluting heavy duty trucks (not subjected to any pollution controls), etc., resulting in millions of children involuntarily exposed to harmful air neurotoxic substances every day since conception.

The results of this study including the significantly low concentrations of Aβ 1-42 and Brain-derived neurotrophic factor (BDNF) in MC children versus controls, suggests that major changes in key neural proteins playing major roles in neurotoxicity, cell survival, axonal and dendritic growth, and synaptic plasticity are evolving in urban MC children. Decreased levels of BDNF are associated with the development of obesity, depression, mood disorders, and neurodegeneration. Interestingly, Mexico City children increased their levels of total prion protein (TPrP) with cumulative PM2.5 up to 5 μg/m3 and then decreased, regardless of cumulative value or age. The low values of this key protein are likely detrimental given its protective effects against oxidative stress and its role in cell signaling, metal interactions, memory, myelin maintenance, axonal growth and neuronal development. Total synuclein showed an increment in childhood years related to cumulated PM2.5, followed by a decrease after age 12 years, while the abnormal synuclein associated with Parkinson's disease exhibited a tendency to increase with cumulated PM2.5.

Mexico City children, teens, and young adults have shown a key marker of Alzheimer disease (AD): hyperphosphorylated tau along significant brain and intrathecal neuroinflammation, dysregulated immune responses, breakdown of epithelial and endothelial barriers, damage to the neurovascular unit, and brain accumulation of metals associated with combustion. Moreover, seemingly healthy children in Mexico City have olfaction deficits, dysregulation of feeding regulatory hormones, deficiencies in attention and short-term memory, and below-average scores in Verbal and Full Scale IQ compared to low air pollution children.

"Researchers are very concerned young Mexico City urbanites exhibit evidence of spectral markers of neurodegeneration that are often seen in adults with mild cognitive impairment, in Alzheimer patients and in mouse models of Alzheimer's disease" said Dr. Lilian Calderón-Garcidueňas.

"Our concern about Parkinson's disease is also increased when we observed children and teens with early autonomic dysfunction and in brainstem materials, extensive accumulation of α- synuclein in key nuclei including auditory nuclei and the dorsal nucleus of the vagus" said authors.

"These results add to growing data from our laboratory and others, suggesting urban residents with chronic high exposures to ozone and fine particulate matter have a higher risk for developing Alzheimer's disease (Jung et al., J Alzheimers Dis, 44, 573-584, 2015) and the potential key role of environmental magnetite nanoparticles in the brains of Mexico City residents (Maher et al., Proc Natl Acad Sci U S A, early edition) commented Dr. Calderón-Garcidueňas.

Air pollution is a serious public health issue and exposures to concentrations of air pollutants at or above the current standards have been clearly linked to neuroinflammation and neurodegeneration.

There is an urgent need for studying air pollution interactions impacting children's brains and their responses, which could provide new avenues for Alzheimer's and Parkinson's disease prevention.

The authors concluded: "We have a 50-year window of opportunity between the time urban children experience the detrimental effects we are describing here and when they will present with mild cognitive impairment, dementia, tremor or all of the above. Our efforts should be aimed to identify and mitigate environmental factors influencing the early development of neurodegenerative diseases and to neuroprotect high risk children. Unfortunately, to date there has been no support for studying the detrimental neurodegenerative effects of air pollution on the pediatric brain."

# # #

Contact:
Lilian Calderón-Garcidueňas, MA, MD, PhD
Biomedical Sciences
University of Montana
+1 406 243 4785
lilian.calderon-garciduenas@umontana.edu

NOTES FOR EDITORS
"Cerebrospinal fluid biomarkers in highly exposed PM2.5 urbanites: The risk of Alzheimer's and Parkinson's diseases in young Mexico City residents" by Lilian Calderón-Garcidueňas, José Avila-Ramírez, Ana Calderón-Garcidueñas, Tonatiuh González-Heredia, Hilda Acuña-Ayala, Chih-kai Chao, Charles Thompson, Rubén Ruiz- Ramos, Victor Cortés-González, Luz Martínez-Martínez, Mario Alberto García-Pérez, Jacques Reis, Partha S. Mukherjee, Ricardo Torres-Jardón, Ingolf Lachmann, J Alzheimers Dis 54, 597-613, 2016.

ABOUT THE JOURNAL OF ALZHEIMER'S DISEASE (JAD)
The Journal of Alzheimer's Disease is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Published by IOS Press.

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Efficacy and Safety of Crocus Sativus L in Patients with Mild Cognitive Impairment: One Year Single-Blind Randomized, with Parallel Groups, Clinical Trial

Scientists from the Aristotle University of Thessaloniki (AUTH), the Greek Association of Alzheimer's Disease and Related Disorders (GAADRD) and the Centre for Research and Technology Hellas/Information Technologies Institute (CERTH/ITI) have succeeded in making the shift to MCI therapy via robust natural remedies that can be used in order to forestall cognitive deterioration. In an article published in the Journal of Alzheimer's Disease, the researchers have indicated that 0,125 gr/ per day lead to better cognitive performance after 12 months as revealed in neuropsychological assessment, ERP response, and 3 Tesla MRI. P300 latency was measured by a HD-EEG [EGI 300 Geodesic EEG system (GES 300) using a 256-channel HydroCel Geodesic Sensor Net (HCGSN)]. A small volume increase on the left inferior temporal gyrus, an area close to medial temporal lobe (MTL) and hippocampus, was found in experimental group. Thus, this study highlighted how Crocus can change brain activation, striatal volume of specific brain regions, neuropsychological performance and cognitive processing in aMCI patients whereas control group exhibited worse performance after 12 months. Consequently, patients with MCI can hopefully have better cognitive functioning by taking Crocus Sativus L. on a daily basis.

It is widely known that no conventional or alternative therapy is currently available and approved to treat MCI patients. Current therapeutic strategies for cognitive impairment in AD, is symptomatic with cholinesterase inhibitors (ChEIs) including donepezil, rivastigmine, galantamine, and the N-methyl-D-aspartate (NMDA) receptor antagonist memantine. The discovery of new natural compounds with neuroactive properties for the management of Neurodegenerative diseases (NDs) has gained much attention recently. Since no drug treatment is available to prevent the development of NDs, studies have shown that diet or plant-based extracts with antioxidant properties may have beneficial effects on improving brain function in NDs.

Nevertheless, preclinical and clinical pharmacological studies have demonstrated that Crocus sativus crude extracts and purified chemicals of it have anti-tumor effects, radical scavenging activity, anti-nociceptive and anti-inflammatory properties, inhibitory activity on Amyloid beta aggregation, reduce atherosclerosis and hepatic damage, counteract hyperlipidemia, protect from myocardial injury, display antihypertensive action, and finally it is safe and effective in mild to moderate AD as revealed from this study. More specifically, crocins and crocetin (molecules of Crocus sativus L.) have a wide range of activities including antioxidant effects, neuroprotective activities in memory impairment and antioxidant capacities. Also, crocin acts on NMDA receptors and on tracheal muscles β2-adrenoceptors, with a possible inhibitory effect on histamine (H1) receptors. More specifically, in vitro and in silico studies also suggest that crocetin can inhibit acetylcholinesterase, a main AD medicinal target.

Our study revealed in all measures we used better performance of treatment group compared with control group in the second assessment after 12 months of follow-up. Until today there is no other study which has proved that any kind of medication can be considered as an effective solution for patients with MCI. The same organizations are also focused on developing other novel pharmaceutical natural compounds that respond to a number of clinical needs in the effort against neurocognitive disorders.

*****

NOTES FOR EDITORS:
Efficacy and Safety of Crocus sativus L. in Patients with Mild Cognitive Impairment: One Year Single-Blind Randomized, with Parallel Groups, Clinical Trial. Tsolaki M, Karathanasi E, Lazarou I, Dovas K, Verykouki E, Karacostas A, Georgiadis K, Tsolaki A, Adam K, Kompatsiaris I, Sinakos Z. J Alzheimers Dis. 2016 Jul 27;54(1):129-33. doi: 10.3233/JAD-160304. PMID: 27472878

Contact-Principal Investigator:
Magda Tsolaki
Professor of 3rd Department of Neurology, Aristotle University of Thessaloniki, Greece
Chair of Greek Federation of Alzheimer's disease in Greece
Scientific Director of Daily Alzheimer's centers in Thessaloniki, Greece
E-mail: tsolakim1@gmail.com
Tel: +306942918933, +302310234239
Fax: +30 2313 307332

About the Aristotle University of Thessaloniki (AUTH)
The Aristotle University of Thessaloniki is the largest university in Greece. It comprises 7 faculties that consist of 33 schools, 5 faculties that consist of one school each, as well as 4 independent schools. About 81,500 students study at the Aristotle University (72,140 in undergraduate programs and 8,360 in postgraduate programs). There are 2,150 faculty members: 739 professors, 435 associate professors, 634 assistant professors, and 342 lecturers. There are also 11 teaching assistants, 58 research fellows, 248 members of the Special Laboratory Teaching Personnel (S.L.T.P.), as well as 15 foreign language teachers and 4 foreign instructors. Faculty members are also assisted by 213 members of the Special Technical Laboratory Personnel (S.T.L.P.).

The Aristotle University of Thessaloniki conducts research projects, participates in European research programs, cooperates with international institutions and organizations and attracts outstanding researchers from within Greece and abroad. The Aristotle University supports research projects in a wide variety of disciplines related to the environment (natural and built), computing, new technologies and nanotechnology, telecommunications, industrial technologies, transport, biotechnology, biomedicine and health, agriculture, forestry and fishery, education and language, history and archaeology, social studies and economics.

About the Greek Association of Alzheimer's disease and Related Disorders (GAADRD)
The Greek Association of Alzheimer's Disease and Related Disorders is a non-profit organization that was founded in 1995 by relatives of patients suffering from Alzheimer's disease, doctors of all specialties (mainly neurologists and psychiatrists) and other experts (such as psychologists, social workers, physiotherapists, etc.) who deal with the problems caused by this disease and other types of dementia. The Association operates 2 day centers in Thessaloniki and has over 4.000 members. It is a member of Alzheimer Europe and Alzheimer's disease International (ADI) and has successfully participated in various national and European research projects producing new scientific knowledge and innovative interventions for cognitive disorders.

The aim of the Association is to offer information and advice concerning the care of patients with cognitive disorders and provide services for patients and their families. It also strives to offer help and support to caregivers in order to reduce the social, economic and emotional burden deriving from the long term care of people suffering from dementia. Lastly, the Association attempts to publicize the social needs of the affected population and inform the public on issues related to dementia and cognitive disorders in general.

About the Information Technologies Institute (ITI)-Centre for Research and Technology Hellas (CERTH)
The Information Technologies Institute, formerly Informatics and Telematics Institute, was established in 1998 in Thessaloniki as a non-profit research organization under the auspices of the General Secretariat of Research and Technology (GSRT) of the Greek Ministry of Development. Since 2000, ITI has joined the Centre for Research and Technology Hellas (CERTH). The main objective of the Institute is to be a research institution of excellence, identifying promising fields for the future and creating an environment that will allow the transfer of basic, applied and technological research in the growth of the digital economy of the 21st century. CERTH/ITI has developed spheres of excellence and critical mass in research and technology in several strategically important fields in a number of areas: Image and Signal Processing, Computer Vision, Human Computer Interaction, Virtual and Augmented Reality, Artificial Intelligence, Security and Surveillance, Biomedicine – Bioinformatics, Robotics, ICT for Environment Monitoring, Geosciences and Remote Sensing, Social Network Analysis, Networks and Communications, Cultural and Educational Technology.

About Journal of Alzheimer's disease (JAD)
The Journal of Alzheimer's Disease is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease and clinical trial outcomes. The Journal of Alzheimer's Disease has an Impact Factor of 4.151 according to Thomson Reuters' 2014 Journal Citation Reports. The Journal is published by IOS Press.

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References
[1] Pitsikas N (2015) The effect of Crocus sativus L. and its constituents on memory: basic studies and clinical applications. Evid Based Complement Alternat Med 2015, 926284.
[2] Howe AS, Bani-Fatemi A, De Luca V (2014) The clinical utility of the auditory P300 latency subcomponent event-related potential in preclinical diagnosis of patients with mild cognitive impairment and Alzheimer's disease. Brain Cogn 86, 64–74.

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Midlife physical activity is associated with better cognition in old age

The association was studied first in all individuals of the cohort, and then by comparing later cognition in pairs where one twin was more physically active than the other.

Increasing the volume of physical activity was not, however, associated with increased memory-protecting benefits. Instead, quite a moderate amount of physical activity was found to be sufficient for memory-protecting benefits, and only the most inactive group of twins stood out with a significantly higher risk for cognitive impairment.

Overall, the study shows that moderately vigorous physical activity, meaning more strenuous than walking, is associated with better cognition after an average of 25 years.

This finding is in accordance with earlier animal model studies, which have shown that physical activity increases the amount of growth factors in the brain and improves synaptic plasticity.

The prevalence of dementia has increased with aging populations both in Finland and globally. Although the incidence of dementia seems to have decreased in less senior generations, the total prevalence of dementia is still expected to rise. No cure for dementia exists, but during the last decade research has produced an abundance of new information on dementia prevention. The traditional vascular risk factors (elevated blood pressure, hypercholesterolemia, obesity, diabetes and lack of exercise) have also been associated with dementia risk. However, few long-term, high-quality, follow-up studies on physical activity and cognition have been published, and it has remained unclear what type and amount of exercise is needed to safeguard cognition.

The study was conducted by scientists at the universities of Helsinki, Jyväskylä and Turku. The twins provided information on physical activity through questionnaire surveys from 1975 and 1981 (mean age in 1981: 49 years), while cognition was assessed by validated telephone interviews conducted between 1999 and 2015.

An early online version of this paper detailing the findings has been published. The full article is scheduled for publication in the 54(4) issue of the Journal of Alzheimer's Disease (Journal of Alzheimer's Disease 2016; 54(4), DOI 10.3233/JAD-160377).

Iso-Markku P, Waller K, Vuoksimaa E, Heikkilä K, Rinne J, Kaprio J, Kujala UM (2016) Midlife Physical Activity and Cognition Later in Life: A Prospective Twin Study. J Alzheimers Dis, DOI 10.3233/JAD-160377

Further information:
Researcher, M.D. Paula Iso-Markku, paula.iso-markku@helsinki.fi, tel. +358 50 428 4611
Professor Urho Kujala, urho.m.kujala@jyu.fi, tel. +358 40 805 3567

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Dapsone treatment for eosinophilic anular erythema

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ROLE OF MIRNA-122 AND MIRNA-200B IN INTRATUMOR HETEROGENEITY FORMATION AND HUMAN BREAST CANCER PROGNOSIS

2016-09-12T01-16-32Z
Source: International Journal of Current Research and Review
Lukianova N., Borikun T., Yalovenko T., Chekhun V..
Aim: To determine the features of miR-122 and -200b expression signature in BC patients due to major clinical-pathological characteristics of the disease. Methodology: The expression levels of miR-122 and -200b and ER, PR, Her2/neu, Ki-67, E-cadh, N-cadh, FTH1, Hepc were analyzed in cancer tissue and sera of BC patients. Relative expression levels of the miR-122 and -200b were examined using qRT-PCR (Quantitative Reverse Transcription PCR), protein expression was measured by immunohistochemical analysis. Results: Correlation between miR-122 and -200b expression clinical-pathological characteristics of BC was established. Prognostic value of miR-122 and -200b was estimated. Discussion and Conclusion: Changes of miR-122 and -200b expression in tumor tissue and sera of BC patients provide information about major clinical-pathological characteristics of BC.

http://ift.tt/2c996Ig

STUDY OF LABORATORY PARAMETERS IN HEMOPHILIA PATIENTS

2016-09-12T01-16-32Z
Source: International Journal of Current Research and Review
T. B. Sadaria, H. M. Goswami, Safal Patel.
Introduction: Haemophilia is X- linked congenital bleeding disorder with a frequency of about one in 10,000 births. Haemophilia is caused by deficiency of coagulation factor VIII (haemophilia A) or factor IX (haemophilia B) related to mutations of clotting factor gene. Objectives: To check effectiveness of various screening and confirmatory tests for diagnosis of haemophilia. Methods: Retrospective study of laboratory diagnosis of haemophilia was conducted in our haematology section of pathology department of Tertiary Care Teaching Centre from 1 August 2014 to 30 July 2016. Patients in the age group of 0 year to 55 years with factor VIII and factor IX level below 50% of normal were included in the study. Routine haematological tests like haemoglobin and platelet count and coagulation profile of patient for prothrombin time, activated partial prothrombin time, factor VIII and factor IX level were analysed. Results: Out of 122 cases, 97 cases were of haemophilia A while 25 cases were of haemophilia B. Haemoglobin count of patients ranged from6gm% to 14.2 gm%. Platelet count and PT (prothrombin time)of patients were within normal limits. APTT (Activated Partial Thromboplastin Time) was prolonged (41.6 sec. to 124 sec) in all patients. Factor VIII level was reduced (

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AN ANTHROPOMETRIC STUDY OF STATURE ESTIMATION AMONG MALES FROM THE MEASUREMENTS OF FEET IN UDAIPUR DISTRICT OF RAJASTHAN

2016-09-12T01-16-32Z
Source: International Journal of Current Research and Review
Charu Taneja, Hitesh Babel, L.K. Jain.
Background: Estimation of stature has a very significant role to play in forensic anthropometry for personal identification. Objective: To discover out the correlation among proportions of feet with stature in tribals of Udaipur district in Rajasthan (India). Material and Methods: The present study was conducted on a total number of 481 male tribals of Udaipur district by using standard anthropometric techniques. Results: There was a high correlation between height and right (0.184) foot length & left (0.186) Foot Length in males. Conclusion: Linear regression equations were deduced in males out of which lowest standard error of estimate was experienced in combined foot length of males.

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Tumescent Liposuction without Lidocaine

Background: Our previous study demonstrated that lidocaine has a negative impact on adipose-derived stem cell (ASC) survival. Currently for large-volume liposuction, patients often undergo general anesthesia; therefore, lidocaine subcutaneous anesthesia is nonessential. We hypothesized that removing lidocaine from tumescent might improve stromal vascular fraction (SVF) and ASC survival from the standard tumescent with lidocaine. Ropivacaine is also a commonly used local anesthetic. The effect of ropivacaine on ASC survival was examined. Methods: Adults who underwent liposuction on bilateral body areas were included (n = 10). Under general anesthesia, liposuction on 1 area was conducted under standard tumescent with lidocaine. On the contralateral side, liposuction was conducted under the modified tumescent without lidocaine. Five milliliters of lipoaspirate were processed for the isolation of SVF. The adherent ASCs were counted after 24 hours of SVF culture. Apoptosis and necrosis of SVF cells were examined by Annexin/propidium iodide staining and analyzed by flow cytometry. Results: Average percentage of live SVF cells was 68.0% ± 4.0% (28.5% ± 3.8% of apoptosis and 3.4% ± 1.0% of necrosis) in lidocaine group compared with 86.7% ± 3.7% (11.5% ± 3.1% of apoptosis and 1.8% ± 0.7% of necrosis) in no-lidocaine group (P = 0.002). Average number of viable ASC was also significantly lower (367,000 ± 107) in lidocaine group compared with that (500,000 ± 152) in no-lidocaine group (P = 0.04). No significant difference was found between lidocaine and ropivacaine on ASC cytotoxicity. Conclusions: Removing lidocaine from tumescent significantly reduced SVF and ASC apoptosis in the lipoaspirate. We recommend tumescent liposuction without lidocaine, particularly if patient's lipoaspirate will be used for fat grafting.

http://ift.tt/2c0NKxX

Radiofrequency-assisted Liposuction for Neck and Lower Face Adipodermal Remodeling and Contouring

Background: The purpose of this study is to report our experience using radiofrequency-assisted liposuction (RFAL) for neck and face contouring. This article details the operative technique, selection, complications, third-party surgeon appraisal, and patient satisfaction survey. Methods: From November 2009 to November 2013, 55 patients who underwent RFAL treatment were enrolled in the study. Postoperative patient satisfaction surveys were conducted, and 2 independent plastic surgeons evaluated contour and skin quality with randomized preoperative and postoperative photographs at 6 months postoperatively. The different parameters recorded involved age, sex, weight, body mass index, operative time, amount of fat aspirated and energy delivered, complications, and aesthetic outcome in 1 and 4 weeks and 3 and 6 months. Our longest follow-up was 4 years. Patients were asked 6 months postoperatively to grade their satisfaction as poor, no change, moderate, good, and excellent. Results: The mean age was 51 years (range, 35–61 years), and the mean amount of fat aspirated was 30 mL (range, 10–200 mL). Five out of 55 patients (9.1%) developed tissue hardness that resolved with massage. All patients were followed up for a minimum of 6 months. Eighty-five percent of patients were satisfied with their contouring result and degree of skin tightening (48/55 patients). Two independent plastic surgeons considered the improvement in contouring and degree of skin tightening good to excellent in 52 of 55 cases. Conclusions: In appropriately selected patients, RFAL neck and face contouring represent a safe procedure to achieve significant improvement of the skin laxity and fat deposits of the cervicomental zone and jowls.

http://ift.tt/2c0OQKb

Direct Hospital Cost of Outcome Pathways in Implant-Based Reconstruction with Acellular Dermal Matrices

Background: Current cost data on tissue expansion followed by exchange for permanent implant (TE/I) reconstruction lack a necessary assessment of the experience of a heterogenous breast cancer patient population and their multiple outcome pathways. We extend our previous analysis to that of direct hospital cost as bundling of payments is likely to follow the changing centralization of cancer care at the hospital level. Methods: We performed a retrospective analysis (2003–2009) of TE/I reconstructions with or without an acellular dermal matrix (ADM), namely Alloderm RTM. Postreconstructive events were analyzed and organized into outcome pathways as previously described. Aggregated and normalized inpatient and outpatient hospital direct costs and physician reimbursement were generated for each outcome pathway with or without ADM. Results: Three hundred sixty-seven patients were analyzed. The average 2-year hospital direct cost per TE/I breast reconstruction patient was $11,862 in the +ADM and $12,319 in the −ADM groups (P > 0.05). Initial reconstructions were costlier in the +ADM ($6,868) than in the −ADM ($5,615) group, but the average cost of subsequent postreconstructive events within 2 years was significantly lower in +ADM ($5,176) than −ADM ($6,704) patients (P

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The Safety, Effectiveness, and Efficiency of Autologous Fat Grafting in Breast Surgery

Background: For years, the safety and effectiveness of autologous fat grafting (AFG) for breast reconstruction have been in question, with particular concern over fat necrosis, calcifications, cyst formation, and interfering with the detection of breast cancer. However, increasing evidence suggests that the complication rates and clinical results are generally acceptable to both clinicians and patients. The emerging challenge is the numerous AFG techniques and systems, where there are limited knowledge and data. The objective of this study was to conduct a literature review that focuses on the safety, effectiveness, and efficiency of various AFG techniques as applied to the breast. Methods: A PubMed search using terms related to AFG was performed over a 5-year period (April 1, 2010–April 30, 2015). Original articles focused on AFG to the breast, with outcomes on safety, effectiveness, and efficiency, were included. Results: Five hundred ninety-eight articles were identified with 36 articles included (n = 4306 patients). Satisfaction rates were high although the prevalence of complications was low—similar to previous findings. Seven studies reported average operating room time with an overall mean of 125 minutes (range: 40–210). The mean volume of fat harvested was 558 mL (range: 120–1299), and fat injected was 145 mL (range: 20–607). A positive association between injection volume and operating time was observed. Conclusions: This review validates previous findings on the safety and effectiveness of AFG to the breast and highlights its efficiency. The efficiency data available, although limited, suggest that there is an opportunity to achieve time and cost savings while not sacrificing safety and effectiveness.

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Anatomy of the Gynecomastia Tissue and Its Clinical Significance

Background: Gynecomastia is a very common entity in men, and several authors estimate that approximately 50% to 70% of the male population has palpable breast tissue. Much has been published with regard to the etiology, diagnosis, and treatment of gynecomastia. However, the anatomy of the gynecomastia tissue remains elusive to most surgeons. Purpose: The purpose of this article was to define the shape and consistency of the glandular tissue based on the vast experience of the senior author (MB). Patients and Methods: Between the years 1980 and 2014, a total of 5124 patients have been treated for gynecomastia with surgical excision, liposuction, or a combination of both. A total of 3130 specimens were collected with 5% of the cases being unilateral. Results: The specimens appear to have a unifying shape of a head, body, and tail. The head is semicircular in shape and is located more medially toward the sternum. The majority of the glandular tissue consists of a body located immediately deep to the nipple areolar complex. The tail appears to taper off of the body more laterally and toward the insertion of the pectoralis major muscle onto the humerus. Conclusions: This large series of gynecomastia specimens demonstrates a unique and unifying finding of a head, body, and tail. Understanding the anatomy of the gynecomastia gland can serve as a guide to gynecomastia surgeons to facilitate a more thorough exploration and subsequently sufficient gland excision.

http://ift.tt/2c0PnvM

Κυριακή 11 Σεπτεμβρίου 2016

A randomized clinical trial on the comparison between hair shaving and snipping prior to laser hair removal sessions in women suffering from hirsutism

Summary

Background and objectives

Hirsutism or excess hair growth is a common dermatological problem in females, affecting up to 10% of females worldwide. We aimed this study to compare the two hair-shortening methods shaving vs. snipping among hirsute women regarding the outcome of the therapy and also the paradoxical hypertrichosis phenomenon (terminal hair regrowth) 6 months after the final therapy session.

Materials and Methods

In this study, 129 premenopausal women affected by hirsutism were randomly divided into two study groups according to hair-shortening method: shaving as group A (66 patients) and hair shortening by scissor as group B (63 patients). Each patient received six alexandrite laser therapy sessions every month for six consecutive months. Chin hairs in a 5 × 5 cm² zone were counted, and the paradoxical hair regrowth was evaluated four times during the study: once at baseline, once before the third session, once before the sixth session, and once 6 months after the last laser session.

Results

Before the third session, the counts were 15.06 ± 5.20 in group A and 13.07 ± 4.44 in group B (P = 0.022); both counts were meaningfully less than the baseline count (P < 0.001). The counts before the sixth session were 2.80 ± 1.16 in group A and 2.71 ± 1.12 in group B (P = 0.673); the counts were significantly lower than the previous session (P < 0.001). Six months after the last laser session, the counts were 11.27 ± 9.30 in group A and 8.15 ± 3.12 in group B (P = 0.012). Paradoxical hypertrichosis was observed in three patients of group A vs. no patients in group B.

Conclusion

We found that alexandrite laser therapy is really effective for treating hirsutism. Both shaving and using a scissor for hair shortening showed similar short-term results, but in one-year follow-up, paradoxical hypertrichosis was only observed in shaving group and also a lower hair count was observed in the snipping group.

http://ift.tt/2c8RcVK

Comparison of skin properties in individuals living in cities at two different altitudes: an investigation of the environmental effect on skin

Summary

Background

Skin properties vary depending on exogenous factors. Various studies have been used for comparing skin properties between cities for studying environment influence on skin properties. However, for comparison of skin properties between cities, various environmental factors have to be considered.

Objectives

The purpose of this study therefore was to compare skin properties in individuals of the same ethnicity and sex (Indonesian women) between different altitudes and to interpret the environmental effect on skin.

Methods

In this study, we reanalyzed the data obtained from previous study. The data were for healthy Sundanese Indonesian females [(n = 136) at Jakarta (n = 49) and Bandung (n = 87)], and the data consisted of published data (skin hydration, sebum level, pH, elasticity, and transepidermal water loss) and unpublished data [skin color (L*, a*, and b*)]. The skin parameters were measured on Indonesian females aged 20–34 using C+K devices (corneometer, sebumeter, pH meter, and cutometer), Delfin vapometer, and Minolta spectrophotometer, respectively.

Results

Sundanese Jakarta (low-altitude) females had higher sebum level and greater redness (a*) value in the forehead than Sundanese Bandung (high-altitude) females. In contrast, Bandung females had higher skin pH, brighter skin color, and greater forehead skin elasticity than Jakarta females.

Conclusions

The skin properties can be influenced by changing altitude because different altitudes have different environments such as air temperature, humidity, UV radiation, and so on, and it is also necessary to investigate the factors which can influence with perceived skin condition such as skin type and skin concerning.

http://ift.tt/2co4CdT

Grasp-specific motor resonance is influenced by the visibility of the observed actor

Publication date: Available online 11 September 2016
Source:Cortex
Author(s): Karen L. Bunday, Roger N. Lemon, James M. Kilner, Marco Davare, Guy A. Orban
Motor resonance is the modulation of M1 corticospinal excitability induced by observation of others' actions. Recent brain imaging studies have revealed that viewing videos of grasping actions led to a differential activation of the ventral premotor cortex depending on whether the entire person is viewed vs. only their disembodied hand. Here we used transcranial magnetic stimulation (TMS) to examine motor evoked potentials (MEPs) in the first dorsal interosseous (FDI) and abductor digiti minimi (ADM) during observation of videos or static images in which a whole person or merely the hand was seen reaching and grasping a peanut (precision grip) or an apple (whole hand grasp). Participants were presented with six visual conditions in which visual stimuli (video vs. static image), view (whole person vs. hand) and grasp (precision grip vs. whole hand grasp) were varied in a 2x2x2 factorial design. Observing videos, but not static images, of a hand grasping different objects resulted in a grasp-specific interaction, such that FDI and ADM MEPs were differentially modulated depending on the type of grasp being observed (precision grip vs. whole hand grasp). This interaction was present when observing the hand acting, but not when observing the whole person acting. Additional experiments revealed that these results were unlikely to be due to the relative size of the hand being observed. Our results suggest that observation of videos rather than static images is critical for motor resonance. Importantly, observing the whole person performing the action abolished the grasp-specific effect, which could be due to a variety of PMv inputs converging on M1.

http://ift.tt/2cQ7yUO

An image-invariant neural response to familiar faces in the human medial temporal lobe

Publication date: Available online 10 September 2016
Source:Cortex
Author(s): Katja Weibert, Richard J. Harris, Alexandra Mitchell, Hollie Byrne, Andrew W. Young, Timothy J. Andrews
The ability to recognize familiar faces with ease across different viewing conditions contrasts with the inherent difficulty in the perception of unfamiliar faces across similar image manipulations. Models of face processing suggest that this difference is based on the neural representation for familiar faces being more invariant to changes in the image, than it is for unfamiliar faces. Here, we used an fMR-adaptation paradigm to investigate neural correlates of image-invariant face recognition in face-selective regions of the human brain. Participants viewed faces presented in a blocked design. Each block contained different images of the same identity or different images from different identities. Faces in each block were either familiar or unfamiliar to the participants. First, we defined face-selective regions by comparing the response to faces with the response to scenes and scrambled faces. Next, we asked whether any of these face-selective regions showed image-invariant adaptation to the identity of a face. The core face-selective regions showed image-invariant adaptation to familiar and unfamiliar faces. However, there was no difference in the adaptation to familiar compared to unfamiliar faces. In contrast, image-invariant adaptation for familiar faces, but not for unfamiliar faces, was found in face-selective regions of the medial temporal lobe (MTL). Taken together, our results suggest that the marked differences in the perception of familiar and unfamiliar faces may depend critically on neural processes in the medial temporal lobe.

http://ift.tt/2cAKmrF

Augmenting Distractor Filtering via Transcranial Magnetic Stimulation of the Lateral Occipital Cortex

Publication date: Available online 10 September 2016
Source:Cortex
Author(s): Jana Eštočinová, Emanuele Lo Gerfo, Chiara Della Libera, Leonardo Chelazzi, Elisa Santandrea
Visual selective attention optimizes perception and behavioral control by enabling efficient selection of relevant information and filtering of distractors. While focusing resources on task-relevant information helps counteract distraction, dedicated filtering mechanisms have recently been demonstrated, allowing neural systems to implement suitable policies for the suppression of potential interference. Limited evidence is presently available concerning the neural underpinnings of these mechanisms, and whether neural circuitry within the visual cortex might play a causal role in their instantiation, a possibility that we directly tested here. In two related experiments, transcranial magnetic stimulation (TMS) was applied over the lateral occipital cortex of healthy humans at different times during the execution of a behavioral task which entailed varying levels of distractor interference and need for attentional engagement. While earlier TMS boosted target selection, stimulation within a restricted time epoch close to (and in the course of) stimulus presentation engendered selective enhancement of distractor suppression, by affecting the ongoing, reactive instantiation of attentional filtering mechanisms required by specific task conditions. The results attest to a causal role of mid-tier ventral visual areas in distractor filtering and offer insights into the mechanisms through which TMS may have affected ongoing neural activity in the stimulated tissue.

http://ift.tt/2cQ7PaD

Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons

Summary: Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients.

http://ift.tt/2ciPAbG

Nipple Reconstruction with the Biodesign Nipple Reconstruction Cylinder: A Prospective Clinical Study

Background: Nipple reconstruction is the last stage in cosmetic reconstruction of the breast after mastectomy, but no method produces reliable and consistent aesthetic results. This study examined the use of the Biodesign Nipple Reconstruction Cylinder (NRC) during reconstruction of the nipple after mastectomy. Methods: Patients with a history of breast cancer and mastectomy desiring nipple reconstruction were invited to participate. After obtaining consent, unilateral or bilateral nipple reconstruction was performed. Skin flaps were raised, the NRC was placed beneath the flaps as a stent, and the site was protected for up to 4 weeks with a nipple shield. Nipple projection was measured for 12 months after surgery. Patient satisfaction was measured and adverse events were recorded. Follow-up examinations were performed at 1 week, and then at 1, 3, 6, and 12 months after surgery. Results: Eighty-two nipple reconstructions were performed in 50 patients. Related postoperative adverse events were minor, but reported in 8 reconstructions (9.8%) representing 7 patients (14.0%). Average projection at 6 and 12 months was 4.1 ± 1.6 mm and 3.8 ± 1.5 mm, respectively, compared with 10.5 ± 2.2 mm 1 week after surgery. Of patients completing the satisfaction questionnaire at 12 months, 70/75 (93.3%) of reconstructions were rated "pleased" or "very pleased" with the overall outcome. Overall, 45/46 (97.8%) patients would recommend nipple reconstruction to other women. Conclusions: The Biodesign NRC offers a safe alternative to nipple reconstruction, resulting in stable projection and a high level of patient satisfaction for 12 months after placement.

http://ift.tt/2ciOo8i

Understanding the Role for Operative Performance Rating Tools in Meeting Surgical Trainee Feedback Needs: A Qualitative Study

No abstract available

http://ift.tt/2cavHaa