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Παρασκευή 12 Ιανουαρίου 2018
Scholar : Archives of Agronomy and Soil Science, Volume 64, Issue 3, March 2018 is now available online on Taylor & Francis Online
Scholar : These new articles for CoDesign are available online
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Scholar : Australian Journal of Linguistics, Volume 38, Issue 1, January 2018 is now available online on Taylor & Francis Online
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A Review of Effects of Governmental Web-Based Information Services [Internet].
This report focuses on the following questions:
http://ift.tt/2Do8omp
Collaborative Care Initiatives for Patients with Serious Mental Disorders Treated in Primary Care Setting [Internet].
The Norwegian Knowledge Centre for the Health Services (NOKC) was asked to perform a systematic review of effects of enhanced collaboration initiatives to improve the management of serious mental illness in primary care settings. The request came in autumn 2006 from the Norwegian Directorate for Health and Social Affairs in autumn 2006. The review was conducted by NOKC staff as well as a group of experts from the field.
http://ift.tt/2CSNlXP
Effect of Physical Activity and Other Care Interventions for People with Dementia [Internet].
About 70,000 people in Norway are afflicted by dementia. Dementia is a progressive disease and the incidence increases with the age. More than the half of people with dementia are living at home and about 80 percent of all residents in nursing homes have a dementia disorder.
http://ift.tt/2DmtWQa
TNF-Inhibitors for Rheumatic Diseases (Part 3): Health Economics [Internet].
Background: Treatment with tumour necrosis factor alpha (TNF-α, or simply TNF) inhibitors is considered to be an alternative to the use of traditional disease-modifying anti-rheumatic drugs (DMARDs) in patients with different rheumatic diseases, i.e. rheumatoid arthritis (RA). There are three TNF-inhibitor drugs currently available on the market (brand names in brackets): adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade). The Norwegian Knowledge Centre for the Health Services has previously summarised the evidence on the drugs' efficacy and safety (in randomised clinical trials and observational studies) while the present report considers cost-effectiveness of the drugs for rheumatoid arthritis. After considerable growth over several years, the aggregate sales of the three drugs amounted to 860 million NOK in 2006.
http://ift.tt/2CTXSC8
Summary of Published Health Economic Studies of Cetuximab as Third Line Treatment for Patients with Metastatic Colorectal Cancer [Internet].
We have summarised published Norwegian and international studies of the cost-effectiveness of cetuximab in combination with irinotecan as third line treatment for patients with metastatic colorectal cancer. The present alternative to such treatment is supportive care. The estimated number of patients with metastatic colorectal cancer eligible for treatment with cetuximab + irinotecan as third line therapy is 70.
http://ift.tt/2DnBkLg
Effects of Support and Follow-Up Interventions for People with Severe Mental Illness [Internet].
Many people diagnosed with and treated for severe mental illness are likely to experience relapse at some point during their lives. In addition to beginning and continuing therapeutic and medical treatment, other types of support and follow-up measures may be important for the patients' health and welfare. Examples of relevant support and follow-up interventions include: patient education and life skills training, structural measures such as supported housing and follow-up monitoring, recreation and leisure activities, and vocational rehabilitation.
http://ift.tt/2CUNhae
Misoprostol for Induction of Labour [Internet].
Background Approximately 55 000 children are born in Norway each year. It is sometimes necessary to induce labour artificially. With respect to induction with drugs, misoprostol and dinoprostone are used irrespective of whether the cervix is mature or not, while oxytocin only is used when the cervix is mature. The Norwegian Board of Health Supervision asked The Norwegian Knowledge Centre for the health Services to systematically review the efficacy and safety of misoprostol for induction of labour.
http://ift.tt/2Dofwz4
Quality Collaboratives as a Tool in Quality Improvement – A Summary of Research and Experiences [Internet].
Participation in quality collaboratives is one of the tools that are used to improve quality in the health care services. The purpose of such collaboratives is to increase competence in different areas, and to improve the quality of the services. The core is joint education and training across professions, departments and organizations. This is in line with the goals of the National Health and Care Services Plan (2011 – 2015).
http://ift.tt/2CTGhdK
The Scientific Knowledge Base for Treatment of Patients with Cleft Lip, Alveolus and Palate [Internet].
In this review we present the evidence base for the effectiveness of interventions in treatment and follow-up of patients with cleft lip, alveolus and/or palate. We searched for systematic reviews and prospective primary studies with a simultaneous control group.
http://ift.tt/2Dp1KvU
Improving the Use of Research Evidence in Guideline Development [Internet].
Major new developments have occurred since the World Health Organisation (WHO) was established that have led governments around the world to reconsider the methods that they use to ensure that decisions about health care are well informed by research evidence. This reflection and subsequent changes in how recommendations about health are developed have been driven by recognition of gaps between available research evidence and what is done in practice, variations in practice and outcomes, concerns about the quality of health care, and rising health care costs.
http://ift.tt/2CVdJAs
The Effects of Sexual Therapy Interventions for Sexual Problems [Internet].
All health care professionals have a role in promoting sexual health, knowledge and allowing for questions. Sexual problems are fairly common. People are, however, reluctant to seek help. In this report we aim to answer questions on the effect of sexual therapeutic interventions on people with different sexual problems. Sexual therapeutic interventions overall are effective for people with sexual problems. This was shown for a broad spectrum of both populations and sexual problems.
http://ift.tt/2Dn1qhi
Developing and Applying Indicators for Monitoring Hospital Performance [Internet].
Performance monitoring is one of several quality enhancing activities designed to improve quality and accountability in health care. During the past years, there has been an increasing interest in such measurement and reporting systems worldwide. Particular emphasis seems to have been put in the design and implementation of systems monitoring hospital performance in a valid and reliable way.
http://ift.tt/2CU5R1X
Supplemented Primary Care Units Compared to Hospitalisation [Internet].
The aim of this systematic review was to summarise the results of studies that compared the effects on patient outcomes for patients admitted to a supplemented primary care unit instead of a general hospital or who examined whether patients with access to a supplemented primary care unit had fewer hospital admissions than patients without such access. Patients should satisfy certain criteria, i.e. they should be in need of emergency treatment, but not need intensive treatment in hospital. A secondary aim was to summarise results of studies that compared larger supplemented primary care units with smaller ones.
http://ift.tt/2Dn1gGI
TNF-α Inhibitors and Efalizumab for the Treatment of Skin Diseases [Internet].
Background Skin diseases like psoriasis, pyoderma gangrenosum and Behcets disease are often chronic with the need for continuous treatment and follow-up. Traditional treatment like phototherapy or systemic therapy with ciclosporin, metotrexate and retinoids are not always effective or cause long-term side effects. New biological agents, which target pathologic T cell activity, have been developed. This report deals with the biological agents tumour necrosis factor alpha (TNF-alpha) inhibitors (infliximab (Remicade®), adalimumab (Humira®), etanercept (Enbrel®) and efalizumab (Raptiva®) which is a T cell modulator.
http://ift.tt/2CSMWoh
Effects of Psychotherapy for Adults with Depression [Internet].
In October 2008, the Norwegian Directorate of Health commissioned the Norwegian Knowledge Centre for the Health Services (NOKC) to complete a review about the effects of psychotherapy for adults with depression. The review would help answer the question of how adults with depression should be best managed. We addressed one main question: What are the effects of psychotherapy on depression symptomatology and quality of life indicators for adults with depression?
http://ift.tt/2Dp2LEy
NIPH Methods Resources [Internet].
A review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant methodology research, and to collect and analyse data from the methodology studies that are included in the review. Statistical methods (meta-analysis) may or may not be used to analyse and summarise the results of the included studies.
http://ift.tt/2CTz25o
Psychosocial Interventions After Large Accidents and Disasters [Internet].
In September 2004, the Directorate for Health and Social Affairs commissioned the Norwegian Knowledge Centre for the Health Services to do a systematic review of the effects of psychosocial interventions after crises, accidents and disasters.
http://ift.tt/2DncYkA
The Effect of Infection Control Interventions in Day-Care Facilities and Schools [Internet].
Can improved infection control in kindergartens and schools help to improve children's and adolescent's health and reduce illness and antibiotic use?
http://ift.tt/2CTyXi6
Effectiveness of Physical Training Among Children and Adolescents with Habilitation Needs [Internet].
The basis for a physically active life and good health is established during childhood and adolescence. Disability in children may reduce participation in daily activities and important social arenas. Obviously, physical training has positive effects on health and function. The aim of this report is to summarize the effectiveness of physical training on activity and participation among children and young people with habilitation needs. "Activity" is a child's performance of tasks and actions while "participation" is its involvement in different life situations.
http://ift.tt/2Dp2nWC
Social Inequalities in Health, Life Style and Use of Health Services Among Children in Akershus County [Internet].
This report investigates whether social inequalities in health, life style and use of health services, as we know them from the adult population, exist also among children aged 8 – 13 in Akershus County. We have assessed the impact of the following factors:
http://ift.tt/2CVdFRe
As Extracellular Glutamine Levels Decline, Asparagine Becomes an Essential Amino Acid
Publication date: Available online 11 January 2018
Source:Cell Metabolism
Author(s): Natalya N. Pavlova, Sheng Hui, Jonathan M. Ghergurovich, Jing Fan, Andrew M. Intlekofer, Richard M. White, Joshua D. Rabinowitz, Craig B. Thompson, Ji Zhang
When mammalian cells are deprived of glutamine, exogenous asparagine rescues cell survival and growth. Here we report that this rescue results from use of asparagine in protein synthesis. All mammalian cell lines tested lacked cytosolic asparaginase activity and could not utilize asparagine to produce other amino acids or biosynthetic intermediates. Instead, most glutamine-deprived cell lines are capable of sufficient glutamine synthesis to maintain essential amino acid uptake and production of glutamine-dependent biosynthetic precursors, with the exception of asparagine. While experimental introduction of cytosolic asparaginase could enhance the synthesis of glutamine and increase tricarboxylic acid cycle anaplerosis and the synthesis of nucleotide precursors, cytosolic asparaginase suppressed the growth and survival of cells in glutamine-depleted medium in vitro and severely compromised the in vivo growth of tumor xenografts. These results suggest that the lack of asparaginase activity represents an evolutionary adaptation to allow mammalian cells to survive pathophysiologic variations in extracellular glutamine.
Graphical abstract
Teaser
Exogenous asparagine can rescue growth and survival of glutamine-deprived cells. Pavlova et al. show that asparagine is not catabolized to produce other amino acids or biosynthetic intermediates, but rather maintains protein synthesis. Introduction of asparaginase suppressed the growth and survival of glutamine-depleted cells and compromised the growth of tumor xenografts.http://ift.tt/2Dkoa1n
Basal Mitophagy Occurs Independently of PINK1 in Mouse Tissues of High Metabolic Demand
Publication date: Available online 11 January 2018
Source:Cell Metabolism
Author(s): Thomas G. McWilliams, Alan R. Prescott, Lambert Montava-Garriga, Graeme Ball, François Singh, Erica Barini, Miratul M.K. Muqit, Simon P. Brooks, Ian G. Ganley
Dysregulated mitophagy has been linked to Parkinson's disease (PD) due to the role of PTEN-induced kinase 1 (PINK1) in mediating depolarization-induced mitophagy in vitro. Elegant mouse reporters have revealed the pervasive nature of basal mitophagy in vivo, yet the role of PINK1 and tissue metabolic context remains unknown. Using mito-QC, we investigated the contribution of PINK1 to mitophagy in metabolically active tissues. We observed a high degree of mitophagy in neural cells, including PD-relevant mesencephalic dopaminergic neurons and microglia. In all tissues apart from pancreatic islets, loss of Pink1 did not influence basal mitophagy, despite disrupting depolarization-induced Parkin activation. Our findings provide the first in vivo evidence that PINK1 is detectable at basal levels and that basal mammalian mitophagy occurs independently of PINK1. This suggests multiple, yet-to-be-discovered pathways orchestrating mammalian mitochondrial integrity in a context-dependent fashion, and this has profound implications for our molecular understanding of vertebrate mitophagy.
Graphical abstract
Teaser
The Parkinson's disease protein PINK1 is regarded as a master regulator of mitophagy. McWilliams et al. discover that endogenous PINK1 is dispensable for basal mitophagy in vivo. Furthermore, they define a rigorous framework to detect endogenous PINK1 protein in mouse tissues. This reveals the complex, context-dependent nature of mammalian mitophagy.http://ift.tt/2DnsJIu
Let-7 Suppresses B Cell Activation through Restricting the Availability of Necessary Nutrients
Publication date: Available online 11 January 2018
Source:Cell Metabolism
Author(s): Shuai Jiang, Wei Yan, Shizhen Emily Wang, David Baltimore
The control of uptake and utilization of necessary extracellular nutrients—glucose and glutamine—is an important aspect of B cell activation. Let-7 is a family of microRNAs known to be involved in metabolic control. Here, we employed several engineered mouse models, including B cell-specific overexpression of Lin28a or the let-7a-1/let-7d/let-7f-1 cluster (let-7adf) and knockout of individual let-7 clusters to show that let-7adf specifically inhibits T cell-independent (TI) antigen-induced immunoglobulin (Ig)M antibody production. Both overexpression and deletion of let-7 in this cluster leads to altered TI-IgM production. Mechanistically, let-7adf suppresses the acquisition and utilization of key nutrients, including glucose and glutamine, through directly targeting hexokinase 2 (Hk2) and by repressing a glutamine transporter Slc1a5 and a key degradation enzyme, glutaminase (Gls), a mechanism mediated by regulation of c-Myc. Our results suggest a novel role of let-7adf as a "metabolic brake" on B cell antibody production.
Graphical abstract
Teaser
Activated B cells require nutrients to build biomass and function physiologically. Jiang et al. show that the microRNA let-7adf cluster acts as a "metabolic brake" in activated B cells by suppressing T cell-independent antigen-induced IgM antibody production. Mechanistically, let-7adf regulates uptake and utilization of key nutrients including glucose and glutamine.http://ift.tt/2DoSZSy
Reprogramming neurodegeneration in the big data era
Source:Current Opinion in Neurobiology, Volume 48
Author(s): Lujia Zhou, Patrik Verstreken
Recent genome-wide association studies (GWAS) have identified numerous genetic risk variants for late-onset Alzheimer's disease (AD) and Parkinson's disease (PD). However, deciphering the functional consequences of GWAS data is challenging due to a lack of reliable model systems to study the genetic variants that are often of low penetrance and non-coding identities. Pluripotent stem cell (PSC) technologies offer unprecedented opportunities for molecular phenotyping of GWAS variants in human neurons and microglia. Moreover, rapid technological advances in whole-genome RNA-sequencing and epigenome mapping fuel comprehensive and unbiased investigations of molecular alterations in PSC-derived disease models. Here, we review and discuss how integrated studies that utilize PSC technologies and genome-wide approaches may bring new mechanistic insight into the pathogenesis of AD and PD.
http://ift.tt/2muH4M0
Recent advances in neural dust: towards a neural interface platform
Source:Current Opinion in Neurobiology, Volume 50
Author(s): Ryan M Neely, David K Piech, Samantha R Santacruz, Michel M Maharbiz, Jose M Carmena
The neural dust platform uses ultrasonic power and communication to enable a scalable, wireless, and batteryless system for interfacing with the nervous system. Ultrasound offers several advantages over alternative wireless approaches, including a safe method for powering and communicating with sub mm-sized devices implanted deep in tissue. Early studies demonstrated that neural dust motes could wirelessly transmit high-fidelity electrophysiological data in vivo, and that theoretically, this system could be miniaturized well below the mm-scale. Future developments are focused on further minimization of the platform, better encapsulation methods as a path towards truly chronic neural interfaces, improved delivery mechanisms, stimulation capabilities, and finally refinements to enable deployment of neural dust in the central nervous system.
http://ift.tt/2qU3jQ1
CNV biology in neurodevelopmental disorders
Source:Current Opinion in Neurobiology, Volume 48
Author(s): Toru Takumi, Kota Tamada
Copy number variants (CNVs), characterized in recent years by cutting-edge technology, add complexity to our knowledge of the human genome. CNVs contribute not only to human diversity but also to different kinds of diseases including neurodevelopmental delay, autism spectrum disorder and neuropsychiatric diseases. Interestingly, many pathogenic CNVs are shared among these diseases. Studies suggest that pathophysiology of disease may not be simply attributed to a single driver gene within a CNV but also that multifactorial effects may be important. Gene expression and the resulting phenotypes may also be affected by epigenetic alteration and chromosomal structural changes. Combined with human genetics and systems biology, integrative research by multi-dimensional approaches using animal and cell models of CNVs are expected to further understanding of pathophysiological mechanisms of neurodevelopmental disorders and neuropsychiatric disorders.
http://ift.tt/2muSMpP
Neural circuit dysfunction in mouse models of neurodevelopmental disorders
Source:Current Opinion in Neurobiology, Volume 48
Author(s): Isabel del Pino, Beatriz Rico, Oscar Marín
Neuropsychiatric disorders arise from the alteration of normal brain developmental trajectories disrupting the function of specific neuronal circuits. Recent advances in human genetics have greatly accelerated the identification of genes whose variation increases the susceptibility for neurodevelopmental disorders, most notably for autism spectrum disorder (ASD) and schizophrenia. In parallel, experimental studies in animal models—most typically in mice—are beginning to shed light on the role of these genes in the development and function of specific brain circuits. In spite of their limitations, understanding the impact of pathological gene variation in animal models at the level of specific neuronal populations and circuits will likely contribute to orienting human clinical studies in the search for precise disease mechanisms and novel treatments.
http://ift.tt/2qSRaL2
Overweight and obesity may play a role in the pathogenesis of chronic spontaneous urticaria
Summary
Background
Chronic spontaneous urticaria (CSU) is one of the commonest diseases in allergological and dermatological practice. It constitutes an interdisciplinary problem, and its pathogenesis is not always easily determined. It has been suggested that metabolic syndrome and hyperlipidaemia are more frequent in patients with CSU, but the influence of overweight and obesity on the development of CSU has not been thoroughly investigated.
Aim
To assess the association between body parameters and the development of CSU.
Methods
The study enrolled 85 patients with CSU, who were divided into three subgroups: patients whose only symptoms were weals, patients whose only symptom was angio-oedema, and patients with urticaria and accompanying angio-oedema. Mean weight, height, body mass index (BMI), body surface area, disease duration and age of disease onset were recorded
Results
There was a statistically significant association between CSU and heavier weight, higher BMI, greater affected body surface area and older age at disease onset. Subjects with higher BMI values had a tendency towards longer disease duration. There were no statistically significant differences between the three subgroups.
Conclusions
Our results suggest that CSU, especially if of long duration, may be associated with overweight and obesity, while increased body mass can result in later onset of urticaria symptoms. Further analyses to confirm the presented results and possible association between obesity and CSU occurrence are needed.
http://ift.tt/2FwIywT
Factors influencing skin cancer excision rates in Scottish primary care
Summary
Skin cancer incidence rates are rising in the UK, yet many areas are experiencing a shortage of dermatologists. We sought to compare skin cancer excision rates between general practice (GP) surgeons to identify factors associated with good practice, through a retrospective analysis of GP skin cancer histopathology reports in three Scottish Health Boards over a 4-year period. Postal questionnaires were used to explore factors affecting surgeons' excision rates. GPs excised 895 skin cancers (4.5% of the 19 853 regional total) during the period. Of the basal cell carcinomas, 308 would be classified as low-risk by current National Institute for Health and Care Excellence criteria. Of the returned questionnaires, 58 accounted for 631 (70.5%) of the excised skin cancers. Analysing completeness of skin cancer excision, there was a statistically significant difference between GPs performing excision on ≥ 11 lesions/month compared with those performing excision on ≤ 10/month. Policymakers may wish to consider systems to facilitate low-risk patients being treated by GPs who undertake frequent surgical procedures.
http://ift.tt/2EC3PE7
Effect of levofloxacin, pazufloxacin, enrofloxacin, and meloxicam on the immunolocalization of ABCG-2 transporter protein in rabbit retina
Abstract
Adenosine triphosphate-binding cassette (ABC) sub-family G member-2 (ABCG-2) is a transporter protein, implicated for multi-drug efflux from tissues. This study evaluated the effect of fluoroquinolones; levofloxacin, pazufloxacin and enrofloxacin, and non-steroidal anti-inflammatory drug, meloxicam; on the immunolocalization of ABCG-2 transporter protein of rabbit retinas. Thirty-two male rabbits were randomly divided in to eight groups. Control group was gavaged, 2% benzyl alcohol in 5% dextrose since these chemicals are excipients of the drug preparations used in the treatment groups of this study. Four groups were exclusively gavaged, levofloxacin hemihydrate (10 mg/kg body weight b.i.d 12 h), pazufloxacin mesylate (10 mg/kg body weight b.i.d 12 h), enrofloxacin (20 mg/kg body weight o.d.), and meloxicam (0.2 mg/kg body weight o.d.), respectively. Three other groups were co-gavaged meloxicam with above fluoroquinolones, respectively. These drugs were administered for 21 days. ABCG-2 immunolocalization was mild in the retinas of control and levofloxacin-alone-treated groups. The immunolocalization intensity was significantly higher in meloxicam-alone-treated group when compared to control and levofloxacin-alone-treated groups. Immunolocalization of this transporter increased in the levofloxacin-meloxicam co-treated group when compared to the levofloxacin-alone-treated group. Highest immunolocalization was observed in the enrofloxacin-meloxicam co-treated group although the immunolocalization of all treatment groups, except the levofloxacin-alone-treated group, was significantly higher than the control and levofloxacin-alone-treated groups.
http://ift.tt/2Dnh7oM
Analysis of multi-year near-surface ozone observations at the WMO/GAW “Concordia” station (75°06′S, 123°20′E, 3280 m a.s.l. – Antarctica)
Publication date: March 2018
Source:Atmospheric Environment, Volume 177
Author(s): Paolo Cristofanelli, Davide Putero, Paolo Bonasoni, Maurizio Busetto, Francescopiero Calzolari, Giuseppe Camporeale, Paolo Grigioni, Angelo Lupi, Boyan Petkov, Rita Traversi, Roberto Udisti, Vito Vitale
This work focuses on the near-surface O3 variability over the eastern Antarctic Plateau. In particular, eight years (2006–2013) of continuous observations at the WMO/GAW contributing station "Concordia" (Dome C–DMC: 75°06′S, 123°20′E, 3280 m) are presented, in the framework of the Italian Antarctic Research Programme (PNRA). First, the characterization of seasonal and diurnal O3 variability at DMC is provided. Then, for the period of highest data coverage (2008–2013), we investigated the role of specific atmospheric processes in affecting near-surface summer O3 variability, when O3 enhancement events (OEEs) are systematically observed at DMC (average monthly frequency peaking up to 60% in December). As deduced by a statistical selection methodology, these OEEs are affected by a significant interannual variability, both in their average O3 values and in their frequency. To explain part of this variability, we analyzed OEEs as a function of specific atmospheric variables and processes: (i) total column of O3 (TCO) and UV-A irradiance, (ii) long-range transport of air masses over the Antarctic Plateau (by Lagrangian back-trajectory analysis – LAGRANTO), (iii) occurrence of "deep" stratospheric intrusion events (by using the Lagrangian tool STLEFLUX). The overall near-surface O3 variability at DMC is controlled by a day-to-day pattern, which strongly points towards a dominating influence of processes occurring at "synoptic" scales rather than "local" processes. Even if previous studies suggested an inverse relationship between OEEs and TCO, we found a slight tendency for the annual frequency of OEEs to be higher when TCO values are higher over DMC. The annual occurrence of OEEs at DMC seems related to the total time spent by air masses over the Antarctic plateau before their arrival to DMC, suggesting the accumulation of photochemically-produced O3 during the transport, rather than a more efficient local production. Moreover, the identification of recent (i.e., 4-day old) stratospheric intrusion events by STEFLUX suggested only a minor influence (up to 3% of the period, in November) of "deep" events on the variability of near-surface summer O3 at DMC.
http://ift.tt/2CRXjZD
Editorial Board
Source:Atmospheric Environment, Volume 175
http://ift.tt/2DpAFss
A Clinically Meaningful Interpretation of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and III Data
Publication date: Available online 11 January 2018
Source:Academic Radiology
Author(s): Paul Cronin, Ben A. Dwamena
Rationale and ObjectivesThis study aimed to calculate the multiple-level likelihood ratios (LRs) and posttest probabilities for a positive, indeterminate, or negative test result for multidetector computed tomography pulmonary angiography (MDCTPA) ± computed tomography venography (CTV) and magnetic resonance pulmonary angiography (MRPA) ± magnetic resonance venography (MRV) for each clinical probability level (two-, three-, and four-level) for the nine most commonly used clinical prediction rules (CPRs) (Wells, Geneva, Miniati, and Charlotte). The study design is a review of observational studies with critical review of multiple cohort studies. The settings are acute care, emergency room care, and ambulatory care (inpatients and outpatients).Materials and MethodsData were used to estimate pulmonary embolism (PE) pretest probability for each of the most commonly used CPRs at each probability level. Multiple-level LRs (positive, indeterminate, negative test) were generated and used to calculate posttest probabilities for MDCTPA, MDCTPA + CTV, MRPA, and MRPA + MRV from sensitivity and specificity results from Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and PIOPED III for each clinical probability level for each CPR. Nomograms were also created.ResultsThe LRs for a positive test result were higher for MRPA compared to MDCTPA without venography (76 vs 20) and with venography (42 vs 18). LRs for a negative test result were lower for MDCTPA compared to MRPA without venography (0.18 vs 0.22) and with venography (0.12 vs 0.15). In the three-level Wells score, the pretest clinical probability of PE for a low, moderate, and high clinical probability score is 5.7, 23, and 49. The posttest probability for an initially low clinical probability PE for a positive, indeterminate, and negative test result, respectively, for MDCTPA is 54, 5 and 1; for MDCTPA + CTV is 52, 2, and 0.7; for MRPA is 82, 6, and 1; and for MRPA + MRV is 72, 3, and 1; for an initially moderate clinical probability PE for MDCTPA is 86, 22, and 5; for MDCTPA + CTV is 85, 10, and 4; for MRPA is 96, 25, and 6; and for MRPA + MRV is 93, 14, and 4; and for an initially high clinical probability of PE for MDCTPA is 95, 47, and 15; for MDCTPA + CTV is 95, 27, and 10; for MRPA is 99, 52, and 17; and for MRPA + MRV is 98, 34, and 13.ConclusionsFor a positive test result, LRs were considerably higher for MRPA compared to MDCTPA. However, both a positive MRPA and MDCTPA have LRs >10 and therefore can confirm the presence of PE. Performing venography reduced the LR for a positive and negative test for both MDCTPA and MRPA. The nomograms give posttest probabilities for a positive, indeterminate, or negative test result for MDCTPA and MRPA (with and without venography) for each clinical probability level for each of the CPR.
http://ift.tt/2qZP3oQ
Thermal Field Distributions of Ablative Experiments Using Cyst-mimicking Phantoms
Source:Academic Radiology
Author(s): Xiao-wen Huang, Fang Nie, Zeng-cheng Wa, Hang-tong Hu, Qing-xiu Huang, Huan-ling Guo, Qiao Zheng, Xiao-yan Xie, Wei Wang, Ming-De Lu
Rationale and ObjectivesThe objective of this study was to explore the thermal field distribution of cystic lesions undergoing microwave ablation (MWA) and radiofrequency ablation (RFA) using in vitro phantoms.Materials and MethodsCyst-mimicking lesions filled with sodium chloride (NaCl) solution in acrylamide phantoms were treated with MWA and RFA in vitro. The radiofrequency electrodes or MWA antennas were implanted in the centers of the artificial cystic lesions. We used temperature fields located 5, 15, and 25 mm from the electrode or the antenna to plot the temperature-rise curves. Solid phantoms without cysts were also fabricated as controls.ResultsThe temperature within cysts increased faster and reached a higher maximum temperature during MWA than during RFA, and this result was independent of the NaCl solution concentration. RFA treatment caused the temperatures within the lesion to increase significantly faster in the cysts containing 0.9% NaCl than in those containing 5.0% NaCl. However, the MWA temperature-rise curves were only weakly affected by the ionic concentration. The median temperature difference values between the 5- and 15-mm points were markedly lower in the 0.9% NaCl cyst-mimicking phantom (P < 0.001) than in the solid phantom after either MWA or RFA.ConclusionsOur data indicate that MWA is a more effective technique for focal cystic lesions than RFA and has higher overall energy utilization. MWA was also less affected by the ionic concentration of the cystic fluid.
http://ift.tt/2munob7
The Clinical Impact of Resident-attending Discrepancies in On-call Radiology Reporting
Source:Academic Radiology
Author(s): Sebastian R. McWilliams, Christopher Smith, Yaseen Oweis, Kareem Mawad, Constantine Raptis, Vincent Mellnick
Rationale and ObjectivesThe purpose of this study is to quantify the clinical impact of resident-attending discrepancies at a tertiary referral academic radiology residency program by assessing rates of intervention, discrepancy confirmation, recall rate, and management change rate; furthermore, a discrepancy categorization system will be assessed.Materials and MethodsRetrospective review of the records was performed for n = 1482 discrepancies that occurred in the 17-month study period to assess the clinical impact of discrepancies. Discrepancies were grouped according to a previously published classification system. Management changes were recorded and grouped by severity. The recall rate was estimated for discharged patients. Any confirmatory testing was reviewed to evaluate the accuracy of the discrepant report. Categorical variables were compared to the chi-square test.ResultsThe 1482 discrepancies led to management change in 661 cases (44.6%). The most common management change was follow-up imaging. Procedural interventions including surgery occurred in 50 cases (3.3%). The recall rate was 2.6%. Management changes were more severe with computed tomography examinations, inpatients, and when the discrepancy was in the chest and abdomen subspecialty. Also, management changes correlated with the discrepancy category assigned by the attending at the time of review.ConclusionsResident-attending discrepancies do cause management changes in 44.6% of discrepancies (0.62% overall); the most frequent change is follow-up imaging. The discrepancy categorization assigned by the attending correlated with the severity of management change.
http://ift.tt/2qSFcRC
Sézary syndrome managed with histone deacetylase inhibitor followed by anti-CCR4 monoclonal antibody
Summary
A 70-year-old man presented to our clinic with a 10-year history of recurrent pruritic erythema and plaques on his trunk and limbs. Based on the pathological findings and monoclonal rearrangement of the T-cell receptor (TCR)–Cβ1 gene, mycosis fungoides (T2N0M0B0 stage IB) was diagnosed. Despite combination therapy including histone deacetylase inhibitor (vorinostat), the symptoms slowly evolved into Sézary syndrome (SS; T4N1M0B2) over 4 years, with dense infiltrates due to atypical lymphocytes expressing CCR4 developing in the entire dermis. Anti-CCR4 monoclonal antibody (mogamulizumab) treatment was started. After seven courses, the CCR4-positive atypical lymphocytes decreased in the dermis to levels below those seen at the outset of treatment. To our knowledge, there is no previous report of a case of SS managed with vorinostat followed by mogamulizumab demonstrating such a remarkable change in the pathological state following treatment.
http://ift.tt/2CVijhY
Πέμπτη 11 Ιανουαρίου 2018
Reversible symptoms present in a patient with Balo's concentric sclerosis
Neurology India 2018 66(1):268-268
http://ift.tt/2DnEO0e
Sertraline-induced reversible myopathy with rhabdomyolysis and trismus
Neurology India 2018 66(1):235-237
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Changing trends in surgery for suprasellar lesions
Neurology India 2018 66(1):4-8
http://ift.tt/2CUHG3C
Russel Brain: Some reflections on genius and other essays
Neurology India 2018 66(1):290-293
http://ift.tt/2DmeYtx
Evolution of concepts in the management of vestibular schwannomas: Lessons learnt from Prof B Ramamurthi's article published in 1970
Neurology India 2018 66(1):9-19
http://ift.tt/2CVtQxN
Dirofilariasis mimicking an osteoma
Neurology India 2018 66(1):255-256
http://ift.tt/2CVJr0m
A medical-legal perspective on overlapping surgery
Neurology India 2018 66(1):20-23
In the U.S., there has recently been increased scrutiny on the appropriateness of surgeons performing overlapping cases and the potential for adverse consequences. This article describes the current literature on overlapping surgery and the ethics that guide behavior by performing a review of the PUBMED literature on overlapping surgery and analysis. Although the literature on overlapping surgery supports it as a safe practice, some public opinion runs contrary to the data, which is driving changes in policy. Surgeons should become familiar with the overlapping surgery policy in the hospital(s) in which they practice and be mindful of the potential consequences of performing overlapping surgeries.
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Authors' Reply: Magnesium supplementation in intracerebral hematoma: The hope and the hype!
Neurology India 2018 66(1):282-283
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Cerebrospinal fluid shunts – How they work: The basics
Neurology India 2018 66(1):24-35
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Association of hemolysis, elevated liver enzymes, low platelets syndrome with posterior reversible encephalopathy and intracranial hypotension
Neurology India 2018 66(1):226-227
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Current status of dystonias including Meige's syndrome
Neurology India 2018 66(1):36-37
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Lumber nerve root cavernous angioma
Neurology India 2018 66(1):244-245
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Botulinum toxin in patients with Meige's syndrome
Neurology India 2018 66(1):38-39
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Nasu–Hakola Disease
Neurology India 2018 66(1):263-263
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Management of intracranial arterial dissection
Neurology India 2018 66(1):40-42
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The Indo-US Collaborative Stroke Registry and infrastructure development project
Neurology India 2018 66(1):276-278
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Endovascular management of vertebral artery dissecting aneurysms
Neurology India 2018 66(1):43-45
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Subgaleoatrial or subgaleopleural shunt?
Neurology India 2018 66(1):285-286
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Dissecting aneurysms of the vertebrobasilar system with non-traumatic subarachnoid haemorrhage: Therapeutic considerations
Neurology India 2018 66(1):46-48
http://ift.tt/2Dk1caF
Supplementing dietary rosemary ( Rosmarinus officinalis L.) powder and vitamin E in broiler chickens: evaluation of humoral immune response, lymphoid organs, and blood proteins
Abstract
The aim of the present study was to evaluate the effect rosemary (Rosmarinus officinalis L.) powder (RP) and vitamin E (VE) at different levels on humoral immunity of broilers during a 42-day production cycle. A total of 270 1-day-old male chicks were assigned to nine groups with three replicates of ten birds each, and diets were supplemented with 0, 0.5, or 1.0% RP and 0, 100, or 200 mg/kg VE, respectively. Commercial-inactivated vaccines against avian influenza (AI) and Newcastle disease (ND) viruses, and living infectious bronchitis virus (IBV) vaccine were administered by spray method. Sheep red blood cells (SRBC) were administered subcutaneously. Blood samples were collected from birds 1 week after each vaccination to determine antibody titers. At the 42nd day, blood samples were also assessed for globulin level, and lymphoid tissues (thymus, spleen, and bursa) were weighed. Neither antibody titers against viruses nor lymphoid tissues weight were affected by RP and/or VE (P > 0.05) treatments. However, broilers supplemented with 0 mg/kg of VE had lower antibody titers against SRBC than those fed 100 mg/kg of VE (P < 0.05) at the 24th day. A significant RP × VE interaction effect (P < 0.05) on plasma globulin level was observed. The findings of our study suggest that dietary RP and VE additives can interact and modulate the humoral immunity of broilers, but not sufficiently to improve antibody titers against specific virus during a 42-day production cycle.
http://ift.tt/2mtWqjU
Testing the role of external debt in environmental degradation: empirical evidence from Turkey
Abstract
This study investigates the role of external debt stock in Turkey, which has suffered from heavy (external and domestic) debt stock for many years. Annual data from 1960 to 2013 was analyzed using time series analysis in order to study this. The results confirm the validity of the conventional environmental Kuznets curve (EKC) in the case of Turkey. However, this study also found that Turkey's external debt stock did not influence the Turkish economy's long-term EKC behavior. Fortunately, the results suggest that there are important interactions among external debt stock, CO2 emissions, energy consumption, and real income; that is, changes in external debt volume precede changes in these aggregates' volumes.
http://ift.tt/2qVl69F
Contrasting effects of alkaline amendments on the bioavailability and uptake of Cd in rice plants in a Cd-contaminated acid paddy soil
Abstract
Reducing cadmium (Cd) concentrations in rice grains is important for food safety, particularly in acid paddy fields in South China where the soils have been previously contaminated with Cd. A field experiment was conducted to evaluate the effects of four alkaline amendments, i.e., lime, compost, biochar, and carbide slag on soil bioavailability and uptake of Cd in plants of two rice cultivars (Oryza sativa L.) in a Cd-contaminated acid paddy soil. The addition of these amendments significantly decreased the concentrations of CaCl2-extractable Cd by 13–41%. Cd in the acid-soluble fraction was decreased in these amended soils while it increased in the residual fraction. The amendments also decreased the uptake of Cd in the plants at the tillering and mature growth stages. The concentrations of Cd in plant tissues at maturity were in the order: root > shoot > bran > polished rice > husk. The amendment of carbide slag decreased Cd concentration in rice grains the most, followed by lime, biochar, and compost. The increases in soil pH and the decreases in the acid-soluble fraction of Cd (F1-Cd) indicated that these amendments can directly transform the highly availability fraction of Cd to a more stable fraction (residual Cd fraction) in soils. Furthermore, the Cd concentrations in polished rice grains of the two rice cultivars used were reduced by 66–67% by treatment with carbide slag. Our study suggests that carbide slag has a great potential to reduce the bioavailability and uptake of Cd in rice plants in Cd-contaminated acid paddy field soils.
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Rhythmic Spontaneous Activity Mediates the Age-Related Decline in Somatosensory Function
http://ift.tt/2mkuT3f
Gli2 Rescues Delays in Brain Development Induced by Kif3a Dysfunction
http://ift.tt/2D3tUPn
The Roles of Subdivisions of Human Insula in Emotion Perception and Auditory Processing
http://ift.tt/2mkcQKE
Streptococcus oralis maintains homeostasis in supragingival biofilms by antagonizing cariogenic pathogen Streptococcus mutans
Summary
Bacteria residing in oral biofilms live in a state of dynamic equilibrium with one another. The intricate synergistic or antagonistic interactions between them are crucial for determining this balance. Using the 6-species Zürich "supragingival" biofilm model, this study aimed to investigate interactions regarding growth and localization of the constituent species. As control, an inoculum containing all six strains was used, whereas in each of the further five inocula one of the bacterial species was absent, and in the last both streptococci were absent. Biofilms were grown anaerobically on hydroxyapatite discs, and after 64 h they were harvested and quantified by culture analyses. For visualization, fluorescence in situ hybridization and confocal laser scanning microscopy was used. Compared to the control, no statistically significant difference of total CFU was observed in the absence of any of the biofilm species, except for F. nucleatum whose absence caused a significant decrease in total bacterial numbers. Absence of S. oralis resulted in a significant decrease in A. oris, and increase in S. mutans (p<0.001). Absence of A. oris, V. dispar or S. mutans did not cause any changes. The structure of the biofilm with regards to the localization of the species did not result in observable changes. In summary, the most striking observation was that absence of S. oralis resulted in limited growth of commensal A. oris and overgrowth of S. mutans. This data establishes S. oralis as commensal keeper of homeostasis in the biofilm by antagonizing S. mutans, thus preventing a caries-favoring dysbiotic state.
This article is protected by copyright. All rights reserved.
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Long-term variations of the riverine input of potentially toxic dissolved elements and the impacts on their distribution in Jiaozhou Bay, China
Abstract
The concentrations of the potentially toxic dissolved elements (PTEs) As, Hg, Cr, Pb, Cd, and Cu in the main rivers into Jiaozhou Bay (JZB) during 1981–2006 were measured, and the impact of the fluvial PTE fluxes on their distributions in the bay was investigated. The overall average concentration in the rivers into JZB ranged from 8.8 to 39.6 μg L−1 for As, 10.1 to 632.6 ng L−1 for Hg, 4.1 to 3003.6 μg L−1 for Cr, 8.5 to 141.9 μg L−1 for Pb, 1.1 to 34.2 μg L−1 for Cd, and 13.2 to 1042.8 μg L−1 for Cu. The interannual average concentration variations of the PTEs in these rivers were enormous, with maximum differences of 41–21,680 times, while their relative seasonal changes were far smaller with maximum differences of 3–12 times. The total annual fluvial fluxes for As, Hg, and Cr into JZB exhibited the inverse "U" pattern, while those for Pb and Cd showed the "N" pattern. As a whole, the total annual Cu flux presented a growing tendency from 1998 to 2006. In general, the changing trends of the PTE concentrations in JZB were similar to those of their annual fluxes from the rivers, indicating a great impact of their fluvial fluxes on their distributions in JZB. The annual concentration of Cd in the bay almost remained constant and differed from the fluvial flux of Cd. The diversified pattern of the environmental Kuznets curve (EKC) represented China's approach to industrialization as "improving while developing."
http://ift.tt/2r0edUw
Biochar amendment with fertilizers increases peanut N uptake, alleviates soil N 2 O emissions without affecting NH 3 volatilization in field experiments
Abstract
Biochar application to soil is currently widely advocated for a variety of reasons related to sustainability. However, the synergistic effects of biochar combined with mineral or organic fertilizer on soil N2O emissions, NH3 volatilization, and plant N uptake are poorly documented. Field plot experiments planted with peanut were conducted under the application of biochar (derived from rice husk and cottonseed husk, 50 t ha−1) with organic or mineral fertilizer. It was found that biochar increased soil nutrient availability and decreased surface soil bulk density, demonstrating that biochar could improve the soil quality especially in the 0–20-cm profile. The total N content of the plant changed little with treatments, but the kernel N concentration increased significantly when biochar was applied with organic fertilizer. Peanut yield increased with biochar amendment while no significant difference was observed in plant biomass, suggesting biochar had a positive effect on belowground biomass. Peanut N uptake was also increased following biochar amendment with either organic or mineral fertilizers. While biochar amendment had no significant effect on soil NH3 volatilization, it did decrease the cumulative N2O emission by 36.3% on average with organic fertilizer, and by 32.6% with mineral fertilizer, respectively (p < 0.05). The copy numbers of 16S rDNA, nifH, nirK, and nirS were not influenced by the application of biochar; however, the copy number of nosZ was significantly increased under biochar plus mineral fertilizer treatment. The results imply that biochar application can suppress N2O emissions, as a result of abiotic factors and enhanced peanut N uptake rather than changes of denitrification genes.
http://ift.tt/2mupLKL
Agro-industrial waste recycling by Trichosporon fermentans : conversion of waste sweetpotato vines alone into lipid
Abstract
Agro-industrial waste can be used to replace traditional carbohydrates, such as sucrose, starch, and glucose in many industrial fermentation processes. This study investigated the conversion of pre-treated waste sweetpotato vines (SV) into lipid by Trichosporon fermentans under the separate hydrolysis and fermentation (SHF) and the simultaneous saccharification and fermentation (SSF) processes. The results showed that SV autoclaving significantly increased the lipid accumulation of T. fermentans compared with acid or alkaline hydrolysis. The effects of different pre-treatments on SV were also studied by scanning electron microscopy and Fourier transform infrared spectroscopy, which showed the partial removal of the aliphatic fractions, hemicelluloses, and lignin during pre-treatment. Moreover, the lipid yield of T. fermentans in SSF was 6.98 g L−1, which was threefold higher than that (2.79 g L−1) in SHF, and the lipid contents of yeast in SSF and SHF were 36 and 25%, respectively. Overall, this study indicated that SSF using autoclaved SV could increase the growth and lipid production of T. fermentans and provided an efficient way to realize the resource utilization of waste SV.
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Investigation of the effect of rapid and slow external pH increases on Enterococcus faecalis biofilm grown on dentine
Abstract
Background
Calcium hydroxide is a common endodontic medicament and has an anti-microbial effect by increasing the localized pH within the root canal. However, Enterococcus faecalis has shown some resistance to calcium hydroxide.
Method
A flow cell apparatus was used to grow an E. faecalis biofilm on dentine discs. Following 4 weeks growth in Todd Hewitt Broth, flow cells were exposed to either a rapid or slow increase to pH 11.5 or 12.5. Cellular viability was determined using serial plating and the number of colony forming units was normalised against the cellular protein content. Scanning electron microscopy was carried out to qualitatively observe the effects of the different rates of pH increase.
Results
A significant difference in viability between the pH rapid and slow groups was not shown in this study. Compared to pH 11.5 solutions, pH 12.5 solutions were more effective at killing bacteria although some E. faecalis still survived.
Conclusion
E. faecalis did not adapt and develop a greater resistance to high pH following a slow rise in pH compared with a rapid rise in pH. As expected, pH 12.5 was more effective in reducing bacterial numbers compared to pH 11.5 although E. faecalis was not completely eliminated.
This article is protected by copyright. All rights reserved.
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An ultrasensitive detection of miRNA-155 in breast cancer via direct hybridization assay using two-dimensional molybdenum disulfide field-effect transistor biosensor
Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Samira Mansouri Majd, Abdollah Salimi, Foad Ghasemi
MicroRNAs (miRNAs), critical biomarkers of acute and chronic diseases, play key regulatory roles in many biological processes. As a result, robust assay platforms to enable an accurate and efficient detection of low-level miRNAs in complex biological samples are of great significance. In this work, a label-free and direct hybridization assay using molybdenum disulfide (MoS2) field-effect transistor (FET) biosensor has been developed for ultrasensitive detection of miRNA-155 as a breast cancer biomarker in human serum and cell-line samples. MoS2, the novel 2D layered material with excellent physical and chemical properties, was prepared through sequential solvent exchange method and was used as an active channel material. MoS2 was comprehensively characterized by spectroscopic and microscopic methods and it was applied for fabrication of FET device by drop-casting MoS2 flacks suspension onto the FET surface. MoS2 FET device showed a relatively low subthreshold swing of 48.10mV/decade and a high mobility of 1.98 × 103cm2V−1s−1. Subsequently, probe miRNA-155 strands were immobilized on the surface of the MoS2 FET device. Under optimized conditions detection limit of 0.03fM and concentration range 0.1fM to 10nM were achieved. The developed biosensor not only was capable to identification of fully matched versus one-base mismatch miRNA-155 sequence, but also it could detect target miRNA-155 in spiked real human serum and extracts from human breast cancer cell-line samples. This approach paves a way for label-free, early detection of miRNA as a biomarker in cancer diagnostics with very high sensitivity and good specificity, thus offering a significant potential for clinical application.
Graphical abstract
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A catalytic and dual recycling amplification ATP sensor based on target-driven allosteric structure switching of aptamer beacons
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Ying Peng, Daxiu Li, Ruo Yuan, Yun Xiang
Abnormal concentrations of ATP are associated with many diseases and cancers, and quantitative detection of ATP is thus of great importance for disease diagnosis and prognosis. In the present work, we report a new dual recycling amplification sensor integrated with catalytic hairpin assembly (CHA) to achieve high sensitivity for fluorescent detection of ATP. The association of the target ATP with the aptamer beacons causes the allosteric structure switching of the aptamer beacons to expose the toehold regions, which hybridize with and unfold the fluorescently quenched hairpin signal probes (HP1) to recycle the target ATP and to trigger CHA between HP1 and the secondary hairpin probes (HP2) to form HP1/HP2 duplexes. Due to the recycling amplification, the presence of ATP leads to the formation of many HP1/HP2 duplexes, generating dramatically amplified fluorescent signals for sensitive detection of ATP. Under optimal experimental conditions, our sensor linearly responds to ATP in the range from 25 to 600nM with a calculated detection limit of 8.2nM. Furthermore, the sensor shows a high selectivity and can also be used to detect ATP in human serums to realize its application for real samples. With the distinct advantage of significant signal amplification without the involvement of any nanomaterial and enzyme, the developed sensor thus holds great potential for simple and sensitive detection of different small molecules and proteins.
http://ift.tt/2r1lBz5
Editorial Board
Source:Biosensors and Bioelectronics, Volume 102
http://ift.tt/2qXHvTt
A quantitative CT imaging signature predicts survival and complements established prognosticators in stage I non-small cell lung cancer
Publication date: Available online 10 January 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Juheon Lee, Bailiang Li, Yi Cui, Xiaoli Sun, Jia Wu, Hui Zhu, Jinming Yu, Michael F. Gensheimer, Billy W. Loo, Maximilian Diehn, Ruijiang Li
BackgroundPrognostic biomarkers are needed to guide the management of early stage non-small cell lung cancer (NSCLC). This work aims to develop an image-based prognostic signature and assess its complementary value to existing biomarkers.MethodsWe retrospectively analyzed outcomes of stage I NSCLC in seven cohorts. Based on an analysis of 39 CT features characterizing tumor and its relation to neighboring pleura, we developed a prognostic signature in an institutional cohort (n=117) and tested it in an external cohort (n=88). A third cohort of 89 patients with CT and gene expression data was employed to create a surrogate genomic signature of the imaging signature. We conducted further validation using data from five gene expression cohorts (n=639), and built a composite signature by integrating with the cell-cycle progression (CCP) score and clinical variables.ResultsAn imaging signature consisting of pleural contact index and normalized inverse difference was significantly associated with overall survival in both imaging cohorts (p=0.0005 and 0.0009). Functional enrichment analysis revealed that genes highly correlated with the imaging signature were related to immune response, such as lymphocyte activation and chemotaxis (false discovery rate<0.05). A genomic surrogate of the imaging signature remained a significant predictor of survival adjusting for known prognostic factors (hazard ratio: 1.81, 95% CI: 1.34-2.44, p<0.0001), and stratified patients within subgroups as defined by stage, histology, or CCP score. A composite signature outperformed the genomic surrogate, CCP score, and clinical model alone (p<0.01) regarding concordance index (0.70 vs 0.62-0.63).ConclusionThe proposed CT imaging signature reflects fundamental biologic differences in tumors and predicts overall survival in patients with stage I NSCLC. When combined with established prognosticators, the imaging signature improves survival prediction.
Teaser
We identified a CT imaging signature that predicts overall survival in stage I NSCLC. The imaging signature is associated with immune response and may serve as a noninvasive prognostic biomarker in stage I NSCLC.http://ift.tt/2mlNE6r
Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis
Abstract
Background
In the last two decades, several studies have examined the association between maternal thyroid hormone insufficiency during pregnancy and neurodevelopmental disorders in children and shown conflicting results.
Aim
This systematic review aimed to assess the evidence for an association between maternal thyroid hormone insufficiency during pregnancy and neurodevelopmental disorders in children. We also sought to assess whether levothyroxine treatment for maternal thyroid hormone insufficiency improves child neurodevelopment outcomes.
Methods
We performed systematic literature searches in MEDLINE, EMBASE, PSYCinfo, CINAHL, AMED, BNI, Cochrane, Scopus, Web of Science, GreyLit, Grey Source and Open Grey (latest search: March 2017). We also conducted targeted web searching and performed forwards and backwards citation chasing. Meta-analyses of eligible studies were carried out using the random-effects model.
Results
We identified 39 eligible articles (37 observational studies and 2 randomised controlled trials (RCT)). Meta-analysis showed that maternal subclinical hypothyroidism and hypothyroxinaemia are associated with indicators of intellectual disability in offspring (odds ratio (OR) 2.14, 95% confidence interval (CI) 1.20 to 3.83, p= 0.01, and OR 1.63, 95% CI 1.03 to 2.56, p=0.04, respectively). Maternal subclinical hypothyroidism and hypothyroxinaemia were not associated with attention deficit hyperactivity disorder, and their effect on the risk of autism in offspring was unclear. Meta-analysis of RCTs showed no evidence that levothyroxine treatment for maternal hypothyroxinaemia or subclinical hypothyroidism reduces the incidence of low intelligence quotient in offspring.
Limitations
Although studies were generally of good quality, there was evidence of heterogeneity between the included observational studies (I2 72-79%).
Conclusion
Maternal hypothyroxinaemia and subclinical hypothyroidism may be associated with intellectual disability in offspring. Currently there is no evidence that levothyroxine treatment, when initiated 8 to 20 weeks gestation (mostly between 12-17 weeks), for mild maternal thyroid hormone insufficiency during pregnancy reduces intellectual disability in offspring.
This article is protected by copyright. All rights reserved.
http://ift.tt/2ARJYPl
In response to: Unsolved enigma of atrial myxoma with biventricular dysfunction
Annals of Cardiac Anaesthesia 2018 21(1):107-107
Thanks to Raut et al.[1] for appreciating our efforts in managing the case of biatrial myxomas. A brief discussion is warranted here on the types, size of cardiac myxomas, interleukin 6 (IL-6) levels, left ventricle (LV) dysfunction, and their relation. IL-6 is a pleiotropic cytokine with a variety of biologic activities, including differentiation of B cell, thymocytes, and T cells; activation of macrophages; and stimulation of hepatocyte to produce acute-phase proteins such as C-reactive protein.[2],[3] It is also said to have paracrine, endocrine, and autocrine growth functions.[3]
http://ift.tt/2DkzXgd
Role of transesophageal echocardiography during left atrial appendage occlusion device closure in a patient with non-valvular atrial fibrillation and angiodysplasia of the colon
Annals of Cardiac Anaesthesia 2018 21(1):88-91
Atrial fibrillation is the most common arrhythmia associated with significant mortality and morbidity secondary to thrombo-embolism. To prevent this thrombo-embolism oral anticoagulation therapy is the recommended treatment. In patients with contraindications to oral anticoagulation therapy, percutaneous left atrial appendage occlusion device is indicated. TEE is essential to guide in all the stages of LAA device deployment. Right from pre-procedure screening, to guiding during deployment, to rule out any complications and post-procedure surveillance and monitoring long term outcomes.
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Perioperative renal protection during cardiac surgery: A choice between dopamine and dexmedetomidine
Annals of Cardiac Anaesthesia 2018 21(1):4-5
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Successful resolution with apixaban of a massive left atrial appendage thrombus due to nonrheumatic atrial fibrillation: A case report and review
Annals of Cardiac Anaesthesia 2018 21(1):76-77
A 32-year-old woman with a past medical history of paroxysmal atrial fibrillation, long QT syndrome, and implantation of an automatic iimplantable cardioverter-defibrillator (AICD) following cardiac arrest presented with disabling symptoms of paroxysmal atrial fibrillation due to recurrent AICD shocks. Before curative ablation, transesophageal echocardiography was performed to assess for existing thrombi. This is a rare case of successful resolution with apixaban of a massive left atrial appendage thrombus due to non-rheumatic atrial fibrillation that was successfully treated with apixaban.
http://ift.tt/2CSyJYK
Noninvasive ventilation using bipap: Expanding indications to post cardiac surgery care
Annals of Cardiac Anaesthesia 2018 21(1):6-7
http://ift.tt/2DleYKe
Pneumopericardium after minimally invasive atrial septal defect closure
Annals of Cardiac Anaesthesia 2018 21(1):99-100
Minimally invasive atrial septal defect (ASD) closure is a commonly performed cardiac surgical procedure and has good outcome. We report an interesting chest X-ray showing pneumopericardium in a patient who underwent ASD closure using a minimally invasive approach.
http://ift.tt/2CUsDqB
Prophylaxis of postoperative nausea and vomiting after cardiac surgery in high-risk patients: A randomized controlled study
Annals of Cardiac Anaesthesia 2018 21(1):8-14
Context: The role of prophylaxis for postoperative nausea and vomiting (PONV) in cardiac surgery is under debate. Aims: To study the risk factors for PONV after cardiac surgery and the role of betamethasone with or without droperidol for its prevention. Setting and Design: Randomized open-label controlled study comparing standard care with PONV prophylaxis from February to November 2016. Methods: Five hundred and two patients with planned nonemergent cardiac surgery were included. Interventions: In the intervention arm, PONV prophylaxis (4 mg betamethasone with/without 0.625 mg droperidol) was administered in high-risk patients (two or more risk factors). Patients in the control arm were treated as per routine hospital practices. Results: Female sex, past history of PONV, and migraines were associated with a significantly increased risk of PONV, while motion sickness, smoking status, and volatile anesthetics were not. Pain and treatment with nefopam or ketoprofen were associated with an increased risk of PONV. PONV was less frequent in the active arm compared to controls (45.5% vs. 54.0%, P = 0.063; visual analogic scale 10.9 vs. 15.3 mm, P = 0.043). Among the 180 patients (35.6%) with ≥2 risk factors, prophylaxis was associated with reduced PONV (intention-to-treat: 46.8% vs. 67.8%, P = 0.0061; per-protocol: 39.2% vs. 69%, P = 0.0002). In multivariate analysis, prophylaxis was independently associated with PONV (odds ratio [OR]: 0.324, 95% confidence interval: 0.167–0.629, P = 0.0009), as were female sex, past history of PONV, and migraines (OR: 3.027, 3.031, and 2.160 respectively). No drug-related side effects were reported. Conclusion: Betamethasone with/without droperidol was effective in decreasing PONV in high risk cardiac surgical patients without any side effect.
http://ift.tt/2DoIVsI
Concomitant neurogenic and vascular thoracic outlet syndrome due to multiple exostoses
Annals of Cardiac Anaesthesia 2018 21(1):71-73
We report a rare case of multiple hereditary exostosis where patient presented with bilateral base of neck exostoses with concurrent compression of brachial plexus and subclavian artery and vein. The patient was a young 26-year-old woman with chief complaints of pain in the left upper extremity, paresthesia in the left ring and little finger, and weakness in hand movement and grip. On referral, history, physical examination, radiological imaging, and electrodiagnostic tests evaluated the patient. Due to severe pain and disability in performing routine activities, surgical intervention was necessary. In the current case, the patient had thoracic outlet syndrome with concomitant venous, arterial, and neurogenic sub types. Radial pulse returned and pain associated with brachial plexus compression was resolved after the surgery.
http://ift.tt/2CTTZgs
Retrospective study of complete atrioventricular canal defects: Anesthetic and perioperative challenges
Annals of Cardiac Anaesthesia 2018 21(1):15-21
Objective: The objective of this study was to highlight anesthetic and perioperative management and the outcomes of infants with complete atrioventricular (AV) canal defects. Design: This retrospective descriptive study included children who underwent staged and primary biventricular repair for complete AV canal defects from 1999 to 2013. Setting: A single-center study at a university affiliated heart center. Participants: One hundred and fifty-seven patients with a mean age at surgery of 125 ± 56.9 days were included in the study. About 63.6% of them were diagnosed as Down syndrome. Mean body weight at surgery was 5.6 ± 6.3 kg. Methods: Primary and staged biventricular repair of complete AV canal defects. Measurements and main results: A predefined protocol including timing of surgery, management of induction and maintenance of anesthesia, cardiopulmonary bypass, and perioperative intensive care treatment was used throughout the study. Demographic data as well as intraoperative and perioperative Intensive Care Unit (ICU) data, such as length of stay in ICU, total duration of ventilation including reintubations, and total length of stay in hospital and in hospital mortality, were collected from the clinical information system. Pulmonary hypertension was noted in 60% of patients from which 30% needed nitric oxide therapy. Nearly 2.5% of patients needed permanent pacemaker implantation. Thorax was closed secondarily in 7% of patients. In 3.8% of patients, reoperations due to residual defects were undertaken. Duration of hospital stay was 14.5 ± 4.7 days. The in-hospital mortality was 0%. Conclusion: Protocolized perioperative management leads to excellent outcome in AV canal defect repair surgery.
http://ift.tt/2DleJPk
Mechanical discordance between left atrium and left atrial appendage
Annals of Cardiac Anaesthesia 2018 21(1):82-84
During standard transesophageal echocardiographic examinations in sinus rhythm (SR) patients, the left atrial appendage (LAA) is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.
http://ift.tt/2CTgimJ
Dexmedetomidine for prevention of skeletal muscle ischaemia-reperfusion injury in patients with chronic limb ischaemia undergoing aortobifemoral bypass surgery: A prospective double-blind randomized controlled study
Annals of Cardiac Anaesthesia 2018 21(1):22-25
Background: Dexmedetomidine is a selective α-2 agonist used for sedation. It has also been shown to have myocardial protective effect and prevent ischemia-reperfusion injury in off-pump coronary artery bypass patients. The aim of our study was to assess the effect of dexmedetomidine for prevention of skeletal muscle ischemia-reperfusion injury in patients undergoing aortobifemoral bypass surgery. Methodology: Sixty adult patients (Group dexmedetomidine n = 30, Group normal saline n = 30) undergoing aortobifemoral bypass surgery were recruited over 3 months. Randomization was done using a computer-generated random table. The attending anesthesiologist would be blinded to whether the drug/normal saline was being administered. He would consider each unlabeled syringe as containing dexmedetomidine and calculate the volume to be infused via a syringe pump accordingly. Dexmedetomidine infusion (1 mcg/kg) over 15 minutes was given as a loading dose, followed by maintenance infusion of 0.5 mcg/kg/h till 2 h postprocedure in Group dexmedetomidine (D) while the same volume of normal saline was given in the control Group C till 2 h postprocedure. Creatine phosphokinase (CPK) values were noted at baseline (T0), 6 h (T1), 12 h (T2), and 24 h (T3) after the procedure. Hemodynamic variables (heart rate [HR] and mean blood pressure [MAP]) were recorded at T0, T1, T2, and T3. Results were analyzed using unpaired Student's t-test, P < 0.05 was considered statistically significant. Results: MAP and HR significantly decreased in Group D as compared to control group (P < 0.05). However, the decrease was never <20% of the baseline. The CPK values at 6, 12, and 24 h were statistically significant between the two groups. Conclusion: Dexmedetomidine prevents skeletal muscle ischemia-reperfusion injury in patients undergoing aortobifemoral bypass surgery.
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Quadricuspid aortic valve: A rare intraoperative diagnosis by transesophageal echocardiography
Annals of Cardiac Anaesthesia 2018 21(1):95-96
Quadricuspid aortic valve (QAV) is a rare congenital anomaly frequently associated with other anomalies particularly coronary anomalies. It may be detected on transthoracic or transesophageal echocardiography. We present here a case report of a 27-year-old male patient with a QAV, the valve being regurgitant and requiring aortic valve replacement. It has been reported as isolated case reports in the literature and various theories exist to the development of QAV. The diagnosis requires a high degree of suspicion and a detailed assessment, and if asymptomatic, then patients need to be carefully followed up for the development of aortic regurgitation.
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Assessment the effect of dexmedetomidine on incidence of paradoxical hypertension after surgical repair of aortic coarctation in pediatric patients
Annals of Cardiac Anaesthesia 2018 21(1):26-33
Objective: The aim of the study was to assess the effect of dexmedetomidine on the incidence of paradoxical hypertension in patients undergoing aortic coarctation repair. Design: Randomized observational study. Setting: University hospital and cardiac center. Patients: The study included 108 pediatric patients with isolated aortic coarctation. Methods: The patients were classified into two groups (each = 54): Group D: the patients received dexmedetomidine as a loading dose of 0.5 μg/kg over 10 min followed by infusion 0.3 μg/kg/h during surgery and continued for the first 48 postoperative hours. Group C: The patients received an equal amount of normal saline. The medication was prepared by the nursing staff and given to anesthetist blindly. The collected data included the heart rate, systolic and diastolic arterial blood pressure, incidence, onset, severity and treatment of paradoxical hypertension, fentanyl dose and end-tidal sevoflurane concentration, amount of blood loss and urine output. Main Results: The heart rate, systolic and diastolic blood pressure decreased significantly with dexmedetomidine than Group C (P < 0.05). The incidence and severity of the paradoxical hypertension was lower with dexmedetomidine than Group C (P = 0.011, P = 0.017, respectively). The onset the paradoxical hypertension was earlier in Group C than dexmedetomidine (P = 0.026). The dose of fentanyl and sevoflurane concentration decreased significantly with dexmedetomidine (P = 0.034, P = 0.026, respectively). The blood loss decreased with dexmedetomidine (P = 0.020) and the urine output increased with dexmedetomidine (P = 0.024). The incidence of hypotension and bradycardia was more with dexmedetomidine (P < 0.05). Conclusion: Dexmedetomidine is safe in pediatric patients undergoing aortic coarctation repair. It minimized the incidence and severity of paradoxical hypertension. It decreased the required antihypertensive medications.
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Ειδοποίηση Μελετητή:[ ωτα ] [HTML] Gender, identity and material: Film screening C Brand - 2017 ftypM4V *M4V M4A mp42isom*a┌moovlmvhd...
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Publication date: September 2017 Source: Free Radical Biology and Medicine, Volume 110 Author(s): Lucía Fernández-del-Río, Anish Nag, Elen...
