Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026: 08/08/17

Τρίτη 8 Αυγούστου 2017

Cortical control of object-specific grasp relies on adjustments of both activity and effective connectivity: a common marmoset study

Abstract

The cortical mechanisms of grasping have been extensively studied in macaques and humans. Here, we investigated whether common marmosets could rely on similar mechanisms despite striking differences in manual dexterity. Two common marmosets were trained to grasp-and-pull three objects eliciting different hand configurations: whole-hand, finger and scissor grips. The animals were then chronically implanted with 64-channel electrocorticogram arrays positioned over the left premotor, primary motor and somatosensory cortex. Power spectrum, reflecting predominantly cortical activity, and phase-slope index, reflecting the direction of information flux, were studied in beta (16–35 Hz) and gamma (75–100 Hz) bands. Differences related to grip type, epoch (reach, grasp) and cortical area were statistically assessed. Results showed that whole-hand and scissor grips triggered stronger beta desynchronization than finger grip. Task epochs clearly modulated gamma power, especially for finger and scissor grips. Considering effective connectivity, finger and scissor grips evoked stronger outflow from primary motor to premotor cortex, whereas whole-hand grip displayed the opposite pattern. These findings suggest that fundamental control mechanisms, relying on adjustments of cortical activity and connectivity, are conserved across primates. Consistently, marmosets could represent a good model to investigate primate brain mechanisms.

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Under the microscope: insights into limb-specific lipid droplet metabolism

Abstract

Intramuscular triglyceride (IMTG) only accounts for a small proportion of total lipid in the human body. However, over the past two decades there has been significant interest in the area of IMTG metabolism, largely due to the contribution that IMTG makes to ATP production during moderate-intensity exercise, and the proposed role of IMTG in the development of skeletal muscle insulin resistance.

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U.N. Drug Policy Reform, with Arild Knutsen - Norway

Here are 4 unique ways you can participate in International Overdose Awareness Day:Help Reduce Stigma –Addiction is a disease and it should be treated as one.Families and individuals affected by the disease should be able to talk about it openly and get the best help possible.So,educate people on what you know about addiction and create forums where people can openly share their xperiences–failures,as well as success.Provide Inspiration–If you are not directly impacted by addiction,stimulate conversation on Twitter and Facebook to get people talking about the harmful effects of drugs,the impact of drugs on their lives,what worked for them,especially how they made it out of the abyss,and how they are living enriching lives.Individuals suffering from the disease of addiction need to know that there is a way out,there is hope and there is a beautiful life without drugs.Open link for full article http://ift.tt/2bdX6Va

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Comparison of the fatty acid profile of Spanish infant formulas and Galician women breast milk

Abstract

The importance of dietary lipids during childhood is evident, as they are necessary for correct growth and development of the newborn. When breastfeeding is not possible, infant formulas are designed to mimic human milk as much as possible to fulfill infant's requirements. However, the composition of these dairy products is relatively constant, while human milk is not a uniform bio-fluid and changes according to the requirements of the baby. In this study, breast milk samples were donated by 24 Spanish mothers in different lactation stages and different infant formulas were purchased in supermarkets and pharmacies. Gas chromatography coupled to flame ionization detection was used for the fatty acid determination. Compared to breast milk, first-stage formulas are apparently very similar in composition; however, no major differences were observed in the fatty acid profiles between formulas of different lactation stages. The Galician women breast milk has a fatty acid profile rich in oleic acid, linoleic acid, arachidonic acid, and docosahexaenoic acid. When comparing human milk with formulas, it becomes evident that the manufacturers tend to enrich the formulas with essential fatty acids (especially with α-linolenic acid), but arachidonic and docosahexaenoic acid levels are lower than in breast milk. Additionally, the obtained results demonstrated that after 1 year of lactation, human milk is still a good source of energy, essential fatty acids, and long-chain polyunsaturated fatty acids for the baby.

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Religious Identity and Health Inequalities in Canada

Abstract

In the past few decades, most new immigrants to Canada have originated from non-Christian countries. During the same period, the unaffiliation rates have sharply increased in Canada. This paper investigates whether there are any health inequalities associated with religious identity, including also the individuals who do not identify with organized religion in the analysis. The study uses the Canadian General Social Survey of 2012 (N = 23,093), focused on Caregiving and Care-receiving. Employing multivariate regression analysis and controlling for a large set of characteristics inclusive of the degree of religious commitment, individuals who identify as Protestant are found at a physical and mental health advantage, compared with Roman Catholics and most other groups. On the other hand, individuals who identify as Jehovah's Witnesses are found at a considerable physical health disadvantage. Among the unaffiliated individuals, those who have retained some ties with organized religion without formally identifying with it are found at a mental health disadvantage compared with all religious groups, as well as the secular individuals who are strictly committed to their nonreligious views. Possible causes and various implications are discussed.

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Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke: A Randomized Controlled Trial.

Background and Purpose: Robot-assisted locomotor training on a bodyweight-supported treadmill is a rehabilitation intervention that compels repetitive practice of gait movements. Standard treadmill speed may elicit rhythmic movements generated primarily by spinal circuits. Slower-than-standard treadmill speed may elicit discrete movements, which are more complex than rhythmic movements and involve cortical areas. Objective: Compare effects of fast (i.e., rhythmic) versus slow (i.e., discrete) robot-assisted locomotor training on a bodyweight-supported treadmill in subjects with chronic, severe gait deficit after stroke. Methods: Subjects (N = 18) were randomized to receive 30 sessions (5 d/wk) of either fast or slow robot-assisted locomotor training on a bodyweight-supported treadmill in an inpatient setting. Functional ambulation category, time up and go, 6-min walk test, 10-m walk test, Berg Balance Scale, and Fugl-Meyer Assessment were administered at baseline and postintervention. Results: The slow group had statistically significant improvement on functional ambulation category (first quartile-third quartile, P = 0.004), 6-min walk test (95% confidence interval [CI] = 1.8 to 49.0, P = 0.040), Berg Balance Scale (95% CI = 7.4 to 14.8, P

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Cauda Equina Syndrome Due to Vigorous Back Massage With Spinal Manipulation in a Patient With Pre-Existing Lumbar Disc Herniation: A Case Report and Literature Review.

Cauda equina syndrome (CES) resulting from acute lumbar disc herniation due to spinal massage is extremely rare. We present a case of CES caused by the acute worsening of a lumbar disc herniation after a vigorous back massage that included spinal manipulation. After vigorous back massage with spinal manipulation performed by a massage therapist, a 38-yr-old male patient experienced CES with severe numbness in both lower limbs, inability to walk due to weakness of bilateral lower limbs, and incontinence of urine and feces. The magnetic resonance imaging and computer tomography scan results showed that the L4-5 disc herniated down into the spinal canal, extensively compressing the ventral dural sac. The patient was successfully treated with an emergency operation including laminectomy, spinal canal decompression, discectomy, interbody fusion, and pedicle screw fixation. The muscle power in both lower limbs of the patient recovered rapidly to support standing only 1 wk later. Moreover, he regained continence of urine and feces. In conclusion, this case brings us novel knowledge that spinal massage or manipulation may worsen pre-existing disc herniation causing CES, and a timely emergency surgery is necessary and effective for treatment of CES-related symptoms. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Unintended activity in homologous muscle during intended unilateral contractions increases with greater task difficulty

Abstract

Purpose

The present study aimed to examine (1) the effect of task difficulty on unintended muscle activation (UIMA) levels in contralateral homologous muscle, (2) the difference between young and old adults in degree of UIMA with respect to task difficulty, and (3) temporal correlations between intended and contralateral unintended muscle activity at low frequency during unilateral intended force-matching tasks.

Methods

Twelve young (21.8 ± 2.4 years) and twelve old (69.9 ± 5.3 years) adult men performed steady isometric abductions with the left index finger at 20–80% of maximal voluntary contraction force. Two task difficulties were set by adjusting the spacing between two bars centered about the target force used for visual feedback on a monitor. The amplitude of surface electromyogram (aEMG) for both hands was calculated and normalized with respect to the maximal value. To determine if oscillations between intended and unintended muscle activities were correlated, cross-correlation function (CCF) of rectified EMG for both hands at low frequency was calculated for samples deemed adequate.

Results

The unintended aEMG (right hand) had significant main effects in task difficulty, age, and target force (all P < 0.05) without any interactions. Distinct significant peaks in CCF (0.38 on average, P < 0.05) with small time lags were present between rectified EMGs of intended and unintended muscles in 14 of the 17 samples.

Conclusions

The current results indicate that UIMA increases with greater task difficulty regardless of age, and temporal correlations exist between intended and contralateral unintended muscle activities at low frequency.

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Distinct temporal filters in mitral cells and external tufted cells of the olfactory bulb

Abstract

Short-term synaptic plasticity is a critical regulator of neural circuits, and largely determines how information is temporally processed. In the olfactory bulb, afferent olfactory receptor neurons respond to increasing concentrations of odorants with barrages of action potentials, and their terminals have an extraordinarily high release probability (Sicard, 1986; Murphy et al. 2004). These features suggest that during naturalistic stimuli, afferent input to the olfactory bulb is subject to strong synaptic depression, presumably truncating the postsynaptic response to afferent stimuli. To examine this issue, we used single glomerular stimulation in mouse olfactory bulb slices to measure the synaptic dynamics of afferent-evoked input at physiological stimulus frequencies. In cell-attached recordings, mitral cells responded to high frequency stimulation with sustained responses, whereas external tufted cells responded transiently. Consistent with previous reports (Murphy et al. 2004), olfactory nerve terminals onto both cell types had a high release probability (0.7), from a single pool of slowly recycling vesicles, indicating that the distinct responses of mitral and external tufted cells to high frequency stimulation did not originate presyaptically. Rather, distinct temporal response profiles in mitral cells and external tufted cells could be attributed to slow dendrodendritic responses in mitral cells, as blocking this slow current in mitral cells converted mitral cell responses to a transient response profile, typical of external tufted cells. Our results suggest that despite strong axodendritic synaptic depression, the balance of axodendritic and dendrodendritic circuitry in external tufted cells and mitral cells, respectively, tunes the postsynaptic responses to high frequency, naturalistic stimulation.

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Evaluating Brain-Computer Interface Performance Using Color in the P300 Checkerboard Speller

A Brain Computer Interface (BCI) is a specific type of human-machine interaction. BCI is a direct link between the human brain and a computer. BCIs can be defined as invasive utilizing techniques requiring implantation such as electrocorticography (ECoG), or non-invasive techniques utilizing techniques requiring surface electrodes such as electroencephalography (EEG [Wolpaw et al. 2003]). A BCI can provide an important communication outlet for those who are "locked-in" by amyotrophic lateral sclerosis (ALS), brain stem stroke, or head trauma.

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Inter-chromosomal Transfer of Immune Regulation During Infection of Barley with the Powdery Mildew Pathogen

Powdery mildew pathogens colonize over 9,500 plant species, causing critical yield loss. The Ascomycete fungus, Blumeria graminis f. sp. hordei (Bgh), causes powdery mildew disease in barley (Hordeum vulgare L.). Successful infection begins with penetration of host epidermal cells, culminating in haustorial feeding structures, facilitating delivery of fungal effectors to the plant and exchange of nutrients from host to pathogen. We used expression Quantitative Trait Locus (eQTL) analysis to dissect the temporal control of immunity-associated gene expression in a doubled haploid barley population challenged with Bgh. Two highly significant regions possessing trans eQTL were identified near the telomeric ends of chromosomes 2HL and 1HS. Within these regions reside diverse resistance loci derived from barley landrace, H. laevigatum (MlLa), and H. vulgare cv. Algerian (Mla1); which associate with the altered expression of 961 and 3,296 genes during fungal penetration of the host and haustorial development, respectively. Regulatory control of transcript levels for 299 of the 961 genes is re-prioritized from MlLa on 2HL to Mla1 on 1HS as infection progresses; with 292 of the 299 alternating the allele responsible for higher expression, including Adaptin Protein-2 subunit μ AP2M and Vesicle Associated Membrane Protein VAMP72 subfamily members VAMP721/722. AP2M mediates effector-triggered immunity via endocytosis of plasma membrane receptor components. VAMP721/722 and SNAP33 form a SNARE complex with SYP121 (PEN1), which is engaged in PAMP-triggered immunity via exocytosis. We postulate that genes regulated by alternate chromosomal positions are repurposed as part of conserved immune complex to respond to different pathogen attack scenarios.

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Child Care Health Consultation Improves Infant and Toddler Care

Many families enroll their infants and toddlers in early education and child care programs. The Pennsylvania Chapter of the American Academy of Pediatrics recruited 32 child care centers that care for infants and toddlers to be linked with a child care health consultant (CCHC).

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Re-bleeding rates and survival after early transjugular intrahepatic portosystemic shunt (TIPS) in clinical practice

Early implantation (<72hours) of a transjugular intrahepatic portosystemic shunt (TIPS) after acute variceal bleeding (AVB) improves survival in highly selected patients.

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ENDOSCOPIC FINDINGS AND COLONIC PERFORATION IN MICROSCOPIC COLITIS; A SYSTEMATIC REVIEW

Microscopic colitis (MC) is a clinical syndrome of severe watery diarrhoea with few or no endoscopic abnormalities. The incidence of MC is reported similar to that of other inflammatory bowel diseases. The need for histological confirmation of MC frequently guides reimbursement health policies. With the advent of high-definition (HD) coloscopes, the incidence of reporting distinct endoscopic findings in MC has risen. This has the potential to improve timely diagnosis and cost-effective MC management and diminish the workload and costs of busy modern endoscopy units.

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The carnivorous feeding behavior of early Homo at HWK EE, Bed II, Olduvai Gorge, Tanzania

Publication date: Available online 7 August 2017
Source:Journal of Human Evolution
Author(s): Michael C. Pante, Jackson K. Njau, Blaire Hensley-Marschand, Trevor L. Keevil, Carmen Martín-Ramos, Renata Franco Peters, Ignacio de la Torre
The regular consumption of large mammal carcasses, as evidenced by butchery marks on fossils recovered from Early Stone Age archaeological sites, roughly coincides with the appearance of Homo habilis. However, the significance of this niche expansion cannot be appreciated without an understanding of hominin feeding behavior and their ecological interactions with mammalian carnivores. The Olduvai Geochronology and Archaeology Project (OGAP) has recovered a large and well-preserved fossil assemblage from the HWK EE site, which was deposited just prior to the first appearance of Acheulean technology at Olduvai Gorge and likely represents one of the last H. habilis sites at Olduvai. This taphonomic analysis of the larger mammal fossil assemblage excavated from HWK EE shows evidence of multiple occupations over a long period of time, suggesting the site offered resources that were attractive to hominins. There was a water source indicated by the presence of fish, crocodiles, and hippos, and there was possible tree cover in an otherwise open habitat. The site preserves several stratigraphic intervals with large fossil and artifact assemblages within two of these intervals. Feeding traces on bone surfaces suggest hominins at the site obtained substantial amounts of flesh and marrow, particularly from smaller size group 1–2 carcasses, and exploited a wide range of taxa, including megafauna. A strong carnivore signal suggests hominins scavenged much of their animal foods during the two main stratigraphic intervals. In the later interval, lower carnivore tooth mark and hammerstone percussion mark frequencies, in addition to high epiphyseal to shaft fragment ratios, suggest hominins and carnivores did not fully exploit bone marrow and grease, which may have been acquired from nutritionally-stressed animals that died during a dry period at Olduvai. The diversity of fauna that preserve evidence of butchery suggests that the HWK EE hominins were opportunistic in their acquisition of carcass foods.

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Re-bleeding rates and survival after early transjugular intrahepatic portosystemic shunt (TIPS) in clinical practice

ENDOSCOPIC FINDINGS AND COLONIC PERFORATION IN MICROSCOPIC COLITIS; A SYSTEMATIC REVIEW

9 steps to fostering EMS community support

By Thomas L. Little Every EMS service has many opportunities to build and maintain community support. Providing top-notch patient care is a priority, but public education and outreach pay big dividends, too. The demand for up-to-date, timely health and safety information is greater than ever before. Establishing your organization as a health and safety authority in the community is an effective method ...

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3 principles for developing FirstNet applications

Seattle Fire Department's Chris Lombard says that first responders have demonstrated remarkable creativity by developing applications that meet the needs of first responders and to keep communities safe and secure.

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3 steps to properly documenting patient care in EMS

All members of the EMS team must commit to improving patient care documentation by expanding on the details and ensuring completion

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3 principles for developing FirstNet applications

Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model

Abstract

Background

Laparoscopic lens fogging (LLF) hampers vision and impedes operative efficiency. Attempts to reduce LLF have led to the development of various anti-fogging fluids and warming devices. Limited literature exists directly comparing these techniques. We constructed a model peritoneum to simulate LLF and to compare the efficacy of various anti-fogging techniques.

Materials and methods

Intraperitoneal space was simulated using a suction bag suspended within an 8 L container of water. LLF was induced by varying the temperature and humidity within the model peritoneum. Various anti-fogging techniques were assessed including scope warmers, FRED^TM, Resoclear^TM, chlorhexidine, betadine and immersion in heated saline. These products were trialled with and without the use of a disposable scope warmer. Vision scores were evaluated by the same investigator for all tests and rated according to a predetermined scale. Fogging was assessed for each product or technique 30 times and a mean vision rating was recorded.

Results

All products tested imparted some benefit, but FRED^TM performed better than all other techniques. Betadine and Resoclear^TM performed no better than the use of a scope warmer alone. Immersion in saline prior to insertion resulted in decreased vision ratings. The robotic scope did not result in LLF within the model.

Conclusions

In standard laparoscopes, the most superior preventative measure was FRED^TM utilised on a pre-warmed scope. Despite improvements in LLF with other products FRED^TM was better than all other techniques. The robotic laparoscope performed superiorly regarding LLF compared to standard laparoscope.

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3 principles for developing FirstNet applications

“To stent or not to stent?”: immediate emergency surgery with laparoscopic radical colectomy with CME and primary anastomosis is feasible for obstructing left colon carcinoma

Abstract

Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery. Particularly, the Consensus Panelists currently state that SEMS placement as a bridge to surgery is not recommended as the standard treatment because (1) it does not reduce the postoperative mortality in the general population, (2) SEMS may be associated with an increased risk of tumor recurrence, and (3) acute resection is feasible in young and fit patients, with an acceptable postoperative mortality rate. A 32-year-old lady was admitted with complete LBO from obstructing sigmoid carcinoma. Initial i.v. CE-CT scan detected a large bowel partial obstruction with fecal impaction in the entire colon until sigmoid with some mildly dilated SB loops. The presence of a thickened area in the colonic wall could not be assessed because the patient was young and thin and in such patients the CT appearance of bowel wall cannot be clearly appreciated. She was initially managed with laxatives and gastrografin. The patient's obstruction did not improve and abdominal distension worsened with nausea and colicky pain. Urgent endoscopy detected a friable mass, consistent with completely obstructing carcinoma of the mid sigmoid. Biopsies were taken and distal ink marking was made. Whole-body urgent CT scan with i.v. contrast was performed in order to obtain full preoperative staging and to rule out distant metastases. CT scan and the previously given oral gastrografin confirmed complete large bowel obstruction with a tight stricture in the sigmoid. Cecum was markedly distended.

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NASEMSO responds to questions on EMS Scope of Practice revisions

National Association of State Emergency Medical Services Officials FALLS CHURCH, Va. — Last week, the National Association of State Emergency Medical Services Officials (NASEMSO) announced that it is soliciting feedback on revised portions contained in the 2007 National EMS Scope of Practice Model that is now available on the project website. An area of discussion contained in the draft references ...

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It's time to weigh in on EMS Scope of Practice revisions

If you ever wanted the opportunity to weigh in on the future of your profession, the time is now. The National Association of State EMS Officials is seeking input from across the nation during its revision process of the National EMS Scope of Practice. Your input will be valuable in helping to move our practice forward, from EMR to Paramedic level. A quick history of the EMS Scope of Practice If you ...

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Association between mild cognitive impairment and trajectory-based spatial parameters during timed up and go test using a laser range sensor

The Timed Up and Go (TUG) test may be a useful tool to detect not only mobility impairment but also possible cognitive impairment. In this cross-sectional study, we used the TUG test to investigate the associa...

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Be ready to save lives: Innovative, new tourniquet available at GideonTactical

COATESVILLE, Pa. - GideonTactical, the top-tier source for all things tactical, now offers a versatile tourniquet that effectively negates the risk of exsanguination (bleeding to death) from occurring: the SAM Medical XT Extremity Tourniquet. When dealing with a potentially life-threatening hemorrhage, every second counts. Many times, inappropriately applied tourniquets result in lost lives, with slack ...

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Rescue Essentials announces the release of the QuikLitter Lite™

SALIDA, Colo. — RESCUE ESSENTIALS, a Colorado based tactical medical supply and training company, has recently released the newest addition to their popular QuikLitter line of soft litters, the QuikLitter Lite™. In response to the need for multiple litters at an MCI or active shooter incident, the QuikLitter Lite™ was specifically designed to be compact and lightweight. This highly ...

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Development of SSR molecular markers for Allium mongolicum

Abstract

Allium mongolicum is high palatability, nutrient, medicinal value and drought resistance wild plant. However, a lack of molecular markers of this plant results in a series of genetic questions remain largely unknown, including molecular marker data, population genetic structure and accuracy of genetic breeding. In this study, a total of 1,409,706 quality-filtered and trimmed reads were obtained from the normalized genomic DNA of pooled A. mongolicum individuals. These sequences were assembled into 2,093,593 high quality contigs, and a total of 219 simple sequence repeats loci were screened. Sixty of them were selected to validate amplification and to determine the degree of polymorphism in the genomic DNA pools. Fifteen primer pairs successfully amplified DNA fragments and detected significant amounts of polymorphism. The number of alleles in ten geographically diverse A. mongolicum populations ranged from 3 to 8 per locus. The observed and expected heterozygosities ranged from 0.350 to 0.860 and 0.516 to 0.931, respectively. Our results provide a valuable resource for A. mongolicum research.

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Bilateral totally extraperitoneal (TEP) repair of the ultrasound-diagnosed asymptomatic contralateral inguinal hernia

Abstract

Background

The aim of this series is to determine the clinical utility of routine ultrasound (US) of the contralateral, clinically normal groin when a unilateral inguinal hernia is referred for hernia repair—specifically assessing the morbidity and short-term change in quality-of-life (QoL) due to repair of this occult contralateral hernia when also repairing the symptomatic side. TEP inguinal hernia repair affords the opportunity to repair any groin hernia through the same small incisions. US detects 96.6% of groin hernias with 84.4% specificity.

Methods

234 consecutive male patients with clinically unilateral and clinically bilateral hernia were enrolled; those with a clinically unilateral hernia were sent for groin US and if positive, a bilateral TEP groin hernia repair was performed (USBH). If negative, a unilateral TEP groin hernia repair was performed (UNIH). Carolina's comfort scales (CCS) and visual analogue scores (VAS) were recorded at 2 and 6 weeks postoperatively, while a modified CCS (MCCS) was recorded for all patients preoperatively.

Results

Bilateral TEP repair resulted in higher VAS scores than unilateral repair at 2 weeks but not 6 weeks. CCS were worse in the USBH group than UNIH group at 2 weeks but were similar by 6 weeks. Complications' rates were similar amongst all 3 groups. Factors contributing to worse scores were: smaller hernia, complications, worse preoperative MCCS results, recurrent hernia and bilateral rather than unilateral repair.

Conclusion

Bilateral TEP for the clinically unilateral groin hernia with an occult contralateral groin hernia can be performed without increased morbidity, accepting a minor and very temporary impairment of QoL.

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Endoscopic submucosal dissection for esophagogastric junction tumors: a single-center experience

Abstract

Background

Surgical resection for esophagogastric junction (EGJ) tumors is more aggressive and worsens the quality of life of the patients and leads to poor prognosis even after surgery compared with tumors in other sites of the stomach. Endoscopic submucosal dissection (ESD) is a widely accepted treatment modality for premalignant lesions and early cancers in the stomach. However, EGJ tumor is one of the most technically difficult lesions to resect by ESD. Therefore, this study aimed to evaluate the therapeutic outcomes of ESD for EGJ epithelial neoplasms and to assess the predictive factors for incomplete resection.

Methods

We conducted a retrospective observational study of 48 patients who underwent ESD for adenomas and early cancers of the EGJ between March 2006 and November 2015 at the Pusan National University Hospital. Therapeutic outcomes of ESD and procedure-related adverse events were analyzed.

Results

En bloc resection, complete resection, and curative resection rates were 96, 77, and 71%, respectively. Multivariate analyses showed that the presence of ulceration was an independent predictive factor for incomplete resection (odds ratio 21.3, 95% confidence interval 1.51–298.49; p = 0.023). The procedure-related bleeding, perforation, and stenosis rates were 8, 4, and 0%, respectively; none of the adverse events required surgical intervention. During a median follow-up period of 25 months (range 6–72 months), local recurrence occurred in four patients with incomplete resection.

Conclusion

ESD is an effective, safe, and feasible treatment for EGJ epithelial neoplasms. However, the complete resection rate decreases for tumors with ulceration.

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Preliminary trial of augmented reality performed on a laparoscopic left hepatectomy

Abstract

Background

Laparoscopic liver surgery is seldom performed, mainly because of the risk of hepatic vein bleeding or incomplete resection of the tumour. This risk may be reduced by means of an augmented reality guidance system (ARGS), which have the potential to aid one in finding the position of intrahepatic tumours and hepatic veins and thus in facilitating the oncological resection and in limiting the risk of operative bleeding.

Methods

We report the case of an 81-year-old man who was diagnosed with a hepatocellular carcinoma after an intraabdominal bleeding. The preoperative CT scan did not show metastases. We describe our preferred approach for laparoscopic left hepatectomy with initial control of the left hepatic vein and preliminary results of our novel ARGS achieved postoperatively. In our ARGS, a 3D virtual anatomical model is created from the abdominal CT scan and manually registered to selected laparoscopic images. For this patient, the virtual model was composed of the segmented left liver, right liver, tumour and median hepatic vein.

Results

The patient's operating time was summed up to 205 min where a blood loss of 300 cc was recorded. The postoperative course was simple. Histopathological analysis revealed the presence of a hepatocellular carcinoma with free margins. Our results of intrahepatic visualization suggest that ARGS can be beneficial in detecting the tumour, transection plane and medial hepatic vein prior to parenchymal transection, where it does not work due to the substantial changes to the liver's shape.

Conclusions

As of today, we have performed eight similar left hepatectomies, with good results. Our ARGS has shown promising results and should now be attempted intraoperatively.

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Differences in waiting list prioritization preferences of occupational therapists, elderly people and persons with disabilities: a discrete choice experiment

Publication date: Available online 7 August 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Marie-Hélène Raymond, Louise Demers, Debbie E. Feldman
ObjectiveTo compare the preferences of occupational therapists, elderly people and adults with disabilities regarding prioritization criteria for occupational therapy waiting lists in home care.DesignDiscrete choice experiment survey. Respondents completed eight choice tasks where they were asked to choose which of two referral scenarios should be prioritized for services. Scenarios varied in terms of four attributes reflecting competing issues that come into play in waiting list prioritization: the person's ability to shower, ability to enter and exit the home, history of falls and time already spent on the waiting list.SettingThe survey was mailed to occupational therapists working in home care and community-dwelling elderly or disabled persons.InterventionsNot applicable.Participants241 home-based occupational therapists, 226 elderly persons from a bank of research participants and 247 adults with physical disabilities recruited through community organizations.Main outcome measuresThe dependent variable was whether the referral scenario was prioritized or not in each question. Results were analyzed through logistic regression using conditional logit models.ResultsPrioritization preferences differed between groups (p < 0.001). Occupational therapists most strongly prioritized people who had had a few falls (OR vs. no falls = 48.9) whereas elderly people and adults with disabilities most strongly prioritized people who were unable to enter and exit the home (OR vs. no difficulty entering and exiting the home = 30.8 for elderly people and 16.9 for persons with disabilities.)ConclusionsOur results highlight the gap between the priorities of home-based occupational therapists and their target clientele. Although further inquiry is needed to inform priority-setting, the findings emphasize the importance of public or patient involvement in decisions on waiting list prioritization.

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Risk factors for falls in community stroke survivors: A systematic review and meta-analysis

Publication date: Available online 7 August 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Tianma Xu, Lindy Clemson, Kate O'Loughlin, Natasha A. Lannin, Catherine Dean, Gerald Koh
ObjectiveTo identify the risk factors for falls in community stroke survivors.Data SourcesA comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, Cochrane Library, and Web of Science databases was conducted.Study SelectionProspective studies investigating fall risk factors in community stroke survivors were included. Reviewers in pair independently screened the articles and determined inclusion through consensus. Studies meeting acceptable quality rating using the Q-Coh were included in the meta-analysis.Data ExtractionData extraction was done in duplicate by four reviewers using a standardized data extraction sheet, and confirmed by another independent reviewer for completeness and accuracy.Data SynthesisTwenty-one articles met the minimum criteria for inclusion; risk factors investigated by three or more studies (n=16) were included in a meta-analysis. The following risk factors had strong association with all fallers: impaired mobility (OR 4.36, CI 2.68-7.10); reduced balance (OR 3.87, CI 2.39-6.26); use of sedative / psychotropic medications (OR 3.19, CI 1.36-7.48); disability in self-care (OR 2.30, CI 1.51-3.49); depression (OR 2.11, CI 1.18-3.75); cognitive impairment (OR 1.75, CI 1.02-2.99); and history of fall (OR 1.67, CI 1.03-2.72). A history of falling (OR 4.19, CI 2.05-7.01) had a stronger association with recurrent fallers.ConclusionsThis study confirms that balance and mobility problems, assisted self-care, taking sedative or psychotropic medications, cognitive impairment, depression, and history of falling are associated with falls in community stroke survivors. We recommend that any future research into falls prevention programs should consider addressing these modifiable risk factors. As the risk factors for falls in community stroke survivors are multifactorial, interventions should be multi-dimensional.

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Smiths Detection technology protects first responders against the threat of fentanyl exposure

EDGEWOOD, Md. — Smiths Detection Inc. (SDI) is at the forefront of arming first responders with solutions to safeguard against the presence of fentanyl. Working directly with international law enforcement and hazmat agencies, SDI has adapted a range of existing technologies to be able to quickly and accurately detect fentanyl and its analogues on scene. Fentanyl, if inhaled, may lead to respiratory ...

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Doctor competing in Ironman performs CPR on fellow triathlete

Dr. Patricia DeLaMora, a pediatric infectious disease physician, stopped when she saw an unconscious man on the road

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Worlds Overdose Awareness Day August 31.st 2016

Time to get the finger O u t ..! Nuff said, It Time To ACT ! If I should introduce this here,I would take my medical officer,-superior Anesthesia department aside, and ask for 5 minutes... Asked him if he knows about the overdose day?-Asked if it was ok that I spent some time/resources on organizing something..?(Knowing he had been"All in")Then I had knocked on the door to the CEO,-asked for 5 minutes. Explained what I wanted -if the hospital could contribute anything more -than to give me a little slack..?(Time/++).Then I had talked with my daily leader :-) Then right down to the town hall, with the Ambulance,-in uniform, asked for a word with the mayor, put forward the idea of something -if they could contribute something (-Loan the town hall?Technical department -Stage,-Sound eqipment,More..!(Mini Concert?)-So right to local press.Police... Are they mature enugh to lett drugs be drugs this day?-Connect in a positive way..? NGOs ..? M o s t Importent is info on Rehab./First Aid !!

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Worlds Overdose Awareness Day August 31.st 2016

Activin signaling mediates muscle-to-adipose communication in a mitochondria dysfunction-associated obesity model [Genetics]

Mitochondrial dysfunction has been associated with obesity and metabolic disorders. However, whether mitochondrial perturbation in a single tissue influences mitochondrial function and metabolic status of another distal tissue remains largely unknown. We analyzed the nonautonomous role of muscular mitochondrial dysfunction in Drosophila. Surprisingly, impaired muscle mitochondrial function via complex I...

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Deacetylase activity of histone deacetylase 3 is required for productive VDJ recombination and B-cell development [Genetics]

Histone deacetylase 3 (HDAC3) is the catalytic component of NCoR/SMRT corepressor complexes that mediate the actions of transcription factors implicated in the regulation of B-cell development and function. We crossed Hdac3 conditional knockout mice with Mb1-Cre knockin animals to delete Hdac3 in early progenitor B cells. The spleens of Hdac3F/−Mb1-Cre+/−...

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Large numbers of explanatory variables, a semi-descriptive analysis [Statistics]

Data with a relatively small number of study individuals and a very large number of potential explanatory features arise particularly, but by no means only, in genomics. A powerful method of analysis, the lasso [Tibshirani R (1996) J Roy Stat Soc B 58:267–288], takes account of an assumed sparsity of...

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Two functionally distinct E2/E3 pairs coordinate sequential ubiquitination of a common substrate in Caenorhabditis elegans development [Genetics]

Ubiquitination, the crucial posttranslational modification that regulates the eukaryotic proteome, is carried out by a trio of enzymes, known as E1 [ubiquitin (Ub)-activating enzyme], E2 (Ub-conjugating enzyme), and E3 (Ub ligase). Although most E2s can work with any of the three mechanistically distinct classes of E3s, the E2 UBCH7 is...

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Detection and quantification of inbreeding depression for complex traits from SNP data [Genetics]

Quantifying the effects of inbreeding is critical to characterizing the genetic architecture of complex traits. This study highlights through theory and simulations the strengths and shortcomings of three SNP-based inbreeding measures commonly used to estimate inbreeding depression (ID). We demonstrate that heterogeneity in linkage disequilibrium (LD) between causal variants and...

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Impact of alkaline alterations to a Brazilian soil on cesium retention under low temperature conditions

Publication date: November 2017
Source:Journal of Environmental Radioactivity, Volumes 178–179
Author(s): Jaqueline Alves de Almeida Calábria, Stela Dalva Santos Cota, Gustavo Ferrari de Morais, Ana Cláudia Queiroz Ladeira
To be used as backfilling materials in radioactive waste disposal facilities, a natural material must have a suitable permeability, mechanical properties and a high sorption capacity for radionuclides. Also important when considering a material as a backfill is the effect of its interaction with the alkaline solution generated from concrete degradation. This solution promotes mineralogical alterations that result in significant changes in the material key properties influencing its performance as a safety component of the repository. This paper presents results of an investigation on the effect of alkaline interaction under a low temperature on cesium retention properties of a local soil being considered suitable as a backfill for the Brazilian near surface disposal facility. A sample of the Brazilian soil was mixed with an alkaline solution, simulating the pore water leached in the first stage of cement degradation, during 1, 7, 14 and 28 days. The experiments were conducted under low temperature (25 °C) aiming to evaluate similar conditions found on a low and intermediate level radioactive waste disposal installation. A non-classical isotherm sorption model was fitted to sorption data obtained from batch experiments, for unaltered and altered samples, providing parameters that allowed us to assess the effect of the interaction on material quality as Cs sorbent. The sorption parameters obtained from the data-fitted isotherm were used then to estimate the corresponding retardation factor (R). Alkaline interaction significantly modified the soil sorption properties for Cs. The parameter Q, related to the maximum sorption capacity, as well as the affinity parameter (K) and the retardation coefficients became significantly smaller (about 1000 times for the R coefficient) after pretreatment with the simulated alkaline solutions. Moreover, the increase in n-values, which is related with the energy distribution width and heterogeneity of surface site energies, demonstrated that the adsorbent surface became more homogenous as a consequence of the alkaline alteration. Together these results suggest that cementitious leachate has a profound effect on Cs retention and should be accounted for estimating radionuclide retention in radioactive waste disposal systems containing cementitious materials.

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Worlds Overdose Awareness Day August 31.st 2016

Cincinnati dumping 911 system after a year of problems

Some callers got a busy signal or their calls were dropped when calling the city's 911 center

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FDNY ambulance collides with SUV while en route to call

The ambulance was near an intersection when the two vehicles collided

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Motor unit remodelling in multifocal motor neuropathy: the importance of axonal loss

Publication date: Available online 7 August 2017
Source:Clinical Neurophysiology
Author(s): Nidhi Garg, James Howells, Con Yiannikas, Steve Vucic, Arun V. Krishnan, Judith Spies, Hugh Bostock, Emily K. Mathey, John D. Pollard, Susanna B. Park, Matthew C. Kiernan
ObjectiveTo estimate the degree of axonal loss in patients diagnosed with multifocal motor neuropathy (MMN) using a novel assessment of motor unit numbers and size.MethodsAutomated motor unit number estimation using a compound muscle action potential (CMAP) scan was undertaken in median nerves with conduction block. Results were compared with 30 age-matched healthy controls.ResultsCompared with healthy controls, MMN patients had fewer motor units (MMN: 33 ± 11 vs HC: 93 ± 36 [mean ± SD]; p<0.0001) and larger 'size of the largest unit' (MMN: 1.2 ± 0.5mV vs HC: 0.4 ± 0.1mV; p<0.0001), despite having normal distal CMAP amplitudes (MMN: 7.6 ± 1.8mV vs HC: 8.7 ± 2.5mV; p=0.24).ConclusionsMMN is associated with marked axonal loss which may be masked by striking re-innervation resulting in preservation of distal CMAP amplitudes.SignificanceAssessment of motor unit properties should be incorporated into assessment of disease progression in MMN, given that nerve conduction studies are insensitive to motor unit remodelling.

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Homozygous Nonsense Mutation in SCHIP1/IQCJ-SCHIP1 Causes a Neurodevelopmental Brain Malformation Syndrome

We report a consanguineous Arab family with three affected siblings who display a disorder of global developmental delay, learning difficulties, facial dysmorphism, hearing impairments, and cataract. The clinical phenotype was associated with characteristic brain Magnetic Resonance Imaging (MRI) features of axonal guidance defects involving anterior commissure agenesis as well as scattered areas of polymicrogyria-cobblestone complex. Whole genome sequencing revealed a novel nonsense mutation (159609921C>T) that segregated in the family consistent in an autosomal recessive pattern. This mutation located in the C-terminal region shared by the Schwanomin-Interacting Protein1 (SCHIP1) isoforms including the IQCJ-SCHIP1. The in-vitro expression of SCHIP1 and IQCJ-SCHIP1 truncated mutant isoforms (NM_001197109.1; p.R209* and NM_001197114.1; p.R501*, respectively) were markedly reduced as compared to their full-length versions suggesting protein stability/folding impairment. The pathogenic nature of this mutation is supported by a previously reported mouse knockout of Schip1 isoforms, which phenocopied the human axon guidance abnormality. This is the first report of a SCHIP1/IQCJ-SCHIP1 point mutation in humans associated with a neurological-developmental phenotype.

Three siblings of a consanguineous parent with developmental delay, hearing loss, cataract, axonal guidance defects & Polymicrogyria.

Genomic organization of the SCHIP1/IQCJ-SCHIP1 isoforms with the nonsense mutation located at the C-terminal region common to all isoforms

Significant wide homozygosity blocks on chromosome 3 encompassing SCHIP1/ IQCJ-SCHIP1 locus supports the data analysis of whole genome sequencing

Sanger sequence validated the recessive segregation of this nonsense mutation in SCHIP1/IQCJ-SCHIP1.

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Bone health and SATB2-associated syndrome

ABSTRACT

SATB2-associated syndrome (SAS) is a rare disorder caused by alterations in the special AT-rich sequence-binding protein 2 (SATB2). Skeletal abnormalities such as tibial bowing, osteomalacia, osteopenia or osteoporosis have been reported suggesting a higher frequency of skeletal complications in SAS. The optimal timing, necessity, and methodology for routine assessment of bone health in individuals with SAS, however, remain unclear. We report molecular and phenotypic features of 7 individuals with SAS documented to have low bone mineral density (BMD) ascertained by dual-energy x-ray absorptiometry (DXA), often preceded by tibial bowing. The lowest BMD Z-scores ranged −2.3 to −5.6. In 4 individuals, total alkaline phosphatase levels were elevated (two with elevated bone fraction) around the time of low BMD documentation. A clinically significant fracture history and a diagnosis of pediatric osteoporosis were present in 4 individuals. Pamidronate treatment in 2 children improved BMD. In conclusion, low BMD, fractures, and tibial bowing are relatively common skeletal complications in individuals with SAS. DXA is a useful tool when evaluating a child with SAS suspected to have low BMD and the results might alter clinical management.

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A basis for human QT interval prolongation and arrhythmia risk in type 2 diabetes?

Abstract

Diabetes is well-established to be a major healthcare problem. Preclinical and clinical data suggest that diabetes influences the heart and may be associated with cardiac repolarisation abnormalities and pro-arrhythmia.

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Excellance, Inc. finishes CNG ambulance for fire department

The compressed natural gas unit burns cleaner and lowers fuel costs

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Nicotine: Sporting Friend or Foe? A Review of Athlete Use, Performance Consequences and Other Considerations

Abstract

Nicotine use amongst athletes is high and increasing, especially in team sports. This narrative review examines the rationale behind its use and evidence of its effect on physical performance, and considers important factors that should determine future research efforts. To date, ten studies have assessed muscular strength and power, sub- or maximal endurance and high-intensity exercise when nicotine (medication) or smokeless tobacco was used as an intervention. Two studies observed an ergogenic effect, one an ergolytic with the remaining seven reporting no change. These studies have notable limitations and confounding factors that include participant tolerance to nicotine, interindividual responses, the nicotine delivery system used and failure to adhere to rigorous experimental/scientific design. Further research is encouraged to address these limitations and determine the extent to which anti-doping and governing bodies should consider promoting, coordinating and monitoring any effort against nicotine and nicotine-containing substances in sports.

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Spontaneous physical activity and mediators of energy homeostasis in the hypothalamus of mice from 4 to 10 months of age

Abstract

The biological control of physical activity is poorly understood. Age decreases insulin, leptin and brain-derived neurotrophic factor (BDNF) signaling in the hypothalamus and all have been shown to modulate spontaneous physical activity (SPA). We investigated the age at which SPA starts to decline and whether this is associated with the emergence of hypothalamic insulin and leptin resistance and reduced BDNF expression. SPA (and other parameters of locomotion) and energy expenditure (EE) were determined monthly in mice from the 4^th to the 10^th month of age. Metabolic and hypothalamic analyses were performed in 4 (4 m), 6 (6 m) and 10-month-old mice (10 m). SPA, distance travelled and speed of locomotion started to decrease in 6-month-old mice. The reduction in SPA became more evident from 8 months of age. EE decreased from the 8^th month. Hypothalamic BDNF protein expression and insulin signaling did not change in the time span studied. Leptin signaling decreased in 6 m and 10 m in relation to 4 m. Compared to 4 m, 6 m and 10 m mice were glucose intolerant. In conclusion, SPA begins to fall in parallel with reduced hypothalamic leptin signaling. Metabolic impairment also manifests as SPA decreases, highlighting the need to understand the regulation of SPA to combat its decline.

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Median preoptic glutamatergic neurons promote thermoregulatory heat-loss and water consumption in mice

Abstract

The median preoptic nucleus (MnPO) serves an important role in the integration of water/electrolyte homeostasis and thermoregulation, but we have a limited understanding these functions at a cellular level. Using Cre-Lox genetic targeting of Channelrhodospin 2 in VGluT2-ires-Cre transgenic mice, we examined the effect of glutamatergic MnPO neuron stimulation in freely-behaving mice while monitoring drinking behaviour and core temperature. Stimulation produced a strong hypothermic response in 62% (13/21) of mice (core temperature: −4.6 ± 0.5°C, P = 0.001 vs. controls) caused by cutaneous vasodilation. Stimulating glutamatergic MnPO neurons also produced robust drinking behaviour in 82% (18/22) of mice. Mice that drank during stimulation consumed 912 ± 163 μL (N = 8) during a 20 min trial in the dark phase, but markedly less during the light phase (421 ± 83 μL, P = 0.0025). Also, drinking during stimulation was inhibited as water was ingested, suggesting pre-systemic feedback gating of drinking. Both hypothermia and drinking during stimulation occurred in 50% of mice tested. Anatomical mapping of the stimulation sites showed that sites associated with hypothermia were more anteroventral than those associated with drinking, although there was substantial overlap. Thus, activation of separate but overlapping populations of glutamatergic MnPO neurons produces effects on drinking and autonomic thermoregulatory mechanisms, providing a structural basis for their frequently being coordinated (e.g. during hyperthermia).

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Sweet T-bursting is the subiculum's true badge

Abstract

Extensive work on the factors that control excitability in neurons steadily reveals that cell output can be governed by voltage-gated ion channels that are expressed on a cell- or region-specific basis.

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Electroencephalographic effect of age-adjusted 1 MAC desflurane and sevoflurane in young, middle-aged, and elderly patients

Abstract

Purpose

We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia.

Methods

One hundred and twenty young (20–30 years), middle-aged (31–65 years), and elderly (66–80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation. Maintenance of anesthesia was started with an end-tidal concentration of desflurane or sevoflurane at age-adjusted 1 MAC and maintained for 10 min, followed by 1-min assessment of bispectral index (BIS), 95% spectral edge frequency (SEF95), and amplitude of the electroencephalogram taken at 10-s intervals.

Results

BIS and SEF95 in patients receiving 1 MAC desflurane were significantly lower than those receiving 1 MAC sevoflurane including all age groups [35 (29, 39) vs. 41 (38, 49); 12.53 (10.99, 13.95) Hz vs. 14.42 (12.99, 17.17) Hz median (25, 75 percentile), respectively, P < 0.001 for both]. Both BIS and SEF95 in young patients were lower than in middle-aged and elderly patients receiving either desflurane or sevoflurane (P < 0.001 for both). There were no differences in amplitude between patients receiving desflurane and sevoflurane.

Conclusions

BIS as well as SEF95 were lower in patients receiving 1 MAC desflurane than those receiving 1 MAC sevoflurane, suggesting that desflurane provides higher depth of anesthesia than sevoflurane at 1 MAC.

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Comparison of the impact of laparoscopic endometriotic cystectomy and vaporization on postoperative serum anti-Mullerian hormone levels

Abstract

Introduction

The aim of this study was to investigate the effect of laparoscopic endometriotic cystectomy and vaporization on ovarian reserve.

Methods

We prospectively analyzed the serum level of anti-Mullerian hormone (AMH) in 62 patients at four different time points— preoperatively and at 1 month, 6 months, and 1 year postoperatively. Among the 62 cases, a bilateral cystectomy was performed in 10, bilateral vaporization in 16, a unilateral cystectomy in 24, and unilateral vaporization in 12.

Results

The rate of AMH decline after unilateral cystectomy or bilateral cystectomy was higher than that after unilateral vaporization or bilateral vaporization. Age and bilaterality were associated with an AMH decline at 1 month, and age alone was associated with an AMH decline at 1 year. Moreover, being older than 38 years of age and having a revised American Society for Reproductive Medicine score >80 were independent risk factors for the non-recovery of AMH.

Conclusion

The rate of AMH decline after laparoscopic endometriotic vaporization is significantly lower than that after cystectomy. Both methods, however, have the potential to lower ovarian reserve, especially in cases of severe endometriosis or in patients older than 38 years of age.

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Osteoporosis in patients with intestinal insufficiency and intestinal failure: Prevalence and clinical risk factors

Clinical Nutrition

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Siemens to update medical scanner software to deal with security bugs

Reuters Health News

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Prevalence and influence on outcome of HER2/neu, HER3 and NRG1 expression in patients with metastatic colorectal cancer

Anti-Cancer Drugs

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Toxic waste from US pot farms alarms experts

Reuters Health News

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Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: A population-based cohort study

European Journal of Clinical Investigation

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Physician satisfaction is widespread, but raises and student loan help are hard to come by, survey says

Healthcare Finance News

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Colorectal endoscopic full-thickness resection using a novel, flat-base over-the-scope clip: A prospective study

Endoscopy

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Complete mucosal healing of distal lesions induced by twice-daily budesonide 2-mg foam promoted clinical remission of mild-to-moderate ulcerative colitis with distal active inflammation: Double-blind, randomized study

Journal of Gastroenterology

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Specific imaging characteristic of solitary necrotic nodule of the liver: Marked peripheral rim-like enhancement with internal hypointensity on longer delayed MRI

European Radiology

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HCVerso1 and 2: Faldaprevir with deleobuvir (BI 207127) and ribavirin for treatment-naïve patients with chronic hepatitis C virus genotype-1b infection

Clinical and Experimental Gastroenterology

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Comparative analysis of the EGFR, HER2, c-MYC, and MET variations in colorectal cancer determined by three different measures: Gene copy number gain, amplification status and the 2013 ASCO/CAP guideline criterion for HER2 testing of breast cancer

Journal of Translational Medicine

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Anal ulcerations in Crohn's disease: Natural history in the era of biological therapy

Digestive and Liver Diseases

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DEA proposes cutting production of some opioid painkillers

Reuters Health News

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Ambovex as a novel immunological modulator drug for the treatment of hepatocellular carcinoma (HCC) in the liver: A Phase II clinical trial

Journal of Hepatocellular Carcinoma

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Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: A systematic scoping review

Digestive Diseases and Sciences

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Inverse relationship between hepatic steatosis and hepatitis B viremia: Results of a large case control study

Journal of Viral Hepatitis

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Diagnostic accuracy of contrast-enhanced ultrasound for the differential diagnosis of hepatocellular carcinoma: ESCULAP versus CEUS-LI-RADS

European Journal of Gastroenterology & Hepatology

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Intensity-modulated radiotherapy combined with paclitaxel and platinum treatment regimens in locally advanced esophageal squamous cell carcinoma

Clinical and Translational Oncology

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Epac1, PDE4, and PKC protein expression and their correlation with AKAP95 and Cx43 in esophagus cancer tissues

Thoracic Cancer

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Durability of response after hepatitis B surface antigen seroclearance during nucleos(t)ide analogue treatment in a multiethnic cohort of chronic hepatitis B patients: Results after treatment cessation

Clinical Infectious Diseases

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Skeletal muscle mass to visceral fat area ratio is an important determinant affecting hepatic conditions of non-alcoholic fatty liver disease

Abstract

Background

Not only obesity but also sarcopenia is associated with NAFLD. The influence of altered body composition on the pathophysiology of NAFLD has not been fully elucidated. The aim of this study is to determine whether skeletal muscle mass to visceral fat area ratio (SV ratio) affects NAFLD pathophysiology.

Methods

A total of 472 subjects were enrolled. The association between SV ratio and NAFLD pathophysiological factors was assessed in a cross-sectional nature by stratification analysis.

Results

When the SV ratio was stratified by quartiles (Q ₁–Q ₄), the SV ratio showed a negative relationship with the degree of body mass index, HOMA-IR, and liver stiffness (Q ₁, 8.9 ± 7.5 kPa, mean ± standard deviation; Q ₂, 7.5 ± 6.2; Q ₃, 5.8 ± 3.7; Q ₄, 5.0 ± 1.9) and steatosis (Q ₁, 282 ± 57 dB/m; Q ₂, 278 ± 58; Q ₃, 253 ± 57; Q ₄, 200 ± 42) measured by transient elastography. Levels of leptin and biochemical markers of liver cell damage, liver fibrosis, inflammation and oxidative stress, and hepatocyte apoptosis were significantly higher in subjects in Q ₁ than in those in Q ₂, Q ₃, or Q ₄. Moreover, fat contents in femoral muscles were significantly higher in subjects in Q ₁ and the change was associated with weakened muscle strength. In logistic regression analysis, NAFLD subjects with the decreased SV ratio were likely to have an increased risk of moderate-to-severe steatosis and that of advanced fibrosis.

Conclusions

Decreased muscle mass coupled with increased visceral fat mass is closely associated with an increased risk for exacerbating NAFLD pathophysiology.

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APOBEC: From mutator to editor

Publication date: Available online 7 August 2017
Source:Journal of Genetics and Genomics
Author(s): Bei Yang, Xiaosa Li, Liqun Lei, Jia Chen
APOBECs (apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like) are a family of cytidine deaminases that prefer single-stranded nucleic acids as substrates. Besides their physiological functions, APOBEC family members were found to cause hypermutations of cancer genomes, which could be correlated with cancer development and poor prognosis. Recently, APOBEC family members have been combined with the versatile CRISPR/Cas9 system to perform targeted base editing or induce hypermutagenesis. This combination improved the CRISPR/Cas9-mediated gene editing at single-base precision, greatly enhancing its usefulness. Here, we review the physiological functions and structural characteristics of APOBEC family members and their roles as endogenous mutators that contribute to hypermutations during carcinogenesis. We also review the various iterations of the APOBEC-CRISPR/Cas9 gene-editing tools, pointing out their features and limitations as well as the possibilities for future developments.

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Regulation of cerebral blood flow and metabolism during exercise

Abstract

Cerebral function in humans is critically dependent upon continuous oxygen delivery, metabolic nutrients and active regulation of cerebral blood flow (CBF). As a consequence, cerebrovascular function is precisely titrated by multiple physiological mechanisms, characterised by complex integration, synergism and protective redundancy. At rest, adequate CBF is regulated through reflexive responses in the following order of regulatory importance: fluctuating arterial blood gases (in particularly partial pressure of carbon dioxide [PaCO₂]), cerebral metabolism, arterial blood pressure, neurogenic activity and cardiac output. Unfortunately, the magnitude that these integrative and synergistic relationships contribute to governing the CBF during exercise remains unclear. Despite some evidence indicating that CBF regulation during exercise is dependent on the changes of blood pressure, neurogenic activity and cardiac output, their role as a primary governor of the CBF response to exercise remains controversial. In contrast, the balance between PaCO₂ and cerebral metabolism continues to gain empirical support as the primary contributors to the intensity dependent changes in CBF observed during submaximal, moderate and maximal exercise. The goal of this review is to summarize the fundamental physiology and mechanisms involved in regulation of CBF and metabolism during exercise. The clinical implications of a better understanding of CBF during exercise and new research directions are also outlined.

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Πληροφορίες

Τρίτη 8 Αυγούστου 2017

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