Clinical Genetics, EarlyView.
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Πέμπτη 3 Μαΐου 2018
Prevalence of BRCA1/2 large genomic rearrangements in Chinese women with sporadic triple‐negative or familial breast cancer
Need a lift? Find out how one tool protects your patients and your back in 3 ways
Binder Lift's torso wrap lifting aid helps prevent injuries, shields EMS providers from fluids and improves patient comfort
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Antimicrobial Resistance Profiles of Enterohemorrhagic and Enteropathogenic Escherichia coli of Serotypes O157:H7, O26:H11, O103:H2, O111:H8, O145:H28 Compared to Escherichia coli Isolated from the Same Adult Cattle
Microbial Drug Resistance, Ahead of Print.
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A Simple Method for Visualization of Locus-Specific H4K20me1 Modifications in Living Caenorhabditis elegans Single Cells
Recently, advances in next-generation sequencing technologies have enabled genome-wide analyses of epigenetic modifications; however, it remains difficult to analyze the states of histone modifications at a single-cell resolution in living multicellular organisms because of the heterogeneity within cellular populations. Here we describe a simple method to visualize histone modifications on the specific sequence of target locus at a single-cell resolution in living Caenorhabditis elegans, by combining the LacO/LacI system and a genetically-encoded H4K20me1-specific probe, "mintbody". We demonstrate that Venus-labeled mintbody and mTurquoise2-labeled LacI can co-localize on an artificial chromosome carrying both the target locus and LacO sequences, where H4K20me1 marks the target locus. We demonstrate that our visualization method can precisely detect H4K20me1 depositions on the her-1 gene sequences on the artificial chromosome, to which the dosage compensation complex binds to regulate sex determination. The degree of H4K20me1 deposition on the her-1 sequences on the artificial chromosome correlated strongly with sex, suggesting that, using the artificial chromosome, this method can reflect context-dependent changes of H4K20me1 on endogenous genomes. Furthermore, we demonstrate live imaging of H4K20me1 depositions on the artificial chromosome. Combined with ChIP assays, this mintbody-LacO/LacI visualization method will enable analysis of developmental and context-dependent alterations of locus-specific histone modifications in specific cells and elucidation of the underlying molecular mechanisms.
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Amyotrophic lateral sclerosis – time for beta testing?
Recognized from the first descriptions of the disease by Charcot and Joffroy in 1869, amyotrophic lateral sclerosis (ALS) involves the progressive degeneration of lower motor neurons (LMN) from the spinal anterior horns and brainstem, combined with loss of upper motor neurons (UMN) from the primary motor cortex and their axonal projections through the corticospinal tract (CST). Diagnosis remains based around clinical findings of UMN and LMN signs in the same symptomatic region, with accurate detection remaining crucial for timely management of this relentlessly progressive disease.
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Oh surprise! fast ripples on scalp EEG
When I heard of the work of Anatol Bragin (Bragin et al., 1999), the recording of ripples (low amplitude brief oscillations at 80 to 250 Hz) and fast ripples (oscillations at 250 to 600 Hz) with extracellular microelectrodes in experimental epileptic rats and in epileptic patients, I thought that we should look in the human intracerebral EEG to see if such high frequencies and such events could be recorded without the complexity and limitations of microelectrodes. I was not optimistic because I thought that the difference in scale between a microelectrode of 40 micrometers in diameter and a clinical intracerebral EEG electrode having a surface of 1 or 2 mm2, 500 to 1000 times larger, was such that an event as local as the High Frequency Oscillations (HFOs) recorded by Bragin would be not be picked up by the much larger clinical electrodes.
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Differential involvement of forearm muscles in ALS does not relate to sonographic structural nerve alterations
Some neuromuscular disorders are characterized by particular patterns of muscle involvement. For instance, ocular muscle weakness in myasthenia gravis or progressive external ophthalmoplegia (CPEO); limb-girdle weakness in early muscular dystrophy syndromes; as well as predominant finger-flexion and quadriceps muscle involvement in inclusion body myositis (IBM).
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Normal sensory membrane properties in amyotrophic lateral sclerosis
In this issue of Clinical Neurophysiology, Dr. Matamala and co-authors investigated membrane properties of peripheral sensory myelinated axons in amyotrophic lateral sclerosis (ALS) (Matamala et al., this issue). The study follows the path of a long-standing tradition of renowned Australian neurologists who approach clinical neurological problems by advanced physiological methods, the tradition being started by doctors Lance and McLeod, followed by Dr. Burke (who is one of the co-authors of the paper), and currently continued by Dr.
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Sharply contoured theta waves are the human correlate of ponto-geniculo-occipital waves in the primary visual cortex
Ponto-geniculo-occipital (PGO) waves are the hallmark of REM sleep in certain animal species (Siegel 2011). In the cat, PGO waves have been recorded from the pons (Jouvet et al., 1959), the lateral geniculate nucleus of the thalamus (Mikiten et al., 1961), and the occipital cortex (Mouret et al., 1963), explaining the nomenclature now used. These waves are biphasic sharp field potentials occurring as either singlets during the transition from slow wave sleep to REM sleep (type 1) or in clusters of 3-5 spikes during REM sleep showing a high correspondence to rapid eye movements (type II) (Datta, 1997; Callaway et al., 1987; Nelson et al., 1983).
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Do you define the limits of normalcy from looking at the patient or the healthy subject? – An e-norms reply
I read with great interest Martin Ballegaard's Editorial (Ballegaard 2018) on how you define the limits of normalcy in his discussion of our e-norms paper on the lack of normative data in pediatric EMG that appeared in the March 2018 issue of Clinical Neurophysiology (Pitt and Jabre 2018).
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Tracking the central and peripheral origin of tremor
Human motor control is a highly complex process that requires extraordinary precision to achieve optimal speed and accuracy of each movement. The dysfunction of the motor control system leads to a variety of movement disorders such as parkinsonism, dystonia, and ataxia. How the nervous system governs the movements in both physiological and pathological conditions in real time remains unclear, partly due to the rather complex nature of movements and the corresponding neurophysiology. Tremor is a type of movement with enriched information (phase, frequency, and amplitude) that can be tracked in real time to correlate with oscillatory neuronal activities in the brain, providing a very unique platform to study human motor control (McAuley and Marsden, 2000).
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Reply to “Syncope is associated with electroencephalography changes” and to “Video-EEG during tilt-table testing is an invaluable aid for understanding syncope”
We appreciate the comments from Dr. Heyer (2018) on our recent publication (Muppidi et al., 2018). We acknowledge the work by Heyer et al. on EEG patterns in tilt-induced syncope and in delayed onset tilt-induced hypotension in young patients. In contrast, our retrospective study included mostly adults, with a mean age of 45 years; the youngest patient was 16 years old. In our study population only 3 out of 7 patients with syncope showed visually discernable changes on scalp EEG. This finding was surprising to us as well and the major motivation for its publication.
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Syncope is associated with electroencephalography changes
I read with interest the article by Muppidi et al., titled "The clinical utility of qualitative electroencephalography during tilt table testing" (Muppidi et al., 2018). In a retrospective study, the authors reported qualitative electroencephalography (EEG) findings during tilt-table testing among 87 patients referred for clinical evaluation. Seven patients had neurally-mediated syncope during testing, but only three developed corresponding EEG changes. The loss of consciousness with syncope is caused by impaired cerebral perfusion and consequent neuronal dysfunction.
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Video-EEG during tilt-table testing is an invaluable aid for understanding syncope
Muppidi et al. in their recent publication, addressing the clinical utility of qualitative electroencephalography (EEG) during tilt table testing (TTT), made several statements that deserve critical consideration (Muppidi et al., 2018). Most importantly, the authors stated incorrectly, referring to our work (Van Dijk et al., 2014), that we described 'multiple patterns of EEG changes with syncope' and added, also erroneously, that 'these findings have not been replicated'. In fact, we discussed just two patterns ('slow' and 'slow-flat-slow').
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Lack of correlation between phonetic magnetic mismatch field and plasma d-serine levels in humans
Language processing is crucial for human social life. However, the molecular basis of physiological responses of language processing has remained an essential challenge in the neurobiology of language, because language processing cannot be investigated by animal studies, and invasive human studies are limited by ethical considerations. Language processing ability, in its early stage of information processing, can be neurophysiologically indexed by event-related potentials (ERPs) elicited by change detection of speech sounds, called mismatch negativity (MMN).
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Removal notice to eight abstracts in ‘Abstracts of the 61st Scientific Annual Meeting of the German Society for Clinical Neurophysiology and Functional Imaging (DGKN), Leipzig, Germany, April 27–29, 2017’
These articles have been removed: please see Elsevier Policy on Article Withdrawal (https://ift.tt/2sF4ZfT).
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Characteristics of Ictal EEG in Magnetic Seizure Therapy at Various Stimulation Frequencies
Electroconvulsive therapy (ECT) is the most effective treatment for treatment-resistant and severe forms of major depression, with approximately 50-65% of patients achieving response (Coffey 1993; Heijnen et al. 2010). Despite the considerable effectiveness of ECT, only a small percentage of individuals who may benefit from the intervention go on to have treatment, often due to concerns regarding adverse cognitive effects (Chakrabarti et al. 2010).
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IFCN-endorsed practical guidelines for clinical magnetoencephalography (MEG)
These are the first IFCN-endorsed clinical guidelines for magnetoencephalography (MEG). MEG guidelines have been previously published by the American Clinical Magnetoencephalography Society (Bagic et al., 2009; Burgess et al., 2011; Bagic et al., 2017), the Japanese clinical MEG community (Hashimoto et al., 2004), and the MEG research community (Gross et al., 2013a).
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Measuring neuropathy in obese populations: Challenge accepted. Reply to “Diagnostic accuracy of neuropathy tests in obese population remains elusive”
Our manuscript "Better diagnostic accuracy of neuropathy in obesity: A new challenge for neurologists" was performed to address a current gap in our understanding of measuring neuropathy in obese populations (Callaghan et al., 2018). We determined the diagnostic characteristics of several neuropathy measures for three of the most common types of peripheral neuropathy, namely distal symmetric polyneuropathy (DSP), small fiber neuropathy (SFN), and cardiac autonomic neuropathy (CAN). We studied morbidly obese patients prior to them participating in a weight management program and defined neuropathy using the Toronto consensus definition of neuropathy, which requires only clinical information (Dyck et al., 2011).
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Diagnostic accuracy of neuropathy tests in obese population remains elusive
In their article entitled 'Better diagnostic accuracy of neuropathy in obesity' Callaghan et al. pose an intriguing question, namely 'how well do the tools we use work for the actual population in which they are needed?' (Callaghan et al., 2018). With an ever expanding, obese and often diabetic or pre-diabetic population, this question is timely and critically important to answer; however, the methods used in their study and the conclusions are disappointingly flawed.
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An improved methodology for intraoperative monitoring of the lateral spreading response during surgery for hemifacial spasm
Lee and colleagues in their study published in this issue of Clinical Neurophysiology collected an impressive number of 486 patients with hemifacial spasm (Lee et al., this issue). They presented an improved classic method of neurophysiologic detection of the lateral spreading response (LSR), during surgery for microvascular decompression for relieving of hemifacial spasm.
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Evoked potentials predict psychomotor development in neonates with normal MRI after hypothermia for hypoxic-ischemic encephalopathy
Major focus of research on neonatal hypoxic-ischemic encephalopathy (HIE) has been the identification of early markers of severe brain damage and their role in predicting severe neurological outcome. Nowadays, therapeutic hypothermia (TH) for neonatal HIE and redirection of care reduced severe outcomes. The rate of death or moderate/severe disability at 18–24 months of age decreased from 62% to 44% but, cognitive impairment at school age was unaffected (Shankaran et al., 2005; Shankaran et al., 2012; Gluckman et al., 2005; Eicher et al., 2005; Azzopardi et al., 2009, 2014; Simbruner et al., 2010; Zhou et al., 2010; Jacobs et al., 2011).
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Current allocation policy is favorable for patients with hepatocellular carcinoma waiting for liver transplantation
Patients with hepatocellular carcinoma (HCC) are a growing population of the transplantation waiting list (WL) for orthotopic liver transplantation (OLT). There is no consensus to prioritize these patients while on the WL.
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Are patient-reported outcome measures biased by method of follow-up? evaluating paper-based and digital follow-up after lumbar fusion surgery
Long-term follow-up of patient-reported outcome measures (PROM) is essential in both modern spinal care as well as in research. Lack of time and staff are commonly reported barriers to implementing long-term follow-up of PROM. Automated and digital follow-up systems for PROM collection are seeing widespread use, yet their validity and comparative effectiveness have never been evaluated.
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Imaging for low back pain: is clinical use consistent with guidelines? A systematic review and meta-analysis
The problem of imaging patients with low back pain (LBP) when it is not indicated is well recognised. The converse is also possible, although rarely considered. The extent of these two problems is presently unclear.Purpose: To estimate how commonly overuse, and also underuse, of imaging occurs in the management of LBP, and how appropriate use of imaging is assessed.
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Annular closure in lumbar microdiskectomy for prevention of reherniation: a randomized clinical trial
Patients with large annular defects following lumbar diskectomy for disk herniation are at high risk for symptomatic recurrence and reoperation.
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Outcome and safety analysis of 3D printed patient specific pedicle screw jigs for complex spinal deformities: A comparative study
Spinal deformities are very challenging to treat and have a great risk of neurological complications due to hardware placement during corrective surgery. Various techniques have been introduced to ensure safe and accurate placement of pedicle screws. Patient-specific screw guides with pre-drawn and pre-validated trajectory seems to be an attractive option.
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Anterior-posterior length discrepancy of the spinal column in adolescent idiopathic scoliosis – a 3d CT study
One of the characteristics of reported observations in adolescent idiopathic scoliosis (AIS) is that the thoracic spine is longer anteriorly than posteriorly, more pronounced around the apex than the transitional zones. This reversal of the normal kyphotic anatomy of the thoracic spine is related to questions of etiopathogenesis of AIS. The changes in the anatomy of the anterior column have been described rather in detail, however, the role of the posterior spinal column and the laminae has so far not been elucidated.
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The anatomical configuration of the splenic artery influences suprapancreatic lymph node dissection in laparoscopic gastrectomy: analysis using a 3D volume rendering program
Abstract
Background
The aim of this study is to categorize splenic artery and vein configurations, and examine their influence on suprapancreatic lymph node (LN) dissection in laparoscopic gastrectomy.
Methods
Digital Imaging and Communications in Medicine images from 169 advanced cancer patients who underwent laparoscopic gastrectomy with D2 dissection were used to reconstruct perigastric vessels in 3D using a volume rendering program (VP Planning®). Splenic artery and vein configuration were classified depending on the relative position of their lowest part in regard to the pancreas. Number of resected LNs and surgical outcomes were analyzed.
Results
The splenic artery was categorized as superficial (36.7%), middle (49.1%), and concealed (14.2%), and the splenic vein was categorized as superior (6.5%), middle (42.0%), and inferior to the pancreas (51.5%). The number of resected LNs around the proximal half of the splenic artery (#11p) and the proportion of the splenic vein located inferiorly to the pancreas were significantly higher in splenic arteries of concealed types. LN metastasis of station #7 was an independent risk factor of LN metastasis in station #11p (p = 0.010). Concealed types showed a tendency towards longer operating times, more blood loss, longer hospital stays, and a higher postoperative morbidity.
Conclusion
Concealed types of splenic artery are associated with an increased difficulty in the dissection of LN station #11p around the splenic artery. A 3D volume rendering program is a useful tool to rapidly and intuitively identify individual anatomical variations, to plan a tailored surgical strategy, and to predict potential challenges.
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Inside EMS Podcast: Why there are exceptions to every EMS rule
Our co-hosts discuss changing the focus of EMS education in order to teach today's EMT and paramedic students
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Involvement of acute neuroinflammation in postoperative delirium-like cognitive deficits in rats
Abstract
Purpose
The purpose of this study was to investigate the age-, time-, and brain region-dependent postoperative neuroinflammatory trajectory, and its association with neurocognitive outcomes in rats.
Methods
Adult and aged rats were randomly assigned to one of three groups: control, isoflurane anesthesia alone, and isoflurane anesthesia with abdominal surgery. On either postoperative day 2 (early phase) or 7 (late phase), all rats were tested for trace and context fear memory retention after acquisition of trace fear conditioning. Freezing behavior was used as an index of fear memory. Following the cognitive testing, the levels of pro-inflammatory cytokines in several brain regions were measured using enzyme-linked immunosorbent assay (n = 8 in each group).
Results
In the early postoperative period, surgery under isoflurane anesthesia induced acute neuroinflammation along with related trace and context memory dysfunction. Such acute neuroinflammatory responses were comparably observed in both adult and aged animals, whereas the aged rats were more likely to exhibit behavioral changes. On the other hand, in the late postoperative period, neither neuroinflammation in all tested brain regions nor concomitant memory decline were found in adult animals. Significant neuroinflammation was detected only in the hippocampus of aged rats, which was associated with context, but not trace memory dysfunction.
Conclusion
Our findings indicate that surgery-induced acute, transient, brain-wide neuroinflammation may be involved in the pathogenesis of the postoperative delirium-like cognitive deficits in rats. Furthermore, neuroinflammation may convert from acute to chronic in an age- and hippocampal-specific manner, likely resulting in the development of sustained cognitive dysfunction.
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National Association of EMS Physicians® recognizes National EMS Week with series of educational opportunities
OVERLAND PARK, Kan. — The National Association of EMS Physicians® (NAEMSP®) will recognize Emergency Medical Services (EMS) Week, May 20-26, to highlight the efforts of all first responders who answer the call, inclusive of more than 1,350 members. EMS Week brings together local communities and medical personnel to promote safety as well as honor the dedication of those who provide the ...
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Son Preference of Immigrants to the United States: Data from U.S. Birth Certificates, 2004–2013
Abstract
Son preference has existed for centuries in many cultures and societies. In some Asian countries, including China and India, the sex ratio at birth (SRB, number of male infants divided by number of female infants times 100) is elevated above the worldwide biological norm of about 105. We investigate whether this ratio is elevated in the U.S. for immigrant women. We analyze U.S. birth certificates for 2004–2013 and categorize births by mother's and father's race/ethnicity; mother's place of birth, and birth order of the child. The SRB is elevated for two groups of women: Chinese women born in China for children of birth order 2 and higher, and Indian women born in India for children of birth order 3 and higher. The SRB is not elevated for Chinese and Indian women born in the U.S., nor for Mexican women, Black women, nor White women, regardless of place of birth. The race/ethnicity of the child's father does not appear to be a strong factor in the SRB. In the early twenty-first century the elevated SRB for Chinese and Indian women born in China and India respectively suggests sex selection for higher order births in the U.S.
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Psychological Distress in Iranian International Students at an Australian University
Abstract
This study investigated psychological distress in Iranian international students at UNSW Australia, and explored the psychosocial factors associated with high levels of distress. A total of 180 Iranian international students pursuing undergraduate and postgraduate degrees during 2012/2013 completed an email questionnaire containing socio-demographic items and five standardized and validated scales. Multivariable logistic regression was used to analyse the predictors of psychological distress. Compared to domestic and international students at two other Australian universities, a significantly smaller proportion of Iranian international students scored as distressed on the Kessler Psychological Distress Scale (K10). Greater levels of psychological distress were associated with being female, poorer physical health, less social support, less religious involvement and spirituality, and negative attitudes towards seeking professional psychological help. Findings from this growing group of international students can help inform culturally competent mental health promotion and service provision in their host countries.
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Psychosocial Determinants of Adherence to Preventive Dental Attendance for Preschool Children Among Filipino Immigrants in Edmonton, Alberta
Abstract
Barriers to accessing oral healthcare are public health concerns faced by minorities and immigrants due to socioeconomic marginalization. Therefore, we explored how immigrant parents in Alberta-Edmonton's Filipino community experience adherence to preventive dental attendance (PDA) for their preschool children and the psychosocial factors influencing parental adherence. Methods: We employed a qualitative focused ethnography design. Data were collected through interviews and focus groups. Audiotapes of sessions were transcribed verbatim and concurrent thematic data analysis was performed. Results: Stressors, resources, paradox and structural barriers comprised emergent psychosocial themes. Upon arriving in Canada, most Filipino parents held low-priority attitudes and perceptions toward PDA. After migration, however, they embraced new knowledge about the importance of PDA for their children. Discussion: Filipino parents were open to the Western model of preventive oral healthcare, with the duration of their time in Canada playing a key role in promoting regular dental visits for their children.
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Women’s Decision-Making Autonomy and their Attitude towards Wife-Beating: Findings from the 2011 Ethiopia’s Demographic and Health Survey
Abstract
The study examined the extent of wife-beating acceptance and factors that influence women's attitude towards wife-beating in Ethiopia from a nationally representative sample of 11,658 participants in the 2011 Ethiopian Demographic and Health Survey. Multivariate logistic regressions were fitted to investigate the relationships between women's attitude towards wife-beating and women's decision-making autonomy after controlling for socio-demographic factors. The majority (56%) of women agreed that wife-beating is justified when wife neglects children, 53% when wife burns the food, 50% when wife argues with husband, 48% when wife goes out without telling husband, and nearly 45% when wife refuses to have sex with husband. Overall, 51% of women had shown highly favorable attitude towards wife-beating. Women's place of residence, household wealth quintiles, educational levels, marital status, and husband/partner's employment status have shown significant association with women's attitude towards wife-beating. Women's decision-making autonomy was also a significant predictor of women's attitude towards wife-beating. The odds of having highly favorable attitude towards wife-beating deceased significantly as the level of decision-making autonomy of women improved. Given the widespread acceptance of wife-beating among Ethiopian women, social policies that empower women could serve as a positive force in changing attitudes towards wife-beating and violence against women.
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The Influence of Hispanic Ethnicity and Nativity Status on 2009 H1N1 Pandemic Vaccination Uptake in the United States
Abstract
Previous research suggests Hispanic vaccination rates for H1N1 were similar to non-Hispanic whites. These previous estimates do not take into account nativity status. Using the 2010 National Health Interview Survey, we estimate adult H1N1 vaccination rates for non-Hispanic whites (n = 8780), U.S.-born Hispanics (n = 1142), and foreign-born Hispanics (n = 1912). To test Fundamental Cause Theory, we estimate odds of H1N1 vaccination while controlling for flexible resources (e.g., educational and economic capital), ethnicity, and nativity status. Foreign-born Hispanics experienced the lowest rates of H1N1 vaccination (15%), followed by U.S.-born Hispanics (18%) and non-Hispanic whites (21%). Regression models show odds of H1N1 vaccination did not differ among these three groups after controlling for sociodemographic characteristics. Insufficient access to flexible resources and healthcare coverage among foreign-born Hispanics was responsible for relatively low rates of H1N1 vaccination. Addressing resource disparities among Hispanics could increase vaccination uptake in the future, reducing inequities in disease burden.
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Overseas Hepatitis B Vaccinations Among Newly Arrived Cubans in Texas—2010–2015
Abstract
We assessed hepatitis B virus (HBV) serologic results among newly arrived Cubans with vaccination documentation. We matched the post-arrival health assessment HBV serologic results of Cubans who arrived during 2010–2015 in Texas with their overseas hepatitis B (HepB) vaccination records in the CDC's Electronic Disease Notification database and calculated the proportion of those immune due to HepB vaccinations. Among 2123 who had overseas HepB vaccination and serologic results, 1072 (50.5%) had three valid documented doses of HepB. Of these 1072, 441 (41.1%) were immune due to HepB vaccination, 24 (2.2%), immune due to natural infection, 599 (55.9%), susceptible to HBV, and 8 (0.7%), HBV infected. Stratified by age, 21 (87.5%) of 24 children <5 years of age showed protection, and the antibody to HepB surface antigen (anti-HBs) decreased as age increased. Our findings concurred with previous observations that anti-HBs serologic results wane over time. Many newly arrived Cubans with complete HepB vaccination records on the U.S. Department of State overseas vaccination forms might be immune despite <10 mIU/mL anti-HBs response levels.
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Adapting Meaning-Centered Psychotherapy in Advanced Cancer for the Chinese Immigrant Population
Abstract
The Chinese immigrant community faces multiple barriers to quality cancer care and cancer survivorship. Meaning-centered psychotherapy (MCP) is an empirically-based treatment shown to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in advanced cancer patients. However, it has not yet been adapted for racial and ethnic minority populations for whom the concept of "meaning" may likely differ from that of westernized White populations. In this study, we conducted a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer, in accordance with Bernal et al. ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. We conducted interviews until saturation with 11 key Chinese-serving community leaders and health professionals with a range of areas of expertise (i.e. oncology, psychology, palliative care, cancer support services), to examine community needs, priorities, and preferences within the context of the MCP intervention. Sessions were audio recorded and transcribed. The research team analyzed the transcripts using Atlas.ti. Six frequently occurring themes were identified. Interviewees described the role of the family, traditional Chinese values, cancer stigma, and social norms (e.g. saving face) in adapting MCP. Researchers and clinicians should consider the role of the family in treatment, as well as specific social and cultural values and beliefs in adapting and delivering MCP for Chinese patients with advanced cancer.
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Depression and Antidepressant Use Among Asian and Hispanic Adults: Association with Immigrant Generation and Language Use
Abstract
This research investigates the psychological well-being and usage of medical treatments by Asian and Hispanic immigrant descendants. Using data from all four waves of Add Health study, this paper focuses on two outcomes: (1) depression and (2) levels of antidepressant use by race/ethnicity, immigrant generation, and linguistic acculturation levels during adulthood. Findings reveal that depression is prevalent among Mexican Americans, other Hispanics, and Asian Americans. Furthermore, Mexican Americans and Asian Americans have reported a lower level of antidepressant use than whites, with Asian Americans attaining the lowest level when immigrant generation, language acculturation levels, and other socioeconomic factors are held constant. We also find that those who are linguistically less acculturated have much lower levels of antidepressant use than their monolingual English-speaking counterparts.
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Identification of drug target candidates of the swine pathogen Actinobacillus pleuropneumoniae by construction of protein–protein interaction network
Abstract
Porcine pleuropneumonia caused by Actinobacillus pleuropneumoniae has led to severe economic losses in the pig industry worldwide. A. pleuropneumoniae displays various levels of antimicrobial resistance, leading to the dire need to identify new drug targets. Protein–protein interaction (PPI) network can aid the identification of drug targets by discovering essential proteins during the life of bacteria. The aim of this study is to identify drug target candidates of A. pleuropneumoniae from essential proteins in PPI network. The homologous protein mapping method (HPM) was utilized to construct A. pleuropneumoniae PPI network. Afterwards, the subnetwork centered with H-NS was selected to verify the PPI network using bacterial two-hybrid assays. Drug target candidates were identified from the hub proteins by analyzing the topology of the network using interaction degree and homologous comparison with the pig proteome. An A. pleuropneumoniae PPI network containing 2737 non-redundant interaction pairs among 533 proteins was constructed. These proteins were distributed in 21 COG functional categories and 28 KEGG metabolic pathways. The A. pleuropneumoniae PPI network was scale free and the similar topological tendencies were found when compared with other bacteria PPI network. Furthermore, 56.3% of the H-NS subnetwork interactions were validated. 57 highly connected proteins (hub proteins) were identified from the A. pleuropneumoniae PPI network. Finally, 9 potential drug targets were identified from the hub proteins, with no homologs in swine. This study provides drug target candidates, which are promising for further investigations to explore lead compounds against A. pleuropneumoniae.
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Temporal stability of posterior EEG alpha over twelve years
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Craig E. Tenke, Jürgen Kayser, Jorge E. Alvarenga, Karen S. Abraham, Virginia Warner, Ardesheer Talati, Myrna M. Weissman, Gerard E. Bruder
ObjectiveWe previously identified posterior EEG alpha as a potential biomarker for antidepressant treatment response. To meet the definition of a trait biomarker or endophenotype, it should be independent of the course of depression. Accordingly, this report evaluated the temporal stability of posterior EEG alpha at rest.MethodsResting EEG was recorded from 70 participants (29 male; 46 adults), during testing sessions separated by 12 ± 1.1 years. EEG alpha was identified, separated and quantified using reference-free methods that combine current source density (CSD) with principal components analysis (PCA). Measures of overall (eyes closed-plus-open) and net (eyes closed-minus-open) posterior alpha amplitude and asymmetry were compared across testing sessions.ResultsOverall alpha was stable for the full sample (Spearman-Brown [rSB] = .834, Pearson's r = .718), and showed excellent reliability for adults (rSB = .918; r = 0.848). Net alpha showed acceptable reliability for adults (rSB = .750; r = .600). Hemispheric asymmetries (right-minus-left hemisphere) of posterior overall alpha showed significant correlations, but revealed acceptable reliability only for adults (rSB = .728; r = .573). Findings were highly comparable between 29 male and 41 female participants.ConclusionsOverall posterior EEG alpha amplitude is reliable over long time intervals in adults.SignificanceThe temporal stability of posterior EEG alpha oscillations at rest over long time intervals is indicative of an individual trait.
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Reply to “high abnormal rate in the repetitive nerve stimulation test in acute onset myasthenia gravis”
Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): Anna Rostedt Punga, Maarika Liik
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Motor unit number index correlates with disability in Charcot-Marie-Tooth disease
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Joachim Bas, Emilien Delmont, Farzad Fatehi, Emmanuelle Salort-Campana, Annie Verschueren, Jean Pouget, Marie-Noëlle Lefebvre, Aude-Marie Grapperon, Shahram Attarian
ObjectiveThe aim of this study was to assess the usefulness of motor unit number index (MUNIX) technique in Charcot-Marie-Tooth disease and test the correlation between MUNIX and clinical impairment.MethodsMUNIX technique was performed in the abductor pollicis brevis (APB), the abductor digiti minimi (ADM) and the tibialis anterior (TA) muscles in the nondominant side. A MUNIX sum score was calculated by adding the MUNIX of these 3 muscles. Muscle strength was measured using the MRC (medical research council) scale. Disability was evaluated using several functional scales, including CMT neuropathy score version 2 (CMTNSv2) and overall neuropathy limitation scale (ONLS).ResultsA total of 56 CMT patients were enrolled. The MUNIX scores of the ADM, APB and TA muscles correlated with the MRC score of the corresponding muscle (p < 0.01). The MUNIX sum score correlated with the clinical scales CMTNSv2 (r = −0.65, p < 0.01) and ONLS (r = −0.57, p < 0.01).ConclusionMUNIX correlates with muscle strength and clinical measurements of disability in patients with CMT disease.SignificanceThe MUNIX technique evaluates motor axonal loss and correlates with disability. The MUNIX sum score may be a useful outcome measure of disease progression in CMT.
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Altered motor axonal excitability in patients with cervical spondylotic amyotrophy
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Chaojun Zheng, Yu Zhu, Cong Nie, Feizhou Lu, Dongqing Zhu, Robert Weber, Jianyuan Jiang
ObjectiveTo investigate the changes in motor axonal excitability properties in cervical spondylotic amyotrophy (CSA).MethodsThreshold tracking was used to measure the median motor axons in 21 patients with CSA, 10 patients with cervical spondylotic radiculopathy (CSR) and 16 normal controls.ResultsCompared with normal controls, patients with distal-type CSA showed increased threshold electrotonus hyperpolarization (TEh [90–100]) and increased superexcitability on the symptomatic side (P < 0.05), which are suggestive of distal motor axonal hyperpolarization, presumably due to motor axonal regeneration. More importantly, compared with normal controls and CSR cases, both distal- and proximal-type CSA cases showed lower accommodation during depolarising currents (reduced S2 accommodation, decreased TEd [undershoot] and/or lower subexcitability) (P < 0.05), indicating that slow K+ conductance may be less active in motor axons in patients with CSA.ConclusionsThe present study demonstrated changes in motor axonal excitability in patients with CSA compared with both normal controls and patients with CSR.SignificanceLess expression of slow K+ conductance may confer greater instability in membrane potential in CSA, thereby presumably contributing to the increased vulnerability of motor axons in patients with CSA.
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Nerve ultrasound normal values – Readjustment of the ultrasound pattern sum score UPSS
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Alexander Grimm, Hubertus Axer, Bianka Heiling, Natalie Winter
ObjectiveReference values are crucial for nerve ultrasound. Here, we reevaluated normal nerve and fascicle cross-sectional area (CSA) values in humans and compared them to published values. Based on these data, ultrasound pattern sum score (UPSS) boundary values were revisited and readjusted.MethodsUltrasound of different peripheral nerves was performed in 100 healthy subjects at anatomically defined landmarks. Correlations with age, gender, height and weight were calculated.ResultsOverall, correspondence to other published reference values was high. Gender-dependency was found for the proximal median nerve. Dependency from height occurred in the tibial nerve (TN). Weight-dependency was not found. However, the most obvious differences were found in the TN between men >60 years and women <60 years. Thus, general boundary values were defined using the mean plus the twofold standard deviation for all subjects and nerve segments except for the TN, in which different cut-offs were proposed for elder men. Accordingly, the cut-offs for the UPSS were re-adjusted, none of the individuals revealed more than 2 points at maximum.ConclusionsThe influence of distinct epidemiological factors on nerve size is most prominent in the TN, for which thus several normal values are useful.SignificanceAdjusted reference values improve the accuracy of the UPSS.
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Reply to “Relationship between age and nerve dimensions in Charcot-Marie-Tooth disease. Do we know the reality?”
Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): Gian Maria Fabrizi, Stefano Tamburin, Tiziana Cavallaro, Giampietro Zanette
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Stroke causes a transient imbalance of interhemispheric information flow in EEG during non-REM sleep
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Frederic Zubler, Andrea Seiler, Thomas Horvath, Corinne Roth, Silvia Miano, Christian Rummel, Heidemarie Gast, Lino Nobili, Kaspar A. Schindler, Claudio L. Bassetti
ObjectiveLarge-scale connectivity, especially interhemispheric connections, plays a crucial role for recovery after stroke. Here we used methods from information theory to characterize interhemispheric information flow in wake- and sleep-EEG after cerebral ischemia.Methods34 patients with unilateral ischemic stroke were included. Symbolic Transfer Entropy (STE) was applied between bipolar EEG signals on the left and the right cerebral hemisphere during polysomnographic recordings in the acute phase and 3 months after stroke.ResultsIn the acute phase, we found a sleep stage-dependent preferred interhemispheric asymmetry: during non-REM sleep the information flow was predominantly directed from the contralesional toward the ipsilesional hemisphere. This effect was greatly reduced in a follow-up recording 3 months after stroke onset.ConclusionOur findings are consistent with functional imaging studies showing a transient hyperactivity of contralesional areas after stroke. We conclude that STE is a robust method for detecting post-stroke connectivity reorganizations, and that sleep stages have to be taken into account when assessing functional connectivity.SignificanceEEG is more widely available than functional MRI. Future studies will have to confirm whether EEG derived STE can be useful in a clinical setting during rehabilitation after stroke.
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Implementing Motor Unit Number Index (MUNIX) in a large clinical trial: real world experience from 27 centres
Source:Clinical Neurophysiology
Author(s): Christoph Neuwirth, Nathalie Braun, Kristl G. Claeys, Robert Bucelli, Christina Fournier, Mark Bromberg, Susanne Petri, Stephan Goedee, Timothée Lenglet, Ron Leppanen, Antonio Canosa, Ira Goodman, Muhammad Al-Lozi, Takuya Ohkubo, Annemarie Hübers, Nazem Atassi, Agessandro Abrahao, Andreas Funke, Martin Appelfeller, Anke Tümmler, Eoin Finegan, Jonathan D. Glass, Suma Babu, Shafeeq S. Ladha, Olga Kwast-Rabben, Raul Juntas-Morales, Amina Coffey, Vinay Chaudhry, Tuan Vu, Chow Saephanh, Colleen Newhard, Marion Zakrzewski, Esther Rosier, Nancy Hamel, Divisha Raheja, Jesper Raaijman, Toby Ferguson, Markus Weber
ObjectiveMotor Unit Number Index (MUNIX) is a quantitative neurophysiological method that reflects loss of motor neurons in Amyotrophic Lateral Sclerosis (ALS) in longitudinal studies. It has been utilized in one natural history ALS study and one drug trial (Biogen USA) after training and qualification of raters.MethodsPrior to testing patients, evaluators had to submit test-retest data of 4 healthy volunteers. Twenty-seven centers with 36 raters measured MUNIX in 4 sets of 6 different muscles twice. Coefficient of variation of all measurements had to be <20% to pass the qualification process. MUNIX COV of the first attempt, number of repeated measurements and muscle specific COV were evaluated.ResultsCOV varied considerably between raters. Mean COV of all raters at the first measurements was 12.9% ± 13.5 (median 8.7%). Need of repetitions ranged from 0 to 43 (mean 10.7 ± 9.1, median 8). Biceps and first dorsal interosseus muscles showed highest repetition rates. MUNIX variability correlated considerably with variability of compound muscle action potential.ConclusionMUNIX revealed generally good reliability, but was rater dependent and ongoing support for raters was needed.SignificanceMUNIX can be implemented in large clinical trials as an outcome measure after training and a qualification process.
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Decrease of motor cortex excitability following exposure to a 20 Hz magnetic field as generated by a rotating permanent magnet
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Eugen Gallasch, Dietmar Rafolt, Magdalena Postruznik, Shane Fresnoza, Monica Christova
ObjectivesRotation of a static magnet over the motor cortex (MC) generates a transcranial alternating magnetic field (tAMF), and a linked alternating electrical field. The aim of this transcranial magnetic stimulation (TMS) study is to investigate whether such fields are able to influence MC excitability, and whether there are parallels to tACS induced effects.MethodsFourteen healthy volunteers received 20 Hz tAMF stimulation over the MC, over the vertex, and 20 Hz tACS over the MC, each with a duration of 15 min. TMS assessments were performed before and after the interventions. Changes in motor evoked potentials (MEP), short interval intra-cortical inhibition (SICI) and intra-cortical facilitation (ICF) were evaluated.ResultsThe tACS and the tAMF stimulation over the MC affected cortical excitability in a different way. After tAMF stimulation MEP amplitudes and ICF decreased and the effect of SICI increased. After tACS MEP amplitudes increased and there were no effects on SICI and ICF.ConclusionsThe recorded single and paired pulse MEPs indicate a general decrease of MC excitability following 15 min of tAMF stimulation.SignificanceThe effects demonstrate that devices based on rotating magnets are potentially suited to become a novel brain stimulation tool in clinical neurophysiology.
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An automatic pre-processing pipeline for EEG analysis (APP) based on robust statistics
Source:Clinical Neurophysiology, Volume 129, Issue 7
Author(s): Janir Ramos da Cruz, Vitaly Chicherov, Michael H. Herzog, Patrícia Figueiredo
ObjectiveWith the advent of high-density EEG and studies of large numbers of participants, yielding increasingly greater amounts of data, supervised methods for artifact rejection have become excessively time consuming. Here, we propose a novel automatic pipeline (APP) for pre-processing and artifact rejection of EEG data, which innovates relative to existing methods by not only following state-of-the-art guidelines but also further employing robust statistics.MethodsAPP was tested on event-related potential (ERP) data from healthy participants and schizophrenia patients, and resting-state (RS) data from healthy participants. Its performance was compared with that of existing automatic methods (FASTER for ERP data, TAPEEG and Prep pipeline for RS data) and supervised pre-processing by experts.ResultsAPP rejected fewer bad channels and bad epochs than the other methods. In the ERP study, it produced significantly higher amplitudes than FASTER, which were consistent with the supervised scheme. In the RS study, it produced spectral measures that correlated well with the automatic alternatives and the supervised scheme.ConclusionAPP effectively removed EEG artifacts, performing similarly to the supervised scheme and outperforming existing automatic alternatives.SignificanceThe proposed automatic pipeline provides a reliable and efficient tool for pre-processing large datasets of both evoked and resting-state EEG.
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Editorial Board
Source:Clinical Neurophysiology, Volume 129, Issue 6
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Targeting high frequency oscillations in epilepsy
Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): Catherine J. Chu
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Deep brain stimulation and motor synergies in Parkinson’s disease
Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): E. Palermo, A. Suppa
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Relationship between age and nerve dimensions in Charcot-Marie-Tooth disease. Do we know the reality?
Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): Daniele Coraci, Claudia Loreti, Costanza Pazzaglia, Luca Padua
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High abnormal rate in the repetitive nerve stimulation test in acute onset myasthenia gravis
Source:Clinical Neurophysiology, Volume 129, Issue 6
Author(s): Ikjae Lee, Shin J. Oh
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Removal notice to eight abstracts in ‘Abstracts of the 61st Scientific Annual Meeting of the German Society for Clinical Neurophysiology and Functional Imaging (DGKN), Leipzig, Germany, April 27–29, 2017’
Source:Clinical Neurophysiology, Volume 129, Issue 6
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Comparison of effect of dexmedetomidine and lidocaine on intracranial and systemic hemodynamic response to chest physiotherapy and tracheal suctioning in patients with severe traumatic brain injury
Abstract
Purpose
Chest physiotherapy and tracheal suction cause sympathetic stimulation and increase heart rate (HR), mean arterial pressure (MAP) and intracranial pressure (ICP) which may have deleterious effect in the head injured. We planned to compare the effect of intravenous dexmedetomidine and lidocaine on intracerebral and systemic hemodynamic response to chest physiotherapy (CP) and tracheal suctioning (TS) in patients with severe traumatic brain injury (sTBI).
Methods
Prospective, randomized study in patients with sTBI, 18–60 years of age, undergoing mechanical ventilation and intraparenchymal ICP monitoring. Patients were randomized to receive either iv dexmedetomidine 0.5 mcg/kg (group I; n = 30) or iv lidocaine 2 mg/kg (group II; n = 30) over 10 min. After infusion of test drug, CP with vibrator and manual compression was performed for 2 min and TS was done over next 15–20 s. The hemodynamic response was recorded before, during and at interval of 1 min for 10 min after CP and TS. A 20% change in hemodynamic parameters was considered significant.
Results
The baseline hemodynamic (HR, MAP), intracranial (ICP, CPP) and respiratory (SPO2, AWPpeak) parameters were normal and comparable in both the groups. After dexmedetomidine infusion, MAP and CPP decreased significantly from baseline value. In group II, there was no significant change in HR, MAP, ICP and CPP. At end of CP and TS, HR, MAP and CPP in group I was lower as compared to group II. During the 10-min observation period following CP and TS, MAP and CPP in group I remained significantly lower as compared to baseline and group II. There was no significant change in value of other measured parameters.
Conclusions
Both dexmedetomidine and lidocaine were effective to blunt rise in HR, MAP and ICP in response to CP and TS in patients with sTBI. However, intravenous dexmedetomidine caused significant decrease in MAP and CPP as compared to the baseline and lidocaine.
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Quantification of kinetic rate law parameters for the dissolution of natural autunite in the presence of aqueous bicarbonate ions at high concentrations
Publication date: October 2018
Source:Journal of Environmental Radioactivity, Volumes 190–191
Author(s): Ravi Gudavalli, Yelena Katsenovich, Dawn Wellman
Uranium is a key contaminant of concern in the groundwater at U.S. Department of Energy (DOE) facilities within the United States and is a potential source of groundwater contamination and a risk to human health and the environment through discharges to surface water. Dissolved inorganic carbon (bicarbonate/carbonate) has a high affinity for complexing with uranium that is present as sorbed or unique uranium-bearing mineral phases within the sedimentary matrix. This process can result in the formation of soluble uranyl carbonate aqueous species, which are mobile under circumneutral pH conditions. This study was conducted to quantify the rate of release of uranium from the autunite mineral, (Ca[(UO2)(PO4)]2•3H2O), that was formed during polyphosphate injection to remediate uranium; the dissolution of uranium was studied as a function of the aqueous bicarbonate concentration, ranging from 25 to 100 mM. Experiments were carried out in the pH range from 7 to 11 in the temperature range of 23–90 °C via single-pass flow-through testing. Consistent with the results of previous studies (Gudavalli et al., 2013a, 2013b), the rate of uranium release from autunite exhibited minimal dependency on temperature, but was strongly dependent on pH and increasing concentrations of bicarbonate in the solution. Data obtained during these experiments were compared with results of previous experiments conducted using a low-concentration range of bicarbonate solutions (0.5–3.0 mM). An 8- to 30-fold increase in the rate of uranium release was observed in the presence of high bicarbonate concentrations at pH 7–8 compared to low bicarbonate values, while at pH 9–11, there was only a 5-fold increase in uranium rate of release with an increase in bicarbonate concentrations. The rate of uranium release was calculated to be between 5.18 × 10−8 and 1.69 × 10−7 mol m−2 s−1. The activation energy values at high and low bicarbonate concentrations were similar, with ratio values in the range of 0.6–1.0.
Graphical abstract
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Differentiation between hepatocellular carcinoma showing hyperintensity on the hepatobiliary phase of gadoxetic acid–enhanced MRI and focal nodular hyperplasia by CT and MRI
American Journal of Roentgenology
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Ribavirin dose management in HCV patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin
Liver International
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Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: A meta-analysis
European Journal of Gastroenterology & Hepatology
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Fasting blood glucose levels provide estimate of duration and progression of pancreatic cancer before diagnosis
Gastroenterology
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Class III obesity is a risk factor for the development of acute on chronic liver failure in patients with decompensated cirrhosis
Journal of Hepatology
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Relationship between Helicobacter pylori infection and bone mineral density: A retrospective cross-sectional study
BMC Gastroenterology
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Risk of GERD-related disorders in obese patients on PPI therapy: A population analysis
Obesity Surgery
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Preoperative apolipoprotein B/apolipoprotein A1 ratio: A novel prognostic factor for gastric cancer
OncoTargets and Therapy
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Lactate kinetics in handcycling under various exercise modalities and their relationship to performance measures in able-bodied participants
Abstract
Purpose
The aim of this study was to expand exercise testing in handcycling by (1) examining different approaches to determine lactate kinetics in handcycling under various exercise modalities and (2) identifying relationships between parameters of lactate kinetics and selected performance measures.
Methods
Twelve able-bodied nationally competitive triathletes performed a familiarisation, a sprint test, an incremental step test, and a continuous load trial at a power output corresponding to a lactate concentration (La) of 4 mmol l−1 (PO4) in a racing handcycle that was mounted on an ergometer. During the tests, La and heart rate (HR) were determined. As performance measures, maximal power output during the 15-s All-Out sprint test (POmax,AO15) and maximal power output during the incremental test (POmax,ST) were determined. As physiological parameters, coefficients of lactate kinetics, maximal lactate accumulation rate ( \(\dot {V}\) Lamax), maximal La following the sprint test and incremental test (Lamax,AO15, Lamax,ST) and the increase in La within the last 20 min of the continuous trial (LaCrit,CT) were determined.
Results
Mean values of POmax,AO15 (545.6 ± 69.9 W), POmax,ST (131.3 ± 14.9 W), PO4 (86.73 ± 12.32 W), \(\dot {V}\) Lamax (0.45 ± 0.11 mmol l−1 s−1), Lamax,AO15 (6.64 ± 1.32 mmol l−1), Lamax,ST (9.64 ± 2.24 mmol l−1) and LaCrit,CT (0.74 ± 0.74 mmol l−1) were in accordance to literature. \(\dot {V}\) Lamax was positively correlated with Lamax,AO15 and POmax,AO15 and negatively correlated with POmax,ST. POmax,ST was negatively correlated with Lamax,AO15. PO4 was negatively correlated with Lamax,ST.
Conclusions
\(\dot {V}\) Lamax was identified as a promising parameter for exercise testing in handcycling that can be supplemented by other parameters describing lactate kinetics following a sprint test.
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Heterogeneity and specialized functions of translation machinery: from genes to organisms
Heterogeneity and specialized functions of translation machinery: from genes to organisms
Heterogeneity and specialized functions of translation machinery: from genes to organisms, Published online: 03 May 2018; doi:10.1038/s41576-018-0008-z
Variation in the composition of translation complexes may serve as a means to regulate gene expression. How translation of select transcripts is achieved by specialized components and the role of this form of dynamic control of gene expression in disease are reviewed.from Genetics via xlomafota13 on Inoreader https://ift.tt/2waSCuY
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Comparison of a new simplified acid–base tool to the original Stewart–Figge approach: a study on cardiac surgical patients
Abstract
Purpose
To suggest a simplified method for strong ion gap ([SIG]) calculation.
Patients and methods
To simplify [SIG] calculation, we used the following assumptions: (1) the major determinants of apparent strong ion difference ([SIDa]) are [Na+], [K+] and [Cl−] (2) [Ca2+] and [Mg2+] do not contribute significantly to [SIDa] variation and can be replaced by their reference concentrations (3) physiologically relevant pH variation is at the order of 10−2 and therefore we can assume a standard value of 7.4. In the new model, [SIDa] is replaced by its adjusted form, i.e. [SIDa,adj] = [Na+] + [K+] − [Cl−] + 6.5 and [SIG] is replaced by "bicarbonate gap", i.e. [BICgap] = [SIDa,adj] − (0.25·[Albumin]) − (2·[Phosphate]) − [HCO3−]. The model was tested in 224 postoperative cardiac surgical patients.
Results
Strong correlations were observed between [SIDa,adj] and [SIDa] (r = 0.93, p < 0.0001) and between [BICgap] and [SIG] (r = 0.95, p < 0.0001). The mean bias (limits of agreement) of [SIDa,adj] − [SIDa] and of [BICgap]–[SIG] was − 0.6 meq/l (− 2.7 to 1.5) and 0.2 meq/l (− 2 to 2.4), respectively. The intraclass correlation coefficients between [SIDa,adj] and [SIDa] and between [BICgap] and [SIG] were 0.90 and 0.95, respectively. The sensitivities and specificities for the prediction of a [lactate−] > 4 meq/l were 73.4 and 82.3% for a [BICgap] > 12.2 meq/l and 74.5 and 83.1% for a [SIG] > 12 meq/l, respectively.
Conclusions
The [BICgap] model bears a very good agreement with the [SIG] model while being simpler and easier to apply at the bedside. [BICgap] could be used as an alternative tool for the diagnosis of unmeasured ion acidosis.
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Moderately heavy exercise produces lower cardiovascular, RPE, and discomfort compared to lower load exercise with and without blood flow restriction
Abstract
Purpose
To determine the acute cardiovascular and perceptual responses of low-load exercise with or without blood flow restriction and compare those responses to that of moderately heavy exercise.
Methods
Twenty-two participants completed unilateral elbow flexion exercise with a moderately heavy-load- [70% one-repetition maximum (1RM); 70/0] and with three low-load conditions (15% 1RM) in combination with 0% (15/0), 40%, (15/40) and 80% (15/80) arterial occlusion pressure. Participants exercised until failure (or until 90 repetitions per set). The cardiovascular response (arterial occlusion) was measured pre and post exercise and the perceptual responses [ratings of perceived exertion (RPE) and discomfort] were determined before and after each set of exercise.
Results
For arterial occlusion pressure, the lower-load conditions had greater change from pre to post compared to 70/00 (e.g., 15/80: 44 vs. 70/0: 34 mmHg). RPE was highest across the sets for the 15/80 condition with the other conditions having similar RPE (e.g., set 4: median rating of 17.2 for 15/80 vs. ~ 15.5 for other conditions). Ratings of discomfort were also greatest for the 15/80 condition (15/80 > 15/40 > 15/0 > 70/0). Exercise volume within the 15/0 and 15/40 conditions were similar but were significantly greater than that observed with the 15/80 and 70/0 conditions.
Conclusion
Low-load exercise to volitional failure results in a greater cardiovascular response to that of moderately heavy-load exercise. When high pressure is applied to low load exercise, there is a reduction in exercise volume but an elevated perceptual response that may be an important consideration when applying this stimulus in practice.
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Useful maneuvers for precise laparoscopic liver resection
Asian Journal of Endoscopic Surgery, EarlyView.
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Nonselective Beta-Blockers Do Not Affect Survival in Cirrhotic Patients with Ascites
Abstract
Background
The role of nonselective beta-blockers in cirrhotic patients with ascites has been recently questioned; however, definitive evidence in this regard is still lacking.
Aims
To analyze published data on the influence of nonselective beta-blockers as compared to control group on survival of cirrhotic patients with ascites.
Methods
Computerized bibliographic search on the main databases was performed. Hazard ratios from Kaplan–Meier curves were extracted in order to perform an unbiased comparison of survival estimates. Secondary outcomes were mortality in patients with refractory ascites, pooled rate of nonselective beta-blockers interruption, spontaneous bacterial peritonitis and hepato-renal syndrome incidence.
Results
Three randomized controlled trials and 13 observational studies with 8279 patients were included. Overall survival was comparable between the two groups (hazard ratio = 0.86, 0.71–1.03, p = 0.11). Study design resulted as the main source of heterogeneity in sensitivity analysis and meta-regression. Mortality in refractory ascites patients was similar in the two groups (odds ratio = 0.90, 0.45–1.79; p = 0.76). No difference in spontaneous bacterial peritonitis (odds ratio = 0.78, 0.47–1.29, p = 0.33) and hepato-renal syndrome incidence (odds ratio = 1.22, 0.48–3.09; p = 0.67) was observed. Pooled rate of nonselective beta-blockers interruption was 18.6% (5.2–32.1%).
Conclusions
Based on our findings, nonselective beta-blockers should not be routinely withheld in patients with cirrhosis and ascites, even if refractory.
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Survey of potential factors involved in the low frequency of CP5 and CP8 expression in Staphylococcus aureus isolates from mastitis of dairy cattle from Argentina, Chile, and Uruguay
Abstract
Staphylococcus aureus produces capsular polysaccharides (CPs) both in vivo and under defined culture conditions being serotypes 5 and 8 the most prevalent. S. aureus isolates that fail to produce CP5 or CP8 are defined as non-typeable (NT). Loss of capsule expression, however, may lead to S. aureus persistence in a chronically infected host. The prevalence of NT strains of S. aureus isolated from bovine mastitis varies according to the geographic origin of the strain. The aims of this work were to detect phenotypically and genotypically the capsular profile of 144 S. aureus isolated from bovine mastitis in Argentina, Chile, and Uruguay and explore the factors that are considered to be associated with capsule expression as presence of IS257, IScap, and agr typing of non-related collection. The detection of the IS257, IScap, cap genes, and agr typing was performed using PCR. The detection and quantification of capsular polysaccharide production were performed by ELISA assays. We found that 96% of the S. aureus isolates investigated carried cap5(8) genes but over 75% of strains do not express capsule in the three countries studied. However, only 6 isolates from Argentina carried the IScap element that totally suppressed the expression of the capsule, suggesting that other factors could influence on CP expression. Moreover, the agrI/NT association was statistically significant suggesting that this profile is a phenomenon observed not only in other parts of the world but also in our region.
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Spleen Regulates Hematopoietic Stem/Progenitor Cell Functions Through Regulation of EGF in Cirrhotic Hypersplenism
Abstract
Background
Hematopoietic abnormality is a common cause of cirrhotic hypersplenism (CH) complications and death; it causes serious adverse effects and is associated with bleeding, anemia, infection in CH patients. However, the underlying mechanism is unclear.
Aims
We aimed to investigate the effects of the spleen on hematopoiesis and hematopoietic stem/progenitor cells (HSPCs) in CH patients.
Methods
Eleven CH patients were enrolled to assess the effects of the spleen on HSPC functions. Hematopoietic changes were examined by flow cytometry analysis. HSPC functions were detected with colony-forming assays and in vitro cell cultures. Enzyme-linked immunosorbent assay (ELISA) was used to test the concentration of epithelial growth factor (EGF).
Results
The number of HSPCs was decreased in CH patients and was rescued after splenectomy. Serum from CH patients dysregulated HSPCs function, and serum from splenectomy patients restored the dysregulated HSPC function in vitro. The concentration of EGF was decreased in CH patients and was restored to normal level after splenectomy. EGF rescued the dysregulated HSPCs function in vitro.
Conclusions
The spleen can regulate the functions of HSPCs in CH patients by regulating EGF signaling. EGF may be a therapeutic target for CH treatment.
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Prolonged Cecal Insertion Time Is Not Associated with Decreased Adenoma Detection When a Longer Withdrawal Time Is Achieved
Abstract
Background
The association between withdrawal time and adenoma detection has been established; however, the effect of cecal insertion time on adenoma detection remains unclear.
Aim
To determine the association between cecal insertion time and adenoma detection.
Methods
This study completed a retrospective analysis of data collected in 4 prospective randomized-controlled trials related to screening and surveillance colonoscopy at a single tertiary care from 2010 to 2016. The primary outcome was cecal insertion time and its association with mean number of adenomas per patient and adenoma detection rate (ADR).
Results
1303 patients met inclusion criteria (average age 59.7 ± 8.7 years; 759 females (58.3%), and 763 Caucasians (58.6%). Mean cecal insertion time was significantly longer in patients who were female (p < 0.001), received moderate sedation (p = 0.001), had fellow involvement (p < 0.001), older (p = 0.002), and lower Boston bowel preparation scale (p < 0.001). Withdrawal time was found to increase as mean cecal insertion time increased (p < 0.001). The mean cecal insertion time was not different in patients with or without adenomas (p = 0.94). Cecal insertion time did not correlate with the mean number of adenomas or advanced adenomas per patient (p > 0.05), which was also true on Poisson regression analysis. Adenomas and advanced adenomas per patient were found to decrease when cecal insertion to withdrawal time ratios were greater than 1 (p < 0.001).
Conclusions
Prolonged cecal insertion time was not associated with a decrease in ADR, mean number of adenomas or advanced adenomas per patient. When withdrawal times were longer than cecal insertion times, the number of adenomas and advanced adenomas detected per patient was significantly improved.
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