Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026: 10/09/18

Τρίτη 9 Οκτωβρίου 2018

Editorial Board w/barcode

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Anaesthesia care team improves outcomes in surgical patients compared with solo anaesthesiologist: An observational study

BACKGROUND In anaesthesiology, little attention has been drawn to the role of anaesthesia nurses as support personnel on quality of care. OBJECTIVES To compare the impact of anaesthesia by an anaesthesiologist alone (solo anaesthesiologist) or in combination with an anaesthesia nurse (anaesthesia care team) on 30-day postoperative mortality and hospital length of stay. RESULTS Anaesthesia was performed by solo anaesthesiologists in 2832 patients and by an anaesthesia care team in 2842 patients. The two groups were comparable in respect of sex and duration of anaesthesia but differed notably for age, American Society of Anesthesiologists' physical status score and type of surgery. Propensity score matching was performed by logistic regression to adjust for baseline differences between the two groups and 2095 pairs of perfectly matched patients were formed. The latter evidenced a significantly lower 30-day mortality rate for the anaesthesia care team compared with solo anaesthesiologists (0.76 vs. 1.56%, P = 0.0014). Length of hospital stay was also significantly reduced when an anaesthesia nurse was present (4.9 ± 10.1 vs. 5.6 ± 11.5 days, P = 0.0011). CONCLUSION Anaesthesia given by the combination of an anaesthesiologist and an anaesthesia nurse is associated with decreased 30-day postoperative mortality and shorter length of stay when compared with a solo anaesthesiologist. Even if without any demonstration of causality, this emphasises the benefits of the anaesthesia care team model. TRIAL REGISTRATION CCB 325201730849. Correspondence to Patrice Forget, Anaesthesiology and Perioperative Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium Tel: +32 24773058; e-mail: forgetpatrice@yahoo.fr Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

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Genotype-by-Environment-by-Environment Interactions in the Saccharomyces cerevisiae Transcriptomic Response to Alcohols and Anaerobiosis

Next generation biofuels including longer-chain alcohols such as butanol are attractive as renewable, high-energy fuels. A barrier to microbial production of butanols is the increased toxicity compared to ethanol; however, the cellular targets and microbial defense mechanisms remain poorly understood, especially under anaerobic conditions used frequently in industry. Here we took a comparative approach to understand the response of Saccharomyces cerevisiae to 1-butanol, isobutanol, or ethanol, across three genetic backgrounds of varying tolerance in aerobic and anaerobic conditions. We find that strains have different growth properties and alcohol tolerances with and without oxygen availability, as well as unique and common responses to each of the three alcohols. Our results provide evidence for strain-by-alcohol-by-oxygen interactions that moderate how cells respond to alcohol stress.

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Phonemic fluency improved after inhibitory transcranial magnetic stimulation in a case of chronic aphasia

Twenty-six months after a left hemispheric ischemic stroke an aphasic patient showed a significant improvement in verbal fluency following ten daily sessions of inhibitory 1 Hz repetitive transcranial magnetic stimulation over the right cortex homologous to the Broca's area. No improvement was observed for other linguistic functions or for executive ones. Results confirm the segregation of neural circuitries subtending phonemic and semantic fluency and suggest a selective usefulness of the repetitive transcranial magnetic stimulation treatment. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/1hexVwJ Correspondence to Luigi Tesio, MD, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca, Via Mercalli 32, 20122 Milan, Italy Tel: +39 025 821 8150; fax: +39 025 821 8155; e-mail: luigi.tesio@unimi.it Received September 15, 2018 Accepted September 17, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Limping on split-belt treadmills implies opposite kinematic and dynamic lower limb asymmetries

Walking on a split-belt treadmill (each of the two belts running at a different speed) has been proposed as an experimental paradigm to investigate the flexibility of the neural control of gait and as a form of therapeutic exercise. However, the scarcity of dynamic investigations challenges the validity of the available findings. The aim of the present study was to investigate the dynamic asymmetries of lower limbs of healthy adults during adaptation to gait on a split-belt treadmill. Ten healthy adults walked on a split-belt treadmill mounted on force sensors, with belts running either at the same speed ('tied' condition) or at different speeds ('split' condition, 0.4 vs. 0.8 or 0.8 vs. 1.2 m/s). The sagittal power and work provided by ankle, knee and hip joints, joint rotations, muscle lengthening, and surface electromyography were recorded simultaneously. Various tied/split walking sequences were requested. In the split condition, a marked asymmetry between the parameters recorded from each of the two lower limbs, in particular from the ankle joint, was recorded. The work provided by the ankle (the main engine of body propulsion) was 4.8 and 2.2 times higher (in the 0.4 vs. 0.8, and 0.8 vs. 1.2 m/s conditions, respectively) compared with the slower side, and 1.2 and 1.1 times higher compared with the same speed in the tied condition. Compared with overground gait in hemiplegia, split gait entails an opposite spatial and dynamic asymmetry. The faster leg mimics the paretic limb temporally, but the unimpaired limb from the spatial and dynamic point of view. These differences challenge the proposed protocols of split gait as forms of therapeutic exercise. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/1hexVwJ Correspondence to Luigi Tesio, MD, Istituto Auxologico Italiano, IRCCS, Ospedale San Luca-Polo Capitanio, via Giuseppe Mercalli 30, 20122 Milan, Italy Tel: +39 025 821 8150; fax: +39 025 821 8155; e-mails: luigi.tesio@unimi.it, l.tesio@auxologico.it Received August 1, 2018 Accepted September 12, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Patient Reported Outcomes Following Surgery for Degenerative Spondylolitshtesis: Comparison of a Universal and Multi-Tier Health Care System

Study Design: Retrospective review of results from a prospectively collected Canadian cohort in comparison to published literature.Objectives: (1) To investigate whether patients in a universal health care system (HCS) have different outcomes than those in a multi-tier HCS in surgical management of degenerative spondylolisthesis (DS).(2) To identify independent factors predictive of outcome in surgical DS patients.Summary of Background Data: Canada has a national health insurance program with unique properties.

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Mutations of mitochondrial DNA are not major contributors to aging of fruit flies [Genetics]

Mammals develop age-associated clonal expansion of somatic mtDNA mutations resulting in severe respiratory chain deficiency in a subset of cells in a variety of tissues. Both mathematical modeling based on descriptive data from humans and experimental data from mtDNA mutator mice suggest that the somatic mutations are formed early in...

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2019 NAEMSP/AMR Foundation Professional Member Scholarship

AUSTIN, Texas — The NAEMSP/AMR Foundation scholarship provides reimbursement of up to $2,000 for expenses to attend the 2019 Annual Meeting in Austin. Who is eligible: Any non-physician, non-student EMS professional who is interested in becoming (or currently is) a professional member of NAEMSP® and would be a first time attendee of the NAEMSP® Annual Meeting in Austin, January...

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ZICO premix container holders now available in black

YARDLEY, Pa. — Responding to popular demand, Zico has expanded their line of premix and bar oil container storage options and is now offering each model in black as well as yellow. The Single Premix/Bar Container Holder – Black, Model QM-PMH-1-B, accommodates your choice of one cylindrical 32 oz. (3-3/8″ dia.) can or one rectangular 32 oz. (2-5/8″ x 4-1/4″) quart...

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How an unexpectedly fast stroke recovery is possible, according to a stroke survivor

Quick action by family, paramedics and doctors combined with innovative procedure made a huge difference

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Oxidative Stress and Inflammation, Key Targets of Atherosclerotic Plaque Progression and Vulnerability: Potential Impact of Physical Activity

Abstract

Atherosclerosis, a complex cardiovascular disease, is a leading cause of mortality and morbidity worldwide. Oxidative stress and inflammation are both involved in the development of atherosclerotic plaque as they increase the biological processes associated with this pathology, such as endothelial dysfunction and macrophage recruitment and adhesion. Atherosclerotic plaque rupture leading to major ischemic events is the result of vulnerable plaque progression, which is a result of the detrimental effect of oxidative stress and inflammation on risk factors for atherosclerotic plaque rupture, such as intraplaque hemorrhage, neovascularization, and fibrous cap thickness. Thus, both are key targets for primary and secondary interventions. It is well recognized that chronic physical activity attenuates oxidative stress in healthy subjects via the improvement of antioxidant enzyme capacities and inflammation via the enhancement of anti-inflammatory molecules. Moreover, it was recently shown that chronic physical activity could decrease oxidative stress and inflammation in atherosclerotic patients. The aim of this review is to summarize the role of oxidative stress and inflammation in atherosclerosis and the results of therapeutic interventions targeting them in both preclinical and clinical studies. The effects of chronic physical activity on these two key processes are then reviewed in vulnerable atherosclerotic plaques in both coronary and carotid arteries.

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MPV17 mutations in juvenile‐ and adult‐onset axonal sensorimotor polyneuropathy

Clinical Genetics, Volume 0, Issue ja, -Not available-.

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Ventilatory constraints influence physiologic dead space in heart failure

Experimental Physiology, Volume 0, Issue ja, -Not available-.

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Extracellular Hsp70 modulates the inflammatory response of CSE in NCI‐H292 cells

Experimental Physiology, Volume 0, Issue ja, -Not available-.

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The similarity of crawling mechanisms in aquatic and terrestrial gastropods

Abstract

Crawling gastropods are unique models for studying the functioning of smooth muscles and ciliated epithelia, since they cover the foot sole and are involved in locomotion, allowing for direct investigation. Two types of crawling are known: creeping by muscular waves in terrestrial gastropods such as Helix and сiliary gliding in aquatic gastropods such as Lymnaea. It was found that the smooth muscles that underlie the ciliated epithelium in Lymnaea are involved in gliding and contribute significantly to fast crawling. Thus, the locomotor apparatus is fundamentally the same in both snails and the difference between crawling reflects an adaptation to a habitat. The control of crawling speed is also the same. Tonic contraction, relaxation, and rhythmic contractions are involved in this control. During a locomotor episode, the sole length and crawling speed spontaneously change and directly correlate with each other via the contraction force of the muscle cells in the locomotory waves. Dopamine, unlike ergometrine, decreases the sole length and crawling speed. Serotonin stimulates, increases crawling and determines the number of muscle cells involved in the locomotory waves for each locomotor episode. This control (taking into account heterogeneity) apparently might exist in any other phasic smooth muscle, including vertebrates.

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ZICO Premix Container Holders now available in black

Delivering baking soda to the brain

The Journal of Physiology, Volume 0, Issue ja, -Not available-.

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Fat or Thin, exercise wins: Endurance exercise training reduces inflammatory circulating progenitor cells in lean and obese adults

The Journal of Physiology, Volume 0, Issue ja, -Not available-.

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A retrospective study of the impact of supraglottic airway devices on the appearance of neck masses in children undergoing serial magnetic resonance imaging

Pediatric Anesthesia, EarlyView.

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Gait speed and frailty status in relation to adverse outcomes in geriatric rehabilitation

Publication date: Available online 9 October 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Aparna Arjunan, Nancye M. Peel, Ruth E. Hubbard

Abstract

Objective

Both slow gait speed and higher levels of frailty are associated with adverse outcomes in community-dwelling older people. However these measures are not routinely utilised to stratify risk status in the hospital setting. Here we assessed their predictive validity in older inpatients.

Design, Setting and Participants

Participants 65 years and older were included in a prospective cohort study conducted in inpatient rehabilitation wards of a tertiary hospital.

Interventions

A frailty index (FI) was calculated from routinely collected data and gait speed (GS) was determined from a timed ten metre walk test.

Outcome measures

Adverse outcomes were longer length of stay (≥75th percentile), poor discharge outcome (discharge to a higher level of care or inpatient mortality) and inpatient delirium and falls.

Results

Of 258 participants recruited, mean (SD) age was 79 (8) and 54% were female. Mean (SD) FI on admission was 0.42 (0.13) and an FI could be derived in all participants. Mean (SD) GS was 0.26 (0.33) m/sec. Those unable to complete a timed-walk on admission (50%) were allocated a gait speed of zero. There was a weak but significant inverse relationship between FI and gait speed (correlation coefficient -0.396). Both parameters were significantly associated with longer length of stay (p<0.001), poor discharge outcome (p≤0.001) and delirium (p<0.05).The prevalence of adverse outcomes was highest in the cohort who were more frail and unable to mobilise at admission to rehabilitation.

Conclusions

FI and GS each showed predictive validity for adverse outcomes. In a geriatric rehabilitation setting, they measure different aspects of vulnerability and combining the two may add value in identifying patients most at risk.

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Effects of a patient-centered graded exposure intervention added to manual therapy for women with chronic pelvic pain: a randomized controlled trial

Publication date: Available online 9 October 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): M José Ariza-Mateos, Irene Cabrera-Martos, Araceli Ortiz-Rubio, Irene Torres-Sánchez, Janet Rodríguez-Torres, Marie Carmen Valenza

Abstract

Objective

To explore the effects of a 6-week patient-centered graded exposure intervention added to manual therapy in women with chronic pelvic pain (CPP) and fear of movement/(re)injury.

Design

Prospective three-armed randomized controlled trial.

Setting

Faculty of Health Sciences.

Participants

A total of forty-nine women with CPP and substantial fear of movement were randomly allocated to one of three groups: 1) patient-centered graded exposure intervention added to manual therapy, 2) manual therapy or 3) control group.

Interventions

The 6-week intervention consisted of 12 sessions in the group receiving manual therapy and 6 additional sessions of graded exposure therapy in the group receiving both interventions.

Main Measures

Primary outcomes were fear-avoidance behavior assessed using the Fear-Avoidance Behavior Questionaire and pain interference and severity evaluated with the Brief Pain Inventory. The secondary outcome was disability evaluated with the Oswestry Disability Index. All the variables were assessed in a blinded manner at baseline, after the treatment, and at 3-month follow-up.

Results

Our results show interaction effects (p<0.05) for all the outcomes. Graded exposure added to manual therapy is distinctly superior to manual therapy alone in maintaining improvements for long-term fear-avoidance behavior and physical functioning.

Conclusions

Graded exposure added to manual therapy is a promising approach with long-term effects for women with CPP and fear of movement/(re)injury.

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Periampullary diverticula and ERCP outcomes: A systematic review and meta-analysis

Digestive Diseases and Sciences

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Diabetes, plasma glucose, and incidence of fatty liver, cirrhosis, and liver cancer: A prospective study of 0.5 million people

Hepatology

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Metabolic features of nonalcoholic fatty liver (NAFL) in obese adolescents: Findings from a multiethnic cohort

Hepatology

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Proton pump inhibitors are associated to minimal and overt hepatic encephalopathy and increase mortality in cirrhotics

Hepatology

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Editorial Board

Publication date: November 2018

Source: International Journal of Psychophysiology, Volume 133

Author(s):

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International Organization of Psychophysiology

Publication date: November 2018

Source: International Journal of Psychophysiology, Volume 133

Author(s):

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Advanced Imaging for Barrett’s Esophagus and Early Neoplasia: Surface and Subsurface Imaging for Diagnosis and Management

Abstract

Purpose of Review

Esophageal adenocarcinoma bears one of the fastest rising incidence of any cancers and generally arises in the setting of gastroesophageal reflux and Barrett's esophagus. However, early detection of neoplasia can be challenging since most patients are asymptomatic until they progress to more advanced and less curable stages, and early dysplastic lesions can be small, multifocal, and difficult to detect. Clearly, new imaging tools are needed in light of sampling error associated with random biopsies, the current standard of practice.

Recent Findings

Advances in endoscopic imaging including virtual chromoendoscopy, confocal laser endomicroscopy, and subsurface imaging with optical coherence tomography have ushered in a new era for detecting subtle neoplastic lesions. Moreover, in light of esophagus-sparing treatments for neoplastic lesions, such tools are likely to guide ablation and follow-up management.

Summary

While there is no ideal single imaging modality to facilitate improved detection, staging, ablation, and follow-up of patients with dysplastic Barrett's esophagus, new advances in available technology, the potential for multimodal imaging, and the use of computer-aided diagnosis and biomarkers all hold great promise for improving detection and treatment.

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Association between self‐reported bruxism and anger and frustration

Journal of Oral Rehabilitation, Volume 0, Issue ja, -Not available-.

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Issue Information

Journal of Oral Rehabilitation, Volume 45, Issue 11, Page ii-iv, November 2018.

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Cover Image

Journal of Oral Rehabilitation, Volume 45, Issue 11, Page i-i, November 2018.

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The postnatal development of ultrasonic vocalization‐associated breathing is altered in glycine transporter 2‐deficient mice

The Journal of Physiology, Volume 0, Issue ja, -Not available-.

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Guardian of mitochondrial function: an expanded role of Parkin in skeletal muscle

The Journal of Physiology, Volume 0, Issue ja, -Not available-.

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Slow periodic activity in the longitudinal hippocampal slice can self‐propagate non‐synaptically by a mechanism consistent with ephaptic coupling

The Journal of Physiology, Volume 0, Issue ja, -Not available-.

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Dilutional coagulopathy in pediatric scoliosis surgery: A single center report

Pediatric Anesthesia, EarlyView.

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Anesthesia in children with osteogenesis imperfecta: Retrospective chart review of 83 patients and 205 anesthetics over 7 years

Pediatric Anesthesia, EarlyView.

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Correlates of Emergency Department Service Utilization Among U.S. Chinese Older Adults

Abstract

Older adults visit emergency departments (EDs) at a disproportionally higher rate than other age groups. Prior studies examining racial disparities in ED utilization focus on African Americans and Hispanics. There is a dearth of information on ED utilization patterns among older Asian Americans despite the evidence that ED expenditures in Asian Americans are comparable to that of Caucasians. To address this knowledge gap, we examined factors associated with ED service utilization in the largest Asian subgroup, U.S. Chinese older adults. Cross-sectional data from the Population Study of Chinese Elderly in Chicago (PINE) (N = 3,157) were used. Multivariate negative binomial regression analyses were conducted to examine significant factors associated with ED use. Higher education (rate ratio [RR] = 1.03, 95% confidence interval [CI] 1.00–1.05) and acculturation levels (RR = 1.02, CI 1.00–1.04), fewer people in the household (RR = 0.94, CI 0.88–0.99), health insurance coverage (RR = 1.34, CI 1.01–1.78), lower income (RR = 0.89, CI 0.80–0.99), poorer perceived health (RR = 0.67, CI 0.58–0.77), more functional limitations (RR = 1.09, CI 1.06–1.13) and depressive symptoms (RR = 1.04, CI 1.02–1.07), and a history of heart disease (RR = 2.28, CI 1.83–2.84), stroke (RR = 1.68, CI 1.20–2.35), cancer (RR = 1.86, CI 1.31–2.63), and hip fracture (RR = 1.42, CI 1.02–1.98) were associated with higher rates of ED visits. Our findings highlight several significant correlates of ED use in U.S. Chinese older adults. Culturally-appropriate interventions modifying these factors have the potential to decrease ED visits and improve care outcomes in this population.

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Correction to: Polymorphisms of genes involved in inflammation and blood vessel development influence the risk of varicose veins

Clinical Genetics, Volume 94, Issue 5, Page 491-491, November 2018.

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Πληροφορίες

Τρίτη 9 Οκτωβρίου 2018

Abstract

Abstract

Abstract

Objective

Design, Setting and Participants

Interventions

Outcome measures

Results

Conclusions

Abstract

Objective

Design

Setting

Participants

Interventions

Main Measures

Results

Conclusions

Abstract

Purpose of Review

Recent Findings

Summary

Abstract