We hypothesized that placing the arm in 90[degrees] abduction, through 90[degrees] flexion and 90[degrees] external rotation, could improve ultrasound visualization of the subclavian vein. In 49 healthy volunteers, a single operator performed a view of the subclavian vein in neutral position and abduction position. A second blinded operator measured the cross-sectional area of the subclavian vein. Abduction position increased the cross-sectional area of the subclavian vein from 124 +/- 46 (mean +/- SD) to 162 +/- 58 mm2 (P = 0.001). An increase of the cross-sectional area of >=50% was observed in 41% volunteers (95% confidence interval, 27%-56%, n = 20); this technique offers an alternative approach (maybe safer) for ultrasound-guided catheterization of the subclavian vein. (C) 2016 International Anesthesia Research Society
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Πέμπτη 5 Μαΐου 2016
Open access colonoscopy: Critical appraisal of indications, quality metrics and outcomes
In an era of cost containment and measurement of value, screening for colon cancer represents a clear target for better accountability. Bundling payment is a real possibility and will likely have to rely on open-access colonoscopy (OAC). OAC is a method to allow patients to undergo endoscopy without prior evaluation by a gastroenterologist. We conducted a cross-sectional study to evaluate the indications and outcomes among patients scheduled for OAC or traditional colonoscopy at a tertiary medical center.
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Non-alcoholic fatty liver disease fibrosis score and preclinical vascular damage in morbidly obese patients
Non-alcoholic fatty liver disease (NAFLD) is strongly related with enhanced morbidity and mortality from cardiovascular disease. In obese patients with both NAFLD and features of the metabolic syndrome, the cardiovascular risk is further increased.
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Open access colonoscopy: Critical appraisal of indications, quality metrics and outcomes
In an era of cost containment and measurement of value, screening for colon cancer represents a clear target for better accountability. Bundling payment is a real possibility and will likely have to rely on open-access colonoscopy (OAC). OAC is a method to allow patients to undergo endoscopy without prior evaluation by a gastroenterologist. We conducted a cross-sectional study to evaluate the indications and outcomes among patients scheduled for OAC or traditional colonoscopy at a tertiary medical center.
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Non-alcoholic fatty liver disease fibrosis score and preclinical vascular damage in morbidly obese patients
Non-alcoholic fatty liver disease (NAFLD) is strongly related with enhanced morbidity and mortality from cardiovascular disease. In obese patients with both NAFLD and features of the metabolic syndrome, the cardiovascular risk is further increased.
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Sonographic evaluation of lumbar interlaminar space opening in a variety of patient body positions for optimal neuraxial anesthesia delivery
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FORMULATION AND EVALUATION OF ACORUS CALAMUS GEL FOR TOPICAL CANDIDITIS
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Stimson Jose, Aswathy.C, Sruthy.T, Anusree.S.S, Deepa Sreekanth.
Traditional medicines take part an important role in treatment in many developing as well as developed countries. It emphasis the usage of herbal medicines in patients as an alternative therapy or a complimentary therapy. Herbal medicines are widely used for the treatment of skin and skin related disorders. The objective of this study is to formulate and evaluate the antifungal herbal gel, from rhizome alcoholic extract of the plant Acorus calamus, which is traditionally been used medicinally and also to make fragrances. Pleasant/Odourless Slight yellow extract with good consistency was extracted and converted into phytosomes and then into gel. The physiochemical parameters and invitro antifungal activities of Acorus calamus gel as well as the combination of honey with Acorus calamus gel are evaluated and compared with the standard; Candid B ointment(Clotrimazole1%+Beclomethasonedipropionate 0.025%).Alcoholic extract showed the presence of amino acid, carbohydrates, saponins, alkaloids, glycosides, phenolic compounds and tannins. The water soluble and acid insoluble ash values of Acorus calamus was found to be 1.7% and 2.2% respectively. The alcoholic extractive value of Acorus calamus was found to be 5% and the gel obtained was found to be easily spreadable and extrudable with pH: 6.8, ie nonirritant to skin. The zone of inhibition of Acorus calamus gel preparation found for Standard, sample A and B are 2.0 cm, 1.1cm, and 1.0cm respectively. From all of observation we can conclude that the formulation showed effective antifungal activity against Candida albicans and is quite comparable with the standard.
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EFFECT OF VITAMIN C ON HAEMATOBIOCHEMICAL PARAMETERS IN SODIUM FLUORIDE (NAF) INTOXICATED CHANNA PUNCTATUS FISHES
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
K. R Shanmugam , A. Srinivas Reddy*.
The present study was carried out to know the impact of Vitamin C on haematobiochemical parameters in Channa punctatus (Bloch) in Sodium fluoride (NaF) induced toxicity fishes. For this purpose the fishes are divided in to 7 groups and treatment was given as per the experimental protocol. Vitamin C supplementation was given to NaF fishes for 30 days and serum was separated. Then haematobiochemical parameters are like Haemoglobin (Hb), Red blood cells (RBC), White blood cells (WBC), packed cell volume (PCV), Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) are estimated. Hb, RBC, PCV, MCV, MCH, MCHC levels are decreased in NaF intoxicated fishes, where as WBC levels increased. However, with vitamin C administration all these heemetological parameters came back to near to normal levels. The present study proves that protective effect of Vitamin C in sodium fluoride intoxicated fishes.
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A NEW VALIDATED RP-HPLC METHOD FOR THE SIMULTANEOUS DETERMINATION OF SIMEPREVIR AND SOFOSBUVIR IN PHARMACEUTICAL DOSAGE FORM
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
B. Raj Kumar*, Dr. K. V.Subrahmanyam.
Simeprevir is indicated in patients with hepatitis C virus (HCV) genotype 1 for the treatment of chronic hepatitis as a combination therapy, which includes peg interferon alfa and ribavirin. Simeprevir is a protease inhibitor for HCV NS3/4A protease, which is required for replication of the virus. Simeprevir functions as a direct-acting antiviral agent because it inhibits hepatitis C viral replication by binding to and inhibiting the protease, hepatitis C virus (HCV) NS3/4A. After oral administration, simeprevir reaches its maximum plasma concentrations in 4-6 hours. SOVALDI is the brand name for sofosbuvir, a nucleotide analog inhibitor of HCV NS5B polymerase. The IUPAC name for sofosbuvir is (S)-Isopropyl 2-((S)-(((2R, 3R, 4R, 5R)-5-(2, 4-dioxo-3,4-dihydropyrimidin-1(2H)-yl)-4-fluoro-3-hydroxy-4-methyltetrahydrofuran-2-yl)methoxy)-(phenoxy)phosphorylamino)propanoate. It has a molecular formula of C22H29FN3O9P and a molecular weight of 529.45. is a hepatitis C virus (HCV) nucleotide analog NS5B polymerase inhibitor indicated for the treatment of chronic hepatitis C (CHC) infection as a component of a combination antiviral treatment regimen A novel reversed phase high performance liquid chromatography (RP-HPLC) method has been developed for the quantitative determination of Simeprevir and sobosuvir in active pharmaceutical ingredients and in its Pharmaceutical dosage form by using symmetry X-Terra C18 as stationary phase and a mobile phase containing a mixture of Acetonitrile: Water (75:25% v/v). The flow rate was 1.0 ml/min and effluent was monitored at 253nm and a peak eluted at .090, 5.289 ±0.02min and column oven temperature was maintained ambient. Calibration curve was plotted with a range from 0-30 μg/ml. The developed RP-HPLC method was validated according to the current International Conference on Harmonization (ICH) guidelines for specificity, LOD, LOQ, linearity, accuracy, precision, intermediate precision and robustness. The results of the study showed that the proposed RP-HPLC method is simple, rapid, precise and accurate, which is useful for the routine analysis of Simeprevir & Sofosbuvir in bulk drug and in its pharmaceutical dosage form.
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QUANTITATIVE PHYTOCHEMICAL AND ANTIOXIDANT STUDIES IN LEAF EXTRACTS OF MANGROVE GRASS MYRIOSTACHYA WIGHTIANA
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
M. Kiran Kumar, M. B. K. Priyanka, S. J. Mounika, Pola Sudhakar, B. V. Sandeep.
Myriostacya wightiana is a perennial mangrove grass belongs to Poaceae family, occurs in India, Bangladesh and extending to Myanmar, Malaysia and Vietnam. Due to more salinity in its habitat Myriostacya wightiana possess high antioxidant potential. The present study evaluates the phytochemicals, antioxidants and free radical scavenging activities of the Myriostacya wightiana leaf extracts. Specific extraction and estimation methods were used to quantify the phytochemicals and antioxidants. The results of in vitro studies were analysed with Mean ± Standard Deviation (SD) obtained from three independent experiments. Among the phytochemicals flavonoids were found in more concentration. i.e., 416±8.2mg/gm. highest enzymatic antioxidant activity was showed by catalase (32.7±1.555 U/mg protein) whereas lowest activity was showed by peroxidase. Carotenoids occupies the major proportion among the non enzymatic antioxidant i.e., 90.16±0 mg/g and ascorbate has least. Leaf extracts of Myriostacya wightiana shows highest percent of scavenging activity with superoxide radicals (80±6.4%). The present study revealed that Myriostacya wightiana had valuable phytochemicals, antioxidants such as enzymatic and non enzymatic which prevents oxidative damage. Because of these properties Myriostacya wightiana is referred as rich medicinal source.
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SYNTHESIS, SPECTRAL AND ANTIMICROBIAL STUDIES ON Co(II) COMPLEXES OF N-SUBSTITUTED 2-CHLORO PHENOTHIAZINES.
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Madhushree N N, Chandrashekara P G*, Umesha S.
The transition metal complexes of Co (II) has been synthesized using 2-chloro phenothiazine derivatives as main ligand and purified by recrystallization in methanol. These have been characterized by elemental analysis, IR, molar conductivity measurement, magnetic studies, TGA, UV and mass. These studies were revealed that an octahedral geometry of the type [M(L)(L1).3H2O] and [M(L)(L1).2H2O], Where M = Co(II), L is ligand, L1 is 1:10-phenathroline. All the metal complexes are mononuclear and have octahedral geometry. Synthesized metal complexes were screened for antimicrobial activities (antifungal and antibacterial) against three bacteria and three fungi using In vitro disc diffusion method. The result revealed that most of the synthesized complex compounds exhibited good antimicrobial activities.
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FORMULATION AND EVALUATION OF TOPICAL MICROSPONGE BASED GEL OF BIFONAZOLE
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Shapali A. Bagde*, Namrata C. Jadhav, Manisha S. karpe, Vilasrao J. Kadam.
Microsponges are tiny, true sponge-like spherical polymeric particles that consist of myriad of interconnecting voids within a non-collapsible structure with large porous surface. This results in a large reservoir within each microsponge, which can be loaded upto its own weight of active agents. The objective of the present work is to formulate a microsponge drug delivery system entrapped with bifonazole (BFZ) having controlled drug release with maximum antifungal activity. Microsponges were prepared using aqueous emulsion diffusion evaporation method. The gel phase was prepared by dispersing carbopol 940 in purified water and allowed to soak. Microsponges containing BFZ equivalent to 1%w/w were dispersed in propylene glycol. Preservatives were dissolved in the purified water. Aqueous solution was then mixed thoroughly into the microsponge containing solution. Finally, gel phase was incorporated into microsponge containing solution with stirring and the pH was adjusted to 6-6.5. Optimized microsponge based gel formulation showed slower flux of drug as compared to marketed formulation indicating controlled release of drug. No significant change in physical appearance as well as % drug content of optimum formulation was observed over the time period of stability studies. The BFZ loaded microsponge based gel was found to have good appearance, other micromeritic properties and entrapment efficiency along with controlled in vitro release profile of drug. Since BFZ, ethyl cellulose as well as carbopol has been reported as nonirritant for skin. The final formulation will not be irritating to skin. On the other ground of efficacy, avoidance of periods of over and under medication and improved patient compliance, microsponge based gel of BFZ will have better role in treating fungal infection of skin.
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SCREENING OF TABUBEIA ROSEA DC: FOR ANTITUBERCULOSIS, ANTIBACTERIAL AND ANTIOXIDANT STUDIES; AN IN VITRO APPROACH
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Suriyamurthy Anupriya, Rajamani Aravind, Kannan Elangovan, Kandasamy Murugesan*.
The aim and objective of this study, to screen phytochemical components which is responsible for antimycobacterial, antibacterial and the antioxidant activities. This study deals with the antimycobacterial activity of Tabubeia rosea against H37RV and MDR clinical isolate of Mycobacterium tuberculosis. Tuberculosis (TB) kills approximately two million peoples annually. The results revealed that 500 μg/mL of the methanolic extract possessed significant antimycobacterial activity against H37RV strain of M. tuberculosis and on the other hand, methanolic extract at 100 μg/mL inhibited the growth of clinically isolated strain of M. tuberculosis. Besides antibacterial activity was tested against 5 human pathogens such as Escherichia coli, Bacillus subtilis, Micrococcus luteus, Staphylococcus aureus and Pseudomonas aeruginosa. Among all the pathogens, Escherichia coli was found to be highly susceptible (18 mm) was recorded at 100 μg/mL. In vitro antioxidant activities revealed that methanolic extract could be a promising source of natural antioxidants. The results confirmed traditional use of Tabubeia rosea extract to fight against tuberculosis.
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INVESTIGATION OF MACROLICHENS FOR ANTIFUNGAL POTENTIALITY AGAINST PHYTOPATHOGENS
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Rashmi Shivanna, Rajkumar H. Garampalli*.
In the present study fungicidal potential of four macrolichens Heterodermia comosa, Parmotrema margaritatum, Pseudocyphellaria aurata and Ramalina farinacea were evaluated against plant pathogenic fungi Fusarium oxysporum and Fusarium solani. The hot crude extract was extracted from solvent methanol, ethyl acetate and acetone. The highest yield of 157 mg/ml was obtained from methanol extract of Pseudocyphellaria aurata. Important phytochemical constituents like tannins, alkaloids, carbohydrates and steroids were present in most of the lichen extracts tested. Antifungal activity of the extracts was evaluated by well diffusion assay, micro dilution assay and TLC bioautographic technique. The ethyl acetate extract of Ramalina farinacea showed highest zone of inhibition against Fusarium oxysporum with 17.0±1.0 mm and Fusarium solani with 13.3±0.57 mm. Micro dilution assay showed least MIC value of 0.781 mg/ml from Ramalina farinacea and Heterodermia comosa in ethyl acetate extracts against Fusarium oxysporum and 3.125 mg/ml against Fusarium solani. Clear zones of fungal inhibition were obtained on chromatogram in the ethyl acetate extract of Parmotrema margaritatum at Rf value 0.1, 0.21, 0.48. The obtained results prove that lichens can be used as potential antifungal agents against phytopathogens. Hence lichens serves as better natural fungicides in order to keep the environment safe, and which may also increase the yield and production of the crops. Further work could be focused on the isolation and purification of active components from the studied lichens.
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SYNTHESIS, CHARACTERIZATION AND EVALUATION OF ANTI-MICROBIAL, ANTI-INFLAMMATORY AND ANTI-CANCER ACTIVITY OF DERIVATIVES OF ISOFLAVANOIDS
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Alex Martin*, Dr. Rakesh Kr Jat.
The synthesis of 7-O substituted Isoflavanone [3-(4-methoxyphenyl)-4H-chromen-4-ones] was crried out by treating p-methoxyphenylacetic acid and resorcinol in the presence of anhydrous zinc chloride and phosphorous oxychloride to yield 1-(2,4-dihydroxyphenyl)-2-(4-methoxyphenyl)ethanone. 1-(2,4-dihydroxyphenyl)-2-(4-methoxyphenyl)ethanone is then treated with N,N-dimethyl(chloromethylene) ammonium chloride to yield 7-hyroxy-3-(4-methoxyphenyl)-4H-chromen-4-one. The resulting compound on subsequent addition with acid chlorides yields the title compounds. The structure of the newly synthesized compounds was established on the basis of physiochemical analysis and spectral analysis such as IR, H1-NMR and Mass Spectral data. The synthesized derivatives are evaluated for their anti-microbial, anti-inflammatory and anticancer activity.
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SEARCH FOR BIOLOGICAL ACTIVE THIAZOLIDINEDIONE: A SHORT REVIEW
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Mousumi Shyam, Biplab Debnath,* Prithesh Devbhuti.
Thiazolidinedione and its analogs are versatile substrates, which can be used for the synthesis of numerous heterocyclic compounds. Thiazolidinedione and its derivatives are used in organic synthesis and they are used in evaluating new product that possesses different biological activities. This review covers updated information on the most active thiazolidinedione derivatives that have been reported to show considerable pharmacological actions such as antimicrobial, antiviral, anticonvulsant, anti-inflammatory and analgesic. From these results, ideas for future molecular modifications leading to compounds with greater favorable pharmacological properties may be derived. Further we can conclude that many other derivatives of thiazolidione can be synthesized which will be expected to show potent pharmacological activities.
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IN VITRO AND IN VIVO CHARACTERIZATION OF CEFACLOR LOADED FLOATING MICROSPHERES
2016-05-05T19-36-43Z
Source: Indo American Journal of Pharmaceutical Research
Swathi Chilukala*, Vijaya Kumar Bontha, Rajeswara Rao Pragada.
Cefaclor loaded floating microspheres were formulated for enhancing gastric residence time to improve its oral absorption and to get sustained drug delivery and evaluated for in vitro and in vivo studies. Microspheres were prepared by using HPMC K4M and ethyl cellulose as the rate controlling polymers by emulsion solvent evaporation technique. The formulated floating microspheres were characterized for their yield, particle size, encapsulation efficiency, in vitro drug release and buoyancy. The optimized formulation (F6) showed 93.6±1.25% of drug release after 12h and 78.8±2.5% of entrapment efficiency. All the formulations have good buoyancy which were floated over 12h in the dissolution medium. Optimized formulation was studied for in vivo pharmacokinetic activity. Optimized formulation treated group shown significant (p
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Y chromosome b2/b3 deletions and male infertility: A comprehensive meta-analysis, trial sequential analysis and systematic review
Publication date: Available online 4 May 2016
Source:Mutation Research/Reviews in Mutation Research
Author(s): Sandeep Kumar Bansal, Gopal Gupta, Singh Rajender
The correlation of Y-chromosome b2/b3 partial deletions with spermatogenic failure remains dubious. We undertook a systematic review of the literature followed by meta-analyses and trial sequential analyses in order to compare the frequency of b2/b3 deletions between oligo/azoospermic infertile and normozoospermicmen. Out of twenty-four studies reviewed for meta-analysis, twenty reported no correlation between this deletion and male infertility and two studies each reported a direct and inverse correlation. In the collective analysis, 241 out of 8892 (2.71%) oligo/azoospermic individuals and 118 out of 5842 (2.02%) normozoospermic controls had a b2/b3 deletion, suggesting a relatively higher frequency of deletions in the cases. Eventually, meta-analysis showed a significant correlation between b2/b3 deletions and the risk of spermatogenic loss/infertility (Fixed model: OR=1.313, 95% CI=1.04–1.65, p=0.02; Random model: OR=1.315, 95% CI=1.02–1.70, p=0.037). Further meta-analysis on studies grouped by ethnicity and geographic regions showed that the b2/b3 deletions are significantly associated with spermatogenic loss/infertility in Mongolians, Nigro-Caucasians, East Asians and Africans, but not in Caucasians, Europeans, South Asians and Dravidians. In summary, the Y-chromosome b2/b3 deletions increase infertility risk; however, it may be significant only in the Mongolian populations and the East Asian region.
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Short-term increases in pressure and shear stress attenuate age-related declines in endothelial function in skeletal muscle feed arteries
Abstract
Purpose
We tested the hypothesis that exposure to a short-term (1 h) increase in intraluminal pressure and shear stress (SS), to mimic two mechanical signals associated with a bout of exercise, improves nitric oxide (NO)-mediated endothelium-dependent dilation in aged soleus muscle feed arteries (SFA). In addition, we hypothesized that pressure and SS would interact to produce greater improvements in endothelial function than pressure alone.
Methods
SFA from young (4 months) and old (24 months) Fischer 344 rats were cannulated and pressurized at 90 (P90) or 130 (P130) cmH2O and exposed to no SS (0 dyn/cm2) or high SS (~65 dyn/cm2) for 1 h. At the end of the 1 h treatment period, pressure in all P130 SFA was set to 90 cmH2O and no SS (0 dyn/cm2) for examination of endothelium-dependent [flow and acetylcholine (ACh)] and endothelium-independent [sodium nitroprusside (SNP)] dilation. To evaluate the contribution of NO, vasodilator responses were assessed in the presence of Nω-nitro-l -arginine (L-NNA).
Results
Flow- and ACh-induced dilations were impaired in Old P90 SFA. Treatment with increased pressure + SS for 1 h improved flow- and ACh-induced dilations in old SFA. The beneficial effect of pressure + SS was abolished in the presence of L-NNA and was not greater than treatment with increased pressure alone.
Conclusion
These results indicate that short-duration increases in pressure + SS improve NO-mediated endothelium-dependent dilation in aged SFA; however, pressure and SS do not interact to produce greater improvements in endothelial function than pressure alone.
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Modality determines V O 2max achieved in self-paced exercise tests: validation with the Bruce protocol
Abstract
Purpose
The Bruce protocol is traditionally used to assess maximal cardiorespiratory fitness (VO2max), but may have limitations, such as an unknown duration and large work rate increases. The use of self-paced VO2max tests (SPVs) may be beneficial if they are able to elicit similar maximal values in a set period of time. In addition, differences in modality between SPVs have not been explored. The purpose of this study was to compare SPVs, utilizing two different modes, with the Bruce (treadmill) protocol.
Method
Thirteen healthy, recreationally active individuals (eight men, five women) volunteered and participated in three different laboratory visits with each utilizing a different VO2max testing protocol. The first visit consisted of the Bruce protocol test, and the remaining visits entailed a maximal SPV on a treadmill (TM SPV) and a cycle ergometer (CE SPV).
Results
There were no differences in VO2max values between the TM SPV and the Bruce protocol tests (55.6 ± 4.9 vs. 56.2 ± 6.8, respectively; p = .510). As expected, the CE SPV (48.3 ± 7.6) was significantly lower than the other two tests (p < .001).
Conclusion
The TM SPV was as effective in eliciting an accurate VO2max as the Bruce protocol and did so with less incline and in less time suggesting that there are no changes in the limits of VO2max even when the test is self-paced and perceptually regulated.
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Posttraumatic Stress Symptoms and their Relationship to Drug and Alcohol use in an International Sample of Latino Immigrants
Abstract
We identify the prevalence and correlates of posttraumatic stress (PTSD) symptoms and their relationship to alcohol and substance use disorders (AUD/SUD) among Latino immigrants in two countries. A screening battery assessing PTSD symptoms (PCL-C), alcohol use (AUDIT), drug abuse (DAST), and psychological measures was administered to 562 Latino immigrants recruited in clinics. We used logistical regression analyses to evaluate the relationship between PTSD symptoms and AUD/SUD. Prevalence of elevated PTSD symptoms was high (53.7 % in Boston, 47.9 % in Madrid and, 43.8 % in Barcelona). Screening positive for psychological measures was significantly correlated to screening positive on the PCL-C (p < 0.001). Significant gender differences in risk of AUD/SUD were moderated by PTSD symptoms. Presence of any PTSD symptoms predicted problems with benzodiazepine misuse. Given the high rates of co-morbidity between PTSD symptoms and AUD/SUD, we recommend early interventions for dual pathology for Latino immigrants with trauma history.
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Sıcak Hava Dalgaları ve Korunma
2016-05-05T16-11-15Z
Source: TAF Preventive Medicine Bulletin
Ömer Faruk Tekbaş.
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İçme ve Kullanma Sularının Kullanımında Dikkat Edilecek Hususlar
2016-05-05T16-11-15Z
Source: TAF Preventive Medicine Bulletin
Ömer Faruk Tekbaş, Recai Oğur.
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Time-frequency analysis of the EEG mu rhythm as a measure of sensorimotor integration in the latter stages of swallowing
Source:Clinical Neurophysiology
Author(s): M. Cuellar, A.W. Harkrider, D. Jenson, D. Thornton, A. Bowers, T. Saltuklaroglu
ObjectiveElectroencephalography (EEG) was used to map the temporal dynamics of sensorimotor integration relative to the strength and timing of muscular activity during swallowing.Methods64-channel EEG data and surface electromyographic (sEMG) data were recorded from 25 neurologically-healthy adults during swallowing and tongue-tapping. Events were demarcated so that sensorimotor activity primarily from the pharyngeal and esophageal phases of swallowing could be compared to activity resulting from tongue tapping.ResultsIndependent component analysis identified bilateral clusters of sensorimotor mu components localized to the premotor and primary motor cortices as well as an infrahyoid myogenic cluster. Subsequent event-related spectral perturbations (ERSP) analyses showed event-related desynchronization (ERD) in the spectral power in the alpha (8-13 Hz) and beta (15-25 Hz) frequency bands of the mu clusters in both tasks. Mu ERD was stronger during swallowing when compared to tongue tapping (pFDR<.05) and the differences in sensorimotor processing between conditions was greater in the right hemisphere than the left, suggesting stronger right hemisphere lateralization for swallowing than tongue-tapping.ConclusionMu activity was interpreted as representing a normal feed forward and feedback driven sensorimotor loop during the later stages of swallowing.SignificanceResults support further use of this novel neuroimaging technique to concurrently map neural and muscle activity during swallowing in clinical populations using EEG.
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Quick and accurate quantification of the premature brain
Source:Clinical Neurophysiology
Author(s): Catherine J. Chu
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Assessment of the upper motor neurone in amyotrophic lateral sclerosis
Source:Clinical Neurophysiology
Author(s): William Huynh, Neil G. Simon, Julian Grosskreutz, Martin R. Turner, Steve Vucic, Matthew C. Kiernan
Clinical signs of upper motor neuron (UMN) involvement are an important component in supporting the diagnosis of amyotrophic lateral sclerosis (ALS), but are often not easily appreciated in a limb that is concurrently affected by muscle wasting and lower motor neuron degeneration, particularly in the early symptomatic stages of ALS. Whilst recent criteria have been proposed to facilitate improved detection of lower motor neuron impairment through electrophysiological features that have improved diagnostic sensitivity, assessment of upper motor neuron involvement remains essentially clinical. As a result, there is often a significant diagnostic delay that in turn may impact institution of disease-modifying therapy and access to other optimal patient management. Biomarkers of pathological UMN involvement are also required to ensure patients with suspected ALS have timely access to appropriate therapeutic trials. The present review provides an analysis of current and recently developed assessment techniques, including novel imaging and electrophysiological approaches used to study corticomotoneuronal pathology in ALS.
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Changes in electrocorticographic beta frequency components precede spreading depolarization in patients with acute brain injury
Source:Clinical Neurophysiology
Author(s): Daniel N. Hertle, Marina Heer, Edgar Santos, Michael Schöll, Christina M. Kowoll, Christian Dohmen, Jennifer Diedler, Roland Veltkamp, Rudolf Graf, Andreas W. Unterberg, Oliver W. Sakowitz
ObjectiveSpreading depolarization (SD) occurs after traumatic brain injury, subarachnoid hemorrhage, malignant hemispheric stroke and intracranial hemorrhage. SD has been associated with secondary brain injury, which can be reduced by ketamine. In this present study frequency bands of electrocorticographic (ECoG) recordings were investigated with regards to SDs.MethodsA total of 43 patients after acute brain injury were included in this retrospective and explorative study. Relative delta 0.5-4 Hz, theta 4-8 Hz, alpha 8-13Hz and beta 13-40 Hz bands were analyzed with regards to SD occurrence and analgesic and sedative administration. Higher frequencies, including gamma 40-70 Hz, fast gamma 70-100 Hz and high frequency oscillations 100-200Hz were analyzed in a subset of patients with a sampling rate of up to 400Hz.ResultsA close association of relative beta frequency and SD was found. Relative beta frequency was suppressed up to two hours prior to SD when compared to hours with no SD. This finding was partially explained by administration of ketamine. Even after removal of all patient data during administration of ketamine, SDs occurred predominantly during times with low relative beta frequency in a patient-independent analysis.ConclusionSuppression of beta frequency by ketamine or without ketamine is associated with low SD counts.SignificanceAlteration of beta frequency might help to predict occurrence of SDs in acutely brain injured patients.
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Association of Bisphenol A Exposure with Breastfeeding and Perceived Insufficient Milk Supply in Mexican Women
Abstract
Introduction Estrogen inhibits lactation and bisphenol A (BPA) is a high production environmental estrogen. We hypothesize an inhibitory effect of BPA on lactation and aim to analyze the association between third trimester pregnancy urinary BPA and breastfeeding rates 1 month postpartum. Methods Odds ratios (OR) and 95 % confidence intervals (95 % CI) of breastfeeding and perceived insufficient milk supply (PIM) in relation to maternal peripartum urinary BPA concentrations were calculated in 216 mothers. Results 97.2 % of mothers in the lowest BPA tertile were breastfeeding at 1 month postpartum, compared to 89.9 % in highest (p = 0.01). Adjusted ORs (95 % CI) for not breastfeeding at 1 month were 1.9 (0.3, 10.7) and 4.3 (0.8, 21.6) for second and third BPA tertiles, respectively, compared to the lowest (p = 0.06, trend). 4.2 % reported PIM in the lowest BPA tertile, compared to 8.7 % in the highest (p = 0.03). Adjusted ORs (95 % CI) for PIM were 1.8 (0.4, 7.7) and 2.2 (0.5, 9.5), for the second and third BPA tertiles, respectively, compared to the lowest (p = 0.29, trend). Discussion These results suggest an association between maternal BPA exposure and decreased breastfeeding.
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'Stayin' Alive': Pa. school teaches students CPR
The training was a hit with the students as they compressed CPR manikins to the beat of the music
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In Healthy Women, Variation of TSH in The Normal Range or Thyroid Autoimmunity Is Not Associated with Fecundity, Pregnancy Loss, or Live Birth
Clinical Thyroidology May 2016, Vol. 28, No. 5: 140-143.
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Older Age at Graves’ Onset, Longer Duration of Graves’ Disease, and Smoking Are Associated with Graves’ Orbitopathy Risk
Clinical Thyroidology May 2016, Vol. 28, No. 5: 133-135.
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Does BRAF V600E, BRAF-wt, or BRAF Pseudogene Expression Predict Aggressiveness of Papillary Thyroid Carcinoma?
Clinical Thyroidology May 2016, Vol. 28, No. 5: 150-152.
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Congenital Malformations Are Much More Common Than Liver Failure or Agranulocytosis in Pregnant Women Treated with Antithyroid Drugs
Clinical Thyroidology May 2016, Vol. 28, No. 5: 144-146.
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Sorafenib May Offer Benefits as a Second-Line Treatment of Metastatic Medullary Thyroid Cancer
Clinical Thyroidology May 2016, Vol. 28, No. 5: 155-157.
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Can Genotyping Predict the Likelihood of Methimazole-Induced Agranulocytosis?
Clinical Thyroidology May 2016, Vol. 28, No. 5: 147-149.
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The Combination of a Limited Mutation Analysis And Sonographic Features Clarifies the Diagnosis of Malignancy in Indeterminate Nodules
Clinical Thyroidology May 2016, Vol. 28, No. 5: 153-154.
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Thyroid-Associated Orbitopathy Occurs in 6% of Patients with Hashimoto's Thyroiditis
Clinical Thyroidology May 2016, Vol. 28, No. 5: 136-139.
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Paramedic Chief Digital: Trends in EMS education and training
The spring Paramedic Chief Digital Edition, a special editorial supplement to the Paramedic Chief eNews, focuses on the latest trends in EMS training, from social media platforms to online training techniques.
In this issue, we explore how to find and evaluate free medical information on social media. We also share examples of how educators are incorporating technology into their EMS training programs.
Read about this and more inside! You can view the issue as digital edition or download as a PDF.
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Paramedic Chief Digital: Trends in EMS education and training
The spring 2016 issue explores how technology and social media can assist EMS education and training
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Inside EMS Podcast: What to consider when choosing your first EMT job
Download this podcast on iTunes, SoundCloud or via RSS feed
In this Inside EMS Podcast episode, co-hosts Chris Cebollero and Kelly Grayson answer an email from a soon-to-be EMT asking for advice on how to pick the right organization for his first job. Chris and Kelly break down the concerns of a bigger system, where it can seem that patient care and treating employees equally is not always a priority. They also look at a slower system, where you may not gain as much experience.
What do you think: Is it better to have your first EMT job in a large or small organization" Weigh in below.
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