Παρασκευή, 20 Μαΐου 2016

Ultrasound-Guided Interscalene Block: Reevaluation of the "Stoplight" Sign and Clinical Implications.

Background and Objectives: The "stoplight" sign is a frequently described image during ultrasound-guided interscalene block, referring to 3 hypoechoic structures found between the anterior and middle scalene muscles. This study was designed to establish the ultrasound-anatomy correlation of this sign and to find any other anatomical features within the roots that could help with the interpretation of the ultrasound images obtained at the interscalene level. Methods: We performed 20 dissections of the brachial plexus in 10 embalmed human cadavers and systematically analyzed and measured the roots of C5 to C7 and then correlated these findings with ultrasonographic images on file. Results: We found that the C5 root is significantly smaller than either C6 or C7 (P

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Bleeding Complications in Patients Undergoing Celiac Plexus Block.

Background and Objectives: Celiac plexus blockade has known risks including bleeding and neurologic injury because of the close proximity of vascular and neuraxial structures. The aim of this study was to determine the incidence of bleeding complications in patients undergoing celiac plexus block (CPB), with an emphasis on preprocedural antiplatelet medication use and coagulation status. Methods: This is a retrospective study from 2005 to 2014 of adult patients undergoing CPB by the pain medicine division at a tertiary care center. The primary outcome was red blood cell (RBC) transfusion within 72 hours of needle placement, with a secondary outcome of bleeding complications requiring emergency medicine, neurology, or neurosurgical evaluation within 31 days. Results: A total of 402 procedures were performed on 298 unique patients, with 58 patients (14.4%) receiving aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) preoperatively. Five patients (1.2%) received RBC transfusion within 72 hours, of which one had received preprocedure NSAIDs. A platelet count measured within 30 days was available for 268 patients, with 7 patients (2.6%) having platelet counts of 100 x 109/L or less at the time of needle placement. A total of 187 patients had a valid preoperative international normalized ratio (INR), with 9 (4.8%) having an INR of 1.5 or higher (range, 1.5-2.6). One patient (11.1%) required RBC transfusion compared with an RBC transfusion rate of 2.3% (4 of 178) in those with normal INR (P = 0.221). We identified no bleeding complications requiring emergency medicine, neurology, or neurosurgical evaluation. Conclusions: This study suggests that CPBs may be safely performed in patients receiving aspirin and/or NSAID therapy. Copyright (C) 2016 by American Society of Regional Anesthesia and Pain Medicine.

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Regional Anesthesia Is Cost-Effective in Preventing Unanticipated Hospital Admission in Pediatric Patients Having Anterior Cruciate Ligament Reconstruction.

Background and Objectives: Published studies have shown a benefit of regional anesthesia (RA) in preventing unplanned hospital admissions (UHAs) and decreasing hospital costs after orthopedic surgeries in adults but not pediatric patients. We performed a retrospective analysis to assess the effect of converting from an opioid to RA-based approach to pain management after pediatric anterior cruciate ligament (ACL) reconstruction. Methods: The records of patients having ACL reconstruction were reviewed. Two groups, those with (n = 115) and without (n = 39) nerve blocks, were identified. Single-shot blocks or indwelling catheters were performed in the operating room (OR) or a block room. Time to discharge readiness, postoperative opiate and antiemetic consumption, hospital admission or discharge, and complications were recorded. The cost of providing RA, the change in UHA and postanesthesia care unit utilization, and subsequent financial impact were calculated. Results: Regional anesthesia-based pain management was associated with a lower rate of UHA (P = 0.045), less time in postanesthesia care unit phase II (P = 0.013), and a reduction in opioid consumption (P

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CD13 Autoantibodies are Elevated in Sera from Mothers of Infants with Neonatal Cholestasis of Different Causes.

Objectives: Human cytomegalovirus (HCMV) infection induces production of CD13-specific autoantibodies, which may promote inflammation and tissue damage. HCMV infection has been suggested as a cause of biliary atresia (BA), but little is known of its role in other forms of neonatal cholestasis. We studied serum levels of CD13-specific autoantibodies in mothers of infants with neonatal cholestasis of different causes, including BA, and in mothers of healthy, term infants without cholestasis, as well as in healthy blood donors. Methods: Using fluorescence-activated cell sorting, we measured CD13-specific autoantibody levels in serum from the above-mentioned groups. Additionally, the effect of serum from mothers of infants with neonatal cholestasis was tested on the differentiation of monocytes into macrophages. Results: CD13-specific autoantibodies were found in mothers of infants with neonatal cholestasis, but not in mothers of infants without cholestasis and healthy blood donors, and were associated with HCMV seropositivity. Sera from mothers of infants with all forms of neonatal cholestasis inhibited differentiation of monocytes into macrophages, but this was not dependent on CD13-specific autoantibodies. Conclusions: The significantly higher frequency of CD13-specific autoantibodies in mothers of infants with neonatal cholestasis of all forms compared to mothers of healthy infants without cholestasis suggests an association, but does not prove that they are pathogenic. The presence of CD13-specific autoantibodies does not correlate with HCMV IgG serostatus, suggesting a more complicated mechanism that possibly reflects active HCMV infection in these individuals. Further studies are needed to elucidate whether these autoantibodies contribute to the development of cholestasis or represent an epiphenomenon. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Cumulative Risk Impact of RET, SEMA3, and NRG1 Polymorphisms Associated with Hirschsprung Disease in Han Chinese.

Objectives: Hirschsprung disease (HSCR) is a congenital aganglionosis of myenteric and submucosal plexuses affecting a variable length of the intestine. The incidence of HSCR is ~1/5,000 live births; however, the risk shows remarkable individual variation caused by single nucleotide polymorphisms (SNPs) at the RET, SEMA3, and NRG1 loci. This study investigated the effects of these variants on the disease development and phenotype in a Chinese population. Methods: In total, 6 SNPs were genotyped in a cohort consisting of 115 HSCR patients and 117 unaffected controls using a TaqMan genotyping assay. Histological identification of the affected-segment length (short, long, or total colonic aganglionosis) was performed for all the samples before DNA extraction. Results: Significant genetic risk was imparted by rs2435357 and rs2506030 at RET and by rs12707682 at SEMA3. In addition, the average cumulative risk score in the HSCR patients was significantly higher than that in the controls. Through the assessment of risk alleles by effect size, individuals were classified into three weighted risk score groups: low (= 5). Individuals in the high group were significantly more susceptible to HSCR than those in the low group with an odds ratio of 7.7 [95% CI 3.7, 16.3]. Conclusions: Cumulative genetic risk varied >35-fold between newborns with zero and more than five accumulated susceptibility alleles. The SNPs rs2435357, rs2506030, and rs12707682 might be useful for stratifying the Chinese population into distinct risk groups. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Prevalence of Peripheral Eosinophilia at Diagnosis in Children with Inflammatory Bowel Disease.

Background: Inflammatory bowel disease (IBD) encompasses two disorders of unknown etiology: Crohn's disease (CD) and ulcerative colitis (UC). There has been a continuous search for markers for disease activity. Eosinophils are granulocytic leukocytes that are implicated in the pathogenesis of IBD. Objectives: The aim of this study was to examine the prevalence and significance of peripheral eosinophilia (PE) at diagnosis in children with IBD Methods: A comprehensive chart review of all children with diagnosed with IBD between January 2006 - August 2014 was performed. Patients with PE at diagnosis were compared to those without in relation to disease clinical activity and disease course. Results: A total of 109 children (mean age 14.6+2.77, range 4.5-17.9 years, 55 boys) with IBD (68 CD and 41 with UC) who were followed for a mean duration of 2.82+1.89 (range 0.1-9.2 years) were identified. At diagnosis, 44 (40.4%) children had PE which was more prevalent in patients with UC compared to those with CD (61.3 vs 36.3%, P

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Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

2016-05-20T09-28-49Z
Source: Medicine Science | International Medical Journal
Besher Helmy, Sami Abdel-Wahab, Mostafa El-Shamy, Sameh M Abdel Monem, Hosam M Dawod.
New therapeutic choices have been developed for hepatocellular carcinoma, including percutaneous ablation therapy, transarterial chemoembolization, radiation therapy and molecular target therapy. Ablation of liver tumors is currently the main alternative to liver resection. This work aimed at comparing percutaneous combined local injection of ethanol and mitoxantrone versus percutaneous radiofrequency ablation in the treatment of Hepatocellular Carcinoma. This study included 124 patients with hepatocellular carcinoma, they were randomly divided into two groups; group I (64 patients) treated with local injection of ethanol plus mitoxantrone. Group II (60 patients) treated with radiofrequency ablation. Clinical assessment, laboratory evaluation and CT studies were performed to all patients prior to treatment and at 1, 3, 6, and 12 months' post treatment. The percentage of ablation in both groups at 1, 3, 6 and 12 months were 81.3%, 81.3%,76.6 and 71.9% in group I respectively versus 88.3%, 88.3, 85%% and 81.7% in group II respectively with no statistical significant difference between the two groups. Percentage of ablation in small tumors is higher than large tumors in both groups. Side effects and complications are statistically higher in group II than group I. Combination of percutaneous local injection of ethanol and mitoxantrone is comparable to radiofrequency ablation with less frequent complications in the treatment of Hepatocellular Carcinoma when surgical resection or liver transplantation is not amenable or available.


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26. Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kongresi Bildiri Özetleri

2016-05-20T09-05-06Z
Source: Çocuk ve Gençlik Ruh Sağlığı Dergisi / Turkish Journal of Child and Adolescent Mental Health
Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları.



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Comprehensive study of health problems in school children of Hyderabad, India

2016-05-20T08-10-33Z
Source: International Journal of Contemporary Pediatrics
Altaf Naseem, Nayantara Rao G..
Background: It is estimated that over one-fifth of our population comprises of children aged 5-14 years and only 80% of these children are enrolled in schools. A child spends most of the time in school and it is considered an ideal place for learning and growing up of a child. In India due to poverty and prevailing socio-cultural milieu a substantial number of school children suffer from various diseases which can be prevented if diagnosed and treated early. We conducted this study to evaluate the health and the nutritional status of school children and comparison was drawn between the rural and urban school children. Methods: This is a cross sectional prospective study where a total of 500 school children from rural and urban government schools were thoroughly assessed by a detailed clinical examination including anthropometry. Results: It was observed that more than half of the children from both rural (56%) and urban (58%) schools were under nourished. The BCG vaccination coverage was better in urban school children (86.5%), with an overall coverage of 80% .Various other problems were more prevalent in rural school children except respiratory diseases which were observed to be more prevalent in urban school children (7.2%). Conclusions: It was learnt that the morbidity of school age children from the communitys perspective is entirely different from morbidity from health care professionals perspective. Therefore, educating the community will go a long way in improving the quality of life.


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Vaccination against hepatitis A and B in patients with chronic liver disease and type 2 diabetes: Has anything changed?

Liver International

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The frequently used intraperitoneal hyponatraemia model induces hypovolaemic hyponatraemia with possible model-dependent brain sodium loss

Abstract

Hyponatraemia is common clinically, and if it develops rapidly, brain oedema evolves, and severe morbidity and even death may occur. Experimentally, acute hyponatraemia is most frequently studied in small animal models in which the hyponatraemia is produced by intraperitoneal instillation of hypotonic fluids (IP-model). This hyponatraemia model is described as "dilutional" or "syndrome of inappropriate ADH (SIADH)", but seminal studies contradict this interpretation. To confront this issue, we developed an IP-model in a large animal (pig) and studied water and electrolyte responses in brain, muscle, plasma and urine. We hypothesised that hyponatraemia was induced by simple water dilution, with no change in organ sodium content. Moderate hypotonic hyponatraemia was induced by a single IV dose of desmopressin and intraperitoneal instillation of 2.5% glucose. All animals were anaesthetised and intensively monitored. In vivo brain and muscle water was determined by magnetic resonance imaging and related to plasma sodium concentration. Muscle water content increased less than expected due to pure dilution, and muscle sodium content decreased significantly (28%). Sodium was redistributed to the peritoneal fluid, resulting in a significantly reduced plasma volume. This shows that the IP-model induces hypovolaemic hyponatraemia and not dilutional/SIADH hyponatraemia. Brain oedema evolved, but brain sodium content decreased significantly (21%). To conclude, the IP-model induces hypovolaemic hyponatraemia due to sodium redistribution and not water dilution. The large reduction in brain sodium is probably due to the specific mechanism that causes the hyponatraemia. This is not accounted for in the current understanding of the brain response to acute hyponatraemia.

This article is protected by copyright. All rights reserved



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Does C-reactive protein monitoring after colorectal resection with anastomosis give any practical benefit for patients with intra-abdominal septic complications?

Colorectal Disease

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The efficacy and tolerability of a triple therapy containing a potassium-competitive acid blocker compared with a 7-day PPI-based low-dose clarithromycin triple therapy

The American Journal of Gastroenterology

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Ascitic calprotectin is a novel and accurate marker for spontaneous bacterial peritonitis

Journal of Clinical Laboratory Analysis

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Nonalcoholic fatty liver disease and risk of incident cardiovascular disease: a meta-analysis of observational studies

Journal of Hepatology

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Factors associated with significant liver steatosis and fibrosis as assessed by transient elastography in patients with one or more components of the metabolic syndrome

Journal of Diabetes and its Complications

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A phase I study of S-1 in combination with nab-paclitaxel in patients with unresectable or recurrent gastric cancer

Gastric Cancer

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Factors that predict the occurrence of and recovery from non-alcoholic fatty liver disease after pancreatoduodenectomy

Surgery

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Pulse transit time as a predictor of the efficacy of a celiac plexus block in patients with chronic intractable abdominal pain

The Clinical Journal of Pain

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Outcomes after resection and/or radiofrequency ablation for recurrences after treatment of colorectal liver metastases

British Journal of Surgery

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Hepatitis E virus infection in the HIV-positive patient

Journal of Clinical Virology

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The effect of tobacco smoking on the natural history of ulcerative colitis

Alimentary Pharmacology and Therapeutics

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Antiretroviral use in the CEASE cohort study and implications for DAA therapy in HIV/HCV co-infection

Open Forum Infectious Diseases

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MEK5 overexpression is associated with the occurrence and development of colorectal cancer

BMC Cancer

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Effect of Helicobacter pylori eradication and ABO genotype on gastric cancer development

Helicobacter

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Evaluation of the role of circulating long Non-Coding RNA H19 as a promising novel biomarker in plasma of patients with gastric cancer

Journal of Clinical Laboratory Analysis

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Risks and predictors of gastric adenocarcinoma in patients with gastric intestinal metaplasia and dysplasia: A population-based study

The American Journal of Gastroenterology

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Computed tomography features of septic pulmonary embolism caused by klebsiella pneumoniae liver abscess associated with extrapulmonary metastatic infection

Journal of Computer Assisted Tomography

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Investigating the role of cortisol and growth hormone in fatty liver development: Fatty liver index in patients with pituitary adenomas

Pituitary

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EVALUATION OF SYSTEMIC MARKERS RELATED TO ANEMIA IN PERIPHERAL BLOOD OF PATIENTS WITH CHRONIC GENERALISED SEVERE PERIODONTITIS A COMPARATIVE STUDY

2016-05-20T01-56-23Z
Source: International Journal of Current Research and Review
Chakravarthy Muppalla, Ramakrishnan Theyagarajan, Geetha Ari, Jaideep Mahendra.
Background: The purpose of this study was to evaluate systemic markers related to anemia in peripheral blood of patients with chronic generalized severe periodontitis and compare them with healthy controls. Materials and Methods: A total of 60 systemically healthy males, aged 18 to 50 years were selected from the out patients department of periodontology, Meenakshi Ammal Dental College and Hospital. They were divided into two groups; Controls (group A) 30 male volunteers with healthy gingiva and Test Group (group B) 30 male patients with chronic generalized severe periodontitis. Periodontal clinical parameters and hematological parameters were recorded in both the groups. Results: Blood parameters of patients with chronic generalized severe periodontitis especially Red Blood Cell (RBC) count, Haemoglobin (Hb) and Packed Cell Volume (PCV) values were reduced in group B indicating that chronic generalized severe periodontitis has a definite systemic effect. Conclusion: RBC count, Haemoglobin (Hb) and PCV values of chronic generalized severe periodontitis patients were low compared to healthy individuals.


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HISTOGENESIS OF MUSCLE LAYERS OF HUMAN URINARY BLADDER

2016-05-20T01-56-23Z
Source: International Journal of Current Research and Review
Shinde Reshma B., Laqeeue Mohammad, Ukey Rahul K., Diwan Chaya V..
Background: Urinary bladder is an organ of considerable importance in mammals, being a site where urine is collected before micturition and without undergoing any significant exchange of water or ions with surrounding. Urinary epithelium (urothelium) is unique in being non-reabsorptive and non-secretory in nature. The earlier studies on the development of urinary bladder were mainly on its gross anatomical features. Objectives: 1) To note structural differentiation and maturity of muscularis externa layer which it attains at different stages of development to show the adult picture. 2) To compare and contrast differences between different age groups and with previous studies and available literature. Material and Method: 50 aborted human fetuses (29 females and 21 males) of different gestational age from 9th week onwards were collected, urinary bladder were taken out and fixed in a fixative. Blocks of tissues were made from bladder wall proper, trigone & bladder neck and processed to get sections which were stained with 1) Haematoxylin and Eosin 2) Massons trichrome stain. Results: Beginning with 12th week, muscularis externa showed well developed circular muscle layer and a thin inner longitudinal layer in the form of thin, scattered bundles. Outer longitudinal layer appeared as discrete, nonuniform bundles of muscle fibres by 13th week. All three layers were seen well developed and thick by 16th week and found thickest by 32nd week with slight variations in their arrangement. Muscle layer thickness at bladder neck and trigone increased progressively from 18th wk onwards. Conclusion: Muscular layer in bladder wall showed all three layers progressively increased in thickness and indistinctly well developed from 16th week onwards and found thickest at 32nd week. Thus Histogenesis of urinary bladder in this instance may represent a powerful tool to delineate structure function relationship.


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Clinical assessment of enamel wear caused by monolithic zirconia crowns

Summary

The purpose of this study was to measure enamel wear caused by antagonistic monolithic zirconia crowns and to compare this with enamel wear caused by contralateral natural antagonists. Twenty monolithic zirconia full molar crowns were placed in 20 patients. Patients with high activity of the masseter muscle at night (bruxism) were excluded. For analysis of wear, vinylpolysiloxane impressions were prepared after crown incorporation and at 6-, 12-, and 24-month follow-up. Wear of the occlusal contact areas of the crowns, of their natural antagonists, and of two contralateral natural antagonists (control teeth) was measured by use of plaster replicas and a 3D laser-scanning device. Differences of wear between the zirconia crown antagonists and the control teeth were investigated by means of two-sided paired Student's t-tests and linear regression analysis. After 2 years, mean vertical loss was 46 μm for enamel opposed to zirconia, 19–26 μm for contralateral control teeth and 14 μm for zirconia crowns. Maximum vertical loss was 151 μm for enamel opposed to zirconia, 75–115 μm for control teeth and 60 μm for zirconia crowns. Statistical analysis revealed significant differences between wear of enamel by zirconia-opposed teeth and by control teeth. Gender, which significantly affected wear, was identified as a possible confounder. Monolithic zirconia crowns generated more wear of opposed enamel than did natural teeth. Because of the greater wear caused by other dental ceramics, the use of monolithic zirconia crowns may be justified.



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Respiratory sinus arrhythmia as a predictor of self-injurious thoughts and behaviors among adolescents

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Publication date: Available online 20 May 2016
Source:International Journal of Psychophysiology
Author(s): Madeline D. Wielgus, Jaclyn T. Aldrich, Amy H. Mezulis, Sheila E. Crowell
Research suggests that self-injurious thoughts and behaviors (SITBs) may function as maladaptive emotion regulation strategies. One psychophysiological index of emotion regulatory capacity is respiratory sinus arrhythmia (RSA). The temporal course of RSA responsivity to a stressor may be characterized by basal RSA, RSA reactivity to stressor, and RSA recovery post-stressor. RSA has been linked to both internalizing and externalizing symptoms in adolescents, but little is known about the relation between RSA and SITBs. Initial research has shown a cross-sectional relation between lower basal RSA and greater RSA reactivity to a sad mood induction and self-injury. To date no prospective research on the relation between RSA and SITBs exists. The current study aims to investigate the prospective relation between RSA and SITBs in a community sample of 103 adolescents (Mage=12.82, SDage=0.82, 53.70% female). At the initial laboratory visit (T1), participants completed an unsolvable anagram stressor task, during which RSA (basal, reactivity, and recovery) was measured. SITBs were assessed at T1 and at the 6-month follow-up (T2). Results indicated basal RSA and RSA reactivity did not significantly predict engagement in SITBs between T1 and T2. Poorer RSA recovery from the stressor task at T1 did significantly predict engagement in SITBs between T1 and T2, over and above depressive symptoms and lifetime history of SITBs. This suggests that adolescents with poor ability to regulate physiologically following a stressor may turn to maladaptive emotion regulation strategies like SITBs.



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Influence of Cognitive Impairment on Mobility Recovery of Patients With Hip Fracture.

Objective: The aims of this study were to study the mobility recovery in hip fracture patients and determine the influence of cognitive impairment on mobility within the first 3 months after surgery. Design: This prospective cohort study was carried out in an acute public hospital in southern Spain and included 275 patients, 65 years or older, with a hip fracture. Mobility and Cognitive status were measured by Tinetti Performance-Oriented Mobility Assessment and Pfeiffers' Scale (Short Portable Mental State Questionnaire), respectively. Multiple linear regression was used to examine the influence of cognitive impairment on mobility. Results: The median Performance-Oriented Mobility Assessment score changed from 4 (3-4) points at discharge to 17 (7-22) at 3 months. All degrees of cognitive impairment were negatively associated with gait and balance at 1 and 3 months after surgery (P

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Water-Cooled Radiofrequency Provides Pain Relief, Decreases Disability, and Improves Quality of Life in Chronic Knee Osteoarthritis.

Chronic osteoarthritis (OA) is a widespread source of pain and disability and represents a growing economic burden across aging populations. Representing a major focus of arthritis care, OA of the knee is especially concerning as it has the potential to restrict mobility and significantly impair quality of life. Chronic OA is often poorly managed both pharmacologically and nonpharmacologically, with surgical management representing the definitive treatment. Those who are not surgical candidates or simply opt for minimally invasive treatments are usually faced with a lack of alternatives. An additional treatment presents itself in the form of water-cooled radiofrequency ablation, which involves the use of thermal lesions to interrupt the active pain pathways. An 81-year-old woman with bilateral severe knee OA was initially seen and evaluated in an outpatient physiatry clinic after multiple previous workups of her ongoing knee pain. With a known diagnosis of end-stage knee OA, the patient chose to proceed with bilateral water-cooled radiofrequency ablation. At 6 weeks and 3 months after the procedure, the patient maintained adequate levels of pain relief, markedly improved function, and enhanced quality of life. Water-cooled radiofrequency ablation has the potential to create lasting pain relief and with minimal adverse effects in patients with chronic knee OA. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Comment on: Clinical Efficacy of Mudpack Therapy in Treating Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Studies.

No abstract available

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LEPTIN: A DRIVING FORCE BEHIND THYROID PROBLEMS

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Singla Gesu, Bedi GK, Sandhu HS, Vij Chittranjan.
Introduction: Apart from diabetes mellitus, thyroid dysfunction is one of the most common endocrine disorders encountered in adults, affecting up to 10% of the UK population Leptin is a 16kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including appetite and metabolism. Aim: The aim of this study was to estimate thyroid hormones and Serum Leptin levels in patients with thyroid disorders and to find their correlation with each other. Material & Methods: 50 diagnosed patients of thyroid disorders and 30 healthy controls were recruited in our study. Serum Leptin Levels, Serum T3, T4, TSH levels were estimated in both cases and controls using ELISA method. Results: There was significant negative correlation between Serum Leptin and Serum T3. There was no significant but negative correlation between Serum Leptin and Serum T4. A very significant positive correlation was seen between Serum TSH and Serum Leptin levels. Conclusion: Leptin problems are a driving force behind thyroid problems. Leptin triggers the decreased production of thyroid hormones. Improving leptin problems and losing weight will improve thyroid function.


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MORPHOLOGICAL STUDY OF THE TIBIAL TUBEROSITY IN THE POPULATION OF SOUTH KARNATAKA, INDIA

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Rashmi Bhat, Ramya Rathan, Neha Samapriya, Shakuntala Pai.
Objective: To estimate the prevalence of various morphological types of Tibial Tuberosity and to determine the side and gender differences. Methods: 170 randomly collected tibiae of unknown sex were analysed to evaluate the shapes and the gender differences in the tibia. The prominence of the Tibial Tuberosity and the gender differences of the bone was determined Results: Type 2 TT was the most common type seen in 34% bones followed by type 3 in 17% of the bones. Type 2 TT was the most common type seen on right side (31%) as well as on the left side (39%). Type 2 was the most common type of TT seen in both males (32%) and females (35%). Conclusion: The present study shows variations in shape may be due to developmental reasons. There were no statistical differences in the side and gender differences. The knowledge of the present study will help further researchers in evaluating anterior knee pain syndromes.


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JOB SATISFACTION AMONGST POST GRADUATE STUDENTS AT TERTIARY CARE TEACHING INSTITUTE IN CENTRAL INDIA- A CRITICAL APPRAISAL

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Vaidya A., DUA H., MUJAWAR N., NANOTI G..
Multifaceted psychological retorts towards ones job covering cognitive, affective and behavioural modalities is collectively known as job satisfaction. Aims and objectives: To study the level of job satisfaction amongst Post Graduate (PG) students at tertiary health care teaching Institute in Central India. Materials and methods: The present study was a cross sectional hospital based study, which included 199 PGs of all faculties of medical field. Results: Out of total 169 PGs, 56 were from 1st year (junior resident I/JRI), 61 were JR II and 52 were JR III. Response rate was 85%. Amongst responses, majority of the participants had low level of satisfaction (43.1%), followed by 72 (42.6%) and 24 (14.2%) for average and high level of satisfaction, respectively. The major factors contributing to the job dissatisfaction were job not according to the interest and abilities, adverse working conditions, less opportunities for development and promotion and decreased autonomy. Conclusion: The high levels of dissatisfaction amongst PGs in our study is alarming sign, which should be taken into account by every medical institute while decision making, because PGs are major component of health care in tertiary health care teaching hospital and it is safe to infer that highly satisfied physician will more likely work to his/her full potential.


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EVALUATION OF GROWTH PROGRESS AMONG MALNOURISHED CHILDREN ATTENDING VILLAGE CHILD NUTRITION CENTRE (VCNC) UNDER THE PROGRAMME ‘MISSION BALAM SUKHAM’ IN A TRIBAL AREA OF WESTERN INDIA

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Dhara I. Zalavadiya, Suraj I. Kuriya, Vihang S. Mazumdar, Sangita V. Patel, Rajendra K. Baxi.
Background: Government has started a programme Mission Balam Sukham to combat the malnutrition with 3 tier approach including Village Child Nutrition Center (VCNC), Child Malnutrition Treatment Center (CMTC) and Nutrition Rehabilitation Center (NRC). Present study was conducted with the aim to evaluate this programme at VCNC level in a tribal area of western India. Methods: Hundred malnourished children according to weight for age criteria by WHO, were selected from 10 VCNCs. Their growth progress was recorded and compared with other 100 malnourished children attending anganwadies from the area nearby, where the programme was not yet launched. VCNC intervention was done for 1 month. Children were followed for 3 months. Results: There was 2 times higher chances of malnutrition grade improvement among VCNC children as compared to anganwadi children with relative risk at the end of 1 month (95% CI =1.2609 to 3.5662) (P-value

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PREVALENCE OF THYROID DISORDERS IN A TERTIARY CARE CENTER

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Deokar PG, Nagdeote AN, Lanje MJ, Basutkar DG.
Background: Thyroid disorders are a widespread endocrinological problem, but data on its prevalence in India is scanty. Aims & Objective: The aim of the present study was to assess the proportion of various thyroid disorders in subjects attending a tertiary care center. Material and Methods: This retrospective hospital based study involved 2076 patients who underwent thyroid function test, in the central clinical biochemistry. Thyroid function tests were performed on Siemens Centaur immunoassay analyzer. Statistical analysis was performed by SPSS version 16 software. Results: We found 22.16% subjects having thyroid dysfunction in our study population. Out of these, 4.24% were overt hypothyroid, 9.44% were subclinical hypothyroid, 2.5% overt hyperthyroid and 5.97% were found to be subclinical hyperthyroid. Conclusion: Our study suggested that the prevalence of thyroid disorders in our study population is high and hypothyroidism is more common than hyperthyroidism. Highest prevalence of thyroid disorder was found in 30-49 years age group. The mean TSH concentration increased with age in euthyroid, hypothyroid (both overt and subclinical) and hyperthyroid (both overt and subclinical) groups studied. The highest TSH concentration was seen in the age group 60- 69 years and lowest TSH was seen in age group 10 19 years.


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COMPARATIVE ANALYSIS OF SENSITIVITY AND SPECIFICITY OF CARDIAC SPECIFIC TROPONIN I AND CK-MB FOR DIAGNOSIS OF ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Sandipkumar R. Patel, Hariom Sharma, Bhavika Vanani.
Background: Study is designed to see correlation of cardiac specific Troponin I and Creatine Kinase-MB level to diagnose ST segment elevation myocardial infarction. Aim and Objectives: To access the diagnostic importance of cardiac specific Troponin I over Creatine Kinase-MB in patient of ST-segment elevation myocardial infarction. Materials and Methods: A comparative study was carried out in 100 patients, having ST segment elevation myocardial infarction. A group of 100 normal healthy individuals, age and sex matched from the same population served as controls. Troponin I and Creatine Kinase-MB levels were estimated in both the groups. Results: Results of present study shows that cardiac specific Troponin I and CK-MB levels were significantly higher in STEMI patients compared to healthy subjects with p value of


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METASTATIC OVARIAN CYSTOSARCOMA PHYLLOIDES OF BREAST

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Papa Dasari, Haritha Sagili, Priyanka Yoga Purani.
Background: Cystosarcoma Phylloides is a rare breast neoplasm constituting ≤ 1% of all breast neoplasms. These are mostly benign and reccur. Malignant cystosarcoma Phylloides can recur and metastasize to lung, bone and abdominal viscera. Metastasis to Ovary is not reported in literature. Case Report: A 46 year old multiparous lady was diagnosed with a recurrent cystosarcoma of right breast and a large Ovarian mass which was causing her dyspnoea. The mass was of 30 weeks size and was firm and tender. CECT showed a large solid abdominopelvic mass with irregular enhancing septate extending from pelvis to infracolic area with minimal free fluid. Uterus and Ovaries could not be delineated. FNAC from the mass was reported as low-grade malignant mesenchymal tumour. CA 125 was within normal range. Laparotomy revealed a large fleshy mass with jelly like material which was adherent to intestines and pelvic and parietal peritoneum. Right ovary is not visualized. Left ovary parially visualised and incorporated into the mass. Excision of the mass with TAH and BSO was carried out. There was diffuse ooze from the pelvic and peritoneal cavity which was managed by packing, blood product transfusion and tranexamic acid. She received massive transfusion and survived. Later she developed haemoptysis and underwent tracheostomy and feeding ileostomy and was managed in ICU for 8 weeks. Palliative mastectomy and adjuvant Radiotherapy and chemotherapy were differed by Oncologists and hence she was discharged after 4 months of admission. Conclusion: Managing ovarian metastasis from cystosarcoma phylloids can be challenging and the quality of life is poor when the primary disease is not managed adequately.


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DERMATOGLYPHICS IN MENTALLY RETARDED CHILDREN

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Anjana P. Gaikwad, Swati R. Pandhare.
Objective: This study was undertaken to evaluate the dermatoglyphic features in children belonging to primary mental retardation and co-relating the findings with previous workers. Methods: Dermatoglyphics obtained from the palm and finger tips in 72 children of primary mental retardation were compared with the similar studies in 72 normal children. These cases were from special institution for mentally retarded children in Pune. Results: The features which showed significant variations included: reduced whorl pattern and increases in ulnar loop on the finger tip, increase frequency of pattern in thenar / I1 and I3 area with distal displacement of axial triradius, higher atd angle, and increase incidence of simian crease. Conclusion: Dermatoglyphics features were noticed in the mentally retarded groups. These are increase ulnar loops on finger tips, decrease in whorl on finger tip, thenar / I1 and I3 area showed significant increase in pattern, higher atd angle, distal shift in axial triradius. It can be assumed that the cases of primary mental retardation could be dermatoglyphically varied from the normal, though the number of cases studied is not enough to make a definite statement.


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DELAY ANALYSIS OF ADHOC NETWORK USING NS 2.34

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Samiksha Nikam, B. T. Jadhav.
Ad hoc network is popular nowadays due to the easy disposition and self-configuring nature. Hence, routing related issues encounter challenges in the ad hoc network. Such network is mainly used for transmission of text, picture and video data. The speed of data delivery decides the quality of service of the network. The quality of service depends upon the protocol used for data transmission. Efficient routing protocol improves the quality of service. The efficiency of the protocol is decided by evaluating different performance parameters like throughput, delay, packet drop, routing load, packet delivery ratio etc. The end to end delay is one of the most important performance parameter sofad-hoc network. It plays a major role in deciding the quality of service. The delay is measured as total time is taken by the packet to reach the destination. Delay in ad hoc network gets affected by the mobility of nodes, and a number of nodes connected to the network. The objective of this research paper is to analyze delay of ad hoc network for DSDV routing protocol. The delay is measured in high and low mobility scenario by changing various parameters of ad hoc network such as a number of nodes, pause time, speed, and connections between the nodes. Network simulator ns2.34 is used for this.


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OXIDATIVE STRESS BIOMARKERS IN RATS EXPOSED TO BROMOXYNIL

2016-05-19T23-52-12Z
Source: International Journal of Current Research and Review
Ahmed K. Salama, Khaled A. Osman, Ahmed S. El-Bakary, Maher S. Salama.
Aim: The present study was designated to evaluate the oxidative stress biomarkers in male rat following oral repetitive administration of 0.1 LD50 of the herbicide bromoxynil. Methodology: Animals were orally received four doses of 0.1 LD50 of bromoxynil every other day. Twenty-four hours after the last oral dosing, all rats were killed by decapitation. Blood, brain, liver, and kidneys were taken for determination of TBARS, lactic dehydrogenase, catalase and alkaline phosphatase. Results: TBARS were found to be significantly increased in the liver, kidneys and brain where they were 390.20, 293.80, and 287.03% of control, respectively. In case of serum it was insignificantly increased to 162.88% of control value. Lactic dehydrogenase activity was significantly enhanced in serum and liver comparing with the control values (119.49 and 114.12%) and insignificantly enhanced in kidneys and brain (105.17 and 107.40%). Catalase activity was increased in all tissues where the enhancement was significant in both of serum and liver (122.68 and 119.99%, respectively) and insignificant in case of kidneys and brain (112.55 and 105.12%, respectively). Alkaline phosphatase activity in serum, liver, kidneys and brain was found to be elevated. These values were significant in liver and kidneys (113.47 and 121.14%, respectively) while they were insignificant in serum and brain (109.91 and 114.46%, respectively). Conclusion: Therefore, the herbicide bromoxynil could produce significant alteration in the lipid peroxidation and activities of some antioxidant enzymes and producing cellular oxidative damage in male rats following repetitive oral dosing.


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