Κυριακή, 31 Ιουλίου 2016

Learning and Reproduction of Memorized Sequences of Right and Left Hand Movements

An important stage in learning, i.e., the acquisition of a new skill, is the repetitive reproduction of a sequence of movements, which plays a significant role in the formation of motor stereotypies. Two groups of right-handed subjects reproduced (6–10 repeats) sequences of movements guided by the experimenter, sequences consisting of six positions, first with the right hand (RH) and then with the left hand (LH) or vice versa. In series 1, an unfamiliar random sequence was reproduced; series 2 and 3 involved reproduction of modified sequences whose elements were in the same positions but in a different order. The processes of reproduction proceeded similarly for the RH and LH. Learning of the modified sequence was different: regardless of order of presentation, information about the positions of the elements of the sequence was used only when the LH performed the task first. This information was not used when the LH operated after the RH or when the RH performed the task. Thus, the means of encoding information activated on operation by the LH promoted learning of the position memorization task, while that activated by the RH interfered. This appears to be linked with the predominant roles of the right hemisphere in encoding positions and in motor learning processes.



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Morphometric Characteristics of the Structure of the Central Nucleus of the Amygdaloid Complex in Men and Women

Objectives. To identify interhemisphere asymmetry in the structure of the central nucleus of the amygdaloid complex in men and women. Materials and methods. The morphometric characteristics of neuron structure in the central nucleus of the amygdaloid complex were determined on histological sections of the brain from six men and six women (24 hemispheres) aged 19–55 years with no history of mental or neurological disease while alive. Neuron profile field sizes were determined in the central nucleus of the amygdaloid complex in the left and right hemispheres of the brain. Results and discussion. Mean neuron size in women was somewhat larger in the left hemisphere than the right, while mean neuron size in men was greater on the right. Neither men nor women showed any statistically significant interhemisphere morphometric differences. Furthermore, neuron profile field size in the central nucleus of the amygdaloid complex in women was statistically significantly larger than in men in both hemispheres. An attempt was made to link these data with the characteristics of emotional perception in men and women.



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Surgical Treatment of Putaminal Hematomas

Current data on the surgical treatment of putaminal hematomas are presented. Features of the clinical picture of the disease and its diagnosis, particularly radiological, are presented. The results of the most important studies on the efficacy of surgical treatment are presented. The indications for surgical treatment of this disease are discussed.



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Cognitive Impairments in Subjects Exposed to Radiation during Prenatal Development

Objective. To evaluate cognitive status in subjects exposed to ionizing radiation during antenatal development. Materials and methods. A total of 77 subjects with antenatal exposure to radiation were studied, along with a reference group of 73 subjects living in radiologically unpolluted territories in the Chelyabinsk region. Clinical, clinical psychological (Mini Mental State Examination, MMSE), Wechsler Adult Intelligence Test (WAIS), and proverb interpretation) neurophysiological (EEG), and laboratory (cholesterol, high- and low-density lipoproteins triglycerides, cortisol, melatonin) methods were used. Results and discussion. These investigations showed that a significantly greater proportion of subjects exposed to radiation during antenatal development had nonpsychotic mental disorders with a predominance of organic mental impairments (cognitive and asthenic). Neurophysiological studies identified more profound abnormalities in brain bioelectrical activity with pathological rhythms and a predominance of the θ rhythm among those exposed to radiation. Clinical psychological study data identified a significant decrease in analytical-synthetic ability in irradiated subjects, along with lower general and verbal IQ levels. These changes were accompanied by higher cortisol and melatonin levels, supporting activation of and tension in the mechanisms of adaptation in subjects irradiated during antenatal development.



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Changes in the Cerebral Cortex after Dosed Craniocerebral Trauma in Rats of Different Ages

Dosed lateral fluid percussion was used to model craniocerebral trauma (CCT) of moderate to severe intensity in one- and two-year-old rats. Brain sections were stained with cresyl violet by the Nissl method and with an immunochemical reaction for glial fibrillary acidic protein (GFAP) – a marker for astrocytes. The results provide evidence that zones of direct and remote injury formed in the side ipsilateral to the blow. The direct injury zone corresponded to the area of direct contact of the column of liquid with the dura mater, while the remote injury zone was positioned lateral and caudal to the direct injury zone. Morphological detection of trauma depended on the strength of the blow and was seen in both age groups as astrocytic gliosis, with thinning of layer I of the cortex due to death of neurons. Signs of ischemic changes to neurons were probably associated with local impairment to blood supply. Brain damage in one-year-old rats was local in nature but was more diffuse in two-year-olds, while gliosis was characterized by inhomogeneity. The reproducibility and appropriateness of the model allow it to be used for investigation of the molecular genetic mechanisms of the sequelae of CCT in humans and for identifying common mechanisms in the sequelae of CCT and the pathogenesis of major diseases comorbid with CCT, particularly depression and epilepsy.



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Auditory Aftereffects of Continuously and Discontinuously Approaching Sound Images

The aftereffects of continuously and discontinuously approaching sound images were studied. Moving images were formed using sequences of wideband noise pulses with linear amplitude modulation delivered via two loudspeakers located in an anechoic chamber at distances of 1.1 and 4.5 m from the subject. Adaptation to continuous approach evoked a change in the perception of continuously moving sound sources, while adaptation to discontinuous approach altered the perception of discontinuously moving sources. Aftereffects did not arise when the adaptation and test stimuli had different movement qualities. Regardless of movement quality (discontinuous or continuous), when the rhythmic structure of the adaptation and test stimuli were the same, aftereffects were stronger than when their rhythmic structures were different. These results suggest that the pathways processing information on continuously and discontinuously moving sound sources are different.



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Potential for the Use of Melatonin in Narcological Practice



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Identification of Phosphoethanolamine and Phosphoserine in the Brain of the Pond Fish Perccottus Glehni (Eleotridae, Perciformes, Dyb. 1877)

Significant modifications to the free amino acid pool and various other compounds in the bodies of poikilotherms in response to decreased temperature reflect significant alterations in their mechanisms of adaptation. The literature lacks data on the contributions of such free compounds to the low-temperature adaptation of the brains of poikilotherms. Our previous studies showed that acute cold shock induced the appearance of large quantities of two ninhydrin-positive compounds of unknown nature in the brain of the eurythermal pond fish Amur sleeper. The experiments reported here show that the brain accumulates these compounds by the beginning of the winter period. They were found to be the phospholipid metabolites phosphoethanolamine and phosphoserine. The winter phosphoethanolamine pool was 94 times greater than the summer level, while phosphoserine was present only in summer. It is suggested that accumulation of phosphoethanolamine and phosphoserine is associated with adaptive modifications of membrane phospholipids at low temperatures.



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The Course of Experimental Allergic Encephalomyelitis in Adult Rats after Administration of Interleukin-1β at Different Periods in Early Life

Multiple sclerosis (MS) is a chronic disease of the CNS affecting people of working age, in which myelin and the cells producing it, and also neurons, become the targets for aggressive immune cells. It has been suggested that common childhood infections in later childhood increase the risk of developing MS. We report here studies of the course of experimental allergic encephalomyelitis (EAE) in rats given interleukin-1β (IL-1β) at different stages of early postnatal ontogeny. EAE was induced in rats at age three months by single subcutaneous immunizations with homologous spinal cord homogenate in complete Freund's adjuvant. The number of sick animals was recorded daily, as were the severity and duration of disease. EAE was found to have a more severe course after administration of IL-1β in weeks 1 and 4 of life than in rats of the corresponding control groups. The harmful or protective consequences of IL-1β administration at different periods of early postnatal ontogeny are discussed, as are the role of stress reactivity and its link with the "hygiene hypothesis."



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Expression of the Serotonin Transporter in the Ventrolateral Part of the Solitary Tract Nucleus in Rats during the Early Postnatal Period in Normal Conditions and in Serotoninergic System Deficiency during the Prenatal Period of Development

An immunocytochemical study method was used to investigate the expression of the serotonin transporter (5-HTT) in the ventrolateral part of the solitary tract nucleus in Wistar rats during the early postnatal period (days 5 and 10) in normal conditions (n = 10) and in conditions of prenatal serotonin deficiency (n = 12). During the early postnatal period, the ventrolateral section of the solitary tract nucleus was found to show transient expression of 5-HTT, most marked in the caudal part of the ventral subnucleus. The numbers of neurons synthesizing 5-HTT in the rostral part of the ventral and lateral subnuclei were small and did not change with age. The caudal part of the ventral subnucleus contained a large number of neurons synthesizing 5-HTT on day 5 of the postnatal period, and this number decreased significantly with age. The caudal part of the lateral subnucleus contained a small number of cells expressing 5-HTT, and this number also decreased with age. 5-HTT expression levels were significantly higher in the caudal areas of both the ventral and lateral subnuclei than in the rostral areas. Prenatal serotonin deficiency decreased the numbers of neurons synthesizing 5-HTT in the nuclei studied here.



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Distribution of Marinesco Bodies in Human Substantia Nigra Neurons

The aim of the present work was to study the frequency and intranuclear locations of Marinesco bodies in neurons in the substantia nigra of the human brain. Marinesco bodies were detected on substantia nigra sections in five males aged 28–58 years. Nissl staining and a immunohistochemical reaction for ubiquitin – a characteristic protein for these intranuclear inclusions – were used. Marinesco bodies were seen in 1–2% of substantia nigra neurons but not in neighboring areas of the brain. One neuron could contain 1–4 Marinesco bodies of size up to 6.7 × 5.1 μm; bodies were positioned both close to and distant from the nucleolus. Ubiquitin was found in most Marinesco bodies. There was a tendency to an increase in Marinesco bodies in human substantia nigra neurons with age.



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Changes in the Expression of Bcl-2 Protein in Neurons in the Hippocampal Fields after Use of Ischemic Postconditioning of the Brain

The expression of Bcl-2 protein in pyramidal neurons in hippocampal fields CA1, CA2, CA3, and CA4 was studied in Mongolian gerbils (Meriones unguiculatus) in the early (two days) and late (seven days) reperfusion periods after 7-min ischemia of the forebrain, after use of ischemic postconditioning (IPostC) and in sham-operated animals (n = 60). The highest level of Bcl-2 expression in the latter group was seen in neurons in field CA4 and the lowest in neurons in field CA1 (p < 0.01). Reversible ischemic injury led to an increase in the deficit of morphologically unaltered neurons in the hippocampus at the later period of reperfusion and a significant decrease in neuronal Bcl-2 expression at the early reperfusion period, this decrease being significantly smaller in the late reperfusion period. IPostC consisting of three episodes of reperfusion-ischemia (15/15 sec) promoted a significant increase in the number of morphologically unaltered neurons in fields CA1 and CA3 in the early reperfusion period. An increase in the level of Bcl-2 expression was seen in the cytoplasm of morphologically unaltered neurons in all hippocampal fields. In the late reperfusion period after IPostC, the number of unaltered neurons was increased in fields CA1, CA3, and CA4 (p < 0.05); only hippocampal field CA1 neurons showed a significant increase in Bcl-2 expression (by 12.7%, p < 0.01). These results lead to the conclusion that the cytoporotective effect of IPostC for hippocampal field CA1 is mediated by a mechanism leading to an increase in Bcl-2 expression, i.e., via blockade of apoptosis.



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Emotional Burnout Syndrome in Narcologists and Its Effects on the Quality of Life of Patients with Alcohol Dependence

Objective. To identify the incidence of emotional burnout syndrome (EBS) and the severity of its individual phases in in-patient and out-patient addiction physicians and to evaluate its influences on their patients' quality of life. Materials and methods. A total of 107 medical addiction doctors were assessed using the Boiko method. After identification of specialists with EBS, groups of patients with alcohol dependence were identified (each of 10 subjects) in whom the level of and changes in quality of life were assessed in relation to the severity of EBS and its phases in their doctors. Results and discussion. Studies using this method showed a significant proportion of doctors displayed signs of EBS, which were more severe in out-patient doctors than in-patient doctors. Establishment of the "exhaustion" phase of EBS was found to develop in 31.5% of doctors in addiction out-patient clinics. EBS in doctors had a negative influence on the quality of life of their patients with alcohol dependence attending drug addiction clinics.



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A New Method for the Treatment of Korsakoff’s (amnestic) Psychosis: Neurostimulation Correction of the Sympathetic Nervous System

Objective. Using data on the evolution of electrical brain stimulation and considering the pathophysiological aspect of neurostimulation correction of the sympathetic nervous system, the aim of the present work was to identify grounds for the potential of the use of this method in Korsakoff's psychosis. Materials and methods. Sixteen patients with Korsakoff's (amnestic) psychosis were treated using this method. Results and discussion. All patients showed improvements, which are illustrated by detailed description of a typical case. It is concluded that sympathetic correction has high therapeutic potential.



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Plastic Rearrangements of Synapse Ultrastructure in the Cerebellum in Toxicity due to Glutamate and NO-Generating Compounds

Ultrastructural changes in synaptic boutons of parallel fibers (PF) and the spines of Purkinje cell dendrites (PCD) in the frog cerebellum were stdied on exposure to high concentrations (1 mM) of glutamate (Glu) and NO-generating compounds, creating a model of stroke. Exposure to Glu led to envelopment of terminal boutons by spines, while NO-generating compounds, conversely, led to envelopment of spines by boutons. Morphological studies showed that in Glu solution, there was a dominance of synapses in which glial cells were surrounded by spines, while boutons were dominant in the presence of NO. On electrical stimulation of PF, the relative content of synapses whose boutons were enveloped by glial cells was greater than the proportion of synapses in which glial cells were enveloped by spines, by a factor of 10. These morphological changes reflect the functional state of PF and PCD synapses in response to the harmful influences of excess Glu and NO, apparent as different forms of synaptic contacts and neuron-glial structures.



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Neuron Activity in the Retrosplenial Cortex of the Rat at the Early and Late Stages of Memory Consolidation

Activity was recorded from single neurons in the retrosplenial cortex during performance of an operant food-procuring behavior in two groups of rats; in the first six days after training to this behavior (group 1) and one week later, during which the animal did not perform the learned skill (group 2). At the same time, these groups showed no significant difference in the percentages of neurons specialized with respect to the learned behavior; in group 1, 40% of the cells of this category showed activation occurring in 80–90% of performances of the specific act, and not in all (100%), which was significantly different from the proportion of such cells (4%) in animals of group 2. All neurons with less than 100% activation at the early post-training stage were specialized with respect to the most recent act in the training history: approach to and pressing of the pedal. It is suggested that at the first stages of consolidation of the operant skill, its realization may occur by means of a variable set of cells in the retrosplenial cortex specialized with relative to the system of new behavioral acts.



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Neuroendocrine Reproductive Centers of the Corticomedial Division of the Amygdaloid Complex of the Brain

This review provides the first systematization of published data characterizing the structural-functional organization of the reproductive centers of the corticomedial division of the amygdaloid complex of the brain. Reports on the physiological mechanisms of their involvement in the organization of sexual behavior and the regulation of gonadotropin secretion and excretion are presented, along with data on their effects on the sexual maturation of the body. The involvement of the amygdaloid complex in the functional systems of the brain determining reproductive functions is determined by its involvement in the sexual differentiation of the brain. Olfactory stimuli play an important role in mediating reproductive functions, which relay via the amygdaloid complex to centers in the preoptic-hypothalamic area controlling gonadotropin secretion and sexual behavior.



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The Role of Melatonin in the Treatment of Chronic Back Pain

Objective. To study the analgesic role of melatonin in the treatment of chronic back pain. Materials and methods. A total of 178 patients aged 40–65 years with lower back pain for at least 12 weeks and pain intensity of more than 3 points on a visual analog scale took part in the study. Patients were divided into six groups and three comparison pairs. In pair 1, patients of the study group (31 subjects) received Artra (glucosamine hydrochloride 500 mg combined with chondroitin sulfate 500 mg) one tablet twice daily for one month followed by one tablet for two months, along with Melaxen (melatonin) 3 mg 30–40 min before going to sleep), while patients of the reference group (29 patients) received only Artra. In the second pair, patients of the reference group (30 patients) received Artra one tablet twice daily and diclofenac 25 mg 2–3 times daily and patients of the study group (30 patients) also received Melaxen as in the fi rst comparison pair. In the third pair, patients of the study group (29 patients) received diclofenac 25 mg three times daily and Melaxen as above, while patients of the reference group (29 patients) did not receive Melaxen. Results were evaluated at three months in pair 1 and at one month in pairs 2 and 3. Results and conclusions. The data obtained here provide evidence of a statistically signifi cantly more marked decrease in the intensity of rest and movement pain in all study groups than reference groups. The possible mechanism of the analgesic properties of melatonin and world experience in its use in the treatment of chronic pain are discussed. The results lead to the conclusion that addition of melatonin to standard treatment regimens increases their effi cacy.



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Gene regulation: May the force be with you

Nature Reviews Genetics. doi:10.1038/nrg.2016.103

Author: Paulina Strzyz



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Transcription factors as readers and effectors of DNA methylation

Nature Reviews Genetics. doi:10.1038/nrg.2016.83

Authors: Heng Zhu, Guohua Wang & Jiang Qian



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Microbiomes: Symbionts — in it for the long run

Nature Reviews Genetics. doi:10.1038/nrg.2016.102

Author: Bryony Jones



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To be g o o d , you must train - A l o t t ..! Camp Torpomoen

Training cost money... ( A 135 took a bath some years ago, during training, water-jobs :-/ -Crew OK :-) ).It is staff, and helos. enough for all bases to have serviced machines att anny time, and a dedicated training-helo, for use att training-base, or touring lokal bases, for shorter training sessions, around contry. The Gov. pays for the daily operation, but members pay for mutch of "the extra" ... Permanent trainig base, Hiering the best experts from around the world, to learn more in different skills, research, Response-car for all crews on stand-by, more... Like "HEMSwx"-Cameras:Advanced safety camera with two7three DSLR Cameras.Taking pics. every quarter.Images sent via mobile net.to all air ambulance bases in country.Images on big screen on bases operating theaters or on tablet / smartphone.Provides very good pictures,especially at night.Also provides information on temperature and airpressure.Today,deployed 32"HEMSvx"Cams. across country,goal =40 more w.i.this year.ExEMTNor

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To be g o o d , you must train - A l o t t ..! Camp Torpomoen

Training cost money... ( A 135 took a bath some years ago, during training, water-jobs :-/ -Crew OK :-) ).It is staff, and helos. enough for all bases to have serviced machines att anny time, and a dedicated training-helo, for use att training-base, or touring lokal bases, for shorter training sessions, around contry. The Gov. pays for the daily operation, but members pay for mutch of "the extra" ... Permanent trainig base, Hiering the best experts from around the world, to learn more in different skills, research, Response-car for all crews on stand-by, more... Like "HEMSwx"-Cameras:Advanced safety camera with two7three DSLR Cameras.Taking pics. every quarter.Images sent via mobile net.to all air ambulance bases in country.Images on big screen on bases operating theaters or on tablet / smartphone.Provides very good pictures,especially at night.Also provides information on temperature and airpressure.Today,deployed 32"HEMSvx"Cams. across country,goal =40 more w.i.this year.ExEMTNor

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To be g o o d , you must train - A l o t t ..! Camp Torpomoen

Training cost money... ( A 135 took a bath some years ago, during training, water-jobs :-/ -Crew OK :-) ).It is staff, and helos. enough for all bases to have serviced machines att anny time, and a dedicated training-helo, for use att training-base, or touring lokal bases, for shorter training sessions, around contry. The Gov. pays for the daily operation, but members pay for mutch of "the extra" ... Permanent trainig base, Hiering the best experts from around the world, to learn more in different skills, research, Response-car for all crews on stand-by, more... Like "HEMSwx"-Cameras:Advanced safety camera with two7three DSLR Cameras.Taking pics. every quarter.Images sent via mobile net.to all air ambulance bases in country.Images on big screen on bases operating theaters or on tablet / smartphone.Provides very good pictures,especially at night.Also provides information on temperature and airpressure.Today,deployed 32"HEMSvx"Cams. across country,goal =40 more w.i.this year.ExEMTNor

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To be g o o d , you must train - A l o t t ..! Camp Torpomoen

Training cost money... ( A 135 took a bath some years ago, during training, water-jobs :-/ -Crew OK :-) ( I can almost here "That" phone-call: Ehh, - hi boss... You know that 135 att Torpomoen, it -got a bitt wet... "Cheef- pilote": Hmmm, -OK, i`l send you a new one... ). It is staff, and helos. enough for all bases to have serviced machines att anny time, and a dedicated training-helo, for use att training-base, or touring lokal bases, for shorter training sessions, around contry. The Gov. pays for the daily operation, but members pay for mutch of "the extra" ... Permanent trainig base, Hiering the best experts from around the world, to learn more from the best in different skills, research, Response-car for all crews on stand-by, more... Like "HEMSwx" Cameras att strategic places all around contry, giving real-time info to crews, -at base, or in flight. This video full screen: https://youtube/-ySUNO7BaV8 ExEMTNor

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Acute pancreatitis: An unusual cause of esophageal stricture

A 25 year-old gentleman with alcohol related acute pancreatitis of 2 month-duration was symptomatic with abdominal pain and fever. Initially, the patient had required admission in ICU for persistent acute lung injury and was diagnosed to have severe acute pancreatitis. Contrast enhanced computed tomography (CECT) of abdomen revealed acute necrotizing pancreatitis with peri-pancreatic necrotic collection extending into left paracolic gutter with air foci. He received intravenous meropenem for pancreatic infection, proton pump inhibitors for stress ulcer prophylaxis and received percutaneous drain as part of step-up approach.

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Acute pancreatitis: An unusual cause of esophageal stricture

A 25 year-old gentleman with alcohol related acute pancreatitis of 2 month-duration was symptomatic with abdominal pain and fever. Initially, the patient had required admission in ICU for persistent acute lung injury and was diagnosed to have severe acute pancreatitis. Contrast enhanced computed tomography (CECT) of abdomen revealed acute necrotizing pancreatitis with peri-pancreatic necrotic collection extending into left paracolic gutter with air foci. He received intravenous meropenem for pancreatic infection, proton pump inhibitors for stress ulcer prophylaxis and received percutaneous drain as part of step-up approach.

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LPN, Paramedic - CSL PLASMA

Job Description 1 Promotes positive customer relations with all donors. 2 Conducts confidential and effective interviews with donors to obtain necessary information regarding suitability to donate plasma. 3 In conjunction with the Center Medical Director and/or Center Physician responds to medically related questions from staff including donor suitability and provides information to staff on medically ...

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"Olanzapine induced hypothermia: a rare case report"

2016-07-31T06-40-16Z
Source: Journal of Behavioral Health
Javed Ather Siddiqui, Shazia Farheen Qureshi, Abdullah Al Zahrani.
ABSTRACT: Introduction: We report a case of 40-year old man who had a diagnose case of schizophrenia on olanzapine, had develop symptomatic hypothermia. The majority of documented cases involve short duration of hypothermia often less than 24 hours. Antipsychotics that are more potent antagonists at 5HT2 than at dopamine2 receptors appear more likely to cause hypothermia. Objective: Hypothermia is an adverse drug reaction of antipsychotic drug use. It is strong 5HT2 antagonistc characteristics which induced hypothermia, have been proposed. 55 percent of hypothermia reports are for atypical antipsychotics. Case presentation: A 40-year old man with schizophrenia who was being treated with a therapeutic dose of olanzapine presented with shivering, slurred speech, Confusion. He had a core temperature of 31.5 celsius. Electrocardiogram showed sinus bradycardia with Osborn waves or J waves. He didnt have any risk factors for developing hypothermia except the use of olanzapine. There was improvement in his clinical condition with reversal of electrocardiogram changes following gradual re-warming and withhold of olanzapine. Conclusion: Olanzapine induced hypothermia is rare and has been reported during initiation and increasing the dose or even in stable dose, but this case report raises the possibility of hypothermia even in patients who are on stable doses of olanzapine for a long period of time. Clinicians should consider the possibility of drug induced illness in hypothermic patients who are taking antipsychotics.


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Effectiveness of preemptive intra-articular levobupivacaine on pain relief after arthroscopic knee surgery

2016-07-31T03-45-29Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Seher Altinel, Ismail Aydin Erden, Banu Ayhan, Seda Banu Akinci, Fatma Saricaoglu, Ulku Aypar.
Background and Aim: Severe pain and comfortlessness may be seen in patients after arthroscopic knee surgery despite various commonly administered analgesic methods, particularly based on local anesthetics. The aim of this study was to determine the effect of intraarticular levobupivacaine injected preoperatively on pain relief and time to first analgesic request during the postoperative period. Material and Methods: 40 adult-patients, ASA I and II, undergoing elective arthroscopic surgery were included in the study. Patients in the levobupivacaine group received intra-articular levobupivacaine at 5mg/ml dosages and 20 ml total volume 30 min before the procedure. Patients in the control group received 20 ml of normal saline. Visual analogue scale (VAS) scores were assessed at the 1st, 2nd, 4th, 8th, 12th and 24th hour postoperatively. Time to first analgesic request and total analgesics used over the course of 24 hours after the surgery were recorded. All patients received continuous morphine infusion via patient controlled analgesia (PCA) devices postoperatively. Additionally, patients pain satisfaction scores were recorded. Results: Lower VAS scores at the 1st, 2nd, 4th and 8th hours postoperatively - both at rest and during motion - were found in the levobupivacaine group compared to the normal saline group (p


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Open hemorrhoidectomy versus stapler hemorrhoidopexy: A prospective study

2016-07-31T03-45-29Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Mumtaz Din Wani, Shabir Ahmad Mir, Saleem Javaid, Yawar Watali.
Background: Stapled hemorrhoidectomy, though significantly less painful, is still in its evolutionary stages, especially in the developing world. The present study was undertaken to ascertain the efficacy, safety and advantages, if any, of the stapled hemorrhoidopexy. Material and Methods: This prospective study was comprised of patients admitted for elective surgery of hemorrhoids over a period of 18 months during the period of January 2014 to June 2015 in various surgical wards of SMHS (Shri Maharaja Hari Singh) Hospital, Srinagar. The patients were randomized into two groups. One group underwent conventional open hemorrhoidectomy and the other group, stapled hemorrhoidopexy. Results: In our study, the mean operating time for stapled hemorrhoidopexy was 35.22±7.23 minutes with an average of 20-50 minutes, while with open hemorrhoidectomy, the mean operating time was 45.67±11.94 minutes (p


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Radical orchiectomy with iliohypogastric nerve blockage: A case report

2016-07-31T03-45-29Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Guldeniz Argun, Seher Altinel.
Iliohypogastric nerve blockage is rarely used for surgical operations in inguinal regions for the purpose of anesthesia without general or spinal anesthesia. A 33-year-old man with severe congenital chest and back deformities as well as cardiac and respiratory system problems had a testicular mass. General or spinal anesthesia may cause severe complications because of existing anatomical conditions and co-morbidities. Therefore, Iliohypogastric nerve blockage was performed with the aim of achieving anesthetic activity without general and spinal anesthesia. There were no side effects related to iliohypogastric nerve blockage during the postoperative period, including nausea, vomiting, hypotension, urinary retention, femoral nerve palsy, and local hematoma. Both the surgeon and the patients satisfaction were evaluated. Using iliohypogastric nerve blockage should be keep in mind for patients with anatomic or heart and pulmonary function problems with the goal of achieving anesthetic activity without general and spinal anesthesia.


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Gait Retraining with real-time Biofeedback to reduce Knee adduction moment: systematic review of effects and methods used

Publication date: Available online 30 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Rosie. Richards, Josien. C. van den Noort, Joost. Dekker, Jaap. Harlaar
ObjectiveTo review the current literature regarding methods and effects of real-time biofeedback used as a method for gait retraining to reduce knee adduction moment (KAM), with intended application for knee osteoarthritis (KOA) patients.Data sourcesSearches were conducted in MEDLINE, EMBASE, CINAHL, SportDiscus, Web of Science and the Cochrane Database for gait, feedback and knee osteoarthritis from inception to May 2015.Study SelectionTitles and abstracts were screened by one individual for studies aiming to reduce KAM. Full text articles were assessed by two individuals against pre-defined criteria.Data extractionData were extracted by one individual according to a pre-defined list, including participant demographics and training methods and effects.Data synthesisElectronic searches resulted in 190 potentially eligible studies, from which 12 met all inclusion criteria. Within group standardised mean differences (SMDs) for reduction of KAM in healthy controls ranged from 0.44 to 2.47 and from 0.29 to 0.37 in KOA patients. In KOA patients, improvements were reported in pain and function, with SMDs ranging from 0.55 to 1.16. Methods of implementation of biofeedback training varied between studies, but in healthy controls increased KAM reduction was noted with implicit, rather than explicit, instructions.ConclusionsThis review suggests that biofeedback gait training is effective primarily for reducing KAM but also for reducing pain and improving function in KOA patients. The review was limited by the small number of studies featuring KOA patients and the lack of controlled studies. The results suggest there is value as well as a need in further researching biofeedback training for reducing KAM. Future studies should include larger cohorts of patients, long term follow-up and controlled trials.



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Patient and therapist agreement on performance rated ability on the de Morton Mobility Index

Publication date: Available online 30 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Romi Haas, Kelly-Ann Bowles, Lisa O'Brien, Terry Haines
ObjectiveTo determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI).DesignInter-rater agreement study; Setting: Outpatient hospital clinic in (blinded). Participants: Consecutive sample of patients (n=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty.InterventionsParticipants completed a therapist-directed assessment of the DEMMI followed by self-report of performance. A random subsample (n=62) also completed a self-report of anticipated performance prior to the therapist-directed assessment. Both raters (participant and therapist) were blinded to the scores obtained from the other rater.Main Outcome Measure(s)Inter-rater agreement between patient self-reported and therapist-directed assessment total DEMMI scores was calculated using the intraclass correlation coefficient (ICC) (Model 2,1) with a 95% confidence interval. Bland-Altman plots were also used to illustrate the agreement between the two raters.ResultsThe ICC between patient self-reported and therapist-directed assessment following performance of the total DEMMI score was 0.967 (95% confidence interval 0.952, 0.977). The ICC between patient anticipated performance and therapist-directed assessment of the total DEMMI score was 0.830 (95% confidence interval 0.730, 0.894). The Bland-Altman plots depicted greater levels of agreement amongst participants with impaired levels of mobility (≤74/100) than those with near maximum DEMMI scores.ConclusionsPatient self-report of anticipated performance is an acceptable proxy for DEMMI scores derived from therapist rating of performance. Caution should be applied when interpreting self-report scores of patients with near maximum levels of mobility. Further research is required to establish whether these results can be generalized across a range of patient populations and to clinicians with differing backgrounds and expertise.



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Social Isolation and Physical Barriers in the Houses of Stroke Survivors in Rural China

Publication date: Available online 30 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Lifang Zhang, Tiebin Yan, Liming You, Kun li, Yan Gao
ObjectiveTo describe the home barriers and social isolation of stroke survivors in the rural areas of China and to explore which home barriers are associated with social isolation.DesignCross-sectional survey.SettingStructured interviews and observation in the participants' homes.ParticipantsCommunity-dwelling stroke survivors in the rural areas of China (N=818).InterventionsNot applicableMain outcome measuresPhysical barriers in rural homes were surveyed using a Home Fall Hazards Assessment. Social isolation was identified if two or more of the following indicators were observed: low frequency of getting out of the home, lacking leisure activities, and living alone in the previous three months.ResultsThe prevalence rates of 18 among 30 home barriers exceeded 20%, and the highest was 93% (lack of hand rails in the bathroom). The prevalence of social isolation was 30%.Three home barriers were independently related to social isolation. They were a distant toilet(OR=2.363; 95%CI: 1.527–3.658; p<0.001), unsuitable seating(OR=1.571; 95%CI: 1.026–2.404; p=0.038), and inaccessible light switches(OR=1.572; 95%CI: 1.064–2.324; p=0.023).ConclusionsMany barriers exist in the houses of stroke survivors in rural China. Some of them are related to social isolation. Eliminating or decreasing home barriers could be a feasible and effective approach to reducing social isolation.



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Alternative RNA splicing and gastric cancer

Publication date: Available online 29 July 2016
Source:Mutation Research/Reviews in Mutation Research
Author(s): Ying Li, Yuan Yuan
Alternative splicing (AS) linked to diseases, especially to tumors. Recently, more and more studies focused on the relationship between AS and gastric cancer (GC). This review surveyed the hot topic from four aspects: First, the common types of AS in cancer, including exon skipping, intron retention, mutually exclusive exon, alternative 5 ' or 3' splice site, alternative first or last exon and alternative 3' untranslated regions. Second, basic mechanisms of AS and its relationship with cancer. RNA splicing in eukaryotes follows the GT-AG rule by both cis-elements and trans-acting factors regulatory. Through RNA splicing, different proteins with different forms and functions can be produced and may be associated with carcinogenesis. Third, AS types of GC-related genes and their splicing variants. In this paper, we listed 10 common genes with AS and illustrated its possible molecular mechanisms owing to genetic variation (mutation and /or polymorphism). Fourth, the splicing variants of GC-associated genes and gastric carcinogenesis, invasion and metastasis. Many studies have found that the different splicing variants of the same gene are differentially expressed in GC and its precancerous diseases, suggesting AS has important implications in GC development. Taking together, this review highlighted the role of AS and splicing variants in the process of GC. We hope that this is not only beneficial to advances in the study field of GC, but also can provide valuable information to other similar tumor research.Although we already know some gene splicing and splicing variants play an important role in the development of GC, but many phenomena and mechanisms are still unknown. For example, how the tumor microenvironment and signal transduction pathway effect the forming and function of AS? Unfortunately, this review did not cover the contents because the current study is limited. It is no doubt that clarifying the phenomena and mechanisms of these unknown may help to reveal the relationship of AS with complex tumor genetic variation and the occurrence and development of tumors.



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Ionizing radiation induced cataracts: Recent biological and mechanistic developments and perspectives for future research

Publication date: Available online 29 July 2016
Source:Mutation Research/Reviews in Mutation Research
Author(s): Elizabeth A. Ainsbury, Stephen Barnard, Scott Bright, Claudia Dalke, Miguel Jarrin, Sarah Kunze, Rick Tanner, Joseph R. Dynlacht, Roy A. Quinlan, Jochen Graw, Munira Kadhim, Nobuyuki Hamada
The lens of the eye has long been considered as a radiosensitive tissue, but recent research has suggested that the radiosensitivity is even greater than previously thought. The recent recommendations of the International Commission on Radiological Protection (ICRP) to substantially reduce the annual occupational equivalent dose limit for the ocular lens have now been adopted in the European Union and are under consideration around the rest of the world. However, ICRP clearly states that the recommendations are chiefly based on epidemiological evidence because there are a very small number of studies that provide explicit biological, mechanistic evidence at doses <2Gy. This paper aims to present a review of recently published information on the biological and mechanistic aspects of cataracts induced by exposure to ionizing radiation (IR). The data were compiled by assessing the pertinent literature in several distinct areas which contribute to the understanding of IR induced cataracts, information regarding lens biology and general processes of cataractogenesis. Results from cellular and tissue level studies and animal models, and relevant human studies, were examined. The main focus was the biological effect of low linear energy transfer IR, but dosimetry issues and a number of other confounding factors were also considered. The results of this review clearly highlight a number of gaps in current knowledge. Overall, while there have been a number of recent advances in understanding, it remains unknown exactly how IR exposure contributes to opacification. A fuller understanding of how exposure to relatively low doses of IR promotes induction and/or progression of IR-induced cataracts will have important implications for prevention and treatment of this disease, as well as for the field of radiation protection.



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Radiation and Circulatory Disease

Publication date: Available online 30 July 2016
Source:Mutation Research/Reviews in Mutation Research
Author(s): Mark P. Little
Exposure to therapeutic doses of ionizing radiation is associated with damage to the heart and coronary arteries. However, only recently have studies with high-quality individual dosimetry data allowed this risk to be quantified while also adjusting for concomitant chemotherapy, and medical and lifestyle risk factors. At lower levels of exposure the evidence is less clear. In this article we review radiation-associated risks of circulatory disease in groups treated with radiotherapy for malignant and non-malignant disease, and in occupationally- or environmentally-exposed groups receiving rather lower levels of radiation dose, also for medical diagnostic purposes.Results of a meta-analysis suggest that excess relative risks per unit dose for various types of heart disease do not differ significantly (p>0.2) between studies. In particular, there are no marked discrepancies between risks derived from the high-dose therapeutic and medical diagnostic studies and from the moderate/low dose occupational and environmental studies. However, risk for stroke and other types of circulatory disease are significantly more variable (p<0.0001), possibly resulting from confounding and effect-modification by well known (but unobserved) risk factors. Adjustment for any of mean dose, dose fractionation or age at exposure results in the residual heterogeneity for cerebrovascular disease becoming non-significant. The review provides strong evidence in support of a causal association between both low and high dose radiation exposure and most types of circulatory disease.



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