Σάββατο, 10 Σεπτεμβρίου 2016

Animal Models of transcranial Direct Current Stimulation: Methods and Mechanisms

This review is an update, with permission, of a previously published work (Bikson et al., 2012).

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Distinctive neuronal firing patterns in subterritories of the subthalamic nucleus

Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for advanced Parkinson's disease (PD). Several studies have demonstrated its effectiveness in improving PD-related motor symptoms (Benabid et al. 2009; Fasano et al. 2012), including younger patients and those at a less advanced disease stage (Schuepbach et al. 2013). An accurate DBS lead location, within the presumed sensorimotor domain of the STN (dorsolateral, dSTN), is crucial to obtain optimal motor benefit (Herzog et al.

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Regional and network relationship in the intracranial eeg second spectrum

There is considerable interest in understanding the correlation in activity between different brain regions. Several fMRI studies have described a number of resting state networks (RSNs), distant brain areas that show relatively high correlation in blood-oxygen-level dependent (BOLD) signal while the patient is in a resting state (Biswal et al., 1995). A resting state network (RSN) that is of particular interest is the default mode network (DMN), which has been linked in fMRI studies to cognitive processes during "rest." The DMN is proposed to include the medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), and retrosplenial cortex (RCC) (Raichle et al., 2001).

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Effect of stimulus type and temperature on EEG reactivity in cardiac arrest

In patients with cardiac arrest, therapeutic hypothermia has vastly improved mortality outcomes (Bernard et al. 2002). There remains a need to determine with greater certainty which patients are amenable to favorable recoveries. Electroencephalography (EEG) is now part of the multimodal outcome prediction models available to treating physicians of cardiac arrest patients who undergo therapeutic hypothermia (TH), and EEG background continuity has emerged as a predictor of favorable outcomes (Cloostermans et al.

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Markers of biological stress in response to a single session of high-intensity interval training and high-volume training in young athletes

Abstract

Purpose

The aim of the present study was to compare the effects of high-intensity interval training (HIIT) vs high-volume training (HVT) on salivary stress markers [cortisol (sC), testosterone (sT), alpha-amylase (sAA)], metabolic and cardiorespiratory response in young athletes.

Methods

Twelve young male cyclists (14 ± 1 years; 57.9 ± 9.4 mL min−1 kg−1 peak oxygen uptake) performed one session of HIIT (4 × 4 min intervals at 90–95 % peak power output separated by 3 min of active rest) and one session of HVT (90 min constant load at 60 % peak power output). The levels of sC, sT, their ratio (sT/sC) and sAA were determined before and 0, 30, 60, 180 min after each intervention. Metabolic and cardiorespiratory stress was characterized by blood lactate, blood pH, respiratory exchange ratio (RER) and heart rate (HR), oxygen uptake ( \(V__{ 2} }}\) ), ventilation (V E) and ventilatory equivalent (V E/ \(V__{ 2} }}\) ).

Results

sC increased 30 and 60 min after HIIT. However, 180 min post exercise, sC decreased below baseline levels in both conditions. sT increased 0 and 30 min after HIIT and 0 min after HVT. sAA and sT/sC ratio did not change significantly over time in HIIT nor HVT. Metabolic and cardiorespiratory stress, evidenced by blood lactate, HR, \(V__{ 2} }}\) , V E, and V E/ \(V__{ 2} }}\) was higher during HIIT compared to HVT.

Conclusion

The metabolic and cardiorespiratory stress during HIIT was higher compared to HVT, but based on salivary analyses (cortisol, testosterone, alpha-amylase), we conclude no strong acute catabolic effects neither by HIIT nor by HVT.



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The effect of exercise hypertrophy and disuse atrophy on muscle contractile properties: a mechanomyographic analysis

Abstract

Purpose

To determine whether mechanomyographic (MMG) determined contractile properties of the biceps brachii change during exercise-induced hypertrophy and subsequent disuse atrophy.

Methods

Healthy subjects (mean ± SD, 23.7 ± 2.6 years, BMI 21.8 ± 2.4, n = 19) performed unilateral biceps curls (9 sets × 12 repetitions, 5 sessions per week) for 8 weeks (hypertrophic phase) before ceasing exercise (atrophic phase) for the following 8 weeks (non-dominant limb; treatment, dominant limb; control). MMG measures of muscle contractile properties (contraction time; T c, maximum displacement; D max, contraction velocity; V c), electromyographic (EMG) measures of muscle fatigue (median power frequency; MPF), strength measures (maximum voluntary contraction; MVC) and measures of muscle thickness (ultrasound) were obtained.

Results

Two-way repeated measures ANOVA showed significant differences (P < 0.05) between treatment and control limbs. During the hypertrophic phase treatment MVC initially declined (weeks 1–3), due to fatigue (decline in MPF), followed by improvement against control during weeks 6–8. Between weeks 5 and 8 treatment, muscle thickness was greater than control, reflecting gross hypertrophy. MMG variables Dmax (weeks 2, 7) and Vc (weeks 7, 8) declined. During the atrophic phase, MVC (weeks 9–12) and muscle thickness (weeks 9, 10) initially remained high before declining to control levels, reflecting gross atrophy. MMG variables D max (weeks 9, 14) and V c (weeks 9, 14, 15) also declined during the atrophic phase. No change in T c was found throughout the hypertrophic or atrophic phases.

Conclusions

MMG detects changes in contractile properties during stages of exercise-induced hypertrophy and disuse atrophy suggesting its applicability as a clinical tool in musculoskeletal rehabilitation.



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Heritability of heart rate recovery and vagal rebound after exercise

Abstract

Purpose

The prognostic power of heart rate recovery (HRR) after exercise has been well established but the exact origin of individual differences in HRR remains unclear. This study aims to estimate the heritability of HRR and vagal rebound after maximal exercise in adolescents. Furthermore, the role of voluntary regular exercise behavior (EB) in HRR and vagal rebound is tested.

Methods

491 healthy adolescent twins and their siblings were recruited for maximal exercise testing, followed by a standardized cooldown with measurement of the electrocardiogram and respiratory frequency. Immediate and long-term HRR (HRR60 and HRR180) and vagal rebound (heart rate variability in the respiratory frequency range) were assessed 1 and 3 min after exercise. Multivariate twin modeling was used to estimate heritability of all measured variables and to compute the genetic contribution to their covariance.

Results

Heritability of HRR60, HRR180 and immediate and long-term vagal rebound is 60 % (95 % CI: 48–67), 65 % (95 % CI: 54–73), 23 % (95 % CI: 11–35) and 3 % (95 % CI: 0–11), respectively. We find evidence for two separate genetic factors with one factor influencing overall cardiac vagal control, including resting heart rate and respiratory sinus arrhythmia, and a specific factor for cardiac vagal exercise recovery. EB was only modestly associated with resting heart rate (r = −0.27) and HRR (rHRR60 = 0.10; rHRR180 = 0.19) with very high genetic contribution to these associations (88–91 %).

Conclusions

Individual differences in HRR and immediate vagal rebound can to a large extent be explained by genetic factors. These innate cardiac vagal exercise recovery factors partly reflect the effects of heritable differences in EB.



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Cardiac stroke volume variability measured non-invasively by three methods for detection of central hypovolemia in healthy humans

Abstract

Purpose

Hypovolemia decreases preload and cardiac stroke volume. Cardiac stroke volume (SV) and its variability (cardiac stroke volume variability, SVV) have been proposed as clinical tools for detection of acute hemorrhage. We compared three non-invasive SV measurements and investigated if respiration-induced fluctuations in SV may detect mild and moderate hypovolemia in spontaneously breathing humans.

Methods

Ten healthy subjects underwent experimental central hypovolemia induced by lower body negative pressure to −60 mmHg or onset of presyncopal symptoms. SV beat-to-beat was estimated simultaneously by ultrasound Doppler, finger arterial blood pressure curve and impedance cardiography. SVV was calculated by spectral analysis between 0.15 and 0.40 Hz.

Results

Relative changes in SV did not show significant differences between the methods. The SVV measured by ultrasound Doppler and arterial blood pressure curve decreased at −30 mmHg to 32 % (ultrasound Doppler: 95 % CI 18–47, arterial blood pressure curve: 95 % CI 21–43) and at maximal simulated hypovolemia to 23 % (ultrasound Doppler: 95 % CI 14–81) and 21 % (arterial blood pressure curve: 95 % CI 9–33) of baseline variability. The variability in cardiac stroke volume from the impedance cardiography did not change significantly during the simulated hypovolemia, to 88 and 76 % of baseline variability.

Conclusion

Cardiac stroke volume estimated by ultrasound Doppler and by arterial blood pressure curve showed parallel variations beat-to-beat during simulated hemorrhage, whereas impedance cardiography did not appear to track beat-to-beat changes in cardiac stroke volume. The variability in cardiac stroke volume was decreased during mild and moderate hypovolemia and could be used for early detection of hypovolemia.



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Predictive and reactive grip force responses to rapid load increases in people with multiple sclerosis

Publication date: Available online 9 September 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kathrin Allgöwer, Claudia Kern, Joachim Hermsdörfer
ObjectiveTo determine the effects of multiple sclerosis (MS) on predictive and reactive grip force control in a catching-task and on clinical tests of hand function.DesignCase-control study with matched-pairs control group.SettingKuratorium for Prevention and Rehabilitation at the Technical University of Munich e.V.ParticipantsFifteen people with MS (PwMS) and fifteen healthy controls, matched for sex, age and hand dominance.InterventionsNot applicable.Main Outcome MeasuresPerformance of the Expanded Disability Status Scale (EDSS), Nine Hole Peg Test (9-HPT), Jebsen Taylor Test (JTHFT) and two-point discrimination (2PD) was evaluated. To analyze grip force control, blindfolded subjects held a receptacle equipped with grip force and acceleration sensors in their hand. In a catching-task a weight was dropped (a) from the experimenter`s hand unexpectedly into the receptacle (reactive force control), respectively (b) from the subject`s opposite hand (predictive force control). Grip forces and time-lags were analyzed.ResultsPwMS (mean EDSS 4.2± 1.86) had impairments in the 9-HPT and JTHFT (p<.001). The 2PD did not differ significantly between PwMS and controls. During reactive force control (a) PwMS showed significantly higher grip forces immediately after impact (p<0.05) and a significant prolongation of the time from grip force increase until reaching the peak of grip force (p<.001). PwMS and controls did not differ during predictive force control (b) (p>0.1).ConclusionExaggerated grip force responses and alterations of timing after an unpredictable perturbation combined with preserved grip force control during predictable conditions is a characteristic pattern of fine motor control deficits in MS. Measures of reactive grip force responses may be used to complement neurologic assessments. Further studies exploring its usefulness should be performed in a broader community in PwMS.



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Peripheral nerve conduction abnormalities precede morphological alterations in an experimental rat model of sepsis

Abstract

Purpose

The pathological mechanisms of critical illness polyneuropathy (CIP), an acute neuromuscular disorder, remain unknown. In this study, we evaluated nerve and vascular properties that might account for electrophysiological abnormalities, including reduced nerve conduction amplitude, in the early phase of CIP.

Methods

Rats were administered intravenous saline (C-group; n = 31) or lipopolysaccharide (3 mg/kg/day; L-group; n = 30) for 48 h. Subsequently, tracheotomy was performed and sciatic nerves exposed bilaterally. A catheter was inserted into the left internal carotid artery to measure the mean arterial pressure (MAP). Nerve conduction velocity (NCV), nerve blood flow (NBF), evoked amplitudes, chronaxie, rheobase, and the absolute refractory period (ARP) were measured from the sciatic nerves. Degeneration, myelination, and neutrophil infiltration were examined in the sciatic nerves using histology and electron microscopy.

Results

The NBF (C-group 25 ± 3 ml/100 g/min, L-group 13 ± 3 ml/100 g/min, p < 0.001) was lower in the L-group, but the MAP was similar between groups (C-group 119 ± 17 mmHg, L-group 115 ± 18 mmHg, p = 0.773). LPS also caused a severe reduction in amplitude (C-group 0.9 ± 0.2 mV, L-group 0.2 ± 0.1 mV, p < 0.001), while latency and NCV were not affected. Of note, response amplitudes partially recovered with an increase in stimulus intensity. LPS treatment increased the rheobase and decreased the chronaxie (rheobase: C vs L-group; 0.35 ± 0.07 vs 1.29 ± 0.66 mA, p < 0.001; chronaxie 171 ± 24 vs 42 ± 20 µs, p < 0.001), while ARP was unchanged. No primary axonal degeneration or inflammatory infiltration was observed.

Conclusions

Our findings suggest that primary electrophysiological deterioration is due to threshold alterations rather than morphological alterations after 48 h of LPS treatment.



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Systematic review of motor evoked potentials monitoring during thoracic and thoracoabdominal aortic aneurysm open repair surgery: a diagnostic meta-analysis

Abstract

Motor evoked potential (MEP) monitoring has been used to prevent neurological complications such as paraplegia in patients who underwent thoracic or thoracoabdominal aortic aneurysm (TAA/TAAA) surgery. The object of this study was making a systematic review to survey the performance of MEP monitoring during TAA/TAAA open repair surgery. We searched electronic databases for relevant studies. We summarized the diagnostic data with summary sensitivity, summary specificity and forest plots of pooled sensitivity, and conducted sub-group analysis. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. We also surveyed the reporting rate of clinical key factors such as methods of anesthesia, surgery, and success rate of MEP. Nineteen studies met our criteria. The results of meta-analysis showed 89.1 % summary sensitivity (95 % confidence interval 47.9–98.6 %) and 99.3 % summary specificity (95 % confidence interval 96.1–99.9 %). Sub-group analysis of pooled sensitivity and specificity by all-or-none cut-off point were better than other cut-off points. The results of the QUADAS-2 were not good. The performance of MEP monitoring was good for detecting postoperative paraplegia in TAA/TAAA open repair surgery. The cut-off point of all-or-none may be the best, according to our review.



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Association of reasons for living inventory scores with suicidal acts among patients with major depression

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Kiran N Vaghia, Darshankumar K Mahyavanshi, Vikas Malik.
Background: Suicide is among the top 3 causes of death among youth worldwide. Objective: This study was aimed to find out the association of reasons for living, among patients with major depression at a tertiary care hospital. Materials and Methods: Total 70 subjects were recruited from patients coming to psychiatry OPD of GMERS medical college hospital, Valsad. Subjects were aged between 18 and 80 years who met DSM-IV-TR criteria for current major depressive episode and were free of severe, unstable medical and neurologic disorders. Analysis of data was done by using Epi-info version 7. Result: The total score for reasons for living of the depressed patients who had not committed suicide was significantly higher than people who had committed suicide (p value 0.01). The mean of the total score on the reasons for living inventory for the suicide attempters was 160.95 and mean for suicide non-attempters 180.1. Conclusion: Reasons for living scores were found lower among suicide attempters compared to non-attempters among depressed patients.


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Surgical site infections: incidence, bacteriological profiles and risk factors in a tertiary care teaching hospital, western India

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Kalpesh H Shah, Suman P Singh, Jignesh Rathod.
Background: A surgical site infection (SSI) is an unintended and oftentimes preventable consequence of surgery. SSIs are associated with patient morbidity and increased healthcare costs. SSIs are commonest nosocomial infections after urinary tract infections (UTI). Objective: The present study was aimed at obtaining the incidence and bacteriological profiles of SSI and determining various risks factors influencing the SSI rate at tertiary care hospital, Gujarat, Western India. Materials and Methods: All patients who underwent various surgeries in Shree Krishna hospital from July 2013 to May 2014 were included with approval from Human Research Ethics Committees. Details of the surgery and patient profile along with various risk factors were collected in predesigned proforma. If there was infection then the suspected samples were obtained from wounds and processed without delay using standard microbiological methods. Infection rates and risk factors were calculated using SPSS13. Result: During the study period 1181 surgeries were conducted. Overall SSI rate was 3.38%. The most common organism isolated was Escherichia coli (34.8%). Increasing age, diabetes mellitus, prolonged preoperative hospital stay, and ASA score >3, emergency surgery, prolonged duration of surgery (more than 75th percentile of NNIS duration cut point) and contaminated and dirty surgical sites were found to be associated with higher rate of SSI. Conclusion: Continuous surveillance of surgical site infections and study of factors that might increase the risk is important to reduce SSI rates if communicated to surgeons on time.


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Is there a difference between the flexible and rigid reamer in femoral tunnel length in ACL reconstruction in anteromedial portal

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Saeed Koaban, Salman Alharbi.
Background: Anterior cruciate ligament (ACL) reconstruction was functionally done on trans-tibial section and was creating vertical long tunnel. Nowadays, it is done by modified trans-tibial and anterior-medial portal which creates short tunnel compared to trans-tibial approach. Objective: To compare femoral tunnel length using a flexible versus rigid reamer in ACL antero-medial portal reconstruction surgery. Materials and Methods: Retrospective medical record analysis of all ACL reconstruction surgeries performed between February and December 2014 among 3 surgeons in security force hospital in Riyadh was done. In all of these procedures, the femoral tunnel length was measured with digital calipers from 20 to 48 mm and was reported in mm. Result: A total of 309 ACL reconstructions were done, 151 (18.9%) using a flexible reamer and 158 (51.1%) with a rigid reamer. The overall mean tunnel length was 38.6 ± 5.2 mm. The mean tunnel length in cases that used the flexible reamer was 39.0 ± 4.9 mm, and the mean tunnel length in cases that used the rigid reamer was 38.1 ± 5.4 mm. The mean difference in the tunnel length between flexible and rigid reamer was 0.88 mm. There was no statistical difference between the mean tunnel lengths between flexible and rigid reamers. There were no significant differences in the tunnel length performed by 3 different surgeons. Conclusion: The femoral tunnel lengths were not significantly different with the use of a flexible or a straight reamer.


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Socio-demographic correlates of deliberate self-harm among the patients of substance abuse disorders attending a Medical College of West Bengal

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Aditya Prasad Sarkar, Subrata Sen, Prasenjit Ray, Amitava Chakraborty, Nandini Bhaduri, Asim Kumar Mallick.
Background: Deliberate self-harm (DSH) is a challenge to public health now-a-days. It is reported across several specific psychiatric illnesses like personality disorders, alcohol and substance abuse, and affective disorders. Objectives: The objectives of the study were (i) to study the socio-demographic characteristics of the patients attending the Drug De-addiction Center of a Medical College in West Bengal and (ii) to determine the proportion of DSH committed by them and to find out the factors responsible for DSH among them. Material and Methods: A descriptive study with cross-sectional design was conducted in the Drug De-addiction Center of Burdwan Medical College and Hospital, West Bengal. Informed consent was obtained from the participants before data collection. In total, 585 new patients were included in the study by complete enumeration. Data analysis was done using statistical software SPSS 20.0. Results: All patients were male having majority in productive age group. Majority was employed and from nuclear families. Alcohol use was majority among the types of addiction. DSH was reported by 14.7% of cases. Employment status and alcohol addiction were statistically significant as factor for DSH. Conclusion: The presence of risk for DSH should be assessed in drug addicts routinely along with motivation of family members to support the patients to prevent DSH.


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Evaluation of Mannheim Peritonitis Index in predicting the prognosis of hollow viscus perforation

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Valluri Mukesh Krishna, Prasanna Kumar Turakar Joseph, Vivek Vattikutti, Gayathri Garika.
Background: Peritonitis due to hollow viscous perforation continues to be one of the most common surgical emergencies and a potentially life threatening condition. Its accurate diagnosis and management is still a challenge to surgeons worldwide. A scoring system should be able to assess the need, type, and quality of the care required for a particular patient. Realizing the need for a simple and accurate scoring system in these conditions, the present study was undertaken to evaluate the performance of Mannheim peritonitis index (MPI) scoring system in predicting the overall risk of morbidity and mortality in patients with peritonitis due to hollow viscous perforation. Objective: To predict the risk of mortality and morbidity in patients with peritonitis due to hollow viscous perforation in a sample study of 100 patients and to study the prognostic factors which determine the outcome of the disease. Materials and Methods: This study is a clinical, prospective, observational, and open study conducted at NRI Medical College and General Hospital during a period of 2 years on 100 patients. MPI scoring system was done in all patients and patients were classified according the scores into 3 groups. Result: MPI scoring system was done on all patients depending on preoperative and intraoperative finding and patients were categorized into the three categories. In the score group of 29 it is observed that, 15.78% had morbidity and 84.22% had mortality. A threshold index score of MPI is derived at 27 for predicting the mortality with a sensitivity of 80%, specificity of 91.94% and a PPV = 76.19%. Conclusion: The results of this study proves that MPI scoring system is a simple and effective tool for assessing this group of patients, and can be used as a guiding tool to decide on the management of the patient after the definitive procedure is done.


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Correlation of serum prostate-specific antigen level in various prostate pathology in elderly men

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Varsha S Khant, Hansa Goswami, Pooja Y Shah.
Background: Carcinoma of prostate is one of common tumors of old age in men. With digital rectal examination (DRE) prostate-specific antigen (PSA) is a major screening tool for prostate cancer. While Trans Rectal Ultra Sound (TRUS)-guided needle biopsies of prostate are considered gold standard for the diagnosis of prostate cancers. Objectives: To determine the spectrum of pathological lesions in TRUS-guided needle biopsies of prostate in men with increased serum PSA levels (≥ 4 ng/ml) with or without symptoms of prostatism. Material and Methods: The study was carried out at the Department of Histopathology, B.J. Medical College Civil Hospital, Ahmedabad from January 2015 to October 2015. The study included 110 cases. Serum PSA level and histopathological examination of prostatic biopsies were performed and correlated. Raised serum PSA level were arbitrarily divided into mild (≥ 410 ng/ml), moderate (≥ 10.120 ng/ml), and marked elevations (≥ 20.1 to highest). Results: The mean age of patients was 66.9 ± 9.4 years. Out of 110 cases, 69 (62.72%) cases were benign and 41 (37.2%) were malignant. Among malignant lesions, all cancers were of moderate to high Gleason grades and scores. Mild serum PSA rise was seen in 63 (57.27%) patients, among these 52 (84.1%) showed benign lesions and 10 (15.9%) malignant. Moderate serum PSA rise was seen in 26 (23.6%) cases, among 12 (46.15%) showed benign and 14 (53.8%) malignant. Briefly, 21 (19.1%) patients had serum PSA level > 20.1 ng/ml. Among these 4 (19.04%) cases were benign and 17 (80.9%) were malignant. Malignant lesions included prostatic adenocarcinoma. Benign lesions included benign prostatic hyperplasia, prostatitis. Conclusion: In the present study, serum PSA level is one of the most useful front line methods for assessing individuals risk of prostate cancer. In addition, elevated level more than 4.0 ng/ml with TURS-guided needle biopsy is most useful and accurate diagnostic method for prostate.


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Micronutrients and growth of children: a literature review

2016-09-10T05-50-57Z
Source: International Journal of Medical Science and Public Health
Aminuddin Syam, Sukri Palutturi, Nurhaedar Djafar, Budu, Nurpudji Astuti, Abdul Razak Thaha.
Optimal growth and development in children will be able to achieve if the nutritional needs can be met. There are many teenagers who are malnourished because of inadequate intake. This study aims to examine the relationship between micronutrients especially folic acid and zinc with growth. The method used is a literature review of various sources of free accredited journals in pdf form e.g. PubMed, Proquest, Google Scholar, and EBSCO. Other sources were such as books, reports on national and international health. We collected literature published in the last 10 years to maintain the novelty of information. Some sources of literatures were beyond the time limit if those are beneficial to this study. The results of the literature review indicate that there is a relationship between micronutrients and growth but this is still being debated. This study recommends for further follow-up especially on experimental studies in certain age groups.


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Antimicrobial prescribing pattern in the treatment of acute respiratory tract infections in children in a tertiary care hospital

2016-09-10T05-49-17Z
Source: International Journal of Basic & Clinical Pharmacology
Vijay R. Kokani, Prasad R. Pandit, Kiran A. Bhave.
Background: Acute respiratory infections are among the most common causes of physician consultation in the pediatric age group. Typically, the underlying etiology is viral, hence does not always requiring antibiotic prescription. However, antibiotics are often used for the treatment of many acute respiratory infections. Hence the present study was undertaken to analyse the current prescribing trends of antimicrobial use in acute respiratory tract infection in children in a tertiary care hospital and to do a quantitative analysis of overall antimicrobials used and their source. Methods: This is a cross sectional, observational study conducted in the pediatrics inpatient department of tertiary care hospital. A total of 100 cases which included both upper respiratory tract infection and lower respiratory tract infection patients were analyzed. The total duration of study was 6 months. Results: Penicillins were the most commonly prescribed class of drugs. Conclusions: We noted a favourable trend towards monotherapy. All drugs in our study were prescribed by generic name.


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Acute toxicity of the aqueous-methanolic Moringa oleifera (Lam) leaf extract on female Wistar albino rats

2016-09-10T05-49-17Z
Source: International Journal of Basic & Clinical Pharmacology
Mitchel O. Okumu, James M. Mbaria, Laetitia W. Kanja, Daniel W. Gakuya, Stephen G. Kiama, Francis O. Ochola, Paul O. Okumu.
Background: Herbal preparations are widely assumed to be safe on oral administration and therefore the documentation of the toxic potential of some herbal concoctions used as medicine and nutrients is limited. Moringa oleifera (MO) is a plant that is gaining tremendous popularity in rural communities in Kenya as a means of offsetting nutritional and medicinal needs. However, very little is known about the safety of the plant on oral administration. Thus, the aim of the current study was to assess the biochemical and histological changes in the liver following the administration of an aqueous-methanolic (AQ-ME) MO leaf extract in female Wistar albino rats. Methods: Acute oral toxicity study on the AQ-ME MO leaf extract was conducted by the use of the limit test dose of the up and down procedure (OECD guideline number 425) with slight modifications. Briefly, ten (10) healthy, nulliparous, non-pregnant female Wistar strain albino rats aged 8-12 weeks and weighing 180±20 grams were used for the study. These animals were randomly selected into two groups; control and treatment group each having five (5) animals. They were then labelled to enable identification and control group animals were orally administered with physiological buffer saline once daily over a 48-hour period. The five (5) rats in the treatment group were dosed orally one at a time and once daily with a 2000 mg/kg dose of the AQ-ME MO leaf extract to determine the median lethal dose over a 48 hour period. Blood was then collected and used to prepare serum for biochemical analysis of aspartate amino transferase (AST), alanine amino transferase (ALT) and total bilirubin (TB) which are important biomarkers of liver dysfunction. Biochemical assays of these enzymes were performed using the method of the International Federation of Clinical Chemists (IFCC). Death was used as an endpoint, livers harvested and used to prepare transverse sections for histopathological examination. These sections were stained using the haematoxylin and eosin (H&E) method and observed for pathological changes using an optical microscope. Results: A 2000 mg/kg oral dose of AQ-ME MO leaf extract caused a significant (p0.05) increase in the mean levels of total bilirubin in the treatment group relative to the control group. On the other hand, the extract caused a non-significant (p>0.05) decrease in the mean levels of ALT in the treatment group relative to the control. The post mortem analysis of the hepatic index (liver to body weight ratio) revealed that there was a non-significant increase (p>0.05) in the hepatic index of the treatment group relative to the control. However, the transverse liver sections of treatment group animals showed mild distortions in the architecture of liver cells. Conclusions: Based on these results, the LD50 of the AQ-ME MO leaf extract was found to be >2000 mg/kg in female wistar albino rats. Keywords: Moringa oleifera, Aqueous-methanol, Wistar rats, OECD 425, Biochemical assays, Liver


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Evaluation of hemoglobin estimation with non-cyanide alkaline haematin D- 575 method

2016-09-10T05-46-01Z
Source: International Journal of Research in Medical Sciences
Vyankatesh T. Anchinmane, Shilpa V. Sankhe.
Background: Anemia is serious cause for concern in the world as it impacts on psychological and physical development, behavior and work performance. There are various methods recommended for estimation of hemoglobin for detection of anemia. Each method has its advantages and disadvantages. Aims and objectives of the present study were to compare conventional Hemoglobinocynide (HiCN) method containing potassium ferricyanide and potassium or sodium cyanide with non- cyanide alkaline haematin Method for hemoglobin estimation. Methods: The prospective study was conducted to evaluate the performance of two methods - HiCN method with Drabkins reagent and non- cyanide alkaline haematin method with AHD 575 reagent, for hemoglobin determination utilizing 201 blood samples. The data statistically analyzed by using coefficient of variation (CV), linear regression and mean differences. Results: A good correlation was observed for hemoglobin estimation between the HiCN method and non-cyanide alkaline haematin Method with AHD 575 reagent. The correlation coefficient of r= 0.9998 was statistically significant. Conclusions: It was concluded that both methods are accurate and precise, however the toxic and biohazardous effects of potassium ferricyanide and sodium cyanide in HiCN method can be prevented by using alkaline haematin method with AHD 575 reagent.


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Avian axons undergo Wallerian degeneration after injury and stress

Abstract

The integrity of long axons is essential for neural communication. Unfortunately, relatively minor stress to a neuron can cause extensive loss of this integrity. Axon degeneration is the cell-intrinsic program that actively deconstructs an axon after injury or damage. Although ultrastructural examination has revealed signs of axon degeneration in vivo, the occurrence and progression of axon degeneration in avian species have not yet been documented in vitro. Here, we use a novel cell culture system with primary embryonic zebra finch retinal ganglion cells to interrogate the properties of avian axon degeneration. First, we establish that both axotomy and a chemically induced injury (taxol and vincristine) are sufficient to initiate degeneration. These events are dependent on a late influx of calcium. In addition, as in mammals, the NAD pathway is involved, since a decrease in NMN with FK866 can reduce degeneration. Importantly, these retinal ganglion cell axons were sensitive to a pressure-induced injury, which may mimic the effect of high intraocular pressure associated with glaucoma. We have demonstrated that avian neurons undergo Wallerian degeneration in response to both physical and chemical injury. Subsequent avian studies will investigate whether blocking the degeneration pathway can protect individuals from neurodegenerative disease.



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Genetics of syndromic and non –syndromic hereditary nail disorders

Abstract

The nail is a unique epithelial skin appendage made up of a fully keratinized nail plate. The nail can be affected in several systemic illnesses, dermatological diseases, and inherited nail disorders. Nail dystrophies can present as isolated disorders or as a part of syndromes. Substantial progress has been achieved in the management and diagnosis of nail diseases; however, not much is known about the underlying molecular controls of nail growth. The homeostasis and development of the nail appendage depends on the intricate interactions between the epidermis and underlying mesenchyme, and comprises different signaling pathways such as the WNT signaling pathway. Digit-tip regeneration in mice and humans has been a known fact for the past 6 decades however only recently the underlying biological mechanisms by which the nail organ achieves digit regeneration have been elucidated. Moreover, significant progress has been made in identifying nail stem cells and localizing stem cell niches in the nail unit. More fascinating, however, is the role they play in orchestrating the processes that lead to the regeneration of the digit. Further elucidating the role of nail stem cells and the signaling pathways driving epithelial-mesenchymal interactions in the nail unit might contribute to the development of novel therapeutic tools for amputees.



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