Flexion radiographs have been used to identify cases of spinal instability. However, current methods are not standardized and are not sufficiently sensitive/specific to identify instability.
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Δευτέρα 17 Οκτωβρίου 2016
Slump sitting X-ray of the lumbar spine is superior to the conventional flexion view in assessing lumbar spine instability
A multicentre cohort study of spinal osteoid osteomas: results of surgical treatment and analysis of local recurrence
Spinal osteoid osteomas are benign primary tumours arising predominantly from the posterior column of the spine. These 'osteoblastic' lesions have traditionally been treated with intralesional excision.
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Subsequent healthcare utilization associated with early physical therapy for new episodes of low back pain in older adults
The association between early physical therapy (PT) and subsequent healthcare utilization following a new visit for low back pain is not clear, particularly in the setting of acute low back pain.
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An allograft generated from adult stem cells and their secreted products efficiently fuses vertebrae in immune compromised athymic rats and inhibits local immune responses.
Spine pain and the disability associated with it are epidemic in the United States. According to the National Center for Health Statistics, >650,000 spinal fusion surgeries are performed annually in the US and yet there is a failure rate of 15-40% when standard methods employing current commercial bone substitutes are utilized. Autologous bone graft is the gold standard in terms of fusion success, but the morbidity associated with the procedure and limitations in the availability of sufficient material has limited its use in the majority of cases.
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Walking balance and compensatory gait mechanisms in surgically treated patients with adult spinal deformity
Gait patterns and their relationship to demographic and radiographic data in patients with adult spinal deformity (ASD) have not been fully documented.
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Individualized functional restoration as an adjunct to advice for lumbar disc herniation with associated radiculopathy. A pre-planned subgroup analysis of a randomized controlled trial
Physical therapy is commonly sought by people with lumbar disc herniation and associated radiculopathy. It is unclear whether physical therapy is effective for this population.
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Lumbar Disc Geometry Affects the Risk for Rod Fracture in Adult Spinal Deformity (ASD) Surgery
BACKGROUND CONTEXT: Rod fracture (RF) has significant consequences for patients, including pain, loss of correction, and revision surgery. Risk factors associated with RF include previous spine surgery, insufficient sagittal vertical axis (SVA) correction and pedicle subtraction osteotomy (PSO). Increased lumbar disc geometry, regardless of PSO, SVA or previous surgery, may be a risk factor affecting RF rates.
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Evolution of Syrinx in Scoliosis Patients Associated with Untreated Syringomyelia Who Underwent One-Stage Posterior Correction for Spinal Deformities
BACKGROUND CONTEXT: Patients with spinal deformities associated with syringomyelia are often characterized by persistent progress scoliosis and neurological deficits. Although deformity correction in patients with untreated syringomyelia has been recognized to harbor an increased risk of iatrogenic neurologic injury, recently published studies reported that one-stage posterior scoliosis surgery for these patients allowed an effective deformity correction with rare neurological complication. To date, few literatures focus on the radiological changes of syrinx following one-stage posterior spinal deformity correction.
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Development of an Inventory to Measure Dysphagia and Dysphonia after Cervical Spine Surgery
BACKGROUND CONTEXT: Dysphagia and dysphonia occur to varying degrees after cervical spine surgery and often are concurrent. Dysfunction may be prolonged and a major component in outcome assessment. Currently there are no surveys to measure dysphagia and dysphonia specifically for cervical spine surgery patients. Such a survey would be useful not only to establish and characterize the condition, but also to delineate improvement over time. A patient-derived survey, meaning items are designated by patients and not set a priori by clinicians, would be preferable to ensure content validity.
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Impact of Instrumented Spinal Fusion on the Development of Vertebral Compression Fracture
BACKGROUND CONTEXT: Instrumented spinal fusion has become one of the most common surgeries for patients with various spinal disorders. Only a few studies have reported subsequent vertebral compression fractures (VCFs) after instrumented spinal fusion.
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C2 Neurectomy during Posterior Atlantoaxial Instrumentation: Feasibility and Facts
BACKGROUND CONTEXT: For C1–C2 (atlantoaxial) instability and other pathologies of axial spine, posterior C1–C2 instrumentation is a feasible approach with highly successful rate of cervical spine fusion. With technical expertise, the fusion rates approach 95%–100%. Nevertheless, poor visualization of lateral mass of C1 due to C2 nerve root and/or C2 ganglia, blood loss from venous plexus around vertebral artery and compression of C2 nerve from lateral mass screw are technical issues during posterior C1–C2 instrumentation.
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Increase in Spinal Deformity Patients in Patients Age 60 and Over is Not Associated with Increased Complications
BACKGROUND CONTEXT: Surgical treatment for adult spinal deformity improves patient quality of life; however, trends in surgical utilization in the elderly, whom may be at higher risk for complications, remain unclear.
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Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants versus Nonsurgical Management for Sacroiliac Joint Dysfunction: 12-Month Outcomes
BACKGROUND CONTEXT: Sacroiliac (SI) joint pain is a prevalent but underdiagnosed cause of low back pain. Surgical fusion can relieve pain and improve quality of life in patients who fail nonoperative care. We report a prospective multicenter randomized clinical trial of minimally invasive SI joint fusion using triangular titanium implants or nonsurgical management (NSM) in patients with chronic SI joint pain.
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Prediction of Shoulder Balance
BACKGROUND CONTEXT: Shoulder balance contributes to overall cosmetic outcome of corrective scoliosis surgery and proves critical to patient satisfaction. It is considered an important measure of success in deformity surgery and accurate estimation of postoperative shoulder balance is desirable. Previous studies report several preoperative predictors of final standing shoulder balance, but intraoperative predictors are not well established. Intraoperative radiographs are widely used to identify malpositioned implants or suboptimal alignment and guide intraoperative decision-making.
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Failure Patterns of Prophylactic Techniques Utilized to Prevent Proximal Junctional Failure following Adult Spinal Deformity Surgery Are Predictable: A Guideline for Surgeons
BACKGROUND CONTEXT: Proximal junctional failure (PJF), defined as vertebral fracture within the cranial region of and/or cranially adjacent to long instrumented spine constructs, is a problematic source of morbidity following adult spinal deformity (ASD) surgery. Several reports have described surgical techniques to prevent PJF, however no technique has eradicated the problem.
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The Effect of Smoking Status on Inpatient Pain Scores following Anterior Cervical Discectomy and Fusion
BACKGROUND CONTEXT: Current literature demonstrates patients who smoke experience unfavorable long-term outcomes following anterior cervical discectomy and fusion (ACDF); however, the effect of smoking on inpatient pain and narcotic consumption in the immediate postoperative period has not been previously reported.
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The Health Impact of Symptomatic Adult Cervical Deformity: Comparison to United States Population Norms and Chronic Disease States Based on the EQ5D
BACKGROUND CONTEXT: Although adult cervical deformity (ACD) has been empirically associated with significant pain and disability, the magnitude of this negative impact has not been objectively quantified.
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Go inside a mobile stroke ambulance
Watch this video see the inside of a mobile stroke ambulance. To read more about the vehicle, click here.
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Go inside a mobile stroke ambulance
Watch this video see the inside of a mobile stroke ambulance. To read more about the vehicle, click here.
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Small and diminutive polyps: No cancer, no risk!
"To be or not to be, that is the question" is the opening phrase of William Shakespeare's play hamlet. "To be or not to be" is also the legitimate question when we are discussing the management of small (i.e. 6–9mm in size) or diminutive (i.e. <5mm in size) colorectal polyps. The background is that most of the tiny lesions in the colorectum, especially when they are located in the rectosigmoid, have only a low prevalence of advanced histology even after accounting for interobserver variation in the pathologic assessment of villous elements and high-grade intraepithelial neoplasia [1].
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Increased rate of abdominal surgery both before and after diagnosis of celiac disease
The detection of celiac disease (CD) is suboptimal.
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Small and diminutive polyps: No cancer, no risk!
"To be or not to be, that is the question" is the opening phrase of William Shakespeare's play hamlet. "To be or not to be" is also the legitimate question when we are discussing the management of small (i.e. 6–9mm in size) or diminutive (i.e. <5mm in size) colorectal polyps. The background is that most of the tiny lesions in the colorectum, especially when they are located in the rectosigmoid, have only a low prevalence of advanced histology even after accounting for interobserver variation in the pathologic assessment of villous elements and high-grade intraepithelial neoplasia [1].
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Increased rate of abdominal surgery both before and after diagnosis of celiac disease
The detection of celiac disease (CD) is suboptimal.
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Effect of ionizing radiation on the DNA damage response in Chlamydomonas reinhardtii
Abstract
The DNA damage response (DDR) is induced by various DNA damaging factors and maintains genome stability in all organisms. The Chlamydomonas reinhardtii genome contains putative homologous genes involved in DDR; however, little is known about the functions and responses of these genes to DNA damage. In this study, DDR by gamma radiation was determined in C. reinhardtii. Irradiation with 80, and 200 Gy gamma radiation caused death in approximately 47 and 97 % of C. reinhardtii cells, respectively. The absolute lethality of cells was at 300 Gy. The rate of DNA breaks was also determined using comet assays after exposure to different doses of gamma radiation. Irradiation with 80 and 400 Gy resulted in 17 and 34 % of nuclear degradation in C. reinhardtii cells, respectively. To identify the major DDR pathway of C. reinhardtii induced by gamma radiation, 24 putative DDR genes were selected from the Joint Genome Institute (JGI) database. Gamma radiation significantly affected expression of 15 genes among these. Therefore, these genes displaying expressional changes by gamma radiation are involved in DDR, which indicate that C. reinhardtii may possess a fundamental conserved DDR pathway with higher plants. Furthermore, radiation responsive proteins were identified by proteomic analysis, which are involved in metabolisms of carbohydrate, energy, and photosynthesis. This is the first report to describe the responses of DDR homologous genes to gamma radiation and to identify gamma radiation-responsive proteins in C. reinhardtii. Our data should provide molecular insights into gamma radiation responses including DNA damage in green algae.
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Genetic factor common to schizophrenia and HIV infection is associated with risky sexual behavior: antagonistic vs. synergistic pleiotropic SNPs enriched for distinctly different biological functions
Abstract
Schizophrenia (SZ) and HIV infection are serious disorders with a complex phenotypic relationship. Observational studies have described their comorbidity; their genetic correlation is not well studied. We performed extensive analysis in search of common genetic factors for SZ and HIV, and their relationship with risky sexual behavior (RSB). Summary statistics from genome-wide association studies of HIV infection and schizophrenia were obtained and 2379 European Americans were genotyped and assessed for RSB score. Genetic relationships between traits were analyzed in three ways: linkage disequilibrium (LD) score regression to estimate genetic correlation; GPA (Genetic analysis incorporating Pleiotropy and Annotation) to test pleiotropy and identify pleiotropic loci; polygenic risk scores (PRS) of SZ and HIV to predict RSB using linear regression. We found significant pleiotropy (p = 5.31E − 28) and a positive genetic correlation (cor = 0.17, p = 0.002) for SZ and HIV infection. Pleiotropic SNPs with opposite effect directions (antagonistic) and SNPs with the same effect direction (synergistic) were enriched for distinctly different biological functions. SZ PRS computed with antagonistically pleiotropic SNPs consistently predicted RSB score with nominal significance, but SZ PRS based on either synergistically pleiotropic SNPs or all SNPs did not predict RSB. The epidemiologic correlation between schizophrenia and HIV can partly be explained by overlapping genetic risk factors, which are related to risky sexual behavior.
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Team-based versus ward-based junior doctors: Where do the differences lie?
2016-10-17T14-06-09Z
Source: Journal of Contemporary Medical Education
Babatunde Oremule, Oluwafikunayo Orekoya, Linda Hacking.
Foundation Year 1 doctors (or pre-registration house officers) are the most junior members on the medical or surgical team. They provide secretarial and clinical services under supervision of more senior clinicians. With the increasing demand on health services in the United Kingdom, employers and educators are searching for ways to maximise their productivity without detriment to their training. One such method was trialled at our Trust. We changed from a team-based system to a ward-based system for Foundation Year 1 doctors on general surgical firms. Following the change we assessed the impact on junior doctor training using qualitative and quantitative methods. We believe that our study and the results will be of great interest to your readers. This project has been presented regionally and nationally and has been met with great interest.
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Assessment of effectiveness of small group teaching among Medical Students
2016-10-17T14-06-09Z
Source: Journal of Contemporary Medical Education
Kashmir Singh, Rashmi Katyal, Arun Singh, Hari Shankar Joshi, Shalini Chandra.
Introduction: Small group teaching has grown in popularity in medical education as it offers a dynamic and collaborative setting for learning. It improves the retention of knowledge and students thinking. Conflicting reports in literature regarding effectiveness of small group teaching vs didactic lectures. Aim and objectives: 1. To assess the effectiveness of small group tutorials versus didactic lectures 2. To know the Students' and faculties perceptions regarding small group tutorials. Methods: Eighty final year MBBS students with informed consent were divided randomly into two groups. Two topics on head injury were taken in two sessions. In which pre and post assessment was done based on MCQs. In first session, one group was subjected to didactic lecture and the other group to tutorials followed by the cross-over in the second session. The same group of teachers took the didactic lectures and tutorials respectively. Perception of faculty based on likert scale taken. The data analysed in SPSS software using paired t-test. Results: There is a significant statistical difference in the pre-test and the post-test scores of each modality of teaching on the application of paired t-test (p-value
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A comparative study of impact of obesity on maximum voluntary ventilation in young adult women
2016-10-17T12-59-40Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Malini M, Baljoshi V S, Kammar K F.
Background: Obesity has become a global epidemic. The prevalence and severity of obesity in young adult females are dramatically increasing worldwide. Along with other organs, respiratory system is also compromised. Obesity is likely the cause of pulmonary function decline which is linked to early morbidity and mortality. The maximum voluntary ventilation (MVV) test evaluates the respiratory endurance and is influenced by the respiratory muscle strength, the lung and chest compliance, and the control of breathing and airway resistance. In the case of obese individuals, this variable is reduced mainly by mechanical injury to the respiratory muscles, caused in particular by the excessive weight on the thorax. Hence, this study was done to know the impact of obesity on MVV in adult females. Aims and Objectives: The purpose of this study was to compare the pulmonary function test (PFT) parameter in obese adult females and non-obese adult female patient and to evaluate the impact of obesity on MVV. Materials and Methods: PFTs of 50 normal, healthy, non-obese females and 50 healthy but obese females, age group 18-30 years of Hubli city were determined and were compared. Criteria for obesity in our study taken were according to the WHO criteria of body mass index. The PFT was carried out with computerized Spirometer Eazy on-PC model. MVV parameter was used as a measure of lung function. Results: In our study, obese females had MVV (liters) of 58 ± 12.2, whereas corresponding values in controls was 87 ± 66. There was statistically highly significant difference between two groups (P
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Frequency: The Overlooked Resistance Training Variable for Inducing Muscle Hypertrophy?
Abstract
The principle of progressive overload must be adhered to for individuals to continually increase muscle size with resistance training. While the majority of trained individuals adhere to this principle by increasing the number of sets performed per exercise session, this does not appear to be an effective method for increasing muscle size once a given threshold is surpassed. Opposite the numerous studies examining differences in training loads and sets of exercise performed, a few studies have assessed the importance of training frequency with respect to muscle growth, none of which have tested very high frequencies of training (e.g., 7 days a week). The lack of studies examining such frequencies may be related to the American College of Sports Medicine recommendation that trained individuals use split routines allowing at least 48 h of rest between exercises that stress the same muscle groups. Given the attenuated muscle protein synthetic response to resistance exercise present in trained individuals, it can be hypothesized that increasing the training frequency would allow for more frequent elevations in muscle protein synthesis and more time spent in a positive net protein balance. We hypothesize that increasing the training frequency, as opposed to the training load or sets performed, may be a more appropriate strategy for trained individuals to progress a resistance exercise program aimed at increasing muscle size.
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Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis
Abstract
Background
Hamstring injuries are among the most common non-contact injuries in sports. The Nordic hamstring (NH) exercise has been shown to decrease risk by increasing eccentric hamstring strength.
Objective
The purpose of this systematic review and meta-analysis was to investigate the effectiveness of the injury prevention programs that included the NH exercise on reducing hamstring injury rates while factoring in athlete workload.
Methods
Two researchers independently searched for eligible studies using the following databases: the Cochrane Central Register of Controlled Trials via OvidSP, AMED (Allied and Complementary Medicine) via OvidSP, EMBASE, PubMed, MEDLINE, SPORTDiscus, Web of Science, CINAHL and AusSportMed, from inception to December 2015. The keyword domains used during the search were Nordic, hamstring, injury prevention programs, sports and variations of these keywords. The initial search resulted in 3242 articles which were filtered to five articles that met the inclusion criteria. The main inclusion criteria were randomized controlled trials or interventional studies on use of an injury prevention program that included the NH exercise while the primary outcome was hamstring injury rate. Extracted data were subjected to meta-analysis using a random effects model.
Results
The pooled results based on total injuries per 1000 h of exposure showed that programs that included the NH exercise had a statistically significant reduction in hamstring injury risk ratio [IRR] of 0.490 (95 % confidence interval [CI] 0.291–0.827, p = 0.008). Teams using injury prevention programs that included the NH exercise reduced hamstring injury rates up to 51 % in the long term compared with the teams that did not use any injury prevention measures.
Conclusions
This systematic review and meta-analysis demonstrates that injury prevention programs that include NH exercises decrease the risk of hamstring injuries among soccer players. A protocol was registered in the International Prospective Register of Systematic Reviews, PROSPERO (CRD42015019912).
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Vascular Health and Genetic Risk Affect Mild Cognitive Impairment Status and 4-Year Stability: Evidence From the Victoria Longitudinal Study
Objectives:
Mild cognitive impairment (MCI) is a high-risk condition for progression to Alzheimer's disease (AD). Vascular health is a key mechanism underlying age-related cognitive decline and neurodegeneration. AD-related genetic risk factors may be associated with preclinical cognitive status changes. We examine independent and cross-domain interactive effects of vascular and genetic markers for predicting MCI status and stability.
Method:We used cross-sectional and 2-wave longitudinal data from the Victoria Longitudinal Study, including indicators of vascular health (e.g., reported vascular diseases, measured lung capacity and pulse rate) and genetic risk factors—that is, apolipoprotein E (APOE; rs429358 and rs7412; the presence vs absence of 4) and catechol-O-methyltransferase (COMT; rs4680; met/met vs val/val). We examined associations with objectively classified (a) cognitive status at baseline (not impaired congnitive (NIC) controls vs MCI) and (b) stability or transition of cognitive status across a 4-year interval (stable NIC–NIC vs chronic MCI–MCI or transitional NIC–MCI).
Results:Using logistic regression, indicators of vascular health, both independently and interactively with APOE 4, were associated with risk of MCI at baseline and/or associated with MCI conversion or MCI stability over the retest interval.
Discussion:Several vascular health markers of aging predict MCI risk. Interactively, APOE 4 may intensify the vascular health risk for MCI.
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Age Effects in Adaptive Criterion Learning
Objective:
Although prior work has examined age-related changes to criterion placement and flexibility, no study tested these constructs through a paradigm that employs adaptive feedback to encourage specific criterion changes. The goal of this study was to assess age differences in how young and older adults adapt and shift criteria in recognition memory decisions based on trial-by-trial feedback.
Method:Young and older adults completed an adaptive criterion learning paradigm. Over 3 study/test cycles, a biased feedback technique at test encouraged more liberal or strict responding by false-positive feedback toward false alarms or misses.
Results:Older adults were more conservative than young, even when feedback first encouraged a liberal response bias, and older adults adaptively placed criteria in response to biased feedback, much like young adults. After first being encouraged to respond conservatively, older adults shifted criteria less than young when feedback encouraged more lenient responding.
Discussion:These findings evidence labile adaptive criteria placement and criteria shifting with age. However, age-related tendencies toward conservative response biases may limit the extent to which criteria can be shifted in a lenient direction.
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Functioning, Forgetting, or Failing Health: Which Factors Are Associated With a Community-Based Move Among Older Adults?
Objective:
To examine whether the health and functioning of middle-aged and older adults are associated with an increased likelihood of community-based moves.
Method:Biennial data from adults aged 51 and older in the Health and Retirement Study (HRS) and discrete-time survival models were used to assess the likelihood of community-based moves from 2000 to 2010 as a function of 11 measures of health and functioning.
Results:Respondents diagnosed with heart disease, stroke, hypertension, lung disease, and psychiatric problems were more likely to move during the study period than those with no such diagnosis. Changes in activities of daily living and instrumental activities of daily living functioning, cognitive impairment, and falls were also related to a greater likelihood of moving during the study period. Cancer and diabetes were not related to overall moves, although diabetes was associated with an increased likelihood of local moves. For the most part, it was longstanding not recent diagnoses that were significantly related to the likelihood of moving.
Discussion:Although some health conditions precipitate moves among middle-aged and older adults, others do not. This work has important implications for understanding the role of different aspects of health and functioning in the likelihood of migration among older adults.
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Relocation and Social Support Among Older Adults in Rural China
Objectives:
China's economic reforms have led to millions of citizens being relocated to support infrastructure development, reduce poverty, and address ecological, disaster-related and other concerns. This study expands on previous research on the implications of relocation in China by examining the impact of rural elders' relocation on the perceived availability of emotional, instrumental, and financial support.
Methods:Data were drawn from the Ankang Study of Aging and Health conducted with a representative sample of 1,062 rural residents aged 60 and over living in Ankang, China. Two-stage probit and least squares regression models assessed the impact of relocation on familial and nonfamilial emotional, instrumental, and financial support.
Results:Relocation was negatively associated with the number of social support resources that older adults perceived as being available. Although this was the case with regard to both familial and nonfamilial support, it was particularly evident with regard to family support and, within families, with regard to instrumental rather than financial or emotional support.
Discussion:Relocation has negative implications for the number of social support resources perceived to be available by older adults in rural China. China will need to come to terms with how to provide for the instrumental support needs of an aging society.
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Racial Differences in the Effects of Neighborhood Disadvantage on Residential Mobility in Later Life
Objectives:
Past research on the residential mobility of older adults has focused on individual-level factors and life course events. Less attention has been paid to the role of the residential environment in explaining residential mobility in older adults. We sought to understand whether neighborhood disadvantage had predictive utility in explaining residential relocation patterns, and whether associations differed between Whites and non-Whites.
Method:Data are from the National Social Life, Health and Aging Project, a nationally representative sample of community-dwelling older adults. Neighborhoods were defined at the census tract level. Local movers (different census tract, same county) and distant movers (different county) were compared with stayers.
Results:After adjusting for individual-level factors, neighborhood disadvantage increased the likelihood of a local move, regardless of race/ethnicity. For non-Whites, higher neighborhood disadvantage decreased the likelihood of a distant move. Among local movers, Blacks and Latinos were less likely to improve neighborhood quality than Whites.
Discussion:Neighborhood disadvantage may promote local mobility by undermining person–environment fit. Racial differences in access to better neighborhoods persist in later life. Future research should explore how older adults optimize person–environment fit in the face of neighborhood disadvantage when the possibility of relocation to a better neighborhood may be restricted.
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Job Strain as a Risk Factor for Incident Diabetes Mellitus in Middle and Older Age U.S. Workers
Objectives:
The current study examined the relationship between the 4 quadrants of the job strain model and incident diabetes in U.S. working adults 50 years and older.
Methods:This study used longitudinal data from the 2006–2012 waves of the Health and Retirement Study (n = 1,396). Kaplan–Meier survival curves and Cox proportional hazard regression models were used to examine whether job strain significantly predicted diabetes incidence.
Results:Participants in high strain and passive jobs had significantly higher risk of diabetes relative to those in low strain jobs. In the univariate survival curves, significantly higher risk of diabetes was observed in men working in passive jobs. After adjustment for relevant covariates, participants in high strain (hazard ratio [HR] = 1.73, 95% confidence interval [CI] = 1.09–2.75) and passive (HR = 1.66, 95% CI = 1.01–2.73) jobs had a significantly increased risk of diabetes. Among adults 65 years and older, high strain and passive jobs were associated with an approximately fourfold increased risk of incident diabetes.
Discussion:High strain and passive occupations which represent low control over work are associated with increased risk of diabetes incidence among older workers. More research is required to better understand how psychosocial work factors impact health in aging workers. Further, research should continue to explore gender differences in effects of job strain on diabetes.
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Gender, Illness-Related Diabetes Social Support, and Glycemic Control Among Middle-Aged and Older Adults
Objectives:
This study examined whether the association between illness-related diabetes social support (IRDSS) and glycemic control among middle-aged and older adults is different for men and women.
Method:This cross-sectional analysis included 914 adults with diabetes who completed the Health and Retirement Study's 2003 Mail Survey on Diabetes. IRDSS is a composite score of 8 diabetes self-care measures. Hemoglobin A1c levels were obtained to measure good glycemic control (<8.0%). Gender-stratified multivariate log-binomial regression models were used to estimate prevalence ratios and examine the association between IRDSS and glycemic control after controlling for sociodemographic, lifestyle, and clinical characteristics.
Results:The prevalence of good glycemic control was 48.9% among women and 51.1% among men. Mean composite IRDSS scores did not differ by gender. Among women, composite IRDSS was associated with adequate glycemic control (prevalence ratio: 1.06; 95% confidence interval: 1.02, 1.08), and all individual components of IRDSS, with the exception of keeping appointments, were positively associated with adequate glycemic control. No significant associations were observed in men for composite or individual components of IRDSS.
Discussion:Determining the gender-specific impact derived from IRDSS is a worthwhile approach to highlighting factors that differentially predict optimal glycemic control among middle-aged and older adults.
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Life-Course Socioeconomic Status and Metabolic Syndrome Among Midlife Women
Objectives:
We examine whether women's risks of having metabolic syndrome (MetS) at pre/early-menopausal baseline, and of developing MetS after baseline, are associated with childhood and adult socioeconomic statuses (SESs); and whether the associations are mediated by adult reproductive, economic, behavioral, and psychosocial factors.
Method:Using data on white and black women collected prospectively for 12 years in the Study of Women's Health Across the Nation, we estimated odds of MetS at pre/early-menopausal baseline with logistic regression, and incidence of MetS after baseline with Cox proportional hazards models.
Results:Women raised in "adverse" childhood SES had marginally greater odds of MetS at baseline than did women raised in "good" SES, and women with a high school credential or less had significantly greater odds than college-educated women, in mutually adjusted models. The elevated odds partly reflected SES-related differences in exercise and alcohol consumption. Incidence after baseline was associated with education, not childhood SES, and partly mediated by health behaviors. Differences in the probability of surviving without MetS between the most and least socioeconomically advantaged women nearly doubled between ages 50 and 60.
Discussion:Childhood and adult SES predict women's risks of MetS as they approach the menopause transition; adult SES is primarily important afterwards.
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More Than A Meal? A Randomized Control Trial Comparing the Effects of Home-Delivered Meals Programs on Participants Feelings of Loneliness
Objective:
Nutrition service providers are seeking alternative delivery models to control costs and meet the growing need for home-delivered meals. The objective of this study was to evaluate the extent to which the home-delivered meals program, and the type of delivery model, reduces homebound older adults' feelings of loneliness.
Methods:This project utilizes data from a three-arm, fixed randomized control study conducted with 626 seniors on waiting lists at eight Meals on Wheels programs across the United States. Seniors were randomly assigned to either (i) receive daily meal delivery; (ii) receive once-weekly meal delivery; or (iii) remain on the waiting list. Participants were surveyed at baseline and again at 15 weeks. Analysis of covariance was used to test for differences in loneliness between groups, over time and logistic regression was used to assess differences in self-rated improvement in loneliness.
Results:Participants receiving meals had lower adjusted loneliness scores at follow-up compared with the control group. Individuals who received daily-delivered meals were more likely to self-report that home-delivered meals improved their loneliness than the group receiving once-weekly delivered meals.
Discussion:This article includes important implications for organizations that provide home-delivered meals in terms of cost, delivery modality, and potential recipient benefits.
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A Role for Identification in the Gradual Decline in the Pleasantness of Flavors With Age
Objectives:
This study investigated a possible role for identification in the decline in flavor pleasantness with age.
Methods:Two hundred sixty-four individuals aged from 16 to 85 years tasted 6 flavored drinks of varying identity and ease of identification, and rated each on pleasantness, a range of other characteristics and identified all flavors.
Results:Using regression, firstly, pleasantness was inversely associated with age (β = –0.22, p < .01). Secondly, the decline in pleasantness with age was associated with poorer identification (β = 0.30, p < .01), lower perceptions of sweetness (β = 0.01, p < .01), lower strength of flavor (β = 0.00, p = .02), lower familiarity (β = 0.01, p < .01), and a lower frequency of usual drink consumption (β = 0.04, p < .01). Thirdly, improved identification with age was associated with increased drink familiarity (β =< 0.01, p < .01), coloration compared with no color (β = <0.06, p < .01), and correct compared with incorrect coloration (β = <0.27, p < .01).
Discussion:These findings demonstrate a clear role for identification in the decline in flavor pleasantness with age. These findings thus provide clear evidence for a cognitive and perceptual element to these hedonic processes. Our findings suggest that likings for flavors in older individuals may be increased/maintained through the use of improved visual cues, easily recognizable foods, and/or identity labels.
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Age Differences in Interpreting Ambiguous Situations: The Effects of Content Themes and Depressed Mood
Objectives:
This study aimed to investigate the boundary conditions of the positivity effect on appraisals of ambiguous situations across content themes and emotional states. We differentiated the processes of interpretation generation and selection to see whether older adults recognize negative aspects of ambiguous situations but tend to select positive interpretations.
Method:Seventy-six younger and 67 older adults went through sad and neutral mood inductions and completed ambiguous situation tasks. Participants were asked to generate interpretations and select one as the most likely explanation for each scenario.
Results:Results demonstrated that compared with younger adults, older adults selected less negative interpretations across content themes but generated fewer negative interpretations in interpersonal but not in health situations. Depressed mood led to more negative interpretations at both generation and selection for younger adults but not older adults.
Conclusions:Our results showed that thematic factors had an effect on the positivity effect on interpretation generation, but regardless of content themes, older adults selected a less negative interpretation as the most likely, despite knowing alternative negative explanations. The positivity effect remained for older adults in high trait and state depressed mood. Together these findings are consistent with the pattern of older adults' tendency to maximize emotional well-being through less negative interpretations of ambiguous situations.
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Response-Conflict Moderates the Cognitive Control of Episodic and Contextual Load in Older Adults
Objectives:
Decline in cognitive control is one of the primary cognitive changes in normal aging. Reaching a consensus regarding the nature of these age-related changes, however, is complicated by the complexity of cognitive control as a construct.
Methods:Healthy older and younger adults participated in a multifactorial test of cognitive control. Within participants, the procedure varied as a function of the amount contextual load, episodic load, and response-conflict load present.
Results:We found that older adults showed impaired performance relative to younger adults. We also found, however, that the response selection process underlying the response-conflict manipulation was a major moderator of age-related differences in both the contextual and episodic load conditions—suggesting a hierarchical organization.
Discussion:These findings are consistent with previous findings, suggesting that deficits in cognitive control in older adults are directly related to the resolution of response-conflict and that other apparent deficits may be derivative upon the more basic response-conflict related deficit.
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Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality
Objectives:
We assess the association between marital quality and both the risk of developing diabetes and the management of diabetes after its onset in later life.
Method:We use data from the first two waves of the National Social Life, Health, and Aging Project to estimate regression models with lagged dependent variables. The sample includes 1,228 married respondents, among whom 389 were diabetic. Those with either a reported diagnosis or with HbA1c ≥ 6.5% are identified diabetic. We categorize diabetic respondents into three groups: controlled, undiagnosed, and uncontrolled diabetes. We conduct factor analysis to construct positive and negative marital quality scales.
Results:For women, an increase in positive marital quality between Waves 1 and 2 is related to a lower risk of being diabetic at Wave 2, net of diabetes status at Wave 1; surprisingly, for men, an increase in negative marital quality between Waves 1 and 2 is related to both a lower risk of being diabetic at Wave 2 and a higher chance of controlling diabetes at Wave 2 after its onset.
Discussion:Our results challenge the traditional assumption that negative marital quality is always detrimental to health and encourage family scholars to distinguish different sources and types of negative marital quality.
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Alone at the Table: Food Behavior and the Loss of Commensality in Widowhood
Objectives:
Eating alone is a known risk factor for nutritional vulnerability in later life. Widowhood often entails loss of commensality (shared meals). This article explores this experience among older widowed women in relation to food behavior.
Method:Qualitative methods based on constructivist grounded theory were used. Interviews were conducted with 15 women living alone in the community, aged 71 to 86 years, and widowed 6 months to 15 years.
Results:Widowhood meant having significantly fewer opportunities for commensality. Participants attributed changes to their food behaviors to the loss of commensality, including food choice, fewer regular meals, and reduced work of meal preparation. These changes were attributed to the experienced difference between shared meals and meals eaten alone, no longer having the commitment of commensality, and having less interest in meal preparation in the absence of obligation or reward of commensality.
Discussion:Eating alone symbolized loss and was less enjoyable, yet the pleasure experienced with food was intact. Focusing on the pleasure of eating may help support women when they lose regular commensality late in life. Free from the commitment of commensality, some shifted away from regular meals and simplified their meal preparation strategies. This has implications for clinical and research endeavors.
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Capturing Between- and Within-Family Differences in Parental Support to Adult Children: A Typology Approach
Objectives:
Families differ widely in the support they provide to adult offspring, both with regard to the overall level as well as the extent to which support is evenly distributed across offspring. This study addressed these dynamics by creating family profiles based on the average level and differentiation of support among children. We also examined demographic and psychological factors that predict typology membership.
Method:We utilized data from 431 middle-aged parents (aged 40–60) with at least two adult children. Parents provided separate ratings of support given to each child. Latent profile analysis was applied to two indicators of within-family support: mean level and differentiation among offspring.
Results:Latent profile analysis identified four patterns of parental support: (a) high support–low differentiation (52%), (b) medium support–high differentiation (26%), (c) low support–low differentiation (17%), and (d) low support–very high differentiation (5%). These patterns reflected distinct family characteristics, such as parental resources, parental beliefs (i.e., equal treatment, obligation), and offspring characteristics.
Discussion:Our findings emphasize the need to capture dynamics of support exchanges among multiple offspring at the level of family.
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Digital Dating: Online Profile Content of Older and Younger Adults
Objectives:
Older adults are utilizing online dating websites in increasing numbers. Adults of different ages may share motivations for companionship and affection, but dating profiles may reveal differences in adults' goals. Theories addressing age-related changes in motivation suggest that younger adults are likely to emphasize themselves, achievements, attractiveness, and sexuality. Older adults are likely to present themselves positively and emphasize their existing relationships and health.
Method:We collected 4,000 dating profiles from two popular websites to examine age differences in self-presentations. We used stratified sampling to obtain a sample equally divided by gender, aged 18–95 years. We identified 12 themes in the profiles using Linguistic Inquiry and Word Count software (Pennebaker, Booth, & Francis, 2007).
Results:Regression analyses revealed that older adults were more likely to use first-person plural pronouns (e.g., we, our) and words associated with health and positive emotions. Younger adults were more likely to use first-person singular pronouns (e.g., I, my) and words associated with work and achievement.
Discussion:Findings suggest that younger adults enhance the "self" when seeking romantic partnership. In contrast, older adults are more positive in their profiles and focus more on connectedness and relationships to others.
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Importance of Numeracy as a Risk Factor for Elder Financial Exploitation in a Community Sample
Objectives:
To examine the role of numeracy, or comfort with numbers, as a potential risk factor for financial elder exploitation in a community sample.
Method:Individually administered surveys were given to 201 independent, community-dwelling adults aged 60 and older. Risk for financial elder exploitation was assessed using the Older Adult Financial Exploitation Measure (OAFEM). Other variables of interest included numeracy, executive functioning, and other risk factors identified from the literature. Assessments were completed individually at the Wood Lab at Scripps College in Claremont, CA and neighboring community centers.
Results:After controlling for other variables, including education, lower numeracy was related to higher scores on the OAFEM consistent with higher risk for financial exploitation. Self-reported physical and mental health, male gender, and younger age were also related to increased risk.
Conclusions:Results indicated that numeracy is a significant risk factor for elder financial exploitation after controlling for other commonly reported variables. These findings are consistent with the broader literature relating numeracy to wealth and debt levels and extend them to the area of elder financial exploitation.
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Early-Life Intelligence Predicts Midlife Biological Age
Objectives:
Early-life intelligence has been shown to predict multiple causes of death in populations around the world. This finding suggests that intelligence might influence mortality through its effects on a general process of physiological deterioration (i.e., individual variation in "biological age"). We examined whether intelligence could predict measures of aging at midlife before the onset of most age-related disease.
Methods:We tested whether intelligence assessed in early childhood, middle childhood, and midlife predicted midlife biological age in members of the Dunedin Study, a population-representative birth cohort.
Results:Lower intelligence predicted more advanced biological age at midlife as captured by perceived facial age, a 10-biomarker algorithm based on data from the National Health and Nutrition Examination Survey (NHANES), and Framingham heart age (r = 0.1–0.2). Correlations between intelligence and telomere length were less consistent. The associations between intelligence and biological age were not explained by differences in childhood health or parental socioeconomic status, and intelligence remained a significant predictor of biological age even when intelligence was assessed before Study members began their formal schooling.
Discussion:These results suggest that accelerated aging may serve as one of the factors linking low early-life intelligence to increased rates of morbidity and mortality.
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Perioperative intravenous fluid therapy in children: guidelines from the Association of the Scientific Medical Societies in Germany
Summary
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1–2.5% glucose is recommended for the intraoperative background infusion to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis. Additional BS without glucose can be used in patients with circulatory instability until the desired effect is achieved. The additional use of colloids (albumin, gelatin, hydroxyethyl starch) is recommended to recover normovolemia and to avoid fluid overload when crystalloids alone are not sufficient and blood products are not indicated. Monitoring should be extended in cases with major surgery, and autotransfusion maneuvers should be performed to assess fluid responsiveness.
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Longitudinal study of factors affecting taste sense decline in old-old individuals
Abstract
The sense of taste plays a pivotal role for personal assessment of the nutritional value, safety, and quality of foods. Although it is commonly recognized that taste sensitivity decreases with age, alterations in that sensitivity over time in an old-old population have not been previously reported. Furthermore, no known studies utilized comprehensive variables regarding taste changes and related factors for assessments. Here, we report novel findings from a 3-year longitudinal study model aimed to elucidate taste sensitivity decline and its related factors in old-old individuals.
We utilized 621 subjects aged 79 to 81 years who participated in the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) Study for baseline assessments performed in 2011 and 2012, and then conducted follow-up assessments 3 years later in 328 of those. Assessment of general health, an oral examination, and determination of taste sensitivity were performed for each. We also evaluated cognitive function using Montreal Cognitive Assessment (MoCA) findings, then excluded from analysis those with a score lower than 20 in order to secure the validity and reliability of the subjects' answers. Contributing variables were selected using univariate analysis, then analyzed with multivariate logistic regression analysis.
We found that males showed significantly greater declines in taste sensitivity for sweet and sour tastes than females. Additionally, subjects with lower cognitive scores showed a significantly greater taste decrease for salty in multivariate analysis.
In conclusion, our longitudinal study revealed that gender and cognitive status are major factors affecting taste sensitivity in geriatric individuals.
This article is protected by copyright. All rights reserved.
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Effects of Oral Care with Tongue Cleaning on Coughing Ability in Geriatric Care Facilities: A Randomized Controlled Trial
Abstract
Background
Methods for preventing aspiration pneumonia are needed soon in order to reduce mortality from aspiration pneumonia and promote the health of the elderly.
Objective
The aim of this randomized controlled trial was to examine whether oral care with tongue cleaning improves coughing ability in elderly individuals living in geriatric care facilities.
Methods
Participants comprised 114 residents of 11 group homes and private nursing homes in Aso City in Kumamoto Prefecture. Participants were randomly assigned to either 1) a group that underwent routine oral care with tongue cleaning (intervention group; n = 58) or 2) a group that underwent routine oral care alone (control group; n = 56). Coughing ability was evaluated by measuring peak expiratory flow (PEF) before and after 4 weeks of intervention.
Results
Before the intervention, PEF did not differ significantly between the intervention group (1.65 ± 1.11 L/s) and control group (1.59 ± 1.05 L/s; P = 0.658). However, on termination of the intervention, PEF was significantly higher in the intervention group (2.54 ± 1.42 L/s) than in the control group (1.90 ± 1.20 L/s; P = 0.014). After the intervention, PEF had increased significantly in both groups; however, this increase was significantly greater in the intervention group (0.90 ± 0.95 L/s) than in the control group (0.31 ± 0.99 L/s; P < 0.001).
Conclusions
Oral care with tongue cleaning led to increased PEF, suggesting improved coughing ability. Oral care incorporating tongue cleaning appears to be important for preventing aspiration pneumonia.
This article is protected by copyright. All rights reserved.
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Obesity as a Risk Factor for Temporomandibular Disorders
Abstract
Background
We conducted a clinical cross-sectional study to evaluate the association between obesity and the presence of painful temporomandibular disorders (TMD), controlling for age, gender, presence of migraine, depression, non-specific somatic symptoms and obstructive sleep apnea syndrome (OSAS) in an adult population
Methods
A total of 299 individuals (76.6% women) with a mean age of 36.8 ± 12.8 years were evaluated. TMD were classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Depression and non-specific somatic symptoms were scored by the Symptom CheckList-90, while pain and disability was rated by the Graded Chronic Pain Scale. Bioimpedanciometry (BIA) was used to assess obesity through total body fat percentage. Migraine was diagnosed according to the criteria of the International Classification of Headache Disorders-2 (ICHD-2). OSAS was classified according to the Berlin Questionnaire. We performed univariate and multivariate models, chi-square tests and odds ratios (OR) with 95% confidence intervals (CI)
Results
In the single regression analysis, painful TMD was significantly associated with total body fat percentage (p=0.01). In the multivariate analysis, migraine, age, non-specific somatic symptoms and OSAS showed to be stronger predictors of TMD-pain, and obesity did not retain in the regression model
Conclusions
The initial association found between obesity and TMD-pain is lost when it was corrected for gender, migraine, non-specific somatic symptoms and OSAS.
This article is protected by copyright. All rights reserved.
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Genetics of Mitochondrial Dysfunction and Infertility
Abstract
Increasingly, mitochondria are being recognised as having an important role in fertility. Indeed in assisted reproductive technologies mitochondrial function is a key indicator of sperm and oocyte quality. Here, we review the literature regarding mitochondrial genetics and infertility. In many multisystem disorders caused by mitochondrial dysfunction death occurs prior to sexual maturity, or the clinical features are so severe that infertility may be under-reported. Interestingly, many of the genes linked to mitochondrial dysfunction and infertility have roles in the maintenance of mitochondrial DNA or in mitochondrial translation. Studies on populations with genetically uncharacterised infertility have highlighted an association with mitochondrial DNA deletions, whether this is causative or indicative of poor functioning mitochondria requires further examination. Studies on the impact of mitochondrial DNA variants present conflicting data but highlight POLG as a particularly interesting candidate gene for both male and female infertility.
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Clinicopathological characteristics of young patients with pancreatic cancer: an analysis of data from pancreatic cancer registry of japan pancreas society
Pancreas
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Fibrosis is not just fibrosis - basement membrane modelling and collagen metabolism differs between hepatitis B- and C-induced injury
Alimentary Pharmacology and Therapeutics
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Genetically determined chronic pancreatitis but not alcoholic pancreatitis is a strong risk factor for pancreatic cancer
Pancreas
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Corticosteroids versus pentoxifylline for severe alcoholic hepatitis: A sequential analysis of randomized controlled trials
Journal of Clinical Gastroenterology
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Therapeutic effect observation of Shanghai-style tuina method for infantile diarrhea
Journal of Acupuncture and Tuina Science
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Treatment of patients with acute colonic diverticulitis complicated by abscess formation: A systematic review and meta-analysis
International Journal of Surgery
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EndoClot polysaccharide hemostatic system in nonvariceal gastrointestinal bleeding: Results of a prospective multicenter observational pilot study
Journal of Clinical Gastroenterology
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Is contralateral exploration justified in endoscopic total extraperitoneal repair of clinical unilateral groin hernias- A long-term control cohort study
International Journal of Surgery
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Real-world effectiveness for 12 weeks of ledipasvir-sofosbuvir for genotype 1 hepatitis C: The Trio Health study
Journal of Viral Hepatitis
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Intraoperative modifiable risk factors of colorectal anastomotic leakage: Why surgeons and anesthesiologists should act together
International Journal of Surgery
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Real life Egyptian experience of efficacy and safety of Simeprevir Sofosbuvir therapy in 6211 chronic HCV genotype IV infected patients
Liver International
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Early enteral versus total parenteral nutrition in patients undergoing pancreaticoduodenectomy: A randomized multicenter controlled trial (Nutri-DPC)
Annals of Surgery
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Time perspective as a predictor of acute postsurgical pain and coping with pain following abdominal surgery
European Journal of Pain
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Utility of emergency department use of abdominal pelvic computed tomography in the management of crohn’s disease
Journal of Clinical Gastroenterology
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No evidence of reactivation of hepatitis B virus among patients treated with ledipasvir-sofosbuvir for hepatitis C virus infection
Clinical Infectious Diseases
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Efficacy and safety of fermented garlic extract on hepatic function in adults with elevated serum gamma-glutamyl transpeptidase levels: A double-blind, randomized, placebo-controlled trial
European Journal of Nutrition
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Could an abdominal drainage be avoided in complicated acute appendicitis? Lessons learned after 1300 laparoscopic appendectomies
International Journal of Surgery
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TTP as a surrogate endpoint in advanced hepatocellular carcinoma treated with molecular targeted therapy: Meta-analysis of randomised controlled trials
British Journal of Cancer
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Prevalence of hepatic steatosis in apparently healthy medical students: A transient elastography study on the basis of a controlled attenuation parameter
European Journal of Gastroenterology & Hepatology
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Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912
Gastric Cancer
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Isolated port-site metastasis of hepatocellular carcinoma after laparoscopic liver resection
Abstract
Port-site metastasis of hepatocellular carcinoma (HCC) is extremely rare, and only one case has been reported in the English-language literature. Contamination with malignant cells along the needle tract during percutaneous biopsy or radiofrequency ablation is a well-recognized cause of HCC recurrence. Here, we describe a case of port-site metastasis after laparoscopic liver resection of HCC. The patient, who had undergone laparoscopic partial resection of the left lateral segment of the liver 18 months earlier, was diagnosed with HCC. CT showed a nodule in the abdominal wall where the laparoscopic port had been inserted during resection. Local excision was performed, and histological examination revealed HCC consistent with recurrence after laparoscopic resection. The experience described in this report highlights the risk of port-site metastasis of HCC. Imaging for oncologic surveillance after laparoscopic resection must include all port sites.
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Cover Image, Volume 170A, Number 11, November 2016
The cover image, by Stéphanie Moortgat et al., is based on the Original Article Two novel EIF2S3 mutations associated with syndromic intellectual disability with severe microcephaly, growth retardation, and epilepsy, DOI: 10.1002/ajmg.a.37792
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Annals of morphology THEODOR BOVERI (1862–1915) To commemorate the centenary of his death and contributions to the Sutton–Boveri hypothesis
One hundred years ago, only 3 days after his 53rd birthday, there died a man who was regarded during his lifetime already such a giant in biology as to rank with Aristotle, von Baer, Darwin, Wallace, Mendel …. Their respective contributions to epigenesis, natural selection, and segregation made it possible to formulate in the late 19th century a science relating "the origin of species" to the origin of the "individual" organisms, their structure and function to that of their parts, their parts to that of their cells, and mitosis to the propagation of their cells. In working out the developmental and cytological details of these processes Boveri achieved his greatness, taking advantage of innate drive, better instrumentation (microscope, microtome), ideal "model" organisms (sea urchin, Ascaris), methods of their study and preservation, and the rediscovery, in 1900, of Mendel's results allowing him to relate mendelism to chromosomal structure and function in what E.B. Wilson subsequently called the Sutton–Boveri hypothesis. When war began in 1914, Boveri married to an American, and father of a 14-year-old girl, was already mortally ill, infested with one of his favorite experimental organisms, Ascaris. Given his health problems and attachment to his native Bavaria, Boveri had declined (1913) the directorship of the nascent Kaiser Wilhelm Institute for Biology in Berlin; but two of his recommended appointees there (Warburg, Spemann) became future Nobel Prize winners. Even before the war, Boveri's renown was such that distinguished foreigners, for example, the Americans E.B. Wilson, Marcella O'Grady, Nettie Stevens, Theophilus Painter, a.o., came to the University of Würzburg to work with him, Wilson dedicating all three editions of his rightly celebrated text "The Cell in Development and Heredity" [1896; 3rd Edition, 1925] to Boveri. Boveri's approach to genetics was primarily morphological; however, he was quick to unite mendelian inferences with chromosomal structure, and embryonic development with evolutionary theory. In retrospect, Boveri is perhaps best known for his formulation of a theory relating chromosomal anomalies to malformations, tumor formation and cancer. © 2016 Wiley Periodicals, Inc.
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Intragenic CNVs for epigenetic regulatory genes in intellectual disability: Survey identifies pathogenic and benign single exon changes
The disruption of genes involved in epigenetic regulation is well known to cause Intellectual Disability (ID). We reported a custom microarray study that interrogated among others, the epigenetic regulatory gene-class, at single exon resolution. Here we elaborate on identified intragenic CNVs involving epigenetic regulatory genes; specifically discussing those in three genes previously unreported in ID etiology—ARID2, KDM3A, and ARID4B. The changes in ARID2 and KDM3A are likely pathogenic while the ARID4B variant is uncertain. Previously, we found a CNV involving only exon 6 of the JARID2 gene occurred apparently de novo in seven patients. JARID2 is known to cause ID and other neurodevelopmental conditions. However, exon 6 of this gene encodes one of a series of repeated motifs. We therefore, investigated the impact of this variant in two cohorts and present a genotype–phenotype assessment. We find the JARID2 exon 6 CNV is benign, with a high population frequency (>14%), but nevertheless could have a contributory effect. We also present results from an interrogation of the exomes of 2,044 patients with neurocognitive phenotypes for the incidence of potentially damaging mutation in the epigenetic regulatory gene-class. This paper provides a survey of the fine-scale CNV landscape for epigenetic regulatory genes in the context of ID, describing likely pathogenic as well as benign single exon imbalances. © 2016 Wiley Periodicals, Inc.
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Knowledge and practices of health care workers regarding needle - stick injury in a tribal setting of Rajnandgaon, Chhattisgarh, India
2016-10-17T01-05-58Z
Source: International Journal of Community Medicine and Public Health
Kiran G. Makade, Dhiraj Bhawnani, Nirmal Verma, Md. Naushad Alam, Laxmikant V. Umate.
Background: Needle Stick Injuries (NSIs) in healthcare settings are a global issue. Percutaneous injuries, caused by needle sticks and other sharps, are a serious concern for all Health Care Workers and pose a significant risk of occupational transmission of blood borne pathogens. The incidence of NSI is considerably higher than current estimates, because of gross under reporting and hence a low injury rate should not be interpreted as a nonexistent problem. The present study was carried out to determine the occurrence of NSI among various categories of HCWs. Methods: The present prospective cross sectional study was carried out at the 400 bedded Government Medical College Hospital, Rajnandgaon, Chhattisgarh, India during period from November 2015 to August 2016. Out of total (180) study participants, 18 were doctors, 142 nurses and 20 lab technicians from different clinical departments/wards of the hospital. Data was collected by using a predesigned pretested questionnaire. The first part of the questionnaire contained information on background characteristics and second part contained the questions regarding knowledge and practices about NSI. Results: Out of 180 HCW, 149 (82.78%) were females and, 31 (17.22%) were males. Majority of the subjects were nurses (78.89%). 92.2% subjects were aware of the Needle Stick Injury (NSI). 85% of the subjects knew that certain diseases can be spread through NSI. Almost all of them were using disposable/auto disabled syringes and needles at the hospital. Re-capping of used needle was practiced by 35.5% subjects. 63.8% subjects gave history of NSI in the last one year. Most chances of getting NSI were found to be while working in the Obstetrics and Gynecology Department (29.4%). 68.9% of the study subjects were immunized completely against Hepatitis B. Conclusions: There was gap between the knowledge and use of preventive measures. There is a need to address this gap by organizing on job training, retraining at regular intervals, workshops for HCWs regarding hazards, preventive measures and post-exposure prophylaxis for NSIs. Preventing NSI should be an essential part of any blood borne pathogen prevention strategy in the work place.
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Biallelic truncating SCN9A mutation identified in four families with congenital insensitivity to pain from Pakistan
(a) Homozygosity-mapping-by-descent of four Bhakkar congenital indifference/insensitivity to pain (CIP) families. (b) Identification of mutation Met1190* in SCN9A. (c) SCN9A/NaV1.7 2D structure (as predicted by CCTOP and SMART) and approximate position of known nonsense (*) and missense (M) mutations ( www.hgmd.cf.ac.uk), as well as the Bhakkar mutation (this study) in red.
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Infant and young child feeding practices: a cross sectional study in Sikkim
2016-10-17T00-03-51Z
Source: International Journal of Contemporary Pediatrics
Ravichandra Reddy, Gangaraj Subba, Sudip Dutta.
Background: Positive parental attitudes towards infant feeding are an important component in child nutritional health. The nutritional well-being of a population is both an outcome and an indicator of national development. Nutrition is therefore, an issue of survival, health and development for current and succeeding generations. The purpose of the study was to assess the breast feeding & complementary feeding practices in children between the age group of 6 months-5 years, to determine the nutritional status of children less than 5 years. Methods: Children between 6 months-5 years who fulfilled the inclusion criterias were studied and analysed. Results: 98.0% of the children has received breast fed and 72.5% of cases received exclusive breastfed till 6 months of age. 72.5% of children received complementary feed at 6 months of age appropriately but formula feed was seen in 99.0%. 46.0% of mother used bottle for feeding although literacy among 90.0% of mothers seen. Conclusions: This study has shown that existence of using bottle for feeding although the most of their mothers were educated with high breastfed rate.
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Incidence of Methicillin-Resistant Staphylococcus aureus (MRSA) infection among patients and hospital staff and impact of preventive measures in reduction of MRSA infection rate: a prospective observational study
2016-10-16T23-53-59Z
Source: International Journal of Basic & Clinical Pharmacology
Gita Nadimpalli, Sunil Bhamare, Rao N. P., Shahu Ingole.
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult to treat infections and high levels of morbidity. It is importance to assess the effectiveness of surveillance screening programs in prevention of MRSA infection. The objective of the study was to assess the type, pattern and antimicrobial sensitivity of MRSA infection and analyse the effectiveness of preventive measures in reduction of MRSA infection rate from 2014 to 2015. Methods: 1044 and 996 samples with positive cultures obtained from patients admitted in 2014 and 2015 respectively were screened for MRSA using chrome agar test. Only MRSA positive cultures were included in the study and their sensitivity to antibiotics was tested. Screening of MRSA infection was conducted in patients as well as staff of Rao Nursing home, Pune for early identification of MRSA infection and prevention of transmission. MRSA infection rates in 2014 and 2015 were compared. Results: Community acquired MRSA (CA-MRSA) was more common when compared to Hospital acquired pneumonia (HA-MRSA). HA-MRSA was more common in patients admitted in isolation units. There was a decrease in number of MRSA positive cultures from 2014 (4.8%) to 2015 (1.3%), proving the effectiveness of screening for MRSA infection amongst patients as well as healthcare workers. Higher hand hygiene rates were observed in 2015 (95.83%), which further contributed to the decrease in incidence of MRSA infection in 2015. Conclusions: Strict adherence to preventive measures of MRSA such as hand hygiene, monitoring and adherence to the bundles for prevention with judicious use of antibiotics can greatly reduce the incidence of MRSA infection.
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