Παρασκευή, 21 Οκτωβρίου 2016

BLOC-2 Subunit HPS6 Deficiency Affects the Tubulation and Secretion of Von Willebrand Factor from Mouse Endothelial Cells

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Publication date: Available online 21 October 2016
Source:Journal of Genetics and Genomics
Author(s): Jing Ma, Zhe Zhang, Lin Yang, Janos Kriston-Vizi, Daniel F. Cutler, Wei Li
Hermansky-Pudlak syndrome (HPS) is a recessive disorder with bleeding diathesis, which has been linked to platelet granule defects. Both platelet granules and endothelial Weibel-Palade bodies (WPBs) are members of lysosome-related organelles (LROs) whose formation is regulated by HPS protein associated complexes such as BLOC (biogenesis of lysosome organelles complex) -1, -2, -3, AP-3 (adaptor protein complex-3) and HOPS (homotypic fusion and protein sorting complex). Von Willebrand factor (VWF) is critical to hemostasis, which is stored in a highly-multimerized form as tubules in the WPBs. In this study, we found the defective, but varying, release of VWF into plasma after desmopressin (DDAVP) stimulation in HPS1 (BLOC-3 subunit), HPS6 (BLOC-2 subunit), and HPS9 (BLOC-1 subunit) deficient mice. In particular, VWF tubulation, a critical step in VWF maturation, was impaired in HPS6 deficient WPBs. This likely reflects a defective endothelium, contributing to the bleeding tendency in HPS mice or patients. The differentially defective regulated release of VWF in these HPS mouse models suggests the need for precise HPS genotyping before DDAVP administration to HPS patients.



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cdc-25.4, a Caenorhabditis elegans Ortholog of cdc25, Is Required for Male Mating Behavior

Cell division cycle 25 (cdc25) is an evolutionarily conserved phosphatase that promotes cell cycle progression. Among the four cdc25 orthologs in Caenorhabditis elegans, we found that cdc-25.4 mutant males failed to produce outcrossed progeny. This was not caused by defects in sperm development, but by defects in male mating behavior. The cdc-25.4 mutant males showed various defects during male mating, including contact response, backing, turning, and vulva location. Aberrant turning behavior was the most prominent defect in the cdc-25.4 mutant males. We also found that cdc-25.4 is expressed in many neuronal cells throughout development. The turning defect in cdc-25.4 mutant males was recovered by cdc-25.4 transgenic expression in neuronal cells, suggesting that cdc-25.4 functions in neurons for male mating. However, the neuronal morphology of cdc-25.4 mutant males appeared to be normal, as examined with several neuronal markers. Also, RNAi depletion of wee-1.3, a C. elegans ortholog of Wee1/Myt1 kinase, failed to suppress the mating defects of cdc-25.4 mutant males. These findings suggest that, for successful male mating, cdc-25.4 does not target cell cycles that are required for neuronal differentiation and development. Rather, cdc-25.4 likely regulates non-canonical substrates in neuronal cells.



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The Interaction of Genotype and Environment Determines Variation in the Maize Kernel Ionome

Plants obtain soil-resident elements that support growth and metabolism from the water- flow facilitated by transpiration and active transport processes. The availability of elements in the environment interacts with the genetic capacity of organisms to modulate element uptake through plastic adaptive responses, such as homeostasis. These interactions should cause the elemental contents of plants to vary such that the effects of genetic polymorphisms will be dramatically dependent on the environment in which the plant is grown. To investigate genotype by environment interactions underlying elemental accumulation, we analyzed levels of elements in maize kernels of the Intermated B73 x Mo17 (IBM) recombinant inbred population grown in 10 different environments spanning a total of six locations and five different years. In analyses conducted separately for each environment, we identified a total of 79 quantitative trait loci controlling seed elemental accumulation. While a set of these QTL were found in multiple environments, the majority were specific to a single environment, suggesting the presence of genetic by environment interactions. To specifically identify and quantify QTL by environment interactions (QEIs), we implemented two methods: linear modeling with environmental covariates and QTL analysis on trait differences between growouts. With these approaches, we found several instances of QEI, indicating that elemental profiles are highly heritable, interrelated, and responsive to the environment.



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Micro-environmental Gene Expression Plasticity Among Individual Drosophila melanogaster

Differences in phenotype among genetically identical individuals exposed to the same environmental condition are often noted in genetic studies. Despite this commonplace observation, little is known about the causes of this variability, which has been termed microenvironmental plasticity. One possibility is that stochastic or technical sources of variance produce these differences. A second possibility is that this variation has a genetic component. We have explored gene expression robustness in the transcriptomes of 730 individual Drosophila melanogaster of 16 fixed genotypes, 9 of which are infected with Wolbachia. Three replicates of flies were grown controlling for food, day/night cycles, humidity, temperature, sex, mating status, social exposure, and circadian timing of RNA extraction. Despite the use of inbred genotypes and carefully controlled experimental conditions, thousands of genes were differentially expressed, revealing a unique and dynamic transcriptional signature for each individual fly. We found that 23% of the transcriptome was differentially expressed among individuals, and that the variability in gene expression among individuals is influenced by genotype. This transcriptional variation originated from specific gene pathways, suggesting a plastic response to the micro-environment; but there was also evidence of gene expression differences due to stochastic fluctuations. These observations reveal previously unappreciated genetic sources of variability in gene expression among individuals, which has implications for complex trait genetics and precision medicine.



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Robust Transgene Expression from Bicistronic mRNA in the Green Alga Chlamydomonas reinhardtii

The unicellular green alga Chlamydomonas reinhardtii is a model organism that provides an opportunity to understand the evolution and functional biology of the lineage that includes the land plants, as well as aspects of the fundamental core biology conserved throughout the eukaryotic phylogeny. Although many tools are available to facilitate genetic, molecular biological, biochemical, and cell biological studies in Chlamydomonas, expression of unselected transgenes of interest (GOIs) has been challenging. In most methods used previously, the GOI and a selectable marker are expressed from two separate mRNAs, so that their concomitant expression is not guaranteed. In this study, we developed constructs that allow expression of an upstream GOI and downstream selectable marker from a single bicistronic mRNA. Although this approach in other systems has typically required a translation-enhancing element such as an internal ribosome-entry site for the downstream marker, we found that a short stretch of unstructured junction sequence was sufficient to obtain adequate expression of the downstream gene, presumably through post-termination reinitiation. With this system, we obtained robust expression of both endogenous and heterologous GOIs, including fluorescent proteins and tagged fusion proteins, in the vast majority of transformants, thus eliminating the need for tedious secondary screening for GOI-expressing transformants. This improved efficiency should greatly facilitate a variety of genetic and cell-biological studies in Chlamydomonas and also enable new applications such as expression-based screens and large-scale production of foreign proteins.



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The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracic malignancy

Abstract

Introduction

Many extrathoracic malignancies can metastasize to lungs and mediastinal lymph nodes. Whether mediastinal lesions are metastasis in these patients changes staging, prognosis, and treatment strategy. In this study, we aimed to find out the contribution of EBUS-TBNA to the diagnosis in cases with extrathoracic malignancy.

Materials and methods

Patients who had been previously diagnosed as extrapulmonary solid organ malignancy and in whom mediastinal or hilar lymphadenopathy developed during their follow-up and EBUS-TBNA was applied for diagnostic purposes were retrospectively included in this study.

Results

A total of 91 patients consisting of 35 females (38.5 %) and 56 males (61.5 %) were included in the study. The mean age of the patients was 60.5 (±11.4). Malignancy was not observed in 54 (59.3 %) patients; primary malignancy metastasis was detected in 33 (36.3 %) patients, and primary lung cancer was detected in 4 (4.4 %) patients with EBUS-TBNA. The sensitivity of EBUS-TBNA in extrathoracic malignancies was determined as 90.2 %; its specificity was determined as 100 %, its negative predictive value as 92.5 %, its positive predictive value as 100 %, and its diagnostic accuracy as 95.6 %. The highest rate was determined in the left lower paratracheal lymph node when they were examined in terms of malignancy detection rate in lymph node stations.

Conclusion

EBUS-TBNA is a minimally invasive method with quite a low complication rate that does not require general anesthesia. It should be the first step method to be used in the diagnosis of mediastinal and hilar lymphadenopathies seen in extrathoracic malignancies since it has high diagnostic accuracy, sensitivity, and specificity. EBUS-TBNA significantly reduces the need for surgical intervention. Further surgical interventions can be planned in patients in whom diagnostic competence is not ensured.



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Simulation-based camera navigation training in laparoscopy—a randomized trial

Abstract

Background

Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon—all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room.

Materials and methods

A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera navigation skills during a laparoscopic cholecystectomy. The secondary outcome was technical skills after training, using a previously developed model for testing camera navigational skills. The exploratory outcome measured participants' motivation toward the task as an operating assistant.

Results

Thirty-six participants were randomized. No significant difference was found in the primary outcome between the three groups (p = 0.279). The secondary outcome showed no significant difference between the interventions groups, total time 167 s (95% CI, 118–217) and 194 s (95% CI, 152–236) for the camera group and the procedure group, respectively (p = 0.369). Both interventions groups were significantly faster than the control group, 307 s (95% CI, 202–412), p = 0.018 and p = 0.045, respectively. On the exploratory outcome, the control group for two dimensions, interest/enjoyment (p = 0.030) and perceived choice (p = 0.033), had a higher score.

Conclusions

Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher interest/enjoyment and perceived choice than the camera group.



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The inferior olive is essential for long-term maintenance of a simple motor skill

The inferior olive (IO) is essential for operant down-conditioning of the rat soleus H-reflex, a simple motor skill. To evaluate the role of the IO in long-term maintenance of this skill, the H-reflex was down-conditioned over 50 days, the IO was chemically ablated, and down-conditioning continued for up to 102 more days. H-reflex size just before IO ablation averaged 62(±2 SE)% of its initial value (P < 0.001 vs. initial). After IO ablation, H-reflex size rose to 75–80% over ~10 days, remained there for ~30 days, rose over 10 days to above its initial value, and averaged 140(±14)% for the final 10 days of study (P < 0.01 vs. initial). This two-stage loss of down-conditioning maintenance correlated with IO neuronal loss (r = 0.75, P < 0.01) and was similar to the loss of down-conditioning that follows ablation of the cerebellar output nuclei dentate and interpositus. In control (i.e., unconditioned) rats, IO ablation has no long-term effect on H-reflex size. These results indicate that the IO is essential for long-term maintenance of a down-conditioned H-reflex. With previous data, they support the hypothesis that IO and cortical inputs to cerebellum combine to produce cerebellar plasticity that produces sensorimotor cortex plasticity that produces spinal cord plasticity that produces the smaller H-reflex. H-reflex down-conditioning appears to depend on a hierarchy of plasticity that may be guided by the IO and begin in the cerebellum. Similar hierarchies may underlie other motor learning.



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Failure to Extend Epidural Labor Analgesia for Cesarean Delivery Anesthesia: A Focused Review

imageExtension of epidural labor analgesia for cesarean delivery anesthesia may fail. There are a number of factors associated with labor epidural catheter failure. This focused review discusses these associations and anesthetic options when faced with inadequate surgical epidural anesthesia for cesarean delivery.

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Towards Understanding Mechanisms of Anesthesia

imageNo abstract available

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Anatomical distribution of primary amine oxidase activity in four adipose depots and plasma of severely obese women with or without a dysmetabolic profile

Abstract

Semicarbazide-sensitive amine oxidase (SSAO), identical to primary amine oxidase or vascular adhesion protein-1, is a membrane enzyme that generates hydrogen peroxide. SSAO is highly expressed at the adipocyte surface, and its plasma levels increase with type 2 diabetes. Since visceral adipose tissue (AT) is more tightly associated with obesity complications than subcutaneous (SC) abdominal fat, we compared SSAO activity in plasma and 4 distinct AT locations in 48 severely obese women (body mass index (BMI), averaging 54 ± 11 kg/m2), with or without a dysmetabolic profile. Higher glucose and triacylglycerol levels vs lower high-density lipoprotein (HDL)-cholesterol characterized dysmetabolic women (DYS; n = 25) from non-dysmetabolic (NDYS; n = 23), age- and weight-matched subjects. SC, mesenteric (ME), omental (OM), and round ligament (RL) fat locations were collected during bariatric surgery. SSAO capacity to oxidize up to 1 mM benzylamine was determined in AT and plasma with radiometric and fluorimetric methods. Plasma SSAO was higher in the DYS group. SSAO activity was higher in fat than in plasma, when expressed as radiolabeled benzaldehyde per milligram of protein. In ATs from DYS women, protein content was 10 % higher, and basal hydrogen peroxide release lower than in NDYS subjects, except for RL location. The SSAO affinity towards benzylamine did not exhibit regional variation and was not altered by a dysmetabolic profile (K m averaging 184 ± 7 μM; n = 183). Although radiometric and fluorimetric methods gave different estimates of oxidase activity, both indicated that AT SSAO activity did not vary according to anatomical location and/or metabolic status in severely obese women.



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Reconstruction of a composite comparative map composed of ten legume genomes

Abstract

The Fabaceae (legume family) is the third largest and the second of agricultural importance among flowering plant groups. In this study, we report the reconstruction of a composite comparative map composed of ten legume genomes, including seven species from the galegoid clade (Medicago truncatula, Medicago sativa, Lens culinaris, Pisum sativum, Lotus japonicus, Cicer arietinum, Vicia faba) and three species from the phaseoloid clade (Vigna radiata, Phaseolus vulgaris, Glycine max). To accomplish this comparison, a total of 209 cross-species gene-derived markers were employed. The comparative analysis resulted in a single extensive genetic/genomic network composed of 93 chromosomes or linkage groups, from which 110 synteny blocks and other evolutionary events (e.g., 13 inversions) were identified. This comparative map also allowed us to deduce several large scale evolutionary events, such as chromosome fusion/fission, with which might explain differences in chromosome numbers among compared species or between the two clades. As a result, useful properties of cross-species genic markers were re-verified as an efficient tool for cross-species translation of genomic information, and similar approaches, combined with a high throughput bioinformatic marker design program, should be effective for applying the knowledge of trait-associated genes to other important crop species for breeding purposes. Here, we provide a basic comparative framework for the ten legume species, and expect to be usefully applied towards the crop improvement in legume breeding.



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Ausschreibung Thieme Teaching Award 2017

Anästhesiol Intensivmed Notfallmed Schmerzther 2016; 51: 645-645
DOI: 10.1055/s-0042-117049


[...]

© Georg Thieme Verlag Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text



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The Most Influential Scientist in the Development of Medical informatics (14): Branko Cesnik

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Izet Masic.



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Study of Scientific Production of Community Medicines’ Department Indexed in ISI Citation Databases

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Mohammad Khademloo, Ali Akbar Khaseh, Hasan Siamian, Kobra Aligolbandi, Mahsoomeh Latifi, and Mousa Yaminfirooz.
Background. In the scientometric, the main criterion in determining the scientific position and ranking of the scientific centers, particularly the universities, is the rate of scientific production and innovation, and in all participations in the global scientific development. One of the subjects more involved in repeatedly dealt with science and technology and effective on the improvement of health is medical science fields. In this research using scientometric and citation analysis, we studied the rate of scientific productions in the field of community medicine, which is the numbers of articles published and indexed in ISI database from 2000 to 2010. Methods: This study is scientometric using the survey and analytical citation. The study samples included all of the articles in the ISI database from 2000 to 2010. For the data collection, the advance method of searching was used at the ISI database. The ISI analyses software and descriptive statistics were used for data analysis. Results: Results showed that among the five top universities in producing documents, Tehran University of Medical Sciences with 88 (22.22%) documents are allocated to the first rank of scientific products. M. Askarian with 36 (90/9%) published documents; most of the scientific outputs in Community medicine, in the international arena is the most active author in this field. In collaboration with other writers, Iranian departments of Community Medicine with 27 published articles have the greatest participation with scholars of English authors. In the process of scientific outputs, the results showed that the scientific process was in its lowest in the years 2000 to 2004, and while the department of Community medicine in 2009 allocated most of the production process to itself. Iranian Journal of Public Health and Saudi Medical Journal each of them had 16 articles which had most participation rate in the publishing of community medicines department. On the type of carrier, community medicines department by presentation of 340(85.86%) articles had presented most of their scientific productions in the format of article, also in the field of community medicine outputs, article entitled: Iron loading and erythrophagocytosis increase ferroportin 1 (FPN1) expression in J774 macrophages(1) with 81 citations ranked first in cited articles. Subject areas of occupational health with 70 articles and subject areas of general medicine with 69 articles ranked the most active research areas in the Production of community medicines department. Conclusion: the obtained data showed the much growth of scientific production. The Tehran University of medical Sciences ranked the first in publishing articles in community medicines department and with most collaboration with community medicine department of England writers in this field and most writers will present their works in paper format.


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Applying Naive Bayesian Networks to Disease Prediction: a Systematic Review

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Mostafa Langarizadeh and Fateme Moghbeli.
Introduction: Naive Bayesian networks (NBNs) are one of the most effective and simplest Bayesian networks for prediction. Objective: This paper aims to review published evidence about the application of NBNs in predicting disease and it tries to show NBNs as the fundamental algorithm for the best performance in comparison with other algorithms. Methods: PubMed was electronically checked for articles published between 2005 and 2015. For characterizing eligible articles, a comprehensive electronic searching method was conducted. Inclusion criteria were determined based on NBN and its effects on disease prediction. A total of 99 articles were found. After excluding the duplicates (n= 5), the titles and abstracts of 94 articles were skimmed according to the inclusion criteria. Finally, 38 articles remained. They were reviewed in full text and 15 articles were excluded. Eventually, 23 articles were selected which met our eligibility criteria and were included in this study. Result: In this article, the use of NBN in predicting diseases was described. Finally, the results were reported in terms of Accuracy, Sensitivity, Specificity and Area under ROC curve (AUC). The last column in Table 2 shows the differences between NBNs and other algorithms. Discussion: This systematic review (23 studies, 53,725 patients) indicates that predicting diseases based on a NBN had the best performance in most diseases in comparison with the other algorithms. Finally in most cases NBN works better than other algorithms based on the reported accuracy. Conclusion: The method, termed NBNs is proposed and can efficiently construct a prediction model for disease.


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Evaluation the Relationship Between Thyroid Nodule Size with Malignancy and Accuracy of Fine Needle Aspiration Biopsy (FNAB)

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Gholamali Godazandeh, Zahra Kashi, Sadegh Zargarnataj, Mehran Fazli, Robab Ebadi, and Ensiyeh Hajializadeh Kerdabadi.
Introduction: Some studies have shown largest thyroid nodule size, especially ≥4cm that can predict malignancy and reduce fine needle aspiration biopsy (FNAB) accuracy. Therefore, this study is designed to evaluate relationship between thyroid nodule sizes with malignancy and its effect on FNBA accuracy. Materials and Methods: a retrospective analytical study design aims to investigate all patients with thyroid nodules who referred to surgery department of Imam-Khomeini Hospital of Mazandaran University of Medical Sciences in Sari from 20 March 2008 to 22 March 2014. We collected patients demographic data, nodules size, FNAB reports and final pathology (after surgery) reports from their medical records. All data were analyses performed by SPSS18. Results: 167 patients (153 women) with mean age of 41.56±13.24 years old were enrolled for this study. In final pathology; 38 patients (22.8%) had malignant nodules. The mean age of patients with or without malignant nodules were 34.93±11.86 and 42.37±12.26 years old, respectively (P=0.002). The mean size of benign and malignant nodules were 2.91±1.29 cm and 3.38±1.86 cm, respectively (P=0.15). 25.2% of


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Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider’s Choice

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Vuong Quan-Hoang.
Background: Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. Aim and Objectives: To investigate the effects that medical/health services information on perceived expensiveness of patients labor costs. Two related objectives are: a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. Results: There is evidence for established relations among the variables Convexp and Convrel (all ps

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The Prediction of the Risk Level of Pulmonary Embolism and Deep Vein Thrombosis through Artificial Neural Network

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Laleh Agharezaei, Zhila Agharezaei, Ali Nemati, Kambiz Bahaadinbeigy, Farshid Keynia, Mohammad Reza Baneshi, Abedin Iranpour, and Moslem Agharezaei.
Background: Venous thromboembolism is a common cause of mortality among hospitalized patients and yet it is preventable through detecting the precipitating factors and a prompt diagnosis by specialists. The present study has been carried out in order to assist specialists in the diagnosis and prediction of the risk level of pulmonary embolism in patients, by means of artificial neural network. Method: A number of 31 risk factors have been used in this study in order to evaluate the conditions of 294 patients hospitalized in 3 educational hospitals affiliated with Kerman University of Medical Sciences. Two types of artificial neural networks, namely Feed-Forward Back Propagation and Elman Back Propagation, were compared in this study. Results: Through an optimized artificial neural network model, an accuracy and risk level index of 93.23 percent was achieved and, subsequently, the results have been compared with those obtained from the perfusion scan of the patients. 86.61 percent of high risk patients diagnosed through perfusion scan diagnostic method were also diagnosed correctly through the method proposed in the present study. Conclusions: The results of this study can be a good resource for physicians, medical assistants, and healthcare staff to diagnose high risk patients more precisely and prevent the mortalities. Additionally, expenses and other unnecessary diagnostic methods such as perfusion scans can be efficiently reduced.


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Accuracy of Conventional Diagnostic Methods for Identifying Structural Changes in Patients with Focal Epilepsy

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Nazim Dakaj, Jera Kruja, Fisnik Jashari, Dren Boshnjaku, Nexhat Shatri, Kamber Zeqiraj.
Background: Epilepsy is a neurological disorder characterized by abnormal firing of nerve impulses in the brain. Aim: This study aims to investigate the frequency of appearance of pathological changes in conventional examination methods (electroencephalographyEEG, brain computerized tomography -CT or brain magnetic resonance imaging MRI) in patients with epilepsy, and relationship between clinical manifestations and localization of changes in CT or MRI. Methods: In this study we have included 110 patients with focal epilepsy who fulfilled the inclusion criteria out of 557 initially diagnosed patients. Detailed clinical examination together with brain imaging (CT and MRI) and electroencephalography examination was performed. We have evaluated the accuracy of each diagnostic method to localize the epileptic focus. Diagnosis of epilepsy was determined by the ILAE (International League Against Epilepsy) criteria of the year 1989, and classification of epileptic seizures was made according to the ILAE classification 2010. Results: Electroencephalography presented changes in 60.9% of patients; brain CT in 42.1%, and MRI in 78% of the patients. The results of our study showed that clinical manifestations were not always conveyed with pathological changes in conventional examining methods performed. Of the total of 79 patients with changes in imaging (8 with changes in CT and 71 in MRI), 79.7% presented a clinical picture compatible with the region in which morphological changes were found, while in 20.3% of patients the presented morphological changes were not aligned with the clinical picture. Conclusion: In patients with epilepsy, conventional examination methods do not always find pathological changes, while clinical manifestations of epilepsy did not always coincide with the location of changes in imaging. Further studies are needed to see if there is clear border between focal and generalized epilepsy.


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Effect of Lead Nanoparticles Inhalation on Bone Calcium Sensing Receptor, Hydroxyapatite Crystal and Receptor Activator of Nuclear Factor-Kappa B in Rats

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Rendra Leonas, Zairin Noor, Hermawan Nagar Rasyid, Tita Husnitawati Madjid, and Fachry Ambia Tanjung.
This study aimed to investigate whether Pb nanoparticle exposure affects the bone calcium sensing receptor (CaSR), hydroxyapatite crystal, and receptor activator of nuclear factor-kappa B (RANK) in rats exposed to subchronic and chronic inhalation. Thirty two rats were randomly divided into eight groups. One group is a non-exposed group. While three groups were exposed to nanoparticles Pb at the following doses 6.25; 12.5; or 25 mg/m3 an hour daily for 28 days. Another three groups were exposed to nanoparticles Pb at following doses 6.25; 12.5; and 25 mg/m3 one hour daily for 6 months. The expression of trabecular CaSR was significantly decreased at the all doses subchronic exposure compared to the control group (P

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Differential Diagnosis of Erythmato-Squamous Diseases Using Classification and Regression Tree

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Keivan Maghooli, Mostafa Langarizadeh, Leila Shahmoradi, Mahdi Habibi-koolaee, Mohamad Jebraeily, and Hamid Bouraghi.
Introduction: Differential diagnosis of Erythmato-Squamous Diseases (ESD) is a major challenge in the field of dermatology. The ESD diseases are placed into six different classes. Data mining is the process for detection of hidden patterns. In the case of ESD, data mining help us to predict the diseases. Different algorithms were developed for this purpose. Objective: we aimed to use the Classification and Regression Tree (CART) to predict differential diagnosis of ESD. Methods: we used the Cross Industry Standard Process for Data Mining (CRISP-DM) methodology. For this purpose, the dermatology data set from machine learning repository, UCI was obtained. The Clementine 12.0 software from IBM Company was used for modelling. In order to evaluation of the model we calculate the accuracy, sensitivity and specificity of the model. Results: The proposed model had an accuracy of 94.84% (Standard Deviation: 24.42) in order to correct prediction of the ESD disease. Conclusions: Results indicated that using of this classifier could be useful. But, it would be strongly recommended that the combination of machine learning methods could be more useful in terms of prediction of ESD.


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Molecular Dynamic Screening Sesquiterpenoid Pogostemon Herba as Suggested Cyclooxygenase Inhibitor

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Sentot Joko Raharjo and Takeshi Kikuchi.
Objective: Virtual molecular dynamic sesquiterpenoid Pogostemon Herba (CID56928117, CID94275, CID107152, and CID519743) have screening as cyclooxygenase (COX-1/ COX-2) selective inhibitor. Methods: Molecular interaction studies sesquiterpenoid compounds with COX-1 and COX-2 were using the molecular docking tools by Hex 8.0 and interactions were further visualized using by Discovery Studio Client 3.5 software tool and Virtual Molecular Dynamic 1.9.1 software. The binding energy calculation of molecular dynamic interaction was calculated by AMBER12 software. Result: The analysis of the sesquiterpenoid compounds showed that CID56928117, CID94275, CID107152, and CID519743 have suggested as inhibitor of COX-1 and COX-2. Conclusion: Collectively, the scoring binding energy calculation (with PBSA Model Solvent) sesquiterpenoid compounds: CID519743 had suggested as candidate for non-selective inhibitor; CID56928117 and CID94275 had suggested as candidate for a selective COX-1 inhibitor; and CID107152 had suggested as candidate for a selective COX-2 inhibitor.


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Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Mohammadreza Shahmohammadi, Reza Jalil Khoshuod, Alireza Zali, Amir Saied Seddeghi, and Nima Mohseni Kabir.
Background: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. Objective: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome. Method: Patients referred to Shohadaye Tajrish Hospital during the years 2009 to 2013, in case of having Cauda equina syndrome symptoms (confirmed with Lumbar MRI), were undergone urodynamic examination and perineal electromyography after surgical decompression action. These both assessments (urodynamic study and electromyography) were repeated during the follow-up of 15 patients in the first and sixth months after surgery and findings were compared with each other. Results: Among the Urodynamic findings, Qmax (maximum urine flow) during three studies had a significant relationship with long-term recovery rate of patients (P


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Comparing Three Data Mining Methods to Predict Kidney Transplant Survival

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Leila Shahmoradi, Mostafa Langarizadeh, Gholamreza Pourmand, Ziba Aghsaei fard, and Alireza Borhani.
Introduction: One of the most important complications of post-transplant is rejection. Analyzing survival is one of the areas of medical prognosis and data mining, as an effective approach, has the capacity of analyzing and estimating outcomes in advance through discovering appropriate models among data. The present study aims at comparing the effectiveness of C5.0 algorithms, neural network and C&RTree to predict kidney transplant survival before transplant. Method: To detect factors effective in predicting transplant survival, information needs analysis was performed via a researcher-made questionnaire. A checklist was prepared and data of 513 kidney disease patient files were extracted from Sina Urology Research Center. Following CRISP methodology for data mining, IBM SPSS Modeler 14.2, C5.0, C&RTree algorithms and neural network were used. Results: Body Mass Index (BMI), cause of renal dysfunction and duration of dialysis were evaluated in all three models as the most effective factors in transplant survival. C5.0 algorithm with the highest validity (96.77%) was the first in estimating kidney transplant survival in patients followed by C&RTree (83.7%) and neural network (79.5%) models. Conclusion: Among the three models, C5.0 algorithm was the top model with high validity that confirms its strength in predicting survival. The most effective kidney transplant survival factors were detected in this study; therefore, duration of transplant survival (year) can be determined considering the regulations set for a new sample with specific characteristics.


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Effect of Dental Chair Light on Enamel Bonding of Orthodontic Brackets Using Light Cure Based Adhesive System: An In-Vitro Study

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Anil Tiwari, Tarulatha Shyagali, Sarvraj Kohli, Rishi Joshi, Abhishek Gupta, and Rana Tiwari.
Aim: The aim of this in vitro study was to evaluate the influence of the Dental chair light on the bond strength of light cured composite resin. Materials and Methods: Sixty therapeutically extracted human premolar teeth were randomly allocated to two groups of 30 specimens each. In both groups light cured composite resin (Transbond XT) and MBT premolar metal brackets (3M Unitek) was used to bond brackets. In group I and II light curing was done using Light-emitting diode light curing units without and with the dental chair light respectively. After bonding, all samples were stored in distilled water at room temperature for 24 hours and subsequently tested for shear bond strength and Adhesive Remnant Index (ARI) scores. Data was subjected to Mann Whitney U statistical test. Results: Results indicated that there was significantly higher shear bond strength (7.71 ± 1.90) for the Group II (composite cured with LED and dental chair light ) compared with Group I (composite cured with LED LCU only) (5.74 ± 1.13).the obtained difference was statistically significant. There was no statistical significant difference between ARI scores in between the groups. Conclusions: light cure bonding with dental chair light switched on will produce greater bond strength than the conventional bonding. However, the ARI score were similar to both the groups. It is advised that the inexperienced orthodontist should always switch off the dental chair light while bonding for enough working time during the bracket placement.


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Role of Endothelial Cell Function Assessment Using Flow-mediated Dilation for Diagnosing Coronary Artery Disease in Low-risk Patients

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Seyed Mahmoud Nouraei, Ali Ghaemian,Hanieh Shiraj,Reza Ali Mohammadpour, and Alireza Malekrah.
Introduction: Flow-mediated dilation (FMD) measurement in the brachial artery (BA) is a method of endothelial cell function assessment. We can use it to predict atherosclerotic coronary artery disease. We investigated the predictive value of FMD for the presence of coronary artery disease (CAD) in a low-risk population of patients without major (CAD) risk factors. Materials and Methods: Three hundred and ninety-seven patients (age 53.2±9 years; 194 men) with chest pain admitted for coronary angiography were enrolled in this study. FMD was measured in the BA before coronary angiography using high-resolution ultrasound. Results: Coronary angiography was normal in (151)patient, (149) with single and (97) multi-vessel disease. FMD was significantly higher in normal coronary groupagainst patients with coronary artery disease (11.1±2.6% vs. 6.8±3.1%; P


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Designing and Implementation of Retina Image Drawing System and Automatic Report Generation from Retina Examinations

2016-10-21T17-13-47Z
Source: Acta Informatica Medica
Reza Safdari, Mehrshad Mokhtaran, and Shahram Tahmasebian.
Introduction: Electronic medical records as one of major parts of electronic health records is an important application of Medical Informatics. EMR includes different types of data, Graphical items being one of these data types. To this end, a standard structure for storing and recovering and finally exchanging this data type is required. In order to standardize information items in this research, UMLS standard is used. In this research, graphical information from fondues designing in retina surgery forms is used for the task of implementation. Implementation: Three-layer software architecture is used for implementation of this system, which includes user interface, data base access and business logic. XML database is used for storing and exchanging of data. User interface is designed by the means of Adobe Flash. Also in the user interface for eye examinations, appropriate icons compatible with current pathologies in retina examinations are considered and UMLS codes are used for standardizations purposes. Results: As this project is independently implemented in Adobe Flash, it can be run in most of electronic patient records software. For evaluation purposes of this research, an EMR system for eye clinics is used. Tree structure is used for data entry and finally a text report based on the entered data will be generated. By storing graphical items in this software editing and searching in medical concepts and also comparing features will be available. Conclusion: One of the data items that we encounter in various medical records is graphical data. In order to cover the patients complete electronic medical records, the Electronic Implementation of this information is important. For this purpose, graphical items in retina surgery forms were used and finally a software application for drawing retina picture was developed. Also, XML files were used for the purpose of storing valuable medical data from the pictures, and also UMLS were applied for the standardization purpose. The developed software is currently being used in some of eye clinics in Iran.


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From the Burning Platform to the Beautiful Island: Clinicians Can Envision the Way to Value-Based Care



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A Scoping Review of Physical Activity in the Parkinson's Disease Literature Using the Behavioral Epidemiological Framework

Motor and non-motor symptoms associated with Parkinson's disease (PD) place individuals at greater risk of sedentary behaviors and comorbidities. Physical activity is one modifiable means to improving health and reducing risk of morbidity. We applied a behavioral framework to classify existing research on physical activity and PD to describe the current evolution and inform knowledge gaps in this area. Research placed in Phase 1 establishes links between physical activity and health-related outcomes; Phase 2 develops approaches to quantify physical activity behavior; Phase 3 identifies factors associated with implementation of physical activity behaviors; Phase 4 assesses the effectiveness of interventions to promote activity; Phase 5 disseminates evidence-based recommendations.

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Impact of fibromyalgia in the sit-to-stand-to-sit performance compared with healthy controls

Fibromyalgia is associated with a reduction in the ability to perform activities of daily living (ADL). Sit-to-stand-to-sit performance is one of the most common ADL and is often evaluated by counting the number of repetitions of the 30 s chair-stand test. However, no study has examined the performance over the 30 s of this test by female fibromyalgia patients on a phase-by-phase basis.

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Spinal intra-operative three-dimensional navigation: correlation between clinical and absolute engineering accuracy

Spinal intra-operative computer-assisted navigation (CAN) may guide pedicle screw placement. CAN techniques have been reported to reduce pedicle screw breach rates across all spinal levels. However, definitions of screw breach vary widely across studies, if reported at all. The absolute quantitative error of spinal navigation systems is theoretically a more precise and generalizable metric of navigation accuracy. It has also been computed variably, and reported in fewer than a quarter of clinical studies of CAN-guided pedicle screw accuracy.

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Are pedicle screw perforation rates influenced by distance from the reference frame in multi-level registration using a CT-based navigation system in the setting of scoliosis?

Pedicle screw fixation is commonly employed for the surgical correction of scoliosis but carries a risk of serious neurovascular or visceral structure events during screw insertion. To avoid these complications, we have been using a computed tomography (CT)-based navigation system during pedicle screw placement. As this could also prolong operation time, multi-level registration for pedicle screw insertion for posterior scoliosis surgery was developed to register 3 consecutive vertebrae in a single time with CT-based navigation.

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Patient reported outcomes after lumbar epidural steroid injection for degenerative spine disease in depressed versus non-depressed patients

Non-operative modalities such as lumbar epidural steroid injections (LESI) are often used in the setting of lumbar spine disorders where other conservative measures have failed. Concomitant depression can lead to worse outcomes in lumbar spine pathology. A number of studies have demonstrated an association between preoperative depression and poor outcomes following surgery but the effect of depression on outcomes following non-operative modalities is poorly understood.

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In Vitro Analysis of Stability, and Potential Risks Associated with a Novel Cervical Interbody Device with Anchors: A Microtomography Study

BACKGROUND CONTEXT: Single- and multilevel anterior cervical discectomy and fusion (ACDF) achieves excellent rates of fusion. Stand-alone implants with integrated screws or anchored implants are known to reduce retraction, dysphagia and irritation to paravertebral soft tissue, but these devices may pose concerns regarding relocation, movement or potential damage to the vertebral body (VB) due to insertion of the anchor through the boney endplate.

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Avoiding Harm and Achieving Good in Rehabilitation Hospitals and Units

No abstract available

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Elastic Band Exercises Improved Activities of Daily Living and Functional Fitness of Wheelchair-bound Older Adults with Cognitive Impairment: A Cluster Randomized Controlled Trial

imageObjective: The purpose of this study was to test the effects of a 6-month Wheelchair-bound Senior Elastic Band (WSEB) exercise program on the activities of daily living (ADL) and functional fitness of wheelchair-bound older adults with cognitive impairment. Design: Cluster randomized controlled trial was used. A convenience sample of 138 wheelchair-bound older adults with cognitive impairment were recruited from 8 nursing homes in southern Taiwan and were randomly assigned based on the nursing homes they lived to the experimental (4 nursing homes; n = 73) or the control group (4 nursing homes; n = 65). The experimental group performed WSEB exercises 3 times per week and 40 minutes per session for 6 months. The ADL and functional fitness (cardiopulmonary function, body flexibility, range of joint motion, and muscle strength and endurance) were examined at baseline, 3 months, and the end of 6-month study. Results: The ADL and functional fitness indicators of participants in the experimental group showed significant improvements compared to the control group (all P

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Dynamic Ultrasonography of the Intra-Articular Long Head Biceps Tendon and Superior Labrum

imageNo abstract available

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Evidence of Improved Efficiency in Functional Gains During Subacute Inpatient Rehabilitation

imageABSTRACT: This comparative study investigated differences in functional capacity and functional gains of patients admitted for hospital rehabilitation between 2005 and 2011. Patients were grouped according to broad diagnostic categories: neurological, orthopedic, and deconditioned. Functional capacity (Functional Independence Measure (FIM), gait speed) and functional gains were compared between two 1-year patient cohorts (2005 and 2011) for diagnostic groups. In 2011, more patients were admitted (n = 626 vs. n = 474) with a shorter length of stay (mean difference 9.72 days, 95% confidence interval (CI) 5.26 to 14.18) compared to 2005. Functional capacity of patients at admission was worse in 2011 for all measures (P 0.497) except for discharge gait speed; in 2011, patients walked faster (mean difference 0.58 m/s, 95% CI 0.05 to 0.11). Higher FIM gain and FIM efficiency was demonstrated in 2011, but differences between diagnostic groups were evident. Deconditioned patients overall demonstrated less gain and efficiency (F > 3.623, P

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Sonographic Nerve Tracking in the Cervical Region: A Pictorial Essay and Video Demonstration

imageABSTRACT: Imaging of the nerves in the cervical region is more complicated than those of the extremities. Although high-resolution ultrasound enables the depiction of peripheral nerves' morphology and their associations with the adjacent soft tissues, precise identification of the nerves in the neck is still challenging. Familiarization with the cervical nerve tracking techniques can help interventional physiatrists explore/treat relevant entrapment syndromes, so does guiding proper electrode placement during nerve conduction studies. The present article integrates serial ultrasound images and videos to demonstrate how to scan brachial plexus, superficial cervical plexus, cranial nerves in the neck region, and certain branches of the major cervical nerves.

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Effects of Functional Electrical Stimulation Lower Extremity Training in Myotonic Dystrophy Type I: A Pilot Controlled Study

imageObjective: Functional electrical stimulation (FES) is a new rehabilitative approach that combines electrical stimulation with a functional task. This pilot study evaluated the safety and effectiveness of FES lower extremity training in myotonic dystrophy type 1. Design: This is a controlled pilot study that enrolled 20 patients with myotonic dystrophy type 1 over 2 years. Eight patients (age, 39–67 years) fulfilled the inclusion criteria. Four participants performed FES cycling training for 15 days (one daily session of 30 minutes for 5 days a week). A control group, matched for clinical and genetic variables, who had contraindications to electrical stimulation, performed 6 weeks of conventional resistance and aerobic training. The modified Medical Research Council Scale and functional assessments were performed before and after treatment. Cohen d effect size was used for statistical analysis. Results: Functional electrical stimulation induced lower extremity training was well tolerated and resulted in a greater improvement of tibialis anterior muscle strength (d = 1,583), overall muscle strength (d = 1,723), and endurance (d = 0,626) than conventional training. Conclusions: Functional electrical stimulation might be considered a safe and valid tool to improve muscle function, also in muscles severely compromised in which no other restorative options are available. Confirmation of FES efficacy through further clinical trials is strongly advised.

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Dysarthria Due to Injury of the Corticobulbar Tract in a Patient With Mild Traumatic Brain Injury

imageNo abstract available

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Cross-Sectional Investigation of Acute Changes in Ultrasonographic Markers for Biceps and Supraspinatus Tendon Degeneration After Repeated Wheelchair Transfers in People With Spinal Cord Injury

imageObjective: The objectives of this work were to investigate how wheelchair transfers influence acute changes in ultrasound markers for biceps and supraspinatus tendon degeneration and to determine how such changes correlate with transfer technique and demographic characteristics. Design: Participants underwent quantitative ultrasound examinations for markers of biceps and supraspinatus tendon degeneration (tendon width, echogenicity, variance, and contrast) before and after a stressful repeated-transfers protocol. The Transfer Assessment Instrument was completed for each participant to identify transfer skills. Linear regression tested whether demographics and transfer skills correlated with ultrasound measures. Results: Sixty-two wheelchair users with spinal cord injury were included (39 with paraplegia and 23 with tetraplegia). Biceps tendon width increased after repeated transfers (P

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Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts

imageObjective: The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Design: Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. Results: In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Conclusions: Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

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Relationship Between Active Trigger Points and Head/Neck Posture in Patients with Migraine

imageObjective: To investigate the relationship between the presence of active trigger points (TrPs), craniocervical posture, and clinical features (frequency, intensity, and duration) in patients with migraine. Design: A cross-sectional study. Methods: Fifty patients with migraine (90% women; age, 34.1 years) participated. Clinical data regarding migraine (frequency, intensity, and duration) were obtained. Trigger points were bilaterally explored in the following muscles: masseter, suboccipital, temporalis (anterior, medium, and posterior fibers), sternocleidomastoid, upper trapezius, and splenius capitis. Eight measures of head and neck posture were obtained from radiographs using the K-Pacs software. Results: Individuals with migraine showed active and latent TrPs in all the muscles, the suboccipital, upper trapezius, sternocleidomastoid, and temporalis muscles being the most affected. The results showed a relationship between the number of active TrPs and several x-ray outcomes, suggesting that the higher number of active TrPs was positively associated with a reduction in cervical lordosis and head extension of the head on the neck. No association between the number of active TrPs and clinical features of migraine was seen. Conclusion: Our study supports the hypothesis that active TrPs are associated with reduced cervical lordosis and head extension in individuals with migraine.

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Ultrasonographic and Surgical Findings of Acute Radial Neuropathy Following Blunt Trauma

imageABSTRACT: Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action. The left superficial radial sensory territory was intact. Electrodiagnostic findings suggested severe left radial neuropathy around the distal arm with sensory sparing. Ultrasonographic study demonstrated 2 stenotic lesions around the distal arm and absence of the left superficial radial sensory nerve. Surgical exploration revealed 2 stenotic lesions with twisting of the nerve, concordant with ultrasonographic study. End-to-end anastomosis was performed in the proximal lesion. Sixteen months later, wrist and finger extension was grade 3, and reinnervation signs in the radial-innervated muscles except extensor indicis muscle were observed. The complementary relationship between electrophysiologic and ultrasonographic examinations is very important for precise lesion location and decision making for treatment of peripheral nerve injury.

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Aquatic Therapy Improves Outcomes for Subacute Stroke Patients by Enhancing Muscular Strength of Paretic Lower Limbs Without Increasing Spasticity: A Randomized Controlled Trial

imagePurpose: The aim of this study was to evaluate the effects of an aquatic exercise program designed to enhance muscular strength in paretic lower limbs in subacute stroke patients. Method: Thirty-six subacute stroke patients were randomly divided to a conventional or an aquatic group (n = 18 each). Outcome measures were assessed at baseline and after 8 wks of training. For the paretic lower limbs, maximum isometric voluntary contraction strength of the rectus femoris and biceps femoris caput longus and the tibialis anterior and lateral gastrocnemius was measured. Cocontraction ratios during knee extension and flexion and ankle dorsiflexion and plantarflexion were calculated respectively. In addition, Modified Ashworth Scale, Functional Ambulation Category, and Barthel Index were assessed. Results: Compared with the conventional intervention, the aquatic intervention resulted in significantly higher knee extension (P = 0.002) and ankle plantarflexion torque (P = 0.002), accompanied with a significantly lower knee extension cocontraction ratio in the paretic limb (P = 0.000). Functional Ambulation Category (P = 0.009) and Barthel Index (P = 0.024) were greater in aquatic group than conventional group posttreatment. Modified Ashworth Scale scores did not show any differences between groups. Conclusions: Aquatic exercise enhanced muscle strength in paretic lower limbs and improved muscle cocontraction without increasing spasticity in subacute stroke patients.

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Ultrasound Imaging in the Management of a Rare Superficial Fibular Nerve Injury

imageNo abstract available

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Electromyographic Activities of the Rotator Cuff Muscles During Walking, Eating, and Washing

imageObjective: The aim of this study was to evaluate the activity of rotator cuff (RC) muscles during activities of daily living. Design: Motion analysis was conducted with 14 volunteers. Activation of RC (subscapularis, supraspinatus, and infraspinatus) was assessed using electromyography (EMG). Walking was performed with or without a shoulder immobilizer. Eating was conducted with or without the support of the elbow with the contralateral hand. Washing the hair was simulated while standing or leaning forward; washing the body was simulated while standing or holding the elbow; and washing the face was simulated using both hands while leaning forward. Results: During walking, RC's peak EMG activities remained below 7% maximum voluntary isometric contraction at all times, regardless of the use of immobilizers. Eating caused mild EMG activities (14%–32%), whereas eating with elbow support resulted in significantly lower EMG activities in the supraspinatus and infraspinatus. Washing the hair standing moderately activated RC (23%–57%), whereas leaning forward decreased it to 6% to 36%. Washing the body while holding the elbow decreased infraspinatus activation to 4% from 10% when standing. Washing the face with both hands and leaning forward resulted in high-peak EMG activities in the upper subscapularis (37%). Conclusions: There was no difference in RC activity level between walking with or without immobilizers. From the point of muscle contraction, an immobilizer is not mandatory. Holding the elbow with the contralateral hand while eating or washing can help decrease the load in the supraspinatus and infraspinatus.

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Massive Reflux and Aspiration After Radiographically Inserted Gastrostomy Tube Placement: Erratum

No abstract available

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Quality of life among lung cancer patients undergoing treatment at a tertiary cancer institute in North India

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Vijay Kumar Barwal, Salig Ram Mazta, Anita Thakur, Rajeev Kumar Seam, Manish Gupta.
Background: Lung cancer patients mostly present with advanced disease. Its treatment has shown limited progress in recent decades, so we studied their quality of life (QOL) and how it is affected during treatment. Methods: Patients ≥18 years of age, diagnosed/registered at our institute from 1st September 2012 through August 2013 were included in the study. QOL was assessed by means of the EORTC QLQ-C30 and QLQ-LC13. Data was analyzed using descriptive and inferential statistics Results: Out of 91 patients included in the study, 73 (80.2%) were males and 18 (19.8%) were females. Mean age of the study population was 59.24±10.53 years and median age was 60 years. A better QOL for nausea and vomiting (P=0.011), sleep disturbance (p=0.021), and coughing (p=0.016) was observed in female patients. There was significant worsening in symptom scales of fatigue (p=0.000), nausea and vomiting (p=0.000), sleep (0.006), appetite (p=0.000) and constipation (p=0.000). Though the mean scores of pain, dyspnoea and financial difficulties decreased, but they were not significant. According to the LC13 module, significant improvement was seen in the symptom scales of cough (p=0.000), haemoptysis (p=0.000) and pain chest (p=0.040). Conclusions: Lung cancer patients undergoing treatment suffer many limitations due to an array of symptoms and disruptions in various areas of QOL, arising from both the disease process and its treatment. It should be studied at every visit for each individual patient.


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Clinical spectrum and complications of scrub typhus: a single-centre, pilot observation from central India

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Jay Deshmukh, Sandhya Saoji, Arjun Deshmukh, Vijay M. Katekhaye.
Background: Scrub typhus is known from various parts of India. However, reports from central India are lacking. We performed pilot observation of confirmed scrub typhus cases from a single, tertiary care centre from central India. Methods: A retrospective analysis of 16 IgM ELISA confirmed scrub typhus cases was done. Clinical features, signs, laboratory parameters and complications were identified. Age (40 years) and gender (male versuss female) specific comparisons were performed. Data were analysed descriptively with appropriate statistical tests. Results: Diagnosed cases of scrub typhus were frequent in patients aged below 40 years (68.8) and in females (81.2%). Fever (100%), nausea±vomiting (68.8%) and headache (56.2%) were common symptoms. Rash was reported in a single case whereas characteristic eschar of scrub typhus was not observed in any patient. Mean hospital stay duration did not vary either by gender or by age-groups. Laboratory abnormalities did not show any significant deviation by gender or age analysis except mean haemoglobin being lower in females than males (10.1±1.4 Vs 12.3±1.1, p


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Identification of patients at high risk for hypocalcemia after total thyroidectomy with serial calcium estimation and intact parathyroid hormone levels-a comparative study

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Pauly T. J., Santhosh P. V., Santhosh T. V., Vinodh M..
Background: In recent years, multiple retrospective and prospective studies have emerged, which support the use of postoperative serum intact parathyroid hormone (iPTH) levels can also predict hypocalcaemia in postoperative thyroidectomy patients. Therefore, the present study was designed to determine the incidence of hypocalcaemia after total thyroidectomy. Methods: 146 patients who underwent total thyroidectomy were recruited. The incidence of hypocalcaemia was analyzed with serial calcium estimation results with 6 hours, 24 hours, 48 hours and 2 weeks post-operative calcium level estimations. The incidence of hypocalcaemia with regards to the number of parathyroid glands was determined and the results between the three groups were compared. Results: The incidence of transient hypocalcaemia at 24hr postoperative period and intact parathyroid hormone (iPTH) level showed a significant difference (p


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Giant adrenal myelolipoma - clinical spectrum and management: a single centre experience

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Santosh Kumar, Ankur Mittal, Aditya Prakash Sharma, Abhinandan Mukhopadhyay.
Background: Adrenal myelolipomas are rare benign tumor composed of mature adipocytes and normal haematopoetic cells. Giant adrenal myelolipomas are rare clinical entities. Most of them are symptomatic. We present 15 such cases, their clinical spectrum and management. Methods: Retrospective analysis of giant adrenal myelolipomas from a tertiary level institute. Initial diagnosis was made by computed tomography. Results: Mean age of patient was 45.6±11 years with slightly higher female preponderance. All patients were overweight with predominantly left sided adrenal myelolipoma. Majority of them (93%) were symptomatic and presented with abdominal pain, anemia or fever. Mean size of the mass on imaging was 14 cm±6 cm, with largest lesion measuring 26 cm. Conclusions: The article highlights the varying clinical presentations including rare emergency presentations of giant adrenal myelolipomas. A brief literature review is also presented.


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Comparative study between histological changes in placenta from pre-eclampsia cases and normal pregnancy with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Bhawana Sahay, Leena Talukdar, Pallavi Sahay, Debashish Datta, Rangnath Chaubey.
Background: Placenta is a vital organ and the most accurate record of the infants prenatal experience. Pregnancy complications like hypertension significantly affect the placenta. Thus there is a need for thorough examination of it. Therefore the present study is dedicated to see the histological changes in placenta of pre-eclampsia with special reference to cytotrophoblastic cell hyperplasia, villous stromal fibrosis and fibrinoid necrosis and compared it with that of normal placenta. Methods: Total 60 placentas were collected (30 from pre-eclampsia and 30 from normal pregnancy). Results were expressed in percentage after counting 100 villi. Data analysis has been done using Graphpad InStat 3 version and data is significant when p value is


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Role of multiparametric MRI in detection of prostatic lesions; of evaluation contrast enhanced MRI, diffusion weighted imaging and MR spectroscopy in malignant and benign prostatic lesions

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Pratiksha Yadav, Rajul Bhargava.
Background: Prostate cancer is the most commonly diagnosed cancer in males and one of the leading causes of cancer-related death in men. Pretreatment assessment of prostate cancer is divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. The purpose of the study is to determine the diagnostic accuracy of multiparametric MRI for prostatic cancer detection using T2 weighted MR imaging, diffusion weighted imaging (DWI) and contrast enhanced MRI. To determine the use of MR spectroscopy in prostatic lesions. Methods: It is a prospective single institutional study done on 29 patients with prostate lesions and elevated PSA level. Axial, coronal and sagittal images were obtained using T1WI, T2WI and STIR sequences. Advanced sequences like Diffusion weighted images, Spectroscopy and post gadolinium T1WI were taken after the basic MRI images. Results: Study was done in 29 patients, age was ranging between 51years to 90 years, mean age is 70.7 years. On multiparametric MRI findings 45% were detected malignant lesions and 55% patients detected benign lesions. On biopsy correlation 42% of these cases turned out to be malignant and 58% as benign lesions. Detection of malignancy by T2WI imaging alone given sensitivity of 80.1% and specificity of 85.4%.By DWI alone sensitivity was 85.7% and specificity was 89.4%,on MRS sensitivity is 90.6% and specificity was 91.1%. Combined (MRI+DWI+MRS) gave sensitivity of 92.3% and specificity of 94.4% for detection of malignant prostatic lesion. Positive predictive value is 90% and negative predictive value was 88%. Conclusions: The best characterization of prostatic cancer in individual patients will most likely result from a multiparametric exam. Recent advances include additional functional and physiologic MR imaging techniques (diffusion weighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer.


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Clinico-radiological correlation of osteoarthritis knee using Western Ontario and McMaster Universities score and Kellegren and Lawrance grading

2016-10-21T00-09-15Z
Source: International Journal of Research in Medical Sciences
Manish Singh Rajpoot, Digember Peepra, Krishna Kumar Pandey, H. S. Varma.
Background: Diagnosis OA is basically based upon clinical and radiological features. In our study we have used a clinical scoring system of OA called as WOMAC (Western Ontario and McMaster Universities) score and a radiological staging system KL staging (Kellegren and Lawrance) OA radiological staging system and correlation between them. Methods: There were total 66 patients with 102 knees. X ray of bilateral knee was taken in weight bearing position (standing) and WOMAC score was calculated. X-rays were assessed with KL grading. WOMAC score a clinical scoring was correlated with a radiological KL grading for the OA of knee. Results: Range of WOMAC score was 11.5-67.7. Mean WOMAC score were 18.75, 31.31, 52.57 and 67.2 in patients of KL grade 1, 2, 3 and 4 respectively. Correlation between KL grading and WOMAC scoring were found to be significant; there were rise in the WOMAC scoring when KL grading increases. Conclusions: Both the KL grading and WOMAC score are directly proportional to each other, and hence, WOMAC scoring can be used to diagnose, assess the progression of the disease and the response to treatment of osteoarthritis.


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