7. Intraoperative seizures during intraoperative motor monitoring: A retrospective study

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): C. Minardi, G. Fedeli, M. Bocchino, L. Tosatto
Aim of this retrospective study is to evaluate the appearance of intraoperative seizures during motor monitoring in brain surgery and to find correlation to stimulation and clinical features. A total of 37 consecutive patients were divided in 2 groups: a prophylaxis group and a therapy group. Patients in prophylaxis group didn't present seizures in their clinical history and underwent to a brief period of antiepileptic treatment before and after surgery. Patients in therapy had a seizures and therapy in their clinical history before surgery.Intraoperative seizures were recorded in 5 patients, 1 patients belonged to the prophylaxis group and 4 patients belonged to the therapy group. In 2 patient seizures were related to cortical stimulation with train of four technic.Our results confirm the low incidence of seizures during intraoperative motor monitoring described in literature. Seizure related to stimulation are reported from 1.2% (Sala 2003) to 9.5% (Berger 1989) in relation to different stimulation technics, lesser than 5% with train of five technic. There are also a relevant variability in data from 20% to 50% (Sartorius 1997, Yingling 1999, Bello 2014). Further multicentric studies need in order to obtain static significativity.



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15. The effect of cannabinoids on the stretch reflex in multiple sclerosis spasticity

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): L. Marinelli, L. Mori, S. Canneva, F. Colombano, A. Currà, F. Fattapposta, F. Bandini, E. Capello, G. Abbruzzese, C. Trompetto
The aim of this observational study was to assess the efficacy of tetrahydrocannabinol-cannabidiol oromucosal spray (THC:CBD, Sativex) on spasticity using the stretch reflex in subjects with multiple sclerosis (MS). Numeric rating scale (NRS) for spasticity, modified Ashworth scale (MAS) and the stretch reflex were assessed before and during treatment in 57 MS patients with spasticity eligible for THC:CBD treatment. A significant reduction of stretch reflex amplitude, as well as significant reductions of NRS and MAS scores were observed. There was a low concordance between the three measures (stretch reflex, NRS and MAS), likely related to the different aspects of muscle hypertonia assessed. Stretch reflex responders were taking a significantly higher number of puffs, while no differences were found in the responders by the other scales, suggesting that higher dosage would add benefit if tolerated. The present study confirms the efficacy of cannabinoids in reducing spasticity in patients with MS, suggesting a higher sensitivity and specificity of the stretch reflex compared to other measures. As an objective and quantitative measure of spasticity, the stretch reflex is particularly useful to assess the effects of cannabinoids on spinal excitability and may have a role in future pharmacological studies.



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23. Cerebellum and attention: Eevidence from an Event-Related Potentials and transranial Direct Current Stimulation study

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): D. Mannarelli, C. Pauletti, M.C. De Lucia, R. Delle Chiaie, F.S. Bersani, F. Spagnoli, A. Minichino, C. Trompetto, A. Currà, F. Fattapposta
The role of the cerebellum extends beyond its traditional role in motor control. In recent years this structure has increasingly been seen as playing a crucial role also in cognitive performance and attentional processes being a subcortical structure that interacts with cortical brain areas. To investigate the role of the cerebellum in attentional processing of the stimulus, we studied the effects of transcranial Direct Current Stimulation (tDCS) delivered over the left cerebellar hemisphere on the ERPs components during a Novelty P300 task in healthy subjects. Fifteen healthy subjects underwent cathodal, anodal and sham tDCS sessions and a P300 Novelty was recorded task prior and after each tDCS session. Only cathodal cerebellar tDCS significantly reduced the amplitude and latency of the N1 component and reduced the amplitude of P3 components for both the target and novel stimuli. These results support the role for the cerebellum in the attentional processing of the stimulus. In particular, we speculate that the cerebellum acts indirectly by regulating and managing the activation and inhibition levels of the cortical areas that work in the attentional networks.



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9. Navigated transcranial magnetic stimulation (nTMS) for preoperative mapping in motor areas tumor surgery: Comparison with functional magnetic resonance imaging (fMRI) and intraoperative direct cortical stimulation

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): C. Lettieri, R. Budai, G. Devigili, F. Muggiolu, S. Rinaldo, R. Canesin, G. Valiante, T. Ius, M. Skrap, R. Eleopra
Navigated transcranial magnetic stimulation (nTMS) is a novel technology in the field of neurosurgery for noninvasive delineation of cortical functional topography. Recent studies show that it can detect eloquent cortical areas directly, comparable to intraoperative direct cortical stimulation (DCS). The aim of this study was to evaluate the nTMS in comparison with functional magnetic resonance imaging (fMRI) in the setting of brain tumors involving motor areas. Thirteen consecutive patients affected by frontal lobe brain tumors were enrolled in the study. All patients received an fMRI and nTMS examination preoperatively. Consistency of preoperative mapping with intraoperative DCS was assessed off-line by means of the neuronavigation system: as result, nTMS produced statistically significant higher accuracy scores of the motor area localization than fMRI. Moreover, nTMS has fewer restrictions for preoperative functional mapping than fMRI and requires only a limited level of compliance: so it represents an useful and reliable technique during preoperative planning for surgical decision making in the clinical setting.



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13. Which is the best evoked potential technique for assessing the nociceptive system? Preliminary results of a neurophysiological study in healthy humans

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): C. Leone, S. La Cesa, G. Di Stefano, A. Pepe, A. Truini, G. Cruccu
Laser evoked potentials (LEPs) and contact heat evoked potentials (CHEPs) are widely agreed method for investigating the nociceptive system. Concentric electrodes (CE) have also recently been introduced to measure pain-related evoked potentials (PREPs) and, thereby, to assess the nociceptive system in patients. Although some authors have reported that low intensity CE stimulation, evoking pinprick sensation, selectively activates nociceptive fibres, the CE reliability in the assessment of nociceptive system is still unclear. In this study we aimed to verify whether low and high intensity CE stimulations selectively activates nociceptive fibres. To do so we recorded LEPs, CHEPs and PREPs before and after capsaicin-induced skin denervation.To date, we have enrolled 6 healthy subjects. All subjects underwent a baseline recording of LEPs, CHEPs and PREPs after stimulation of the right forearm. For PREP recording we used both low intensity stimulation, evoking a distinct pinprick sensation and high intensity stimulation, evoking an electrical painless sensation. After the baseline evoked potential recordings, we applied an 8% capsaicin plaster on the right forearm. After one-two weeks, we recorded LEPs, CHEPs and PREPs after stimulation of the capsaicin-induced denervated forearm skin. In a small skin area spared by evoked potential stimulations we have also collected a skin biopsy for assessing the skin denervation.While LEPs and CHEPs were suppressed after topical application of capsaicin, low and high intensity PREPs did not differ before and after capsaicin-induced skin denervation. The skin biopsy documented the skin denervation induced by the capsaicin plaster.Our data indicate that both low and high intensity CE stimulation elicit PREPs after skin denervation, thus suggesting that the CE stimulation probably coactivates non-nociceptive fibres.



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17. Simultaneous recording of motor related cortical potentials to different basal components of voluntary movements

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): W. Troni, F. Boretto, A. Di Sapio, F. Melillo, R. Morese, M.C. Valentini
The purpose of the paper was to compare motor related cortical potentials (MRCPs) to basic components of voluntary movements in prolonged recording sessions.EEG activity (27 electrodes placed over the sensorimotor cortex) was recorded in 10 normal volunteers instructed to perform a sequence of 3 simple self-paced movements with the right index finger, separated by an interval of at least 3–4s: (1) rapid, ballistic-type (Bt-) extension with immediate automated return to resting position; (2) rapid extension (Ex-) to reach and maintain a defined target followed by (3) relaxation (Re-) with passive return to resting position. A prolonged recording session (80min) provided, for each task, a sequence of 4 MRCPs resulting from the average of 4 successive blocks of 40–80 artefact-free EEG epochs (3s before and 1s after onset of individual movements derived from the mechanogram). Recording breaks of about 10–20s, without interruption of motor task, were interposed at intervals of 3–4min.Pre- and post-movement components were stable in all MRCPs throughout the recording session. All potentials showed a similar onset and duration of pre-movement components with a similar scalp distribution. Clear-cut differences were observed in the post-movement components probably reflecting different afferent patterns from peripheral effectors.



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Editorial Board

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12





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21. Habituation of somatosensory evoked potentials in patients with dementia

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): M. Gorini, A. Tanzilli, A. Cardillo, D. Greco, S. Rinalduzzi, F. Pierelli, F. Fattapposta, C. Trompetto, A. Currà
Habituation is defined as "a response decrement with repeated stimulation". In normal cerebral cortex repetitive stimulation delivered with various sensory modalities elicits responses characterized by habituation, presumably owing to mechanisms that alter synaptic effectiveness. Habituation may represent an early, pre-clinical marker of synaptic dysfunction. In dementia, evidence of changes in synaptic functioning in sensory cortices is lacking.We investigated somatosensory evoked potentials (SEPs) habituation in 29 patients with mild dementia, grouped according to clinical, neuropsychological, and neuroimaging features.We recorded median-nerve SEPs in 15 AD-type and 14 VD-type, mild dementia, and 15 controls. We measured N20-P25 amplitudes from 3 blocks of 200 sweeps, and assessed amplitude of block 1, and habituation from amplitude changes between the 3 sequential blocks.ANOVA showed a main effect of factor group (F=3.43 p=0.042). AD-type patients, had normal block1 SEP amplitudes, but abnormal habituation (p=0.036). VD-type patients had normal SEP amplitudes and habituation (p=0.58).SEP habituation is altered in AD-type dementia suggesting hyperresponsivity of the somatosensory cortex. This abnormality is not found in patients with VD-type mild dementia, which manifest normal synaptic function to repetitive stimulation. Further investigation is deserved to see whether abnormal SEP habituation may represent a neurophysiological marker of degenerative dementia.



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Contents

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12





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25. Attentional dysfunctions in Ataxia-teleangectasia: A psychophysiological study

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): D. Mannarelli, C. Pauletti, V. Leuzzi, D. D'Agnano, S. Rinalduzzi, A. Currà, N. Locuratolo, F. Fattapposta
Ataxia-telangiectasia (AT) is a human disease caused by mutations in the ATM gene. The neural phenotype of AT includes progressive cerebellar neurodegeneration, which results in ataxia, oculocutaneous teleangiectasias, immunodeficiency, recurrent infections and proneness to cancer. Cognitive disturbances seem to affect both the attention and the executive functions. The aim of this study was to investigate the attentional functioning in AT patients using a psychophysiological evaluation. Ten young AT-patients (age: 12.4±1.7years) and ten matched healthy controls underwent a Contingent Negative Variation (CNV) recording. MICARS and UPDRS III scales were administered in order to assess clinical performance and disability. CNV amplitude (total and in two different temporal windows – W1, W2) was evaluated. Reaction times were also obtained. Total CNV amplitude (Fz p=0.001; Cz p=0.007; Pz p=0.03) and W2-CNV areas (Fz p=0.02; Pz p=0.05) were significantly lower in patients than in controls. RTs were prolonged in patients with respect to controls (p=0.004). Our data indicated a difficulty in sustain attention and in motor preparation during an executive choice motor task. These attentional dysfunctions could result from the abnormal prefrontal-cerebellum circuit activity pattern, which has been proven to be altered in AT patients.



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29. ERP generators in an omitted-target oddball task: A simultaneous EEG-fMRI study

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): A. Di Rollo, M. Cosottini, I. Pesaresi, S. Fabbri, F. Di Russo, R.L. Perri, D. Barloscio, T. Bocci, A. Ragazzoni, F. Sartucci
This study investigated the cerebral sources of the visual event-related potential (ERP) with the help of simultaneous recording of functional magnetic resonance imaging (fMRI). As tasks, in addition to a standard two-stimuli visual "oddball" paradigm, we applied a similar paradigm, in which the rare (target) stimuli were omitted in a sequence of regularly presented visual stimuli. Pre-stimulus ERP showed larger prefrontal activity over the righ hemisphere in the omitted-target task. Post-stimulus ERP showed a clear P1/N1/P2/Pp2/P3 complex during the standard "oddball" paradigm, whereas during the "omitted target" task, only the Pp2 and P3 components were present. The P3 was reduced amplitude and increased latency (from 450 to 520ms). fMRI showed, during both tasks, activations in lateral frontal, fronto-operculum, anterior insula regions, prevailing on the right. Minor activations were observed bilaterally in the parietal cortex near the intraparietal sulcus and in posterior temporal regions, also more evident on the right hemisphere. The "omitted task" paradigm showed larger fMRI activations in prefrontal areas. These results showed for the first time the strong top-down preparatory cognitive control in the "omitted target" task and highlight the endogenous nature of P3.



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6. Glutamate Receptor Ionotropic AMPA 3 (GRIA3) gene polymorphism influences cortical response to somatosensory stimulation in medication-overuse headache patients

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): G. Coppola, C. Di Lorenzo, G.S. Grieco, M. Santoro, F.M. Santorelli, E. Pascale, F. Pierelli
Glutamate-mediated pathways seem to play a relevant role in the generation of somatosensory evoked potentials (SSEPs) in supragranular parietal layers, but also in maintaining central sensitization, a mechanism that may be responsible for medication overuse headache (MOH). Here, we tested whether Glutamate Receptor Ionotropic AMPA 3 (GRIA3) rs3761555 polymorphisms may influence SSEPs sensitization and habituation in patients with MOH.We recorded median nerve SSEPs (two blocks of 100 sweeps) in 60 MOH patients. We measured N20-P25 1st block amplitude, as a marker of sensitization, and amplitude changes between two sequential blocks, as a marker of habituation. According to their genotype, patients were divided in three groups: "T/T" (N=27), "T/C" (N=26) and "C/C" (N=7).No differences emerged among genotypes in terms of grand-average for all the neurophysiological measures. Patients carrying T/T polymorphism had larger-amplitude block 1 SSEP than those carrying C/C (z=2.604; p=0.028), with T/C falling in between. No between groups differences were observed regarding delayed habituation.In patients with MOH, GRIA3 rs3761555 polymorphisms influence SSEP sensitization and, in general, cortical excitability. These data suggest that the glutamatergic system is one of the main drivers of central sensitization in MOH patients.



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8. Neurophysiological monitoring and pharmacological provocative test in the endovascular treatment of brain arteriovenous malformations

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): F. Valzania, S. Contardi, F. Cavallieri, E. Menozzi, S. Vallone, S. Baroni, A. Feletti, G. Pavesi
Neurophysiological monitoring and pharmacological provocative test in the endovascular treatment of brain arteriovenous malformations.The improvement of endovascular techniques increase embolization indications for cerebral arteriovenous malformations (AVMs). Intraoperative monitoring (IOM) techniques are very useful to reduce risks by a step-by-step check of the patient during treatment.We report a series of 5 patients affected by brain AVMs who underwent embolization assisted by IOM and superselective provocative pharmacological test (PTs) with intraarterial amobarbital.We used different IOM setting (MEPs, SEPs, BAERs and VEPs) in relation to the localization of AVM, which was rolandic in 2 patients, brainstem in 2 patients and occipital cortex in one case.We performed six endovascular procedures in five patients, carrying out nine PTs. Changes in IOM signals were detected in 3 out of 5 patients, leading to the decision to partially embolize one AVM and to avoid embolization of 2 other AVMs.No one experienced new permanent neurological deficit. In two patients we achieved complete nidus embolization; in the third patient another endovascular procedure is scheduled with complete resolution of AVM. In any patients we have false negative PTs.The use of IOM during embolization of AVM close to eloquent brain areas, implemented by PTs, is a valuable tool, which allows minimizing the risk of postoperative neurological deficits.



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10. Somatosensory Evoked Potentials as predictors of evolution toward brain death in comatose patients after acquired brain injury

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): M. Scarpino, G. Lanzo, R. Carrai, F. Lolli, M.L. Migliaccio, M. Spalletti, M. Cozzolino, A. Peris, A. Amantini, A. Grippo
We assessed whether Somatosensory Evoked Potentials (SEPs), recorded within 24h after ICU admission, are reliable predictors of brain death (BD) in comatose patients with acquired brain injury (ABI) of several aetiologies. SEPs were classified as Absent (A), Pathological (P), and Normal (N). Taking into consideration responses in both hemispheres, six SEP patterns were defined: NN, NP, PP, AN, AP, and AA. The final endpoint was BD. Of the 203 patients, 70 (34%) evolved toward BD. Using survival analysis, the comparison of survival curves indicated that the most powerful aggregation of SEP patterns resulted in the following: grade I (NN-NP-PP-NA) and grade II (AP-AA). This aggregation predicted BD with a sensitivity of 75.7% (CI 64–84) and a specificity of 76.6% (CI 68–83) in overall patients, and with a sensitivity of 75.0% (CI 63–84) and a specificity of 84.9% (CI 75–90) in all patients excluding cardiac arrest.It is worth including SEPs, in association with other instrumental and clinical signs, in prognostic scores of BD. The early identification of patients that would probably evolve toward BD could help physicians to identify potential organ donors and to optimise their diagnostic-therapeutic work-up.



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12. Outcome prediction in comatose patients after cardiac arrest, the utility of early EEG/SEP recordings during therapeutic hypothermia: The italian multicentric study (PRONECA) preliminary data

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): A. Grippo, R. Carrai, D. Audenino, C. Callegarin, M. di Capua, M. Lombardi, O. Mecarelli, C. Minardi, F. Minicucci, L. Motti, L. Politini, F. Valzania, E. Vitelli, M. Scarpino, M. Spalletti, C. Cossu, G. Lanzo, A. Peris, S. Valente, A. Amantini
Somatosensory evoked potentials(SEPs) and EEG are reliable outcome predictors of coma after cardiac arrest (CA). Nevertheless, only few multicentric studies are available. Aim of the study was to evaluate the prognostic value of EEG and SEPs association in post-anoxic comatose patients at different recording time from cardiac arrest (CA) in an Italian multicentric study. Comatose patients after CA treated with TH were included. EEG and SEPs were recorded within 12h and at 72h after CA. EEG was classified into "non-continuous" and "continuous". SEPs were dichotomized into "bilaterally absent" (BA) and "present". Neurologic outcome was evaluated at 6months by GOS: "awakening"(GOS 3–5) was considered good outcome. 83 patients were included to date."Continuous" EEG pattern at 12h always predicted good outcome, "non-continuous" pattern at 72h always predicted poor outcome. BA SEPs always predicted poor outcome. Early "continuous" EEG pattern was always associated with present SEPs. SEPs provide a specific and time-independent predictor of poor outcome. EEG provide a specific and time-dependent predictor of good outcome (at <12h) and poor outcome (at 72h). Early "continuous" EEG and BA SEPs are never associated together. Combined EEG/SEPs recordings are a useful tool for reliable prognostication both of good and poor outcome in comatose patients treated with TH.



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14. Abdominal acupuncture reduces pain at spinal level

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): C. Pazzaglia, E. Testania, S. Liguori, D. Coraci, C. Pecchioli, L. Padua, M. Valeriani
Abdominal acupuncture (AA) reduces laser-evoked potentials (LEP) amplitude and laser pain perception in healthy subjects (Pazzaglia et al., 2014). The aim of the current study was to investigate the site of AA analgesic effect. We recorded LEPs in 6 healthy volunteers by using 32 EEG scalp electrodes. The experimental protocol included 3 times: (1) baseline, in which LEPs evoked to stimulation of the bilateral dorsal wrist and right foot were recorded before acupuncture; (2) acupuncture, in which LEPs were recorded during AA performed in the abdominal area corresponding to right wrist; (3) rest, in which LEPs were recorded 15min after the needle removal. Compared to baseline, N2/P2 LEP amplitude evoked by stimulation of both wrists was reduced in the acupuncture and rest times while LEP amplitude evoked by foot stimulation was not modified. Our results suggest that the AA analgesic effect occurs at spinal level.



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16. Presynaptic and postsynaptic inhibition in the human dorsal column nuclei

Publication date: December 2016
Source:Clinical Neurophysiology, Volume 127, Issue 12
Author(s): M. Valeriani, A. Insola, P. Mazzone
The study aimed to investigate the site of the movement related inhibition of the human dorsal column nuclei. Median nerve somatosensory evoked potentials (SEPs) were recorded from 18 patients suffering from Parkinson's disease, who underwent electrode implantation in the pedunculopontine (PPTg) nucleus. SEPs were recorded at rest and during movement of the thumb of the stimulated wrist. The PPTg electrode recorded a triphasic potential generated in the cuneate nucleus. The PPTg potential was subtended by 2 high frequency oscillation (HFO) components: (1) an earlier one with 1000Hz frequency, and (2) a later one with 1700Hz frequency. Movement reduced both HFO components. We suggest that the 1000Hz and 1700Hz HFO bursts are generated at pre- and post-synaptical level, respectively. Therefore, movement exerts both pre- and post-synaptic inhibition on the dorsal column nuclei.



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210Po secretion from sweat glands

Publication date: Available online 18 November 2016
Source:Journal of Environmental Radioactivity
Author(s): Grzegorz Romańczyk, Alicja Boryło
The results of the research indicated that the ²¹⁰Po activity concentration in sweat samples was between 0.22 ± 0.03 to 2.10 ± 0.15 mBq·g⁻¹ d.w. The obtained results of the studies showed that smoking and eating fish led to higher activity concentrations of ²¹⁰Po in sweat in comparison to the control group. Statistical analysis of ²¹⁰Po activity concentrations in sweat samples showed significant differences between control, smoking, fish eating and age groups, while no significant differences was found for ²¹⁰Po between volunteers as far as gender is concerned.



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Natural radionuclides in lichens, mosses and ferns in a thermal power plant and in an adjacent coal mine area in southern Brazil

Publication date: Available online 18 November 2016
Source:Journal of Environmental Radioactivity
Author(s): Juliana Aparecida Galhardi, Rafael García-Tenorio, Inmaculada Díaz Francés, Daniel Marcos Bonotto, Marcelo Pinto Marcelli
The radio-elements ²³⁴U, ²³⁵U, ²³⁸U, ²³⁰Th, ²³²Th and ²¹⁰Po were characterized in lichens, mosses and ferns species sampled in an adjacent coal mine area at Figueira City, Paraná State, Brazil, due to their importance for the assessment of human exposure related to the natural radioactivity. The coal is geologically associated with a uranium deposit and has been used as a fossil fuel in a thermal power plant in the city. Samples were initially prepared at LABIDRO (Isotopes and Hydrochemistry Laboratory), UNESP, Rio Claro (SP), Brazil. Then, alpha-spectrometry after several radiochemical steps was used at the Applied Nuclear Physics Laboratories, University of Seville, Seville, Spain, for measuring the activity concentration of the radionuclides. It was ²¹⁰Po the radionuclide that most bio-accumulates in the organisms, reaching the highest levels in mosses. The ferns species were less sensitive as bio-monitor than the mosses and lichens, considering polonium in relation to other radionuclides. Fruticose lichens exhibited lower polonium content than the foliose lichens sampled in the same site. Besides biological features, environmental characteristics also modify the radio-elements absorption by lichens and mosses like the type of vegetation covering these organisms, their substrate, the prevailing wind direction, elevation and climatic conditions. Only ²¹⁰Po and ²³⁸U correlated in ferns and in soil and rock materials, being particulate emissions from the coal-fired power plant the most probable U-source in the region. Thus, the biomonitors used were able to detect atmospheric contamination by the radionuclides monitored.

Graphical abstract

Teaser

Coal contains U, Th and Po that can be released into the atmosphere and may be absorbed by the biota. Mosses, lichens and ferns act as bioindicators of the air pollution in southern Brazil.


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An analysis of the radioactive contamination due to radon in a granite processing plant and its decontamination by ventilation

Publication date: Available online 18 November 2016
Source:Journal of Environmental Radioactivity
Author(s): Pedro M. Dieguez-Elizondo, Tomas Gil-Lopez, Paul G. O'Donohoe, Juan Castejon-Navas, Miguel A. Galvez-Huerta
This work focuses on studying concentration distribution of ²²²Rn radioisotope in a granite processing plant. Using Computational Fluid Dynamic Techniques (CFD), the exposure of the workers to radiation was assessed and, in order to minimise this exposure, different decontamination scenarios using ventilation were analysed. Natural ventilation showed not sufficient to maintain radon concentration below acceptable limits, so a forced ventilation was used instead. Position of the granite blocks also revealed as a determining factor in the radioactive level distribution. Thus, a correct layout of the stored material and an adequate ventilation system can guarantee free of exposure to radiation zones within the studied workshop. This leads to a drastic fall in the exposure of the workers and consequently minimises their risk of developing aggressive illness like lung cancer.

Graphical abstract

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Prevalence and Etiology of Hypogonadism in Young Men with Chronic Spinal Cord Injury: A Cross-Sectional Analysis from Two University-Based Rehabilitation Centers

Spinal cord injury (SCI) triggers an 'accelerated aging' process that may include development of hypogonadism, even among younger men with SCI; however, few studies have investigated the prevalence or etiology of hypogonadism in men with SCI. Young men with SCI are also at increased risk for developing metabolic dysfunction after injury, which may be exacerbated by concomitant testosterone (T) deficiency, thus identifying the prevalence and risk factors for T deficiency in men with SCI is important for their long-term health.

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Improvement in Compensation for Chronic Post-Stroke Homonymous Hemianopsia Following Initiation of an SSRI: A Case Report

Homonymous hemianopsia (HH) is a common adverse outcome following stroke. Spontaneous improvement more than 6 months post stroke is thought to be unlikely, and traditional visual rehabilitation techniques lack clear evidence of efficacy. The case presented is of a 22 year-old woman who demonstrated improved compensation of her stroke-induced HH following the initiation of a selective serotonin reuptake inhibitor (SSRI). There is evidence supporting the use of SSRIs to improve post-stroke cognitive impairment, motor impairment and depression.

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Relationship Between Preoperative Anemia and In-Hospital Mortality in Children Undergoing Noncardiac Surgery

BACKGROUND: The relationship between preoperative anemia and in-hospital mortality has not been investigated in the pediatric surgical population. We hypothesized that children with preoperative anemia undergoing noncardiac surgery may have an increased risk of in-hospital mortality. METHODS: We identified all children between 1 and 18 years of age with a recorded preoperative hematocrit (HCT) in the 2012, 2013, and 2014 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) pediatric databases. The endpoint was defined as the incidence of in-hospital mortality. Children with preoperative anemia were identified based on their preoperative HCT. Demographic and surgical characteristics, as well as comorbidities, were considered potential confounding variables in a multivariable logistic regression analysis. A sensitivity analysis was performed using propensity-matched analysis. RESULTS: Among the 183,833 children included in the 2012, 2013, and 2014 ACS NSQIP database, 74,508 had a preoperative HCT recorded (41%). After exclusion of all children

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Disruption of Memory Consolidation May Explain Patterns of Memory Better Than Emotion-Induced Retrograde Amnesia in Study by Chen et al

No abstract available

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SEER Sonorheometry: Listening to What the Clot Has to Say

No abstract available

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Translational Research in Pain and Itch (Advances in Experimental Medicine and Biology)

No abstract available

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“A Time of Opportunity”: Patient Safety and the Perioperative Surgical Home

No abstract available

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In Response

No abstract available

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Moving Beyond the 0–10 Scale for Labor Pain Measurement

No abstract available

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Effects of Obesity and Leptin Deficiency on Morphine Pharmacokinetics in a Mouse Model

BACKGROUND: Obesity causes multiorgan dysfunction, specifically metabolic abnormalities in the liver. Obese patients are opioid-sensitive and have high rates of respiratory complications after surgery. Obesity also has been shown to cause resistance to leptin, an adipose-derived hormone that is key in regulating hunger, metabolism, and respiratory stimulation. We hypothesized that obesity and leptin deficiency impair opioid pharmacokinetics (PK) independently of one another. METHODS: Morphine PK were characterized in C57BL/6J wild-type (WT), diet-induced obese (DIO), and leptin-deficient (ob/ob) mice, and in ob/ob mice given leptin-replacement (LR) therapy. WT mice received several dosing regimens of morphine. Obese mice (30 g) received one 80 mg/kg bolus of morphine. Blood was collected at fixed times after morphine injection for quantification of plasma morphine and morphine 3-glucuronide (M3G) levels. PK parameters used to evaluate morphine metabolism included area-under the curve (AUC150), maximal morphine concentration (CMAX), and M3G-to-morphine ratio, and drug elimination was determined by clearance (Cl/F), volume of distribution, and half-life (T1/2). PK parameters were compared between mouse groups by the use of 1-way analysis of variance, with P values less than .05 considered significant. RESULTS: DIO compared with WT mice had significantly decreased morphine metabolism with lower M3G-to-morphine ratio (mean difference [MD]: −4.9; 95% confidence interval [CI]: −8.8 to −0.9) as well as a decreased Cl/F (MD: −4.0; 95% CI: −8.9 to −0.03) Ob/ob compared with WT mice had a large increase in morphine exposure with a greater AUC150 (MD: 980.4; 95% CI: 630.1–1330.6), CMAX (MD: 6.8; 95% CI: 2.7–10.9), and longer T1/2 (MD: 23.1; 95% CI: 10.5–35.6), as well as a decreased Cl/F (MD: −7.0; 95% CI: −11.6 to −2.7). Several PK parameters were significantly greater in ob/ob compared with DIO mice, including AUC150 (MD: 636.4; 95% CI: 207.4–1065.4), CMAX (MD: 5.3; 95% CI: 3.2–10.3), and T1/2 (MD: 18.3; 95% CI: 2.8–33.7). When leptin was replaced in ob/ob mice, PK parameters began to approach DIO and WT levels. LR compared with ob/ob mice had significant decreases in AUC150 (MD: −779.9; 95% CI: −1229.8 to −330), CMAX (MD: −6.1; 95% CI: −11.4 to −0.9), and T1/2 (MD: −19; 95% CI: −35.1 to −2.8). Metabolism increased with LR, with LR mice having a greater M3G-to-morphine ratio compared with DIO (MD: 5.3; 95% CI: 0.3–10.4). CONCLUSIONS: Systemic effects associated with obesity decrease morphine metabolism and excretion. A previous study from our laboratory demonstrated that obesity and leptin deficiency decrease the sensitivity of central respiratory control centers to carbon dioxide. Obesity and leptin deficiency substantially decreased morphine metabolism and clearance, and replacing leptin attenuated the PK changes associated with leptin deficiency, suggesting leptin has a direct role in morphine metabolism.

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Pediatric Anemia: It Is in the Eye of the Beholder

No abstract available

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Indigenous Continuous Positive Airway Pressure Device for Mitigation of Hypoxemia During One Lung Ventilation

No abstract available

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Preventing Opioid-Induced Postoperative Hypoxemia: No Simple Answer?

No abstract available

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In Response

No abstract available

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Incremental Value of Preoperative Copeptin for Predicting Myocardial Injury

BACKGROUND: Copeptin, a novel marker of endogenous stress, has shown diagnostic and prognostic value in nonsurgical patients with a suspected coronary event. We aimed to assess the incremental value of copeptin in addition to established preoperative risk indices to predict the occurrence of postoperative myocardial injury. METHODS: This secondary analysis of prospectively collected data included adults undergoing noncardiac surgery with risk factors for adverse perioperative cardiac events based on preoperative risk stratification. We examined preoperative copeptin in patients without elevated preoperative troponin and its association with myocardial injury by receiver operator characteristic curves, logistic regression, and net reassignment indices. RESULTS: Of the 190 patients included, 33 (17.4%) experienced myocardial injury within 48 hours, and 17 (8.9%) experienced cardiac death and/or major adverse cardiac events within the first postoperative year. Preoperative copeptin showed an area under the receiver operator characteristic curve of .66 (95% confidence interval, .55–.76) for myocardial injury and an optimal cutoff of 9.6 pmol/L. This cutoff was an independent predictor of myocardial injury, with an odds ratio of 4.67 (95% confidence interval, 2.06–11.19) when adjusted for age, sex, and the revised cardiac risk index. The net reassignment improvement for myocardial injury was between 39% and 50% for both events and nonevents when adding copeptin to established preoperative risk indices. No significant difference in major adverse cardiac event and/or cardiac death was observed. CONCLUSIONS: Copeptin (≥9.6 pmol/L) was associated with significantly higher rates of myocardial injury and improved risk stratification in patients scheduled for noncardiac surgery with nonelevated preoperative troponin.

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Diversity and Similarity of Anesthesia Procedures in the United States During and Among Regular Work Hours, Evenings, and Weekends

BACKGROUND: Anesthesiologists providing care during off hours (ie, weekends or holidays, or cases started during the evening or late afternoon) are more likely to care for patients at greater risk of sustaining major adverse events than when they work during regular hours (eg, Monday through Friday, from 7:00 AM to 2:59 PM). We consider the logical inconsistency of using subspecialty teams during regular hours but not during weekends or evenings. METHODS: We analyzed data from the Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry (NACOR). Among the hospitals in the United States, we estimated the average number of common types of anesthesia procedures (ie, diversity measured as inverse of Herfindahl index), and the average difference in the number of common procedures between 2 off-hours periods (regular hours versus weekends, and regular hours versus evenings). We also used NACOR data to estimate the average similarity in the distributions of procedures between regular hours and weekends and between regular hours and evenings in US facilities. Results are reported as mean ± standard error of the mean among 399 facilities nationwide with weekend cases. RESULTS: The distributions of common procedures were moderately similar (ie, not large, <.8 between regular hours and evenings index .59 .01 weekends .55 .02 for most facilities the number of common procedures differed by p .0001 average was .12 .13 weekends. pairwise differences facility were .07 .090 in contrast respectively when calculated using nationally pooled data. this because numbers .05 .11>2x the number of common procedures calculated by facility). CONCLUSIONS: The numbers of procedures commonly performed at most facilities are fewer in number than those that are commonly performed nationally. Thus, decisions on anesthesia specialization should be based on quantitative analysis of local data rather than national recommendations using pooled data. By facility, the number of different procedures that take place during regular hours and off hours (diversity) is essentially the same, but there is only moderate similarity in the procedures performed. Thus, at many facilities, anesthesiologists who work principally within a single specialty during regular work hours will likely not have substantial contemporary experience with many procedures performed during off hours.

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A Novel Device for the Evaluation of Hemostatic Function in Critical Care Settings

Major surgical procedures often result in significant intra- and postoperative bleeding. The ability to identify the cause of the bleeding has the potential to reduce the transfusion of blood products and improve patient care. We present a novel device, the Quantra Hemostasis Analyzer, which has been designed for automated, rapid, near-patient monitoring of hemostasis. The Quantra is based on Sonic Estimation of Elasticity via Resonance Sonorheometry, a proprietary technology that uses ultrasound to measure clot time and clot stiffness from changes in viscoelastic properties of whole blood during coagulation. We present results of internal validation and analytical performance testing of the technology and demonstrate the ability to characterize the key functional components of hemostasis.

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Epidural Local Anesthetics Versus Opioid-Based Analgesic Regimens for Postoperative Gastrointestinal Paralysis, Vomiting, and Pain After Abdominal Surgery: A Cochrane Review

BACKGROUND: The aim of this review was to compare the effects of postoperative epidural analgesia with local anesthetics to postoperative systemic or epidural opioids in terms of return of gastrointestinal transit, postoperative pain control, postoperative vomiting, incidence of gastrointestinal anastomotic leak, hospital length of stay, and cost after abdominal surgery. METHODS: Trials were identified by computerized searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 12), Medical Literature Analysis and Retrieval System Online (MEDLINE) (from 1950 to December, 2014) and Excerpta Medica dataBASE (EMBASE) (from 1974 to December 2014) and by checking the reference lists of trials retained. We included parallel randomized controlled trials comparing the effects of postoperative epidural local anesthetic with regimens based on systemic or epidural opioids. The quality of the studies was rated according to the Cochrane tool. Two authors independently extracted data. We judged the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group scale. RESULTS: Based on 22 trials including 1138 participants, an epidural containing a local anesthetic will decrease the time required for return of gastrointestinal transit as measured by time required to observe the first flatus after an abdominal surgery standardized mean difference (SMD) −1.28 (95% confidence interval [CI], −1.71 to −0.86; high quality of evidence; equivalent to 17.5 hours). The effect is proportional to the concentration of local anesthetic used. Based on 28 trials including 1559 participants, we also found a decrease in time to first feces (stool): SMD −0.67 (95% CI, −0.86 to −0.47; low quality of evidence; equivalent to 22 hours). Based on 35 trials including 2731 participants, pain on movement at 24 hours after surgery is also reduced: SMD −0.89 (95% CI, −1.08 to −0.70; moderate quality of evidence; equivalent to 2.5 on a scale from 0 to 10). Based on 22 trials including 1154 participants, we did not find a difference in the incidence of vomiting within 24 hours: risk ratio 0.84 (95% CI, 0.57–1.23); low quality of evidence. Based on 17 trials including 848 participants we did not find a difference in the incidence of gastrointestinal anastomotic leak: risk ratio 0.74 (95% CI, 0.41–1.32; low quality of evidence). Based on 30 trials including 2598 participants, epidural analgesia reduces length of hospital stay for an open surgery: SMD −0.20 (95% CI, −0.35 to −0.04; very low quality of evidence; equivalent to 1 day). Data on cost were very limited. CONCLUSIONS: An epidural containing a local anesthetic, with or without the addition of an opioid, accelerates the return of the gastrointestinal transit (high quality of evidence). An epidural containing a local anesthetic with an opioid decreases pain after an abdominal surgery (moderate quality of evidence). An epidural containing a local anesthetic does not affect the incidence of vomiting or anastomotic leak (low quality of evidence). For an open surgery, an epidural containing a local anesthetic would reduce the length of hospital stay (very low quality of evidence).

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SEER Sonorheometry Versus Rotational Thromboelastometry in Large Volume Blood Loss Spine Surgery

BACKGROUND: Sonic estimation of elasticity via resonance (SEER) sonorheometry is a novel technology that uses acoustic deformation of the developing clot to measure its viscoelastic properties and extract functional measures of coagulation. Multilevel spine surgery is associated with significant perioperative blood loss, and coagulopathy occurs frequently. The aim of this study was to correlate SEER sonorheometry results with those of equivalent rotation thromboelastometry (ROTEM) and laboratory parameters obtained during deformity correction spine surgery. METHODS: Four independent SEER sonorheometry hemostatic indices (clot time, clot stiffness, fibrinogen, and platelet contribution) were measured. SEER sonorheometry clot time, using kaolin as an activator, was correlated with ROTEM intrinsic temogram clotting time and the activated partial thromboplastin time. For clot stiffness, thromboplastin was the primary activator, and this was correlated against ROTEM external temogram amplitude at 10 minutes (A10). The assay for the fibrinogen contribution was similar to clot stiffness, but abciximab was added to inhibit platelet function. The fibrinogen contribution assay was correlated with the ROTEM fibrinogen temogram A10. Finally, the SEER sonorheometry platelet contribution was calculated by subtracting the fibrinogen contribution from the clot stiffness. This variable was correlated with both absolute platelet counts, and ROTEM determined clot elasticity attributable to platelets. RESULTS: Fifty-one patients were enrolled in this prospective observational study. SEER sonorheometry clot stiffness, fibrinogen, and platelet contribution had a very strong correlation with ROTEM external temogram A10 (rs = .92; 99% confidence interval, .85–.96), fibrinogen temogram A10 (rs = .90; 99% confidence interval, .83–.93), and ROTEM-determined clot elasticity attributable to platelets (rs = .89; 99% confidence interval, .80–.95). SEER sonorheometry clot time exhibited moderate correlation with ROTEM intrinsic temogram clotting time (rs = .62; 99% confidence interval, .44–.77) and very weak correlation with activated partial thromboplastin time (rs = .33; 99% confidence interval, .10–.51). CONCLUSIONS: SEER sonorheometry demonstrates very strong correlation with ROTEM for determining clot stiffness and assessing fibrinogen and platelet contribution to clot strength in major spine surgery. An advantage of SEER sonorheometry is direct measurement of clot elasticity with no need to transform amplitude oscillation to elasticity.

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Does Only Size Matter or Is There Still a Place for Single-Center Studies in the Era of Big Data?

No abstract available

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Comparison of SEER Sonorheometry With Rotational Thromboelastometry and Laboratory Parameters in Cardiac Surgery

BACKGROUND: The Quantra Hemostasis Analyzer is a novel diagnostic device that uses an ultrasound-based technology, sonic estimation of elasticity via resonance (SEER) sonorheometry, to characterize the dynamic changes in viscoelastic properties of a blood sample during coagulation. Cardiac surgery utilizing cardiopulmonary bypass (CPB) is associated with a significant impact on the coagulation system and can result in perioperative coagulopathy. The aim of this study was to correlate SEER sonorheometry results to corresponding rotational thromboelastometry (ROTEM) and laboratory parameters obtained before, during, and after CPB. METHODS: The Quantra uses a multiwell cartridge that performs 4 independent measurements with different combination of reagents. The output test results include Clot Time, Clot Stiffness, Fibrinogen and Platelet Contribution, Clot Time Ratio, and Heparinase Clot Time. Clot Time was compared with ROTEM INTEM clotting time and the adjusted partial thromboplastin time. Clot Stiffness was compared with ROTEM EXTEM. The Fibrinogen Contribution to the Clot Stiffness was correlated to ROTEM FIBTEM as well as fibrinogen concentration by the Clauss method. The Platelet Contribution to Clot Stiffness was compared with absolute platelet count and ROTEM-determined clot elasticity attributable to platelets. RESULTS: Fifty-five patients undergoing elective cardiac surgery were enrolled in this prospective observational study. Clot Time exhibited good correlation with ROTEM INTEM clotting time (pre-CPB r = 0.84, post-CPB r = 0.65) and adjusted partial thromboplastin time (pre-CPB r = 0.72, post-CPB r = 0.89); however, the majority of values were within a narrow normal range. Clot Stiffness exhibited significant correlation with ROTEM EXTEM A10 throughout the course of the study in all samples (r = 0.84). Fibrinogen Contribution correlated strongly with FIBTEM A10 (r = 0.85), and moderately with the fibrinogen concentration (r = 0.73) determined with the Clauss assay. The Platelet Contribution to Clot Stiffness showed moderate correlation to absolute platelet counts (r = 0.48). However, the correlation between Platelet Contribution and ROTEM-determined clot elasticity attributable to platelets was stronger (r = 0.78) than platelet number. All of the correlation coefficients were statistically significant with P

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Clinical Anesthesia Procedures of the Massachusetts General Hospital

No abstract available

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The modulation of delta responses in the interaction of brightness and emotion

Publication date: Available online 18 November 2016
Source:International Journal of Psychophysiology
Author(s): Pınar Kurt, Kübra Eroğlu, Tubanur Bayram Kuzgun, Bahar Güntekin
The modulation of delta oscillations (0.5–3.5Hz) by emotional stimuli is reported. Physical attributes such as color, brightness and spatial frequency of emotional visual stimuli have crucial effect on the perception of complex scene. Brightness is intimately related with emotional valence. Here we explored the effect of brightness on delta oscillatory responses upon presentation of pleasant, unpleasant and neutral pictures. We found that bright unpleasant pictures elicited lower amplitude of delta response than original unpleasant pictures. The electrophysiological finding of the study was in accordance with behavioral data. These results denoted the importance of delta responses on the examination of the association between perceptual and conceptual processes while in the question of brightness and emotion.



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FT - Paramedic - Stuart Rescue - City of Stuart

POSITION SUMMARY The City of Stuart, Iowa is seeking a full time Paramedic to work alongside other city employees and volunteers within Stuart's Emergency Services. This position will provide quality medical care to the community. In addition, this position will assist with recruitment, provide training of the volunteer staff, assist with billing records, as well as maintaining facilities and ...

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Director, Medical Transport - Medical Transport

Sentara Healthcare is currently seeking a full time Director for Medical Transport. This position will be based in Virginia Beach. Medical Transport is the premier commercial EMS agency and ambulance transport service in Virginia. Established in 1982, Medical Transport has been delivering quality ambulance transport for the Commonwealth of Virginia for three decades. Medical Transport is dedicated to ...

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Effect of aerobics on general well-being and physical parameters

2016-11-18T09-36-12Z
Source: International Journal of Medical Science and Public Health
Pooja Godiyal, Grace M Singh, Priya JP Narayan.
Background: Many people suffer physically and mentally due to various diseases and ailments as a result of erratic lifestyles. Lifestyle modification is a pro-active approach toward optimum health and wellness by bringing about appropriate changes in the way we live to Live Life More and physical activity plays an important role in this aspect. Objectives: To evaluate the effectiveness of dance aerobics on general well-being (GWB) and selected physical parameters of nursing students. Materials and Methods: Quasi-experimental approach with time series design was used in the study. The study was conducted in Himalayan College of Nursing, HIHT, Dehradun. Consecutive sampling technique was used to collect data from 40 subjects. Results: The improvement in GWB with a mean difference (MD) of 26.45 was found significant at P

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Comprehensive knowledge of HIV/AIDS among adults of reproductive age group in an urban slum of Bengaluru: A cross-sectional study

2016-11-18T09-36-12Z
Source: International Journal of Medical Science and Public Health
Ranganath T S, Shibi S, Nimra Shireen, Swetha N B.
Background: People living in slums are often deprived of health-care facilities, making them vulnerable to several health issues and infections. One of the most fatal infections is HIV/AIDS, and moreover, many are not even aware of available services for the treatment of such fatal diseases. HIV-related stigma and discrimination remain an important barrier in effectively fighting the HIV and AIDS epidemic. Objectives: To assess the comprehensive knowledge of HIV/AIDS among adults of reproductive age group in an urban slum in Bengaluru and to assess the attitude toward people living with HIV/AIDS (PLWHA)among the slum population. Materials and Methods: A community-based, cross-sectional study was carried out among adults of reproductive age group (15-49 years of age)in urban slums of Bengaluru. The study was conducted among 260 participants over a period of 3 months (July to September 2015). House to house survey was done and data were collected using a semi-structured questionnaire. Data were entered in Microsoft Excel sheet and analyzed using SPSS 21 software. Descriptive statistics such as frequency tables, pie diagrams, and bar charts were used wherever necessary. Results: Only 35.3% (92)of study participants were aware of the fact that HIV can be transmitted through breastfeeding, and 41.9% (109)knew about transmission from mother-to-child during delivery. Although the majority of the participants said they felt sympathetic toward PLWHA, 207 (79.6%)of them believed that PLWHA should not marry, and 114 (43.8%) thought that HIV positive women should not give birth to a child. Conclusion: Comprehensive knowledge of transmission and preventive methods of HIV/AIDS is still low among the slum population. Therefore, programs must focus on appropriate behavior change communication especially among women in the reproductive age group in slum areas.


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Impact of active smoking, passive smoking, and smoking cessation on overweight and obesity: First national cross-sectional study

2016-11-18T09-36-12Z
Source: International Journal of Medical Science and Public Health
Amani Haidar, Lama Jouni, Mohamad Koubar, Sarine El Daouk, Maha Hoteit.
Background: Smoking and obesity are two major modifiable leading causes of preventable mortality and morbidity worldwide. The relationship between smoking and body weight is still incompletely understood. Objective: To examine the impact of active smoking, passive smoking, and smoking cessation on overweight and obesity in the Lebanese population, aged 18 years and above in Beirut. Materials and Methods: In this cross-sectional study, 300 Lebanese adults aged 18 years and older were recruited. The Global Tobacco Surveillance System questionnaire was used to collect the data about smoking in the population studied. Anthropometric measurements (height, weight, and body mass index [BMI]) were also performed to test possible association between smoking status and body weight. Results: No significant association exists between current smoking and body weight (P = 0.166), but smokers may have 2.59 times more chance to be overweight, 2.37 times to be obese, and 2.68 times to have a morbid obesity. Former smokers have a 0.15 times higher risk of being overweight compared to nonsmokers (odds ratio = 0.15, 95% confidence interval: 0.036-0.70]. Passive smoking at home was associated with lower BMI compared to nonsmokers (P = 0.034). Conclusions: We conclude that smoking may be a crucial factor in overweight and obesity among men and women mainly who have stopped smoking. It may be expected that from a public health perspective the problems from weight gain do not outweigh the benefits from smoking cessation. There is a large unused potential to prevent weight gain among smokers before and after they quit. Overweight might probably be prevented by support of smokers who quit, for example, by the provision of information on weight control or by teaching coping skills. Furthermore, passive smokers should be provided with the information that the nicotine smoked prevents weight gain during the time of exposure and once quit weight gain will be unpreventable.


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A post-mortem study of coronary atherosclerosis and relationship to myocardial infarction in Ajmer region

2016-11-18T09-36-12Z
Source: International Journal of Medical Science and Public Health
Dinesh Beelwal, Geeta Pachori, Ravi Kant Sunaria, Vinit Goyal.
Background: The incidence of coronary heart disease has markedly increased in India over the past few years. Ischemic heart disease, the largest cause of morbidity and mortality in the developed and developing countries today, is overwhelmingly contributed by atherosclerosis. Objectives: The study was done to determine the burden of atherosclerotic lesions in the population of Ajmer district. This study also highlights the various grades of atherosclerotic lesions in coronary arteries and the relationship of atherosclerosis with myocardial infarction (MI). Materials and Methods: We studied atherosclerotic lesions in coronary arteries in cases subjected to autopsy in last 5 years, to grade and to evaluate the atheromatous plaques; and to assess the cases of MI among them. The study comprises dissected specimens of heart in total 600 cases subjected for an autopsy. The vessels were examined for the presence of atherosclerotic lesions which were graded according to the American Heart Association and examined for evidence of MI. Results: The study comprises the cases in the age group between 0 to 80 years. The most common type of atherosclerosis seen was Grade 5. Left anterior descending coronary was most commonly involved artery. MI was the cause of death in 75 cases (12.5%). The data obtained may form a baseline for the forthcoming studies. Conclusion: This study highlights the importance of cardiovascular risk factors screening from early ages of third decades. Our study aids valuable data to the literature regarding the morphology of atherosclerotic lesions.


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Behavior of plasma interferon-gamma with graded exercise in individuals with varied body mass index and age: Risk stratification of predisposition to inflammation

2016-11-18T08-46-40Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Ambarish Vijayaraghava.
Background: Increasing body mass index (BMI) and age predispose one to cardiometabolic disorders and their complications. Cardiometabolic disorders and their complications are associated with excessive inflammation leading to further exacerbation. Regular moderate exercise modulates inflammatory processes. Interferon-gamma (IFN-γ) is an anti-inflammatory cytokine which protects against excessive inflammation. We assessed the plasma levels of IFN-γ after different grades of exercise in normal healthy individuals with variable BMI and age. Aims and Objective: To study the behavior of plasma IFN-γ with graded exercise in individuals with varied BMI and age. Materials and Methods: A total of 40 healthy volunteers (21 males and 19 females) between the ages of 18 and 35 years were enlisted into the study. Each volunteer performed a bout of moderate exercise, a bout of severe exercise, and 1 month regular moderate exercise under supervision. Mean and standard deviation (SD) of BMI was 22.26 ± 3.3 kg/m2. BMI ranged between 19 kg/m2 and 26 kg/m2. Blood samples from cubital vein were collected before a bout of moderate exercise (baseline), after moderate exercise, after a bout of severe exercise, and at the end of 1 month of regular moderate exercise. Plasma IFN-γ was measured by the enzyme-linked immunosorbent assay technique. Results: Mean and SD of IFN-γ at baseline (no exercise) was 10.54 ± 2.21 pg/ml. After a bout of moderate exercise, its levels increased to 21.21 ± 1.34 pg/ml. Mean and SD of IFN-γ after a bout of strenuous exercise was 8.32 ± 1.45 pg/ml. The IFN-γ levels increased to 38.98 ± 2.33 pg/ml at the end of 1 month of regular moderate exercise. Its levels were higher in healthy individuals with lower BMI and lower age. But on the performance of 1 month of regular moderate exercise, the IFN-γ levels of higher age group and higher BMI came closer to that of the lower age group with lower BMI. This indicates that regular physical activity confers protection against excessive inflammation in spite of higher BMI and age. Conclusion: Although an increase in physical stress, BMI and age predispose one to inflammation, regular physical activity of moderate nature protects against inflammation by increasing levels of anti-inflammatory cytokine, IFN-γ.


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