Τρίτη, 3 Ιανουαρίου 2017

Body Composition Trajectories From Infancy to Preschool in Children Born Premature Versus Full-Term.

Objectives: The aim of the study was to longitudinally characterize infancy to preschool body composition trajectories and the association of early fat and fat-free mass gains with preschool age body composition in children born premature versus full-term. Methods: A cohort of appropriate-for-gestational age preterm (n = 20) and term (n = 51) infants were followed at 3 visits: "neonatal" visit 1 at 2 weeks of age for term and near term corrected age for preterm; "infancy" visit 2 at 3 to 4 months (preterm corrected age); "preschool" visit 3 at 4 years. Body composition via air displacement plethysmography and anthropometrics were measured at all visits. Tracking of infancy weight and body composition with preschool measurements was tested using Pearson partial correlation coefficients. Associations between serial body composition measurements were assessed using multiple linear regression. Results: Early differences in body composition between premature (mean gestational age 31.9 weeks, mean birth weight 1843 g) and full-term (mean gestational age 39.8 weeks) infants were not present at preschool age. Visit 1 body composition was not correlated with preschool measurements in the preterm infants. Visit 2 measurements were correlated with preschool measures. Fat-free mass accretion from visit 1 to visit 2 was positively associated with preschool lean mass ([beta] = 0.038, P = 0.049) in preterm children, whereas fat accretion was not associated with preschool body composition. Conclusions: Children born prematurely and full-term have similar body composition at preschool age. For preterms infancy fat-free mass gains, and not adiposity gains, are positively associated with preschool fat-free mass; this may be associated with lower risk of later obesity and adverse metabolic outcomes. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Diverting Ileostomy for the Treatment of Severe, Refractory, Pediatric Inflammatory Bowel Disease.

Objectives: Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. Methods: Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD. Clinical variables were compared in the 1 year before ileostomy and 1 year after diversion. Surgical and disease outcomes including changes in diagnosis were reviewed through 2015. Results: Twenty-four patients underwent diverting ileostomy for refractory colonic disease. Initial diagnoses were Crohn disease in 10 (42%), ulcerative colitis in 1 (4%), and IBD-unclassified in 13 patients (54%). Comparing data before and after surgery, there were statistically significant improvements in height and weight velocities, height velocity z score, blood transfusion requirement, hemoglobin, and hospitalization rates. Chronic steroid use decreased from 71% to 22%. At the conclusion of the study, 10 patients had undergone subsequent colectomy, 7 had successful bowel reanastomosis, and 7 remain diverted. Seven patients (29%) had a change in diagnosis. There were 13 surgical complications in 7 subjects, including prolapse reduction, stoma revision, and resection of ischemic bowel. Conclusions: In pediatric patients with refractory colonic IBD, diverting ileostomy can be a successful intervention to induce clinical stability. Importantly, diversion is a steroid-sparing therapy and allows additional time to clarify the diagnosis. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Clinical Variability Following Partial External Biliary Diversion in Familial Intrahepatic Cholestasis 1 Deficiency.

Objectives: Familial intrahepatic cholestasis 1 (FIC1) **deficiency is caused by a mutation in the ATP8B1 gene. Partial external biliary diversion (PEBD) is pursued to improve pruritus and arrest disease progression. Our aim is to describe clinical variability after PEBD in FIC1 disease. Methods: We performed a single-center, retrospective review of genetically confirmed FIC1 deficient patients who received PEBD. Clinical outcomes after PEBD were cholestasis, pruritus, fat-soluble vitamin supplementation, growth, and markers of disease progression that included splenomegaly and aspartate aminotransferase-to-platelet ratio index. Results: Eight patients with FIC1 disease and PEBD were included. Mean follow-up was 32 months (range 15-65 months). After PEBD, total bilirubin was 0.7 suggesting development of fibrosis 24 months after PEBD. Conclusions: Clinical variability is evident among genetically defined FIC1 deficient patients after PEBD, even among those with identical mutations. Recurrent, self-limited episodes of cholestasis and pruritus are reminiscent of the benign recurrent intrahepatic cholestasis phenotype. Despite diversion of bile from the intestinal lumen, weight gain improved while fat-soluble vitamin requirements persisted. Significant progression of liver disease was not evident during follow-up. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Isolated Appendiceal Pinworms on Colonoscopy.

No abstract available

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Nutritional Practices and Growth in Premature Infants after Surgical Necrotizing Enterocolitis.

Objective: To describe the nutritional provisions received by infants with surgical NEC and the associated effects on short-term growth. Study Design: Through the Children's Hospitals Neonatal Database we identified infants born 0.3 between groups for weight and length). Unadjusted and independent associations were identified with HC changes and HP dose ([beta]= 0.1 cm/week, p=0.03) after adjusting for gestational age, the presence of severe bronchopulmonary dysplasia, short bowel syndrome, blood stream infection, severe intraventricular hemorrhage (IVH), or small for gestational age (SGA) and calorie intake. Eventual non-survivors received 18% less protein and 14% fewer calories over the first post-operative month. Conclusions: Post-operative protein doses in infants with surgical NEC appear related to increases in HC. The influence of post-operative nutritional support on risk of adverse outcomes deserves further attention. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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The Association Between Celiac Disease and Eosinophilic Esophagitis: Mayo Experience and Meta-analysis of the Literature.

Background: The association between celiac disease (CD) and eosinophilic esophagitis (EoE) has been the focus of multiple studies with variable results. Both diseases are immune mediated, and dietary triggers play a role in their pathogenesis. Objectives: The aim of the study was to analyze the risk of EoE in children with CD, assess the magnitude of association between CD and EoE in children, and report the characteristics and outcomes of children with both conditions. Methods: We conducted a retrospective study of the Mayo Clinic Electronic medical records between January 1, 1998 and December 31, 2015. Systematic review and meta-analysis of multiple databases was conducted to include studies reporting on the same association. Random-effects model was used to report pooled odds ratio (OR) and 95% confidence interval (CI). Results: In this cohort study, of 10,201 children who underwent at least 1 endoscopy, 595 had EoE, and 546 had CD. The risk of having EoE was not increased in children with CD compared to those without CD (OR, 0.29; 95% CI, 0.154-0.545). Nine of 10 children improved with gluten-free diet, topical glucocorticosteroid, and/or elimination diet. One child lost to follow-up. Meta-analysis of 5 studies showed similar results (OR, 0.525; 95% CI, 0.364-0.797). A total of 45 cases in the literature had both CD and EoE (mean age, 10 years; 64% boys; majority presenting with abdominal pain, vomiting, and diarrhea). Conclusions: Based on our cohort and the observational data, the diagnosis of CD in children is not associated with increased risk of EoE. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Study of Carnitine/Acylcarnitine and Aminoacid Profile in children and adults with Acute Liver Failure.

Objectives: Fatty acid oxidation defects (FAODs) may underlie or modify the course of acute liver failure (ALF). Overall significance of carnitine/acylcarnitine and aminoacid profile in ALF is similarly undetermined. Thus, this study was undertaken to study the abnormalities in carnitine/acylcarnitine and aminoacid profile in ALF. Patients and Methods: A prospective study was performed including all cases of ALF and detailed evaluation including metabolic testing was done. Results: A total of 55 patients (33 pediatric and 22 adult cases) were included in the study. Three patients (a 1 year 6-month-old child, a 13 year old adolescent and a 21 year old adult) i.e 5.5% of all, were detected to be having underlying metabolic etiology i.e Carnitine Palmitoyl Transferase-1 or CPT-1 deficiency based on abnormal carnitine/acylcarnitine profile. Almost three-fourths of patients (78%) had evidence of serum hyperaminoacidemia. Thirty-one patients (56%) had evidence of abnormal carnitine/acylcarnitine profile with predominant abnormality being low free carnitine (C0). Higher levels of serum tyrosine (p 0.002) and lower levels of serum C0 (p 0.032) in children and higher levels of serum phenyalanine (p 0.047) in adults predicted poor outcome (death/liver transplant) on univariate analysis. Conclusion: FAODs are not uncommon in ALF with a suggested prevalence of around 5.5%. FAODs can cause ALF or modify the natural course of ALF caused by other etiologies. Serum hyperaminoacidemia and low serum free carnitine may predict poor outcome in ALF cases. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Seeing without Looking: Predicting Mucosal Healing without Endoscopic Evaluation in Pediatric Ulcerative Colitis.

No abstract available

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Transanal Irrigations: A Few Considerations.

No abstract available

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Capillary Flow Rates in the Duodenum of Pediatric Ulcerative Colitis Patients are Increased and Unrelated to Inflammation.

Background: Inflammatory bowel diseases (IBD), including Crohn disease (CD) and ulcerative colitis (UC), are chronic pediatric disorders. Changes in vasculature are described in IBD but these could be secondary to inflammation and the role in pathogenesis is poorly understood. Assessing circulatory changes in typically unaffected sites in IBD (e.g., duodenum), when inflammation is absent, can identify vascular changes associated with pathogenesis. Aim: To measure capillary flow rates in duodenal mucosa using probe-based confocal laser endomicroscopy (pCLE) during endoscopy in children with IBD. Methods: Images of villi with visible blood vessels obtained using pCLE were captured as video sequences. Capillary flow rate (mm/s) was calculated by dividing the distance travelled by blood cells by the duration of the sequence. Flow rates were correlated with various clinical parameters. Results: Forty-five patients (22 non-IBD, 14 CD, 9 UC) were included in the study. Duodenal capillary flow rates were significantly higher in UC patients (0.75 +/- 0.07 mm/s) as compared to non-IBD (0.57 +/- 0.03) and CD patients (0.65 +/- 0.04). There was no correlation between serum hemoglobin and albumin, disease activity indices, serum inflammatory markers, and capillary flow rates in patients. Conclusions: This pilot study shows, for the first time, increased capillary blood flow in the duodenum of UC patients that was unrelated to inflammatory markers or disease activity. Thus, early vascular changes can be assessed using pCLE during endoscopy. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Iodine Status and Growth in Cow's Milk Allergy.

No abstract available

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Autophagy in Hepatocytes in Infants with Alpha-1 ATD and Different Liver Disease Outcomes. A Retrospective Analysis.

Objectives: It is unclear whether a distinct activity of pathways removing the AT protein in Alpha-1-Antitrypsin Deficiency ([alpha]1ATD) are associated with an unfavorable predisposition toliver disease in the future. The aim of this study was to determine whether liverspecific activity of AT protein disposal occurs at infancy in [alpha]1ATD with PiZZ phenotype (ATZ). Methods: Liver samples of 17 infants with unfavorable ATZ outcome (Group I, n = 8, median age = 0.35 year) and good outcome (Group II, n = 9, 0.17 year), and 9 with biliary atresia(BA, median age = 0.17 year) as control, were enrolled. For each subject were investigated autophagy activity by mRNA, protein expression (Calnexin, Beclin-1, p62 and Parkin), and hepatocyte ultrastructure with morphometric analyses. Results: No significant differences in gene expression in the liver of infants were found between the two ATZ groups. Although a correlation between patients' age and protein expression was observed, the ATZ groups differed Parkin immunohistochemical expression. Moreover, the hepatocytes in ATZ infants with unfavorable outcome were characterized by low Parkin expression and the presence of isolated mitophagosoms and numerous enlarged mitochondria. The mentioned findings differed in patients with BA. Conclusions: Thus, mentioned specific features occurring at infancy may suggest association with poor liver outcome. Parkin low expression could have a potential for disease prognosis and treatment; however, further studies in a greater number of patients are needed. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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EVALUATION OF MERCURY (HG) AND ARSENIC (AS) RESIDUES IN ORGANS AND MUSCLES OF SLAUGHTERED PIGS AT NSUKKA SLAUGHTER HOUSE IN ENUGU STATE, NIGERIA

2017-01-03T22-02-02Z
Source: International Journal of Current Research and Review
Felix Chidiebere Obioha, Lynda Onyinye Obodoechi, Johnbosco Chinwuba Ukoha.
Aim: The aim of this study was to determine the presence and concentration of mercury (Hg) and arsenic (As) in organs and tissues of slaughtered pigs in Nsukka slaughter house. Methodology: From a total of 110 slaughtered pigs, liver, kidney and muscle samples of each pig were collected and analyzed for the detection of mercury and arsenic residue using Atomic Absorption Spectrophotometer. Results: A prevalence rate of 66.4% and 29.1% were recorded for mercury and arsenic respectively. The level of mean concentrations of arsenic in kidney, liver and muscle were 0.0016mg/kg, 0.0025mg/kg and 0.0012mg/kg respectively. While level of mean concentrations of mercury were 0.0009mg/kg, 0.0010mg/kg and 0.0006mg/kg in kidney, liver and muscle respectively. There was a significant difference (P

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A STUDY ON VARIOUS DETERMINANTS OF MATERNAL MORBIDITY AMONGST MARRIED WOMEN IN REPRODUCTIVE AGE GROUP IN URBAN SLUMS OF JAMNAGAR, GUJARAT, INDIA

2017-01-03T22-02-02Z
Source: International Journal of Current Research and Review
Neha A. Patel, J. P. Mehta, Sumit Unadkat, Sudha B. Yadav.
Background: Maternal morbidities associated with antenatal, Intranatal and postnatal period are affecting the outcome of pregnancy. Amongst these morbidities, many are preventable. Various determinants which have effect on these morbidities can be utilized to improve maternal health as well as to reduce Maternal deaths. Government has many programs and policies to improve maternal health, but determinants like education of woman, socio economic status, cultural barriers, and women empowerment are regulating the health seeking behaviour of a woman. Current study was designed with an. Objective: To study various determinants affecting maternal morbidity in married women of reproductive age group. Materials and Methods: Cross sectional study was conducted in Jamnagar. 450 women were selected by 30 cluster sampling. Data analysis was done with Microsoft office Excel and SPSS 20.Chi square test was applied. Results: 302(67.11%) women suffered from any type of Maternal Morbidity during their pregnancy, childbirth or puerperium, 55.56% ,20.22 % and 24.44% women had antenatal, Intranatal and postnatal morbidities respectively. Conclusion: The study indicate that raising educational status of women, Proper Antenatal care, birth interval of >3 years, knowledge regarding danger signs of pregnancy; all of these determinants have a positive contribution in preventing Maternal Morbidity and Mortality.


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EVALUATION OF LIVER SPACE OCCUPYING LESIONS BY FINE NEEDLE ASPIRATION CYTOLOGY

2017-01-03T22-02-02Z
Source: International Journal of Current Research and Review
Sameer B. Dalsaniya, Majal G. Shah, Trupti S. Patel, Jahnavi S. Gandhi, Dhaval H. Jetly, Priti P. Trivedi.
Objective: To evaluate the different liver space occupying lesions diagnosed on FNAC presenting at our hospital and share our experience of Fine Needle Aspiration Cytology of liver lesions. Material and Method: Retrospective study of total of 400 cases of liver space occupying lesions was done at Gujarat Cancer and Research Institute, Ahmedabad during 6 months period (January 2015 to June 2015). Papanicolau (PAP) and May-Grunwald-Giemsa (MGG) stained smears were reviewed and analyzed. Inconclusive aspirations and inadequate aspirations were excluded from study. Results: 294 cases out of 400 cases - where FNA yielded adequate cellularity were analyzed. Age ranged from 1 to 80 years with male predominance. Out of 294 cases, 292 cases (99.32%) were diagnosed as neoplastic and 2 cases (0.68%) as non neoplastic lesions. Of total 292 cases, 66 cases (22.44%) were diagnosed as primary hepatic malignancies in which 7 cases (2.37%) were of Hepatoblastoma and 59 cases (20.07%) of Hepatocellular carcinoma. Metastatic tumor was the most common and constituted 226 cases (76.88%). Metastatic lesions were Adenocarcinoma (62.93%), Small cell carcinoma (7.15%), Squamous cell carcinoma (1.36%), Malignant Melanoma (1.36%), Neuroendocrine tumor (1.70%) and Medullary carcinoma (0.34%) in decreasing order of frequency. The two non neoplastic lesions were of Abscess formation (0.68%). Conclusion: Cytology is a first line of investigation in liver space occupying lesions as the procedure is minimally invasive, safe, simple, quick and cost effective.


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A STUDY ON THE PREVALENCE OF NUTRITIONAL PROBLEMS OF SCHOOL GOING ADOLESCENT GIRLS OF KASHMIR VALLEY WITH SPECIAL FOCUS ON ANEMIA

2017-01-03T22-02-02Z
Source: International Journal of Current Research and Review
Darakshan Ali, Anjum Fazili, Rohul Jabeen Shah, Mir Mohammad Rafiq.
Background: In India adolescents constitute about 22.8% of total population forming a significant proportion of the population [3].Nutrition is an important area of concern in adolescent health especially in girls. Improper nutrition in girls has been shown to lead to adverse intergenerational effects. Aims and Objectives: To identify the nutritional problems of school going adolescent girls of Kashmir Valley and to study the factors associated with anemia in these girls. Methodology: A cross sectional study design was adopted and the study was conducted in randomly selected schools in three districts of Kashmir Valley. A total of 428 girls in the age group of 12 to 18 years were included in the study. Data was collected using a pre tested and pre structured questionnaire which included assessment of the dietary habits, anthropometric measurements and general physical examination of the study population. Hb estimation of a subset of the study population was also done. Data was analyzed using SPSS 20.0. Results: It was seen that anemia was the most common nutritional problem in the adolescent girls seen in 53.30% of them followed by thinness in 35.70% of them[7]. Other problems seen were overweight, obesity and thyromegaly. Conclusion: Thus it is concluded from this study that a considerable proportion of adolescent girls suffered from nutritional problems which need to be addressed in order to improve the overall health status of these girls..


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REFLECTIONS OF MEDICAL STUDENTS’ ON CADAVERIC DISSECTION IN PRESENT SCENARIO

2017-01-03T22-02-02Z
Source: International Journal of Current Research and Review
Anita Rani, Jyoti Chopra, Archana Rani, Rakesh Kumar Verma, Arvind Kumar Pankaj.
Objective: Continuation of cadaveric dissection in era of computer assisted learning is losing its charm in many medical schools worldwide. For the past few years, we were observing that our undergraduates were not able to complete the whole body dissection in time. Therefore, we planned to substitute dissection with demonstration of carefully dissected parts (prosections). The views of students were taken regarding dissection and demonstration of prosections for learning anatomy. Methods: A questionnaire regarding perception of human cadaveric dissection, preference towards demonstration of prosections for anatomy learning and problems encountered during dissection was distributed to the first year MBBS students (n=243) immediately after completion of first professional examination. Results: Majority (78%) of students were in favor of performing dissection but only 45% students performed dissection when the chance was given to them. 49% students did not dissect all the allotted regions while 6% students never attempted for dissection. 21% students were not able to complete the given dissection task. Prosection alone was least preferred whereas 50% students voted for both activities. 33% expressed that dissection alone is sufficient. Students felt that cadaveric dissection helped them in understanding of the subject. They also expressed that shortage of time, mass bunking, lack of supervision by teachers, excessive fat, lack of prior knowledge and irritating formalin fumes are some difficulties which they face while performing dissection. Conclusion: Dissection should continue to be a cornerstone in learning gross anatomy but only after reframing objectives which are realistic and achievable in given time frame. Prosected parts should be used as an adjunct for teaching and learning in anatomy.


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Motivation, emotion regulation, and the latent structure of psychopathology: An integrative and convergent historical perspective

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Publication date: Available online 3 January 2017
Source:International Journal of Psychophysiology
Author(s): Theodore P. Beauchaine, Aimee Zisner
Motivational models of psychopathology have long been advanced by psychophysiologists, and have provided key insights into neurobiological mechanisms of a wide range of psychiatric disorders. These accounts emphasize individual differences in activity and reactivity of bottom-up, subcortical neural systems of approach and avoidance in affecting behavior. Largely independent literatures emphasize the roles of top-down, cortical deficits in emotion regulation and executive function in conferring vulnerability to psychopathology. To date however, few models effectively integrate functions performed by bottom-up emotion generation system with those performed by top-down emotion regulation systems in accounting for alternative expressions of psychopathology. In this article, we present such a model, and describe how it accommodates the well replicated bifactor structure of psychopathology. We describe how excessive approach motivation maps directly into externalizing liability, how excessive passive avoidance motivation maps directly into internalizing liability, and how emotion dysregulation and executive function map onto general liability. This approach is consistent with the Research Domain Criteria initiative, which assumes that a limited number of brain systems interact to confer vulnerability to many if not most forms of psychopathology.



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IOP-details

Publication date: January 2017
Source:International Journal of Psychophysiology, Volume 111





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Editorial Board

Publication date: January 2017
Source:International Journal of Psychophysiology, Volume 111





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Instructions to Authors

Publication date: January 2017
Source:International Journal of Psychophysiology, Volume 111





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Reviewer Acknowledgment

Publication date: January 2017
Source:International Journal of Psychophysiology, Volume 111





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Best practices for repeated measures ANOVAs of ERP data: Reference, regional channels, and robust ANOVAs

Publication date: January 2017
Source:International Journal of Psychophysiology, Volume 111
Author(s): Joseph Dien
Analysis of variance (ANOVA) is a fundamental procedure for event-related potential (ERP) research and yet there is very little guidance for best practices. It is important for the field to develop evidence-based best practices: 1) to minimize the Type II error rate by maximizing statistical power, 2) to minimize the Type I error rate by reducing the latitude for varying procedures, and 3) to identify areas for further methodological improvements. While generic treatments of ANOVA methodology are available, ERP datasets have many unique characteristics that must be considered. In the present report, a novelty oddball dataset was utilized as a test case to determine whether three aspects of ANOVA procedures as applied to ERPs make a real-world difference: the effects of reference site, regional channels, and robust ANOVAs. Recommendations are provided for best practices in each of these areas.



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Psychometric considerations in the measurement of event-related brain potentials: Guidelines for measurement and reporting

Publication date: January 2017
Source:International Journal of Psychophysiology, Volume 111
Author(s): Peter E. Clayson, Gregory A. Miller
Failing to consider psychometric issues related to reliability and validity, differential deficits, and statistical power potentially undermines the conclusions of a study. In research using event-related brain potentials (ERPs), numerous contextual factors (population sampled, task, data recording, analysis pipeline, etc.) can impact the reliability of ERP scores. The present review considers the contextual factors that influence ERP score reliability and the downstream effects that reliability has on statistical analyses. Given the context-dependent nature of ERPs, it is recommended that ERP score reliability be formally assessed on a study-by-study basis. Recommended guidelines for ERP studies include 1) reporting the threshold of acceptable reliability and reliability estimates for observed scores, 2) specifying the approach used to estimate reliability, and 3) justifying how trial-count minima were chosen. A reliability threshold for internal consistency of at least 0.70 is recommended, and a threshold of 0.80 is preferred. The review also advocates the use of generalizability theory for estimating score dependability (the generalizability theory analog to reliability) as an improvement on classical test theory reliability estimates, suggesting that the latter is less well suited to ERP research. To facilitate the calculation and reporting of dependability estimates, an open-source Matlab program, the ERP Reliability Analysis Toolbox, is presented.



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Garcinia subelliptica (Fukugi): A Multi-purpose Coastal Tree with Promising Medicinal Properties

2017-01-03T16-34-43Z
Source: Journal of Intercultural Ethnopharmacology
Tomomi Inoue, Mami Kainuma, Karin Baba, Nozomi Oshiro, Norimi Kimura, Eric Wei Chiang Chan.
In this short review, the current knowledge on the botany, ecology, uses and medicinal properties of the multi-purpose Garcinia subelliptica (Fukugi) is updated. As yet, there are no reviews on this indigenous and heritage coastal tree species of the Ryukyu Islands in Japan, which has ethno-cultural, ecological and pharmacological significance. Planted by the Okinawan people some 300 years ago, Fukugi trees serve as wind-breaks and accord protection against the destructive typhoons. The species has become a popular ornamental tree, and its bark has been used for dyeing fabrics. It forms part of the food chain for mammals and insects, and serves as nesting sites for birds. Endowed with bioactive compounds of benzophenones, xanthones, bioflavonoids and triterpenoids, G. subelliptica possesses anticancer, anti-inflammatory, anti-tyrosinase, choline acetyltransferase enhancing, and other pharmacological properties such as trypanocidal, antibacterial, antioxidant, DNA strand-scission, hypoxia-inducible factor-1 inhibitory, DNA topoisomerase I and II inhibitory and anti-androgenic activities. Fukugetin and fukugiside are two bioflavonoids named after the species. The chemical constituents of Fukugi fruits when compared with those of mangosteen yielded interesting contrasts.


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Assessment of in-vitro Cholinesterase Inhibitory and Thrombolytic Potential of bark and seed extracts of Tamarindus indica (L.) relevant to the treatment of Alzheimer’s disease and clotting disorders

2017-01-03T16-34-43Z
Source: Journal of Intercultural Ethnopharmacology
Kushal Biswas, A.K. Azad, Taposhi Sultana, Farzana Khan, Saiyara Hossain, Sanzida Alam, Rayhan Chowdhary, Yasmin Khatun.
Background: Low level of acetylcholine (ACh) is an important hallmark of Alzheimers disease (AD), a common type of progressive neurodegenerative disorder. Effective treatment strategies rely mostly on either enhancing the cholinergic function of the brain by improving the level of acetylcholine from being a breakdown by cholinesterase enzymes. Beside this atherothrombosis is a major cause of global life threatening cerebral diseases. Traditionally Tamarindus indica (L.) has widely known for its medicinal values. Our aim is to investigate the cholinesterase inhibitory activities as well as thrombolytic activities of the bark and seeds crude methanolic extracts (CME) in the treatment of AD and clotting disorder. Method: The crude methanol extract was prepared by cold extraction method and were assessed for acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) inhibitory activity by the Ellmans method. For thrombolytic activity clot lysis method were applied. Results: To compare both the fraction, extract from the bark got more AChE inhibitory activity than the seed with the IC50 of 268.09 µg/ml and 287.15 µg/ml respectively. The inhibitory activity of BuChE quiet similar to AChE as IC50 values of both the fractions were 201.25 µg/ml and 254.71 µg/ml. Again in-vitro thrombolytic activity of bark was 30.17% and with seed it was 22.53%. Conclusion: The results revealed that the CME of bark and seed both have moderate Cholinesterase inhibitory activities as well as thrombolytic activities which may be useful in the treatment of AD as well as clotting disorder.


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Antioxidant activity, phenolic - flavonoid content and HPLC profiling of three different variants of Syzygium cumini seeds - a comparative study

2017-01-03T16-34-43Z
Source: Journal of Intercultural Ethnopharmacology
Syama Hari Priya, Nisha Prakasan, Jayamurthy Purushothaman.
Background: The medicinally important phytochemicals present in Syzygium cumini seeds probably accounts for its wide use in traditional systems of medicines in India, like Ayurveda, Unani and Siddha. Aim: The aim of the study was to determine the antioxidant potential of three different geographical variants of Syzygium cumini seeds and to compare the phenolic profiling inorder to know the effect of geographical variation in phenolic composition. Methods: Total phenolic and flavonoid content of Syzygium cumini seeds were analyzed. Antioxidant activities in terms of DPPH, ABTS, nitric oxide and superoxide radical scavenging assays were performed. The most active fractions were subjected to HPLC profiling to identify the phenolic composition. Results: 70% methanolic fraction of Syzygium cumini seed showed potent antioxidant activity among all the fractions. There existed a linear correlation between phenolic content and antioxidant activity. HPLC profiling of 70% methanol fractions of all the variants revealed the presence of phenolic compounds with high concentrations of ellagic acid and gallic acid. The differences in phenolic concentration due to geographical changes might be the reason for higher antioxidant potential showed by 70% methanol of TVM variant. Conclusion: 70% methanolic fraction of Syzygium cumini can act as a novel source of natural antioxidant.


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Selective induction of IL-1β after a brief isoflurane anesthetic in children undergoing MRI examination

Abstract

Purpose

To determine if isoflurane anesthesia without surgery causes systemic inflammation in children. Inflammation is targeted as responsible for the development of many neurologic pathologies. The effect will be evaluated by measuring serum cytokine levels before and after isoflurane anesthesia. The possible neurotoxic effect of anesthetic agents is a concern in pediatric anesthesia. Questions remain as to the true effects of anesthesia alone on systemic inflammation. The current study assesses systemic inflammatory response to general anesthesia in children not exposed to surgical stress.

Methods

Twenty-five patients, aged 6 months to 11 years undergoing MRI scanning were recruited. Patients with ASA Physical Status Classification >II, known neurologic disease, prematurity, recent infection, or current treatment with anti-inflammatory medications were excluded. Each patient received a sevoflurane induction, peripheral intravenous catheterization, and laryngeal mask airway placement. Isoflurane was titrated to ensure adequate depth of anesthesia. Two peripheral blood samples were obtained: one immediately after placement of the PIV and one upon arrival to the post-anesthesia care unit. Serum cytokine levels were compared between pre- and post-isoflurane time points using paired t tests.

Results

For all patients, interleukin-1β increased after isoflurane when compared to pre-isoflurane samples (pre = 25.97 ± 9.01, post = 38.53 ± 16.56, p = 0.0002). Serum levels of IL-6 (pre = 2.28 ± 2.27, post = 2.04 ± 2.15, p = 0.146) and tumor necrosis factor-α (pre = 94.26 ± 18.07, post = 85.84 ± 12.12, p = 0.057) were not significantly changed. Interleukin-10 and vascular endothelial growth factor were undetectable in pre- and post-isoflurane samples at a minimum detection threshold of 6.6 and 10 pg/ml, respectively.

Conclusions

A brief (approximately 60 min) exposure to isoflurane general anesthesia, without induced surgical stress, significantly increased serum IL-1β, a selective activation marker of systemic inflammation (IL-1β pathway).



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Swallowing action immediately before intravenous fentanyl at induction of anesthesia prevents fentanyl-induced coughing: a randomized controlled study

Abstract

Purpose

Fentanyl is a strong µ-opioid analgesic which attenuates the stimulation of surgical invasion and tracheal intubation. However, intravenous fentanyl often induces coughing [fentanyl-induced coughing (FIC)] during induction of anesthesia. We found that the swallowing action, when requested at induction of anesthesia, attenuated FIC. In the current study, we investigated the relationship between the occurrence of FIC and the swallowing action.

Methods

The study included American Society of Anesthesiologists physical status I or II patients, aged 20–64 years, who were undergoing elective surgery. They were divided into two groups—one group was urged to perform the swallowing action immediately before intravenous fentanyl (S group), and the other group performed no swallowing action (non-S group). The patients first received intravenous fentanyl and were observed for 90 s. Each patient's background, dose of fentanyl and occurrence of coughing were investigated from their records and a motion picture recording. The incidence of FIC was evaluated by chi-squared test, and severity was tested by Wilcoxon rank-sum test. P < 0.05 was considered statistically significant.

Results

The incidence of FIC in the S group and non-S group was 14.0 and 40.4%, respectively. The risk of FIC was reduced in the S group by 75%; risk ratio (95% confidence interval) was 0.35 (0.20, 0.60). The number of coughs in the S group were less than in the non-S group (P < 0.001).

Conclusion

The swallowing action immediately before intravenous fentanyl may be a simple and clinically feasible method for preventing FIC effectively.

Clinical trial number: UMIN000012086 (http://ift.tt/2ix8Fel).



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Fear-avoidance beliefs are independently associated with the prevalence of chronic pain in Japanese workers

Abstract

Purpose

Pain is a global public health problem with implications for both personal and social heath. Fear-avoidance beliefs (FABs) have been demonstrated to negatively impact and prolong pain in many Western countries, but little is known about the association between FABs and chronic pain (CP) in Asian countries, including Japan. We examined the relationship between FABs and CP in Japanese white-collar workers, a growing population with a high prevalence of CP.

Methods

Questionnaires and company records were used to gather data from 433 Japanese white-collar workers. Data were related to experience of pain, participant sociodemographic/health/lifestyle characteristics, fear-avoidance beliefs [Tampa Scale for Kinesiophobia (TSK)], work-related psychosocial factors (Brief Job Stress Questionnaire), and depressive illness [Psychological Distress Scale (K6)]. Analysis of covariance and multilevel logistic regression modeling were used to analyze associations between the data while controlling for factors known to influence CP prevalence.

Results

Prevalence rate of CP was 11.1% (48 of 433 persons). Adjusted odds ratios for participants with CP significantly increased in participants with high TSK scores, even after adjusting for factors known to influence CP prevalence.

Conclusion

We found a significant association between high TSK scores and CP in Japanese white-collar workers when controlling for other known factors that influence CP such as work-related psychosocial characteristics and depressive conditions. This finding suggests that FABs are independently associated with prevalence of CP.



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Is there a role for homeopathy in breast cancer surgery? A first randomized clinical trial on treatment with Arnica montana to reduce postoperative seroma and bleeding in patients undergoing total mastectomy

2017-01-03T13-39-18Z
Source: Journal of Intercultural Ethnopharmacology
Luca Sorrentino, Salvatore Piraneo, Eliana Riggio, Silvia Basilicò, Alessandra Sartani, Daniela Bossi, Fabio Corsi.
Aim: We administered A. montana 1000K to evaluate its benefits on post-operative blood loss and seroma production in women undergoing unilateral total mastectomy. Methods: From 2012 to 2014, 53 women were randomly assigned to A. montana or placebo and were followed up to 5 days. The main endpoint was the reduction in blood and serum volumes collected in drainages. Secondary endpoints were duration of drainage, a self-evaluation of pain, and the presence of bruising or hematomas. Results: The per-protocol analysis revealed a lower mean volume of blood and serum collected in drainages with A. montana (-94.40 mL; 95%CI 22.48-211.28; p=0.11). A regression model including treatment, volume collected in the drainage on the day of surgery and patient weight showed a statistically significant difference in favour of A. montana (-106.28 mL; 95%CI 9.45-203.11; p=0.03). Volumes collected on the day of surgery and following days were significantly lower with A. montana at day 2 (p=0.033) and 3 (p=0.0223). Secondary endpoints have not revealed significant differences. Conclusions: A. montana 1000K could reduce post-operative blood and seroma collection in women undergoing unilateral total mastectomy. Larger studies are needed with different dilutions of A. montana to further validate these data.


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Massive blood loss in elective spinal and orthopedic surgery: Retrospective review of intraoperative transfusion strategy

To evaluate the perioperative dynamics of hematologic changes and transfusion ratio in patients undergoing a major spinal surgery accompanied with massive bleeding defined as blood loss >5 liters.

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Case reports: Should we do away with them?

There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports?

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The effect of second-stage pushing and body mass index on postdural puncture headache

To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles.

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Intraoperative aberrant bispectral index values due to facial nerve monitoring

Bispectral index is an accepted depth of anaesthesia monitor for guiding intraoperative hypnotic agent administration. Frontalis EMG displayed on BIS monitor may increase due to twitching of frontalis muscle. EMG increases are also known to cause artefactual increases in BIS values. We report a case of artefactual increase of EMG and subsequently BIS values, due to electrical artefact from cranial nerve stimulator being used to identify the facial nerve. An explanation of the effect of stimulator signal on BIS EMG and BIS values has been provided.

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Effects of the concurrent use of a reduced dose of propofol with divided supplemental remifentanil and moderate hyperventilation on duration and morphology of electroconvulsive therapy-induced electroencephalographic seizure activity: A randomized controlled trial

The clinical adequacy of electroconvulsive therapy (ECT) depends on not only seizure duration but also seizure amplitude and postictal suppression. The objective of this study was to evaluate the effects of combination of a reduced dose of propofol and moderate hyperventilation on seizure duration and electrical stimulus requirement for adequate ictal amplitude and postictal suppression.

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Dexmedetomidine decreases the required amount of bupivacaine for ultrasound-guided transversus abdominis plane block in pediatrics patients: a randomized study

The effect of dexmedetomidine on the potency of bupivacaine for transversus abdominis plane (TAP) block in pediatric patients has not been investigated.

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Effects of pneumoperitoneum on severe hypernatremia in an adult patient who underwent laparoscopic surgery of hydatid cysts

We describe the first case of severe hypernatremia associated to laparoscopic surgery for hydatid cyst in an adult patient after the use of hypertonic saline solution with complete resolution. Severe hypernatremia is an unusual fact at the immediate postoperative period but may have fatal consequences for the patient and need immediate action. The patient reached a serum sodium concentration of 179 mmol/L without adverse effects after 6 days of treatment. Laparoscopy could play a crucial role in Na+ absorption due to high intraabdominal pressure caused by the pneumoperitoneum and its limitations to avoid peritoneal absorption of hypertonic saline solution.

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Volunteer Firefighter/EMT - West Thurston Regional Fire Authority

Volunteer Firefighter/EMT Job Duties as a FF/EMT: respond to and provide various emergency services such as fire suppression, rescue, and emergency medical services. • transport patients to the hospital • perform Basic Life Support Services • Fire suppression and prevention • Operate power tools and manual tools • Drive and operate Fire/EMS apparatuses such as an aid unit, fire ...

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2 paramedics, woman hurt in Ill. ambulance crash

Authorities found the ambulance flipped on its side; no patients were on board at the time of the crash

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Myxofibrosarcoma – An enigma in diagnosis: Case report

2017-01-03T08-29-52Z
Source: The Southeast Asian Journal of Case Report and Review
Deepu Vijayan, Sandeep Vijayan, Monappa A Naik, Sharath K Rao.
Myxofibrosarcoma is a distinct malignant neoplasm of fibroblastic origin with variable clinical and histopathologic features. It is common in elderly, and up to two thirds present as dermal tumors, frequently with infiltrative borders making complete resection difficult. We present here a case, which initially on clinical and radiological grounds appeared as a benign hemangioma, but turned out to be myxofibrosarcoma on histopathological examination, to highlight the diagnostic difficulties it may present. This patient was treated according to standard protocol including radiation therapy and followed for 1 year without any evidence of local recurrence or metastasis.


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India Needs Effective Surveillance to Control Hepatitis C



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Colorectal Cancer in Inflammatory Bowel Diseases: A Population-Based Study in Utah

Abstract

Background and Aims

The molecular, endoscopic, and histological features of IBD-associated CRC differ from sporadic CRC. The objective of this study was to describe the prevalence, clinical features, and prognosis of IBD-associated CRC compared to patients with sporadic CRC in a US statewide population-based cohort.

Methods

All newly diagnosed cases of CRC between 1996 and 2011 were obtained from Utah Cancer Registry. IBD was identified using a previously validated algorithm, from statewide databases of Intermountain Healthcare, University of Utah Health Sciences, and the Utah Population Database. Logistic regression was performed to identify risk factors associated with IBD-associated cancer and Cox regression for differences in survival.

Results

Among 12,578 patients diagnosed with CRC, 101 (0.8%) had a prior history of IBD (61 ulcerative colitis and 40 Crohn's disease). The mean age at CRC diagnosis was greater for patients without IBD than those with IBD (67.1 vs 52.8 years, P < 0.001). Individuals with IBD-associated CRC were more likely to be men (odds ratio [OR] 1.90, 95% CI 1.23–2.92), aged less than 65 years (OR 6.77, 95% CI 4.06–11.27), and have CRC located in the proximal colon (OR 2.79, 95% CI 1.85–4.20) than those with sporadic CRC. Nearly 20% of the IBD-associated CRCs had evidence of primary sclerosing cholangitis. After adjustment for age, gender, and stage at diagnosis, the excess hazard of death after CRC diagnosis was 1.7 times higher in IBD than in non-IBD patients (95% CI 1.27–2.33).

Conclusions

The features of patients with CRC and IBD differ significantly from those without IBD and may be associated with increased mortality.



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Clinical Characteristics, Comorbidities and Hospital Outcomes in Hospitalizations with Cyclic Vomiting Syndrome: A Nationwide Analysis

Abstract

Background

Data on cyclic vomiting syndrome (CVS) are limited to studies from tertiary care centers. There is a paucity of information about CVS on a national scale.

Aim

To study the clinical characteristics, comorbidities, and hospital outcomes in patients hospitalized with CVS using a nationwide database.

Methods

We identified all hospitalizations associated with a primary diagnosis of CVS in 2010 and 2011 using the Nationwide Inpatient Sample with an age category of 18–55 years. A 1:2 random sample of non-CVS hospitalizations with the same age category was obtained, and comparisons between groups were made. Multivariate logistic regression analysis was used to determine comorbidities independently associated with CVS.

Results

Our study included 20,952 CVS and 44,262 non-CVS patients. CVS patients tended to be younger, male, and white compared to non-CVS patients. On multivariate analysis, CVS was significantly associated with comorbidities including dysautonomia, migraine, anxiety, marijuana use, irritable bowel syndrome, gastroparesis, gastroesophageal reflux disease, asthma, cigarette smoking, and hypertension. CVS patients underwent esophagogastroduodenoscopy, colonoscopy, and gastric emptying tests more frequently. They had more favorable hospital outcomes like more routine discharges (discharge to home/self-care), lower mortality, and shorter length of stay but tended to leave against medical advice more frequently. CVS patients incurred total hospital charges of about $400 million over the 2 years.

Conclusions

Our study showed that CVS is associated with several comorbidities and incurred substantial health care costs despite benign outcomes. Efforts to optimize therapy of CVS, manage comorbid conditions and reduce healthcare utilization are warranted.



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Roles of microRNA-330 and Its Target Gene ING4 in the Development of Aggressive Phenotype in Hepatocellular Carcinoma Cells

Abstract

Background

Aberrant expression of microRNAs contributes to tumor growth and progression.

Aims

This study was designed to explore the prognostic and biological significance of miR-330 in hepatocellular carcinoma (HCC).

Methods

The expression of miR-330 and its associations with tumor parameters and overall survival were analyzed in HCC patients. The biological functions of miR-330 in HCC cell growth, invasion, and tumorigenesis were investigated. Bioinformatic analysis and luciferase reporter assays were performed to search for potential targets of miR-330.

Results

The miR-330 level was significantly higher in HCCs than in adjacent normal tissues (P = 0.0085). High expression of miR-330 was significantly associated with more aggressive phenotypes and shorter overall survival in HCC. Loss- and gain-of-function studies indicated the favorable effect of miR-330 on tumor cell growth, invasion, and tumorigenesis. Inhibitor of growth 4 (ING4) was identified to be a direct target of miR-330. Overexpression of miR-330 reduced the expression of ING4 in HCC cells. Importantly, restoration of ING4 almost completely reversed the promotion of HCC cell proliferation and invasion by miR-330.

Conclusions

Altogether, this study demonstrates that upregulation of miR-330 is associated with poor prognosis and contributes to more aggressive phenotypes of HCC. The oncogenic role of miR-330 in HCC is linked to downregulation of ING4.



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The Role of cIAP1 and XIAP in Apoptosis Induced by Tumor Necrosis Factor Alpha in Esophageal Squamous Cell Carcinoma Cells

Abstract

Background

The inhibitor of apoptosis protein (IAP) family are reported to play important roles in cancer cells evading apoptosis. However, the significance of their expression in human esophageal squamous cell carcinoma (ESCC) cells remains uncertain.

Aims

The present study aimed to investigate the role of the IAP family members in tumor necrosis factor-α (TNF-α)-induced apoptosis of human ESCC cells.

Methods

Five human ESCC cell lines were pretreated with TNF-α, cycloheximide (CHX, protein synthesis inhibitor), epoxomicin (proteasome inhibitor). Apoptosis assay and protein study with Western blot testing were conducted. Knockdown experiments with IAP siRNA were conducted, and the effect on cell apoptosis was analyzed.

Results

Significant apoptosis was induced in five ESCC cell lines by TNF-α plus CHX stimulation, but not when treated with TNF-α or CHX alone. The protein expression levels of cIAP1 and XIAP were decreased by treatment with TNF-α in the presence of CHX, and the degree of cIAP1 and XIAP expression decrease was correlated with sensitivity to TNF-α plus CHX-induced apoptosis. Epoxomicin suppressed TNF-α plus CHX-induced degradation of survivin, cIAP1, and XIAP, in addition to apoptosis. A caspase inhibitor (z-VAD-fmk) suppressed TNF-α plus CHX-induced apoptosis, but did not suppress degradation of survivin, cIAP1, and XIAP. Furthermore, cIAP1 or XIAP siRNA transfected cells underwent apoptosis in response to treatment with TNF-α alone. Double knockdown of both genes resulted in further increased apoptosis.

Conclusion

cIAP1 and XIAP play an essential role in the resistance of ESCC cells against apoptosis.



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Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users

Abstract

Background

The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated.

Aims

To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users.

Methods

From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals. Incidences of bleeding and thrombosis during endoscopic procedures were evaluated.

Results

A total of 270 patients [221 for endoscopic mucosal biopsy and 49 for endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) were enrolled. The bleeding rate was 0.9% for endoscopic mucosal biopsy and 22% for EMR/ESD, respectively. The bleeding rate after endoscopic mucosal biopsy was not significantly high, even if antithrombotic drugs were continued (0 vs. 1%, P > 0.99), while it was significantly higher among multiple antithrombotic drug users than single drug users (5.9 vs. 0%, P < 0.05). The bleeding rate after EMR/ESD was also higher among multiple antithrombotic drug users than single drug users, but was not significantly different (33 vs. 14%, P = 0.17). Moreover, there were no differences in bleeding rates according to the cessation or continuance of antithrombotic drugs (20 vs. 25%, P = 0.74). There were no thromboembolisms in all cases.

Conclusions

Upper gastrointestinal endoscopic procedures performed under the new guidelines appear acceptable. However, endoscopic procedures among multiple antithrombotic drug users show a greater potential for bleeding.



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Daily Intake of High-Fat Diet with Lysophosphatidic Acid-Rich Soybean Phospholipids Augments Colon Tumorigenesis in Kyoto Apc Delta Rats

Abstract

Background

Oral administration of lysophosphatidic acid (LPA) was shown to attenuate gastric ulceration in rats and mice but aggravate intestinal tumorigenesis in mice.

Aims

The present study examined whether dietary LPA induces or prevents development of colorectal tumor in rats.

Methods

Kyoto Apc Delta rats fed high-fat diet with or without an LPA-rich soybean phospholipid mixture (LSP, 0.1 or 1%) were treated with azoxymethane and dextran sodium sulfate to induce colorectal tumorigenesis. Rats were killed 15 weeks after azoxymethane treatment, and size, total number, location, and severity of colorectal tumors were assessed. Expression of mRNA of LPA receptors in rat colon tissue was assayed.

Results

Rats fed the diet supplemented with 1% LSP had a higher number of tumors 2–4 mm long compared than those with or without 0.1% LSP. The mean distance of tumors >4 mm long from the anus was significantly higher than those of tumors <2 and 2–4 mm long in rats fed 1% LSP-supplemented diet. Supplementation of the diet with 0.1% LSP decreased mRNA expression of LPA5 in colon tumors of rats.

Conclusions

Dietary supplementation of LPA-rich phospholipids dose-dependently augmented colorectal tumorigenesis. Decreased expression of LPA5 in colon tumors may be relevant to augmented tumorigenesis.



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Deciding to become an EMT, again

By Nicole M. Volpi

When I received my initial NREMT certification at age 18, I couldn't work as an EMT-Basic. The ambulance services in my area required their medics to be at least 24-years-old because of insurance policies. So, I did the next best thing and joined the military. 

Twenty years later, I retired from the military and needed a new career, making it a great time to go back to my original plan of becoming an EMT, again. This time the age requirement wouldn't be an issue.

Not knowing where to begin, the internet helped me navigate through a lot of information about training and testing. It seemed a bit overwhelming.

Using my experience, I'd like to share five tips that you may find beneficial whether you are becoming an EMT for the first time or if you are returning to EMS after a long absence.

1. Registry is there to help

The best place to start is with the organization that sets the processes to assess the knowledge and skills required to become certified. The NREMT website provides plenty of information on how to obtain and maintain an EMS certification. Additionally, the NREMT certification representatives were very good at reviewing my information and providing detailed instructions on how to obtain a national and state certification.

Since my certification was lapsed with an extended break, I had two options. The first was to research the Commission on Accreditation of Pre-Hospital Continuing Education website, previously known as the Continuing Education Coordinating Board for Emergency Medical Services website, for a refresher, transition and continuing education courses. The second option was to repeat EMT training. Since I wanted to go back to the basics, the second choice was best for me.

2. Finding an EMT course

In order to become an EMT, you must complete an initial training from a state-approved EMS education program. Most programs are taught on campus at local colleges, universities or technical institutions. There are some satellite programs available that are affiliated with these venues as well. The training can be completed in five to six months depending on program requirements and the national registry test schedule. You will need to contact the training site directly to find out more information about these programs.

There may be several programs offered in your area, but it may be difficult to decide which one to choose. The methods that helped me decide were internet searches, contacting the school directly and networking with course graduates.

The internet let me search for programs in my area. Using keywords such as "EMT programs near New Orleans" helped me find a list of programs available. Once the information about the program was reviewed online, I contacted the institution's academic advisor to find out more information. The advisor was very helpful in providing additional admission requirements, program director contact information and offered to schedule a meeting with a professor.

Lastly, I looked for networking opportunities from those who are currently working in the field as providers. These opportunities were available through friends, family and public events such as career-awareness fairs, festivals or health fairs. This was a great way to gather a different perspective about a program and learn some tips to help succeed throughout the entire process of becoming an EMT again.

Once I found a program and was accepted, it was time to get to work.

3. Prepare for the workload AND study time

The decision to become an EMT should not be taken lightly. The training program is intense, compact and often physically demanding. It will be like no other class or test that you've taken before. It's a combination of lecture, practical hands-on skills and clinical requirements.

You'll be introduced to an exorbitant amount of information in a short-period of time that you'll have to regurgitate with precision. You'll be required to understand the homeostasis of the body and the effects that can result when this harmony is interrupted.

If you haven't already, it would be beneficial to complete an anatomy and pathophysiology course before taking an EMT course. It'll help in understanding the various systems of the body and how each one interacts with the other. This is paramount when conducting patient assessments in a medical or trauma situation. As an added bonus, an A&P course will make sure you aren't hearing about the importance of electrolytes for the first time in EMT class.

4. Start early and stay ahead

Most EMT classes are designed with a particular rhythm or cycle in mind. Our class rhythm went something like this for each of the major topics:

  • Lecture
  • Practical
  • Lecture
  • Study
  • Written test
  • Practical test

The above cycle repeated with each new topic or content area. It was beneficial to adapt my life routine to this rhythm. Depending on the topic, I made adjustments for extra study time and skills practice. The more you practice and study, the more confidence you'll likely have when tackling both the written and skills tests.

Our class met twice a week for lecture and once a week for lab. Our clinicals were two 12-hour shifts with an ambulance service toward the end of the semester. Our class was designed to teach us everything we needed to know before clinicals were scheduled. We were expected to know psychomotor skill sheets and understand patient assessment before stepping foot on a truck. 

5. Create and rely on your support system

A support system is your network for practical or emotional support. Completing an EMT course requires a solid support system from family, friends, neighbors, instructors and classmates. It's important to create a system of positive vibes that will light a fire under your butt when you're feeling defeated or pat you on the back when you've reached a milestone. When you embark on your EMT career, you'll find that a support system is what makes the job bearable on the worst days and enjoyable on the best days. 

What was your path to entering or re-entering the EMS career field?

About the author
Nicole M. Volpi, MS, NREMT-B, works for the City of Westwego Emergency Medical Services in Westwego, La. She is also a sergeant for the Westwego Police Department Reserve Division. She is currently a research student at Capella University studying leadership and emergency management. Her research focuses on prehospital care coordination, preparation and response of disaster events.



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Perception of Child Weight and Feeding Styles in Parents of Chinese-American Preschoolers

Abstract

Parent perception of weight and feeding styles are associated with obesity in other racial groups but have not been explored in-depth in Chinese-American preschoolers. Cross-sectional survey of 253 Chinese-American parents with preschoolers was performed in a community clinic. Regression analysis was used to assess relationships between parental perception of weight and feeding styles. Parent under-perception of weight was common but more likely in boys than girls (χ2 = 4.91, p = 0.03). Pressuring was also greater in boys [adjusted mean difference (95% CI) 0.24 (0.004, 0.49)]. In girls, pressuring was lower for children perceived as overweight [adjusted mean difference in CFQ scores −0.75 (−1.27, −0.23)]; in boys, pressuring was high regardless of perceived child weight. Weight perceptions and feeding styles related to childhood obesity in other groups were identified in Chinese-American families. Parent under-perception of child weight and pressure to eat were more common in boys. These factors should be addressed in Chinese-American preschooler obesity prevention programs.



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Health Outcomes and Costs Associated with the Provision of Culturally Competent Services for Underrepresented Ethnic Populations with Severe Mental Illness

Abstract

Underrepresented racial/ethnic populations (UREPs) face disparities in their use of behavioral health services for multiple reasons including lack of culturally competent services and stigma. This paper employs mixed methods to compare health outcomes and costs among clients in 14 culturally competent behavioral health programs targeting specific UREPs to five programs without a specific racial or ethnic focus. We found that UREP-focused programs were associated with similar improvements in health outcomes, but greater costs relative to the comparison programs. Main themes from the qualitative analysis included: addressing stigma, building trust and understanding confidentiality, looking for a cure, and moving beyond linguistic competency.



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Impact of sleep quality and general health on academic performance

2017-01-03T06-21-26Z
Source: International Journal of Medical Science and Public Health
Omar I Modayfer, Meshail A Al Aamer, Abdulellah M Al Adel, Laura I Al Olayan.
Background: Sleep has many important effects on the human body. One of its most important effects is on ones memory, where it plays a role in stabilizing perceived information and facilitating generalized knowledge. Objective: We attempted to correlate the quality of sleep and its effects on general mental health and academic performance of health sciences students. Materials and Methods: A cross-sectional study was carried out in a Saudi University in Riyadh, for 12 months starting September 2014. Validated self-reports: Pittsburgh Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ), demographic, and academic information were collected from 378 students of both genders through convenience sampling technique. PSQI measures quality and disturbance while GHQ assesses psychological and occupational wellbeing. English version was used of both questionnaires and was validated in previous studies. We used frequency (%) for categorical variables and mean (standard deviation) for continuous variables. Total score for GHQ and PSQI scales were calculated and divided into categories based on quartiles. Pearson coefficient was used to examine correlation. Multiple linear regression model was applied to predict student grade-point average (GPA) from sleep quality score and health quality and to predict sleep quality from health quality score and students GPA. We defined results to be statistically significant if P

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Assessment of menopausal problems among rural women using modified menopause rating scale

2017-01-03T06-21-26Z
Source: International Journal of Medical Science and Public Health
Anita Punia, Surya Lekha, Mehar Singh Punia.
Background: Menopause, although not a disease in itself, is associated with many frustrating physiological changes, diverse symptoms and psychological dysfunctions such as anxiety, depression, lack of concentration and decreased selfesteem to the extent of affecting the quality of life of middle aged and elderly women. Hence, to ensure quality life to these women, attention needs to be focused on menopausal problems too to mitigate/manage these problems through appropriate interventions. Objectives: To assess the magnitude of menopausal problems and associated factors among rural women. Materials and Methods: A cross-sectional study was conducted among rural women aged 40-60 years resident of study area. A random sample of 400 eligible women was drawn from those. The required information was collected on a pretested, semi-structured schedule from randomly selected respondents by the investigators by house-to-house visits. Results: Mean age of menopause was 46.2 ± 1.61 standard deviation (SD) years, median 46 years with a range from 43 to 50 years. Mean age of menarche was 11.95 ± 0.775 SD years. The most frequent menopausal symptoms were joint and muscular discomfort (77.5%), sleep problems (76.5%), hot flushes (62.0%), irritability (58.5%), and bladder problems (54.5%). Awareness about these problems was inadequate. Conclusions: The mean age at menopause of 46.2 years is in the lower side of the global range of 45-55 years (as per WHO) and lies almost in the middle of the observed range of 43-49 years for developing countries. The magnitude of menopausal/perimenopausal problems was very high and the common problems were almost similar to as observed in other such studies but varied in frequency possibly due to difference in perception, adaptation, sociocultural environment, etc. The awareness about menopausal problems was inadequate necessitating to educate and to counsel these women to make them fully aware about menopausal phenomenon.


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An observational study on career aspiration among students of a medical college in Kolkata

2017-01-03T06-21-26Z
Source: International Journal of Medical Science and Public Health
Tarun Kumar Sarkar, Mrinmoy Adhikary, Vinoth Gnana Chellaiyan D, Pulak Kumar Jana, Akash Rai, Indranil Biswas.
Background: Medical profession has been the choice of best minds from various family backgrounds as it offers an acclaimed and financially secure career. An undergraduate medical student has to pass through 4½ years of rigorous teaching and training followed by a year of internship before he/she is awarded the Bachelor of Medicine and Bachelor of Surgery (MBBS) degree. After MBBS, it becomes a tough decision to decide the future course of the career. Changing economic and social panorama in India has opened new gates and made this decision a mammoth task. Objective: The study was conducted with the objective to study sociodemographic profile of the medical students of College of Medicine and Sagore Dutta Hospital, Kolkata, and to study career aspiration and its determinants among the medical students of College of Medicine and Sagore Dutta Hospital, Kolkata. Materials and Methods: A crosssectional study was carried out among medical students of Sagore Dutta Medical College and Hospital, Kolkata, India, during October and December 2015. A total of 152 final year medical students were included in the study. A pre-tested and pre-designed self-administered questionnaire was used as the study tool. Data were analyzed with SPSS IBM software version 21.0. Means and proportions were calculated. Results: Majority of the students were in the age group of 18-20 years. Two-third of the students were from urban background. Self-interest and passion constituted the major reason (66.5%) to choose MBBS as a career. Nearly 95.4% of the students were willing to pursue their postgraduation. Majority (40.8%) preferred medicine or its allied specialty subjects. Only 16.5% wanted to go for public sector and only 7.9% wanted to work in rural area. Conclusion: Having understood the wants of the current generation of medical graduates, appropriate packages of monetary and non-monetary incentives need to be designed to encourage them to work in rural and remote areas. Only then, the goal of Universal Health Coverage may be achieved.


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Functional genomics: Screening for lncRNA function

Nature Reviews Genetics. doi:10.1038/nrg.2016.168

Author: Linda Koch



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Ground rules of the pluripotency gene regulatory network

Nature Reviews Genetics. doi:10.1038/nrg.2016.156

Authors: Mo Li & Juan Carlos Izpisua Belmonte



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Muscle fascicle shortening behaviour of vastus lateralis during a maximal force–velocity test

Abstract

Purpose

Muscle fascicles–tendon interactions are the main determinant in production of high joint velocity. Currently, no study has investigated the muscle fascicles behaviour of knee extensor muscles until the highest reachable velocity (e.g., unloaded knee extension). We aimed to track the changes in vastus lateralis fascicles length during knee extensions to quantify muscle fascicles and tendinous tissues contributions to muscle–tendon unit shortening and to determine maximal muscle fascicles shortening velocity.

Methods

Fifteen participants performed isokinetic and isoinertial knee extensions, and ultrafast ultrasound imaging was used to observe the vastus lateralis fascicles from low to very high joint velocity.

Results

The muscle fascicles shortening velocity increased linearly with the increase in knee joint velocity up to the maximal joint velocity (mean R 2 = 0.93 ± 0.08). Muscle fascicles contribution to muscle–tendon unit shortening velocity was almost constant regardless of the condition (83 ± 23%). Using Hill's equation, the maximal velocity of knee joint and muscle fascicles was determined at 1000 ± 489°s−1 and 5.1 ± 2.0 L0 s−1 (47.4 ± 18.7 cm s−1), respectively.

Conclusions

Contribution of muscle fascicles to the muscle–tendon unit shortening velocity was much higher for the vastus lateralis in this study compared to the gastrocnemius medialis in two previous studies. Moreover, this contribution of muscle fascicles shortening velocity was constant whatever the velocity condition, even at the highest reachable velocity. Thus, the vastus lateralis fascicles shortening velocity increases linearly with the knee joint velocity until high velocities and its behaviour strongly accorded with the classical Hill's force–velocity relationship.



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Issue Information

No abstract is available for this article.



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Secure, low-cost technique for laparoscopic hepatic resection using the crush-clamp method with a bipolar sealer

Abstract

Introduction

Laparoscopic hepatectomy is difficult because surgeons must perform the transection using many (four and more) energy devices and without direct manual maneuvers. Here we introduce hepatic transection by the classical method with a few (two or three) energy devices.

Materials and Surgical Technique

We performed laparoscopic hepatectomy for 40 patients with hepatic tumor and liver dysfunction. For parenchymal transection, we used bipolar radiofrequency coagulation forceps connected to a voltage-controlled electrosurgical generator and ultrasonic dissector. The demarcation of the liver surface was made by an ultrasonic dissector. Along the demarcation line, the blades of a BiClamp were opened slightly and inserted into the hepatic parenchyma. We clamped slowly, softly, and gradually, and a small amount of hepatic parenchyma was consequently coagulated and fractured. After the crush, the small vessels and intrahepatic bile duct that were sealed were left as atrophic strings, and the strings were divided by an ultrasonic dissector. Large vessels and Glisson's sheaths were left because of the small clamp. Large Glisson's sheaths and hepatic veins were ligated with a titanium clip or autosutures, and cut without bile leakage or bleeding. The mean operation time of the procedure was 196.9 min, mean blood loss was 69.9 mL, and mean postoperative hospitalization was 9.5 days. No blood transfusions were needed. Two cases had perioperative complications—one involving right shoulder pain and the other involving ascites due to liver dysfunction—but there were no serious postoperative complications.

Discussion

The present results appear to demonstrate that this simple and safe method helps decrease intraoperative bleeding and shorten hospital stay.



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Usefulness of a CT-guided hookwire marking in laparoscopic partial hepatectomy for hepatocellular carcinoma invisible on ultrasonography

Abstract

Introduction

The intra-operative detection of hepatocellular carcinoma (HCC) by ultrasonography is indispensable for laparoscopic partial hepatectomy. However, it is occasionally difficult to localize an HCC on an ultrasound in chronic liver disease. Two cases of partial hepatectomy using hookwire marking under CT guidance are presented.

Materials and Surgical Technique

The location of the HCC was identified by CT scan, and the puncture site was determined. A hookwire system, made of a stainless steel hook, was used to localize the HCC. The hookwire was placed percutaneously close to the HCC, and then the patient was taken to the operating room as soon as possible. After identification of the hookwire marker, the cutting line was determined on the liver surface to ensure a sufficient surgical margin in laparoscopic partial hepatectomy.

Discussion

Two cases underwent these procedures with easy intra-operative marking of the resection area. This technique facilitates safe laparoscopic partial hepatectomy for an HCC that is invisible on ultrasound.



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Serosal and muscular layers incision technique in laparoscopic surgery for gastric gastrointestinal stromal tumors

Abstract

Introduction

To minimize the resection of stomach tissue, especially for lesions close to the esophagogastric junction or pyloric ring, we developed laparoscopic wedge resection with the serosal and muscular layers incision technique (SAMIT) for gastric gastrointestinal stromal tumors.

Materials and Surgical Technique

SAMIT involves resection of the mucosal and submucosal layers and then an incision in serosal and muscular layers around the tumor. SAMIT is simple and does not require special devices. The data of 13 patients who underwent laparoscopic wedge resection with SAMIT for primary gastric gastrointestinal stromal tumors were reviewed. No intraoperative complications were observed, and postoperative stenosis occurred in only one case of a middle stomach lesion. Adequate oncological resection was performed in all cases.

Discussion

Laparoscopic wedge resection with SAMIT is technically and oncologically safe. It is useful for treating gastric gastrointestinal stromal tumors, including those close to the esophagogastric junction or pyloric ring.



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Safe approach to the splenic hilum by first mobilizing the pancreatic tail in laparoscopic splenectomy

Abstract

Introduction

We employed a safe approach during laparoscopic splenectomy by first mobilizing the pancreatic tail and then dissecting the splenic vessels at the splenic hilum before mobilizing the spleen.

Materials and Surgical Technique

Patients were placed in the lithotomy position, and only the upper body was twisted to the right side. Five trocars were placed. After the bursa omentalis was opened, an avascular layer was identified behind the pancreas. This avascular layer was bluntly dissected, and the pancreatic tail was isolated from the retroperitoneum. The tissue surrounding the splenic hilum was dissected by a handling tape that was placed around the pancreatic tail. Because the spleen remained connected to the retroperitoneum with the splenorenal ligament, a good operative view of the splenic hilum was obtained with proper extension. After sufficient space was secured between the pancreatic tail and the spleen, the splenic vessels were divided with a linear stapler. The spleen was detached in the final stage.

Discussion

The current standardized procedure is highly recommended for a safe laparoscopic splenectomy.



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Percutaneous endoscopic transpedicle approach for herniated nucleus pulposus in the lumbar hidden zone

Abstract

Introduction

Although endoscopic procedures for lumbar disc diseases have improved greatly, treating migrated disc herniation is still a challenging task. Because of anatomic limitations, a rigid endoscope cannot effectively reach the herniated nucleus pulposus (HNP) in the hidden zone. The purpose of this study was to describe the transpedicle approach for HNP in the hidden zone using the percutaneous endoscopic lumbar discectomy system and to demonstrate the clinical results.

Materials and Surgical Technique: Under fluoroscopy, the percutaneous endoscopic lumbar discectomy cannula is placed on the superior articular process, and a trephine with a diameter of 7.3 mm is used to make a bone hole. Through the bone hole, an HNP in the hidden zone can be detected with a rongeur for percutaneous endoscopic lumbar discectomy, the HNP can be removed, and then the decompressed nerve root is verified. We have treated two cases of hidden-zone HNP using the transpedicle approach. In all cases, the HNP was successfully removed, as confirmed by postoperative MRI. Clinical outcomes were acceptable.

Discussion

The percutaneous endoscopic transpedicle approach is an effective technique for managing HNP in the lumbar hidden zone.



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Feasibility of umbilical loop ileostomy in overweight and obese patients with rectal cancer during laparoscopic surgery: Preliminary results

Abstract

We examined the feasibility of umbilical diverting ileostomy for overweight and obese patients with rectal cancer undergoing laparoscopic surgery. Four patients who were overweight or obese (BMI > 27 kg/m2) were initially scheduled for the creation of a conventional loop ileostomy. Intraoperatively, however, this was considered too complicated because of thick subcutaneous fat, bulky mesentery, or both. Instead, patients received a diverting ileostomy with the placement of an umbilical stoma. All patients had protruding umbilical ileostomies. No severe stoma-related complications were encountered. One patient had minor skin dehiscence, and another had paralytic ileus but resumed oral intake after a short time. Performing a temporary loop ileostomy at the umbilicus was safe and feasible in this small group of overweight and obese patients. This stoma placement may avoid the problems inherent to conventional loop ileostomy in obese subjects.



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Rare cause of huge splenomegaly: Gaucher’s Disease- 2 cases

2017-01-03T04-28-50Z
Source: The Southeast Asian Journal of Case Report and Review
Chandrasekhar Dey, Shibani Pal, Pradipprava Paria, Malay Kumar Dasgupta.
Often patients with splenomegaly present as diagnostic challenge to the clinicians. Even extensive laboratory investigations fail to yield the diagnosis. In 1908 Williams Osler correctly stated all diseases of the spleen are of secondary in nature. Here we outline two such cases of huge splenomegaly. They were diagnosed as Gauchers disease only after bone marrow study.


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To Study The Etiology And Symptoms Associated With Dyspepsia In A Tertiary Care Hospital

2017-01-03T03-00-06Z
Source: National Journal of Integrated Research in Medicine
Abhyudaya Verma*, Deepika Verma**, Pooja Bansal***, Akhil Bansal****.
Background & objectives: dyspepsia is a global concern and a common disorder affecting many peoples. Our objective is to study the etiology and symptoms associated with Dyspepsia in a tertiary care hospital. Method: Total 203 patients with dyspepsia participated in the study and analyzed for H. pylori infection and different etiology and symptoms associated with dyspepsia along with endoscopic diagnosis. Result: Most of the patients were from age group of 18-38 years and minimum from 49-60 yrs. Out of 203 patients 36 was found positive for H. pylori infection.104 males and 99 females participated in the study. The males were found to be more infected with H.pylori than female. Functional dyspepsia (48%)& GERD(36%) were found more prevalent than other etiological factors.Most prominent symptoms were early satiety, regurgitation, and epigastric pain. Conclusion: Adult age group, male gender and functional dyspepsia with H. pylori infection were found to be most predominant in these study populations. [Abhyudaya V NJIRM 2016; 7(6): 97-100]


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Effectiveness of Modified Jigsaw as an Active Learning Strategy In Physiology.

2017-01-03T03-00-06Z
Source: National Journal of Integrated Research in Medicine
Monika Bansal*, Anshu Gupta**, Manoj Goyal***.
Background & Introduction: Teaching in the subject of physiology is undertaken with the help of didactic lectures, practical demonstrations and tutorials. Essence of tutorials is bilateral discussion, many times the students don't participate and it becomes a unilateral flow of information. In order to address this problem, active learning strategies are required where the students are engaged and they are made to participate actively. One such strategy is JIGSAW, which promotes active learning, critical thinking, problem solving and communication skills. The current paper describes the experience of using the technique for the tutorials. Methods: The method was implemented in the class of first professional MBBS students (N=150) in the practical (tutorial) sessions. The pre-assigned topic (for tutorial) was divided into five subtopics. Students were also divided into subgroups. Number of students in each subgroup was equal to the number of subtopics. First of all, one subtopic was given to individual students in each subgroup (home group), then the students who are given same topic assembled (expert group) and discussed the subtopic and developed common understanding about the subtopic. After that they returned to the home groups, and taught each other. Later on the subtopic was presented to the whole class. Perceptions of the students were taken using a questionnaire. Results: Most of the students felt that it provided them an active learning opportunity. Majority also felt that they were able to understand the subject better, it was an enjoyable learning experience and they would like to have more such sessions. Conclusions: Jigsaw is an active learning strategy, which can be used for providing meaningful and significant learning opportunities for the students. [Monika B NJIRM 2016; 7(6): 93-96]


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Comparative Evaluation of Strontium Chloride Desensitizer and Novel Proarginin Desensitizer on Dentinal Tubule Occlusion-A Scanning Electron Microscopic Study

2017-01-03T03-00-06Z
Source: National Journal of Integrated Research in Medicine
Mayur Parmar*, Surabhi Joshi**, Mira Thakkar***, Chintan Joshi****, Pratik Rupakar*****, Hima Desai*****.
Background: Dentinal hypersensitivity is the commonest dental problem. For this,the products that occlude the dentinal tubules are most widely accepted. Objective: The objective of the present study was to compare the effects of a well-established desensitizing dentifrice containing 2% strontium chloride with a new product 8% arginine on the dentinal tubules, following repeated brushing strokes on a dentine disc model. Methods: For the study, freshly extracted premolars were sectioned at the level of CEJ. The prepared dentin discs were cleaned in an ultrasonic cleaner, polished and etched with 0.5 M EDTA for 2 minutes to expose dentin tubule orifices. The samples were randomly divided into 3 groups: Group 1: control, Group 2: 2% strontium chloride and Group 3:8% pro-argin. The treatment consisted of application with the test dentifrices to the dentin discs followed by preparation for scanning electron microscopic examination. Results: The numbers of dentinal tubules open, partially occluded and completely occluded were counted and statistical analysis was obtained using Post-Hoc ANOVA test. Group 3 i.e. 8% arginine and calcium carbonate group showed highest complete tubule, with a statistically significant difference from group 1 and group 2. Conclusion: Proargin technology appears more promising in providing immediate relief as well as could be more effective on further application than strontium chloride based formulation. [Mayur P NJIRM 2016; 7(6): 85-92]


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Functional genomics: Screening for lncRNA function



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Ground rules of the pluripotency gene regulatory network

In this article, the authors review the mechanisms by which the pluripotency gene regulatory network governs the acquisition, maintenance and dissolution of the pluripotent state, including the interaction of these networks with chromatin-mediated and RNA-mediated regulatory mechanisms. They discuss recent evidence for alternative pluripotency states and the factors that affect transitions between these states.

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Ocimum basilicum extract exhibits antidiabetic effects via inhibition of hepatic glucose mobilization and carbohydrate metabolizing enzymes

2017-01-03T01-56-20Z
Source: Journal of Intercultural Ethnopharmacology
Chinelo Ezeani, Ifeoma Ezenyi, Theophine Okoye, Charles Okoli.
Aim: Ocimum basilicum L (Lamiaceae) is used as traditional remedy for different ailments, including diabetes mellitus. This study investigated the antidiabetic effects of an extract of aerial parts of O. basilicum. Methods: Antihyperglycemic effect of the extract was determined by its effects on alpha amylase and alpha glucosidase in vitro, while antidiabetic properties were studied in alloxan-induced diabetic rats treated for 28 days with extract and compared to those treated with oral metformin (150 mg/kg). The study and analysis was conducted between 2014 and 2015. Results: Treatment with 100 and 200 mg/kg extract significantly (P

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Antinociceptive and Anti-Inflammatory Effects of Aqueous Extract of Chenopodium Opulifolium Schrad Leaves

2017-01-03T01-56-20Z
Source: Journal of Intercultural Ethnopharmacology
Abayomi M Ajayi, Julius Khidzee TANAYEN, Albert MAGOMERE, Joseph OC EZEONWUMELU.
Aim: Chenopodium opulifolium is a specie of the Chenopodiaceae commonly used as vegetables in local diet and for treating different ailment in Uganda. This study was conducted to evaluate the antioxidant, antinociceptive and anti-inflammatory effects of the aqueous extract of C opulifolium leaves (AECo). Methods: The dried leaf of the plant was extracted by maceration in water. Qualitative and quantitative phytochemical analysis, antioxidants and membrane stabilizing effects were determined in the extract. The extract was then investigated for acute toxicity effect, antinociceptive (writhing, hot plate and open field test) and anti-inflammatory (egg albumin-induced paw oedema) in rodents. Results: Phytochemical analysis revealed the presence of alkaloids, tannins, phlobatannins, flavonoids and saponins in AECo. Total caffeic acid derivatives and total flavonoids content yields 91.7 mgCAE/g sample and 94.7 mgRE/g sample, respectively. AECo demonstrated antioxidant effects in both DPPH and NO assays. Significant membrane stabilizing activity was observed in both the heat and hypotonic solution-induced lysis of erythrocytes. The acute toxicity test showed that AECo (5000 mg/kg) did not cause any significant change in behavior or death in rats. AECo (100-400 mg/kg) produced a significant antinociceptive effects in both the writhing and hot plate tests, but no significant reduction in the locomotory activity in mice. Furthermore, the extract significantly (p

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A high carbohydrate diet remains the evidence based choice for elite athletes to optimise performance

Abstract

Fat loading or simply consuming a diet rich in fat has been used for more than 100 years to manipulate substrate oxidation both at rest and during exercise.

This article is protected by copyright. All rights reserved



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Effects of hypercapnia on the lung

Abstract

Gases are sensed by lung cells and can activate specific intracellular signaling pathways, and thus have physiologic and pathophysiologic effects. Carbon dioxide (CO2), a primary product of oxidative metabolism, can be sensed by eukaryotic cells eliciting specific responses via recently identified signaling pathways. However, the physiological and pathophysiological effects of high CO2 (hypercapnia) on the lungs and specific lung cells, which are the primary site of CO2 elimination, are incompletely understood. In this review, we provide a physiological and mechanistic perspective on the effects of hypercapnia on the lungs and discuss the recent understanding of CO2 modulation of the alveolar epithelial function (lung edema clearance), epithelial cell repair, innate immunity and airway function.

This article is protected by copyright. All rights reserved



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KRAS/NF-κB/YY1/miR-489 signaling axis controls pancreatic cancer metastasis

Cancer Research

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Short-term effectiveness of golimumab for ulcerative colitis: Observational multicenter study

World Journal of Gastroenterology

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Modified Martius flap procedure for refractory ileal pouch-vestibular fistula: A report of three cases

International Journal of Colorectal Disease

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Long-term safety and efficacy of telbivudine in infants born to mothers treated during the second or third trimesters of pregnancy

Journal of Viral Hepatitis

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The feasibility of laparoscopic pancreaticoduodenectomy--A stepwise procedure and learning curve

Langenbeck's Archives of Surgery

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Clinical observation on acupuncture treatment for constipation due to intestinal qi stagnation

Journal of Acupuncture and Tuina Science

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Identification of liver metastases with probe-based confocal laser endomicroscopy at two excitation wavelengths

Lasers in Surgery and Medicine

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Long-term follow-up of patients having false positive multi-target stool DNA tests after negative screening colonoscopy: The long-haul cohort study

Cancer Epidemiology, Biomarkers & Prevention

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Brain training with video games in covert hepatic encephalopathy

The American Journal of Gastroenterology

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Clinical features of acute hepatitis E super-infections on chronic hepatitis B

World Journal of Gastroenterology

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Metabolites distinguishing visceral fat obesity and atherogenic traits in individuals with overweight

Obesity

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Relationship between ghrelin, Helicobacter pylori and gastric mucosal atrophy in hemodialysis patients

World Journal of Gastroenterology

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Inflammatory bowel disease among patients with psoriasis treated with ixekizumab: A presentation of adjudicated data from an integrated database of 7 randomized controlled and uncontrolled trials

Journal of the American Academy of Dermatology

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A systematic model improves hepatitis C virus birth cohort screening in hospital-based primary care

Journal of Viral Hepatitis

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