The cre- inducer doxycycline lowers cytokine and chemokine transcript levels in the gut of mice

Abstract

The antibiotic doxycycline is used as an inducer of recombinase (cre)-based conditional gene knockout in mice, which is a common tool to show the effect of disrupted gene functions only in one period of a research animal's life. However, other types of such antibiotics have been shown to have a strong impact on the immune system. Here we show that in C57BL/6 mice, the most commonly applied strain for genetic modification, doxycycline treatment lowered transcription of the genes Il1b, Il10, Il18, Tnf, Cxcl1, and Cxcl2 in the ileum, and of the gene Il18 in colon. Cytokines and chemokines encoded by these genes are important in the disease expression in a range of mouse models. Although protein abundances only rarely correlate 100% to transcript levels, and the net result, therefore, may be less dramatic, it seems reasonable to be aware that a broad spectrum antibiotic, such as doxycycline, may impact the transgenic animal in ways unrelated to the activation of the gene deletion.

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Sex and genetic background influence Superoxide dismutase (cSOD) related phenotypic variation in Drosophila melanogaster

Mutations often have drastically different effects in different genetic backgrounds; understanding a gene's biological function then requires an understanding of its interaction with genetic diversity. The antioxidant enzyme cytosolic superoxide dismutase, cSOD, catalyzes the dismutation of the superoxide radical, a molecule that can induce oxidative stress if its concentration exceeds cellular control. Accordingly, Drosophila melanogaster lacking functional cSOD exhibit a suite of phenotypes including decreased longevity, hypersensitivity to oxidative stress, impaired locomotion, and reduced NADP(H) enzyme activity in males. To date, cSOD-null phenotypes have primarily been characterized using males carrying one allele, cSodⁿ¹⁰⁸red, in a single genetic background. We used analysis of variance, and the effect size partial eta squared, to partition the amount of variation attributable to cSOD activity, sex, and genetic background across a series of life history, locomotor, and biochemical phenotypes associated with the cSOD-null condition. Overall, the results demonstrate that the cSOD-null syndrome is largely consistent across sex and genetic background, but also significantly influenced by both. The sex-specific effects are particularly striking and our results support the idea that phenotypes cannot be considered fully defined if they are examined in limited genetic contexts.

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How does cytomegalovirus factor into diseases of aging and vaccine responses, and by what mechanisms?

Abstract

Cytomegalovirus (CMV) is an important pathogen for both clinical and population settings. There is a growing body of research implicating CMV in multiple health outcomes across the life course. At the same time, there is mounting evidence that individuals living in poverty are more likely to be exposed to CMV and more likely to experience many of the chronic conditions for which CMV has been implicated. Further research on the causal role of CMV for health and well-being is needed. However, the strong evidence implicating CMV in type 2 diabetes, autoimmunity, cancer, cardiovascular disease, vaccination, and age-related alterations in immune function warrants clinical and public health action. This imperative is even higher among individuals living in socioeconomically disadvantaged settings and those exposed to high levels of chronic psychosocial stress.

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Modeling Urban PM 2.5 Concentration by Combining Regression Models and Spectral Unmixing Analysis in a Region of East China

Abstract

Understanding the spatial distribution of PM_2.5 concentration and its contributing environmental variables is critical to develop strategies of addressing adverse effects of the particulate pollution. In this study, a range of meteorological and land use factors were incorporated into a linear regression (LR) model and a logistic model-based regression (LMR) model to simulate the annual and winter PM_2.5 concentrations. The vegetation cover, derived from a linear spectral unmixing analysis (LSUA), and the normalized difference built-up index (NDBI), were found to improve the goodness of fit of the models. The study shows that (1) both the LR and the LMR agree on the predicted spatial patterns of PM_2.5 concentration and (2) the goodness of fit is higher for the models established based on the annual PM_2.5 concentration than that based on the winter PM_2.5. The modeling results show that higher PM_2.5 concentration coincided with the major urban area for the annual average but focused on the suburban and rural areas for the winter. The methods introduced in this study can potentially be applied to similar regions in other developing countries.

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Water Scarcity and Wastewater Reuse Standards in Southern Europe: Focus on Agriculture

Abstract

Climate change affects water resources worldwide, and Southern Europe is one of the areas where water scarcity is expected to increase in the future. Different water scarcity indicators discussed in this manuscript (e.g. total annual actual renewable water resources, water exploitation index and dependency ratio) showed that some parts of this region are already facing water stress and that climate change could have a great impact on their water supply sector. As agriculture is the biggest consumer of water in the world and also in this particular region, potential water scarcity will impose the need to find new water sources. Treated wastewater reuse would decrease the pressure on the environment and is especially suitable for reuse in agriculture since it already contains some nutrients required for plant growth. However, in order to use it safely, treated wastewater must reach a certain quality that should be regulated. In the south of Europe, 4 countries out of 15 have already adopted wastewater reuse regulations (Greece, Italy, Portugal and Spain). This review compares these regulations and discusses their differences.

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Why don’t we mention “impact on intimacy” when we ask patients to give consent for treatment of oral cancer?

About a third of patients, usually younger rather than older, have reported serious concerns that sexual interest or enjoyment will be diminished after treatment of head and neck cancer.1 Ironically, as oncogenic variants of the human papillomavirus become more common, younger patients are more likely to be affected.2

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Lung Adenocarcinoma Survival in EGFR-Mutated African-Caribbean Patients: A Multicenter Study in the French West Indies

Abstract

Background

Lung cancer is the leading cause of cancer-related death worldwide. Shorter survival has been repeatedly reported for patients of African ancestry. Multivariate analysis demonstrated that this gap could be a consequence of socio-economic disparities instead of genetic specificities. However, those results were obtained in a pre-targeted therapies era and the effect of tyrosine kinase inhibitors targeting EGFR are not known in this population.

Objective

In this French West Indies study, we report overall survival (OS) in a frequently mutated population treated for lung adenocarcinoma within an equal-access healthcare system.

Patients and Methods

Clinical, demographic, survival, and treatment data have been retrospectively assessed for all patients diagnosed with lung adenocarcinoma in the islands of Martinique and Guadeloupe between 2013 and 2015.

Results

Two hundred and forty-one patients (82% African-Caribbean) were included. EGFR mutations were detected in 37% of all tumor specimens and were associated with non-smoker status in multivariate analysis. Median OS was 16.2 months. For patients with advanced disease, median OS was 11.5 months, depending on EGFR mutation (23 vs. 8.3 months for non-mutated patients, p = 0.0012). There was no difference in survival according to ethnicity or island. In multivariate analysis, performance status (PS) and EGFR mutation were the only independent prognostic factors.

Conclusions

Despite a higher frequency of EGFR mutations in African-Caribbean patients, ethnicity was not an independent factor of OS in lung adenocarcinoma. Lower initial PS in this mainly non-smoking African-Caribbean population may explain the absence of a difference in OS.

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Targeting the PD-1/PD-L1 Immune Checkpoint in EGFR- Mutated or ALK- Translocated Non-Small-Cell Lung Cancer

Abstract

Immune checkpoint inhibitors, notably antibodies targeting programmed death–1 (PD-1) and programmed death ligand–1 (PD-L1), have modified the management of patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC). Several PD-1/PD-L1 inhibitors have been approved by health authorities for this indication and others are in clinical development. However, only a subset of patients truly benefits from these agents. For patients with mutated EGFR or translocated ALK NSCLC, for whom an immune checkpoint inhibitor can be prescribed after progression on tyrosine kinase inhibitors and chemotherapy, information is scarce and sometimes contradictory. Phase III randomized clinical trials have evaluated different immune checkpoint inhibitors (nivolumab, pembrolizumab, atezolizumab) vs. chemotherapy as second- or subsequent-line therapy in NSCLC, but included very few patients with EGFR/ALK-positive disease. Subgroup analyses found that these patients did not benefit from immune checkpoint inhibitors. Retrospective data show progression-free survival lasting only 1.2–2.1 months. Preclinical data suggested a lower expression of PD-L1 in EGFR/ALK-positive patients compared to EGFR/ALK-negative patients. Our objective herein is to provide an up-to-date review of available data from the various publications on the impact of immune checkpoint inhibitors in patients with EGFR/ALK-positive NSCLC.

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Distribution, subtype population, and IgE positivity of mast cells in chronic rhinosinusitis with nasal polyps

Chronic rhinosinusitis with nasal polyps (CRSwNP) has been categorized into 2 subtypes in the Asian population: eosinophilic chronic rhinosinusitis (ECRS; similar to CRSwNP in Western countries) and non-ECRS (characterized by inflammation dominated by T-helper cell type 1). The pathogenesis of CRSwNP and the role of mast cells are poorly understood.

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Accumulated evidence on Helicobacter pylori infection and the risk of asthma

Helicobacter pylori (H pylori) infection has been suggested to be related to a decreased risk of asthma, but findings in the literature are inconsistent.

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Mycoplasma pneumoniae and health outcomes in children with asthma

Acute infections with Mycoplasma pneumoniae (Mp) have been associated with worsening asthma in children. Mp can be present in the respiratory tract for extended periods; it is unknown whether the long-term persistence of Mp in the respiratory tract affects long-term asthma control.

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Economic evaluation of epinephrine auto-injectors for peanut allergy

Three commercial epinephrine auto-injectors were available in the United States in the summer of 2016: EpiPen, Adrenaclick, and epinephrine injection, USP auto-injector.

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Transnasal endoscopic removal of bilateral postoperative maxillary cysts after aesthetic orthognathic ssurgery: Differences from that of Caldwell-Luc operations

Postoperative maxillary cysts (PMCs) after orthognathic surgery are a rare disease condition. In this study, we reported first case of bilateral PMCs after cosmetic orthognathic surgery which was treated via the intranasal endoscopic approach. In addition, we compared the characteristics of PMCs after aesthetic orthognathic surgery with those of PMCs after Caldwell-Luc operation. We expect that this case will be helpful to surgeons who encounter similar cases.

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The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial

Abstract

Objective

Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP.

Materials and methods

Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored.

Results

Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm, p < 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm, p < 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%, p < 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p < 0.05); and the level of inflammatory mediators was significantly reduced (p < 0.003) compared to SRP alone.

Conclusions

SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone.

Clinical relevance

Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.

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Biomechanical evaluation of different osteosynthesis methods after mandibular sagittal split osteotomy in major advancements

The aim of this study was to assess the biomechanical stability of six different osteosynthesis methods after sagittal split osteotomy. Sixty polyurethane hemimandibles were divided into two groups, with six subgroups in each. After 10-mm advancement of the distal segment (group 1) and 10-mm advancement combined with 20° counterclockwise rotation (group 2), the bone segments were fixed using 2.0-mm plates/screws as follows: subgroup A, one conventional straight plate; subgroup B, two conventional straight plates; subgroup C, one conventional sagittal plate; subgroup D, one locking straight plate; subgroup E, two locking straight plates; subgroup F, one locking sagittal plate.

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LY294002, a PI3K inhibitor, attenuates Tourette syndrome in rats

Abstract

The present study was designed to investigate the effects of LY294002 on Tourette syndrome (TS) in rats. TS model was induced in rats by DOI (the selective 5-HT2A/2C agonist 1- (2, 5- dimethoxy −4 - iodophenyl) -2- aminopropane). Behavior was assessed by stereotypic score and autonomic activity. Inflammatory cytokines such as interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in serum and striatum were detected. The protein levels of PI3K/Akt/NF-B in striatum were detected by Western Blot. LY294002 treatment significantly reduced IL-6, IL-1β and TNF-α in serum and striatum of TS rats, Also, highly expressed P-PI3K, P-Akt, P-NF-κBp65, P-IκBα in TS rats were restored respectively by LY294002 treatment as indicted in western blot analysis and immunohistochemistry analysis. Thus, it was supposed that the protective effect of LY294002 against TS in rat might be associated with the regulation of PI3K/Akt/NF-B pathway.

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Vitrification of bovine ovarian tissue: effect of perforated antral follicles on the structural preservation of follicles

Abstract

Despite all scientific studies, researches are continuing to increase outcomes of freezing ovarian tissue. The objective was to evaluate whether follicular perforation could improve the survival of antral follicles after vitrification. The present study was conducted on 20 bovine ovaries collected at slaughterhouse and a total of 344 antral follicles (less than 4 mm in diameter). For each ovary, three slices (approximately 1 × 1 cm) were separated from the cortex of each ovary and randomly were assigned in three groups, control (without freezing, fixed in 10% buffered formalin), non­perforated vitrified and perforated vitrified (after exposure to equilibration solution, antral follicles were immediately perforated) groups. After thawing, the tissue slices were evaluated histopathologically. Our histological evaluation showed that vitrification in group V1 did not significantly influence the degree of follicle damage compared to the follicles in fresh group as 69.8% of vitrified follicles were appeared as normal. Increasing follicular size had a significant effect on the vulnerability of follicles using different methods (p < 0.05). Therefore, perforation of follicles of bovine ovarian cortical tissue did not improve freezability of antral follicles by vitrification.

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Comparison of endocranial morphology according to age in one-piece fronto-orbital advancement using a distraction in craniosynostotic plagiocephaly

The capacity for cranial remodelling is known to be better at younger ages. The timing of cranioplasty could affect the axis of the skull base. We investigated whether age at the time of distraction is related to the outcome of endocranial morphology correction. In this retrospective study, we investigated the surgical outcome of 14 patients with unilateral craniosynostotic plagiocephaly who underwent one-piece fronto-orbital advancement without bandeau by using a distraction technique between April 2005 and December 2015.

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Spatiotemporal propagation patterns of generalized ictal spikes in childhood absence epilepsy

Childhood absence epilepsy (CAE) is the prototype syndrome of genetic (idiopathic) generalized epilepsy (GGE/IGE) characterized by typical absence seizures (TAS) (Gibbs et al., 1935; Penfield and Jasper, 1954; ILAE 1989; Berg et al., 2010). TAS manifest as brief impairment of consciousness of sudden onset and offset, without aura or post-ictal symptoms (Panayiotopoulos et al., 1989), frequently accompanied by spontaneous eye-opening, staring, random eye-blinking and automatisms (Hirsch and Marescaux, 1994; Panayiotopoulos, 1997).

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TMS-evoked long-lasting artefacts: a new adaptive algorithm for EEG signal correction

In the last twenty years, the combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has provided new insights into the investigation of brain dynamics (Ilmoniemi and Kičić, 2010). However, besides the potential of combining these two techniques, their simultaneous use produces different EEG artefacts of electrical and physiological nature. Electrical artefacts result from the voltage induced in the electrodes by the TMS pulse, which is several orders of magnitude larger than the physiological responses (Virtanen et al., 1999).

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Spatiotemporal propagation patterns of generalized ictal spikes in childhood absence epilepsy

Childhood absence epilepsy (CAE) is the prototype syndrome of genetic (idiopathic) generalized epilepsy (GGE/IGE) characterized by typical absence seizures (TAS) (Gibbs et al., 1935; Penfield and Jasper, 1954; ILAE 1989; Berg et al., 2010). TAS manifest as brief impairment of consciousness of sudden onset and offset, without aura or post-ictal symptoms (Panayiotopoulos et al., 1989), frequently accompanied by spontaneous eye-opening, staring, random eye-blinking and automatisms (Hirsch and Marescaux, 1994; Panayiotopoulos, 1997).

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TMS-evoked long-lasting artefacts: a new adaptive algorithm for EEG signal correction

In the last twenty years, the combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has provided new insights into the investigation of brain dynamics (Ilmoniemi and Kičić, 2010). However, besides the potential of combining these two techniques, their simultaneous use produces different EEG artefacts of electrical and physiological nature. Electrical artefacts result from the voltage induced in the electrodes by the TMS pulse, which is several orders of magnitude larger than the physiological responses (Virtanen et al., 1999).

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Vincristine-induced neuropathy in pediatric patients with acute lymphoblastic leukemia in Oman: Frequent autonomic and more severe cranial nerve involvement

Abstract

Background

Vincristine (VCR) induced peripheral neuropathy is a common complication in children with acute lymphoblastic leukemia (ALL).

Procedures

A retrospective data analysis over an interval of 10 years (2006–2016) of all children with ALL seen at Sultan Qaboos University Hospital was carried out. Electronic medical records of eligible patients were reviewed. Patients with clinical evidence of neuropathy and abnormal nerve conduction studies (NCSs) were included in the study.

Results

Nineteen (nine females and 10 males) out of 103 pediatric patients developed VCR-related neuropathy, and their age ranged between 2.5 and 14 years. Symptoms started after 2–11 doses of VCR. All 19 patients had documented peripheral neuropathy on NCSs. The autonomic nervous system and cranial nerves affection was relatively common in our patients; two presented with bradycardia, two patients with unexplained tachycardia, and five had abdominal pain and constipation, complicated by typhlitis in two patients. One patient developed unilateral hearing loss. Two patients developed severe life-threatening cranial nerve involvement with bilateral ptosis and recurrent laryngeal nerve involvement presented as vocal cord paralysis, hoarseness of voice, frequent chocking, and aspiration episodes.

Conclusions

Peripheral neuropathy was the commonest form of VCR-related neuropathy. Autonomic neuropathy was relatively common in our patients. Cranial neuropathy is a serious side effect of VCR that can be severe, involving multiple cranial nerves and needs prompt recognition and management. Concomitant administration of pyridoxine and pyridostigmine does not seem to protect against further neurological damage in some patients.

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Spasticity Video Challenge: A Look at Methods for Addressing Difficult Cases

As seen in this CME online activity (available at http://ift.tt/2sLbIF4), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals.

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Dose-Dependent Effects of Abobotulinumtoxina (Dysport®) on Spasticity and Active Movements in Adults With Upper Limb Spasticity: Secondary Analysis of A Phase 3 Study

AbobotulinumtoxinA has beneficial effects on spasticity and active movements in hemiparetic adults with upper limb spasticity (ULS). However, evidence-based information on optimal dosing for clinical use is limited.

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The effect of preoperative cognitive behavior and exercise therapy for patient with implanted LVAD in Korea: Case presentation

Left ventricular assist devices (LVADs) are used in patients with progressive heart failure symptoms to provide circulatory support. Patients with LVADs are referred to inpatient cardiac rehabilitation to prevent postoperative complications and improve aerobic capacity and quality of life (QOL). Preoperative exercise therapy for cardiac patients is an emerging treatment modality, and several studies have reported that it improves postoperative outcomes such as length of hospital stay and postoperative complications.

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Acupressure Therapy for Acute Ankle Sprains: A Randomized Clinical Trial

Ankle sprains occur frequently among young and active people, accounting for almost two million injuries per year. Previous reports suggest that acupressure therapy for acute ankle sprains may shorten the recovery time.

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Characteristics of a Mild Traumatic Brain Injury Sample Recruited Using Amazon’s Mechanical Turk

Several barriers exist in the recruitment of individuals with a history of mild traumatic brain injury (mTBI). The current study is the first to examine whether crowdsourcing, which has been used in other clinical populations, is useful in the recruitment of those with mTBI.

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Spasticity Video Challenge: A Look at Methods for Addressing Difficult Cases

As seen in this CME online activity (available at http://ift.tt/2sLbIF4), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient’s impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients’ goals.

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Dose-Dependent Effects of Abobotulinumtoxina (Dysport®) on Spasticity and Active Movements in Adults With Upper Limb Spasticity: Secondary Analysis of A Phase 3 Study

AbobotulinumtoxinA has beneficial effects on spasticity and active movements in hemiparetic adults with upper limb spasticity (ULS). However, evidence-based information on optimal dosing for clinical use is limited.

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The effect of preoperative cognitive behavior and exercise therapy for patient with implanted LVAD in Korea: Case presentation

Left ventricular assist devices (LVADs) are used in patients with progressive heart failure symptoms to provide circulatory support. Patients with LVADs are referred to inpatient cardiac rehabilitation to prevent postoperative complications and improve aerobic capacity and quality of life (QOL). Preoperative exercise therapy for cardiac patients is an emerging treatment modality, and several studies have reported that it improves postoperative outcomes such as length of hospital stay and postoperative complications.

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Acupressure Therapy for Acute Ankle Sprains: A Randomized Clinical Trial

Ankle sprains occur frequently among young and active people, accounting for almost two million injuries per year. Previous reports suggest that acupressure therapy for acute ankle sprains may shorten the recovery time.

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Characteristics of a Mild Traumatic Brain Injury Sample Recruited Using Amazon’s Mechanical Turk

Several barriers exist in the recruitment of individuals with a history of mild traumatic brain injury (mTBI). The current study is the first to examine whether crowdsourcing, which has been used in other clinical populations, is useful in the recruitment of those with mTBI.

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Otolaryngology consultation tracheostomies and complex patient population

To assess for the differences in patients undergoing tracheostomy by the otolaryngology consult service versus other specialties.

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The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial

Abstract

Objective

Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP.

Materials and methods

Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored.

Results

Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm, p < 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm, p < 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%, p < 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p < 0.05); and the level of inflammatory mediators was significantly reduced (p < 0.003) compared to SRP alone.

Conclusions

SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone.

Clinical relevance

Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.

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Low serum diamine oxidase (DAO) activity levels in patients with migraine

Abstract

Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among the several multi-faced symptoms associated with histamine intolerance, headache is one of the most recognized and disabling consequences. The aim of this study was to determine the prevalence of DAO deficiency in patients with a confirmed migraine diagnosis according to the current International Headache Society (IHS) and in non-migraine subjects. DAO activity was assessed in a total of 198 volunteers recruited at the Headache Unit of the Hospital General de Catalunya, 137 in the migraine group and 61 as a control group. DAO enzyme activity in blood samples was determined by ELISA test. Values below 80 HDU/ml (Histamine Degrading Unit/ml) were considered as DAO deficient. Mean value of DAO activity from migraine population (64.5 ± 33.5 HDU/ml) was significantly lower (p < 0.0001) than that obtained from healthy volunteers (91.9 ± 44.3 HDU/ml). DAO deficiency was more prevalent in migraine patients than in the control group. A high incidence rate of DAO deficiency (87%) was observed in the group of patients with migraine. On the other hand, 44% of non-migranous subjects had levels of DAO activity lower than 80 HDU/ml. Despite the multifactorial aetiology of migraine, these results seem to indicate that this enzymatic deficit could be related to the onset of migraine.

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Influence of food consumption patterns and Galician lifestyle on human gut microbiota

Abstract

The proportion of different microbial populations in the human gut is an important factor that in recent years has been linked to obesity and numerous metabolic diseases. Because there are many factors that can affect the composition of human gut microbiota, it is of interest to have information about what is the composition of the gut microbiota in different populations in order to better understand the possibilities for improving nutritional management. A group of 31 volunteers were selected according to established inclusion and exclusion criteria and were asked about their diet history, lifestyle patterns, and adherence to the Southern European Atlantic Diet. Fecal samples were taken and subsequently analyzed by real-time PCR. The results indicated different dietary patterns for subjects who consumed a higher amount of fruits, vegetables, legumes, and fish and a lower amount of bakery foods and precooked foods and snacks compared to Spanish consumption data. Most participants showed intermediate or high adherence to Southern European Atlantic Diet, and an analysis of gut microbiota showed high numbers of total bacteria and Actinobacteria, as well as high amounts of bacteria belonging to the genera Lactobacillus spp. and Bifidobacterium spp. A subsequent statistical comparison also revealed differences in gut microbiota depending on the subject's body weight, age, or degree of adherence to the Southern European Atlantic Diet.

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Preoperative Predictors of Extraprostatic Extension of Prostate Cancer (pT3a) in a Contemporary Indian Cohort

Abstract

We present our experience with robotic radical prostatectomy and analyse the predictors for extracapsular extension (EPE) in a cohort of Indian patients. Four hundred fifty-three patients underwent robotic radical prostatectomy from May 2010 to October 2015. Post hoc analysis of prospectively maintained data was done. Multivariable regression analysis was used on variables which had significant association with EPE on univariable analysis. Receiver operating characteristic (ROC) curves were plotted for the independent predictors of EPE. Mean age was 64.62 ± 6.44 years. Mean BMI 26.03 ± 4.01 kg/m². Median prostate-specific antigen (PSA) was 13.38 ng/ml (IQR 8.1–23.5). Seventy-seven (16.99%) patients had Gleason >7. Mean core positivity (percentage of cores positive) was 48,93 ± 27.29% and mean maximum percentage of tumour in a core was 33,04 ± 31.16%. Positive surgical margins were present in 141/453 (31.15%). Lymph nodes were positive in 21.2% of those who had nodes removed (77/364). Maximum cancer in a core (p < 0.001), core positivity (p = 0.002) and Gleason score ≥4 + 3 (p = 0.028) were significant predictors of EPE, independent of BMI, PSA, PNI and clinical stage. Receiver operating characteristic (ROC) analysis for core positivity showed an area under the curve (AUC) of 0.775, and a 76% core positivity predicted EPE with a sensitivity of 65% and a specificity of 87.1%, respectively. ROC curve for maximum cancer in a core showed an area under the curve of 0.898. Seventy per cent cancer in a single core predicted EPE with a sensitivity of 80.6% and a specificity of 85.9% Indian patients present with more advanced disease, higher PSA and have higher incidence of EPE. Maximum cancer in a core, ratio of positive cores and Gleason score ≥4 + 3 are predictors of EPE independent of PSA and clinical stage.

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Identification of Sentinel Lymph Nodes Using Contrast-Enhanced Ultrasound in Breast Cancer

Abstract

Sentinel lymph node (SLN) biopsy has become the standard of care in axillary staging of breast cancer patients who are clinically node negative as it reduces the morbidity of axillary nodal dissection. SLN biopsy using blue dye and radioisotopes have high identification rates but its limitations include anaphylaxis, disposal of radioactive waste, and potential second surgery in up to 35% of patients who show nodal metastases on SLN biopsy. Contrast-enhanced ultrasound (CEUS) has the potential for SLNs to be identified without the aforementioned risks. CEUS involves the administration of intravenous contrast agents containing microbubbles of perfluorocarbon or nitrogen gas. The bubbles greatly affect ultrasound backscatter and increase vascular contrast in a similar manner to intravenous contrast agents used in CT and MRI. It is safe and easily performed with no requirement for ionizing radiation and no risk of nephrotoxicity. Microbubbles are taken up by lymph nodes when injected directly into tissues, including sub-areolar injection in the breast cancer patient. This method may prove valuable in patients with ductal carcinoma in situ, where operative SLN biopsy remains controversial, and in women undergoing prophylactic mastectomies for high risk. This technique may also have a role after neoadjuvant chemotherapy where frequently there is fibrosis in the treated SLNs.

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Évolution des techniques d’irradiation pour la prise en charge de la maladie de Hodgkin : histoire et avenir

Publication date: Available online 16 June 2017
Source:Cancer/Radiothérapie
Author(s): Y.M. Kirova, S. Horn, J.-Y. Chen




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Measuring the carbon footprint of Plastic Surgery: a preliminary experience in a Chilean teaching hospital

Publication date: Available online 16 June 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Juan Enrique Berner, Maria del Pilar Gras, Luigi Troisi, Thomas Chapman, Pedro Vidal




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Reply to: ‘Patients with low-risk cutaneous squamous cell carcinoma do not require extended out-patient follow-up’

Publication date: Available online 16 June 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Nihull Jakharia-Shah, Priyanka Chadha, Jenny Geh




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Pedicled Omental Flaps in the treatment of complex spinal wounds after en-bloc resection of spine tumors

Publication date: Available online 16 June 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Andrea Sambri, Alessandro Gasbarrini, Sergio Cialdella, Pierandrea De Iaco, Stefano Boriani
Study DesignA retrospective study of 5 patients who underwent pedicled omental flap following spine tumor removal.Summary of Background DataPostoperative wound dehiscence represents a major complication in spinal surgery, in particular after en-bloc tumor resections, due to the extended sacrifice of soft tissues and adjuvant radiation and chemotherapies.MethodsFive patients (mean age of 52 years (range, 24-71 years) who underwent omental flaps for the treatment of post-operative complication in spine tumor resections were retrospectively evaluated.ResultsFour out of 5 patients underwent omental transposition after a mean of 15 months (range, 4-27) from the previous surgery because of a dehiscence of the wound (all of them had cerebrospinal fluid leak, 1 transpleural, in 3 cases associated to deep infection) whereas 1 patient underwent the omental flap procedure at the time of elective spinal surgery because of several contemporary risk factors for wound healing.At the time of discharge after a mean of 36 days (range, 23-53), all patients had well-healed surgical wounds with an acceptable structural and aesthetic result.One of the patients had ileus, requiring a surgical lysis of abdominal adhesions 3 months after omentum flap procedure. No other complications were observed.ConclusionOur data suggest that a pedicled omental flap is a viable option for the treatment of complicated spinal wounds, helping in the resolution of the infection and CSF leak.



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Aggressive natural killer cell leukemia or extranodal NK/T cell lymphoma? a case with nasal involvement

Aggressive natural killer cell leukemia/lymphoma (ANKL) is a rare and highly aggressive NK cell neoplasm with a short clinical course and poor prognosis and is often misdiagnosed and confused with NK/T cell ly...

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Programmed death-ligand 1 (PD-L1) is expressed in a significant number of the uterine cervical carcinomas

The programmed death-1/programmed death-ligand-1 (PD-1/PD-L1) immune regulatory axis has emerged as a promising new target for cancer therapeutics, with lasting responses seen in the treatment of metastatic re...

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The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis

Tympanoplasty is a common procedure performed by Otolaryngologists. Many types of autologous grafts have been used with variations of techniques with varying results. This is the first systematic review of the...

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Molecular cloning and mRNA expression pattern of Sox4 in Paramisgurnus dabryanus

Publication date: Available online 16 June 2017
Source:Gene Expression Patterns
Author(s): Xiaohua Xia, Ruyan Wan, Weiran Huo, Linxia Zhang, Xiaopei Xia, Zhongjie Chang
Sox4 belonged to the SoxC subfamily of the Sox family, which play important roles in the development of the vertebrate gonad and nervous system. A Sox4 homologue was cloned from brain of Paramisgurnus dabryanus by using homologous cloning and rapid amplification of cDNA ends (RACE), designated as PdSox4. The full-length cDNA was 2163bp, containing the 759bp 5'-untranslated region, 267bp 3'-untranslated region and encoding a putative protein of 378 amino acids with a characteristic high mobility group box (HMG-box) DNA-binding domain of 79 amino acids with the specific motif (RPMNAFMVW). Alignment and phylogenetic analyses indicated that PdSox4 shares highly identical sequence with Sox4 homologues from different species. The signal peptide analysis predicted that PdSox4 is a non-secretory protein. The hydropathy profile of PdSox4 protein revealed that this protein is hydrophilic in nature. The expression profiles of PdSox4 in different developmental stages and various adult tissues of sexs were analyzed by quantitative real-time RT-PCR (qRT-PCR) and In situ hybridization (ISH). The results showed that PdSox4 was ubiquitously expressed during embryogenesis and various adult tissues, especially in central nervous system. Tissue distribution analyses revealed that PdSox4 was expression in developing germ cells. Taken together, these preliminary findings suggested that PdSox4 is highly conserved during vertebrate evolution and involved in a wide range of developmental processes including embryogenesis, neurogenesis and gonad development.



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Evaluation of four designs of short implants placed in atrophic areas with reduced bone height: a three-year, retrospective, clinical and radiographic study

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): J.A. Lopez Torres, S.A. Gehrke, J.L. Calvo Guirado, L.F.R. Aristazábal
The aim of the present study was to evaluate retrospectively the clinical and radiographic behaviour of four commercially-available short implants with different macrodesigns and microdesigns in areas in which the height of the bone was reduced. We took into account the success and survival, peri-implant crestal bone loss, and the level of probing at which the gum bled. Patients were included if they had been given one or more short implants (≤8.5mm long) in the posterior jaws at least three years earlier. Three hundred and ninety-one short implants were placed in 170 subjects, and were divided in four groups based on the brand of implant. The implants were evaluated one, two, and three years after they had been inserted. Short implants had a three-year survival and success rate of 90% in all groups, and bone loss was acceptable after three years with no significant differences between them. These results support the use of short implants as an effective and safe treatment. However, within the limitations of this study, the design of the implant does seem to influence the behaviour of peri-implant bone at the crestal level.



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Myositis in the head and neck: challenges in diagnosis and management

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): R Ratansi, G. Fabbroni, A. Kanatas
Myositis in the head and neck may present with non-specific symptoms, and radiographically may mimic malignancy. Multidisciplinary management is often essential, and we describe the challenges in an effort to raise awareness of the condition.



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Extracapsular dissection in the parapharyngeal space: benefits and potential pitfalls

Publication date: Available online 16 June 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): K. Mantsopoulos, S. Müller, A. Agaimy, M. Goncalves, M. Koch, W. Wüst, C. Bohr, H. Iro
The aim of this study was to investigate the benefits and potential pitfalls of transcervical extracapsular dissection in the treatment of parotid gland tumours in the parapharyngeal space. We retrospectively evaluated the records of all patients with parapharyngeal parotid gland lesions treated between 2000 and 2015 by transcervical extracapsular dissection. Patients having revision operations and patients whose records were not complete were excluded, leaving 49 patients in the study. We found acceptable oncological and functional outcomes throughout. Special attention should be paid in cases with multilobular growth of the tumour on magnetic resonance imaging, satellite tumours of pleomorphic adenomas, tumours in broad contact with the inner surface of the deep lobe, and lesions suspected of malignancy. Extracapsular dissection in the parapharyngeal region is associated with acceptable oncological and functional outcomes. These outcomes can be expected only after a thorough assessment of patient’s history and preoperative imaging.



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A contextual review of the Carnivora of Kanapoi

Publication date: Available online 16 June 2017
Source:Journal of Human Evolution
Author(s): Lars Werdelin, Margaret E. Lewis
The Early Pliocene is a crucial time period in carnivoran evolution. Holarctic carnivoran faunas suffered a turnover event at the Miocene-Pliocene boundary. This event is also observed in Africa but its onset is later and the process more drawn-out. Kanapoi is one of the earliest faunas in Africa to show evidence of a fauna that is more typical Pliocene than Miocene in character. The taxa recovered from Kanapoi are: Torolutra sp., Enhydriodon (2 species), Genetta sp., Helogale sp., Homotherium sp., Dinofelis petteri, Felis sp., and Parahyaena howelli. Analysis of the broader carnivoran context of which Kanapoi is an example shows that all these taxa are characteristic of Plio-Pleistocene African faunas, rather than Miocene ones. While some are still extant and some went extinct in the Early Pleistocene, P. howelli is unique in both originating and going extinct in the Early Pliocene.



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Clinical pharmacology and clinical trials of ribonucleotide reductase inhibitors: is it a viable cancer therapy?

Abstract

Purpose

Ribonucleotide reductase (RR) enzymes (RR1 and RR2) play an important role in the reduction of ribonucleotides to deoxyribonucleotides which is involved in DNA replication and repair. Augmented RR activity has been ascribed to uncontrolled cell growth and tumorigenic transformation.

Methods

This review mainly focuses on several biological and chemical RR inhibitors (e.g., siRNA, GTI-2040, GTI-2501, triapine, gemcitabine, and clofarabine) that have been evaluated in clinical trials with promising anticancer activity from 1960’s till 2016. A summary on whether their monotherapy or combination is still effective for further use is discussed.

Results

Among the RR2 inhibitors evaluated, GTI-2040, siRNA, gallium nitrate and didox were more efficacious as a monotherapy, whereas triapine was found to be more efficacious as combination agent. Hydroxyurea is currently used more in combination therapy, even though it is efficacious as a monotherapy. Gallium nitrate showed mixed results in combination therapy, while the combination activity of didox is yet to be evaluated. RR1 inhibitors that have long been used in chemotherapy such as gemcitabine, cladribine, fludarabine and clofarabine are currently used mostly as a combination therapy, but are equally efficacious as a monotherapy, except tezacitabine which did not progress beyond phase I trials.

Conclusions

Based on the results of clinical trials, we conclude that RR inhibitors are viable treatment options, either as a monotherapy or as a combination in cancer chemotherapy. With the recent advances made in cancer biology, further development of RR inhibitors with improved efficacy and reduced toxicity is possible for treatment of variety of cancers.

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Reconstruction of the bony chin using sagittal split osteotomies of the remaining mandible─a new technique for a special indication: Case report

Publication date: Available online 16 June 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Berthold H. Hell
There are several indications for resecting the bony chin, such as squamous cell carcinoma, sarcoma, or benign tumors of the jaw such as ameloblastoma. Several techniques for reconstruction of the bony chin, such as the use of metal plates and also revascularized free bone grafts of the iliac crest, fibula, or scapula, are common. In the case of poor vascular supply, however, alternative techniques may be necessary. In this report, a new technique is described using pedicled bone flaps from both sagittally split mandibular stumps following chin resection. These flaps were pedicled on the mylohyoid muscles and advanced to restore the continuity of the mandible. An advantage of this procedure was minimization of the soft tissue defect, making repair easier. Morbidity of the resection and reconstruction was thus reduced, and recovery of the patient was very quick.



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Cytomegalovirus (CMV) research in immune senescence comes of age: overview of the 6th International Workshop on CMV and Immunosenescence

Abstract

Cytomegalovirus (CMV) is one of the most complex and most ubiquitous latent persistent viruses, with a considerable ability to evade and manipulate the immune system. Following an early-life infection, most immunocompetent humans spend several decades living with CMV, and, because the virus in these hosts does not cause manifest disease, CMV can be considered part of normal aging for more than half of humanity. However, there is accumulating evidence that CMV carriage is not a null event and that both potentially harmful and potentially beneficial outcomes emanate from the interaction of CMV with its mammalian hosts. This article provides an overview of the 6th International Workshop on CMV and Immunosenescence, highlighting the advances in the field made in the past two years, as related to CMV epidemiology/geroscience, CMV virology with an accent on latency, and CMV immune evasion and immune recognition of the virus and its antigens.

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Strand-specific RNA sequencing in pig testes identifies developmentally regulated genes and circular RNAs

Abstract

Testicular development and spermatogenesis are strictly regulated with the complex interactions between several cell types in testis. However, the limited availability of genomic and molecular information limits our understanding of this complex physiological process. In this study, we characterized the transcriptome between immature (30-day-old) and mature (180-day-old) pig testes using RNA-seq technology. 24,469 known coding gene transcripts corresponding to 20,566 genes were mapped in these two developmental stages, 3,328 genes were differentially expressed, and numerous novel transcripts and alternative splicing events were also identified. Ten differentially expressed genes were validated by measuring the relative expression using real-time quantitative polymerase chain reaction (PCR). 125 Gene Ontology (GO) terms were significantly enriched, and most of them involved in GO terms related to male reproduction, testicular development, and spermatogenesis. In addition, this study also represented the prediction of 10,000 circRNAs, as well as the validation of six pig circRNAs using Find_cric algorithm. Our study substantially expanded our knowledge about the transcriptomic profile of immature and mature pig testes, and provided a useful resource to study the mechanisms of pig testis development and spermatogenesis at the molecular level.

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Transcription factor Sp1 is necessary and functional in regulating expression of oncogene ZNF703

Abstract

Zinc finger protein 703 (ZNF703) is a putative oncogene in patients with the luminal B molecular subtype of breast cancer. Although the exact function of ZNF703 protein remains largely unknown, its expression and regulation have been implicated in several physiological and pathological processes. In the current study, for the first time, we identified and characterized the human ZNF703 gene promoter region. As a means of characterizing the transcription elements required for expression of ZNF703 protein at different stages, we cloned the promoter region of ZNF703 then created chimeric reporter plasmids for use in luciferase assays. A progressive deletion analysis of the ZNF703 gene's 5′ and 3′ -flanking regions revealed that the core promoter is located in a 256-bp region ranging from nt-539 to nt-283. Next, we examined the effects of site-specific mutations and treatment with mithramycin A to identify the functional Sp1 binding site, which was found to be located in a 447 bp region that ranged from nt-509 to nt-76, displayed the characteristics of a CpG island, and overlapped with the promoter region. In conclusion, our data suggest that ZNF703 transcription is regulated by transcription factor Sp1. This finding should facilitate future studies of the mechanism which regulates expression of this important gene.

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Associations between the 1-deoxy- d -xylulose-5-phosphate synthase gene and aroma in different grapevine varieties

Abstract

Linalool, α-terpineol, citronellol, nerol, geraniol, and geraniol acid are the main monoterpenes in the grapevine (Vitis vinifera L.) with the concentrations of these substances differing in different varieties. This research performed association analyses using a core collection of 92 grape accessions to identify causal SNPs in the gene 1-deoxy-d-xylulose-5-phosphate synthase (VvDXS), a regulator of monoterpene metabolism. We evaluated the free linalool, α-terpineol, citronellol, nerol, geraniol, and geraniol acid content of 92 grape varieties in two consecutive years (2014 and 2015). Twenty-two SNPs were found in the VvDXS coding region and were used in an association analysis. We found that the linalool, α-terpineol, nerol, and geraniol acid levels were higher in varieties with a G/T genotype at P852 than in varieties with other genotypes at this site. Additionally, we found a novel polymorphism site P1678 (A/G) with a functional effect on terpenoid content that was related to the regulation of gene transcription. This study revealed the relationship between VvDXS and aroma, with the identified polymorphism site potentially assisting in the screening of aroma compounds at early stages in fruit development in grapevines.

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Structural variations generated by simian foamy virus-like (SFV) in Crocodylus siamensis

Abstract

Endogenous retrovirus (ERV) integrates into the germline of its host and could remain in the genome as a molecular fossil. ERV is one of sources that cause INDEL and recombination events in the vertebrate genomes, leading to various genomic and genetic changes in their hosts. There have been many studies conducted on ERVs in the vertebrate genomes to elucidate their evolutionary history. However, ERVs have not been studied well in Crocodylus siamensis. Here, we report structural variations among SFV1 elements (simian foamy virus-like), ERVs in C. siamensis. We initially identified 26 SFV1 candidates in the genome and experimentally verified 9 SFV1_1 and 5 SFV1_10 elements using PCR display. Their structural analyses showed that most of them are solitary-LTRs but two SFV1_1 elements are full-length. Through further analyses, we found that the two full-length elements retain intact ORFs. We examined transcription factor binding sites within their LTR sequences to predict promoter/enhancer activities. In sum, we identified 14 crocodile-specific SFV1 elements and the results of their structural analyses suggest that they could contribute to genomic or phenotypic variations in C. siamensis population.

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Reconstruction of the bony chin using sagittal split osteotomies of the remaining mandible─a new technique for a special indication: Case report

Publication date: Available online 16 June 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Berthold H. Hell
There are several indications for resecting the bony chin, such as squamous cell carcinoma, sarcoma, or benign tumors of the jaw such as ameloblastoma. Several techniques for reconstruction of the bony chin, such as the use of metal plates and also revascularized free bone grafts of the iliac crest, fibula, or scapula, are common. In the case of poor vascular supply, however, alternative techniques may be necessary. In this report, a new technique is described using pedicled bone flaps from both sagittally split mandibular stumps following chin resection. These flaps were pedicled on the mylohyoid muscles and advanced to restore the continuity of the mandible. An advantage of this procedure was minimization of the soft tissue defect, making repair easier. Morbidity of the resection and reconstruction was thus reduced, and recovery of the patient was very quick.



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Comment on: The cut surface of the neck as depicted in two paintings of Judith and Holofernes

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Comment on: The cut surface of the neck as depicted in two paintings of Judith and Holofernes

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Characterisation of voice quality of Parkinson’s disease using differential phonological posterior features

Publication date: Available online 16 June 2017
Source:Computer Speech & Language
Author(s): Milos Cernak, Juan Rafael Orozco-Arroyave, Frank Rudzicz, Heidi Christensen, Juan Camilo Vásquez, Elmar Nöth
Change in voice quality (VQ) is one of the first precursors of Parkinson’s disease (PD). Specifically, impacted phonation and articulation causes the patient to have a breathy, husky-semiwhisper and hoarse voice. A goal of this paper is to characterize a VQ spectrum – the composition of non-modal phonations – of voice in PD. The paper relates non-modal healthy phonations: breathy, creaky, tense, falsetto and harsh, with disordered phonation in PD. First, statistics are learned to differentiate the modal and non-modal phonations. Statistics are computed using phonological posteriors, the probabilities of phonological features inferred from the speech signal using a deep learning approach. Second, statistics of disordered speech are learned from PD speech data comprising 50 patients and 50 healthy controls. Third, Euclidean distance is used to calculate similarity of non-modal and disordered statistics, and the inverse of the distances is used to obtain the composition of non-modal phonation in PD. Thus, pathological voice quality is characterised using healthy non-modal voice quality “base/eigenspace”. The obtained results are interpreted as the voice of an average patient with PD and can be characterised by the voice quality spectrum composed of 30% breathy voice, 23% creaky voice, 20% tense voice, 15% falsetto voice and 12% harsh voice. In addition, the proposed features were applied for prediction of the dysarthria level according to the Frenchay assessment score related to the larynx, and significant improvement is obtained for reading speech task. The proposed characterisation of VQ might also be applied to other kinds of pathological speech.



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A systematic review and narrative synthesis of group self-management interventions for adults with epilepsy

Epilepsy is a serious and costly long-term condition that negatively affects quality of life, especially if seizures persist on medication. Studies show that people with epilepsy (PWE) want to learn more about...

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Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol

For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidenc...

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In reply: Desflurane anesthesia and cognitive function

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Editorial Board

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Editorial Board

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Does Memory Consolidation by Anesthetics Relate to a Time Window of Age?.

No abstract available

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In Response.

No abstract available

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Insufficient Astrocyte-Derived Brain-Derived Neurotrophic Factor Contributes to Propofol-Induced Neuron Death Through Akt/Glycogen Synthase Kinase 3[beta]/Mitochondrial Fission Pathway.

BACKGROUND: Growing animal evidence demonstrates that prolonged exposure to propofol during brain development induces widespread neuronal cell death, but there is little information on the role of astrocytes. Astrocytes can release neurotrophic growth factors such as brain-derived neurotrophic factor (BDNF), which can exert the protective effect on neurons in paracrine fashion. We hypothesize that during propofol anesthesia, BDNF released from developing astrocytes may not be sufficient to prevent propofol-induced neurotoxicity. METHODS: Hippocampal astrocytes and neurons isolated from neonatal Sprague Dawley rats were exposed to propofol at a clinically relevant dose of 30 [mu]M or dimethyl sulfoxide as control for 6 hours. Propofol-induced cell death was determined by propidium iodide (PI) staining in astrocyte-alone cultures, neuron-alone cultures, or cocultures containing either low or high density of astrocytes (1:9 or 1:1 ratio of astrocytes to neurons ratio [ANR], respectively). The astrocyte-conditioned medium was collected 12 hours after propofol exposure and measured by protein array assay. BDNF concentration in astrocyte-conditioned medium was quantified using enzyme-linked immunosorbent assay. Neuron-alone cultures were treated with BDNF, tyrosine receptor kinase B inhibitor cyclotraxin-B, glycogen synthase kinase 3[beta] (GSK3[beta]) inhibitor CHIR99021, or mitochondrial fission inhibitor Mdivi-1 before propofol exposure. Western blot was performed for quantification of the level of protein kinase B and GSK3[beta]. Mitochondrial shape was visualized through translocase of the outer membrane 20 staining. RESULTS: Propofol increased cell death in neurons by 1.8-fold (% of PI-positive cells [PI%] = 18.6; 95% confidence interval [CI], 15.2-21.9, P .05]). Astrocytes secreted BDNF in a cell density-dependent way and propofol decreased BDNF secretion from astrocytes. Administration of BDNF, CHIR99021, or Mdivi-1 significantly attenuated the propofol-induced neuronal death and aberrant mitochondria in neuron-alone cultures (FC = 0.8, 95% CI, 0.62-0.98; FC = 1.22, 95% CI, 1.11-1.32; FC = 1.35, 95% CI, 1.16-1.54, respectively, P

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Predictors, Prognosis, and Management of New Clinically Important Atrial Fibrillation After Noncardiac Surgery: A Prospective Cohort Study.

BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients. We also aimed to derive a clinical prediction rule for new clinically important AF in this population. We defined new clinically important AF as new AF that resulted in symptoms or required treatment. We recorded an electrocardiogram 6 to 12 hours postoperatively and on the 1st, 2nd, and 30th days after surgery. RESULTS: A total of 211 (2.5% [8351 patients]; 95% confidence interval, 2.2%-2.9%) patients developed new clinically important AF within 30 days of randomization (8140 did not develop new AF). AF was independently associated with an increased length of hospital stay by 6.0 days (95% confidence interval, 3.5-8.5 days) and vascular complications (eg, stroke or congestive heart failure). The usage of an oral anticoagulant at the time of hospital discharge among patients with new AF and a CHADS2 score of 0, 1, 2, 3, and >=4 was 6.9%, 10.2%, 23.0%, 9.4%, and 33.3%, respectively. Two independent predictors of patients developing new clinically important AF were identified (ie, age and surgery). The prediction rule included the following factors and assigned weights: age >=85 years (4 points), age 75 to 84 years (3 points), age 65 to 74 years (2 points), intrathoracic surgery (3 points), major vascular surgery (2 points), and intra-abdominal surgery (1 point). The incidence of new AF based on scores of 0 to 1, 2, 3 to 4, and 5 to 6 was 0.5%, 1.0%, 3.1%, and 5.3%, respectively. CONCLUSIONS: Age and surgery are independent predictors of new clinically important AF in the perioperative setting. A minority of patients developing new clinically important AF with high CHADS2 scores are discharged on an oral anticoagulant. There is a need to develop effective and safe interventions to prevent this outcome and to optimize the management of this event when it occurs. (C) 2017 International Anesthesia Research Society

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Impact of Sternotomy and Pericardial Opening in Patients With Ventricular Septal Defects: Assess Before Sawing!

No abstract available

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Postoperative Respiratory Complications in Patients at Risk for Obstructive Sleep Apnea: A Single-Institution Cohort Study.

BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent condition that is associated with early postoperative respiratory complications (PRCs). As the majority of patients with OSA are undiagnosed, preoperative screening remains the most efficient method to identify suspected OSA. METHODS: This retrospective study was performed on patients undergoing anesthesia in a single academic medical center. We assigned OSA risk class retrospectively to all patients in the study by using the Perioperative Sleep Apnea Prediction (PSAP) score. We evaluated the relationship between PSAP categories and early postoperative invasive airway placement after adjusting for several preoperative and intraoperative factors (including surgical risk) previously associated with PRC occurrence. RESULTS: A total of 108,479 patients were included in the final analysis with an incidence of PRC was 0.3% (n = 280). High PSAP score was associated with postoperative intubation (adjusted odds ratio, 2.3; 95% confidence interval, 1.5-3.7). Several risk factors reflecting anesthetic agents, neuromuscular blocking agents, and opioids were also independently associated with early PRC. CONCLUSIONS: We report that suspected OSA based on the PSAP score is independently associated with increased risk of early PRC. Specific anesthetic agents are independently associated with early PRC, pointing to the potential for examining risk modification through these exposures in future studies. (C) 2017 International Anesthesia Research Society

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Labor Analgesia Onset With Dural Puncture Epidural Versus Traditional Epidural Using a 26-Gauge Whitacre Needle and 0.125% Bupivacaine Bolus: A Randomized Clinical Trial.

BACKGROUND: Lumbar epidurals (LEs) provide excellent analgesia. Combined spinal epidural and dural puncture epidural (DPE) are 2 techniques to expedite neuraxial analgesia onset. In DPE, dura is punctured but medication is not administered in the cerebrospinal fluid. Expedited analgesia onset has been demonstrated with DPE, using 0.25% bupivacaine; however, this concentration may impede an unassisted vaginal birth and is not currently used for induction and maintenance of labor analgesia. The primary goal of this study was to compare the percentage of patients who achieved adequate labor analgesia following DPE or LE with an epidural bolus of 0.125% bupivacaine. Adequate labor analgesia was defined as Visual Analog Scale (VAS) measurement

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Patient-Proxy Agreement on the Health-Related Quality of Life One Year after Traumatic Brain Injury

Publication date: Available online 16 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Hei-Fen Hwang, Chih-Yi Chen, Mau-Roung Lin
ObjectiveTo examine the level of agreement between patients and their proxies on a measure of health-related quality of life (HRQL) 1 year after traumatic brain injury (TBI).DesignA cross-sectional study.Participantsand Setting: Eighty-eighty patients with TBI identified from discharge records of four hospitals in Taiwan and 88 family members or friends who could answer questions regarding the patient's health and HRQL 1 year after the injury.Main Outcome MeasuresA health profile of the brief Taiwanese version of the World Health Organization Quality of Life (WHOQOL-BREF) and two health utility measures of the time tradeoff (TTO) and standard gamble (SG).ResultsCompared to proxy responses, patients provided higher ratings of the WHOQOL-BREF's domains and lower ratings of the TTO and SG. Intraclass correlation coefficients between patient and proxy ratings varied among the four WHOQOL-BREF's domains, in which levels of agreement were moderate or good for physical capacity (0.69) and low for psychological well-being (0.45), social relationships (0.24), and the environment (0.32). Levels of agreement were extremely low for the TTO (0.0) and SG (0.10). A profile analysis showed that patients' ratings on the WHOQOL-BREF, on average, were significantly greater than those of their proxies (with a mean difference of 3.07), with a similar distribution of scatter responses (with a mean difference of 0.002) and shape agreement (0.57). Greater variations in the patient-proxy level of agreement appeared in patients who were younger and had more-severe injuries, and also with parent and child proxies.ConclusionsTo assess the HRQL of patients with a TBI, the level of patient-proxy agreement was adequate for the physical domain but was lower for the social and environmental domains, and the agreement was very low for the TTO and SG. Furthermore, a patient's age and injury severity, and patient-proxy' relationship may affect the agreement.



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Do Patients with Carpal Tunnel Syndrome Benefit from Low-Level Laser Therapy? A Systematic Review of Randomized Controlled Trials

Publication date: Available online 16 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Thierry P.C. Franke, Bart W. Koes, Sven J.G. Geelen, Bionka M.A. Huisstede
ObjectiveTo systematically review the literature on the effectiveness of low-level laser therapy for patients with carpal tunnel syndrome.Data SourcesThe Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8 2016.Study SelectionTwo reviewers independently applied the inclusion criteria to select potential studies.Data ExtractionTwo reviewers independently extracted the data and assessed the methodological quality.Data SynthesisA best-evidence synthesis was performed to summarize the results of the two systematic reviews and 17 RCTs that were included. Strong evidence was found for the effectiveness of low-level laser therapy compared to placebo treatment in the very short term (0≤5 weeks). After five weeks the positive effects of low-level laser therapy on pain, function, or recovery diminished over time (moderate and conflicting evidence were found at seven and 12-weeks follow-up, respectively).ConclusionIn the very short term low-level laser therapy is more effective as a single intervention than placebo low-level laser therapy in patients with carpal tunnel syndrome, after which the positive effects of low-level laser therapy tend to subside. Evidence in the mid and long term is sparse.



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Physical Activity and Sedentary Behaviour Subsequent to Serious Orthopaedic Injury: A Systematic Review

Publication date: Available online 16 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Christina L. Ekegren, Ben Beck, Rachel E.D. Climie, Neville Owen, David W. Dunstan, Belinda J. Gabbe
ObjectiveTo systematically review and synthesise the evidence on physical activity and sedentary behaviour following serious orthopaedic injury.Data sourcesEight electronic databases and reference lists of relevant articles were searched from inception to March 2016.Study selectionStudies on physical activity and sedentary behaviour measured objectively or via self-report among patients with serious orthopaedic injury (acute bone or soft-tissue injury requiring emergency hospital admission and/or non-elective surgery) were included.Data extractionData extraction and methodologic quality assessment were independently performed by two reviewers using standardised checklists.Data synthesisTwelve out of 2572 studies were included: eight were on hip fractures and four on other orthopaedic injuries. Follow-up ranged from four days to two years post-injury. When measured objectively, physical activity levels were low at all time points post-injury, with individuals with hip fracture achieving only 1% of recommended physical activity levels seven months post-injury. Studies using objective measures also showed patients to be highly sedentary throughout all stages of recovery, spending 76-99% of the day sitting or reclining. For studies using self-report measures, no consistent trends were observed in post-injury physical activity or sedentary behaviour.ConclusionFor studies using objective measures, low physical activity levels and high levels of sedentary behaviours were found consistently following injury. More research is needed not only on the impact of immobility on long-term orthopaedic injury outcomes and the risk of chronic disease, but also the potential for increasing physical activity and reducing sedentary behaviour in this population.



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General Anesthesia and Young Brain: What is New?.

Considering that growing population of very young children is exposed to general anesthesia every year, it is of utmost importance to understand how and whether such practice may affect the development and growth of their very immature and vulnerable brains. Compelling evidence from animal studies suggests that an early exposure to general anesthesia is detrimental to normal brain development leading to structural and functional impairments of neurons and glia, and long-lasting impairments in normal emotional and cognitive development. Although the evidence from animal studies is overwhelming and confirmed across species examined from rodents to non-human primates, the evidence from human studies is inconsistent and not conclusive at present. In this review we focus on new developments in animal studies of anesthesia-induced developmental neurotoxicity and summarize recent clinical studies while focusing on outcome measures and exposure variables in terms of their utility for assessing cognitive and behavioral development in children. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved

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Cortical function and corticomotoneuronal adaptation in monomelic amyotrophy

Publication date: August 2017
Source:Clinical Neurophysiology, Volume 128, Issue 8
Author(s): José Manuel Matamala, Nimeshan Geevasinga, William Huynh, Thanuja Dharmadasa, James Howells, Neil G. Simon, Parvathi Menon, Steve Vucic, Matthew C. Kiernan
ObjectiveTo evaluate corticomotoneuronal integrity in monomelic amyotrophy using threshold tracking transcranial magnetic stimulation (TT-TMS).MethodsCortical excitability studies were prospectively performed in 8 monomelic amyotrophy patients and compared to 21 early-onset amyotrophic lateral sclerosis (ALS) patients and 40 healthy controls. Motor evoked potentials responses were recorded over abductor pollicis brevis.ResultsMaximal motor evoked potential (MEP/CMAP ratio) was significantly increased in monomelic amyotrophy compared with controls (monomelic amyotrophy 51.2±12.4%; control 22.7±2.1%, p=0.04). Averaged short-interval intracortical inhibition (SICI, ISI 1–7ms) in monomelic amyotrophy patients was similar to controls (monomelic amyotrophy 9.6±2.1%; control 10.0±0.9%, p=0.98). However, it was significantly reduced in early-onset ALS in comparison with monomelic amyotrophy patients (monomelic amyotrophy 9.6±2.1%; ALS 2.3±1.7%, p<0.001). Averaged SICI is a good parameter (area under the curve 0.79, p=0.02) to discriminate between monomelic amyotrophy and early-onset ALS patients.ConclusionsTT-TMS technique has identified normal cortical function in monomelic amyotrophy, a feature that distinguishes it from early-onset ALS. The greater corticomotoneuronal projections to spinal motoneurons may represent central nervous system adaptive change in monomelic amyotrophy.SignificanceCorticomotoneuronal dysfunction does not drive the lower motor neurone loss presented in monomelic amyotrophy.



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Effect of Exercise Intensity and Duration on Postexercise Executive Function—Erratum

No abstract available

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Utility of Genetic Testing in Elite Volleyball Players with Aortic Root Dilation

Basketball and volleyball attract individuals with a characteristic biophysical profile, mimicking features of Marfan syndrome. Consequently, identification of these abnormalities can be lifesaving. Purpose: To determine how physical examination, echocardiography, and genetic screening can identify elite volleyball players with a previously undiagnosed aortopathy. Methods: We have performed cardiac screening on 90 US Volleyball National Team members and identified four individuals with dilated sinuses of Valsalva. This case series reports on three individuals who underwent a comprehensive genetics evaluation, including gene sequencing. Results: Cardiac screening combined with genetic testing can identify previously undiagnosed tall athletes with an aortopathy, in the absence of noncardiac findings of a connective tissue disorder. Subject 1 had a revised Ghent systems (RGS) score of 2 and a normal aortopathy gene panel. Subject 2 had a RGS score of 1 and genetic testing revealed a de novo disease causing mutation in the gene encoding fibrillin-1 (FBN1). Subject 3 had an RGS score of 4.0 and had a normal aortopathy gene panel. Conclusions: Despite variable clinical features of Marfan syndrome, dilated sinuses of Valsalva were found in 4.9% of the athletes. A disease-causing mutation in the FBN1 gene was identified in subject 2, who had the lowest RGS but the largest aortic root measurement. Subjects 1 and 3, with the highest RGS, had a normal aortopathy gene panel. Our findings provide further evidence suggesting that a cardiac evaluation, including a screening echocardiogram, should be performed on all elite tall adult athletes independent of other physical findings. Genetic testing should be considered for athletes with dilated sinuses of Valsalva (male, >4.2 cm; female, >3.4 cm), regardless of other extracardiac findings.

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Calibration of Self-Report Measures of Physical Activity and Sedentary Behavior

Introduction: Calibration equations offer potential to improve the accuracy and utility of self-report measures of physical activity (PA) and sedentary behavior (SB) by rescaling potentially biased estimates. The present study evaluates calibration models designed to estimate PA and SB in a representative sample of adults from the Physical Activity Measurement Study. Methods: Participants in the Physical Activity Measurement Study project completed replicate single-day trials that involved wearing a Sensewear armband (SWA) monitor for 24 h followed by a telephone administered 24-h PA recall (PAR). Comprehensive statistical model selection and validation procedures were used to develop and test separate calibration models designed to predict objectively measured SB and moderate-to-vigorous PA (MVPA) from self-reported PAR data. Equivalence testing was used to evaluate the equivalence of the model-predicted values with the objective measures in a separate holdout sample. Results: The final prediction model for both SB and MVPA included reported time spent in SB and MVPA, as well as terms capturing sex, age, education, and body mass index. Cross-validation analyses on an independent sample exhibited high correlations with observed SB (r = 0.72) and MVPA (r = 0.75). Equivalence testing demonstrated that the model-predicted values were statistically equivalent to the corresponding objective values for both SB and MVPA. Conclusions: The results demonstrate that simple regression models can be used to statistically adjust for overestimation or underestimation in self-report measures among different segments of the population. The models produced group estimates from the PAR that were statistically equivalent to the observed time spent in SB and MVPA obtained from the objective SWA monitor; however, additional work is needed to correct for estimates of individual behavior.

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Pulmonary Artery Wedge Pressure Relative to Exercise Work Rate in Older Men and Women

Purpose: An augmented pulmonary artery wedge pressure (PAWP) response may explain exercise intolerance in some humans. However, routine use of exercise hemodynamic testing is limited by a lack of data from normal older men and women. Our objective was to evaluate the exercise PAWP response and the potential for sexual dimorphism in healthy, nondyspneic older adults. Methods: Thirty-six healthy volunteers (18 men [54 ± 7 yr] and 18 women [58 ± 6 yr]) were studied at rest (control) and during two stages of semi-upright cycle ergometry, at heart rates of 100 bpm (light exercise) and 120 bpm (moderate exercise). Right heart catheterization was performed to measure pulmonary pressures. The PAWP response to exercise was assessed in context of exercise work rate and body size. Results: At control, PAWP was similar between men and women. Work rates were significantly smaller in women at comparable HR (P

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Calcium Supplementation Attenuates Disruptions in Calcium Homeostasis during Exercise

An exercise-induced decrease in serum ionized calcium (iCa) is thought to trigger an increase in parathyroid hormone (PTH), which can stimulate bone resorption. Purpose: The purpose of this study was to determine whether taking a chewable calcium (Ca) supplement 30 min before exercise mitigates disruptions in Ca homeostasis and bone resorption in competitive male cyclists. Methods: Fifty-one men (18 to 45 yr old) were randomized to take either 1000 mg Ca (CA) or placebo (PL) 30 min before a simulated 35-km cycling time trial. Serum iCa and PTH were measured before and immediately after exercise and a marker of bone resorption (C-terminal telopeptide of type I collagen) was measured before and 30 min after exercise. Results: Serum iCa decreased in both groups from before to after exercise (mean ± SD, CA = 4.89 ± 0.16 to 4.76 ± 0.11 mg·dL−1, PL = 4.92 ± 0.15 to 4.66 ± 0.22 mg·dL−1, both P ≤ 0.01); the decrease was greater (P = 0.03) in the PL group. There was a nonsignificant (P = 0.07) attenuation of the increase in PTH by Ca supplementation (CA = 30.9 ± 13.0 to 79.7 ± 42.6 pg·mL−1, PL = 37.1 ± 14.8 to 111.5 ± 49.4 pg·mL−1, both P ≤ 0.01), but no effect of Ca on the change in C-terminal telopeptide of type I collagen, which increased in both groups (CA = 0.35 ± 0.17 to 0.50 ± 0.21 ng·mL−1, PL = 0.36 ± 0.13 to 0.54 ± 0.22 ng·mL−1, both P ≤ 0.01). Conclusion: It is possible that ingesting Ca only 30 min before exercise was not a sufficient time interval to optimize gut Ca availability during exercise. Further studies will be needed to determine whether adequate Ca supplementation before and/or during exercise can fully mitigate the exercise-induced decrease in serum iCa and increases in PTH and bone resorption.

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Cerebral Blood Flow Responses to Aquatic Treadmill Exercise

Introduction: Aquatic treadmills are used as a rehabilitation method for conditions such as spinal cord injury, osteoarthritis, and stroke, and can facilitate an earlier return to exercise training for athletes. However, their effect on cerebral blood flow (CBF) responses has not been examined. We tested the hypothesis that aquatic treadmill exercise would augment CBF and lower HR compared with land-based treadmill exercise. Methods: Eleven participants completed incremental exercise (crossover design) starting from walking pace (4 km·h−1, immersed to iliac crest [aquatic], 6 km·h−1 [land]) and increasing 1 km·h−1 every 2 min up to 10 km·h−1 for aquatic (maximum belt speed) or 12 km·h−1 for land. After this, participants completed two 2-min bouts of exercise immersed to midthigh and midchest at constant submaximal speed (aquatic), or were ramped to exhaustion (land; increased gradient 2° every min). Middle cerebral artery blood flow velocity (MCAv) and HR were measured throughout, and the initial 10 min of each protocol and responses at each immersion level were compared. Results: Compared with land-based treadmill, MCAvmean increased more from baseline for aquatic exercise (21% vs 12%, P

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Crucial Points for Analysis of Ischemic Preconditioning in Sports and Exercise

No abstract available

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Exercise Training Reduces Intrathoracic Fat Regardless of Defective Glucose Tolerance

Purpose: Epicardial (EAT) and pericardial (PAT) fat masses and myocardial triglyceride content (MTC) are enlarged in obesity and insulin resistance. We studied whether the high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) similarly decrease ectopic fat in and around the heart and whether the decrease is similar in healthy subjects and subjects with defective glucose tolerance (DGT). Methods: A total of 28 healthy men (body mass index = 20.7–30.0 kg·m−2, age = 40–55 yr) and 16 men with DGT (body mass index = 23.8–33.5 kg·m−2, age = 43–53 yr) were randomized into HIIT and MICT interventions for 2 wk. EAT and PAT were determined by computed tomography and MTC by 1H-MRS. Results: At baseline, DGT subjects had impaired aerobic capacity and insulin sensitivity and higher levels of whole body fat, visceral fat, PAT, and EAT (P

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Muscle Metaboreflex Control of Sympathetic Activity in Obstructive Sleep Apnea

Purpose: Previous studies report abnormal muscle metaboreflex control of muscle sympathetic nerve activity (MSNA) in obesity, hypertension, and heart failure. We hypothesized that obstructive sleep apnea (OSA) is associated with augmented metaboreflex control of MSNA. Methods: Thirty-one sedentary individuals with no comorbidities (age = 52 ± 1 yr, body mass index = 28 ± 1 kg·m−2) without (control, n = 14) and with OSA (n = 17) defined by polysomnography, underwent echocardiography. HR, blood pressure (BP), MSNA (microneurography), and forearm blood flow measured by venous occlusion plethysmography were continuously measured 4 min at baseline, during 3 min of 30% handgrip static exercise, and during 2 min of post-handgrip muscle ischemia (PHMI). Results: Control and OSA groups were similar in age, body mass index, and ejection fraction. Baseline HR, BP, and forearm blood flow increased similarly during handgrip exercise. Blood pressure remained significantly elevated in relation to baseline during PHMI, but HR and forearm blood flow returned toward baseline during PHMI in both groups. Baseline MSNA was significantly higher in the OSA group than in controls (P

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Physical Activity Is Related with Cartilage Quality in Women with Knee Osteoarthritis

Purpose: To study the relationship between 12-month leisure-time physical activity (LTPA) level and changes in estimated biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). Methods: Originally, 87 volunteer postmenopausal women, age 60 to 68 yr, with mild knee OA (Kellgren Lawrence I/II and knee pain) participated in a randomized controlled, 4-month aquatic training trial (RCT), after which 76 completed the 12-month postintervention follow-up period. Self-reported LTPA was collected along the 12-month period using a diary from which MET task hours per month were calculated. Participants were divided into MET task hour tertiles: 1, lowest (n = 25); 2 = middle (n = 25) and 3 = highest (n = 26). The biochemical composition of the cartilage was estimated using transverse relaxation time (T2) mapping sensitive to the properties of the collagen network and delayed gadolinium-enhanced magnetic resonance imaging of the cartilage (dGEMRIC index) sensitive to the cartilage glycosaminoglycan content. Secondary outcomes were cardiorespiratory fitness, isometric knee extension and flexion force, and the knee injury and OA outcome questionnaire. Results: During the 12-month follow-up period, there was a significant linear relationship between higher LTPA level and increased dGEMRIC index changes in the posterior region of interest (ROI) of the lateral (P = 0.003 for linearity) and medial (P = 0.006) femoral cartilage. Furthermore, these changes were seen in the posterior lateral femoral cartilage superficial (P = 0.004) and deep (P = 0.007) ROI and in the posterior medial superficial ROI (P

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The Respiratory Compensation Point is Not a Valid Surrogate for Critical Power

Purpose: It is unclear whether the respiratory compensation point (RCP) may be used as a valid surrogate for critical power (CP). Accordingly, we sought to determine the measurement agreement between the CP and the RCP obtained during incremental cycling of varying ramp slopes. Methods: Eleven recreationally active men completed three separate ramp-incremental cycling protocols, where the work rate increment was slow (SR, 15 W·min−1), medium (MR, 30 W·min−1), or fast (FR, 45 W·min−1). The RCP was obtained using the ventilatory equivalent for CO2 output method. The CP was determined via Morton's model for ramp-incremental exercise. The assumption that the RCP and the CP occur at equivalent external work rates was assessed by one-way repeated-measures ANOVA and by evaluating the concordance correlation coefficient (CCC) and typical error (root-mean-square error [RMSE]) for each ramp protocol, separately. Results: The external work rate corresponding to the RCP increased with increases in the ramp-incremental slope (P

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Neural and Muscular Contributions to the Age-Related Reductions in Rapid Strength

Introduction: The purposes of this study were to investigate the age-related differences in absolute and normalized plantarflexion rate of torque development (RTD) at early (0–50 ms) and late (100–200 ms) time intervals and to examine specific neural and muscular mechanisms contributing to these differences. Methods: Thirty-two young (20.0 ± 2.1 yr) and 20 older (69.5 ± 3.3 yr) recreationally active men performed rapid plantarflexion isometric muscle actions to examine absolute and normalized RTD and muscle activation using EMG at early and late time intervals. Ultrasonography was used to examine medial gastrocnemius muscle size, echo intensity (EI), and muscle architecture (fascicle length [FL] and pennation angle [PA]). Results: The older men were weaker (23.9%, P

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Improper Assessment of the Effect of Ad Libitum Drinking on Cycling Performance

No abstract available

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Muscle Protein Turnover and the Molecular Regulation of Muscle Mass during Hypoxia

Effects of environmental hypoxia on fat-free mass are well studied. Negative energy balance, increased nitrogen excretion, and fat-free mass loss are commonly observed in lowlanders sojourning at high altitude. Reductions in fat-free mass can be minimized if energy consumption matches energy expenditure. However, in nonresearch settings, achieving energy balance during high-altitude sojourns is unlikely, and myofibrillar protein mass is usually lost, but the mechanisms accounting for the loss of muscle mass are not clear. At sea level, negative energy balance reduces basal and blunts postprandial muscle protein synthesis, with no relevant change in muscle protein breakdown. Downregulations in muscle protein synthesis and loss of fat-free mass during energy deficit at sea level are largely overcome by consuming at least twice the recommended dietary allowance for protein. Hypoxia may increase or not affect resting muscle protein synthesis, blunt postexercise muscle protein synthesis, and markedly increase proteolysis independent of energy status. Hypoxia-induced mTORC1 dysregulation and an upregulation in calpain- and ubiquitin proteasome–mediated proteolysis may drive catabolism in lowlanders sojourning at high altitude. However, the combined effects of energy deficit, exercise, and dietary protein manipulations on the regulation of muscle protein turnover have never been studied at high altitude. This article reviews the available literature related to the effects of high altitude on fat-free mass, highlighting contemporary studies that assessed the influence of altitude exposure (or hypoxia) on muscle protein turnover and intramuscular regulation of muscle mass. Knowledge gaps are addressed, and studies to identify effective and feasible countermeasures to hypoxia-induced muscle loss are discussed.

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Noyes' Knee Disorders: Surgery, Rehabilitation, Clinical Outcomes, 2nd Edition

No abstract available

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